text:
Retrievable Heart Valve Anchor and Method
A method for endovascularly replacing a heart valve of a patient. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor in an unexpanded configuration within a catheter to a vicinity of the heart valve; deploying the anchor from the catheter; expanding the anchor to contact tissue at an anchor site; and retrieving the anchor into the catheter. The invention also includes an apparatus for endovascularly replacing a heart valve, including: a catheter; a replacement valve configured to be disposed within the catheter for delivery to a vicinity of the heart valve; and an expandable anchor configured to be disposed within the catheter for delivery to a vicinity of the heart valve, to be deployed from the catheter, to be expanded to contact tissue at an anchor site and to be retrieved back into the catheter after having been expanded.
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This application is a continuation of U.S. application Ser. No. 10/746,285 filed Dec. 23, 2003, issued as U.S. Pat. No. 8,603,160 on Dec. 10, 2013, the entire contents of which are hereby incorporated herein by reference.BACKGROUND OF THE INVENTION
The present invention relates to methods and apparatus for endovascularly replacing a heart valve. More particularly, the present invention relates to methods and apparatus for endovascularly replacing a heart valve with a replacement valve using an expandable and retrievable anchor.
Heart valve surgery is used to repair or replace diseased heart valves. Valve surgery is an open-heart procedure conducted under general anesthesia. An incision is made through the patient's sternum (sternotomy), and the patient's heart is stopped while blood flow is rerouted through a heart-lung bypass machine.
Valve replacement may be indicated when there is a narrowing of the native heart valve, commonly referred to as stenosis, or when the native valve leaks or regurgitates. When replacing the valve, the native valve is excised and replaced with either a biologic or a mechanical valve. Mechanical valves require lifelong anticoagulant medication to prevent blood clot formation, and clicking of the valve often may be heard through the chest. Biologic tissue valves typically do not require such medication. Tissue valves may be obtained from cadavers or may be porcine or bovine, and are commonly attached to synthetic rings that are secured to the patient's heart.
Valve replacement surgery is a highly invasive operation with significant concomitant risk. Risks include bleeding, infection, stroke, heart attack, arrhythmia, renal failure, adverse reactions to the anesthesia medications, as well as sudden death. 2-5% of patients die during surgery.
Post-surgery, patients temporarily may be confused due to emboli and other factors associated with the heart-lung machine. The first 2-3 days following surgery are spent in an intensive care unit where heart functions can be closely monitored. The average hospital stay is between 1 to 2 weeks, with several more weeks to months required for complete recovery.
In recent years, advancements in minimally invasive surgery and interventional cardiology have encouraged some investigators to pursue percutaneous replacement of the aortic heart valve. Percutaneous Valve Technologies ("PVT") of Fort Lee, N.J., has developed a balloon-expandable stent integrated with a bioprosthetic valve. The stent/valve device is deployed across the native diseased valve to permanently hold the valve open, thereby alleviating a need to excise the native valve and to position the bioprosthetic valve in place of the native valve. PVT's device is designed for delivery in a cardiac catheterization laboratory under local anesthesia using fluoroscopic guidance, thereby avoiding general anesthesia and open-heart surgery. The device was first implanted in a patient in April of 2002.
PVT's device suffers from several drawbacks. Deployment of PVT's stent is not reversible, and the stent is not retrievable. This is a critical drawback because improper positioning too far up towards the aorta risks blocking the coronary ostia of the patient. Furthermore, a misplaced stent/valve in the other direction (away from the aorta, closer to the ventricle) will impinge on the mitral apparatus and eventually wear through the leaflet as the leaflet continuously rubs against the edge of the stent/valve.
Another drawback of the PVT device is its relatively large cross-sectional delivery profile. The PVT system's stent/valve combination is mounted onto a delivery balloon, making retrograde delivery through the aorta challenging. An antegrade transseptal approach may therefore be needed, requiring puncture of the septum and routing through the mitral valve, which significantly increases complexity and risk of the procedure. Very few cardiologists are currently trained in performing a transseptal puncture, which is a challenging procedure by itself.
Other prior art replacement heart valves use self-expanding stents as anchors. In the endovascular aortic valve replacement procedure, accurate placement of aortic valves relative to coronary ostia and the mitral valve is critical. Standard self-expanding systems have very poor accuracy in deployment, however. Often the proximal end of the stent is not released from the delivery system until accurate placement is verified by fluoroscopy, and the stent typically jumps once released. It is therefore often impossible to know where the ends of the stent will be with respect to the native valve, the coronary ostia and the mitral valve.
Also, visualization of the way the new valve is functioning prior to final deployment is very desirable. Visualization prior to final and irreversible deployment cannot be done with standard self-expanding systems, however, and the replacement valve is often not fully functional before final deployment.
Another drawback of prior art self-expanding replacement heart valve systems is their lack of radial strength. In order for self-expanding systems to be easily delivered through a delivery sheath, the metal needs to flex and bend inside the delivery catheter without being plastically deformed. In arterial stents, this is not a challenge, and there are many commercial arterial stent systems that apply adequate radial force against the vessel wall and yet can collapse to a small enough of a diameter to fit inside a delivery catheter without plastically deforming. However when the stent has a valve fastened inside it, as is the case in aortic valve replacement, the anchoring of the stent to vessel walls is significantly challenged during diastole. The force to hold back arterial pressure and prevent blood from going back inside the ventricle during diastole will be directly transferred to the stent/vessel wall interface. Therefore the amount of radial force required to keep the self expanding stent/valve in contact with the vessel wall and not sliding will be much higher than in stents that do not have valves inside of them. Moreover, a self-expanding stent without sufficient radial force will end up dilating and contracting with each heartbeat, thereby distorting the valve, affecting its function and possibly migrating and dislodging completely. Simply increasing strut thickness of the self-expanding stent is not a practical solution as it runs the risk of larger profile and/or plastic deformation of the self-expanding stent.
U.S. patent application Serial No. 2002/0151970 to Garrison et al. describes a two-piece device for replacement of the aortic valve that is adapted for delivery through a patient's aorta. A stent is endovascularly placed across the native valve, then a replacement valve is positioned within the lumen of the stent. By separating the stent and the valve during delivery, a profile of the device's delivery system may be sufficiently reduced to allow aortic delivery without requiring a transseptal approach. Both the stent and a frame of the replacement valve may be balloon-expandable or self-expanding.
While providing for an aortic approach, devices described in the Garrison patent application suffer from several drawbacks. First, the stent portion of the device is delivered across the native valve as a single piece in a single step, which precludes dynamic repositioning of the stent during delivery. Stent foreshortening or migration during expansion may lead to improper alignment.
Additionally, Garrison's stent simply crushes the native valve leaflets against the heart wall and does not engage the leaflets in a manner that would provide positive registration of the device relative to the native position of the valve. This increases an immediate risk of blocking the coronary ostia, as well as a longer-term risk of migration of the device post-implantation. Further still, the stent comprises openings or gaps in which the replacement valve is seated post-delivery. Tissue may protrude through these gaps, thereby increasing a risk of improper seating of the valve within the stent.
In view of drawbacks associated with previously known techniques for endovascularly replacing a heart valve, it would be desirable to provide methods and apparatus that overcome those drawbacks.SUMMARY OF THE INVENTION
One aspect of the invention provides a method for endovascularly replacing a heart valve of a patient. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor in an unexpanded configuration within a catheter to a vicinity of the heart valve; deploying the anchor from the catheter; expanding the anchor to contact tissue at an anchor site; and retrieving the anchor into the catheter. Expansion of the anchor may include application of an actuation force on the anchor, such as a proximally or distally directed force, to expand or contract at least a region of the anchor.
Another aspect of the invention provides an apparatus for endovascularly replacing a heart valve, including: a catheter; a replacement valve configured to be disposed within the catheter for delivery to a vicinity of the heart valve; and an expandable anchor configured to be disposed within the catheter for delivery to a vicinity of the heart valve, to be deployed from the catheter, to be expanded to contact tissue at an anchor site and to be retrieved back into the catheter after having been expanded. The apparatus may also include a deployment tool configured to apply an actuation force to the anchor-such as a proximally or distally directed force-when the anchor is in the vicinity of the heart valve.INCORPORATION BY REFERENCE
All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.
With reference now to
Anchor 30 has a lip region 32, a skirt region 34 and a body region 36. First, second and third posts 38a, 38b and 38c, respectively, are coupled to skirt region 34 and extend within lumen 31 of anchor 30. Posts 38 preferably are spaced 120° apart from one another about the circumference of anchor 30.
Anchor 30 preferably is fabricated by using self-expanding patterns (laser cut or chemically milled), braids and materials, such as a stainless steel, nickel-titanium ("Nitinol") or cobalt chromium but alternatively may be fabricated using balloon-expandable patterns where the anchor is designed to plastically deform to it's final shape by means of balloon expansion. Replacement valve 20 is preferably from biologic tissues, e.g. porcine valve leaflets or bovine or equine pericardium tissues, alternatively it can be made from tissue engineered materials (such as extracellular matrix material from Small Intestinal Submucosa (SIS)) but alternatively may be prosthetic from an elastomeric polymer or silicone, Nitinol or stainless steel mesh or pattern (sputtered, chemically milled or laser cut). The leaflet may also be made of a composite of the elastomeric or silicone materials and metal alloys or other fibers such Kevlar or carbon Annular base 22 of replacement valve 20 preferably is coupled to skirt region 34 of anchor 30, while commissures 24 of replacement valve leaflets 26 are coupled to posts 38.
Anchor 30 may be actuated using external non-hydraulic or non-pneumatic force to actively foreshorten in order to increase its radial strength. As shown below, the proximal and distal end regions of anchor 30 may be actuated independently. The anchor and valve may be placed and expanded in order to visualize their location with respect to the native valve and other anatomical features and to visualize operation of the valve. The anchor and valve may thereafter be repositioned and even retrieved into the delivery sheath or catheter. The apparatus may be delivered to the vicinity of the patient's aortic valve in a retrograde approach in a catheter having a diameter no more than 23 french, preferably no more than 21 french, more preferably no more than 19 french, or more preferably no more than 17 french. Upon deployment the anchor and replacement valve capture the native valve leaflets and positively lock to maintain configuration and position.
A deployment tool is used to actuate, reposition, lock and/or retrieve anchor 30. In order to avoid delivery of anchor 30 on a balloon for balloon expansion, a non-hydraulic or non-pneumatic anchor actuator is used. In this embodiment, the actuator is a deployment tool that includes distal region control wires 50, control rods or tubes 60 and proximal region control wires 62. Locks 40 include posts or arms 38 preferably with male interlocking elements 44 extending from skirt region 34 and mating female interlocking elements 42 in lip region 32. Male interlocking elements 44 have eyelets 45. Control wires 50 pass from a delivery system for apparatus 10 through female interlocking elements 42, through eyelets 45 of male interlocking elements 44, and back through female interlocking elements 42, such that a double strand of wire 50 passes through each female interlocking element 42 for manipulation by a medical practitioner external to the patient to actuate and control the anchor by changing the anchor's shape. Control wires 50 may comprise, for example, strands of suture.
Tubes 60 are reversibly coupled to apparatus 10 and may be used in conjunction with wires 50 to actuate anchor 30, e.g., to foreshorten and lock apparatus 10 in the fully deployed configuration. Tubes 60 also facilitate repositioning and retrieval of apparatus 10, as described hereinafter. For example, anchor 30 may be foreshortened and radially expanded by applying a distally directed force on tubes 60 while proximally retracting wires 50. As seen in
Deployment of apparatus 10 is fully reversible until lock 40 has been locked via mating of male interlocking elements 44 with female interlocking elements 42. Deployment is then completed by decoupling tubes 60 from lip section 32 of anchor 30 by retracting one end of each wire 62 relative to the other end of the wire, and by retracting one end of each wire 50 relative to the other end of the wire until each wire has been removed from eyelet 45 of its corresponding male interlocking element 44.
As best seen in
With reference now to
During foreshortening, tubes 60 push against lip region 32 of anchor 30, while wires 50 pull on posts 38 of the anchor. Wires 62 may be retracted along with wires 50 to enhance the distally-directed pushing force applied by tubes 60 to lip region 32. Continued retraction of wires 50 relative to tubes 60 would lock locks 40 and fully deploy apparatus 10 with replacement valve 20 properly seated within anchor 30, as in
Deployment of apparatus 10 is fully reversible until locks 40 have been actuated. For example, just prior to locking the position of the anchor and valve and the operation of the valve may be observed under fluoroscopy. If the position needs to be changed, by alternately relaxing and reapplying the proximally directed forces exerted by control wires 50 and/or control wires 62 and the distally directed forces exerted by tubes 60, expansion and contraction of the lip and skirt regions of anchor 30 may be independently controlled so that the anchor and valve can be moved to, e.g., avoid blocking the coronary ostia or impinging on the mitral valve. Apparatus 10 may also be completely retrieved within lumen 112 of sheath 110 by simultaneously proximally retracting wires 50 and tubes 60/wires 62 relative to sheath 110. Apparatus 10 then may be removed from the patient or repositioned for subsequent redeployment.
Referring now to
Referring to
Apparatus 10 is deployed from lumen 112 of sheath 110, for example, under fluoroscopic guidance, such that anchor 30 of apparatus 10 dynamically self-expands to a partially deployed configuration, as in
Once properly aligned, wires 50 are retracted relative to tubes 60 to impose foreshortening upon anchor 30 and expand apparatus 10 to the fully deployed configuration, as in
As seen in
With reference now to
Delivery system 100′ comprises leaflet engagement element 120, which preferably self-expands along with anchor 30. Engagement element 120 is disposed between tubes 60 of delivery system 100′ and lip region 32 of anchor 30. Element 120 releasably engages the anchor. As seen in
Alternatively, foreshortening may be imposed upon anchor 30 while element 120 is disposed proximal of the leaflets, as in
With reference to
Referring now to
As an alternative delivery method, anchor 30′ may be partially deployed via partial expansion of inflatable member 130. The inflatable member would then be advanced within replacement valve 20 prior to inflation of inflatable member 130 and full deployment of apparatus 10″. Inflation pressures used will range from about 3 to 6 atm, or more preferably from about 4 to 5 atm, though higher and lower atm pressures may also be used (e.g., greater than 3 atm, more preferably greater than 4 atm, more preferably greater than 5 atm, or more preferably greater than 6 atm). Advantageously, separation of inflatable member 130 from replacement valve 20, until partial deployment of apparatus 10″ at a treatment site, is expected to reduce a delivery profile of the apparatus, as compared to previously known apparatus. This profile reduction may facilitate retrograde delivery and deployment of apparatus 10″ even when anchor 30′ is balloon-expandable.
Although anchor 30′ has illustratively been described as fabricated from balloon-expandable materials, it should be understood that anchor 30′ alternatively may be fabricated from self-expanding materials whose expansion optionally may be balloon-assisted. In such a configuration, anchor 30′ would expand to a partially deployed configuration upon removal of outer sheath 110. If required, inflatable member 130 then would be advanced within replacement valve 20 prior to inflation. Inflatable member 130 would assist full deployment of apparatus 10″, for example, when the radial force required to overcome resistance from impinging tissue were too great to be overcome simply by manipulation of wires 50 and tubes 60. Advantageously, optional placement of inflatable member 130 within replacement valve 20, only after dynamic self-expansion of apparatus 10″ to the partially deployed configuration at a treatment site, is expected to reduce a delivery profile of the apparatus, as compared to previously known apparatus. This reduction may facilitate retrograde delivery and deployment of apparatus 10″.
With reference to
The angioplasty balloon catheter or inflatable member 130 then is advanced within the replacement valve, as in
As will be apparent to those of skill in the art, the order of imposed foreshortening and balloon expansion described in
Referring now to
Advantageously, providing multiple arrowheads 46 along posts 38 yields a ratchet that facilitates in-vivo determination of a degree of foreshortening imposed upon apparatus of the present invention. Furthermore, optionally constraining appendages 48 of arrowheads 46 via eyelets 49 prevents actuation of lock 40″ (and thus deployment of apparatus of the present invention) even after male element 44′ has been advanced through female element 42. Only after a medical practitioner has removed the wire constraining appendages 48 is lock 40″ fully engaged and deployment no longer reversible.
Lock 40′″ of
With reference to
With reference now to
Referring to
With reference to
With reference to
As seen in
As seen in
As will be apparent to those of skill in the art, lip region 472 optionally may be expanded prior to expansion of skirt region 474. As yet another alternative, lip region 472 and skirt region 474 optionally may be expanded simultaneously, in parallel, in a step-wise fashion or sequentially. Advantageously, delivery of apparatus 450 is fully reversible until lip region 472 or skirt region 474 has been locked in the expanded configuration.
With reference now to
Body region 476a comprises male interlocking element 482 of lip lock 480, while body region 476b comprises female interlocking element 484 of lip lock 480. Male element 482 comprises eyelet 483. Wire 424b passes from female interlocking element 484 through eyelet 483 and back through female interlocking element 484, such that there is a double strand of wire 424b that passes through lumen 422 of catheter 420 for manipulation by a medical practitioner external to the patient. Body region 476b further comprises male interlocking element 492 of skirt lock 490, while body region 476c comprises female interlocking element 494 of the skirt lock. Wire 424a passes from female interlocking element 494 through eyelet 493 of male interlocking element 492, and back through female interlocking element 494. Lip lock 480 is configured to maintain expansion of lip region 472, while skirt lock 490 is configured to maintain expansion of skirt region 474.
With reference to
Referring to
Once properly positioned, wires 424a are retracted to expand skirt region 474 of anchor 470 within left ventricle LV. Skirt region 474 is locked in the expanded configuration via skirt lock 490, as previously described with respect to
Wires 424b are then actuated external to the patient in order to expand lip region 472, as previously described in
As seen in
With reference to
When replacing a patient's aortic valve, apparatus 510 preferably may be delivered through the patient's aorta without requiring a transseptal approach, thereby reducing patient trauma, complications and recovery time. Furthermore, apparatus 510 enables dynamic repositioning of anchor piece 550 during delivery and facilitates positive registration of apparatus 510 relative to the native position of the patient's valve, thereby reducing a risk of device migration and reducing a risk of blocking or impeding flow to the patient's coronary ostia. Furthermore, the expanded deployed configuration of apparatus 510, as seen in
As seen in
Groove section 570 of anchor piece 550 is adapted to engage an expandable frame portion, described hereinbelow, of valve piece 600 to couple anchor piece 550 to valve piece 600. As compared to previously known apparatus, groove section 570 comprises additional material and reduced openings or gaps G, which is expected to reduce tissue protrusion through the gaps upon deployment, thereby facilitating proper seating of the valve within the anchor. Groove section 570 optionally may be covered or coated with biocompatible film B (see
Finally, skirt section 580 of anchor piece 550 maintains proper positioning of composite anchor/valve apparatus 510 post-deployment by precluding proximal migration. When replacing a patient's aortic valve, skirt section 580 is deployed within the patient's left ventricle. As with lip section 560 and groove section 570, skirt section 580 optionally may be covered or coated with biocompatible film B (see
The basic anchor cell structure seen in
If balloon expandable, anchor piece 550 would be fanned from an appropriate material, such as stainless steel, and then crimped onto a balloon delivery catheter in a collapsed delivery configuration. If self-expanding and fanned from a shape-memory material, such as a nickel-titanium alloy ("Nitinol"), the anchor piece would be heat-set such that it could be constrained within a sheath in the collapsed delivery configuration, and then would dynamically self-expand to the expanded deployed configuration upon removal of the sheath. Likewise, if anchor piece 550 were formed from a wire mesh or braid, such as a spring steel braid, the anchor would be constrained within a sheath in the delivery configuration and dynamically expanded to the deployed configuration upon removal of the sheath.
Referring again to
Anchor piece 550 and valve piece 600 of apparatus 510 preferably are spaced apart and releasably coupled to a single delivery catheter while disposed in their reduced delivery configurations. Spacing the anchor and valve apart reduces a delivery profile of the device, thereby enabling delivery through a patient's aorta without requiring a transseptal approach. With reference to
Delivery system 700 comprises delivery catheter 710 having inner tube 720, middle distal tube 730, and outer tube 740. Inner tube 720 comprises lumen 722 adapted for advancement over a standard guide wire, per se known. Middle distal tube 730 is coaxially disposed about a distal region of inner tube 720 and is coupled to a distal end 724 of the inner tube, thereby forming proximally-oriented annular bore 732 between inner tube 720 and middle tube 730 at a distal region of delivery catheter 710. Outer tube 740 is coaxially disposed about inner tube 720 and extends from a proximal region of the inner tube to a position at least partially coaxially overlapping middle distal tube 730. Outer tube 740 preferably comprises distal step 742, wherein lumen 743 of outer tube 740 is of increased diameter. Distal step 742 may overlap middle distal tube 730 and may also facilitate deployment of valve piece 600, as described hereinbelow with respect to
Proximally-oriented annular bore 732 between inner tube 720 and middle distal tube 730 is adapted to receive skirt section 580 and groove section 570 of anchor piece 550 in the reduced delivery configuration. Annular space 744 formed at the overlap between middle distal tube 730 and outer tube 740 is adapted to receive lip section 560 of anchor piece 550 in the reduced delivery configuration. More proximal annular space 746 between inner tube 720 and outer tube 740 may be adapted to receive replacement valve 610 and expandable frame 620 of valve piece 600 in the reduced delivery configuration.
Inner tube 720 optionally may comprise retainer elements 726a and 726b to reduce migration of valve piece 600. Retainer elements 726 preferably are fabricated from a radiopaque material, such as platinum-iridium or gold, to facilitate deployment of valve piece 600, as well as coupling of the valve piece to anchor piece 550. Additional or alternative radiopaque elements may be disposed at other locations about delivery system 700 or apparatus 510, for example, in the vicinity of anchor piece 550.
With reference now to
Delivery catheter 710′ is substantially equivalent to catheter 710 described hereinabove, except that catheter 710′ does not comprise retainer elements 726, and annular space 746 does not receive valve piece 600. Rather, valve piece 600 is received within catheter 760 in the collapsed delivery configuration. Catheter 760 comprises inner tube 770 and outer tube 780. Inner tube 770 comprises lumen 772 for advancement of catheter 760 over a guide wire. The inner tube optionally may also comprise retainer elements 774a and 774b, e.g. radiopaque retainer elements 774, to reduce migration of valve piece 600. Outer tube 780 is coaxially disposed about inner tuber 770 and preferably comprises distal step 782 to facilitate deployment and coupling of valve piece 600 to anchor piece 550, as described hereinbelow. Valve piece 600 may be received in annular space 776 between inner tube 770 and outer tube 780, and more preferably may be received within annular space 776 between retainer elements 774.
Referring now to
With reference now to
Aortic valve AV comprises native valve leaflets L attached to valve annulus An. Coronary ostia O are disposed just proximal of diseased aortic valve AV. Coronary ostia O connect the patient's coronary arteries to aorta A and are the conduits through which the patient's heart muscle receives oxygenated blood. As such, it is critical that the ostia remain unobstructed post-deployment of apparatus 510.
Lip section 560 may be dynamically repositioned until it properly engages the valve leaflets, thereby ensuring proper positioning of anchor piece 550 relative to the native coronary ostia O, as well as the valve annulus An, prior to deployment of groove section 570 and skirt section 580. Such multi-step deployment of anchor piece 550 enables positive registration and dynamic repositioning of the anchor piece. This is in contrast to previously known percutaneous valve replacement apparatus.
As seen in
With anchor piece 550 deployed and native aortic valve AV displaced, valve piece 600 may be deployed and coupled to the anchor piece to achieve percutaneous aortic valve replacement. Outer tube 740 is further proximally retracted relative to inner tube 720 such that valve piece 600 is partially deployed from annular space 746 between inner tube 720 and outer tube 740, as seen in
Subsequent re-advancement of outer tube 740 relative to inner tube 720 causes distal step 742 to distally advance valve piece 600 within anchor piece 550 until tips 622 of expandable frame 620 engage groove section 570 of anchor piece 550, as seen in
Hoop 624 friction locks within groove section 570 of anchor piece 550, thereby coupling the anchor piece to the valve piece and forming composite two-piece apparatus 510, which provides a percutaneous valve replacement. As seen in
Referring now to
When anchor piece 550′ is self-expanding and collapsed in the delivery configuration, guideposts 653 may be deployed with skirt section 580′, in which case guideposts 653 would rotate upward with respect to anchor piece 550′ into the deployed configuration of
Sleeves 655 of second portion 654 of alignment/locking mechanism 650 comprise lumens 656 sized for coaxial disposal of sleeves 655 about guideposts 653 of first portion 652. Upon deployment, sleeves 655 may friction lock to guideposts 653 to ensure proper radial and longitudinal alignment of anchor piece 550′ with valve piece 600′, as well as to provide a secondary lock of the anchor piece to the valve piece. The secondary lock enhances the primary friction lock formed by groove section 570′ of the anchor piece with hoop 624′ of expandable frame 620′ of the valve piece.
To facilitate coupling of the anchor piece to the valve piece, suture or thread may pass from optional eyelets 651a of guideposts 653 through lumens 656 of sleeves 655 to a proximal end of the delivery catheter (see
Referring now to
With reference now to
Female guides 672 are translatable about male posts 670, but are constrained by flared ends 671 of the male posts. In this manner, anchor piece 550′″ and valve piece 600′″ remain coupled and in radial alignment with one another at all times—including delivery but may be longitudinally separated from one another during delivery. This facilitates percutaneous delivery without requiring a transseptal approach, while mitigating a risk of inadvertent deployment of the anchor and valve pieces in an uncoupled configuration. Additional alignment/locking mechanisms will be apparent in view of the mechanisms described with respect to
Prior to implantation of one of the replacement valves described above, it may be desirable to perform a valvoplasty on the diseased valve by inserting a balloon into the valve and expanding it using saline mixed with a contrast agent. In addition to preparing the valve site for implant, fluoroscopic viewing of the valvoplasty will help determine the appropriate size of replacement valve implant to use.
1. An apparatus for endovascularly replacing a heart valve comprising: a replacement valve configured to be disposed within the catheter for delivery to a vicinity of the heart valve;
- a catheter tube;
- an expandable anchor configured to be disposed within the catheter for delivery to a vicinity of the heart valve, to be deployed from the catheter tube, to be expanded through application of a radially directed force directed to contact tissue at an anchor site,
- the expandable anchor comprises posts or arms with interlocking female elements extending from a lip region of the anchor and interlocking male elements extending from a skirt region of the anchor which form actuatable locks;
- an inflatable member disposed with the lumen of the anchor in a deflated configuration and in an expanded configuration, said expandable member expands said expandable anchor through application of said radially force; and
- wherein the anchor can be retrieved back into the catheter tube upon actuation of the a actuatable locks.
2. The apparatus of claim 1 further comprising a deployment tool to reposition, lock and retrieve the anchor.
3. The apparatus of claim 2 wherein said deployment tool comprises a distal region, the distal region comprising control wires, control rods or tubes and a proximal region comprising control wires.
4. The apparatus of 3 wherein the male interlocking elements have eyelets formed therein, the distal region of the deployment tool comprises control wires, the control wires pass from a catheter delivery system through the female interlocking elements, through the eyelets of the male interlocking elements and back through the female interlocking elements for manipulation external of a body lumen.
5. The apparatus of claim 3 wherein the anchor is releasably connected to the control wires, control rods or tubes.
6. The apparatus of claim 4 wherein the interlocking elements are connected to a braided structure by one of interweaving elements, suturing, soldering, welding or adhesively.
7. The apparatus of claim 1 wherein the valve comprises valve commisures, the valve commissures are connected to the male interlocking elements, the replacement valve comprises an annular base, the annular base is connected to the distal end of the anchor, the male interlocking elements include holes that mate with tabs extending into holes in the female interlocking elements.
8. The apparatus of claim 7 further comprising control wires, the male interlocking elements and female interlocking elements further comprising eyelets, the control wires pass through the eyelets and holes of the male interlocking elements and can be pulled proximally of a proximal end of the anchor drawing the male interlocking elements through the holes such that the tabs engage the holes of the male interlocking elements.
9. The apparatus of claim 8 further comprising release wires, the release wires pass through the eyelets of the female interlocking elements such that if the release wires are pulled, the orientation of the tabs are reversed and the anchor is released allowing for repositioning of the device.
10. The apparatus of claim 1 wherein the replacement valve is coupled to the anchor.
11. The apparatus of claim 1 wherein the inflatable member is inflated at pressures of about 3 to about 6 atmospheres.
12. The apparatus of claim 1 wherein the inflatable member is separated from the replacement valve until partial deployment of the apparatus at the treatment site.
13. The apparatus of claim 1 wherein the inflatable member comprises an inner shaft, the inner shaft comprises a lumen configured for passage of a guidewire, the apparatus further comprising a guide tube for passage of push tubes and pull wires, guide tube is disposed within the lumen of the catheter tube.
14. The apparatus of claim 1 wherein the catheter tube has a diameter no more than 21 french.
Type: Application
Filed: Dec 9, 2013
Publication Date: Apr 3, 2014
Patent Grant number: 9393113
Applicant: Sadra Medical, Inc. (Los Gatos, CA)
Inventors: Amr Salahieh (Saratoga, CA), Brian D. Brandt (San Jose, CA), Dwight P. Morejohn (Davis, CA), Ulrich R. Haug (Campbell, CA), Jean-Pierre Dueri (Los Gatos, CA), Hans F. Valencia (Santa Clara, CA), Robert A. Geshlider (San Francisco, CA), Jeff A. Krolik (Campbell, CA)
Application Number: 14/100,482
International Classification: A61F 2/24 (20060101);


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Mental flexibility, patience, adaptability, and the ability to handle stress are often cited benefits of yoga and meditation. These are also some of the same skills many employers look for and hope to cultivate in their employees. People who have or are able to develop these practices may be seen as an asset to employers for these reasons, and they may even cost less to employ. Ohio State University researcher Maryanna Klatt led a pilot study which found that six weeks of guided workplace meditation and yoga can lower feelings of stress by more than 10%. She believes these findings are also significant in understanding and improving the way people handle stress in the workplace. "If they can't change the external events in their life, they can instead change the way they view the stress, which can make a difference in how they experience their day-to-day life," Klatt notes.
Recognizing the potential benefits of developing these practices, GSSS Institute of Engineering and Technology for Women in Karnataka, India added a yoga and meditation space designed to train students to more effectively handle stressful situations. As students learn to cultivate yoga and meditation practices to deal with the stress of schoolwork, they are also building skills that will one day help them deal with the pressures of the workplace. While it is too early to track the results of the program, graduates may be more desirable to employers for their ability to show grace under pressure.
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In addition to potentially outperforming their co-workers, yogis may also save companies money in reduced health care costs. Many large corporations have already begun to add yoga and meditation to their corporate wellness programs, sometimes with drastic results. A report from the US Department of Health and Human Services states that workplace exercise programs have been shown to increase morale and productivity in workers, as well as decrease disability claims and the number of days of paid sick leave, thereby reducing health care costs by 20 – 55%. Considering the CDC finding that 23% of Americans do not exercise in their leisure time, these statistics are not surprising.
Even if your employer doesn't appreciate the benefits of these practices, they may be the very things that land you the job. The interview is usually the first stressful situation of any job. Presenting yourself as calm and articulate can certainly increase your chances of making a positive impression.
Does a regular yoga and meditation practice make you a better employee? Has it helped you get a job?


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Watching watermelons and sheets of plywood meet their demise at the hands of a twisted slingshot creation is entertaining. But Joerg Sprave's latest creation, a custom crossbow bolt that has been modified to deliver a lethal dose of poison, is a little disheartening since it was created for killing, not just smashin' stuff.
And it goes without saying, but we'll say it anyway: do NOT try this at home. Or anywhere. It's all but guaranteed that this particular experiment in home-grown weaponry will get you in hot water with local law enforcement. And explaining it away as a handy way to inject some extra flavour into a frozen turkey isn't going to fool anyone. We miss the cuddly, zombie-slaying Joerg. Can that guy come back and build us a Hello Kitty catapult or something? [YouTube]


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Professor John Anthony Allan, who pioneered the concept of "virtual water," was named this year's Laureate
Professor John Anthony Allan from King's College London and the School of Oriental and African Studies, a pioneer of concepts key to the understanding and communication of water issues and how they are linked to agriculture, climate change, economics and politics, was named the 2008 Stockholm Water Prize Laureate.
People do not only consume water when they drink it or take a shower. In 1993, Prof. Allan made a major breakthrough in how to demonstrate this by introducing "virtual water," a measurement of the water that is embedded in the production of foods and consumer products. Behind that morning cup of coffee, there are about 37 gal of water that was consumed to grow, produce, package, and ship the beans. That is roughly equal to the amount of water used by an average person in England for all their daily drinking and household needs. One hamburger holds about 634 gal. An average American consumes over 1,585 gal of virtual water every day; over triple the average Chinese.
These insights gained through Allan's work have made major impacts on global trade policy and research and have redefined discourse in water policy and management. Water-intensive commodities can be traded from places where high returns to water can be achieved to economies that cannot produce as efficiently.
This has influenced national water and trade policies and has significant implications for balancing global water resources. Application of the virtual water concept provides the potential to use trade to alleviate regional water scarcity and make water resources use more efficient. This both improves capacity for sustainable management of global water resources for future generations and reduces the risk that nations go to war over scarce water resources.
Allan, a prolific author and educator, is a leading expert on global water resources, conflict resolution and the Middle East and North Africa regions. He has been described as one of the most influential thinkers in the water sector today.
The Stockholm Water Prize, presented annually by the Stockholm Water Foundation, is worth $150,000. The prize will be presented during the World Water Week in Stockholm, Sweden, on Aug. 21 in the Stockholm City Hall. H.M. King Carl XVI Gustaf of Sweden is the Patron of the Stockholm Water Prize.


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AebleskiverTuesday, July 31st, 2007
Aebleskiver covered in powdered sugar and served with jam.
I first encountered Aebleskiver when I was in the Danish city Fredrikshavn with my mother many years ago. At that time, I guess that it was 20 years ago, we used to take the car on the 3 hour long ferry ride between Göteborg and Fredrikshavn and then packed the car full of groceries once every month during the colder months. We shopped meat, Danish sausages and liver pâté, thick delicious fruit yoghurt and other food. The food in Denmark at that time was really cheap compared with the Swedish one, it was long before all those cheap LL, Willy's, Lidl and Netto stores and my mother saved a lot of money making the groceries for our family of 5 hungry persons. And as she often pointed out, the Danish food tasted and was much better and she was right. As she can't stand the Swedish liver pâté she used to buy loads of the Danish one instead. I still remember the yummy sandwiches with creamy liver pâté that I loved to eat, together with a glass of thick yoghurt.
During one of those many trips over to Denmark when I accompanied my mother, we followed the lovely smell from a café where we went in and ordered Aebleskiver and tea. We didn't really know what we ordered, we thought it was some kind of apple cake due to the name, as aebleskiver means apple slices in Danish. But we didn't get any apple cake or any apples at all. Instead we got delicious and warm Danish doughnut holes, covered with powdered sugar and served with jam in which we dipped the aebleskiver. We were thrilled and in love with these fluffy fried little balls and after a conversation with the staff me and my mother went out shopping again, this time on hunt after a special thing: an aebleskiver baker. We searched around the city and finally we found the very last aebleskiver pan, at least that day or week. An aeble skiver pan is either in cast iron and used on the stove or electric. We got an electric one and this spring when my sweet mother was up in Stockholm to visit me she had the aebleskiver pan with her as a gift. She still had the original box and I was so glad that she gave it to me.
The machine used to bake the aebleskiver.
The Danish aebleskiver are most often eaten during the winter months, especially around Christmas. As the weather this summer was really crappy I made some aebleskiver during a rainy day to get in mood. My husband hadn't eat aebleskiver before but was really excited and thought that they were delicious. He said that they were the best doughnut holes and doughnuts ever. Myself I thought of my childhood memories with every yummy bite.
This post is also an entry for That crazy kitchen gadget by Not Eating Out in New York. Maybe the pan isn't that crazy, but it's unusual and it's the craziest thing I have in my kitchen except for the curry loving cat Yoshi ;-) The round-up can be read here.
- Aebleskiver
(makes 40-50. Demands an aebleskiver pan. Adapted from Kerstin Kokk)
250 gram flour
125 gram butter, melted
375 ml lukewarm milk
3 eggs divided into yolks and eggwhites
1 tsp salt
0.5 tsp cardamom
2 tsp baking powder
1.5 tbsp vanilla infused caster sugar
Combine the milk with the egg yolks. Add flour, salt, cardamom and baking powder. Mix and then add the melted butter. Mix the batter until everything is well mixed.
In a separate bowl, whip the eggwhites until stiff and then gently fold them into the batter. Let the batter rest while you heat your aebleskiver pan. I don't need any butter for my pan but if you have a cast iron one you probably need some butter. Pour about 1 tablespoon of batter in each hole and fry until browned and crisp on bottom. Turn them over with the help of a chopstick or fork. For me this went really quickly, as soon as I had filled all holes in my pan it was time to start turning the first one, but that all depends on your pan.
Serve the aebleskiver while still warm, with powdered sugar and jam.


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So, you may not know this yet, but Windows 8 has these two different "user modes", one is the normal desktop windows experience that we're all accustomed to and the other is a more "smartphony" or "tablety" experience called Metro. The usage is a little bit disjoint and confusing for my tastes, but that isn't really the issue. The issue relates to Internet Explorer 10 (IE10), and how it behaves and operates on Windows 8 in desktop vs metro mode.
The Problem
You see, when running IE from the Metro experience, IE10 behaves in a different way. The UI is different, and one of the more notable differences is that no ActiveX plugins will work, at all, period. If you're running is desktop mode, then IE doesn't have this limitation and works pretty much as it does on Windows 7. Fine, a hard line decision that seems to stem from their push to get people to write HTML5 and Metro apps, but I've got no real issues with that either. The issue I do have is this: there is no way for a web app developer to tell if IE is running in "metro mode" or not. This is a problem.
You see, I work on a product which requires a native plugin to work. There is no HTML5 way to monitor a screen for changes and then capture those changes, compress them efficiently and then send them to a server to be shared with other people you have elected to share them with. This is the kind of thing that is only possible through a native code that can interface with the HTML on a browser page, and so our product requires a plugin that makes available an ActiveX control that our HTML web app can communicate with. So, for our product to be able to work on Windows 8, you'll need to be running on IE10 from the desktop, not in "Metro mode" (or Firefox or Chrome, we have plugins for those browsers as well that work just fine). However, since we have no way of detecting that you are in Metro mode, then we can't put up friendly UI to explain that we won't work in Metro mode. To our code, everything just looks like you don't have our plugin installed, and we will desperately try to install it, to no avail. The easiest solution to this, for me, seems to be some sort of addition to the User-Agent string that IE10 in Metro mode publishes to indicate that it is in Metro mode.
X-UA-Compatible: requiresActiveX=true
Microsoft has attempted to add something, but, unfortunately it isn't acceptable. You can add a HTTP header to a response, or a meta tag in your HTML to indicate that your page requires a plugin. This will cause IE running in Metro mode to display something like this:
However, this UI is fairly easy to miss, goes away quickly, and doesn't allow for any indication as to what parts of the website might not work due to the lack of plugin support. All of which could be handled by the web app were it able to detect that the features were unavailable.
Plugin Free Web
In doing some research on this problem, I came across some sentiment that plugins don't belong on the web. I find this disconcerting. I understand it to a point, there are certain things that are becoming possible with HTML5 and the hope is to push people in that direction instead of relying on browser plugins (ie. Adobe's Flash). The problem is where web applications need to do things that are outside of the browser sandbox and will likely NEVER be possible using HTML technology alone (ex: Web-based Application Sharing). For these applications there will always need to be some sort of bridge from the web application to a native component, be it a plugin or a native app that should be launched to take over the rest of the interaction. Even still, if the stance for one particular browser is, "no plugins, tough luck" then there should at least be a way for web developers to be able to detect this browser so that they can present clear information to their users about what is going on and what they can do.
I am rushing this post out a bit, and I'm sure I'm missing some key points, but I hope some people from MS will chime in with comments on this, or even better, make some changes to IE10 to fix this problem. I also hope some other web developers will chime in with comments of how this problem is effecting your applications as well.


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– Brian Burns, Greater Sydney HEMS.
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A blog on anaesthesia, intensive care and emergency medicine. In-hospital and outside. Mostly focusing on the critically ill patient. Written by two Scandinavian senior anaesthetic registrars turned consultants.
This is our way of keeping log of articles and interesting things we come across in our work and on the internet. Should any of you out there stumble across this blog and find it useful then all the better.
Please leave comments or questions if you have any. The best way to keep learning is to keep the conversation going.


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Remembering the Martian: Tomasi on FC: Requiem
The first superhero of the Silver Age is dead.
DC's Martian Manhunter met his end in a rather ignoble fashion in Final Crisis #1. Having posed as the criminal Blockbuster among the villains on a prison planet, J'onn J'onzz was betrayed by Catwoman and captured in the Salvation Run miniseries. He was later brought to earth by Libra and killed when the villain stabbed him through the chest with a flaming staff.
Readers saw J'onn's funeral in Final Crisis #2 (earth's heroes traveled to Mars to bury him), but the story does not end there. This week, Final Crisis: Requiem arrives in stores, written by Peter Tomasi, with art by Doug Mahnke and Christian Alamy.
We spoke with Tomasi for more about the special and what part of J'onn's story is left to tell.
Newsarama: To start off with Peter, how did you land this project? Was it one of the originally planned Final Crisis tie-ins, and your name came up, or was it something you suggested after hearing what was going down in Final Crisis #1?
Peter Tomasi: Actually, Dan Didio and Eddie Berganza knew of my love for the character. I had written some Showcase stories featuring J'onn several years back and
also edited his monthly book by John Ostrander and Tom Mandrake, so Dan and Eddie figured I was the right guy for the job.
NRAMA: So you're a fan, and you also know of J'onn's importance to the DC Universe. How did his death in Final Crisis #1 hit you?
PT: As I said, I really love the character and feel he's got a ton of stories to explore, so I was shocked to say the least that they had chosen J'onn to bite the red dust. He is one of those mainstays you expect to be around forever, but he is also a character that's taken for granted, so I think once it settles that he's gone, it'll hit people how much they like the character and wish he's had some better opportunities to shine in the DCU a little bit more.
NRAMA: So what's in store for Requiem? We've seen the funeral in Final
Crisis #2, but this is more?
PT: I don't wanna say too much about the issue, but there is a lot more.
NRAMA: Fair enough. Who is hardest hit by the Martian Manhunter's death?
PT: The whole DCU is hit hard by J'onn's death, but I do focus on just a few DCU heroes in the issue who I felt would be a good representation of the grief that follows such an event, especially the way he is discovered and such.
NRAMA: From the solicits, the story is said to involve the Martian Manhunter's final wishes. How do they find out what they are, since he's, you know, dead?
PT: Let's not forget J'onn does happen to be one of the most powerful, if not the most powerful, telepath on the planet, so his ability to share his final thoughts isn't much of a stretch.
NRAMA: From your point of view, what does J'onn's death do to both the Justice League and the larger hero community?
PT: J'onn's death will have repercussions, some on a smaller interpersonal level, but also on a larger scale when the rage and anger as a result of his death is channeled by some of the big guns, especially Hal Jordan, into other outlets.
NRAMA: Something that was interesting in all of this, and hinted at the characters being
aware of the world they live in - Superman's comment that they will miss him, "And pray for a resurrection." Your thoughts on that line?
PT: Not sure really. All I know is that when I typed the words: THE END in the
script for Requiem, it was really and truly the end of J'onn's journey within the DCU at this moment in time. My job was to bury J'onn in a respectful and interesting way. I hope I've accomplished that, and also given the readers some insight into J'onn' heart and soul.
NRAMA: But in that vein - this is Final Crisis: Requiem, not Final Crisis: Resurrection, right?
PT: Absolutely, "Requiem" is most definitely the operative word for this Final
Crisis tie in. There are no 'outs', no "resurrection" seeds planted. J'onn is dead and buried by the people who loved and cared about him.


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MINTIE BY MINT VELVET Star Blocked Sweater
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Spun with a touch of cashmere for lasting softness, this sweater is knitted with the same luxurious yarn from Mint Velvet's main range - but don't worry, it can still go into the washing machine.
Round neck, long sleeves, star detail, multicoloured panels.
Composition and Care: 47% cotton, 24% viscose, 22% polyamide, 7% cashmere. Machine wash.
Composition and Care: 47% cotton, 24% viscose, 22% polyamide, 7% cashmere. Machine wash.
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Brown Thomas Click & Collect is a complimentary service which enables you to place an order online and collect from your nearest store.
Your Click & Collect order will take 3-4 working days to arrive at your selected store. Click & Collect is available at Brown Thomas Dublin, Brown Thomas Cork, Brown Thomas Limerick, Brown Thomas Galway, BT2 Dundrum and BT2 Blanchardstown.
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COSHOCTON TRIBUNE / SEARCH: 799 North Court St Medina, OH 44256
- $650 price
- 4172612 mls id
- Year Built: 1963
- Lot Size: 1.75 acres
- Status: Active
Includes CAM charges. Street frontage on Medina's North Court Street (US-42) office/retail corridor. Signage above entrance and on monument sign on North Court. Access to on-site conference room at no additional charge. Lessor maintains all mechanical and electrical systems. Lessee responsible for gas, electric and sewer bills. Build-out available. Ample parking. Low gross rent. Elevator to second floor. Other spaces available for lease also.
- Site Link
- Property SubType Other
Courtesy of: Keller Williams Tri-County Pro
Office Phone: 3302398688
Listing Agent: Roger Nair
Updated: 3rd April, 2020 1:02 PM.
799 North Court St Medina, OH
Real Estate | Coshocton Tribune Powered by Placester


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- Company
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We regard our company's good name, its reputation, as the foundation and the essential factor underpinning our business activities for long-term success. We regard the trust our customers place in us as a key resource and the foundation for our business success. We nurture our company's reputation, garnered over 100 years, and the well-founded confidence of our business partners by attaching the utmost importance to Integrity & Compliance – as an equal priority together with the innovation expertise and technology leadership of our company.
The basic values "trusted to deliver excellence", "acting with integrity" and "operating safely" of Rolls-Royce Power Systems AG and its subsidiaries are set out in the Rolls-Royce Global Code of Conduct and apply to all areas of work in the company and form the plumb line against which all business conduct is judged in the Rolls Royce group companies. Our Code of Conduct applies to all managers and employees employed by the Rolls-Royce Group and any subsidiary or joint venture where we have control. Policy directives, instructions for conduct and training courses all help ensure that the ethical principles in the Code of Conduct are lived out by everyone who is part of the company.
Our Code of Conduct is also available as App. You can download it on the App store or get it on Google Play searching for 'Rolls-Royce Code'.
If you have any questions or comments relating to integrity and compliance at RRPS or would like to report a potential breach of corporate principles (confidentially, upon request), please contact:
You may also report compliance breaches via our Ethics Line. This service is available 24 hours a day, 7 days a week in multiple languages and if requested also on an anonymous basis:


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It's a record — Denver gets snowiest February since 1912
On the last day of February (the 29th) in 1912, the Denver Post ran a roundup story of the month's snowy weather records. Today, February 27, 2015, the city has a new record of 22.2″ of snowfall for the month, breaking that of 1912.
It's fun to turn back the pages — and the clock– and enjoy the news coverage as if it was happening today.
Here's the headline:
And the best of the 1912 story:
"All records for snowfall have been broken by the fall this month. Twenty-two and one-tenth inches have fallen during the month, the greatest fall ever recorded by the weather bureau since it began its present system of records, in 1885.
The greatest snowfall in twenty-four hours ever recorded also occurred this month between 6 p.m. February 23 and 6 p.m. February 24. On the evening of February 25 there was 12.8 inches of snow on the ground, which breaks still another record, the next greatest amount which the weather man can show in his books being 10 inches on February 23, 1909.
All railroad lines connecting Denver with the East and Southeast at 9 o'clock this morning were again open to traffic for the first time in four days. The Santa Fe was the last of the roads to overcome the snow blockades in Kansas. Denver passengers, who were aboard eight Santa Fe trains held up since Sunday at Dodge City and Kinsley, Kan., began arriving in the city this afternoon.
Twelve trains on the Santa Fe, all of which were blocked by snow in Kansas since last Sunday, passed through La Junta today. There was no suffering among passengers on blockaded trains as the company held trains at stations where there was an ample supply of food and where the passengers during their enforced stay were fed at the expense of the company. In some places in Kansas, according to reports brought to Denver, the tracks were buried under fifteen feet of snow."
The story goes on to give the local transport picture:
"The local Tramway company was seriously troubled yesterday by snow drifts which were piled up on its lines by the high wind. Out on the Littleton line, the cars ran into drifts four feet deep. Today there was a series of accidents on the Aurora line which delayed the cars all morning and there was also trouble on the West Larimer line. The Globeville cars had to couple up to get through."
Golly. Sounds rather familiar, doesn't it? Drive safely!


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Recently, LinkedIn sent out
spam congratulatory emails to some of its members, telling them that they ranked in the top one, five, or ten percent of the most viewed profiles. Which sounds great, till you realize that LinkedIn has 200 million members. Now I'm no math whiz, but I'm pretty sure that ten percent of 200 million is 20 million. Even the lofty top one percent loses some of its luster when you realize it's a distinction shared with 1,999,999 other users.
So if being a member of such a large crowd pleases you, that's fine. But do you really want to brag about it on Twitter and Facebook? The distinction is dubious and the self-promotional element seems a little tone deaf. It's kind of like trumpeting your Klout score or how many Google Wave friends you have. There's nothing wrong with self-promotion, as long as it's done with authenticity and class. By all means, shout out your accomplishments to your friends — they'll be proud of you for the stuff you've actually done.
By the way, I've got nothing against LinkedIn for running this promotion. I give the company credit for getting people to promote the site for free.


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Filter results:
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1992 May 5
McCormack, Mark H.
Japan - McCormack asks Haji Fukuhara and Shigeki Uji to recall the attached fax. He indicates they have got to discuss this when he is in Tokyo since he has to get back with an intelligent idea to the Royal & A (Royal and Ancient Golf Club of St. Andrews). Attached is an April 14, 1992 fax from McCormack to Fukuhara and Uji informing them that he had a lengthy meeting with the R & A officials at the Masters g... more


text: The wobbegong has a wide, flat body that sports a series of dark lines and splotches against a pale background. This pattern helps it disappear amid the ocean floor. It has a series of highly branched dermal lobes and nasal barbells surrounding its mouth that resemble a fringe pattern. During the day, the wobbegong tends to hide under reef ledges. It comes out at night and perches on the reef to hunt. It will lunge up to grab its prey with its large jaw and very sharp teeth. Females are (aplacental viviparous), which means that they produce eggs that they keep inside their bodies until they hatch. They then give birth to live pups. Did You Know? It has huge jaws that are nearly impossible to escape from. Diet It eats bottom-dwelling fishes and sometimes invertebrates. Size A typical maximum size is 4 feet. Range Indo Pacific Ocean off Indonesia, northern Australia, Queensland Population Status IUCN Near Threatened Predators Larger fish, sharks, marine mammals Back to the Top


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Welcome to our Author Interview series.
Today we're featuring an interview with John Allison, author of Saturday Night at Sarah Joy's. Our author interview series provides an opportunity for our readers to get to know our authors on a deeper level and also learn more about the types of books we're publishing.
Philadelphian John Allison spent 25 years at a Big Ten University teaching Chemistry, and is now home teaching at The College of New Jersey. He enjoys constructing plays, short stories, and monologues. The world premiere of his first play, "Bud's Used People Lot" (2004), was produced by the Twin City Players (suburban Chicago). Jersey Voices selected two of his One-Act plays for their productions of short play collections by Jersey Playwrights. 23 of his monologues were read in Kate Daly's Monologue Mania (Bloomfield, NJ) over a two-year period. Look for him on the Barnegat Bay, on the sailing vessel Abby-Gale.


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BERWYN - Lincoln Middle School eighth-graders from Berwyn will knock out 10 kilometers at the Morton West High School track for the middle school's 10th annual UCP Seguin 10K fundraiser at 9 a.m. Saturday.
Close to 350 Lincoln students are hoping to raise $10,000 for UCP Seguin – bringing their 10-year total to more than $85,000 to benefit individuals with disabilities and other special needs served by UCP Seguin.
For the past 10 years, The eighth grade students have participated in UCP Seguin's Youth Leadership & Disability Awareness program. This unit is designed to promote acceptance and understanding of individuals with developmental disabilities and other special needs.
As part of their unit, Lincoln students host a pizza party and dance for UCP Seguin program participants, attend a guest lecture by author June Rae Wood and solicit donations from family and friends to support innovative programs and services offered by UCP Seguin. Previous 10K walks have raised funds to help equip a fitness center at UCP Seguin's Carr Center in Cicero.
Opportunities to sponsor this event are still available. To become a sponsor or for more information, call Kelley Currier at 708-222-5143m or by visiting www.seguin.org.


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Habitat for Humanity is dedicated to helping low-income people realize their dreams of homeownership. See how we're making a difference.
Meditation is powerful. If you're still unsure whether or not the practice is worth trying, check out these top benefits of meditation and consider how they can help improve your life.
When bad things happen, how do we act individually, and how can we come together as a society? How can we be kind in times of darkness?
Whether it's a few hours or a long commitment, volunteering not only supports those around you but positively influences you as well.
Living a full and altruistic life is about more than just doing your best. It's about sharing your best with others around you and connecting with them through our inherent need to tell stories.
Did you know you can give back by supporting small businesses? Here are some hows, whys and benefits of supporting small businesses for your altruistic lifestyle.
If you want your child to start on the right path, help them get involved in their community and start volunteering today.
If you're still not sure what you're doing over spring break, check out these ideas for how you can have fun and give back.
You can give the most lovely Valentine's Day gift by giving back to your community. Check out 14 altruistic ways to celebrate this special day.
Don't let winter get you down. Resist seasonal affective disorder with five tips to stay positive during the coldest season.
Our words are powerful and should be handled with respect. Because they can impact others, choose yours wisely with these helpful tips.
How can we be kind in times of darkness? Today we're going to talk about just that, and how we can continue to live altruistically when facing heart-wrenching times.
Self-defeating thoughts can come when we least expect them and tear down our self-esteem and break our spirits. Stand up to them and choose joy instead with five ways to overcome self-defeating thoughts.
Memorial Day means much more than time off from work and hosting a barbecue, so if you want to get involved this weekend, check out these great ways to give back.
No matter how old you are, what your musical taste is or whether or not you can read a note, there's never a wrong time to learn how to play an instrument.
So, do you want to embrace social networking to have a positive influence on the world? Here are some ideas for how to use social media to make a difference.
With more than 440,000 youth in foster care, there are plenty of ways to make a difference during this month. Here are ideas for how to support National Foster Care Month.
You want to make a difference, but aren't sure where to start without money. Fortunately, we have ideas to help you donate to charity without breaking the bank.
Turns out, even the smallest steps can have an impact. This Earth Day, consider your ecological footprint and enact these seven green ways to embrace today.
The arts still play a vital role in much of our society. In fact, without the arts, much of our history, expression and culture would be virtually nonexistent.
For seniors, volunteering is the perfect chance to use extra time to make a difference in the community. Check out these positive reasons for seniors to volunteer.
This month aims to increase awareness about stress, its negative effects and how to relieve it. If you're experiencing stress, keep these ideas in mind for how to relax.
Even a small gesture can have a huge influence on the people around you. Here are a few ideas of some easy things you can do to brighten someone's day.
If you strive to live a good life in all areas, journaling might be the next step to consider. Take a look at simple ways journaling can improve your life.
There's no doubt about it: If you want to live a more knowledgeable, cultural and altruistic lifestyle, then learning another language has big benefits in store.
Nutrition impacts every area of our lives, including our ability to live altruistically for others. So let's dive into how you can celebrate National Nutrition Month.
Even if you care about a cause, how can you ensure you're a good fit for the position? Here are some ideas to help you find the right fit for volunteering.
There are ways we can challenge ourselves to grow in empathy. If you want to learn more, check out these tips for how to cultivate more empathy for others.
What if you could live with more compassion this week and share love with other people in your community, country or even the world? Turns out, you can!
It can sometimes be difficult to consider how exactly to recognize Black History Month. What can you do? Here are six ideas for honoring Black History Month.
There is a genuine skill to meeting new people and establishing relationships with them. And, you don't even have to be a social butterfly to master it!
Recent studies have shown how volunteering with people or a cause you care about can actually mitigate depression and anxiety issues. Here's how.
If you strive to live an altruistic lifestyle, there are a variety of different ways to be more charitable without spending money. Here are some ideas to try.
You want 2019 to be a great year! If you want to start the new year off on a positive note, check out these seven steps to keep in mind as we dive into 2019.
If you want to make a difference in 2019, make giving a part of your New Year's resolutions. Here are some ideas for how you can create resolutions that give back.
If you live an altruistic lifestyle, you can give back and make someone's holiday a bit more joyful. Here are six ways you can brighten someone else's Christmas.
As you prepare for all of the gifts, parties and dinners headed your way this season, here are some ideas for how to decrease stress during the holidays.
For those of us who are able to give more, this is the perfect opportunity to get involved in the community and help spread the holiday cheer this season.
If you want to join in and celebrate National Write a Friend Month during this wonderful winter season, here are a couple writing ideas to get you started.
If you want to live a more altruistic lifestyle, help give back in the upcoming season by checking out these volunteering ideas for cold weather months.
Thanksgiving marks an important season for all of us to take a moment and remember the little things in life—and every little thing we're thankful for.
If you have a student in your life who you want to serve the community, here are some tips for how to encourage teenagers to volunteer with a cause they care about.
Caregiving is a valuable position in our community which often goes unrecognized. Let's look at what National Family Caregivers Month is and how you can celebrate it.
If you strive to live an altruistic lifestyle, there are lots of ways to help out this Halloween. Here are some top tricks to make Halloween a treat for everyone.
How can you encourage the children in your life to be active and volunteer with their community? We have some ideas for how to get kids involved in giving back.
There are plenty of ways to get involved in your community. To get you started, we came up with six spooky-fun volunteering ideas for October.
Books are a valuable source of information, creativity and empathy. If you're not a book lover now, you will be soon. Here's how reading makes you a better person.


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"If then you have been raised with Christ, seek the things that are above, where Christ is, seated at the right hand of God. Set your minds on things that are above, not on things that are on earth. For you have died, and your life is hidden with Christ in God. When Christ who is your life appears, then you also will appear with him in glory." - Colossians 3:1-4
Jun 19, 2011
Sermon Series: Reel to Real
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One of the reasons the NIA requested this IOM report is because of growing concern about the increase in the number of men using testosterone replacement therapy in the absence of sufficient scientific information about its risks and benefits. This concern remains. This report offers an initial approach to addressing this problem.
We will consider the IOM recommendations very carefully, including options for implementing the type of trials suggested in the IOM report. In particular, the recommendation that researchers focus their initial efforts on conducting short-term, randomized, double blind, placebo-controlled studies of testosterone in symptomatic older men with low testosterone levels to determine the potential risks and benefits seems to be a reasonable strategy. While there may be risk of yet unknown consequences, there is also some prospect of potential benefit for men with low testosterone levels who have one or more symptoms that might be related to deficiency of this hormone. Consideration of any trials to assess longer term risks and benefits of testosterone therapy should be contingent on the results of these shorter-term studies.
We concur with the IOM's recommendation that any trial be designed in such a way that it elicits useful information about the effects of testosterone therapy on a variety of conditions associated with deficiencies of this hormone. These problems, including frailty, disability and sexual and cognitive disorders, are serious concerns for older men, and it is important to learn more about the potential risks and benefits of testosterone treatment for older men who suffer from these conditions. However, it is also important to point out that these initial studies will not address generalized use of testosterone therapy in men--regardless of age--who do not have extreme deficiencies of this hormone.
The NIA shares the IOM Committee's concern about minimizing the risk and protecting those participating in clinical trials of testosterone therapy. Therefore, we will do our utmost to adhere to the Committee's recommendations regarding the safety of trial participants. As is common practice in all National Institutes of Health sponsored clinical studies, we will carefully communicate the potential risks and benefits of participation to all volunteers prior to enrollment.
Finally, although some older men who have tried these treatments report feeling "more energetic" or "younger," testosterone therapy remains a scientifically unproven method for preventing or relieving any physical or psychological changes that men with normal testosterone levels may experience as they get older. Except for a relatively few younger and older men with extreme deficiencies, testosterone treatment is not deemed appropriate therapy for most men at this time. For now, the risks and benefits of testosterone therapy for most men who do not have extreme deficiencies of the hormone are unknown, and there is insufficient evidence for making well-informed decisions on whether this therapy is suitable in these individuals. The clinical trials and other studies recommended by the IOM could do much to clarify the future role of testosterone therapy in aging men.


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Previous Lecture
Complete and continue
Journal Pages
Getting Started
An Overview of Journaling
An Overview of Transitions (3:56)
Your Transition Tools
Your eBook: Wouldn't It Be Nice...
Soulful Self Care
Your Passion Mind Map
Dream Big Audio & Playsheets
Your Inner GPS
Making Peace With Your Gremlins
Transition Triangle
New Story, New Life
Sparks of Journaling Inspiration
Wouldn't It Be Nice...
Five Minutes To Clarity (5:41)
All About Me
Where's Your Satisfaction?
One Question, Three Actions
This, Not That (2:22)
Hello Gratitude!
An Interesting Conversation
Manifesting Mantra
List of 100
Note to Self
Doodling in the Round
Random Collage
Sparks of Visual Journaling Inspiration
Your Basic Toolkit
Cut, Paste, Vision
Grid Collage
Stencil Stamp Collage
Cardboard & Ribbon
Self-Portrait Collage
Redefine Success Collage
Case Study... How Journaling Helped Me Produce A Public Radio Story
Tool #1... Journaling to Clarity (5:41)
Tool #2... The Power of A Simple Question (7:15)
The Story That Aired on Interlochen Public Radio
Dream Big Audio & Playsheets
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This weekend I finally took advantage of the box of Natural Instincts Cinnaberry that has been sitting on my counter for the past three weeks and colored my hair (again). It's a temporary color (cuz I'm non-committal like that) that washes out after 28 shampoos. I'm thinking of getting a shorter (fun? funky?) cut to go with it and some new glasses as well. I have an eye appointment coming up this week and went scouting out specs this weekend. I'm trying my best to deviate from my usual brown glasses (which is what I almost always seem to get – if it ain't broke, don't fix it?) and have a purple frame in mind. We'll see if I go through with it or not. There's also a black and green frame that I rather like and a couple of (yes) brown ones too.
What kind of hairstyle do you think I should go with? Send me links to pics if you have suggestions. Maybe I'll put together 2 or 3 styles that I like and then post a poll and let the internets decide my next hair style. Ya think?
Here I am with the new shades of Cinnaberry hair. I'm a red-head. (For the record, it doesn't look as red here as it does in person. I'm surprised every time I see myself in the mirror.)


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Law has several new programs to help new graduates gain meaningful legal
experience while also assisting employers to address unmet needs.
Service Fellowship Program
UCLA School of Law's Public Service Fellowship Program seeks to support graduating
students who have demonstrated a longstanding commitment to public service,
enabling them to work with a variety of nonprofit organizations and government
agencies, both domestically and abroad. Please contact Katherine Eklund for
more information.
Graduate Opportunity Program
New Graduate Opportunity Program funds part-time, temporary work with nonprofit
organizations and government agencies for up to 20 hours per week for 10 weeks,
for a total of 200 hours of funding. Participants are paid by UCLA School of
Law, which provides participating legal employers with well-qualified
post-Bar volunteers, while the recent graduates have a unique opportunity to
further build their resume and to enhance their legal skills while awaiting Bar
results. Although participating employers are not required to permanently
hire these graduates, many host employers have offered our graduates long-term
employment at the conclusion of the program. Please contact Lisa Barash for
more information.
Associate Program
new pilot program reaches out to boutique and mid-sized law firms that do not normally hire
recent graduates. Participating firms will hire at least one UCLA Law 2016 or 2017 graduate to work as an apprentice associate for a one-year term. UCLA Law
will provide additional personalized training to participating graduates. The program allows participating firms a creative way of responding to market
changes and client demands, while allowing more senior associates the ability
to develop additional management and business skills. Contact Elizabeth Moeller,
Assistant Dean of Career Services, for more information.


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This morning, Ravens coach John Harbaugh went on a Baltimore radio station to say that the Patriots' championships have "asterisks" and that those titles have been "stained" because of Spygate. It didn't take long for Harbaugh to issue a statement clarifying his remarks to say he was referring to "the perception out there" that continues to linger about the Patriots because of Spygate. And by listening to the actual audio of Harbaugh's initial comments, which were said in response to a question about cheating in general (you can hear them here, beginning at the three-minute mark), it does sound like that was the point he was trying to make.
But what about the man who alerted the NFL that the Patriots were taping opponents' signals? Eric Mangini was the Jets' head coach in 2007 when he turned the Patriots in, and he knew what they were doing because he had spent six seasons as a Patriots assistant, a tenure that included all three of the team's Super Bowl triumphs. These days, Mangini is an analyst on NFL Live, and, you know, he just hates that people still think New England might have done anything untoward to win those titles. It's a sentiment Mangini has expressed before, with a hint at his own direct involvement. But now that Harbaugh has again dredged the whole thing up, Mangini felt the need to explain himself by again stopping short of explaining himself. This is what he said on the program this afternoon, per the Boston Globe:
"It's regret, it's disappointment, it's all of those things," Mangini said. "Because I know what it took to win those Super Bowls and I have so much respect for the people that were involved there. I'm disappointed that this is what it's translated into.
"Never in a million years did I expect it to play out like this," Mangini continued. "This is one of those situations where I didn't want them to do the things they were doing. I didn't think it was any kind of significant advantage, but I wasn't going to give them the convenience of doing it in our stadium, and I wanted to shut it down. But there was no intent to get the league involved. There was no intent to have the landslide that it has become."
So Mangini didn't want the Patriots to gain an advantage by doing something he doesn't think gave them an advantage, and even though he knew they gained an advantage that wasn't really an advantage, he can't believe people think they gained any advantage because it was all no big deal. Oh, and he wasn't the guy who went to the league, OK? According to the Globe, Mangini was on NFL Live with former Patriots linebacker Tedy Bruschi, who defended the team's actions. That then brought this reaction from Mangini:
"To have guys like Tedy have to defend the championships that we earned in New England, and to have anything taken away from the Kraft family, from coach Belichick, and the players and coaches that have meant so much to me, never in a million years did I think it was going to translate into what it was going to translate into," Mangini said. "And it doesn't tarnish what we achieved there. It doesn't tarnish what they achieved after the fact. I think when you look at the history of success that they had after that incident, it's pretty obvious that it didn't play any type of significant role in the victories we had or the success that we had."
Let's keep in mind why any perception that the Patriots cheated still exists in the first place: They were caught doing something that necessitated an investigation by the NFL. As a result of that investigation, the NFL fined Bill Belichick $500,000, and the Patriots were fined $250,000 in addition to having to forfeit a first-round draft pick. But then the NFL destroyed the tapes, thus preventing an outside, independent inquiry of what those tapes contained, and exactly how they might have been used. Maybe the Patriots cheated, maybe they didn't. But for many people, there's still a perception that they did. The NFL got rid of the evidence because they were hoping to make Spygate go away. Five years on, their decision has only ensured that it wouldn't.
Photo via AP.


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Greg Spencer necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 116 diseños de 36 diseñadores freelance.
Beyond Technology Consulting is a boutique Australian consulting firm that will assist your business to align its technology and business strategies. We provide "Actionable Advice" on how to create optimal technical solutions for your business based on our real world experience, industry best practises, and proven technology. Our catch cry's are "Business focused technology alignment" and "Actionable Advice". We do not implement technology, we provide advice on what organisations should do. Our consultants are all technical people with engineering degrees and all have MBA's from leading business school. We call ourselves Technology Management Consultants because IT consultants generally get involved with the actual implementation, and management consultants generally don't fully understand the technology that we recommend.
Our current branding has 3 stairs behind our name representing us taking our clients on a journey "beyond the technology", i.e. focusing on solving the business problems using technology not just giving them shiny new toys. We recently upgraded our website that previously had a very dark background to the current one. The logo banner on the current website is an interim solution that kinda works with the new whiter website, but still looks like our printed branding that has a navy blue background and dark orange text. We want a design that suits the new site.
We are targeting senior executives of medium to large size enterprises. We work for companies that are large enough to have IT departments, and we are generally hired by the CEO, CFO or CIO. Consulting is all about building trust, we aim to be our clients "Trusted advisor" so we want our image to represent very strong technical competence that people trust.
Check out the web site beyondtechnology.com.au We are looking for a design that will fit in with the design, but ideally doesn't mean that we have to re-print all our business cards immediately. We don't hate the current design or think that it looks to dated, however we don't think that it works very well on the new website. We would look to use the design for the website, our business cards, letterhead, product brochures and powerpoint templates.
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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855 East Peckham Lane, Reno, Nevada 89502
Phone: (775) 827-3033
Fax: (775) 827-0397
Monday - Friday: 7:30am-5:30pm
Visit Reno Hospital for Cats
Animal Medical Center of Reno
We will do our best to accommodate your busy schedule. Schedule an appointment today!
Request Appointment
Please complete this form to request an appointment. Please note that you do not have an appointment until you receive confirmation from us. Thank you!


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Andrew Bledsoe necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 141 diseños de 26 diseñadores freelance.
Royalty Marine
I am the owner of a newly formed yacht management company. We are currently in the startup phase and looking for a high quality logo which we can use for our website, business cards, polo shirts and other branding opportunities. Our list of services include:
1. Survey Corrections
2. Yacht Management and Consultation
3. Captain's Services and Yacht Delivery
4. Provisioning Services
5. Engine Repair (Gas and Diesel)
6. Systems Checks
7. Fiberglass and gelcoat Repair
8. A/C and D/C Electrical Repair
9. Electronics Installation and Consultation
10. Interior and Exterior Detailing
11. Compound and waxing
We are looking to attract high end, sophisticated clientele. We are NOT looking to attract owners of sailboats. We ARE looking to attract owners of yachts and powerboats. So please do not submit any logos with a sailing design even though our website appears to be about sailing. It is just a template which we will need to change.
If we are happy with your work and select your design as the winning one there will be a possibility for future design work, and also a possibility for website implementation if you are also skilled in that area.
Thank you for taking the time to review my competition. I have never used this site but I am hoping that I can get some good turn out!
This competition is for skilled graphic designers. Please read the requirements carefully before submitting. I am open to creative designs and do not want to limit you as a designer by giving too many restrictions. In the event I do not see anything that catches my eye within the first or second day I will suggest some alternative ideas. Thank you!
I am looking for a logo design which should incorporate the name of my company: "Royalty Marine"
Below is a link to the website template which we are thinking of using. It would be great if the logo you designed could work well with this template. Please note however that we are NOT a sailing company and that is NOT the clientele which we are hoping to attract. We are looking to attract yacht and powerboat owners. For more information you may contact me or read the About Me section.
Website template:
-The logo will go on the upper left side of the webpage, on business cards and polo shirts
-The logo should be delivered as a Photoshop (*.psd file)
-Last but not least I would like the colors to include some form of Royal Blue. Two photoshop colors that I like for this are #4169E1 and #002366. I also like #CFB53B but am a little bit more unsure of that color. I am open to any shade suggestions though so please feel free to be creative.
Many thanks!
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Brides will often have a rough idea of the style of wedding dress they're after before beginning the wedding planning journey, but this may change with the help of a trained bridal consultant. To find the wedding dress of your dreams, read reviews of bridal shops and visit the store in person to try on a few gowns. Have fun with it!Wedding Dresses Brisbane
Wedding Dresses Insights
There are 15 Brisbane Wedding Dress suppliers from which to choose. Overall, they have an average rating of 4.8 out of 5. Couples usually enquire with 6 vendors in this category and book 16 months out from their wedding date, typically after a Wedding Planner and before a Photographer. Wedding Dress suppliers charge between $400 and $3,050, averaging at $1,675. Across Australia, the average cost is $2,040. Given Australian weddings typically cost $33,640, this means Australian couples spend 7% of their wedding budget on Wedding Dress.
0 suppliers match your filters. Clear
No suppliers match your filters. Please try a different search


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This event has been canceled.Continue reading »
Staff Review of The Wild Inside"Seventeen year old Tracy Petrikoff loves the outdoors. She is an avid hunter with an unusual... proclivity for the animals she kills. Her family is heavily involved with dog sledding but following..."
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Homework Help
Brainfuse HelpNow offers live tutoring 2 - 11 p.m. daily plus a writing lab and study resources.
Using the Library
Borrow a book from libraries around the country with Interlibrary Loan, or reserve a Meeting Room for your next get together, all with your Library Card.
Coming Up...CANCELED - Preschool Storytime
This event has been canceled.
Oak Park Library


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This solar-charged monkey toy that uses solar energy to climb the rope, hand over hand, is probably the first of its kind that we've seen.
Unfortunately, there is some assembly required, but it'll teach the young'ns about how monkeys need to often be under direct sunlight. The solar chimp will cost you about £14.19 ($US20), and while the product description says its suitable for kids over 8, I don't think anyone over the age of 8 is going be lining up, Hannah Montana tickets style. Your best bet is to hang it by a window and hope your toddler can comprehend "photovoltaic arrays" even though their thoughts will be more, "where's my DS?" [Select Solar via DVICE]