text:
|Publication number
|Publication type
|Application number
|Publication date
|Mar 12, 2002
|Filing date
|Aug 25, 2000
|Priority date
|Oct 9, 1991
|Fee status
|Also published as
|Publication number
|Erik Andersen, Ernst Peter Strecker
|Original Assignee
|Scimed Life Systems, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (34), Non-Patent Citations (13), Referenced by (35), Classifications (23), Legal Events (7)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation of U.S. application Ser. No. 08/922,156, filed Sep. 2, 1997, now U.S. Pat. No. 6,146,416, which is a continuation of application Ser. No. 08/528,061, filed Sep. 14, 1995, now U.S. Pat. No. 5,662,713, which is a continuation of application Ser. No. 07/960,584, filed Oct. 13, 1992, now abandoned, which is a continuation-in-part of application Ser. No. 07/773,847, filed Oct. 9, 1991, now U.S. Pat. No. 5,234,457.
This invention relates to endoprosthetic stents that are placed within body lumens that exhibit physiologic motion such as peristaltic motion.
Medical stents are tubular endoprostheses placed within the body to perform a function such as maintaining open a body lumen, for example, a passageway occluded by a tumor. Typically, the stent is delivered inside the body by a catheter that supports the stent in a compacted form as it is transported to the desired site. Upon reaching the site, the stent is expanded so that it engages the walls of the lumen. The expansion mechanism may involve forcing the stent to expand radially outward, for example, by inflation of a balloon carried by the catheter, to inelastically deform the stent and fix it at a predetermined expanded position in contact with the lumen wall. The expansion balloon can then be deflated and the catheter removed.
In another technique, the stent is formed of a highly elastic material that will self-expand after being compacted. During introduction into the body, the stent is restrained in the compacted condition. When the stent has been delivered to the desired site for implantation, the restraint is removed, allowing the stent to self-expand by its own internal elastic restoring force.
Strictures of the esophagus often produce obstructive dysphagia resulting in debilitating malnutrition. To date, the theoretical advantages of placing a plastic stent to restore the patient's ability to swallow have been offset by technical difficulty of placement, morbidity and mortality associated with the procedure, and poor long-term prosthesis performance. In particular, previous stents have transmitted the force and deformation of peristaltic waves inappropriately, for instance causing the stent to creep toward the stomach, perforate the esophagus, or rupture the aorta.
In a first aspect, the invention features a method for providing reinforcement to the lumen of a peristaltic organ. The stent is formed by knitting a filament into interknit loops, the pattern of the loops selected such that from a relaxed state each row of loops may shift axially relative to and independently of the rows on either side.
The local lengthening and shortening allowed by the shifting allows the stent to accommodate the peristalsis of the organ without migrating within the organ.
Preferred embodiments of the stent feature the following. The lumen treated is the esophagus. The elongation factor ε by which the stent can locally lengthen by shifting is related to the angle Θ at which the lumen can incline inward by the relationship: ε=1.0/cos Θ. The stent is knitted of metal wire to be self-expandable such that the stent expands outward against the body lumen wall by an elastic restoring force of the wire. The stent is knitted from nitinol wire having a diameter of about 0.15 mm. The stent, in its free state, has a point of constricted cross-section. The constriction may have a valve.
A stent according to the invention offers the following advantages. The stent exerts a constant, gentle radial force on the wall of the lumen that maintains lumen patency and actively resists compression, as by a tumor. The inherent flexibility of the knitted stent adapts to peristalsis, transmitting the peristaltic wave to the lumen, but without changing overall length or creeping. This reduces complications and promotes long-term stability, patency, and patient comfort. The force exerted by the stent against the lumen is sufficient to compress the capillaries of the organ so that growth into the lumen is retarded. The stent can be delivered via a low-profile delivery system which is smaller than a standard endoscope. The small diameter of the delivery system simplifies implantation by eliminating the need for pre-dilating the stricture, and allows placement even in patients with tortuous esophageal anatomy or strictures prone to perforation by plastic stents.
In a second aspect, the invention features a stent for providing reinforcement to a selected region of a selected body lumen. The stent comprises two resilient cylindrical mesh layers and a semi-permeable compliant membrane sandwiched between.
Preferred embodiments of the invention feature the following. The two mesh layers may be knit of a flexible filament, and the knit may be configured so that the stent can adapt to peristalsis of the body lumen. The membrane is composed of expanded polytetrafluoroethylene.
The invention or preferred embodiments thereof may feature the following advantages. The semi-permeable membrane prevents cell ingrowth of the stent. The force exerted by the stent against the lumen is sufficient to compress the capillaries of the organ so that growth into the lumen is retarded.
In a third aspect, the invention features a method of manufacturing a delivery system for a resilient tubular device so that the tubular device can be inserted into the body in a substantially reduced diameter. The method uses a confining block having a bore and a slot leading into the bore. The tubular device is pinched and inserted into the bore and the slot. Two mandrels are inserted into the bore, one inside the tubular device and one outside. The mandrels are revolved about each other to roll the tubular device on itself until the tubular device is entirely rolled and confined at the reduced diameter within the bore. The tubular device is removed from the bore while being restrained in the reduced diameter.
Preferred embodiments of the method of manufacture feature the following. The removing step may be accomplished by pushing the tubular device from the end of the bore and restraining the tubular device as it emerges. The restraining my be by means of wrapping a wire around the tubular device. The slot may be tangent to the bore of the confining block. The tubular device may be a stent knit of an elastic filament. One of the mandrels may be part of the delivery system that will be used to deliver the stent.
The inventive method of manufacturing the stent features the following advantages. Certain prior methods required several operators to simultaneously hold and constrain the resiliency of the stent and hurt the fingers of the operators. The method of the invention requires only one operator and is comfortable to execute. The stent delivery systems produced by the method are more uniform than those manufactured by previous methods, both in distribution of stresses within a single stent and in variation between stents, thus avoiding deformation of the stent during manufacture and allowing the physician to place the stent more precisely in the patient. A stent delivery system manufactured according to the method has a small profile, and thus minimizes trauma to the patient during implantation.
Other advantages and features of the invention will become apparent from the following description of a preferred embodiment, and from the claims.
FIGS. 1 and 1c are perspective views of a stent according to the invention.
FIG. 1a is an end elevation view of the stent.
FIGS. 1b, 1 d-1 h, 4 a, and 6 are detail views of the knitted loops of a knitted stent.
FIGS. 2, 2 a, 3, and 3 a-3 e are sectional views of a body, showing effects and operation of a stent in the esophagus.
FIG. 4 is a sectional view of a peristaltic organ.
FIGS. 5, 5 a, and 5 b are schematic representations of alternate embodiments of the stent.
FIG. 5c is a partially broken-away view of an alternate embodiment.
FIGS. 6a, 7, 7 a, 7 c-7 j, 7 l, 7 m, and 7 p-s are perspective views of tools and a time sequence of steps in a process for manufacturing a delivery system for the stent.
FIG. 6b is a perspective view of a stent knit of interlocking pre-formed sinusoidal rings.
FIGS. 7b, 7 k, 7 n, and 7 o are cross-sectional views taken during the process of manufacturing the delivery system.
FIG. 7t is a sectional view of the delivery system.
FIG. 7u is a perspective view of the delivery system, cut away.
FIGS. 8 and 8a-8 e are a time sequence of sectional views of an esophagus showing delivery of a stent.
FIGS. 9, 9 a, and 9 b are a time sequence of cutaway views of an alternate delivery method.
Referring to FIGS. 1 and 1a, a stent 100 according to a preferred embodiment is formed of a knit cylinder with length L and diameter D. The knitting forms a series of loosely-interlocked knitted loops (e.g., as indicated by adjacent loops 132 and 134 in FIG. 1b) that may slide with respect to each other. This sliding or shifting allows the stent to adapt to the movement of the organ without moving axially in the organ. The adaptation is accomplished with mere bending of the stent filament.
The stent maintains its axial working length L when locally radially compressed, by locally lengthening or shortening due to shifting of the rows of loops relative to each other. FIG. 1c shows a region 130 of the stent not under radial compression where adjacent loops 132 and 134 are in an overlapping, relaxed configuration, and the heads of the loops are separated by a short distance s. In the case of an esophagus, a large piece of food distends the esophagus. At the first instant of the expansion, the wall may be deflected by an angle Θ, but the diameter of the organ will not have changed appreciably. In such a region, 140 in FIG. 1c, the local length of the wall elongates by a factor 1/cos Θ. The rows of loops of the stent shift axially with elastic deformation of the wire of the loops so that the separation of the heads increases to a loop length l1, as shown in FIG. 1e. In the region of maximum expansion 150, the length of each portion of the esophagus returns to its rest length, but the diameter is extended. The knit loops of the stent can widen, as shown in FIG. 1f, to accommodate this extension. Returning again to considering any peristaltic organ, the organ contracts (c of FIG. 1c) to compress a region. In a region 160 where the wall is at an angle of deflection Θ but the diameter is essentially equal to the rest diameter, the length of the wall of the organ will elongate by a factor 1/cos Θ, and the loops will again pass through a state where their width is essentially the same as the rest width, but, by relative shifting of the rows of loops axially, they are extended to length l1, the state shown in FIG. 1e. In a region of maximum compression 170, the wall of the organ is at its rest length, but the circumference is much reduced. In this region, the loops of the stent deform into the configuration of FIG. 1g, where the length of the loops is s but the width is compressed. Finally, as the peristalsis relaxes, the wall of the organ returns to its rest length and rest circumference, region 190 of FIG. 1c, and the loops of the stent return to the overlapped rest configuration of FIG. 1d.
In the case of organs that can constrict almost closed, as the lumen compresses radially the circumference shortens, and thus part of the length of the filament that contributes to the circumference of the stent in its rest state is freed to contribute to length, and thus the loops can lengthen to length l2, as shown in FIG. 1h.
The lengthening from s to l2 all occurs without significant elongation of the filament of the stent itself, only by elastic bending deformation and sliding of the rows of loops against one other. The ratio of the maximum local length to the relaxed local length, l2/s, is determined by the configuration of the loops and the elastic limit of the material of the filament.
Referring again to FIG. 1c, the local lengthening in regions of radial extension, compression or slope does not substantially affect the loops in nearby regions that are not exposed to the radial compression, which are in turn free to elongate, contract or widen in response to the movements of their own local portions of the organ. Thus, the stent maintains its overall working length L even when locally extended or compressed. When the radial compression is released, the elasticity of the filament causes the stent to expand back to its original rest diameter D without change of the overall length, since adjacent loops in the region of compression slide back to the relaxed overlapped state, separated by distance s. Because the stent maintains point-for-point contact with the organ, averaged over a local area about the size of one loop, the stent maintains its placement in the organ, and does not migrate with the peristalsis.
A further property of the stent is that the state characterized by all adjacent loops being separated by distance s is the stable equilibrium between the elastic restoring forces of the wire and the compressive force of the esophagus. Thus, the stent automatically adjusts to overall length L regardless of the initial configuration of the loops and length of the stent. For example, if the loops are in extended positions as in FIG. 1e or 1 h, then upon compression the loops adjacent the compressed region draw axially inward to the relaxed configuration in FIG. 1b, thus drawing the proximal end (120 of FIG. 1) and distal end 122 inward. When the compression releases, the loops in the region of the compression also shorten, since the ends 120 and 122 of the stent have been drawn inward and adjacent loops slide inward to adjust for the reduced overall length. Once the stent has settled into this equilibrium state, the overall length and position within the lumen are stable.
These features are enabled in the preferred stents of the invention by a sliding motion of adjacent filament loops, which in turn is enabled by the method of knitting that reduces overlap of the loops, as shown, and the elasticity of the filament and the shape of the loops. The sliding motion allows local axial lengthening or shortening of the stent substantially independently of other remotely located portions of the stent. The elasticity of the stent filament allows the stent and lumen to return to their desired patency when the compacting force is removed, without inelastic deformation. The loops are configured so that the stent assumes its desired diameter and overall length as the elastic restoring forces seek their minimum stress, the relaxed state of FIG. 1b. This minimization occurs when adjacent loops touch at their widest points, as for instance point 136 between loops 132 and 134.
These features are particularly useful in body passages in which physiologic function includes motion of the lumen walls, such as peristaltic motion of the esophagus. For example, referring to FIG. 2, an esophagus 200 is occluded by a tumor 202. In FIG. 2a, after insertion of the stent 100, the lumen's patency is restored. Once implanted in the esophagus, the stent is held in a rest diameter that is slightly compressed by the esophagus from its free diameter when outside the body. It is the elastic restoring force of the stent resisting this compression that holds the stent in place.
A stent for an organ like the esophagus, according to the invention, not only holds the lumen open but allows the organ to maintain its physiologic motion. Further, the stent adapts to this motion without itself being subject to the peristaltic force—it does not creep toward the stomach with each esophageal contraction, nor does the overall length change. The operation of the elastic knitted stent is illustrated in FIGS. 3 and 3a-3 e. A food particle 310 is urged through the lumen 320 by a peristaltic wave 322 that propagates down the esophagus 200. The wave is induced by circumferential contraction of the muscular tissue surrounding the lumen, a consequence of which is radial inward extension of the wall. Before the wave reaches the stented portion, the stent lies between points T and B, with length L between. As the wave reaches point T and the portion of the esophagus reinforced by the stent 100, the stent complies with the radial contraction, as shown in FIGS. 3a-3 e. As shown in FIG. 3e, after passage of the peristaltic wave the stent has not migrated from points T and B, and maintains its overall length L. The adjustment and restoration feature allows the stent to maintain its position in the lumen, without migrating axially as might occur with a unitary structure in which stresses in one portion are substantially transmitted to other portions.
Referring to FIGS. 4 and 4a, the configuration of the knit loops of the stent may be determined based on the degree of radial motion and consequent axial lengthening imposed by the peristaltic motion. Generally, the loop length of the stent in its extended position l can be expressed as:
where s is the axial length of the portion of the body lumen over which two adjacent loops of the stent extend, and ε is the factor by which the stent must elongate in response to local lengthening of the body lumen wall. It will be seen that the maximum local lengthening will occur over the portion of the wall that lies at the largest angle Θ from the at-rest position. In a worst-case limit, the entire peristaltic wave can be approximated as having a wall at angle Θ, thus distending a portion of the lumen that has rest length a to a triangular wave with hypotenuse b. Thus,
b/a=1/cos Θ (2)
This ratio, b/a, is the elongation factor by which the loops must lengthen from their relaxed length s to their extended length l to accommodate the lengthening of the lumen wall at the incline of the peristaltic wave. Thus,
For the stent as a whole to maintain point-for-point contact with the wall of the lumen and thus for the stent as a whole to remain stationary along the axis of the lumen, the heads of the loops are allowed to slide locally in the region of peristaltic compression by a distance (1−s)/2.
It will be noted that the stent will accommodate the elongation of the lumen wall if it is capable of local elongation ε equal to 1/cos Θ, independent of the amount of deflection c, even in the extreme case where the organ is capable of constricting completely shut—deflection c in FIG. 4a being equal to the radius D/2 of the lumen.
The amount of force exerted by the stent against the lumen wall is chosen to exceed the blood pressure within the capillaries of a typical tumor, and thereby prevent the tumor from further growth into the lumen of the esophagus. The exerted force is determined by the coefficient of elasticity of the filament, by the configuration of the loops and density of the knit (loops per unit of axial length), and by the diameters of the lumen and the stent. For instance, a stent design would exert more force against the lumen wall by choosing a stiffer material for the filament, by knitting the stent with more, smaller loops per unit of length (decreasing s, and reconfiguring the loops to maintain the ratio l/s), or by knitting the stent to a larger rest diameter D. The radial force exerted is bounded at the point where the loops reach the relaxed configuration of FIG. 1b and the stent's diameter reaches diameter D—the forces sum to zero at the contact points 136, and the force exerted on the lumen itself falls to zero. Thus, the diameter D of the stent must be slightly larger than the diameter of the lumen if the stent is to retain its place in the lumen.
Referring again to FIGS. 1, 1 a and 1 b, a particular embodiment for use as an esophageal stent is knitted of nitinol wire of about 0.15 millimeters in diameter to have a diameter D of about 18 mm, though diameters of 14 mm to 25 mm may be useful. The proximal end 120 is flared to 20 mm, to secure fixation to the esophageal wall. Stents manufactured in overall lengths varying from 5 to 15 cm allow selection of a stent tailored to the patient's needs. The relaxed loop length s is about 0.80-0.85 mm, and the maximum loop length l attained without significantly distorting the loops is about 1.05-1.15 mm. This elongation factor of about 1.4 is close to 2, allowing for a maximum angle Θ of about 45�. The peak-to-peak height p of the loops is about 2.2 mm when the loops are in their rest state.
Examples of filament materials include shape memory metals, for example, nitinol, tantalum steel, stainless steel or other elastic metals, or plastics such as polyester, polypropylene, or carbon fiber. The filament may be selected to have a sufficiently high elastic limit to allow the delivery system to rely entirely on this elasticity, rather than, for example, the balloon 820 of FIG. 8e to expand the stent. The filament may be formed of a two-component metal wire system that exhibits desirable physical properties such as enhanced radiopacity along with desirable mechanical properties, such as extreme elasticity.
A full discussion of composite medical wires will be found in U.S. application Ser. No. 07/861,253, "Medical Wire" by Kevin R. Heath, incorporated herein by reference. The stent may be knit of two or more filaments.
As shown in FIG. 4a, the stent is knitted of a single filament. This view shows only the front half of the stent. The loops that appear in this view as independent rows in fact are a single spiral-wrapped sequence, much as a common screw has only one ridge from head to tip. In alternate embodiments of the stent, multiple filaments or other knits could be used, so long as the knit structure allows a single row to elongate without forcing the two adjacent rows to shift. The last loop of the wire is cut 440. To prevent the stent from unravelling, the last three loops (two shown, 450 and 452) of the stent are coated in urethane, as shown in FIG. 4b. The coating also covers the sharp ends of the filament.
It will be realized that the stent is applicable to malignant or benign obstructions of many other organs. Stents to treat biliary duct obstructions, for instance when treating liver sclerosis or bleeding, would be about 8 to 10 mm in diameter and 4 to 8 cm in length. Stents for the ureter would be about 6 to 10 mm in diameter and about 2 to 10 cm in length. Urethral stents would be about 10 to 20 mm in diameter and about 2 to 6 cm in length. Stents for the prostatic urethra would be about 10 to 20 mm in diameter and about 2 to 6 cm in length. Colonic stents would be about 10 to 20 mm in diameter and about 4 to 10 cm in length. Stents for hemodialysis shunts would be about 6 to 8 mm in diameter and about 2 to 6 cm in length. Stents for the porta canal would be about 8 to 14 mm in diameter and 4 to 8 cm in length. Stents for the trachea and bronchi would be about 8 mm to 25 mm in diameter and 1 to 8 cm in length. Stents for gastric outlet obstructions would be about 8 to 20 mm in diameter and 1 to 25 cm in length. Peristaltic stents may also be configured for aortic aneurysms or dissections (preferably weaving the filament material with a covering such as DACRON), and treatment of superior vena cava syndrome and venous restrictions. The invention is also useful in lumens in which compression is caused by some outside force, for example in blood vessels compressed by muscular contraction, movement of an extremity, or pressure exerted by an object external to the body.
FIGS. 5, 5 a, and 5 b represent alternate forms for stents. (Showing the knit loops in these projections would obscure the shape; these figures represent only shapes of the stents.) The stent could be shaped to include, in its free and rest states, a narrowing at a point in its length.
This narrowing would accommodate the stent to the anatomy of a natural sphincteric structure, for instance the pylorus or the cardia. A stent so narrowed would enable the organ to close, for instance to prevent reflux. The narrowing could be shaped at one of the ends, for instance for use in the rectum at the anus or in the common duct for a Papilla of Vater.
The narrowing could be shaped conically, as in FIG. 5 for use in sphincter organs. FIG. 5a shows a stent incorporating a flattening, with the circumference in the area of the flattening reduced so that the width remains constant. The latter embodiment could be used in an occlusion with two lips such as the vocal cords. In either case, it may be desireable to form the loops in the region of the constriction so that their free state is similar to one of the compressed configurations, e.g. FIG. 1g, so that the constriction is capable of opening to the rest diameter D.
As shown in FIG. 5b, the margins of the narrowing could incorporate a valve to ensure complete closure of the stented organ, as for instance the reinforced lips 520. This valve could be opened and closed either by the muscles normally surrounding the point of constriction or by a manually-operated control extended to outside the body. This would allow the use of the stent, for instance, across the aortic valve or as a replacement for the urinary sphincter. It may be desireable to reinforce the point of the constriction, e.g., with a stiff wire, especially in conjunction with the flattened constriction of FIG. 5a. It may also be desireable to provide a valved stent with a watertight membrane, similar in form to that discussed below and shown in FIG. 5c.
The stent can be made to exert varying force along its length, for instance by varying the gauge of the wire or the density of the knit. In the narrowed stents discussed above, it may be desireable to make the stent particularly flexible in the region of the narrowing.
Some tumors are so invasive that the stent is quickly ingrown by the tumor. As shown in FIG. 5c, the stent may be manufactured with an elastic semi-permeable membrane 530 of porosity less than 50 microns and of very low modulus of elasticity, sandwiched between two knit layers. The membrane may advantageously be of expanded polytetrafluoroethylene (TEFLON) or latex. The inner layer 532 is essentially identical to the single-layer stent, providing most of the elastic force against the lumen. The outer knit layer 534, which acts to retain the membrane, is typically constructed of thinner wire, for instance 0.07 mm diameter, or a less-resilient material such as polypropylene or polyethylene. The outer knit layer is slightly shorter in length than the inner layer.
The stent is knit on a conventional knitting machine, very similar to that used to knit stockings. During the knitting process, the wire is deformed past its elastic limit. Referring to FIG. 6, on some knitting machines, or for stents of some diameters, it may be convenient to produce a knit with the "up loops" 610 of a different shape than the "down loops" 612. In some applications, for instance the aorta, it is important that the loops be uniform so that the stent exerts uniform pressure along the lumen wall. During the knitting process, the wire will be under tension, and thus the loops will be in a tight configuration, similar to FIG. 1e, or possibly to FIG. 1f or 1 h depending on the geometry and setup parameters of the knitting machine itself.
The knitting machine produces a long "rope" of knit loops. The rope is cut into lengths somewhat longer than the final length of the stent. The extra length allows for the shortening of the stent that will occur as the loops are shortened from the elongated state in which they emerge from the knitting machine to the rest state of FIG. 1b, and allows for some trimming. As shown in FIG. 6a, after knitting, the stent is mounted on a mandrel 620 for annealing, to relieve the strains induced by the plastic deformation of knitting and to produce greater elasticity in the wire. The mandrel is in the free shape of the stent, 18 mm in diameter with a flare 622 to 20 mm at one end. To achieve the constricted embodiments of FIGS. 5 and 5a, the mandrel would have a constriction formed in it, and an external restraint would be applied to the stent so that the annealed shape would be as shown in those figures. As the stent is loaded onto the mandrel, the operator shortens the overall length so that the loops assume the relaxed, shortened state of FIG. 1b. The stent is annealed at approximately 450� C. for about 15 minutes.
After annealing, the stent is cut to its final length, and the three loops at each end of the stent each receive a drop of urethane (450 of FIG. 4a or FIG. 6) to prevent unravelling.
Alternately, the stent may be knit of interlocking pre-formed sinusoidal rings, two of which 630, 632 are shown in FIG. 6b.
The stent itself is packaged into a delivery catheter as shown in FIGS. 7 and 7a-7 u. The center of the delivery catheter is a carrier tube 700, shown in FIG. 7. The carrier is a flexible tube of Pebax, a polyether/polyamide-12 resin from Atochimie with desireable flexibility/rigidity characteristics, 2.5 mm in diameter and approximately 80 cm long. The carrier has several radiopaque O-rings 704,706 mounted along the most-distal 20 cm. The preferred radiopaque material is tantalum.
The preferred process of mounting the stent on the carrier tube 700 uses several tools: a confining block, two mandrels, and a pusher. The confining block 710, shown in FIGS. 7a-c, is cylindrical, somewhat longer than the stent itself at about 20 cm, and formed of a rigid plastic with low friction characteristics, preferably delrin or nylon. The block has a drilled bore 712 of 8 mm diameter, with a 1 mm-wide slot 714 cut from the top of the outside of the block and meeting the inner bore 712 at a tangent. The slot and bore may have a guideway 718 formed, to make the following steps easier. The block may also have flats 716 milled in the bottom so that the block may be mounted in a vise. A first mandrel 720, shown in FIG. 7d, is a simple rod approximately 30 cm long and about 3 mm in diameter. A second mandrel 722, shown in FIG. 7e, has a shaft of about 3 mm diameter and length longer than the confining block, two handles 724, each about 10 mm in diameter, with center bores that friction fit on the ends of the mandrel shaft, and slots 726 of width to accommodate the carrier tube. Both mandrels have rounded ends so that they will not catch on the loops of the stent. A third tool is a pusher 728, shown in FIG. 7f, with a shaft 729 of slightly less than 8 mm diameter and a bore 730 somewhat larger than the outer diameter of the carrier 700. The bore may either be the full length of the pusher, or as shown in FIG. 7f, may have a breech hole 732. A fourth tool, which will be seen in FIG. 7q, is a soft copper wire with a silicone sheath 760 (silastic) over it. The sheathed wire is about 50 cm long, and the sheath is about 1-2 mm in diameter.
Referring to FIG. 7g, the confining block 710 is securely mounted, as in a vise 750. An operator squeezes a stent 100 flat and works it into the slot 714 preferably starting at a corner 752, and bottoms it in the bore 712. Referring to FIG. 7h, the stent is positioned in the confining block so that the proximal end 120 of the stent extends from the end of the confining block. The first mandrel 720 is inserted into the distal end of the carrier 700, and then the mandrel and carrier tube are passed through the center of the stent. The operator slides the stent to the center of the confining block, as shown in FIG. 7i. Referring to FIG. 7j, the stent is slid back so that the flared proximal end again extends from the end of the confining block. One handle of the second mandrel is removed, and the shaft 722 of the second mandrel inserted through the bore of the confining block but outside the stent. Referring to FIG. 7k, the first mandrel 720 lies inside the carrier tube 700, which in turn lies inside the stent 100. The lower portion of the stent and the second mandrel 722 lie inside the bore 712 of the confining block. Referring to FIG. 7l, the stent is slid back to the center of the confining block. The several slides forward and back equalize the distribution of the knit loops evenly over the length of the stent. The second handle of the second mandrel is affixed to the shaft of the second mandrel, and the slots 726 of the handles engaged with the carrier tube 700 and/or first mandrel 720. The operator can center the O-rings 704,706 within the stent so that the carrier will be axially positioned roughly correctly within the stent. Referring to FIG. 7m, the operator twists the handles, revolving the two mandrels about each other and winding the stent about the two mandrels. FIG. 7n shows the configuration of the stent and the two mandrels after about half a revolution. The operator continues winding until the stent is completely rolled on itself in the bore of the confining block. The operator removes a handle from the second mandrel and removes the second mandrel from the confining block. The stent is held in the wound conformation by the confining block, as shown in FIG. 7o.
Referring to FIG. 7p, the operator threads the pusher 728 over the proximal end of the carrier, with the shaft 729 distal. The pusher will be used to slowly push the stent out of the bore of the confining block.
Referring to FIG. 7q, using the pusher the stent is pushed out of the confining block by about 1 cm. The operator makes any final adjustments required to center the radiopaque O-rings within the stent. The operator wraps several turns of the copper wire and silicone sheath 760 around the exposed distal end 122 of the stent, with about a 1 mm gap between turns, and lays the bight of the sheathed wire into the slot of the confining block. Referring to FIG. 7r, the operator gradually feeds the stent out of the confining block using the pusher, and wraps the sheathed wire around the stent to keep it confined to a diameter of about 8 mm. The operator maintains a roughly uniform 1 mm spacing between wraps.
After the stent is fully bound in the copper wire 760, the pusher is removed back over the proximal end of the carrier tube and the carrier tube is pulled out of the bore of the confining block, the stent and silastic/copper wrap is dipped in U.S.P. grade dissolving gelatin, and the gelatin is allowed to set. The copper wire can then be unwrapped; the silicone sheath acts as a release surface so that the gelatin peels off the wire and remains set on the stent in a 1 mm-wide "threaded" strip, 770 in FIG. 7s, confining the stent.
Referring to FIGS. 7t and 7 u, the stent delivery system catheter 799 is completed by affixing a nose piece 772 onto the distal end of the carrier 700, and surrounding the entire assembly in a cylindrical sheath 774. Both the carrier and sheath are essentially rigid in the axial direction, so that they can be used to push or pull the catheter to position it, and so that handles 782 and 784 can be squeezed together to retract the sheath from over the stent. Also shown in FIG. 7t are the radiopaque markers 704,706 and in FIG. 7u graduation markings 778 on the sheath, both of which will be used during implantation to guide positioning. The inner pair of the markers indicate the length the stent will assume at its 18 mm fully-expanded diameter, and the outer pair indicate the length of the stent when compressed to 8 mm diameter. A guidewire 778 will be threaded through the center bore 776 of the carrier during implantation.
The process of implanting the stent is illustrated in FIGS. 8 and 8a-8 e. Referring to FIG. 8, using an endoscope 810, the proximal margin 812 of a stricture 814 is identified. The guidewire 778 is advanced across and beyond the stricture. In FIG. 8a, an 8 cm-long balloon 820 is advanced over the guidewire and inflated to 12 mm diameter, dilating the stricture to 12 mm. After examining the stricture endoscopically and fluoroscopically, a gelatin-encased stent 4-6 cm longer than the stricture is chosen. The delivery system 799 is passed over the guidewire and advanced until the distal inner radiopaque marker 704 is 2-3 cm below the distal margin 832 of the stricture.
Referring to FIG. 8c, The outer sheath is retracted by squeezing together handles 782 and 784 (see FIG. 7u), and the stent begins to deploy. The gelatin will immediately begin to dissolve, allowing the stent to expand under its own elastic restoring force. The material of the stent filament, nitinol, is chosen so that even the fairly severe deformation required to compact the stent into the delivery system does not exceed the elastic limit. Referring to FIG. 8d, after the proximal 120 and distal ends 122 of the stent have expanded and firmly attached to the esophageal wall, the catheter 799 can be removed. Referring to FIG. 8e, depending on the patient, a 12 mm-diameter balloon 820 may be inflated within the stent to ensure that the occlusion is opened to the desired patency, to affix the stent firmly to the esophageal wall, and to ensure adequate esophageal lumen size for endoscopic examination. Peristaltic contractions of the esophagus will allow the stent to "settle" into its most-relaxed configuration.
Referring to FIG. 9, in another delivery system, the stent 100 is formed of an elastic filament material that is selected so compaction produces internal restoring forces that allow the stent to return to its rest diameter after the compacting restraint is removed. The stent may be compressed onto a catheter 900 that includes a sleeve 902; the sleeve holds the stent in a relatively compacted state. The compaction is typically achieved by rolling the stent upon itself using two mandrels, as in FIGS. 7g-7 o. In other cases, the stent may be positioned coaxially over the catheter. The catheter is positioned within the lumen at the region of the tumor 202. In FIG. 9a, the sleeve is removed from about the stent, for example, by withdrawing axially in the direction of arrow 910, thus allowing the stent 100 to radially expand by release of its internal restoring force. As shown in FIG. 9b, the axial force exerted by the stent is sufficient to dilate the lumen 200 by pushing the tumor growth 202 outward, or in some cases to compress the occlusion against the lumen wall. The catheter can then be removed.
Other embodiments are within the following claims.
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|Becton, Dickinson And Company
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|Arterial graft prosthesis
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|Expandable Grafts Partnership
|Expandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft
|Mar 13, 1987
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|Endovascular stent and delivery system
|May 26, 1981
|Jul 25, 1989
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|Jan 9, 1989
|Aug 15, 1989
|Cordis Corporation
|Endovascular stent apparatus and method
|May 29, 1987
|Oct 10, 1989
|Taheri Syde A
|Method and apparatus for transarterial aortic graft insertion and implantation
|Nov 7, 1988
|Aug 21, 1990
|Boston Scientific Corporation
|Stent delivery system
|Jun 15, 1989
|May 14, 1991
|Cordis Corporation
|Non-woven endoprosthesis
|Oct 17, 1989
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|Apr 26, 1991
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|Dec 24, 1974
|Jul 3, 1975
|Sauvage Lester R
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|Catheter for producing or extending connections to or between body cavities
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|PTFE coating for metal mesh prosthesis used in artery expansion - internal and external coatings are applied to mesh and prevent thrombosis and further arterial restriction
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|Mesh composite graft
|Title not available
|Oct 30, 1981
|May 27, 1982
|Robert L Kaster
|Vascular graft
|Apr 11, 1983
|Nov 10, 1983
|Wallsten Hans Ivar
|A prosthesis comprising an expansible or contractile tubular body
|Dec 8, 1983
|Jun 21, 1984
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|Fischell Robert
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|Oct 6, 1992
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|Boston Scientific Corporation Strecker Esophageal Stent Literature, New Product Bulletin, Apr. 1992.
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|Microvasive Boston Scientific Corporation Ultraflex Esophageal Prosthesis literature, "Setting New Standards for Management of Esophageal Obstruction," May, 1992.
|Rosch et al., Radiology. Feb. 87, vol. 162. pp. 481-485.
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|Strecker, E.P., et al. "Expandable Tubular Stents for Treatment of Arterial Occlusive Diseases: Experiment al and Clinical Results", Radiology, vol. 175. No. 1, pp. 97-102, Apr. 1990.
|Strecker, E.P., et al. "A New Vascular Balloon-expandable Prosthesis—Experimental Studies and Fist Clinica Results," Journal of Interventional Radiology, 1987, pp. 59-62.
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|Filing date
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|Sep 5, 2002
|Mar 14, 2006
|Scimed Life Systems, Inc.
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|Oct 22, 2003
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|Gastrointestinal stimulation device
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|Device and method for treating obesity
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|Stent with flexible elements
|May 9, 2003
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|Radially expandable gastrointestinal stimulation device
|May 22, 2008
|Apr 9, 2013
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|Jul 13, 2012
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|Idev Technologies, Inc.
|Secured strand end devices
|Jul 13, 2012
|Jun 3, 2014
|Idev Technologies, Inc.
|Secured strand end devices
|Dec 27, 2013
|Aug 12, 2014
|Bfkw, Llc
|Bariatric device and method
|Jul 13, 2012
|Nov 4, 2014
|Board Of Regents, The University Of Texas System
|Plain woven stents
|May 28, 2014
|Mar 3, 2015
|Idev Technologies, Inc.
|Secured strand end devices
|Dec 17, 2013
|Mar 10, 2015
|Board Of Regents, The University Of Texas System
|Plain woven stents
|Sep 3, 2003
|Apr 7, 2015
|Anson Medical, Ltd.
|Flexible stent-graft
|Jul 24, 2012
|Jun 16, 2015
|Bfkw, Llc
|Bariatric device and method for recipient with altered anatomy
|Apr 23, 2014
|Oct 6, 2015
|Idev Technologies, Inc.
|Methods for manufacturing secured strand end devices
|Jun 25, 2014
|Dec 1, 2015
|Bfkw, Llc
|Bariatric device and method
|May 18, 2012
|Jun 28, 2016
|Bfkw, Llc
|Intraluminal device and method with enhanced anti-migration
|Jan 20, 2015
|Aug 9, 2016
|Idev Technologies, Inc.
|Secured strand end devices
|Jan 19, 2016
|Aug 9, 2016
|Idev Technologies, Inc.
|Secured strand end devices
|Oct 22, 2015
|Aug 16, 2016
|Bfkw, Llc
|Bariatric device and method
|Mar 5, 2013
|Jan 17, 2017
|Bfkw, Llc
|Intraluminal device delivery technique
|Aug 5, 2016
|Mar 7, 2017
|Idev Technologies, Inc.
|Secured strand end devices
|Oct 21, 2016
|Apr 25, 2017
|Idev Technologies, Inc.
|Secured strand end devices
|Sep 5, 2002
|Mar 11, 2004
|Scimed Life Systems, Inc.
|Flat knitted stent and method of making the same
|Mar 26, 2004
|Sep 16, 2004
|Scimed Life Systems
|Male urethral stent device
|May 9, 2003
|Nov 11, 2004
|Gellman Barry N.
|Stricture retractor
|Oct 22, 2003
|Apr 28, 2005
|Imran Mir A.
|Gastrointestinal stimulation device
|Apr 26, 2004
|Oct 27, 2005
|Peter Aliski
|Stent improvements
|Sep 2, 2003
|Jul 6, 2006
|Amie Smirthwaite
|Flexible stent-graft
|Aug 15, 2006
|Dec 7, 2006
|Boston Scientific Scimed, Inc.
|Male urethral stent device
|Nov 12, 2008
|Jun 18, 2009
|Vitezslav Ondracek
|Self-expanding biodegradable stent
|Feb 3, 2010
|Nov 11, 2010
|Intrapace, Inc.
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|Interstitial Therapeutics
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|Intraluminal device and method with enhanced anti-migration
|U.S. Classification
|623/23.7, 623/1.2, 623/902, 606/198
|International Classification
|Cooperative Classification
|European Classification
|Jan 19, 2001
Owner name: SCIMED LIFE SYSTEMS, INC., MINNESOTA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BOSTON SCIENTIFIC CORPORATION;REEL/FRAME:011456/0533
Effective date: 20010102
|Aug 26, 2005
|Fee payment
Year of fee payment: 4
|Nov 6, 2006
Owner name: BOSTON SCIENTIFIC SCIMED, INC., MINNESOTA
Free format text: CHANGE OF NAME;ASSIGNOR:SCIMED LIFE SYSTEMS, INC.;REEL/FRAME:018505/0868
Effective date: 20050101
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|Aug 21, 2009
|Fee payment
Year of fee payment: 8
|Oct 18, 2013
|Maintenance fee reminder mailed
|Mar 12, 2014
|Lapse for failure to pay maintenance fees
|Apr 29, 2014
|Expired due to failure to pay maintenance fee
Effective date: 20140312


text:
The European Central Bank made a record volume of cheap loans available to eurozone banks on Wednesday hoping to turn back the debt crisis, but analysts were sceptical that it was enough.
Analysts said the banks were unlikely to use the cash to buy up sovereign bonds, as governments have been pressing them to do.
And so although the cash might temporarily ease strains in the banking system, it would not provide the long-lasting boost to confidence that markets had been looking for.
In its first-ever 36-month refinancing operation, the ECB lent 489.19 billion ($641 billion) to 523 banks at a rate of just 1.0 percent for an exceptionally long period of three years.
That is the biggest amount ever, beating a previous record of 442 billion euros in a one-year auction in June 2009. It also came in at the top end of analysts' expectations for 100-500 billion euros.
Stock markets and the euro had been higher in the run-up to the auction. But but they fell back into the red afterwards as investors questioned whether the move would get to the root of the crisis and commented that the scale of requests from banks revealed the depth of underlying strains in the banking system.
Analysts at RBS estimated that about 61 percent, or 289.5 billion euros, of the total amount actually represented a roll-over of banks' shorter-term seven-day, three-month and one-year loans into three-year cash and so was effectively a recycling existing liquidity in the system.
That meant the overall net addition to liquidity was much lower at about 191 billion euros.
"The key question now is whether this net new liquidity addition of close to 200 billion euros will be used to purchase sovereign bonds, lend to the economy or pay maturing bonds," RBS said in a note to investors.
"In a deleveraging world, we doubt that this will be used in any meaningful way to buy sovereign bonds ... given the amount of scrutiny under which banks are regarding their sovereign exposures."
In addition, markets would see any earnings boost coming from this operation as a one-off and so the operation was "unlikely to have a long lasting confidence boosting impact," the analysts said.
German banks welcomed the move, saying it had "decisively improved the liquidity situation of the European banking sector."
Along with the other liquidity measures announced by the ECB last week, "these are the right and important steps to counter the danger of a credit crunch in the euro area," said the head of the German BdB banking federation, Michael Kemmer.
In addition to providing unlimited funds to banks on exceptionally easy terms, ECB chief Mario Draghi unveiled last week a relaxation of rules for the collateral required from banks as guarantees for loans and a reduction in the ratio of reserves that banks must hold at ECB, also freeing up capital.
The ECB takes such measures because although it adamantly refuses to act as the lender of last resort to governments, it has always made clear it will do so for banks.
"While the action is very important to help stabilise the situation and reduce the funding risk for the banks, it is unlikely to bring about a turning point in this crisis as the problems are much greater than those in the banking sector and has other political and economic dimensions," RBS explained.
Jonathan Loynes, chief European economist at Capital Economics, said that while the allocation was much bigger than anticipated and might help to address recent signs of renewed tensions in credit markets and support bank lending, "we remain sceptical of the idea that the operation will ease the sovereign debt crisis too."
There has been much speculation that governments have been pressing banks to use the ECB cash to buy up large volumes of sovereign debt of the troubled eurozone countries.
Many eurozone governments are having great difficulty in borrowing money on the bond market but need to sell huge amounts of bonds next year to fund their mountains of accumulated debt.
ING economist Martin Van Vliet calculated that the amount the ECB was making available was nearly one and a half times the bond issuance programmes of Spain and Italy in 2012.
But Loynes at Capital Economics pointed out that banks have generally been cutting their exposure to sovereign debt in recent months and would be reluctant to invest the ECB cash in what they continued to view as risky assets.
Christian Schulz, senior economist at Berenberg Bank, was similarly sceptical whether the auction would also help to restore confidence in sovereign borrowers in the eurozone.

subset: commoncrawl


text:
Start-up since 1969, earliest video adopters, and incubator in the utopian 1970s; indy video pioneers, art video innovators, and pirate TV broadcasters.
Video from the MAYDAY Vietnam War protest – on demand!
For personal viewing and academic purchase.
Authentic "The Vietnam War" counter-program from the counter culture! Or maybe it's Episode 11.
(66 minutes, 1971/2017)
Feel the fervor of 1970s activism! Action-packed, emotionally charged. 30 young indy filmmakers cover the country's largest civil disobedience peace protests from inside. Rated R: Radical politics, Violence, Language. A Videofreex and Mayday Video presentation. View trailer and full video.
– Videofreex Pirate TV streaming channel is on the air!
(well, actually it's on the web!)
– "Here Come the Videofreex" for schools / streaming
Feature documentary, produced and directed by Jenny Raskin and Jon Nealon, about the activist and artistic escapades of these video pirates in the utopian 1970s. Recently screened theatrically in more than 50 cities, the movie is now available for academic acquisition. Coming soon: streaming on-line!
Meet the Videofreex
Videofreex was one of the pioneer production groups that formed when consumer video was first introduced in the late 1960s. Over their nine-plus years together, they produced thousands of videotapes, installations and multimedia events and trained hundreds of videomakers in the brand new video medium. Many of the videos are now archived at Chicago's Video Data Bank.
They went on to found the country's first pirate TV station and capture some of the most up-close and memorable records of the social movements of the 1960s and 70s.
The Videofreex Archive, established in 2007, isn't the only way to observe the group's early videotape coverage of this unique era of social and cultural change. Two recent books, the documentary Here Come the Videofreex, and a museum exhibit continue to tell the tale.
What they say about the Videofreex
The Freex are the most production oriented of the video groups… in terms of finished, cleanly edited, high quality tape, which is generally quite entertaining, the Videofreex are clearly the best.
– Michael Shamberg, Guerilla Television, 1971, Holt, Rhinehart & Winston
and NOW:
Self-described "electronic Johnny Appleseeds," the Freex were precursors for… video journalism, reality TV, music videos, Saturday Night Live-style sketch comedy, crowd sourcing, and art collectives.
What we take for granted, they pioneered.
– Cliff Bellamy, The Herald-Sun


text: In Travel/ Travel Talk Get Going! 4 Simple Things to Do to Prepare for Your Next Vacation March 6, 2017 By Paige Wunder Preparing for a vacation is almost as exciting as actually going on it – the anticipation is incredible! Plus, we all know that it's a lot more fun packing to… Continue Reading →


text:
VideoHive Organic Glitches Logo Reveal 8720110
After Effects Project \ Logo Stings \ Abstract
Included \ Project \ Reveal \ Details \ Higher \ Required \ Plugins \ Customizable
After Effects Project - Organic Glitches Logo Reveal 8720110 by bluemotions @ VideoHive
After Effects Project \ Logo Stings \ Abstract
Organic Glitches Logo Reveal is after effects project. It's perfect for any cinema title, corporate, film intro, YouTube Channel, your web, movie and so one… It is very easy to customize. Just drop your logo or text into Logo place holder compositions and edit your text with text layer. All customizing is very user friendly. Any way you can get in touch with me via my Page. Audio not included. You can buy it here
Details of project
CS5 and higher
1920×1080 full HD
Frame rate: 25
Duration 15 seconds
Well organized and easily customizable
No Plugins required
Video help file included
Audio not included you can download it audiojungle
After Effects Version: CS5, CS5.5, CS6, CC; Resolution: 1920x1080; File Size: 140mb.
Keywords: cinematic, distortions, fast, glitch, identity, intro, light, logo, logos, organic, reveal, teaser, text, titles, twitch.


text:
Lyme disease diagnosis & treatment are highly controversial and a very big deal.....for patients and in general. I've seen a number of Lyme disease hubs here when I've searched for it, but haven't seen a hub topic area. I posted a hub just now and regretted not asking this sooner, since my disease was missing from the list.
Apologies in advance if I'm posting this in the wrong place.
Hi RMM,
I've just added it to our list of Topics. You can now find it under Health> Diseases, Disorders and Conditions> Lyme Disease. It will take up to 24 hours for the new Topic Page to show up, but you can start putting Hubs under the new Topic now.
Oh, thank you! This makes me very happy. Lyme patients are very active in fighting for awareness, and several have written great hubs here, it appears. So 'we' Lymies like seeing Lyme recognize any and everywhere.
Thank you!
I'm moving my newest hub there now : )
I didn't have to, it was there already---thank you!
by larryfreeman8 years ago
As I mentioned in a previous announcement, categories are coming to HubPages.Here is the planned breakdown of the Health Category:Health (Top Level)* Aging & Longevity* Cancer* Children's Health* Death & Grief*...
by donotfear7 years ago
Knew I hadn't been my old self, darnit. Dragged out, muscle fatigue, exhaustion, inability to sleep. Finally had blood tests done. Doc said I was positive for one of the antibodies of Lyme. I gotta find an...
by Simone Haruko Smith5 years ago
We all encounter diseases, disorders, and conditions some way or another- usually firsthand, though even more frequently through friends, coworkers, and family members. What have you learned from your experience that...
by Little Nell6 years ago
I was doing some internet research following a suggestion by my husband's doctor that he should have a blood test for Lyme Disease. I came across a research paper that had carried out blood tests on children...
by donotfear5 years ago
If you don't know me, I had Lyme disease 2 years ago and still suffer the after affects: aching joints, muscle twitches and letter reversal issues. It's my responsibility, as a survivor and activist, to warn...
by Aya Katz8 years ago
Should we try to eradicate all infectious diseases, so that children born in the next generation never have to suffer from disease at all, not even the common cold? Or, does surviving a childhood disease confer health...
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terms of use privacy policy (0.24 sec)


text:
In Today's fast culture most students has working Parents and can not spend enough time to be up to date about their child school activity, events, exams, results etc. By Developing "eSchoolWorks" we reduce communication gap between School - Teachers - Parents and uplifting you to the new technology era.
We are constantly updating this application to make "eSchoolWorks", the best Next Generation Institute Management Solution form small classes to Major Universities.
"eSchoolWorks" has unique and easy accessible user interface that anyone can excess this application easily.
Its not working


text:
The collection will consist of six designs.
Moncler, a luxury retailer known for its down jackets, is launching a line of eyewear.
The collection will be produced through a licensing deal with Marcolin, according to a Women's Wear Daily article published by the Los Angeles Times.
The collection, to be called Moncler Lunettes, will consist of six sunglass designs.
The eyewear will sell in the $290 to $560 range, according to the article.
Read more at the Los Angeles Times


text:
No, I haven't been updating. Not because people don't read it, but because I procrastinate.
P. and I closed on the house and then spent three weeks removing wallpaper with a water/fabric softener mixture. For the rest of my life, if I get a whiff of generic Mountain Fresh fabric softener, I will think of the three weeks I spent exhaustively working on the house, all the while working 40+ hours a week, taking care of the apartment, eating, kind of sleeping, etc.
Then we washed the walls. Then we sanded.
Sanding sucked.
But we had a house. It was still pretty cool outside, being March in Indiana, so we got to try out the furnace. Other than that, those three weeks are a blur to me now.
We're all moved in now and are enjoying the summer. My cousin D. got a job here and stayed with us for about a month before finding an apartment, and that was fun. P.'s best friend B. also just moved back to town, after working in Madison for two years after college, and he's living in our garage. It's funny what I miss now that my cousin isn't living with us. Oddly enough, I miss cooking for him all the time. When B. moves out, it'll be weird having the whole house to ourselves. I don't know what we'll do with our time... though, D. and B. will still live in town.
... delicately trying to put fires out at work...


text: Catherine Maher Ulster Bank Catherine Maher is a bank official at Ulster Bank College Green with 19 years experience in financial services spanning Technology, Retail and Business Banking. She is a long standing member of The Institute of Banking. Catherine holds a BA from UCD, along with QFA and Certificates in Customer Relationships & Service, Front Line Management and Banking Operations from the Institute. Catherine is a trustee/director of the Ulster Bank Pension scheme and the Ireland deputy on the RBS European Employee Council. Back to Council members


text:
Welcome to the web site of the Butte Local Agency Formation Commission (LAFCO).
Those interested in LAFCOs throughout the State of California may wish to visit the California Association of Local Agency Formation Commissions (CALAFCO) web site.
NEW Public Hearing Notice - 17-10 - City of Chico - Burnap Avenue Annexation No. 06
Butte County Public Health Dept. Letter dated Sept. 28, 2017 Re: Mosquito borne diseases.
Public Review Draft Municipal Service Reviews and Sphere of Influence Plans for the Mosquito Abatement Districts in Butte County. A public hearing for review of these documents is scheduled for LAFCo's August 3, 2017, meeting. Click here for the public hearing notice.
Enterprise System Catalog - SB 272
What is LAFCo? Brochure. An introduction to Local Agency Formation Commissions.
50 Years of LAFCOs - A Guide to LAFCOs (Third Edition, December 2013)
Guide to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000


text:
Earth's crammed with heaven,
And every common bush afire with God;
But only he who sees, takes off his shoes,
The rest sit round it and pluck blackberries,
And daub their natural faces unaware.
Mundane: common place
God is found in the common places. He walked in the cool of the day. He was found in the still small voice. He rides on the wings of the wind. His glory is etched in the drifting clouds above. Present in the fragrance of a flower.
The mundane moments of daily life are ripe with His presence, doing the dishes, driving to work, nursing the baby, waiting on tables, walking in the woods. The Celtic culture nurtured and facilitated a sacramental approach to life. Not only recognizing but expecting Gods presence in the ordinary routine of life.
The Celt's recognized and celebrated the sacred in the common place. They anticipated and invited the presence into everyday activities such as setting the fireplace, milking the cow, churning the butter, ploughing the fields.
"I AM smooring the fireAs the Son of Mary would smoor Blest be the house, blest be the fire, Blest be the people all." (a blessing for preparing the night hearth)
"The guarding of God and the Lord be yours... Traveling meads long and grassy...Be the bright Michael king of the angels Protecting, and keeping, and saving you." ( a portion of a herders prayer)
When we begin to recognize and acknowledge the presence in our mundane daily activities, we then begin to take off our shoes in the presence of every common bush a fire with God. All activities become sacred and sacramental, all ground holy. Every moment becomes pregnant with possibility and a live with wonder. And the simplest common activities can become "spiritual practices'.
living water reprint from 2009


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Share your Frugalista recipes!
Posted by + Show Post
Replies (281-285):
by Bronze Member on Jun. 25, 2013 at 6:47 PM
Brownies: can of pumpkin, box of devil's food
1 mom liked this
Bump. I am going to be back to write all these down. Wish I had a printer. Oh wait, I do have a printer. Had one for 3 months now. Dh hasn't hooked it up yet. I do not know how or I would lol. I guess I have to do by hand. Good post though.
Posted via mobile.cafemom.com
by New Member on Jul. 16, 2013 at 3:32 PM
I'm gonna try this one soon!
Quoting SlightlyPerfect:
Brownies: can of pumpkin, box of devil's food
by New Member on Jul. 16, 2013 at 3:33 PM
Ramen and grilled cheese/pbj is always a winner in our house.
by Rhonda on Aug. 29, 2013 at 5:00 PM
By bullwinkle on March 13, 2004
Photo by AllThingsMamma
- Prep Time: 0 mins
- Total Time: 1 hrs
- Servings: 6
About This Recipe
"This recipe is from the back of a Kraft Cheese wrapper that I have had forever. Our favorite add-ins are chopped ham, chopped broccoli and mushrooms. Prep. time is not included."
- 1 1/2 cups shredded cheddar cheese
- 2 tablespoons flour
- 1 cup milk
- 3 eggs, slightly beaten
- 1/2 cup grated parmesan cheese (optional)
- 1 (9 inch) unbaked pie shells
- 1 dash pepper
- Toss cheddar cheese with flour.
- Add milk, eggs, and parmesan cheese (if using), and pepper; mix well.
- Pour into unbaked pie shell.
- Bake at 350* for 50-60 minutes or until set.
- Variations: Add 10 oz. pkg frozen chopped broccoli, cooked and drained and 4 oz. can sliced mushrooms, drained.
- Add 1 cup finely chopped ham, 1/4 cup finely chopped green pepper, and 1/4 cup chopped pimentos.
- Add 8 slices bacon, crisply cooked and crumbled and 1/4 cup chopped green onions.
- Substitute 1 1/2 cup Mozzarella cheese for the cheddar cheese.
- Add a 4 oz, pkg. sliced pepperoni, 4 oz. can sliced mushrooms, drained and 1/4 teaspoon oregano leaves, crushed.
- Top with thin tomato slices just before serving.
- Add 1/2 lb. bulk pork sausage cooked and drained; 10 oz. pkg. frozen chopped spinach, cooked and well drained; 1/4 cup chopped onion and a dash of garlic powder.
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You must be a member to reply to this post.


text:
Move over Hustler Club - the hottest New Yorkers work in media.
Facebook and the digital communications firm MediaVest USA top a list of Big Apple firms with the most attractive employees, according to data compiled by the dating app Hinge.
Hinge reviewed 18,000 profiles to determine which users most often get "favourited" - or named hot by other users - to rank companies according to "most desirable" employees.
It found that men working for Facebook were named attractive 38 per cent of the time, placing number one on a list of hot-guy-boasting firms such as ESPN and JP Morgan Chase.
Women at MediaVest USA were ranked most desirable, pulling in the virtual thumbs up 57 per cent of the time and beating out stylish companies such as Victoria's Secret and Tory Burch.
Hinge is a social media dating app that connects users with friends' single friends. Users can see each others' place of employment.
"The inquiry at the heart of these findings is whether attractive people are more likely to be hired by these companies - or that by working at these companies, people become more attractive to others," a representative for the company said.
"We think it's a mixture of both."
The finance company Brown Brothers Harriman placed second on the list of most attractive firms and MTV ranked third.
Women at the public relations firm Weber Shandwick placed second and Victoria's Secret placed third.
Bloomingdales, Chanel and Bergdorf Goodman also made the list for women. Paul Weiss, Apple Inc and Lenox Hill Hospital made the list for men.
1. Facebook
2. Brown Brothers Harriman
3. MTV networks
4. JP Morgan Chase
5. Digitas
7. Paul Weiss
8. Apple Inc
9. Lenox Hill Hospital
10. McKinsey and Company
1. MediaVest USA
2. Weber Shandwick
3. Victoria's Secret
4. Chanel
5. Tory Burch
6. Bloomingdales
7. Ralph Lauren
8. Sacks Fifth Avenue
9. Bergdorf Goodman
10. Facebook


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This casebook takes a "collaborative" approach to legal interviewing and counseling. It suggests that clients will be best served when lawyers and clients work together to resolve problems. Under a "collaborative decision making" model, the client controls most decisions, but the lawyer structures the process and provides advice in a manner that is likely to yield wise decisions.
This book explores the major approaches to legal interviewing and counseling and outlines the available research on the psychology and the sociology of clients and lawyers. The Counselor-at-Law: A Collaborative Approach to Client Interviewing and Counseling explores communication and decision-making theory, memory and recall, power and submission, personality types, and ethics. From this base, the authors construct a model of interviewing and counseling based on the techniques that are effective in real-life encounters. They also include the Myers-Briggs Type Indicator (MBTI) and explain how it can be used to improve a lawyer's communication, interviewing, and counseling skills. This casebook provides students with a template for effective legal interviewing and counseling. The authors posit that the most effective legal counselors are the ones instilled with respect for the client, cognizant of building rapport, aware of the psychological dynamics of the lawyer-client relationship, and equipped with technical communication skills to gather information without sacrificing rapport.


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VideoHive Event Promotion 2450049
After Effects Project \ Video Displays \ Special Events
After Effects Project - Event Promotion 2450049 by HappyCreative @ VideoHive
After Effects Project \ Video Displays \ Special Events
After Effects Version: CS3, CS4, CS5; File Size: 40.2mb; Requires Plugins: No; Resolution: 1920x1080.
Promote your next event with this energetic video. Fast moving, hard hitting and smooth graphics combine to show off your images/video and message. Can be used for a wide variety of marketing campaigns, especially music concerts or festivals.
- After Effects CS3 and higher.
- No plug-ins needed.
- Resolutions of 1920×1080 and 1280×720.
- Handy help file with screenshots
- Just drag and drop in your content and render!
- Change colors easily.
Combine the video with this poster by Indieground as part of your promotional campaign. Special mention to Indieground for inspiration.
Music track: 'Speed of Fire' by Soundroll can be found here . Font used can be found here.
(Images of musicians not included, but PhotoDune links included in help file.)
Keywords: club, concert, dance, energy, entertainment, event, festival, grunge, music, poster, promo, promotion, rock, special, stage.
Download Link


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OPEC has made a surprising choice with its newest member: a country that consumes about twice as much crude as it pumps. Indonesia will rejoin the OPEC as its 13th nation next month, almost seven years after suspending its membership. Source: Bloomberg
GEFIRA provides in-depth and comprehensive analysis of and valuable insight into current events that investors, financial planners and politicians need to know to anticipate the world of tomorrow; it is intended for professional and non-professional readers.
Yearly subscription: 10 issues for 225€
Renewal: 160€
The Gefira bulletin is available in ENGLISH, GERMAN and SPANISH.
Rosneft had signed an oil supply deal with CEFC China Energy Company Ltd, Russia's largest oil producer said in a regulatory filing on Monday. Access to Russian crude could help China, the world's top crude importer, in its ambition to create a globally integrated oil supply chain. Source Reuters
European stocks slipped and safe haven government bonds were in demand early on Monday as the collapse of coalition talks in Germany served as a reminder of political risk that still runs as an undercurrent in Europe. Source: Reuters
Bitcoin topped $8,000 for the first time, as investors set aside technology concerns that had derailed its advance earlier this month. It's now up more than 700 percent this year. Source: Bloomberg


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Newegg.com - A great place to buy computers, computer parts, electronics, software, accessories, and DVDs online. With great prices, fast shipping, and top-rated customer service - once you know, you Newegg.
If you are reading this message, Please click this link to reload this page.(Do not use your browser's "Refresh" button). Please email us if you're running the latest version of your browser and you still see this message.
Newegg.com - Computer Parts, Laptops, Electronics, HDTVs, Digital Cameras and More!
Sold and Shipped by Newegg
NVIDIA GeForce 210
Enjoy Digital Domination
Because life is what happens when you're not gaming, you need a graphics card that helps you get your work done faster - so you can get back to your game! The XFX (NVIDIA® GeForce® GT 220 / Geforce® 210) graphics cards deliver digital domination no matter what task your tackling. Clean up and convert video, then put it on your iPod in minutes. Watch DVDs in "looks like HD" quality. And, most important, play your favorite games with 10 times the performance of any Intel integrated solution. Now that's digital domination. That's XFX.
World Class Graphics Performance Plus PhysX
Experience world class graphics performance in the hottest games of this season and bring your games to life with NVIDIA® PhysX™ effects for massively destructible environments and ultra-realistic physical interaction in games such as Mirror's Edge by Electronic Arts Inc.
GPU-Accelerated Video Transcoding, Image Editing and HD Video Playback
Accelerate video transcoding of digital movies to your iPod, PSP, or Zune up to 10X faster than a CPU. Experience super fast, silky smooth image processing with full GPU acceleration support for Adobe® Photoshop® CS4.
Your request will be processed within the next 24 hours.
Please add "firstname.lastname@example.com" to your address book to ensure delivery.See Today's E-Blast Promo
Some manufacturers place restrictions on how details of their products may be communicated.
Some manufacturers place restrictions on how details of their products may be communicated.
Some manufacturers place restrictions on how details of their products may be communicated.


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DETROIT — Nick Swisher is returning to pinstripes.
Sort of.
Swisher began working out at the Yankees' minor-league complex Saturday morning and will sign a minor-league deal with the club this week, the team said, pending a physical.
The intent will be for Swisher, limited to 173 games the last two seasons because of injury, to be stored at Triple-A Scranton/Wilkes-Barre as potential depth at first base, the outfield and designated hitter.
"When he was here, he was extremely productive and loved playing here," Joe Girardi said after the Yankees' 8-4 victory over the Tigers on Saturday.
Swisher, 35, played for the Yankees from 2009-12, posting a .268/.367/.483 slash line with 105 homers and 349 RBIs in that time. He became a free agent after the 2012 season and the Yankees did not make an effort to re-sign him. Swisher ended up signing a four-year, $56-million deal with the Indians.
Knee problems beset him almost immediately, though he did manage to play 145 games in 2013. Swisher was traded last season to the Braves, who released him late in spring training this year.
Swisher, who had both knees operated on during the last two seasons, took batting practice and worked out at first base Saturday morning in Tampa. He is slated to be back at the complex Sunday.
"The fact they let me come out here and work is great," Swisher told The Associated Press after Saturday's workout. "It keeps me in the game, keeps me going strong, and I appreciate that. This place is like family . . . I still feel like I can do this."
The Yankees also have Chris Parmelee in the minors as first-base depth should something happen to Mark Teixeira. But Parmelee, 28, is not a true first baseman, having played only 139 games at the position in his major-league career. Swisher has been primarily an outfielder in his big-league career but still has played in 483 games at first base.
Depending on Swisher's health and production in Triple-A, he also could bump Aaron Judge as the first option in rightfield should something happen to Carlos Beltran. Of his 1,481 games in the majors, 749 have been at that position.
"We believe in having depth in our organization," Girardi said. "Swish was a good player and has been a good player for a long time, so if one of our guys was to go down, we don't necessarily have a true first baseman, and Swish is a guy that can do that or play the outfield."


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Start buy-back programme Nutreco shares on 8 February 2013
February 8, 2013 - London
Nutreco announces that its share buy-back programme for 700,000 shares (approximately €45 million) will start on 8 February 2013. The share buy-back programme will be carried out in order to cover future stock dividends and employee stock plans.
The share buy-back programme will be carried out in accordance with the mandate given by the Annual General Meeting of Shareholders on 27 March 2012. Within the limits set at that meeting, the maximum price to be paid for the Nutreco shares will be 110% of the average closing price of the last five preceding trading days on the NYSE Euronext Amsterdam stock exchange.
The share buy-back programme will ultimately end on 28 March 2013, unless the maximum number of 700,000 shares has been repurchased prior to that date. In that case the programme will end on the date on which this maximum is reached and the early termination will immediately be disclosed.
Nutreco has mandated ING Corporate Finance to undertake the share buy-back programme. ING Corporate Finance makes its trading decisions with regard to the number of shares and the timing of the purchases, independently of Nutreco. This means that the share buy-back programme may be continued during closed periods.
Nutreco will provide updates on the progress of the programme by means of weekly press releases.
End of press release
Nutreco is a global leader in animal nutrition and fish feed. Our advanced feed solutions are at the origin of food for millions of consumers worldwide. Quality, innovation and sustainability are guiding principles, embedded in the Nutreco culture from research and raw material procurement to products and services for agriculture and aquaculture. Over 100 years of experience brings Nutreco a rich heritage of knowledge and experience for building its future. Nutreco employs approximately 10,000 people in 30 countries, with sales in 80 countries. Nutreco is listed on the NYSE Euronext stock exchange in Amsterdam and had annual revenues of €5.2 billion in 2012.
For more information:
Jurgen Pullens, Director Investor Relations
Telephone: +31 (0)33 422 6134
Mobile: +31 (0)6 5159 9483
E-mail: firstname.lastname@example.com
The owner of this announcement warrants that:
(i) the releases contained herein are protected by copyright and other applicable laws; and
(ii) they are solely responsible for the content, accuracy and originality of the
information contained therein.
Source: Nutreco via Thomson Reuters ONE


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Stock Graphic - Commercial License One clip art set 265950 by LABFcreations @ CreativeMarket
File Size: 49.86 KB; Requirements: Adobe CS1+.
Commercial License No Credit For One Clip Art Set or Collection
You must purchase this commercial License No One Clip Art to use my designs to create (other than personal use), sell &/or distribute.
I offer commercial use of all my graphics, which means you can use my graphics on your blogs, sites, Facebook pages etc. without having to credit me. Usually if you are to use my clip art in an item that you make for sale you must give credit to me.
This license allows you to use one clip art set in an item or items for sale without having to credit me in any way.
You will receive a PDF license agreement that you should keep stored on your computer. You can purchase this along with another item in your basket or at a later stage. I may ask you to provide me with your order number for you to be able to prove that you have bought a license from me for each clip art set used.
It allows you to use one set of graphics in an unlimited, royalty-free way with no credit to "'LABFcreations" necessary.
You can use all my digital products to create new products for sale e.g. cards, stationery, digital collage sheets, templates ЁC flattened or editable, prints, iPhone cases, fabric, websites, banners, blogs and such like items.
Sell created items on third party sites such as CafЁ¦ Press, Zazzle, or Teachers Pay Teachers, Spoonflower.
Copy or transfer to anyone else.
Re-sell these items in their original digital form as they are sold as digital files by ''LABFcreations". This also includes using my graphics in its current form as part of a digital scrapbook kit.
If you want to use my graphics in an item and create for sale without purchasing a license,no problem. When you list an item for sale, in the item description you MUST include credit.
I have used graphics from 'LABFcreations' (or words to that effect.)
Still have questions? Feel free to message me, I am happy to help ! :)
Thank you!
Buy Now ~ $10
Commercial License One clip art set.
by LABFcreations
Keywords: commercial use, commercial license, one clip art set, graphic design, clip art, watercolor clip art, royalty free, labfcreations, extended license, extended commercial use, illustration and painting, sale.


text:
I love looking at old menus and their lists of cocktails, some of which are still fairly popular, some that pop up at 'speakeasy' style craft bars, and some that nobody's heard of in decades... often for good reason. What are some cocktails you remember or have even tried that nobody drinks anymore?
For example, I was at a terrific old German restaurant in Massachusetts this weekend, and an old menu in the restroom listed their house cocktail (.85!) as The Student Prince: Dooley's Cream and XO.


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While it is essential not to harp on your past, it is likewise extremely important to reflect on your it and exactly what is has to do with how you are today. Wrongs from your past can help you move and settle things on and find out about how to deal with your existing situation.
If you are stuck in a task you hate, have no objectives, or feel normally miserable with your life, only you can make changes to improve. By requesting for support and setting sensible goals, you can begin turning your life around. Keep in mind the suggestions in this article so you can work on individual development and feel much better.
Company ought to be central in your life. Not just will being organized make you feel accomplished, but it will likewise increase your confidence. The anxiety triggered by poor organization will certainly likewise be relieved. Including structure to your life will certainly bring you peace.
Believe it or not, laughter will contribute to your individual development! If you feel that you have much better things to do with your time, you are wrong. Stop and sit for an hour to watch something that is going to make you laugh.
To manage loneliness, make certain to go out every day and interact with somebody. Stop shopping, banking and doing business with large, impersonal store. Instead, go to smaller sized, local shops where you will certainly experience the very same individuals on a regular basis. Discover their names and inquire about them. Interested individuals are interesting and make good friends!
Believing positively instead of adversely helps you stop concentrating on the unfavorable and attain favorable outcomes in all features of your life.
Individual development involves setting goals in order to feel happier and healthier. Making goals that are too easy or too challenging can trigger unneeded stress and make you less likely to follow with, lowering any development that you would be able to make in your self-help program.
Personal development is the power to make modification in your own life. It is something that numerous strive to accomplish, and some end up being extremely effective since of making modifications. Make prepares for monetary, professional and individual fall-outs that could occur but do not dwell on the reality that they can occur.
The best frame of mind is extremely inspirational as long as you filter the unneeded. Numerous problems will present themselves in your every day life. You must take the time to sort with your daily life and categorize concerns and concerns as irrelevant or relevant. Clearing yourself of self-doubt by minimizing unneeded tension will certainly increase your confidence and drive.
Refrain from drinking liquor. You have most likely heard that liquor is a downer. This is real. It can also interfere with any medications you may be taking. It can trigger you to feel even worse, become ill, or maybe even overdose. It is constantly the most ideal to steer clear of alcoholic beverages if you are feeling miserable.
Value all the choices that you make. Turn those options into possibilities to enhance who you are. The more we value, the even more we will accomplish. If something is important to you, you will be eager to do everything you can to ensure you keep that in your life.
We all aim to be a better version of ourselves. You owe it to yourself to look at these concepts about developing yourself if this is the case for you. Whether it is an effort to carry out better at work or be a more personalized person in your social life, you will find some ideas right here to assist you develop a much better you.


text:
William A.
Columbus, OH, 43220
Joined on February, 2011
Gender: Male
Average Rating:
Any day at any time
Lives Near:
Can Meet:
Up to 1 hour away for a flat fee
EducationBA Psychology, BA Criminology - The Ohio State University '10
ExperienceRecent graduate looking to help further someone's education, while utilizing my college degrees.
3.8 cumulative GPA upon graduation.
Dual degrees in Psychology and Criminology
5+ years in Latin
Played violin and saxophone thru elementary, middle, and high school.
HobbiesI've done a good deal of traveling overseas, so would consider myself well versed in various cultures, as well as various learning styles. Looking to put my degrees to work, and better someone's education.
Preferred Subjects
Biology, Latin, English, ACT, GED, SAT, History, Writing, Psychology, Study Skills, Social Studies, Organization, Music
Inquire about this tutor
The tutor will respond if they are available/interested.


text:
Follow-Up to 'Purpose Driven Life' to Hit Shelves in November
Megachurch Pastor Rick Warren will be releasing the follow-up to his bestselling Purpose Driven Life in November through Christian publishing giant Zondervan, according to a recent announcement.
The Hope You Need, which Warren has been working on since July, will invite readers to "plug into the unparalleled power that exists within the words of the best-known prayer on the planet," the Lord's Prayer, through which Jesus taught his disciples to pray.
"With his classic approachability, passion and candor, Warren provides helpful insight and much-needed inspiration in these tough times regarding every area of life that God tells us turn over to Him, including fear, resentment, worry, guilt and loneliness," Zondervan stated in their announcement.
Though Warren's original plan was to release the book next year on Easter Sunday – the 30th anniversary of his Southern California megachurch – the increasingly influential evangelical leader noted that many individuals, including his own congregation, are right now feeling the pinch of the recession, and are in need of hope.
"My motivation as an author has always been the message, not the market and I have been waiting for the right time, until I had something to say that would speak to the personal and societal problems we all face, " he explained.
Adding to Warren's comments, Zondervan CEO Moe Girkins said, "Gaining insight and meaning to the way Jesus prayed to His Father no doubt will inspire all of us."
"We are thrilled to partner once again with our long-time friend to bring this timeless and timely message to everyone," she said.
According to Zondervan, The Hope You Need will release simultaneously in English and Spanish worldwide on Nov. 17.
The book draws its inspiration from an eight-part sermon series Warren taught on the Lord's Prayer at Saddleback Church in Lake Forest, Calif. earlier this year.


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English 11 B. Narrative Writing Fluencies . Narrative #1. Can you swim? Who taught you? How old were you when you learned? Tell the story of learning to swim, or if you cannot swim, what it is like not being able to. Narrative #2.
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
Narrative Writing Fluencies


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St. Paddy's Day is celebrated usually for a week or so around this time. However, Sunday, March 17 is the day, so we'll offer up a pair of recipes based on kale, a healthy green we all should be eating more of.
Kalecannon is simply colcannon, the dish of mashed potatoes, leek or onion and cabbage that is an Irish favorite.
I didn't know this until recently, but colcannon was traditionally used for predicting marriage on Halloween. Any unmarried woman who found a charm buried in the dish of colcannon placed the charm into a sock with a couple of spoonfuls of colcannon added. The (we'd think very gooey) socks would be placed on the handle to their front doors — and the first man to enter the house was who they would marry.
This recipe for Kalecannon is just as good as the original. If you want to serve it in a sock, go for it. Otherwise, it's awfully good served in a heated bowl with a little butter melted on top. (Recipe link below)
The second recipe is one that has been around for quite some time, though it has come into its own over the past couple of years. I first heard of Kale Chips at a cooking class at Central Market, where cook and author Deborah Madison described it to us. At that time, about 10 years ago, I found it interesting to think about, but not at all appealing enough to make me want to prepare it.
That has changed. Now, we've heard from just about every health expert in the world that kale is a superfood. And, may of us want to pay attention. In this recipe, the leaves are lightly rubbed with olive oil, then crisped in the oven and finally sprinkled with a seasoned salt and a little lemon or lime juice. It's (almost) as good as popcorn. OK, almost almost as good. And certainly good for you. (Recipe link below)
Kale Chips with Chili Powder, Lemon and Sea Salt


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Award date:
Jun 5, 2015
Award amount:
Organization name:
KindHeart, Inc.
Principal Investigator:
Grubbs, William A
Grant program category:
Business Financing
Grant program name:
Strategic Growth Loan
Research Triangle
KindHeart, of Chapel Hill, is developing animated porcine-organ surgical simulation devices to assist in the testing of medical devices and in the surgical training of medical professionals. The company received a $250,000 loan to manufacture its surgical simulators in preparation for sales and marketing to its medical customers.
Fiscal year:


text: So after I finally got my new droid, I turned the phone over and noticed a nice DENT in the speakerphone grill...sound familiar! After trying my best to remove the dent from the delicate sticker, I was still not happy with the results. So after searching the net looking for a replacement sticker with no success, I decided to fix this problem myself. After much consideration and trial & error, I discovered that the best material to use to replace the sticker was solid brass mesh. It has to be just the right MPI (mesh per inch) not to interfere with the sound quality of the speakerphone. And it also has to be thin enough to fit underneath the battery cover without raising it more than a mm. Here are the results... I had to buy the material in bulk, so if anyone is interested in a cheap fix to "droid dent", feel free to hit me up at elijah(dot)357(at)hotmail(dot)com. This isnt rocket science, anyone can fix this problem themselves. Its finding the right materials thats the challenge. Bronze mesh looks better, but it turns dark really fast...brass doesn't tarnish. Stainless is another possiblity, but the brass looks closer to factory in my opinion? Anyway... I hope this info helps those who are OCD like myself when it comes this issue. I wish motorola would have done this to begin with. Outside of this small cosmetic problem, the droid is awesome!


text:
Seventeen Turkish soldiers have been killed after their helicopter crashed in southeastern Turkey due to bad weather.
The Sikorsky helicopter crashed on Herekol mountain, in the Pervari area of Siirt province. The victims were members of the country's gendarmerie special forces and there were no survivors on board, the province's governor said.
The Turkish military has been carrying out operations on the mountain recently to flush out militants from outlawed separatist group the Kurdistan Workers Party, who have hideouts there.
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I DON'T blame the kettle drums—they are hungry.
And the snare drums—I know what they want—they are empty too.
And the harring booming bass drums—they are hungriest of all.. . .
The howling spears of the Northwest die down.
The lullabies of the Southwest get a chance, a mother song.
A cradle moon rides out of a torn hole in the ragbag top of the sky.
Poems are below...
Provide your analysis, explanation, meaning, interpretation, and comments on the poem Blizzard Notes here.


text: In the 20 years since publication of John Sloboda's landmark volume The Musical Mind, music psychology has developed as a vibrant area of research - exerting influence on areas as diverse as music education and cognitive neuroscience. This new book brings together 24 selected essays and reviews written by an internationally acclaimed authority on music and the mind. Chapters are grouped into four main areas of study. These are, cognitive processes (including music reading, memory and performance), emotion and motivation, talent and skill development, and music in the real world (including functions of music in everyday life and culture). The book ends with a newly written chapter on music psychology and social benefits. The books brings together in one place a range of influential writings, whose links to one another provide a compendious overview of a subject that has come to maturity during the author's career, a career which has significantly contributed to the development of the field.


text:
Hawk-Woods VL-DC7 V-Lok 15mm-Bar Adaptor
This product is not currently in stock, but is usually available from our supplier within 5-7 days of your order being placed.
Free delivery also available - more info
The Hawk-Woods VL-DC7 V-Lok 15mm-Bar Adaptor allows users to power a variety of devices from one V-Lok battery, using either the 4 x Hirose (4-pin) or the 1 x Power-Con (D-Tap) connections. It provides nominal battery voltage, offering versatile, dependable power for a wide range of applications. It is compatible with the DC-15A and DC-19A rod-mounting clamps. More
1x Hawk-Woods VL-DC7 V-Lok 15mm-Bar Adaptor Sorry, there are no more available.
Key Features: Hawk-Woods VL-DC7 V-Lok 15mm-Bar Adaptor
- Nominal Battery Voltage
- 4 x Hirose (4-pin) Outputs
- 1 x Power-Con (D-Tap) Outputs
- V-Lok/V-Mount Battery Compatible
- Compatible with DC-15A & DC-19A clamps


text:
An inspiring speaker, Wendy Hinman presents programs on pursuing your dreams, sailing and otherwise. She has an entertaining slideshow about her seven-year Pacific adventure. plus a number of "how to" style presentations. Contact her about presenting to your group or book club today. email her at: info_at_wendyhinman.com.
Buy now!
Read Wendy's Voyage Blog!


text:
|A drone scale test by Ian Hubert with Sarah Schoofs and Tony Travostino.
Call Back, Casey. All is Forgiven
10 months ago
Pandora Machine is a micro-studio in New York City specializing in science - fiction. This blog (like our movies) is rated "R" for nudity.
|The beautifully feral Kate Britton going all Ghost in the Shell on us.
|A new semiotic standard. Duplicates are unavoidable.
|Julia Rae Maldonado looking quite noir today.
|Joe Chapman lends and literal and figurative helping hand.
|Not the first time we've killed Willow Csulik.