text:
|Publication number
|Publication type
|Application number
|Publication date
|May 17, 2005
|Filing date
|Jan 22, 2003
|Priority date
|Jan 22, 2002
|Fee status
|Also published as
|Publication number
|Anand Kumar, Winni Hofman, William Burzelewski
|Original Assignee
|Medcare Flaga Hf
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (4), Referenced by (18), Classifications (12), Legal Events (18)
|External Links: USPTO, USPTO Assignment, Espacenet
This application claims the benefit of U.S. Provisional Application Ser. No. 60/350,770, filed Jan. 22, 2002.
Obstructive Sleep Apnea one of the most common disorders in the U.S. Lower oxygen levels associated with Obstructive Sleep Apnea (OSA) is now known to be a major cause of cardiovascular morbidity including heart attack and stroke. At present expensive polysomnography is used to identify these patients but not on a sufficient scale to provide diagnosis as a practical matter. The development of a diagnostic system which can allow simplified diagnosis of obstructive sleep apnea by the primary care physician would be a major step. The prevention of hundreds of thousands of annual excess deaths, stroke and heart attacks associated with obstructive sleep apnea through simplified recognition of this disorder is the most important purpose of the present invention. These excess deaths are occurring annually in a great part due to the lack of availability of this technology resulting in a vast pool of undiagnosed cases of Sleep Apnea and other breathing disorders. Despite the fact that obstructive sleep apnea is easily treated, both the patient and the family are often completely unaware of the presence of this dangerous disease, thinking the patient just a"heavy snorer".
Obstructive sleep apnea often develops insidiously as a patient enters middle age and begins to snore. The major cause is an increase in fat deposition (often age related) in the neck which results in narrowing of the airway. (In fact the probability that a 40 year old has sleep apnea is directly related to his or her neck circumference). When the muscle tone of the upper airway diminishes during sleep coupled with negative pressure associated with inspiration through this somewhat narrow airway results in collapse of the upper airway in a manner analogous to the collapse of a cellophane straw. This results in airway obstruction and, effectively chokes off all air movement The choking patient (still asleep) begins to struggle and inhales more forcibly, thereby, further lowering upper airway pressure and causing further collapse of the upper airway. During this time, substantially no air movement into the chest occurs and the patient experiences a progressive fall in oxygen (similar to the fall occurring early in drowning). The fall in oxygen produces central nervous system stimulation contributing to hypertension and potential heart and blood vessel injury and finally results in arousal. Upon arousal, increase in airway muscle tone opens the airway and the patient rapidly inhales and ventilates quickly to correct the low oxygen levels. Generally, the arousal is brief and the patient is not aware of the arousal (or of the choking since this occurs during sleep). Once oxygen levels have been restored, the patient begins again to sleep more deeply, upper airway tone again diminishes, the upper airway collapses and the cycle is repeated stressing the heart with low oxygen in a repetitive fashion. Often this repeating cycle over many years eventually results in damage to the heart muscle and/or the coronary arteries. As the patient ages, the consequences of undiagnosed obstructive sleep apnea is often either a progressive decline in heart muscle function (and eventual heart failure) or heart infarction.
The duration and severity of each apnea event is quite variable from patient to patient and with the same patient throughout the night. Indeed, the disease process represents a spectrum of severity from mild snoring, which is associated with incomplete and inconsequential airway obstruction, to severe apneas which can result in fatal hypoxemia.
This disease commonly results in excessive daytime sleepiness and can disrupt cognitive function during the day due to fragmentation of sleep during the night associated with recurrent arousals of which the patient is not aware.
Although this disease commonly affects obese patients, it may occur in patients with any body habitus. Because this disease is so common and because it presents with the subtle and common symptoms of excessive daytime sleepiness, morning headache, and decreasing ability to concentrate during the day, it is critical that an inexpensive technique for accurately diagnosing and treating this disease be developed. Traditionally, this disease has been diagnosed utilizing a complex and expensive multi-channel polysomnogram. This is generally performed in a sleep lab and involves the continuous and simultaneous measurement and recording of an encephalogram, electromyogram, electroculogram, chest wall plethysmogram, electrocardiogram, measurements of nasal and oral air flow, and pulse oximetry. These, and often other, channels are measured simultaneously throughout the night and these complex recordings are then analyzed to determine the presence or absence of sleep apnea.
The problem with this traditional approach is that such complex sleep testing is expensive and limited to laboratories. Since sleep apnea is so common, the cost of diagnosing obstructive sleep apnea in every patient having this disease in the United States is prohibitive. It is critical that a new, inexpensive technique of accurately diagnosing sleep apnea be developed.
For example, nocturnal oximetry alone has been used as a screening tool to screen patients with symptoms suggestive of sleep apnea to identify whether or not oxygen desaturations of hemoglobin occur. Microprocessors have been used to summarize nocturnal oximetry recordings and to calculate the percentage of time spent below certain values of oxygen saturation However, oxygen desaturation of hemoglobin can be caused by artifact, hypoventilation, ventilation perfusion mismatching. For these reasons, such desaturations identified on nocturnal oximetry are not specific for sleep apnea and the diagnosis of sleep apnea has generally required expensive formal polysomnography.
The diagnosis of sleep disorders often involves polysomnography (PSG), the monitoring and recording over an extended period of time of the temporal variations in the amplitude of the patient's sleep-impacted, physiological parameters, including: heart rate, eye blink activity, airflow rate, thorax and abdomen respiration rates, the blood's oxygen saturation level, electroencephalograms (EEG), electrooculograms (EOG), and electromyograms (EMG). Such intensive monitoring activities are typically conducted in clinical settings by trained PSG technicians who utilize expensive monitoring equipment having multiple sensors that are tethered to a centralized recording system and power supply.
For several decades, the recordings of such physiological parameters were provided by strip chart recorders that produced long strips of paper with ink markings that displayed the varying physiological parameters. The clinician would then examine such records and "score" each abnormal sleep event that occurred. This practice continues today with the clinician now viewing computer screens displaying the varying physiological parameters.
More recently, a number of portable recording systems for screening and diagnosing sleep disorders have been marketed. These systems range from multi-channel, PSG-style systems to much simpler units that monitor only one or more of the possible physiological parameters of interest. However, these multi-channel, portable systems remain technically complex, expensive and usually require trained PSG technicians to supervise their use.
Some of the newer of these portable systems offer comprehensive software for display and analysis of the collected sleep data, and some offer automatic sleep event scoring. However, such scoring has been found to have varying degrees of reliability due to the technical problems associated with assuring good signal fidelity in the monitored parameters. Thus, all of these systems recommend for accurate identification of abnormal sleep events that the data be interpreted and evaluated by experienced clinicians or trained PSG technicians.
Since PSG scoring is largely subjective, experienced scorers can generally interpret with good accuracy the action and interactions of poorly shaped and time skewed signals. Although these distortions are commonly accepted as normal for manual scoring, such poor fidelity signals would be unsatisfactory for automated or computer-based scoring.
All of the current, portable sleep testing systems share common, less-than-desirable features for home use: (1) they are bedside portable, but their size and weight does not allow the patient to be ambulatory, which can be essential for diagnosing patients problems such as excessive sleepiness, (2) they are not designed for unattended use-a technician must come to the home for set-up, disconnection and data retrieval, (3) patients must be outfitted with an array of tethered electrode wires and sensors for connection to bulky body monitors or table-top consoles, and (4) most require subjective analysis of the data by highly trained, sleep professionals.
Recognizing the need for an improved apparatus or method for diagnosing of the various medical conditions of a fully ambulatory subject who exhibits temporal variations in various physiological parameters as a result of this medical condition, it is therefore a general object of the present invention to provide a novel method and ambulatory, distributed recorders system to meet such needs.
The present invention relates to a method of diagnosing sleep apnea that non-intrusive and quantitative. Diagnosis of sleep apnea can be achieved by monitoring the phase angle between abdominal effort during sleep and thoracic effort during sleep, determining the phase of each effort, determining the difference in phase between each type of effort, and then determining the rate of phase angle change over time. The instability of the phase angle correlates with respiratory distress index (RDI) and thus is a useful tool for diagnosis.
The invention also provides for treatment to detect events and trigger therapy apparatus such as airway positive pressure apparatus whether operating in CPAP, multi-level CPAP, IPAP or EPAP modes.
The therapy is a pressurized air infusion device and the system further determines the rate of change of phase angle between abdominal effort in breathing and thoracic effort in breathing for determining optimal pressure of the infusion device with or without other signals of polysomnograpy.
In particular, the invention recognizes that the phase angle, the difference between the phase of abdominal effort during breathing and thoracic effort during breathing, while useful in diagnosis or screening is not the most useful factor, but rather the change in phase angle as a function of time is. For instance, thoracic and abdominal effort could be measured by mechanical means and graphed on a strip chart as a function of time, the phase of each type of effort could be determined as well as the change of phase, and the instability of the phase angle could be determined. The degree of uncertainty then is used to measure the degree of breathing disturbance the patient demonstrates.
According to
In another method to reduce computational burden the user is given the option to sub-sample data at about 10 Hz. This ensures that recordings that have recorded respiratory signals at high sample rates will not result in unacceptable long phase calculation times. The results of the phase calculation are stored at 1-second intervals (to reduce the storage requirements). The result is a value per second between −180� and +180� which is indicative for the current phase angle between the two effort signals. The values can be plotted per second in a signal window or as a mean value over a longer period (30 seconds) in an overview window.
Method of Determining Change in Phase Angle
In a means for analyzing data the standard deviation of the phase angle between the two respiratory signals is calculated over a sample period (generally 30 seconds but this period can be adjusted). In a window that gives an overview for a prolonged sample period (perhaps a night's sleep), the standard deviation of the phase angle as well as the original phase values are plotted as a function of time. This gives instantaneous information about the variability of the phase angle over sample period. The changes in phases can also be plotted by calculating differences between adjacent phase values.
Method to Calculate the Variability of Phase
The variability of the phase angle over a certain period is an indication of the extent to which the phase angle between the two effort signals fluctuates. The standard deviation of the phase angle over a certain period is a statistical method to calculate this variability. In one embodiment the standard deviation is presented for every 30 minutes. For diagnostic purposes, shorter period (10 seconds) is chosen to calculate the standard deviation of the phase angle. The following steps are used to calculate this index:
Other methods for calculating variability of phase angle can be employed. However, the method must be chosen so that variability can be measured. The measure of variability in one case was chosen so that for the whole the night the number of 10 sec periods with more than 10 standard deviation was summed. This measure was termed a flip-flop state and the percentage of time is calculated. It is called the Flip Flop State Index. The Flip Flop State Index is directly related to upper airway obstruction.
Method to Validate and Generate Normative Data
Polysomnography (PSG) data from various sleep laboratories was used. Registered polysomnography technicians or clinicians manually scored this data for apnea's, desaturations and sleep stages. Data is from patients who are diagnosed for sleep apnea. For each night, RDI (based on standard rules) was calculated for each patient. For each night, also the Flip Flop State Index was calculated as shown in
A highly significant correlation was found between the Flip Flop State Index and the respiratory disturbance index in a group of adults, indicating that the Flip Flop State Index was related to a high respiratory disturbance. If the Flip Flop State Index was higher than 0.1, then it was predicted that patient was an OSA patient. This prediction was validated against RDI numbers calculated independently. From these calculations. ROC and percentages of hits and misses were calculated.
Method to Use Flip-Flop State to Evaluate and/or Initiate CPAP Titration
In another group of apnea patients receiving CPAP treatment a lower phase variability was found in the part of the night with a high CPAP value than in the part of the night with a low CPAP value. Normative values of the Flip-Flop State Index calculated from this data should provide a tool to help judge whether the pressure too high or too low.
While thoracic abdominal asynchrony (TAA) is a known measure that has been used for COPD, other respiratory abnormalities and in paradoxical breathing during sleep, it has not been used in diagnosis of apnea. The study of paradoxical breathing, where the phase angle between abdominal effort and thoracic effort is about 90 degrees, has shown that long periods of paradoxical breathing are deleterious. However, no connection has been made between paradoxical breathing and apnea. Literature in this field has been more concerned with the absolute measure of phase angle rather than the rate of phase angle change with time.
The rate of change of phase angle correlates to the respiratory disturbance index (the number of times arousal from sleep occurs per hour). A correlation exists between the rate of change of phase angle and RDI, and thus apnea and hypopnea can be diagnosed.
In practice a patient is provided with a means for measuring thoracic and abdominal effort. Such equipment might include piezzo belts, PDF belts, inductance or impedance measurement devices and the like. The design and function of the effort sensors is to allow for monitoring the volume in each region as a function of time and allow determination of the phase of abdominal effort and thoracic effort so that they can be compared and the phase angle difference between the two can be determined. The difference in the phases of the two types of efforts changes over time and is stored for evaluation.
Besides a manual approach to determining phase angle instability, automated means can be used as well. For instance the abdominal and thoracic phase information could be collected and input into a computer with a software utility that calculates phase change and determines whether there is a significantly significant change or changes in a set of date. Likewise, this calculation could also be performed by a device with embedded-software on a chip, or analog hardware, or combination thereof.
|Cited Patent
|Filing date
|Publication date
|Feb 17, 1987
|Oct 18, 1988
|Respitrace Corporation
|Method and apparatus for distinguishing central obstructive and mixed apneas by external monitoring devices which measure rib cage and abdominal compartmental excursions during respiration
|Nov 6, 1987
|Mar 28, 1989
|Respitrace Corporation
|Method and apparatus for monitoring respiration
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|Cns, Inc.
|Volume variation sensor and method for obstructive sleep apnea monitoring
|Oct 3, 1998
|Oct 23, 2001
|Individual Monitoring Systems, Inc.
|Ambulatory distributed recorders system for diagnosing medical disorders
|Citing Patent
|Filing date
|Publication date
|Feb 16, 2007
|May 25, 2010
|Imthera Medical, Inc.
|RFID-based apparatus, system, and method for therapeutic treatment of obstructive sleep apnea
|Mar 30, 2005
|Feb 1, 2011
|Michael Farrell
|Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing
|Apr 1, 2010
|May 3, 2011
|Imthera Medical Inc.
|Apparatus, system and method for therapeutic treatment of obstructive sleep apnea
|Oct 2, 2009
|Apr 23, 2013
|Imthera Medical, Inc.
|Method of stimulating a Hypoglossal nerve for controlling the position of a patient's tongue
|Dec 30, 2010
|Aug 27, 2013
|Resmed Limited
|Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing
|Mar 19, 2013
|Jun 10, 2014
|Imthera Medical, Inc.
|Method of stimulating a hypoglossal nerve for controlling the position of a patients tongue
|Feb 28, 2013
|Nov 11, 2014
|Imthera Medical, Inc.
|System for stimulating a hypoglossal nerve for controlling the position of a patient's tongue
|Nov 19, 2009
|Jan 20, 2015
|Inspire Medical Systems, Inc.
|System for treating sleep disordered breathing
|Apr 24, 2014
|May 12, 2015
|Imthera Medical, Inc.
|Method of stimulating a hypoglossal nerve for controlling the position of a patient's tongue
|Apr 9, 2015
|Apr 19, 2016
|Imthera Medical, Inc.
|Method of stimulating a hypoglossal nerve for controlling the position of a patient's tongue
|Oct 7, 2014
|May 17, 2016
|Imthera Medical, Inc.
|System for stimulating a hypoglossal nerve for controlling the position of a patient's tongue
|Mar 30, 2010
|Nov 8, 2016
|Inspire Medical Systems, Inc.
|Percutaneous access for systems and methods of treating sleep apnea
|Mar 7, 2016
|Feb 28, 2017
|Imthera Medical, Inc.
|Method of stimulating a hypoglossal nerve for controlling the position of a patient's tongue
|Apr 6, 2016
|May 30, 2017
|Imthera Medical, Inc
|System for stimulating a hypoglossal nerve for controlling the position of a patient's tongue
|Mar 30, 2005
|Jul 12, 2007
|Michael Farrell
|Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing
|Feb 16, 2007
|May 8, 2008
|Lima Marcelo G
|RFID-based apparatus, system, and method for therapeutic treatment of obstructive sleep apnea
|Dec 30, 2010
|Jun 16, 2011
|Michael Farrell
|Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing
|Mar 25, 2014
|Feb 4, 2016
|Technion Research & Development Foundation Ltd.
|Apnea and hypoventilation analyzer
|U.S. Classification
|600/538, 600/534, 600/529
|International Classification
|Cooperative Classification
|European Classification
|Jan 22, 2003
Owner name: MEDCARE FLAGA HF, ICELAND
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text:
Minster FM News
Yorkshire welcomes 59 million pounds from visitors
12:00am 9th August 2011
New figures just released show overseas visitors are choosing to spend more time and money in Yorkshire according to the International Passenger Survey.
In the first quarter of 2011, people who came to Yorkshire from abroad spent over 70% more than in the same period in 2010.
The outstanding news for the county's tourism industry also reveals results which show the amount of money generated by overseas visitors holidaying in Yorkshire during the peak summer months has almost doubled in two years.
The overall expenditure of overseas visitors taking their summer holidays in Yorkshire has seen a major increase in recent years. In the summer (July - September) 2008 period overseas visitor spend was £33m.
This increased dramatically following the launch of Welcome to Yorkshire and has virtually doubled to £59m (up from £43m for the same period in 2009).
Having been awarded World Travel Awards for its high profile marketing campaigns, beating off stiff competition from global agencies such as Virgin and Kuoni Group, Welcome to Yorkshire has continued the push into key international markets. Last year saw a major increase in visitors from Asia, US, and European countries such as Spain, Italy, Germany and France.
Gary Verity, chief executive of Welcome to Yorkshire, said:
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"Yorkshire really is a global brand. The combination of attractive exchange rates and our intensive international marketing and PR campaigns is having a direct impact on the overseas visitor market. And once they are here we make sure they receive a warm welcome and an experience to remember. This is a real boost to the local economy and a fantastic result for the county's tourism industry."
Welcome to Yorkshire hopes to encourage more overseas visitors into the county with the high profile sponsorship of the Welcome to Yorkshire in the Clipper 2011-12 Round the World Yacht Race and its bid to bring the Tour de France Grand Depart to Yorkshire.

subset: commoncrawl


text:
Paiste 2002 14'' Sound Edge Hi Hat Cymbals
Paiste 2002 14'' Sound Edge Hi Hat CymbalsDetails
This legendary series of cymbals has defined the sound of generations of drummers since the early days of Rock. The present 2002 is built on the foundation of the original classic cymbals and is expanded by modern sounds for today's progressive popular music.
Product Ref: 17861View Full Description
Full DescriptionView Full Description
Medium bright, full, warm, brilliant. Wide range, fairly complex mix. Fast, responsive feel. Full, bright, energetic open sound. Sharp, full chick sound. The original, patented, wavy bottom hi-hat.
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The product price includes 4 years' warranty and 90 day money back guarantee.
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Once the product is delivered, you have 90 days to decide that you definitely want to keep it. If you decide it is not suitable for any reason, you can return it back to us for replacement or full refund, including standard delivery charges.
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text: The USACE has begun construction on the $585-million replacement of the navigation lock on the Industrial Canal in New Orleans and is now enlisting community leadership to scope out a mitigation plan. Community input is needed because Congress not only approved the construction of a larger, modern lock, but also approved a $35 million Community Impact Mitigation Plan to be carried out during the 10 to 12 years of mitigation. "This project is moving forward after controversy and large, expensive changes - including the mitigation plan - made by the USACE in response to the community," said Col. Thomas Julich, commander, New Orleans District.


text:
Over 20,000 summer flowers in flowerbeds, flower towers, boxes and buckets in the streets, as well as 2000m2 of roses and perennials, adorn the centre of Kristiansand from May till late in September
In Wergelands Park in the spring you find more than 8500 flowering bulbs in fantastic colours. Pre-school children grow plants in their nursery school, and these are then planted out by the children.
Also in Wergeland's Park you will find a bronze statue of Henrik Wergeland from 1908, made by Gustav Vigeland.


text:
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Xiamen Forsee Outdoor Accessories Co., Ltd.
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|Business Type:
|Manufacturer, Trading Company
|Fujian, China (Mainland)
|Main Products:
|Cover (Car Cover,Boat Cover,Motorcycle Cover,BBQ Cover,RV Cover,Paito Furniture Cover)
|Total Employees:
|11 - 50 People
|Total Annual Revenue:
|US$5 Million - US$10 Million
|Year Established:
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|North America 52.72% Western Europe 18.65% Oceania 18.48%
China Car Cover Company (4C) , the original car cover manufacturer, has extended its product lines t...
China Car Cover Company (4C) , the original car cover manufacturer, has extended its product lines to all kinds of protective textile covers for Marine, Powersport and Home & Patio Furniture as well as pets applications, since 2005, and now is reconstructed and refresh for superior custom service.
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4C stands for our Creative & Cost-effective products and our Courageous & Collective goal!
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|Main Markets
|Total Revenue(%)
|North America
|Western Europe
|South America
|Eastern Europe
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|Have Own Export License
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|3-5 People
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- Meal can be requested on the spot
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156.15 € / person / night, no meal
Description of the accommodation:
Rooms, services Jaypee Greens Golf and Spa Resort Greater Noida is offering 170 nicely furnished rooms to stay in to those seeking accommodation in Greater Noida. Car parking possibility is available nearby. You may also rent a car to discover all must-sees of the area. For meetings and nice evening chats the local café will provide an ideal location. Your valuables may be the safely secured in the safe. An exact and detailed list of equipment in the rooms and of the services provided by Jaypee Greens Golf and Spa Resort Greater Noida you will find on the information sheet below, including any applicable additional fees.
Payment Depeding on the selected room, date and price, you may be asked to provide credit card guarantee or to pay by credit card in advance.
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Jaypee Greens Golf and Spa Resort Greater Noida rooms Rooms
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Accommodation services
Car rental nearby
- Finnish sauna
- Jacuzzi
- Pool (Outdoor - seasonally open)
- Hairdresser's parlour
Cafe, Elevator, Safe deposit box


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Author Monday, May 08, 2017
Wednesday Group Ride -- Starting Early May
Wednesday Nights: May 10th - September 27th, 2017
Everyone is welcome. Rides will start at 6:00pm plan to come early enough to be ready!
Tonka Cycle & Ski
16 Shady Oak Rd, Hopkins, MN 55343
· Water/Restrooms available


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This irresistible picture was the winner of the WNYC's Amy Sedaris Craft Challenge. The rule was very simple: make food come alive with googly eyes! There are several great (and funny) shots among the 196 photos submitted to the group pool. And after explore it my first conclusion was: even who didn't win had a lot of fun producing the pictures. I would have. (via FlickrBlog)
More funny food photos: Gummy Bears Photos, Bento Windows & Bento Art, Bologna art, Banana Art, Food to amuse, Funny sausages and Cute bento boxes.
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Sore Throat (cont.)
Sore Throat and Pregnancy
Pregnant women who develop a sore throat can still receive treatment for the condition. Viral illnesses only require supportive treatment, and home remedies and self-care steps (described above) are generally safe in pregnancy. Talk to your doctor about the right choice for pain medication if it is required. Some antibiotics are safe for pregnant women; if you develop a bacterial infection, your doctor can prescribe antibiotics that have been proven to be safe for both mother and baby. It is very important not to abstain from treatment for a bacterial infection; since if untreated, the infection may cause serious complications.
Sore Throat Follow-up
As with other illness, a doctor should be contacted doctor if a person becomes worse despite treatment. Sometimes, determining whether a condition became worse because of the natural course of the illness, or because of a side effect of the medication the patient is taking can be difficult. (For example, both the infection causing a sore throat and a reaction to medication can cause nausea.)
How to Prevent Sore Throat
Avoiding close contact with ill people can help a person from getting a throat infection. Cold viruses appear to be more readily transmitted than Streptococcal infections. Only some family members exposed to Streptococcus develop strep throat. Usually a person with strep throat becomes noninfectious within 24 hours after the first antibiotic dose. The incubation period (the time between exposure to strep germs and onset of illness) is usually 2-5 days. Children should stay home from school and day care during infectious periods.
Being vigilant about hand washing is the best way to prevent any kind of infection. Many viruses can be transmitted by contamination of common surfaces. It is important to teach children the importance of hand washing using soap and water and/or hand sanitizer. Avoid sharing of drinking and eating utensils and other personal items can also be an effective preventive measure.
Sore Throat Prognosis
Only in very rare cases are sore throats due to serious conditions. Although rare, complications of strep throat such as rheumatic fever, poststreptococcal glomerulonephritis, and epiglottitis can cause serious illness or death.
What Are Sore Throat Complications?
Rarely, bacterial infections of the throat can lead to complications including abscess formation and spread of the infection. Rheumatic fever (a condition that can cause damage to the heart, nerves, skin, and joints) and poststreptococcal glomerulonephritis (a form of kidney inflammation) are rare complications of untreated strep throat.
Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine
Medically Reviewed by a Doctor on 11/20/2017
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Skip to main content
May 8-9, 2018 | Javits Center, NY
Javits Center
655 West 34th Street
New York, NY 10001
If you need help accessing your Exhibitor Dashboard, please contact Customer Service at 877-232-8845 or 203-840-5646 or email firstname.lastname@example.com.
If you have additional questions, contact your Customer Success Specialist.
We've put together a 'How-To Guide' with step-by-step directions on how to make the most of your online profile in the Exhibitor Dashboard. View our How-To Guide for help with navigating the Exhibitor Dashboard.
You can order your badges right up until the show, to do this you will need to log into your Exhibitor Dashboard with your ID & Password. You will receive a confirmation email with bar code for each badge which can be picked up onsite at the "ALREADY REGISTERED EXHIBITOR with Bar Code" desk.
If you have misplaced your log in information for the Exhibitor Dashboard feel free to email your Customer Success Specialist.
Just order your badges as you would have through the Exhibitor Dashboard with your ID/PW and you will get a confirmation email with BAR CODE. Bring your bar code with you and pick up your badges onsite at the Javits Center.
Inside the Exhibitor Manual you will find an Exhibitor Action Checklist, which will provide you with the contact information for all of the official Show contractors. Check back soon for the 2017 Exhibitor Manual.
Freeman is the official BuildingsNY Show contractor and they do offer discounts for exhibitor orders placed on their website prior to February 27, 2017.
Check back soon for the Exhibitor Manual for more information.
You can create an account with Freeman at: www.freemanco.com
If you take advantage of shipping to the Advanced Warehouse, your crates will be in your booth based on your move-in dates. You can ship your materials to arrive at the Advanced Warehouse before Monday, March 13.
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Many people assume that ICMP Echo, more familiar as" ping", is a valid tool for measuring the performance and behavior of the internet.
That assumption is incorrect. Ping is a tool of value mainly for determining whether connectivity exists or not. Ping is a weak tool for measuring delay, variation in delay (jitter), and throughput.
Key Topics Covered:
- What are ICMP and ICMP Echo?
- How does Ping work
- What does Ping do well?
- What does Ping do poorly?
- What are the alternatives to Ping?
Protocols Discussed:
- Internet Control Message Protocol (ICMP)
- Transmission Control Protocol (TCP)
- User Datagram Protocol (UDP)
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Steering Committee Bios
Allen Hippler, VP of Northrim Bank
Expertise: Commercial and Industrial Loans; Residential Real Estate; Construction; Acquisition and Development
Community Engagement: Vice Chairman/Secretary &Treasurer of Alaska Chamber of Commerce; Treasurer of Alaska Business Political Action Committee, BP Community Advisory Council Member; Commissioner of Alaska Health Care Commission
Bruce Lamoreux, Senior Vice President/Chief Executive Officer of Providence Hospital
Bruce Lamoureux serves currently as chief executive for the Providence Alaska region, including operating entities in Anchorage, Kodiak, Palmer, Seward and Valdez. Bruce joined Providence Health & Services Alaska in 2006, when he assumed the role of chief executive for the Providence Alaska Medical Center. In 2009, he transitioned to the role of chief operating officer, followed by a shift into the chief executive role in 2012.
Providence's programs range from acute, long-term, assisted living and residential care to ambulatory clinics, as well as joint ventures in imaging technologies, long-term acute care, ambulatory surgery and air ambulance services. The collective services deliver care for more than 17,000 acute care admissions and nearly 500,000 outpatient visits annually. Providence Alaska employs approximately 4,000 people and is the largest private employer in Alaska.
Lamoureux' health care career began in Southern California in 1976 and progressed through more than a dozen positions across multiple functions and service lines, including as chief executive officer for a large urban hospital. Lamoureux earned a Bachelor's degree in management from the University of Redlands, and a Master's degree in business administration from the University of Southern California.
Carol Gore, President and CEO of Cook Inlet Housing Authority
Carol Gore has been involved in the development, acquisition, management, and disposition of residential and commercial real estate for over 30 years. Carol is enjoying her 15th year as the president and chief executive officer of Cook Inlet Housing Authority (CIHA, "See-ha") in Anchorage, Alaska – the TDHE for Cook Inlet Region Inc. CIHA supports a wide range of affordable housing activities, including the development, ownership and management of affordable rental housing for families and seniors, a homeless shelter, construction and sales of affordable homes for immediate homeownership, third party project management for nonprofit organizations and the establishment and operation of an affiliate Native CDFI, Cook Inlet Lending Center.
Under Carol's leadership, the CIHA team has more than doubled its affordable rental housing, from 267 units in 2000 to over 1,000 units owned and managed in 2015.
Ms. Gore is a proud Alaskan of Aleut decent.
Curtis McQueen, Chief Executive Officer of Eklutna, Inc.
Eklutna Incorporated is the Alaska Native Village Corporation for Anchorage and the Mat-Su Borough. They are the Largest Private Land Owner in both communities. Among his many responsibilities, Curtis directs and facilitates all Corporate Communications, Public Relations and Shareholder Relations on behalf of Eklutna, Inc. Curtis sets, guides, and drives company strategies; leads business operations, community involvement, and legal and financial matters; proactively seeks and recommends areas for new business development, investments, and operation and financial improvement. Assist Board in developing and monitoring corporate policy, oversees all subsidiaries, including 8(a), real estate, natural resources, and construction. Has financial responsibility for all aspects of the company.
Curtis brings a combination of post-secondary education and 30+ years of business, business development, communications, project management, administrative management and governmental affairs experience and has worked extensively in the Native community. Curtis attended ASU and Gateway Community College in Tempe & Phoenix, AZ from 1987-1989 and the University of Alaska Southeast 1990. From 1989-1994 Curtis worked for (2)-two Governors, Governor Steve Cowper & Governor Wally Hickel with the Department of Transportation & Public Facilities and the Department of Natural Resources.
In his current position Curtis has worked with Alaska Governors Sarah Palin, Sean Parnell, and Bill Walker, Senators Mark Begich, Ted Stevens, Lisa Murkowski, and Dan Sullivan, Congressman Don Young, and Anchorage Mayors, Mark Begich, Dan Sullivan, and Ethan Berkowitz. Curtis also works with many current and past Alaska lawmakers in both the House and the Senate.
Deena Paramo, Superintendent of the Anchorage School District
Regent Paramo is the superintendent of the Anchorage School District and has been an Alaska educator since 1991. Prior to being selected to lead Alaska's largest school district, she is proud to have served as a teacher, an assistant principal, a principal, an assistant superintendent and the superintendent of the Mat-Su Borough School District.
Regent Paramo holds a Bachelor of Science degree in Education with a specialization in Bilingual Education, a Master of Education degree in Administration, and a Doctor of Education degree in Learning Assessment and System Performance. Most recently she graduated from the American Association of School Administrators National Superintendents Certification two-year program, of which she was the first cohort.
Regent Paramo's teaching and educational leadership experiences have shaped her agenda, which has an unwavering focus on student achievement and success. It is her desire that all students in the State of Alaska are prepared for a successful career, military, college, or post-college experience.
Regent Paramo is active in several local and civic organizations including the Education Commission of the States, Alaska Superintendents' Association, 90% by 2020 Partnership, Anchorage and Chugiak-Eagle River Chambers of Commerce, East Anchorage Rotary, Foraker Group, and United Way. She serves on several non-profit boards and enjoys spending time with her family, snow and water skiing, running, and interior painting. Regent Paramo has two college-age daughters, one of whom is proud to attend UAA.
Dana Thorp Patterson, Executive Director of the Chugiak-Eagle River Chamber of Commerce
Dana holds a Bachelor of Arts in Criminal Justice, Master of Science in Counseling, and an Educational Doctorate in Higher Education Administration. Dana has a background in law enforcement, psychiatric services, and administration in higher education institutions with oversight of workforce/professional development training departments. She is originally from Whale Pass, a former logging community in Southeast Alaska.
Mayor Ethan Berkowitz
Mayor Ethan Berkowitz has lived in Anchorage since 1990. He and his wife, Dr. Mara Kimmel have two children, Ziva and Noah.
Mayor Berkowitz earned an undergraduate degree studying Government and Economics at Harvard University, where he graduated with honors. He received a Master's degree from the Scott Polar Research Institute at Cambridge University, and a law degree from Hastings College of the Law. After moving to Alaska, he worked as an assistant district attorney before serving for ten years in the Alaska State Legislature, eight as Minority Leader. As a state legislator, he supported fiscal responsibility and a more comprehensive and sustainable energy policy. In the private sector, Mayor Berkowitz worked on technology and energy projects, including deployment of fiber optic cables in Alaska and across the Arctic, and a major geothermal project in Northwest Alaska.
Ethan Tyler, Manager of Economic Development in the Division of Economic Development at the State of Alaska.
Ethan has an extensive background in Alaska Tourism, marketing, public relations, and business development. He has been building and growing relationships throughout the state and beyond since 2000, and he continues to engage with community and business leaders around Alaska.
Ethan is a member of the Girdwood 2020 Board of Directors, and was named Top 40 Under 40 by the Alaska Journal of Commerce in 2014. When not on the job, Ethan can be found surfing the Turnagain
Arm Bore Tide, or ski instructing at Alyeska Resort. He lives in Girdwood with his wife and 9 year old daughter.
Grace Greene, Vice President & Alaska General Manager of Totem Ocean Trailer Express Alaska
As Vice President & Alaska General Manager, Grace is responsible for the operation and profitability for Alaska and fostering positive relationships with customers and political and community organizations in the region.
Grace brings over 16 years of professional experience managing a wide range of activities from complex oil and gas exploration logistics, aviation operations and safety in remote Arctic Alaska, to business development and consulting. Most recently, Grace was responsible for leading all aviation logistics operations in the Alaska Venture for the Shell Exploration and Production Company.
Grace received her bachelor's degree in Oceanography from the United States Naval Academy and served in the U.S. Marine Corps as a helicopter pilot and Aircraft Commander. During her service she held various leadership roles in Operations and Logistics as well as Director of Safety and Standardization.
Grace lives in Anchorage with her husband, Stuart, and her two children, Claire (6) and Patrick (3).
John Parrott, Airport Manager
John attended the USAF Academy and graduated with a BS in Chemistry in 1978. He has a Master's Degree in Management and Education from Embry Riddle Aeronautical University. John enjoyed 20 years in the USAF flying AT-38's, F-4's, F-16's and B-1's and retired from the US Air Force in 1998.
John began working at the Ted Stevens Anchorage International Airport in December of 1998. He has served as the Airport Security Manager (1998-2001), the Operations Manager (2001-2004), Deputy Director (2004-2008) and is currently the Airport Manager.
John is an Accredited Airport Executive, American Association of Airport Executives Board member, Past Chair of the Airports Council-North America Cargo Committee, Armed Services YMCA of Alaska Board of Management member, and an Ex Officio Advisor to Visit Anchorage and the Anchorage Economic Development Corporation Boards.
John is married to Dee Hanson and they have a beautiful 7 year old daughter, Lexus.
Julie Saupe, President of Visit Anchorage
With a 20-year career in promoting tourism in Alaska, Julie Saupe reached the industry's leadership ranks as president of Visit Anchorage in May 2007. Ms. Saupe first joined the organization in 2002 as Director of Community, Member and Visitor Relations.
She began her career as Director of Tourism at the Fairbanks Convention and Visitors Bureau in 1989. She then worked in various roles at the Alaska State Chamber of Commerce and Alaska Visitors Association. In 1999, she became Executive Director of the Mat-Su Convention and Visitors Bureau.
In 2011, Visit Anchorage reported more than $97 million in conventions booked, 658 events held in the city's two convention centers, and more than 1.1 million visits to Anchorage.net. Ms. Saupe also named the filming of "The Frozen Ground," an action thriller set in Alaska and starring Nicholas Cage, eight arrivals of the ms Amsterdam at the Port of Anchorage, and the opening of new domestic and international flights among Visit Anchorage's successes.
Ms. Saupe led the team from Visit Anchorage who recently organized a dinner for 400 travel industry representatives at Icelandair's Mid-Atlantic Conference in February 2013 at the Hilton Nordica Hotel in Reykjavik.
Ms. Saupe studied at the University of Puget Sound.
Katherine Jernstrom, owner and co-founder of The Boardroom
The Boardroom is a co-working and shared workspace for entrepreneurs, freelancers and small businesses. Prior to founding The Boardroom, Katherine has worked in business development, marketing and fundraising for the nonprofit sector for the past 9 years.
Most recently she worked for Bean's Café developing feasibility studies, completing market research and designing business plans for progressive social enterprise ventures. Not only did she secure over $150,000 through private donations but she also designed successful ventures that did not rely on charitable funding but rather operated on sustainable business concepts. Katherine founded the local chapter of the national Social Enterprise Alliance and organized and presented at educational forums on how to design socially responsibly business models. In addition, Katherine serves on the board of directors for several local nonprofit organizations including Spirit of Youth, United Way of Anchorage, United Way Emerging Leaders Advisory Council Co-chair and she is a mayoral appointed Commissioner for the Anchorage Women's Commission. She graduated from Leadership Anchorage, an intensive humanities based leadership development course in 2012. Katherine
has an undergraduate degree in Communications from the University of Washington and is a candidate in the Masters of Public Administration program at the University of Alaska Anchorage with an anticipated 2014 graduation.
Kirk Rose, Executive Director of the Anchorage Community Land Trust (ACLT).
Kirk has been with the company for six years and has served as Executive Director for two years. During his time as Community Development Manager, ACLT was awarded the National Development Council's highest honor as the 'Most Innovative Community Development Project' in the United States.
He's led a number of ACLT's defining projects including development of Anchorage's first façade improvement program, creating Anchorage's largest community garden, the city's first microloan program and the development of the Alaska Regional Hospital Community Health Clinic in Mountain View.
He envisions ACLT as a vehicle for reinvestment in Anchorage's areas of concentrated poverty, and is configuring ACLT to leverage resources of all kinds, including ACLT properties, to build great places. Having started at the organization as a volunteer, he knows the company and community development work from the ground up.
Lee Thibert, CEO of Chugach Electric
Thibert began working at Chugach in 1987 and has held a variety of senior management positions; most recently serving as senior vice president, strategic development and regulatory affairs. During his long career with the utility he has been responsible for a number of important divisions including regulatory, engineering, operations, telecommunications, power production, and power control & fuel supply.
Michelle Rizk - Vice President of University Relations & Chief Strategy, Planning and Budget Officer
Michelle Rizk joined the Statewide Office of Planning and Budget in 2006 as the Director of Budget. She is responsible for developing the operating and capital budget request guideline recommendations for the President and Board of Regents. In addition, she is responsible for developing the budget request and distribution recommendations for the President and Board of Regents. Rizk works very closely with the Institutional Research and Planning department to assure alignment of resources to strategic priorities and performance-based budgeting.
Rizk came to the University of Alaska in 1993 to pursue a degree in International Business. During her studies she was a student employee at the University of Alaska Museum. Upon graduation, Rizk served as the fiscal officer at the Statewide Office of Information Technology. Her duties included financial management and strategic planning. During her tenure, the Information Technology functions at UAF and Statewide were consolidated and as part of the consolidation team, she led the financial aspects of the Business Plan which provided her a strong campus perspective. She completed her master's degree in Business Management in 2001.
Peter Pounds, Senior Vice President, Chief Financial Officer, and Secretary, GCI
Pete Pounds was named GCI's senior vice president and chief financial officer, effective January, 2014. Prior to that, he has been the company Secretary since 2012, and vice president, Finance since 2009. He joined the company in 1997, as a business analyst, from KPMG Peat Marwick. He is both a Certified Public Accountant and a Chartered Financial Analyst.
Sophie Minich, President and Chief Executive Officer of CIRI
Sophie Minich became CIRI's president and chief executive officer in January 2013. As CIRI president and CEO, Minich is responsible for the development and implementation of the company's corporate strategies, programs, policies and procedures. She oversees all the company's business operations and is the primary contact with the company's stakeholders.
Minich is Athabascan and a CIRI and Doyon shareholder who grew up in Seward, Alaska. She joined CIRI in 1993 and has served as chief operating officer, senior vice president of business development, chief financial officer, vice president of administration and director of accounting.
Minich sits on the board of directors for the Seattle Branch of the Federal Reserve Board. She is also a current director and former chair of the Anchorage Economic Development Corp.'s board of directors. In addition, Minich serves as a trustee of Alaska Regional Hospital and CIRI Elders' Settlement Trust.
Minich chaired the 2010 United Way of Anchorage community giving campaign. She was inducted into the Athena Society in 2008, is a 2011 YWCA Women of Achievement Award recipient and the recipient of the 2013 UAA Alumni of Achievement Award. She earned a bachelor's degree in finance from the University of Alaska Anchorage.
Steve Ribuffo, Director of the Port of Anchorage
Mr. Ribuffo is responsible for overseeing the day-to-day business operations of the Port; interacting as needed with tenants, the U.S. Coast Guard, the military and any new business prospects interested in operating out of the Port. He has been with the Port since August 2007, when he came aboard as Deputy Port Director.
Steve retired from the United States Air Force as a Colonel, having served 30 years on active duty. He is an Accredited Marine Port Executive, and a member of the Board of Directors of the International Association of Maritime and Port Executives. Steve also serves on the University of Alaska – Anchorage's Global Supply Chain Management curriculum advisory committee, and is Chairman of the Cook Inlet Harbor Safety Committee.
Susanne Fleek-Green, Mayor Ethan Berkowitz's Chief of Staff
Susanne is Mayor Ethan Berkowitz's Chief of Staff, coordinating the Mayor's leadership team and strategic initiatives. She previously served as the State Director for U.S. Senator Mark Begich. In that role she oversaw Senator Begich's six offices around the state. Susanne has a deep background in public service, working for the Municipality of Anchorage in the Office of Economic and Community Development, the United States Senate in Washington, DC, and as a Presidential Management Fellow with the U.S. Department of the Interior.
Susanne was born and raised in Alaska, living in Yakutat, King Salmon, Juneau, and Anchorage. She has worked in a Southeast logging camp, at a remote fish camp for ADF&G and on the North Slope. She is a Sealaska shareholder and tribal member of Central Council of Tlingit Haida Indian Tribes of Alaska. Susanne has a B.A. and Masters of Public Policy from the University of California, Berkeley.
Quotes about the Anchorage CEDS
"The Anchorage CEDS is going to gather all the pieces we need to work on to begin improving the economy at a local level. All these pieces form the picture that is going to set our focus for the next five years." – AEDC President & CEO Bill Popp
"The more we know, the more we grow. In a competitive global economy and evolving Alaska economy, success depends on developing and implementing a good strategy." – Mayor Ethan Berkowitz
"This survey is a unique opportunity for every Anchorage resident to weigh in on what makes a strong economy. Our diversity of background, experiences and priorities will be very valuable in setting the course for our economic future." – Lee Thibert, Chugach Electric CEO
Press Contact
Sean Carpenter, Communications Director
Press Releases
- Initial CEDS release – 1/3/2017


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inca link's gap year experience
Calling all 18-22 year olds! Are you a high school senior who is unsure if starting college next year is right for you? Are you a college student who needs a break? Are you a college senior who is searching for what the Lord has for you next? We have an amazing opportunity for you! Inca Link wants to invite you to take a Link Year and join us in reaching the least of these. Our Linkers serve for 9 months in 3 different countries. Through serving a Link Year, we believe you will learn about how the Lord has wired you and where He may be calling you to next. So, take a break from school or work and come serve!
- Availability: this is a 9-month commitment from September to May
- Cost: $9999*
*Cost includes round trip flight to South America from Raleigh (Sept 1- May 22). Linker is responsible for getting to Raleigh for training and their return flight home from Raleigh after their Link Year is complete.
link year 2017-2018 schedule:
- August 27-31: Training in Pinehurst (one hour from Raleigh, NC)
- September 1- November 27: Peru
- November 28- February 23: Ecuador
- February 24- May 18th: Colombia
- May 18-22: Debrief in Colombia
- May 22: Return home
next steps:
If you are interested in serving for a Link Year, complete the application below. For questions, email Lindsey at email@example.com.


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Photographer's Note
Security is the name of this black and white photograph taken during the Royal visit. It appears security was very tight as indicated by this photograph. There were numerous individual watching every move.
This photograph was converted to black and white and saved for the web.
Nobody has marked this note useful
Photo Information
- Copyright: Jim Costello (bullybeef53) (3365)
- Genre: People
- Medium: Black & White
- Date Taken: 2009-11-04
- Categories: Ceremony
- Camera: Canon 40D, Canon EF 100-400mm f/4.5-5.6L IS USM, 77 mm UV filter
- Exposure: f/5.6, 1/160 seconds
- More Photo Info: view
- Photo Version: Original Version
- Theme(s): Police ! [view contributor(s)]
- Date Submitted: 2009-11-07 14:40
Viewed: 1766
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- Wednesday, July, 08, 2015
Blog: Women's Soccer and Return on Investment
In the days after the U.S. Women's soccer team's World Cup win, we've heard a lot of back and forth over the issue of how much the players were paid. The women's team received a record-setting $2 million for their win… record-setting for women, that is. Last year, the German men's team earned $35 million for its World Cup win.
"But it's all about the revenue!" claim those who justify the discrepancy. The women's tournament brought in a mere $17 million in sponsorship revenue compared to $529 million for last year's men's World Cup. Thus, because the men bring in more revenue, it only makes sense that they get paid more.
When I was in college, I interned for an editor at a book publishing company. I recall, among the editor's many tales of the publishing world, the story of how he signed one particular new author and set her up for success. Her work was good, he said, but she was relatively unknown and still new.
For those more familiar with coaching contracts than book contracts, book contracts typically pay an advance, anything as low as a couple thousand dollars (J.K. Rowling was given a £1500 advance on the first Harry Potter book) to upwards of $100,000, if you're an established name. If a new author doesn't go over well with the audience, the publisher hasn't lost much. If they're good, the publisher simply ups the advance on the next book.
Rather than offering this new author something at the lower end of the spectrum as would befit the situation, the editor swung big. I don't recall the exact dollar amount, but I think it was at least $20,000 (chump change for a pro athlete, but a big deal for a struggling writer).
His reasoning? The more the publisher invested in an author, the harder it would work to ensure her success, giving her a preferred launch date, better marketing and visibility. Part of this was about recouping the investment — book advances are paid against royalties, which means a larger advance needs to be offset by greater book sales if the publisher wants to come out ahead.
What does this have to do with soccer?
I'm not in the sports marketing business. I'm not even in the book marketing business. But I do know that a product's success is as much about the effort that goes into marketing it as the quality of the product itself.
Don't justify lower pay for female athletes by pointing to the lower revenue they generate — they're not the ones negotiating sponsorship contracts or selling commercial slots. In the case of women's soccer, FIFA secretary general Jerome Valcke attributes the lower revenues to women's soccer being a newer sport than men's.
"We played the [20th] men's World Cup in 2014, when we are now playing the seventh women's World Cup," Valcke said in December press conference. "We have still another [13] World Cups before potentially women should receive the same amount as men. The men waited until 2014 to receive as much money as they received."
Or, how about this: Pay the players what they're worth, and then put in the effort to back that investment up.
- Thursday, June, 25, 2015
Break Point: College Tennis Tries to Rally
The college tennis world is undergoing a quiet revolution. Or not so quiet, as anyone attending a Big 12 Conference match this past season would tell you. The new Roditi Rule, named after Texas Christian University men's tennis coach David Roditi, encourages fans to cheer for players (and heckle opponents — within reason) as they would at a football or basketball game. Combined with free pizza, contests and other activities to keep spectators engaged, the new rule created a noticeable difference in the fan atmosphere at Big 12 competitions.
- Friday, June, 19, 2015
A Response to Critics of Soaring College Rec Spending
"LSU Faces Dramatic Budget Cuts While It Builds An Expensive Lounging Pool" This was the headline of an article that appeared in The Huffington Post this past May criticizing Louisiana State University's spending of $84.75 million on an overhaul of its recreation facilities despite a threatened $55.5 million funding cut from the state.
Last week New Jersey governor Chris Christie admonished what he considers wasteful spending in the higher education system, denouncing "extras" such as lazy rivers and climbing walls.
"Some colleges are drunk on cash and embarking on crazy spending binges," he said.
If you work in college recreation, the incidents made you cringe.
The cost of higher education is going to get a lot of attention leading up to the 2016 election, and unfortunately, that's going to come with a lot of misguided scrutiny of campus recreation programs.
What both incidents overlook — as anyone working in college recreation will immediately recognize — is that a university's education budget and recreation budget are two entirely different things. Campus recreation centers are not built at the expense of science labs or classrooms. For most universities, such projects are funded (and maintained) from students fees.
"The funds for the project come directly from the student fee and can only be used for the project," LSU spokesman Ernie Ballard told The Huffington Post. "Similar to donations to the university or funds from the state for capital projects, these types of funds can't be shifted to fill in budget holes or be used in another way. They can only be used for what they were originally designated for."
The impact of such facilities on the price of a college education is actually minimal, according to David Feldman, economics professor at College of William & Mary.
"Lazy rivers are only a tiny piece of the costs," he told Inside Higher Ed. "These lazy rivers are not the reason why student debt is soaring seemingly out of control. The big problem that higher education faces today, at the public side, is cuts in state spending."
Some argue that cuts in spending are actually driving the construction of bigger and better recreation amenities, as universities look draw in more out of state students. According to research from the University of Michigan, "wealthier students [are] much more willing to pay for consumption amenities."
Despite its negative headline, The Huffington Post article went on to admit as much, quoting a 2013 article in which former Miami University president James Garland explains, "We took advantage of low interest rates for municipal bonds and invested in rehabilitating our residence halls and eating facilities and putting in more recreation -- workout rooms and lounges, and the kinds of accouterments that really dressed up a campus and made it a much more comfortable and familiar place for upper-middle class students. So those students started applying to us in droves. Application numbers went up, we became more selective, and the SAT scores of the entering class became higher."
So, in the face of a $55.5 million budget cut (avoided, thankfully) LSU would need to rely more heavily on the appeal of its non-academic offerings to bring in more students and more revenue. As Jane Wellman, a finance expert with College Futures Foundation, told Inside Higher Ed, the issue is not of how colleges spend money, but the priorities of schools.
"The sense is that college costs are going up too rapidly, and institutions aren't doing enough to control them," she says. "The critique underneath that is the critique of the decision-making culture in higher education."
Rather than ask why LSU would spend $85 million on a recreation center, maybe politicians should be asking why the state of Louisiana was mulling a $55 million cut to education.
We won't get into the other complexities of campus recreation facilities, such as the positive economic impact of construction (According to NIRSA, $1.7B was spent on 157 recreation construction projects in 2012), the employment opportunities afforded to students, the educational programming opportunities, the importance of recreation to students' quality of life (and GPA), the role in building a schools' reputation, or any number of issues.
Unfortunately, neither will the politicians pinning the climbing costs of higher education on climbing walls.
- Thursday, June, 18, 2015
New Projects: Foley Sports Tourism Complex | IU Natatorium
Breaking Ground
The Rockford Park District and Rockford Area Convention & Visitors Bureau have broken ground on the Downtown Sports Complex, (above) the latest phase in the Illinois city's Reclaiming First initiative, which aims to revitalize sports tourism in the area. The complex will redevelop an old manufacturing building into a 100,000-square-foot court facility designed to host basketball, volleyball, wrestling, pickleball and other events. Designed by Sink Combs Dethlefs of Chicago, Ill., the $30 million project also includes renovations to the city's outdoor athletic complexes, Sportscore One and Sportscore Two, as well as the city's Indoor Sports Complex. The Downtown Sports Complex is expected to open in June 2016, as are five lighted multipurpose turf fields and an indoor soccer field at Sportscore Two.
- Tuesday, June, 16, 2015
The Market for Public Recreation Projects Is Rebounding
Two years ago, the public recreation submissions to the Architectural Showcase could be divided into two distinct categories: those costing more than $5 million and those costing less. All but one of the facilities in the former category are located in Canada.
- Tuesday, May, 26, 2015
How Lighting Changes the Group Fitness Environment
Neal Pire has spent more than 30 years designing, managing and consulting for fitness and training centers, including the development of fitness programs. Also serving on the NSF International Joint Committee on Health Fitness Facility Standards, Pire has seen a lot of good and bad facility design.
- Thursday, May, 21, 2015
Athletes Must Pass Phys. Ed. Under School's New Standards
The Wareham, Mass., School District approved a proposal earlier this week to change the high school policy addendum to include stricter academic standards for athletes. Student-athletes must now pass at least seven major subjects per quarter to remain eligible for varsity sports.
- Thursday, May, 14, 2015
New Projects: Wehrle Innovation Center | Maryland Heights Community Center
Breaking Ground
The University of Charleston breaks ground this month on its Russell and Martha Wehrle Innovation Center (above), named to reflect a $5 million contribution from the namesakes' memorial foundation. Designed by Associated Architects of Charleston, W.V., the $15.5 million project is the final piece of a $100 million campus renovation project undertaken over the past decade. Phase one will replace the existing Eddie King Gym with a new arena featuring stadium-style seating, new concessions and a walking track. Phase two will renovate the aquatic and auxiliary gymnasium areas, add racquetball courts and a climbing wall, and link the new addition to the existing fitness center. The center will also house programming space for developing innovative projects and promoting entrepreneurship.
- Tuesday, May, 12, 2015
Mermaid Tails Newest Safety Concern at Canadian Pools
The growing popularity of mermaid tail aquatic accessories has officials in Alberta, Canada, concerned for swimmers' safety. The tail, popular among young girls in particular, typically consist of brightly colored fabric that covers a swimmer's legs and ends in a wide fin.
- Wednesday, May, 06, 2015
Two Boys Hospitalized After Tree Collapse at Park
Two young boys in Chelsea, Mass., were hospitalized Monday night after a tree collapsed onto the playground where they had been playing.
- Monday, March, 06, 2017
An Index to the Industry
This is the 41st Buyers Guide published by Athletic Business — the first having launched the Athletic Purchasing & Facilities brand back in 1977. As the story goes, founder Fenton Kelsey Jr. was working to construct an indoor ice arena in Madison, Wis., but couldn't find any references to guide him through the construction process or future management. So he decided to create one.
- Wednesday, November, 23, 2016
AB Show 2016: Thankful for the Chance to Share Ideas
Nothing helps transition back into office life after the whirl and excitement of another Athletic Business Show quite like a three-day workweek (apologies to our audience in Canada!). But even as I look forward to a day of good food and family, I'm reminded of some of the new ideas shared among recreation professionals at a revenue roundtable seminar hosted by Jeff King and Ken Ballard of Ballard*King Consultants.
- Thursday, November, 17, 2016
AB Show 2016: A Recreation Rundown
An abundance of sunshine made up for the slight chill in the air as AB Show attendees boarded the bus to University of Central Florida. Undeterred by the 7:30 am start time, the mix of tourists hailed from as far as Hawaii (5 hours behind) and Taipei (13 hours behind!) and was excited to see what Central Florida had to offer.
- Monday, November, 14, 2016
Letter from the Editor: Our Military Fitness Problem
This article appeared in the November | December issue of Athletic Business. Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.
- Tuesday, October, 04, 2016
Letter from the Editor: Facilities Worth Talking About
This article appeared in the October issue of Athletic Business. Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.
- Tuesday, August, 30, 2016
Letter from the Editor: Preparing for the Year to Come
This article appeared in the September issue of Athletic Business. Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.
- Thursday, July, 07, 2016
Letter from the Editor: Eat Your Veggies
This article appeared in the July/August issue of Athletic Business. Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.
- Monday, June, 06, 2016
Passing the Torch in Facility Design
This article appeared in the June issue of Athletic Business. Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.
- Thursday, May, 05, 2016
At the moment...
I can't think of a recent issue of Athletic Business that captures the feel of our industry quite as comprehensively as this one. No, we don't have any momentous, industry-changing topics this month, but what we do have speaks to the current environment of athletic, fitness and recreation professionals.
- Thursday, March, 31, 2016
Our Common Ground
This article appeared in the April issue of Athletic Business. Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.


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Caitlyn General Guide by itzxpremium
Not Updated For Current Season
This guide has not yet been updated for the current season. Please keep this in mind while reading. You can see the most recently updated guides on the browse guides page.
Thank You!
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Caitlyn Build
Starting Items [1]
Starting Items [2]
Defensive Choices
Ability Sequence
Not Updated For Current Season
The masteries shown here are not yet updated for the current season, the guide author needs to set up the new masteries. As such, they will be different than the masteries you see in-game.
iTz x premium here.
I'm currently Silver II, but I'm working hard to get higher.
This guide is about my way to play Caitlyn, so If you aren't satisfied with my build and Runes...so please don't downvote my Guide if this is the cause.
I'd like to get some criticsm, but please only serious.
Exspecially spelling/grammar mistakes :-)
So I talked much, and you aren't here to read my Introduction, so let's start.
Pros / Cons
- High Range [650]
- Strong Poke
- Strong early and late game
- High Range Ult Ace in the Hole
- squishy as all carries
- Has to channel Ace in the Hole for 1 second,
so it can be interrupted
- Fast oom, due to Piltover Peacemaker
Greater Seal of Armor
Greater Mark of Attack Damage
Greater Glyph of Magic Resist
Greater Quintessence of Attack Damage
- For Marks I'd like to get Greater Mark of Attack Damage x9, because they give you 8.55 Attack Damage. So you can easily farm (Farming in later section).
- For Seals I'd like to get Greater Seal of Armor x9 , because they give you ~12.7 Armor, this doesn't sound much, but they'll give you an early advantage to put in some AA's from your enemy.
- For Glyphs I'd like to get Greater Glyph of Magic Resist x9 , because they give you ~12 Magic Resistance, this also doesn't sound much, but if you have an annoying enemy-support like Sona, this can help you a lot as well as in later Teamfights.
- For Quintessences I'd like to get Greater Quintessence of Attack Damage x9, because they give you 6.75 Attack Damage, together with your Marks you have + 15.3 Attack Damage.
- As in other Guides, there are other choices, I have no other choices, because they don't give you the same advantages as my recommended Runes.
I hate this section, so I don't really like to explain it.
Just stick to my Masteries. :D
Skill Sequence
Just level your W in level 1, because you need to place it in the bush to see your enemies, if they are invading you!
Then level your Q Piltover Peacemaker up to rank 5 in level 9.
Then you max. your W Yordle Snap Trap up to rank 5 in level 13.
As last you max. your E 90 Caliber Net up to rank 5 in level 18.
As all Ultimates you always skill it at level 6/11/16.
Every 8/7/6 attacks(attacks while in brush count as 2), Caitlyn's attack will be enhanced to be a Headshot, dealing 150% damage to a champion or 250% damage to a minion/monster.
Caityln revs up her rifle for 1 second to unleash a penetrating shot in a line which will deal physical damage to al targets hits. It will deal 10% less damage for each subsequent target hit, down to a minimum of 50% damage dealt.
Lv1: 20(+1.3 Attack Damage)
Lv2: 60(+1.3 Attack Damage)
Lv3: 100(+1.3 Attack Damage)
Lv4: 140(+1.3 Attack Damage)
Lv5: 180(+1.3 Attack Damage)
Lv1: 1300
Lv2: 1300
Lv3: 1300
Lv4: 1300
Lv5: 1300
Mana Cost:
Lv1: 50
Lv2: 60
Lv3: 70
Lv4: 80
Lv5: 90
Caitlyn sets a trap at the target nearby location. The trap triggers when a champion walks over it.(includes also LeBlanc's Mirror Image or Yorick's Omen of Death)When sprung, the trap immobilizes the champion for 1.5 seconds, dealing magic damage over the duration and additionally revealing the target for 9 seconds. Caitlyn can set up to 3 trags and they last 4 minutes each. If she already set 3, the oldest will reactivate itself.
Lv1: 80(+0.6 Ability Power)
Lv2: 130(+0.6 Ability Power)
Lv3: 180(+0.6 Ability Power)
Lv4: 230(+0.6 Ability Power)
Lv5: 280(+0.6 Ability Power)
Lv1: 800
Lv2: 800
Lv3: 800
Lv4: 800
Lv5: 800
Mana Cost:
Lv1: 50
Lv2: 50
Lv3: 50
Lv4: 50
Lv5: 50
Caitlyn fires a heavy net in front of her. The net will slow down the first target hit by 50%(Also slows invisible unity, but doesn't reveal them) and will deal magic damage to it. Upon firing it, the recoil will knock Caitlyn back.
Lv1: 80(+0.8 Ability Power)
Lv2: 130(+0.8 Ability Power)
Lv3: 180(+0.8 Ability Power)
Lv4: 230(+0.8 Ability Power)
Lv5: 280(+0.8 Ability Power)
Lv1: 1000
Lv2: 1000
Lv3: 1000
Lv4: 1000
Lv5: 1000
Lv1: 400
Lv2: 400
Lv3: 400
Lv4: 400
Lv5: 400
Mana Cost:
Lv1: 75
Lv2: 75
Lv3: 75
Lv4: 75
Lv5: 75
Caitlyn marks an enemy champion at a huge range and channels for 1 second to line up the perfect shot, providing vision of the target for the duration. She then fires the projectile to deal massive physical damage. Other enemy champions can intercept the bullet for their ally.
Lv1: 250(+2.0 Bonus Attack Damage)
Lv2: 475(+2.0 Bonus Attack Damage)
Lv3: 700(+2.0 Bonus Attack Damage)
Lv1: 2000
Lv2: 2500
Lv3: 3000
Mana Cost:
Lv1: 100
Lv2: 100
Lv3: 100
- If you take #I Doran's Blade, you are on the safe-side. You have your required sustain, Damage and health-get-back (also known as Life-Steal).
- If you take #II Boots of Speed +3 Health Potion, you are on an uncertain-side. Although you have the MS but you didn't got your 10 bonus Attack Damage and Life-Steal.
----> Conclusion for the Starting Items: Beginners should take #I , advanced could take #II.
In summary #I is more viable.
- You'll ALWAYS finish your Berserker's Greaves, if you havn't enough Gold to buy other items...
- As your Core-Items you should first buy your Infinity Edge, it gives you your required Burst, including Crits, Attack Damage and the nicest passive of the whole game :
Your Crit's now deal 250% instead of 200% damage.
- Your second item should be The Bloodthirster. It gives you (when farming good), +100AD and +18% life-steal (my health-get-back :D).
- So... you've finished your Infinity Edge and your The Bloodthirster, now it's time to force Last Whisper. It's necessary if your enemies are building a lot of Armor
, with this 35% Armor Penetration, you shredder your enemies Armor :).
- And last but NOT least you should get your Phantom Dancer. It gives you your required Attack speed, nice Crit chance and 5% Movement Speed (it soesn't sound much, but it will help you chasing your enemies or running away from them).
- After this you can decide wheter you take Guardian Angel, Banshee's Veil or Mercurial Scimitar. All of this Items are suitable for Caitlyn, it just depends on how much CC/Assassins your opponents got.
As you (I'm sure that you) know, farming is the most important thing all over the game.
Pls keep my rule in mind:
~100cs/10min = 100 minions/monsters per 10 minutes (does include game-start-time)
So you should have after...:
10min : 100cs +-5
20min : 200cs +-10
and after you've hit 200 creeps, the mid-game should've began.
ALWAYS when your lane is pushed, go to your wraiths or wolves and farm them.
That's all you should care about...
p.s. litte maths:
creep: ~25 gold / champ: ~300 gold
So as you can see one champion kill = 300g = 12 creeps.
Early Game
So the announcer said "30 seconds until minions spawn" and you've hit your lane with your support (best support for cait in later section), and you've chosen your starting Item(s), the minions have spawned and you face the first time your enemy bot-lane.
Possible actions:
#1: You and your opponent are farming and are waiting for a jungler-gank.
#2: You are playing aggresive and your support is chasing a lot.
#3: Your opponets are annoying to you and poke you down and out of lane.
If #1 is the cause, you're fine and on the save side. You should hit the Farming Goal, and hopefully farming better than your opponent.
> You have the options to:
-try to zone them out or
-still farming and look up for your Core-Items
If #2 is the cause, you aren't save and you are more vulnerable then 100%...
>The laning options are:
-You'll become ganked of your opponent...and you'll die,
-You understand the situation and going back, so that your opponents can push and they are vulnerable to YOUR ganks
If #3 is the cause, just ask your jungler for help. There's no other choice in this sitution.
Mid Game
Mid-Game usually begins when dragon has been killed or turrets have started to go down.
This is when Caitlyn becomes weak. Unless you are insanely insanely fed, at this point you should only have Berserker's Greaves, B. F. Sword and Vampiric Scepter. These items coupled together is not able to beat other champion's items at this point, until you acquire Infinity Edge and Phantom Dancer.
If your damage against the enemy is low, try not to focus so much on killing champions. Focus on creeps to gain gold; last hit in your lane, get the Dragon , or kill Jungle Creeps like Wolves . Do whatever you need to stay alive but earn gold at the same time. Fear not; if you do not feed the enemy and farm effectively and quickly to get your Infinity Edge early, you will begin to dominate the game once again.
Map awareness is key if your teammates are losing their lanes. Look for potential ganking opportunities and help your teammates.
Late Game
Late game is when it is impossible to stay alive when roaming solo, and dying at this point pays a heavy price (due to long respawn times). Typically during late game everyone is at >Level 14 so they have quite long respawn times. This is the point where teamfights will occur and everyone will be sticking like glue.
You are the main source of damage for your team during teamfights. The most important elements are positioning and knowing who to aim. Aim a tank with Thornmail, and you are doing more harm to yourself than to the enemies. Never aim tanks in a 5v5. Go for the squishy ones. Typically I follow this order: Carries > Support > Offtanks > Tanks
You may be thinking that Last Whisper will make it better to aim tanks, but while this item do help with killing tanks it is best to aim those who can dish damage out. It takes quite a number of attacks and time to kill the tank, and in that time damage can be dealt by the enemies easily annihilating your team. But imagine if you take down all their damage sources and only one huge tanky rock without any damage is remaining, your whole team can easily focus him down and he has no way of damaging you hard. However, there is NO absolute rule on who to aim, and in some teamfights aiming the tank is better.
Positioning is also important in teamfights. Caitlyn should never engage teamfights head on. Let the tankier ones engage and go first. Caitlyn should stay behind the team, dealing damage from far away with her high range and kiting the enemies. Remember, Caitlyn should NEVER be the first to die and should constantly be doing damage. This is my definition of good positioning. Stand your ground and land as many attacks until you feel the need to escape.
Also, try to lure them to your base and let the turret get some free damage on them.
Remember, if you see an enemy just by himself during late game, attack him and quickly kill him. But if he manages to get away, DO NOT CHASE HIM. It is most likely a bait and all his teammates are waiting to pounce on you somewhere.
Lane Match-Ups
I'll tell you the match-up difficulty, so I won't write a text:
Easy Lane Match-Ups:
Kog'Maw: Easy, due to his low range and his high Mana costs.
Quinn: Easy, due to her skill-shot based Damage tool.
Medium Lane Match-Ups:
Vayne: Medium, all know why she's so dreaded.
Hard Lane Match-Ups:
Varus: Hard, due to his Q, it got a higher range than any of Caits normal abilities.
Draven: Hard, due to his enhanced AA's, it's almost always a Cait's Headshot.
A very very very big thanks to jhoijhoi, here's her best ADC guide, which I've read too and succesfully tried it out : Ashe's to Ashes
And a thanks to emoriam for helping me improve.
Change Log
Here are my changes, orders like [dd/mm/yyyy]:
[12/09/2013] Guide was published!!!
[13/09/2013] Added Mercurial Scimitar to Defensive Choices./Improved some graphics, thx to emoriam