text:
Are you Walid F Gellad?Claim your profile
Publications (44)321.23 Total impact
Article: Dual Use of Department of Veterans Affairs and Medicare Benefits and Use of Test Strips in Veterans With Type 2 Diabetes Mellitus.[Show abstract] [Hide abstract]
ABSTRACT: Self-monitoring of blood glucose is a costly component of care for diabetes mellitus, with unclear benefits for patients not taking insulin. Veterans with dual Department of Veterans Affairs (VA) and Medicare benefits have access to test strips through both systems, raising the potential for overuse.JAMA Internal Medicine 11/2014; · 13.25 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Nursing home patients with dementia may be more likely to suffer adverse drug events from suboptimal prescribing. Previous studies have not used national samples, nor have they examined multiple types of suboptimal prescribing by dementia severity.The Annals of pharmacotherapy. 11/2014;
Article: Geographic Variation in Receipt of Psychotherapy in Children Receiving Attention-Deficit/Hyperactivity Disorder Medications.JAMA Pediatrics 09/2014; · 4.28 Impact Factor
- JAMA The Journal of the American Medical Association 08/2014; 312(5):558-9. · 29.98 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Little is known about how Medicare Part D plan features influence choice of generic versus brand drugs. To examine the association between Part D plan features and generic medication use. Data from a 2009 random sample of 1.6 million fee-for-service, Part D enrollees aged 65 years and above, who were not dually eligible or receiving low-income subsidies, were used to examine the association between plan features (generic cost-sharing, difference in brand and generic copay, prior authorization, step therapy) and choice of generic antidepressants, antidiabetics, and statins. Logistic regression models accounting for plan-level clustering were adjusted for sociodemographic and health status. Generic cost-sharing ranged from $0 to $9 for antidepressants and statins, and from $0 to $8 for antidiabetics (across 5th-95th percentiles). Brand-generic cost-sharing differences were smallest for statins (5th-95th percentiles: $16-$37) and largest for antidepressants ($16-$64) across plans. Beneficiaries with higher generic cost-sharing had lower generic use [adjusted odds ratio (OR)=0.97, 95% confidence interval (CI), 0.95-0.98 for antidepressants; OR=0.97, 95% CI, 0.96-0.98 for antidiabetics; OR=0.94, 95% CI, 0.92-0.95 for statins]. Larger brand-generic cost-sharing differences and prior authorization were significantly associated with greater generic use in all categories. Plans could increase generic use by 5-12 percentage points by reducing generic cost-sharing from the 75th ($7) to 25th percentiles ($4-$5), increasing brand-generic cost-sharing differences from the 25th ($25-$26) to 75th ($32-$33) percentiles, and using prior authorization and step therapy. Cost-sharing features and utilization management tools were significantly associated with generic use in 3 commonly used medication categories.Medical care 06/2014; 52(6):541-8. · 3.24 Impact Factor
- JAMA The Journal of the American Medical Association 04/2014; 311(13):1353-5. · 29.98 Impact Factor
Article: Effect of multiple pharmacy use on medication adherence and drug-drug interactions in older adults with medicare part d.[Show abstract] [Hide abstract]
ABSTRACT: To assess the association between multiple pharmacy use and medication adherence and potential drug-drug interactions (DDIs) in older adults. Cross-sectional propensity score-weighted analysis. 2009 claims data. A nationally representative sample of 926,956 Medicare Part D beneficiaries aged 65 and older continuously enrolled in fee-for-service Medicare and Part D that year who filled one or more prescriptions at a community retail or mail order pharmacy. Multiple pharmacy use was defined as concurrent (overlapping time periods) or sequential use (non-overlapping time periods) of ≥2 pharmacies in the year. Medication adherence was calculated using a proportion of days covered of 0.80 or greater for eight therapeutic categories (beta-blockers, renin angiotensin system antagonists, calcium channel blockers, statins, sulfonylureas, biguanides (metformin), thiazolidinediones, and dipeptidyl peptidase-IV inhibitors). Potential DDIs arising from use of certain drugs across a broad set of classes were defined as the concurrent filling of two interacting drugs. Overall, 38.1% of the sample used multiple pharmacies. Those using multiple pharmacies (concurrently or sequentially) consistently had higher adjusted odds of nonadherence (ranging from 1.10 to 1.31, P < .001) across all chronic medication classes assessed after controlling for sociodemographic, health status, and access to care factors than single pharmacy users. The adjusted predicted probability of exposure to a DDI was also slightly higher for those using multiple pharmacies concurrently (3.6%) than for single pharmacy users (3.2%, adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 1.08-1.15) but lower in individuals using multiple pharmacies sequentially (2.8%, AOR = 0.85, 95% CI = 0.81-0.91). Filling prescriptions at multiple pharmacies was associated with lower medication adherence across multiple chronic medications and a small but statistically significant greater likelihood of DDIs in concurrent pharmacy users.Journal of the American Geriatrics Society 02/2014; 62(2):244-52. · 4.22 Impact Factor
- New England Journal of Medicine 01/2014; 370(1):81. · 54.42 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Objectives: A "chiral switch" occurs in the pharmaceutical market when a drug made up of 2 enantiomer forms is replaced with a purified single-enantiomer version, often in the context of a patent expiration. We studied the prevalence of chiral switching in the United States over the past decade, including trends in use of, and expenditures on, these products in Medicaid. Study Design: Retrospective analysis. Methods: We used US Adopted Names prefixes (lev/levo/ar/es/dex/dextro) to identify all single-enantiomer drugs approved from 2001 to 2011. From publicly available US Food and Drug Administration (FDA) approval documents, we extracted the characteristics of the pivotal premarket trials for the single enantiomers. Specifically, we evaluated whether the single enantiomer was directly compared with the precursor racemic drug and whether there was evidence of superior efficacy. We used quarterly drug expenditure data from each state Medicaid program to chart trends in use of, and spending on, the single-enantiomer products and their racemic precursors during the study period. Results: From 2001 to 2011, the FDA approved 9 single-enantiomer products: dexlansoprazole, levoleucovorin, levocetirizine, armodafinil, arformoterol, eszopiclone, escitalopram, dexmethylphenidate, and esomeprazole. Of those 9 drugs, 3 had at least 1 pre-approval randomized trial that included the racemic precursor as a direct comparator, but there was no evidence of superiority of the single enantiomer over the racemic at comparable doses. Between 2001 and 2011, US Medicaid programs spent approximately $6.3 billion on these 9 single-enantiomer drugs. Conclusions: Recently approved single-enantiomer drugs showed no evidence of superior efficacy over the older racemic precursors in the pivotal trials leading to their approval, and in a majority of cases, they were not directly compared.The American journal of managed care 01/2014; 20(3):e90-7. · 2.12 Impact Factor
- 60th Meeting of American Academy of Child and Adolescent Psychiatry; 10/2013
Article: Brand-Name Prescription Drug Use Among Veterans Affairs and Medicare Part D Patients With Diabetes: A National Cohort Comparison.[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND: Medicare Part D and the U.S. Department of Veterans Affairs (VA) use different approaches to manage prescription drug benefits, with implications for spending. Medicare relies on private plans with distinct formularies, whereas the VA administers its own benefit using a national formulary. OBJECTIVE: To compare overall and regional rates of brand-name drug use among older adults with diabetes in Medicare and the VA. DESIGN: Retrospective cohort. SETTING: Medicare and the VA, 2008. PATIENTS: 1 061 095 Medicare Part D beneficiaries and 510 485 veterans aged 65 years or older with diabetes. MEASUREMENTS: Percentage of patients taking oral hypoglycemics, statins, and angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) who filled brand-name drug prescriptions and percentage of patients taking long-acting insulins who filled analogue prescriptions. Sociodemographic- and health status-adjusted hospital referral region (HRR) brand-name drug use was compared, and changes in spending were calculated if brand-name drug use in 1 system mirrored the other. RESULTS: Brand-name drug use in Medicare was 2 to 3 times that in the VA: 35.3% versus 12.7% for oral hypoglycemics, 50.7% versus 18.2% for statins, 42.5% versus 20.8% for ACE inhibitors or ARBs, and 75.1% versus 27.0% for insulin analogues. Adjusted HRR-level brand-name statin use ranged (from the 5th to 95th percentiles) from 41.0% to 58.3% in Medicare and 6.2% to 38.2% in the VA. For each drug group, the 95th-percentile HRR in the VA had lower brand-name drug use than the 5th-percentile HRR in Medicare. Medicare spending in this population would have been $1.4 billion less if brand-name drug use matched that of the VA. LIMITATION: This analysis cannot fully describe the factors underlying differences in brand-name drug use. CONCLUSION: Medicare beneficiaries with diabetes use 2 to 3 times more brand-name drugs than a comparable group within the VA, at substantial excess cost. PRIMARY FUNDING SOURCE: U.S. Department of Veterans Affairs, National Institutes of Health, and Robert Wood Johnson Foundation.Annals of internal medicine 06/2013; · 13.98 Impact Factor
Article: Medication acquisition across systems of care and patient-provider communication among older veterans.[Show abstract] [Hide abstract]
ABSTRACT: PURPOSE: The results of a survey assessing Medicare Part D enrollment, the use of pharmacotherapies for chronic diseases, and other medication-use issues in a population of elderly military veterans are presented. METHODS: Medicare-eligible (i.e., ≥65 years of age) patients with documented recent service use at a single Veterans Affairs (VA) medical center were targeted for a mail survey. Women were oversampled (20%) to ensure an adequate sample size; the sample was weighted to adjust for this oversampling. Usable survey data were received from 458 survey respondents. RESULTS: Nearly all respondents (93.2%) reported having one or more chronic conditions; of those, 93.3% reported regular use of multiple drug therapies, and 30.1% reported using medications prescribed by both VA and non-VA providers for the same chronic condition. About half of the survey respondents reported at least one office visit with a non-VA physician during the previous year, and 55.8% reported obtaining medications from non-VA pharmacies. More than half (54.1%) of the respondents reported non-VA medication coverage, with 21.2% indicating they were enrolled in Medicare Part D. Among the respondents who reported obtaining medications from non-VA pharmacies, substantial proportions reported discussing those medications with VA physicians never (38.4%) or infrequently (15.7%). CONCLUSION: Although large proportions of Medicare-eligible veterans take multiple medications and use non-VA health care services and pharmacies, many do not discuss medications obtained outside the VA system with VA physicians, suggesting that increased efforts to enhance provider-patient communication and medication reconciliation across VA and non-VA systems of care may be warranted.American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists 05/2013; 70(9):804-813. · 2.10 Impact Factor
- Value in Health 05/2013; 16(3):A248. · 2.19 Impact Factor
Article: Adherence to hormonal contraception among women veterans: differences by race/ethnicity and contraceptive supply.[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND AND OBJECTIVE: Little is known about contraceptive use and adherence in the Veterans Health Administration (VA) health care system. We assessed contraceptive adherence among women who were using hormonal contraception (pill, patch, ring, and injectable) and examined the relationships between race/ethnicity and months of contraceptive supply dispensed with contraceptive adherence. MATERIALS AND METHODS: We conducted a retrospective analysis of data from national VA administrative databases. The study cohort included all women veterans ages 18-45 years who made at least 1 visit to a VA primary care clinic or women's health clinic during the study period (FY 2008: Oct. 1, 2007, through Sept. 30, 2008) and who had hormonal contraceptive (pills, patch, vaginal ring, or injection) coverage during the first week of the study timeframe. Women who had undergone hysterectomy or tubal sterilization or who used an IUD or implant in FY 2008 were excluded. We constructed several patient-level indicators of contraceptive adherence over FY 2008. These indicators included gaps of ≥7 days between refills, total months of contraceptive coverage, and presence of contraceptive coverage during the last week of FY 2008. For the last outcome we distinguished between coverage with gaps and continuous coverage throughout the year (perfect adherence). Our primary predictors of interest were race/ethnicity and months of contraceptive supply dispensed. In this analysis, "3-month supply" indicates that the woman received a 3-month supply of contraception at each fill all year; "1-month supply" indicates that the woman received only a 1-month supply at each fill. Anyone who received a 2-month supply or varied months of supply over the course of the year received "other supply." We summarized the indicators of contraceptive adherence (gaps of ≥7 days, total months of contraceptive supply, and contraceptive coverage during the last week of FY 2008) and compared the differences across the key independent variables: race/ethnicity and months of supply dispensed with the use of descriptive statistics and adjusted Cox and logistic regression models. RESULTS: Our study cohort included 6946 women, of whom 46.9% were white, 5.7% Hispanic, 22.2% black, and 3.1% of other race; race information was missing for 22.1%. Most women (83.5%) received a 3-month supply at each fill; 3.6% received a 1-month supply; and 12.9% received other supply. Overall, 64.2% of women had at least 1 gap during the year. Compared to white women, Hispanics were significantly more likely to have a gap (63.7% vs 69.6%, P=.02). Women who received a 1-month supply were significantly more likely than women who received a 3-month supply to have any gap (71.5% vs 63.2%, P=.008). Women had a mean of 9.2 months of contraceptive coverage over the year, with Hispanics and blacks having fewer months of coverage than whites (8.9 and 9.0 months vs 9.3 months, respectively, P<.001). Women who received a 1-month contraceptive supply had significantly fewer months of coverage than those who received a 3-month supply (6.9 vs 9.3 months, P<.001). Of the full cohort, 65.6% had contraceptive coverage the last week of the fiscal year, but the majority (66.9%) of these women had experienced one or more gaps during that time. Only 21.7% of women received a full 12 months of contraception with no gaps between refills (perfect adherence). Bivariable analysis found no racial/ethnic differences related to the likelihood of having contraceptives on hand during the last week of FY 2008. Compared to women who received 3-month supplies, those who received only 1-month supplies were significantly less likely to be on a method the last week of the fiscal year (65.5% vs 43.0%, P<.001) and to have achieved perfect adherence than those who received 3-month supplies (22.2% vs 10.8%, P<.001). Kaplan-Meier curves demonstrating time to first gap of ≥7 days between refills showed that Hispanics experienced shorter time to first gap compared to white and black women (P=.02) (Figure). Women who received 1-month supplies experienced shorter time to first gap than those who received 3-month supplies (P<.001). In adjusted Cox regression analysis, Hispanics remained significantly more likely to experience a gap than white women (hazard ratio [HR],1.18; 95% CI,1.03-1.34). Women who received 1-month supplies remained more likely to experience a gap than women who received 3-month supplies (HR, 1.62; 95% CI, 1.39-1.90). Adjusted models of perfect adherence identified no statistically significant differences by race/ethnicity. Women receiving 1-month supplies were significantly less likely to achieve perfect adherence than those receiving 3-month supplies (odds ratio [OR], 0.46; 95% CI, 0.30-0.69).American journal of obstetrics and gynecology 03/2013; · 3.28 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND:: Antipsychotic medications are commonly prescribed to nursing home residents despite their well-established adverse event profiles. Because little is known about their use in Veterans Affairs (VA) nursing homes [ie, Community Living Centers (CLCs)], we assessed the prevalence and risk factors for antipsychotic use in older residents of VA CLCs. METHODS:: This cross-sectional study included 3692 Veterans age 65 or older who were admitted between January 2004 and June 2005 to one of 133 VA CLCs and had a stay of ≥90 days. We used VA Pharmacy Benefits Management data to examine antipsychotic use and VA Medical SAS datasets and the Minimum Data Set to identify evidence-based indications for antipsychotic use (eg, schizophrenia, dementia with psychosis). We used multivariable logistic regression and generalized estimating equations to identify factors independently associated with antipsychotic receipt. RESULTS:: Overall, 948/3692(25.7%) residents received an antipsychotic, of which 59.3% had an evidence-based indication for use. Residents with aggressive behavior [odds ratio (OR)=2.74, 95% confidence interval (CI), 2.04-3.67] and polypharmacy (9+ drugs; OR=1.84, 95% CI, 1.41-2.40) were more likely to receive antipsychotics, as were users of antidepressants (OR=1.37, 95% CI, 1.14-1.66), anxiolytic/hypnotics (OR=2.30, 95% CI, 1.64-3.23), or drugs for dementia (OR=1.52, 95% CI, 1.21-1.92). Those residing in Alzheimer/dementia special care units were also more likely to receive an antipsychotic (OR=1.66, 95% CI, 1.26-2.21). Veterans with dementia but no documented psychosis were as likely as those with an evidence-based indication to receive an antipsychotic (OR=1.10, 95% CI, 0.82-1.47). CONCLUSIONS:: Antipsychotic use is common among VA nursing home residents aged 65 and older, including those without a documented evidence-based indication for use. Further quality improvement efforts are needed to reduce potentially inappropriate antipsychotic prescribing.Medical care 11/2012; 50(11):954-960. · 3.24 Impact Factor
- Archives of internal medicine 10/2012; · 11.46 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: In complex survey sampling, a fraction of a finite population is sampled. Often, the survey is conducted so that each subject in the population has a different probability of being selected into the sample. Further, many complex surveys involve stratification and clustering. For generalizability of the sample to the finite population, these features of the design are usually incorporated in the analysis. While the Wilcoxon rank sum test is commonly used to compare an ordinal variable in bivariate analyses, no simple extension of the Wilcoxon rank sum test has been proposed for complex survey data. With multinomial sampling of independent subjects, the Wilcoxon rank-sum test statistic equals the score test statistic for the group effect from a proportional odds cumulative logistic regression model for an ordinal outcome. Using this regression framework, for complex survey data, we formulate a similar proportional odds cumulative logistic regression model for the ordinal variable, and use an estimating equations score statistic for no group effect as an extension of the Wilcoxon test. The proposed method is applied to a complex survey designed to produce national estimates of the health care use, expenditures, sources of payment, and insurance coverage.Applied Statistics 08/2012; 61(4):653-664. · 1.25 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To describe facility-level variation in two measures of potentially inappropriate prescribing prevalent in Veterans Affairs (VA) facilities-exposure to high-risk medications in elderly adults (HRME) and drug-disease interactions (Rx-DIS)-and to identify facility characteristics associated with high-quality prescribing. Cross-sectional. VA Healthcare System. Veterans aged 65 and older with at least one inpatient or outpatient visit in 2005-2006 (N = 2,023,477; HRME exposure) and a subsample with a history of falls or hip fractures, dementia, or chronic renal failure (n = 305,059; Rx-DIS exposure). Incident use of any HRME (iHRME) and incident Rx-DIS (iRx-DIS) and facility-level rates and facility-level predictors of iHRME and iRx-DIS exposure, adjusting for differences in patient characteristics. Overall, 94,692 (4.7%) veterans had iHRME exposure. At the facility level, iHRME exposure ranged from 1.6% at the lowest facility to 12.8% at the highest (median 4.7%). In the subsample, 9,803 (3.2%) veterans had iRx-DIS exposure, with a facility-level range from 1.3% to 5.8% (median 3.2%). In adjusted analyses, veterans seen in facilities with formal geriatric education had lower odds of iHRME (odds ratio (OR) = 0.86, 95% confidence interval (CI) = 0.77-0.96) and iRx-DIS (OR = 0.95, 95% CI = 0.88-1.01). Patients seen in facilities caring for fewer older veterans had greater odds of iHRME (OR = 1.54, 95% CI = 1.35-1.75) and iRx-DIS exposure (OR = 1.22, 95% CI = 1.11-1.33). Substantial variation in the quality of prescribing for older adults exists across VA facilities, even after adjusting for patient characteristics. Higher-quality prescribing is found in facilities caring for a larger number of older veterans and facilities with formal geriatric education.Journal of the American Geriatrics Society 06/2012; 60(7):1222-9. · 4.22 Impact Factor
Article: The impact of family caregivers on potentially inappropriate medication use in noninstitutionalized older adults with dementia.[Show abstract] [Hide abstract]
ABSTRACT: The risk of potentially inappropriate medication (PIM), both prescription and over-the-counter, use in dementia patients is high. Informal caregivers often facilitate patients' use of medications, but the effect of caregiver factors on PIM use has not been a focus of previous research. The aim of this study was to examine PIM use in dementia patients and caregivers and identify caregiver risk factors for PIM use in dementia patients. We conducted a secondary data analysis of the baseline wave of the Resources for Enhancing Alzheimer's Caregiver's Health study. The sample comprised 566 persons with dementia aged 65 and older and their coresiding family caregiver. PIM was defined using the 2003 Beers criteria and was examined in both dementia patients and their caregivers. Caregiver and patient risk factors included a range of sociodemographic and health variables. In dementia patients, 33% were taking at least 1 PIM, and 39% of their caregivers were also taking a PIM. In fully adjusted models, the following caregiver factors were associated with an increased risk of dementia patient PIM use: caregiver's own PIM use, spouse caregivers, Hispanic caregivers, and greater number of years that the caregiver has lived in the United States. Increased caregiver age was associated with a decreased risk of PIM use in patients. PIM use may be higher in dementia patients and their informal caregivers compared with the general older adult population. Further, patterns of medication use in 1 member of the dyad may influence PIM risk in the other dyad member. These results suggest that interventions to increase appropriate medication use in dementia patients and their caregivers should target both members of the dyad and target over-the-counter agents along with prescription medications.The American journal of geriatric pharmacotherapy. 06/2012; 10(4):230-41.
- [Show abstract] [Hide abstract]
ABSTRACT: Despite the fact that medication adherence has been extensively described in the literature over the last several decades, a quote by Becker and Maiman from over 35 years ago best captures the current state of our understanding: "Patient compliance[sic adherence] has become the best documented, but least understood, health behavior." Future research is greatly needed to identify and translate safe and effective interventions into routine clinical practice to improve adherence. Only then can we begin to make significant improvements to the medication use process and, in turn, the health of older adults.Clinics in Geriatric Medicine 05/2012; 28(2):287-300. · 3.14 Impact Factor
Top Journals
U.S. Department of Veterans Affairs
Washington, D. C., DC, United States
- Center for Health Equity Research and Promotion (CHERP)
Claremont Graduate University
Claremont, CA, United States
- School of Community and Global Health
RAND CorporationSanta Monica, California, United States
University of Pittsburgh
Pittsburgh, PA, United States
- • Department of Health Policy & Management
- • School of Medicine
- • Division of General Internal Medicine
Brigham and Women's Hospital
Boston, MA, United States
- • Division of General Internal Medicine and Primary Care
- • Department of Medicine
Harvard Medical School
Boston, Massachusetts, United States
- Department of Medicine


text:
A vacuum device is provided which assists in the drawing of blood samples from alternative puncture sites such as the forearm, abdomen or inner thigh and which may advantageously be used by diabetics. The device includes a hollow body which slidably receives a hollow plunger. A transparent cylindrical tip is attached to the lower end of the hollow body. A spring is carried inside the hollow body and hollow plunger, the lower end of the spring seating against a webbing formed in the transparent tip and the upper end seating against the upper end of the plunger. The device is actuatable by the thumb and two fingers of one hand. The plunger is depressed, the device is placed over a preexisting puncture site, and the plunger is released wherein the internal spring drives the plunger upwardly and creates a vacuum at the puncture site, allowing the user to easily see the formation of a droplet of adequate size for obtaining the necessary blood reading.
1. A vacuum device for use in drawing a capillary blood sample from a previously formed puncture site in a patient's skin, comprising:
a hollow body having an upper end and a lower end,
plunger means having upper and lower ends and adapted to be slidably carried inside said hollow body, said plunger being movable between a depressed position and an upward position,
sealing means between said plunger and said hollow body, said sealing means remaining in sealing contact with said body and plunger as said plunger moves in either direction between its depressed and upward positions,
a single spring urging said plunger in an upwardly direction, and
a cylindrical tip attached to the lower end of the hollow body and located below said spring, said tip forming a vacuum chamber around said puncture site when the plunger is urged upwardly by said single spring,
said single spring, said sealing means and said plunger means cooperating to produce a variable strength vacuum in said vacuum chamber depending on how fully said single spring is compressed by said plunger means,
wherein said vacuum device includes only one spring and does not include a lancet for forming a puncture.
2. The apparatus of
3. The apparatus of
4. The apparatus of
5. The apparatus of
said hollow body and said finger flanges are formed as a first injection molded part,
said cylindrical tip is formed as a second injection molded part,
said hollow plunger and said O-ring support is formed as a third injection molded part, and
said plunger cap is formed as a fourth injection molded part.
6. A vacuum device actuatable by the thumb and two fingers of one hand for use in drawing a capillary blood sample from a previously formed puncture site, comprising:
a hollow body with an upper end and a lower end,
a transparent tip means carried by said lower end of said hollow body, said tip means adapted to contact the user's skin around said puncture site,
a finger flange means carried by said hollow body and adapted to be grasped by two of said user's fingers,
a hollow plunger means having upper and lower ends and adapted to be slidably carried inside said hollow body, said hollow plunger means having a plunger cap means at its upper end adapted to be depressed by the user's thumb, said plunger means movable between a first position wherein it extends upwardly from said hollow body and a second position wherein it extends downwardly into said hollow body,
a sealing means between said hollow plunger means and said hollow body means, said sealing means remaining in sealing contact between said body and plunger means as said plunger moves in either direction between its second and first positions, and
a single spring carried inside said hollow body and said hollow plunger means so that said single spring urges said hollow plunger means into said first position, and whereby said user moves said hollow plunger means into said second position by grasping said finger flange means with two fingers and pressing downwardly on said plunger cap means with a thumb, compressing said single spring, and whereby said transparent tip is placed against the skin around said puncture site, and a vacuum is created around said puncture site as the user releases said plunger means and said single spring urges said plunger means towards said first position, wherein the strength of the vacuum is controllable by the user, the vacuum being stronger as said single spring is compressed further by the user, and wherein said vacuum device includes only one spring and does not include a lancet for forming a puncture.
This application claims the benefit of and priority from U.S. provisional application Ser. No. 60/205,639 dated May 18, 2000.
This application relates generally to devices used by diabetics for obtaining blood samples. More particularly, the present invention provides a simple but effective vacuum device which assists in drawing blood samples from alternative puncture sites, such as the forearm, abdomen or inner thigh.
Frequent samplings of capillary blood from the fingertip is now the standard of care in the management of diabetes. Samplings may be needed as often as 8-10 times per day for control of this common metabolic disorder. The problem of fingertip discomfort has encouraged a search for alternative sites for capillary blood sampling. The underside of the forearm, the abdomen and the inner thigh are attractive sites because of their lower number of nerve endings as compared to the fingertips. Unfortunately, these alternative sites, while having fewer sensitive nerve endings, are also less likely to bleed readily when perforated by a lancet.
This well-recognized dilemma has been approached in a number of ways by various inventors and makers of equipment for diabetics. For example, attempts have been made to design a lancet device with an internal vacuum so that, immediately after causing a skin perforation, the vacuum inside the device encourages the formation of a blood drop. Many such devices are described in the patient literature. Examples are seen in U.S. Pat. Nos. 6,027,459; 5,891,053; 5,662,127; 5,666,966; 5,368,047; 4,895,147 and 4,653,513. All of the above mentioned designs are relatively complicated and therefore difficult and expensive to produce.
A simpler approach is presented in U.S. Pat. No. 5,054,499 which describes a bendable, collapsible metal dome with a skin piercing member attached to the underside of the dome. Deformation followed by reformation of the original shape of the dome is said to form a partial vacuum over the puncture site and assist in the formation of a capillary blood sample. Disadvantages of this device are the inability to see the sample, or to repeat the flexion of the metal dome if necessary, as well as the minimal amount of vacuum which can be obtained using this type of device.
Another approach is described in several patents assigned to Mercury Diagnostics (now Amira Medical). Listed U.S. Pat. Nos. of Amira are 5,867,983; 5,951,493; 5,964,718; 5,879,311 and 6,015,392. All of these patents describe devices with so-called �stimulator rings� which, in various ways, surround the puncture site and, when forced down against the skin, urge the blood towards, and then out of, the skin incision. A disadvantage in all of the Amira devices is the inability to see whether an adequate blood drop has actually formed at the puncture site. Mechanically, the devices described in these Amira patents are cumbersome and expensive to manufacture.
The prior art includes various hand-held vacuum devices. For example, U.S. Pat. No. 5,871,456 provides a hand-held device vacuum device for correcting flat, inverted or retracted nipples. The device also includes a transparent tip. However, the device requires the use of two hands and does not use a spring to help generate a vacuum. Vacuum devices have also been proposed for the extraction of toxic venoms, pus or other body fluids from a skin puncture site. Goodrich in U.S. Pat. No. 5,387,203 teaches a tubular device with a plunger which is pulled upwards by the user to create an internal vacuum. Tissue is pulled into the device by the vacuum and lanced by an internal piercing member. A device specifically designed for venom extraction is taught by Andre Emerit in U.S. Pat. No. 4,287,819. In this two-chambered device, downward pressure on a plunger expels air from a lower chamber while creating a vacuum in an upper chamber. In the final moment of depression of the plunger, the two chambers are connected by an orifice in the hollow plunger, causing a vacuum over the skin. A device based on U.S. Pat. No. 4,287,819 is presently marketed by Sawyer Products of Long Beach, Calif. A disadvantage of the device is the suddenness of the vacuum application and the inability to vary its force. A related device is taught by Michel Emerit in U.S. Pat. No. 5,984,876. Neither Emerit device uses any kind of internal spring, therefore differing fundamentally from the present invention.
The invention to be described has advantages over prior devices in that it is small, simple to use and inexpensive to manufacture. A transparent tip allows easy viewing of the developing blood drop. The amount of vacuum force can be readily controlled by the user. If necessary, the vacuum can be recreated without removing the device from the skin or disturbing an already partially formed drop. These and other advantages will become apparent with further descriptions of the device.
FIG. 1 is a semi-transparent three-dimensional view of the device with the spring inside the plunger and cylindrical body;
FIG. 2 is a perspective view of the outer cylinder body of the invention with lateral finger flanges;
FIG. 3 is a perspective view of the transparent tip which forms a portion of a vacuum chamber when the device is activated;
FIG. 4 is a perspective view of the plunger cap utilized with the present invention;
FIG. 5 is a perspective view of the hollow plunger utilized with the present invention and which includes a pair of shoulders which carry therebetween an O ring;
FIG. 6 is a perspective view of the O ring used to create a vacuum seal;
FIG. 7 is a perspective view of a spring which generates a vacuum when allowed to expand.
FIG. 8 shows a user utilizing a prior art lancet device to pierce the forearm skin;
FIG. 9 is a perspective view showing a user depressing the plunger with his thumb while holding the finger flanges with two fingers;
FIG. 10 is a perspective view showing the plunger in its depressed position;
FIG. 11 shows the user placing the transparent tip of the vacuum device over the puncture site formed as shown in FIG. 8, with the plunger depressed;
FIG. 12 shows the user allowing the plunger to be pushed upwards by the internal spring, creating a vacuum and enlarging the blood droplet at the puncture site;
FIG. 13 shows the enlarged blood droplet underneath the transparent tip of the invention in response to the vacuum;
FIG. 14 shows the patient utilizing a prior art glucose sensor strip applied to the blood droplet on the forearm;
FIGS. 15A-15D are scale drawings showing dimensions of the injection molded cylindrical body;
FIGS. 16A-16D are scale drawings showing the injection molded hollow plunger;
FIGS. 17A-17D are scale drawings showing the plastic injection molded plunger cap;
FIGS. 18A-18D are scale drawings showing the transparent plastic injection molded transparent tip;
FIGS. 19A and 19B are frontal and sectional views showing the plunger pushed completely upward by the internal spring; and
FIGS. 20A and 20B are frontal and sectional views showing the assembled vacuum device with the plunger fully depressed.
The drawings show the device of the present invention that assists in the drawing of capillary blood samples from alternative sites, such as the forearm, abdomen or inner thigh. The preferred embodiment is comprised of four injection molded plastic parts; an outer cylindrical body 20 with lateral finger flanges 31 and 32 (FIG. 2), a hollow plunger 60 (FIG. 5), a plunger cap 65 (FIG. 4), and a tip 40 which is transparent and which becomes a vacuum chamber when the device is activated (FIG. 3). The device also contains an inner compression spring 90 (FIG. 7) and an �O� ring 80 (FIG. 6) which fits into a circular groove near the lower end of the plunger.
FIGS. 8-14 illustrate how the present vacuum device 10 is utilized to assist in obtaining a blood sample from a patient's forearm. FIG. 8 shows the patient using a prior art lancet 5 to puncture the skin on the forearm 6. FIGS. 9 and 10 show the user grasping the vacuum device 10 of the present invention and depressing the plunger 60 and holding the plunger 60 down (FIG. 10). Depression of the plunger 60 causes a tension buildup within the spring 90. After the user depresses the plunger, the device 10 is firmly placed against the skin, at the puncture site, as shown in FIG. 11. The plunger is then released resulting in upward movement of the plunger due to spring pressure, as shown in FIG. 12. A partial vacuum is thereby formed within the transparent tip 40 which pulls skin and subcutaneous tissue upward into the chamber. Formation of the enlarging blood drop 9 is easily seen by the user, as shown in FIG. 13. The vacuum is released after the drop has formed by again depressing the plunger. Finally, as shown in FIG. 14, the user places the blood drop 9 onto a prior art glucose sensitive strip 100 to obtain a blood glucose measurement.
FIGS. 2-7 show the separate components of the present invention.
FIG. 2 shows the hollow body 20 which has an upper end 21 and a lower end 22. The body section 20 is preferably circular in cross section and made of injection molded plastic.
A finger flange means 30 is carried by the hollow body 20 near its upper end 21. Flange means 30 includes in the preferred embodiment two flange members 31 and 32 which may be grasped by two fingers of a user as shown in FIGS. 9-12.
FIG. 3 illustrates in perspective view the transparent tip means 40 which is injection molded. Transparent tip means 40 includes a hollow cylindrical sleeve 41 having a lower end 42. Lower end 42 is intended to contact the user's skin around the preexisting puncture site. The upper end 43 of sleeve 41 is connected to the lower end of cylindrical body 20 by ultrasonic welding. The interior of sleeve 41 carries an integrally molded webbing 50 which includes in the preferred embodiment six separate arms 51-56 which radiate outwardly from the center of sleeve 41 and are molded integrally with the side wall of sleeve 41. Webbing 50 has an annular surface 57 (FIG. 19) formed in arms 51-56 which forms the seat for spring means 90; spring 90 is not shown fully seated against seat 57 in the drawings for clarity. Webbing 50 extends from the top portion of sleeve 41 downwardly through approximately one-third of the height of sleeve 41 as shown best in FIG. 19. Webbing 50 preferably includes an upwardly extending portion 59 having an outer diameter sized to slidably engage the lower portion 91 of spring 90 as shown best in FIG. 19. Webbing 50 not only provides a seat for spring means 90 but also allows air to move freely into and out of the interior of plunger means 60 and simultaneously provides a transparent lower portion 58 shown best in FIG. 19 which allows the user a clear view of the blood droplet 9 as it is forming.
FIG. 5 illustrates the hollow plunger means 60 capable of being injection molded. Hollow plunger means 60 includes a cylindrical central sleeve 61 and has a lower end 62 and an upper end 63. Upper end 63 carries an injection molded plunger cap 65 illustrated in FIG. 4 which can be ultrasonically welded to the plunger. Plunger cap 65 has a depressed upper surface 66 designed to comfortably interact with the tip of a user's thumb or finger. The plunger means 60 is movable between a first position illustrated best in FIG. 20 wherein it extends upwardly from hollow body 20 and a second position illustrated best in FIG. 19 wherein it extends downwardly into said hollow body 20. It should be noted that while a solid plunger could be used in a variation of the present invention, a hollow plunger allows the use of the longest possible spring for the best mechanical advantage while at the same time keeping the total length of the device to a minimum.
FIG. 6 illustrates an O-ring 81 which provides one type of sealing means. Sealing means 80 is provided between the hollow plunger means 60 and hollow body 20 and is illustrated best in FIGS. 19 and 20. The sealing means 80 includes an O-ring 81 (FIG. 6) and a pair of O-ring support shoulders 65 and 66 (FIG. 5) which carry O-ring 81. It is within the scope of the invention to use alternate forms of seal between hollow body 20 and plunger means 60.
Spring means 90 is illustrated best in FIG. 7 and is a conventional metallic helical spring having a lower end 91 that seats against webbing 50 and an upper end 92 that seats against the under surface 63 of plunger cap 60. It is also within the scope of the invention to select a wire diameter and coil number for the spring so that the desired vacuum strength is produced over the puncture site.
FIGS. 15 through 18 are self-explanatory scaled parts drawings, illustrating the four key components which are designed to be efficiently injection molded.
Patent Citations
Referenced by
Legal Events
Original Image

subset: commoncrawl


text:
Sears offers the Craftsman 50-lb. Sandblaster Kit with 1/4" Ceramic Nozzle, model no. 16706, for $52.19. Coupon code "SEARS2014" drops it to $47.19. Choose in-store pickup to dodge the $8.99 shipping charge. That's tied with our mention from four days ago and the lowest price we could find by $31. It has a maximum operating pressure of 90psi.
Of note, Shop Your Way Rewards members will earn a Sears credit with this purchase and may be eligible for additional credits and discounts. Plus, Shop Your Way Max members are eligible for free shipping.
$47 + pickupSHOP NOW
Craftsman 50-lb. Sandblaster Kit at Sears
Posted August 7, 2014


text:
November 29, 2014
KRAKOW, Poland (AP) - From distant Canada to small Polish towns, pilgrims are arriving in places linked to Pope John Paul II for concerts and prayers held on the eve of him being declared a saint.
People are gathering on Saturday in John Paul's hometown of Wadowice, now festively decorated in national and papal colors, and in Krakow, where Karol Wojtyla served as priest and bishop for more than 30 years before being chosen pope.
The late John Paul and Pope John XXIII will be made saints Sunday in an unprecedented Vatican ceremony that will be celebrated by Pope Francis with help from Emeritus Pope Benedict XVI.
John Paul remains special to his countrymen for having inspired the ouster of communism from Poland and for his teaching centered on human dignity.
Copyright 2014 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Click Here to access the online Public Inspection File
Viewers with disabilities can get assistance accessing this station's FCC Public Inspection File by contacting the station with the information listed below. Questions or concerns relating to the accessibility of the FCC's online public file system should be directed to the FCC at 888-225-5322, 888-835-5322 (TTY), or firstname.lastname@example.com.


text:
BigOven Pro required (try it free)
Notice a categorization error? Let us know by clicking [alert editor] on the recipe page, in the ingredients box.
Baked Chicken Cordon Bleu
Healthy Cranberry Chicken Salad
Orange Chicken
Feta and Bacon Stuffed Chicken with Onion Mashed Potat...
Richie's Amazing Buffalo Chicken Dip
Sesame Chicken with Honey Dip
Buffalo Chicken Dip
Onion-Crunch Chicken Thighs
Bollywood Chicken Skewers with Spiced Yogurt Dip
Main - Company Chicken
Buffalo Chicken Mac and Cheese
Chicken Piccata (Frugal Gourmet)
Sausage, Hash Brown Casserole
Oven Fried Chicken (uses instant mashed potatoes)
Chicken Croquettes
Crispy Chicken Wings
Shanny's Chicken Enchiladas
Southern Ontario Fried Chicken
Low carb fried chicken
Stuffed Chicken Breasts with Spinach and Mushrroms
Discover new recipes, add your own, create grocery lists and plan your menus.


text:
Whether you love it or hate it, the implementation of the qualifying offer under Major League Baseball's collective bargaining agreement has undeniably changed both free agency and the First-Year Player Draft.
For some teams, signing a free agent with a qualifying offer simply isn't worth sacrificing a future draft pick; for others, it's incentive to at least consider extending an offer to notable free agents.
This year's free-agency period has already impacted the 2015 draft, as the New York Mets (No. 15 overall) and Toronto Blue Jays (No. 17) lost their respective first-round picks as a result of signing Michael Cuddyer and Russell Martin. On the flip side, the signings awarded the Colorado Rockies and Pittsburgh Pirates compensatory picks after the first round, giving both teams a better chance to build for the future or add to what's already in place.
Next year's draft order has already changed and will continue to over the offseason, albeit subtly, but here's an early look at several teams poised to turn free-agent losses into draft gains.


text:
An affiliation of archives, registrars, family history societies and other organisations that hold and promote genealogical resources for the north east of Scotland to visitors both at home and abroad.
An affiliation of archives, registrars, family history societies and other organisations that hold and promote genealogical resources for the north east of Scotland to visitors both at home and abroad.
Get friendly, helpful advice. We are the largest Family History Society in Scotland with a large genealogical library, with extensive Scottish and worldwide records.
Publisher of Old Ordnance Survey Reprints from late 1800's to Early 1900's. Over 2800 maps have been published in the series, with over 180 for Scotland.
Ancestor Network Ltd is a collective of leading professional genealogists based in Ireland. We focus on Irish genealogy research, advice, education, consultancy services and e-publishing.
Ancestry.co.uk is the largest online family history resource, with over 14 billion records and 60 million family trees. As you build your family tree, the site automatically searches for information on your ancestors, and gives you personal hints to point you in the right direction. You'll also find a range of expert advice to help you discover your family's past.
If you have roots in Angus and would like information about the resources available to help you with your family history research, visit the Angus Heritage stand.
APG members represent a broad range of genealogical expertise and are based throughout the world. You can search our directory by geographical region, specialty or member name at www.apgen.org .
Members of the Association of Professional Genealogists in Ireland will be offering free advice for anyone interested in tracing their Irish ancestors.
Our professional genealogists will be in attendance to help with queries about research, or to advise on hiring a professional genealogist/researcher. Speak to an assessor about membership of ASGRA.
Baseline Research offers an annotated timeline approach to capturing histories - telling the story from the perspective of those who have lived along the timeline of that history.
You are being redirected to the Who Do You Think You Are? Magazine forum where you can meet other family history enthusiasts and have your say about the show


text:
Gulf States Toyota Inc.
Q&A: Toyota's Lentz on what triggered the move, and the upheaval ahead
3:45 pm U.S. ET | April 28, 2014In the wake of Toyota's announcement that it is centralizing its U.S. operations in Plano, Texas, Toyota North America CEO Jim Lentz spoke with Automotive News West Coast Editor Mark Rechtin. Here is a transcript....
Read More »
Special Report
How 3 dealerships are connecting with tech-savvy shoppersThree dealers have found ways to forge bonds with car shoppers who are short on time and long on Web smarts. A Honda store has mobilized a young sales team hired from Starbucks and Best Buy. Mon., November 17
» Watch the Video
News by Brand


text:
The hotel is dirty. Especially the bathroom. We were checked into several rooms before we finally settled for the 3rd room. Yet the bathroom feels dirty. Bedsheet wasn't changed today. Towels are not clean. Regretting I paid for 3nights. There's nothing epic about this hotel. It's not worth it. Pricy hotel for terrible service. The air conditioning also didn't. work well
It was fixed after the second call
I'm currently not enjoying my stay.
- Official Description (provided by the hotel):
- The new EPIC Hotel is the premier luxury hotel in Miami, a sparkling cosmopolitan destination on the bank of the Miami River where it meets Biscayne Bay. A stunning addition to Miami, this hotel, a Kimpton Hotel, epitomizes urban design while offering guests a level of style and service expected of such a resort. With exceptional amenities, breathtaking views and dining venues like Area 31, EPIC Hotel makes for an unparalleled Miami experience. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Expedia, Booking.com, Hotels.com, Travelocity, TripOnline SA, Despegar.com, Agoda, getaroom.com, Odigeo, Tingo and Jetsetter so you can book your EPIC Hotel - a Kimpton Hotel reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Epic Hotel Kimpton


text:
Most Popular Articles
Products & Newsletters
IFA 2014 Radio to be Heard Across Germany on Nationwide Multiplex
LONDON—The DRM Consortium will present three programs at the upcoming IBC 2014 convention, happening in Amsterdam from September 11-16:
• 'DRM Pit Stop' on the 12th, in Hall D8, stand D35 (from 4 PM)
• 'DRM Pit Stop' on the 13th, in Hall 8, stand C35 (noon to 1 pm)
• 'Building to a Billion and Beyond' on the 13th, Hall 8, stand C49 (3 to 5 PM)
DRM Consortium members that will be present at the show include Nautel, GatesAir, RF Mondial, Thomson Broadcast, Transradio, and Fraunhofer IIS.
Interested parties should RSVP to email@example.com.
Acceptable Use Policy blog comments powered by Disqus
[an error occurred while processing this directive]
Today in Radio History
Milestones From Radio's Past
The history of radio broadcasting extends beyond the work of a few famous inventors.
Digital Edition
Each Issue as a Digital Edition
Read each issue online in our Digital Edition Format in your Web browser.
EAS Information More on EAS
NWS XML/Atom Feed for CAP Messages
The feed provides feeds for all US states and territories.
Wallpaper Calendar
Radio 2014 Calendar Wallpaper
Need a calendar for your computer desktop? Use one of ours.
The Wire
A virtual press conference
Information from manufacturers and associations about industry news, products, technology and business announcements.
Current Issue
88Nine Radio Milwaukee
A New Home Brings Community Together
Browse Back Issues[an error occurred while processing this directive]
Also in the November Issue
- Trends in Technology: HD Radio Transmission Update
- Franken FM Stations
- Wi-Fi on Wheels: The Connected Car
- Field Report: Yamaha MG10XU
- Transmitter Site Cleanup


text:
Local Weather Forecast
Breaking News Tweets
- Good morning @FAMUNewsNetwork Bria Kelly @BriAKA14 has your morning news update. @FAMU_1887 @NABJ 12 months ago
- Hello Everyone, I am Bria Kelly @briaka14 with the #FAMUNewsNetwork 12 months ago
- Hi I'm Bria Kelly broadcasting live with the @FAMUNewsNetwork update at ustre.am/zSD1 come and check it out! @briaka14 12 months ago
- Thank you for watching. FAMU-TV News at 5 returns after Thanksgiving. (Broadcasting live at ustre.am/zSD1) 1 year ago
- The News at 5 on FAMU-TV is 1 minute away. (Broadcasting live at ustre.am/zSD1) 1 year ago
Top Posts & Pages
As Seen On
FAMU Athletics
- Lady Rattlers Notch 3-2 Win Over Jacksonville To Celebrate Senior Day November 25, 2014The FAMU Lady Rattlers closed out the 2014 season with a big victory over the Jacksonville University Dolphins 3-2, here at the Al Lawson Center on Senior Day
- Head Coach Byron Samuels Signs Two To 2015-2016 Class November 25, 2014Florida A&M University Men's Basketball coach Byron Samuels announced the early signing last week of two ace prep players to join the 2015-16 Rattler squad.
- Lady Rattlers Fall Short In Battle With Troy Trojans 65-59 November 25, 2014Cold shooting and turnovers sank the hopes of the FAMU Women's Basketball team Monday night in a 65-59 loss to visiting Troy (Ala.) University at the Al Lawson Center.
- Lady Rattlers Notch 3-2 Win Over Jacksonville To Celebrate Senior Day November 25, 2014
Associated Press Headlines
- INSIDE KOBANI: Devastation mixed with optimism November 28, 2014KOBANI, Syria (AP) -- Blocks of low-rise buildings with hollow facades, shattered concrete, streets strewn with rubble and overturned, crumpled remains of cars and trucks. Such is the landscape in Kobani, where the sounds of rifle and mortar fire resonate all day long in fighting between Islamic State extremists and the Syrian town's Kurdish defenders.. […]
- BLACK FRIDAY LIVE: Thinner crowds, protests, beer November 28, 2014NEW YORK (AP) -- Black Friday shoppers are starting to look like procrastinators....
- Ferguson protest closes huge St. Louis-area mall November 28, 2014FERGUSON, Mo. (AP) -- Demonstrators temporarily shut down a large shopping mall in suburban St. Louis on one of the busiest days of the year during Friday during one of several organized rallies to protest a grand jury's recent decision not to indict the police officer who fatally shot Michael Brown in nearby Ferguson....
- Michael Brown's legacy continues to evolve November 28, 2014NEW YORK (AP) -- For some Americans on opposite sides of a national debate, Michael Brown has become a symbol, epitomizing their polarized views on who bears the blame for the toll of young black men killed by police officers. Brown was a gentle giant, in one version. A defiant troublemaker, in another....
- Police: Blasts at mosque in Nigeria kill 35 people November 28, 2014KANO, Nigeria (AP) -- Multiple explosions tore through the central mosque in Nigeria's second-largest city on Friday, killing 35 people, police said....
- INSIDE KOBANI: Devastation mixed with optimism November 28, 2014
Entertainment News
Scott Disick and Kourtney Kardashian Have Heart-to-Heart: "We Haven't Slept Together in 5 Years!"—See the Clip! November 28, 2014On this Sunday's brand new Kourtney & Khloé Take The Hamptons, Scott Disick leaves rehab earlier than planned, which makes Kourtney Kardashian feel uneasy about their...
7 Reasons Why Being the DVF Brand Ambassador Would Be the Best Job Ever November 28, 2014On House of DVF, eight young ladies are competing for the position of Diane Von Furstenberg's first-ever Global Brand Ambassador—which sounds like the best job in the...
DVF Candidates Argue in Front of Customers: "I'm Not Going to Apologize"—See the Tense House of DVF Clip! November 28, 2014On this Sunday's brand new House of DVF, the girls continue their adventure to becoming Diane Von Furstenberg's first-ever Brand Ambassador! One of the challenges set up...
Trend Tracker: Updated Black and White November 28, 2014Black, white, and hot all over. Yes, we know. A black and white combination has been around since the dawn of time. What makes this Trend Of The Week so different isn't the color...
Best of 2014: Vote for Your Favorite Food of the Year! November 28, 20142014 was a wild year for food! For starters, it seemed like the whole world was gushing about how much they love the flaky goodness of cronuts, the half-donut, half-croissant treat...
- Scott Disick and Kourtney Kardashian Have Heart-to-Heart: "We Haven't Slept Together in 5 Years!"—See the Clip! November 28, 2014
Go Mobile w/ FAMU TV News
Your Capital Bureau
The FAMUan Online
Journey Magazine
90.5 The Flava Station


text:
Mini Desktop Computer Host
type 107cm cable 1 x AC 100~240V power adapter 102cm cable
free shipping
(2 Reviews)
» Other Parts
Add To Cart
Computer Multifunction Audio Converter
Brand JiaHui Qty 1 Color Translucent white Material Plastic + electronic component Interface Type 3.5mm Application Interfaces: Multimedia speaker Earphone Microphone; No
(0 Review)
» A/V Adapters & Converters
Universal Computer IEC320 Travel AC Power Plug Adapter
- ABS case
- IEC320 to universal socket
- Compact design for easy storage
- Can connect all the overseas electrical adapter
- Suitable for 125V 15A 250V 10A devices
More Buying Choices
(3 Reviews)
» Plugs & Sockets
3-Pin Computer Fan Power Adapter Cable
Quantity 1 Color White + black + red Material Plastic Interface Type N A Application Power adapter cable Other Length: 10cm Packing List 1 x Power adapter cable
» Computer Cable&Adapter
2-Port USB Rear Bracket Adapter for Desktop Computer (15CM-Cable)
- Directly connected to desktop computer
- 2-port USB output
- Cable length: 15cm
(7 Reviews)
4-Port USB Rear Bracket Adapter for Desktop Computer (15CM-Cable)
- Directly connected to desktop computer - 4-port USB output - Cable length: 15cm
4-Port USB Rear Bracket Adapter for Desktop Computer (20 CM-Cable)
- Directly connected to computer
- 4-port USB output
- Cable length: 20 CM
(8 Reviews)
» USB Hubs & Switches
YS-588 Waterproof Bike Computer Bicycle Speed Meter - White + Black
. Count down distance; 6. Calories level; 7. Temperature; 8. "+" "-" Compare; 9. Backlight; 10. 4 Language; 11. Adaptable for KM hr or M hr; 12. Setting wheel cycle; 13. Auto
(1 Review)
» Bike Computer
LX-B3504 USB 2.0 Bluetooth v4.0 + HS Adapter for Computer - Black
x Adapter
» Bluetooth & IrDA
20-pin to Dual USB 3.0 Adapter Cable w/ Baffle for Desktop Computer - Blue (50cm)
socket can be changed directly to 2 USB 3.0 plug socket Packing List 1 x Adapter cable
DEEP COOL Desktop Computer CPU Heatsink Cooling Fan
+ aluminum sheet Others Power supply: 12V, 0.11A; Input power: 1.32W Packing List 1 x Cooling fan 1 x AMD buckle 1 x Adapter holder 8 x Buckles 4 x Screws 1 x Heat dissipation
» Hardware Cooling Gears
Universal EU Plug AC Power Cable for Computer / Display (150cm-Length)
- Color: Black
- Material: Plastic housing
- Interface: EU plug 2-round-pin
- Cable length: 150cm
ABS Desktop Computer 1.8" to 2.5" SSD to HDD Mounting Adapter Holder - Black
Color: Black Brand: N A Quantity: 1Piece Material: ABS Form Factor: 1.8" , 2.5" , 3.5" , 5.25" Powered By: No Supports Max. Capacity: NoB Slot: No Supports System: Win xp
» HDD Dockings
1000Mbps Ethernet PCI-Express Card for Desktop Computer / Server
Features Full duplex half duplex adaptive; Suitable for desktop computer server; Support remote wake-up function OS Supported Windows 2000 XP Vista 7 linux Mac Packing List 1 x
» Network Cards
M3 DIY Computer Cooling Compression Spring - Silver (10 PCS)
Color: Silver Brand: N A Model: M3 Quantity: 10Piece Shade Of Color: Silver Material: Steel nickel plated Other Features: Wire diameter: 0.8mm; Length: 10mm; Stiffness co
Digital Computer TV Program Receiver Analog TV Box
resolution mode; 3D motion adaptive de-interlace, multiple digital image enhancement and digital noise reduction technology will bring you the real effect of home theater; All
» TV Receivers
USB 3.0 Connection Cable for PC Computer Case - Blue
Brand No Quantity 1 Color Blue Interface Super speed USB 3.0 Features High quality connection cable; Length: 25cm Packing List 1 x Connection cable
» Network Cables and Adapters
2-Port USB 2.0 Expansion Board Connection Cable for Computer - White + Silver
extend the USB 2.0 pin of motherboard into USB 2.0 interface, without adapter function; USB expansion port distance: 1.4~1.5cm; Two USB ports pitch: 2.7~2.8cm; USB baffle
Universal Large 4-Pin to 3-Pin Power Supply Adapter Cable for Computer CPU Fan - White
Brand N A Quantity 1 Color White Material Copper wire Interface Type Large 4-Pin to 3-pin Application Suitable for computer fan power supply adapter Packing List 1 x
Aluminum Alloy Desktop Computer 2.5" to 3.5" SSD / HDD Mounting Adapter Holder - Black
Color: Black Brand: N A Quantity: 1Piece Material: Aluminum alloy Form Factor: 2.5" Powered By: No Supports Max. Capacity: NoB Slot: No Supports System: Universal
Resin Desktop Computer 2.5" to 3.5" SSD / HDD Mounting Adapter Holder - Green
Color: Green Brand: N A Quantity: 1Piece Material: Resin Form Factor: 2.5" Powered By: No Supports Max. Capacity: NoB Slot: No Supports System: Universal
Universal EU Plug AC Power Cable for Computer (90-Length)
Quantity 1 Color Black Material PC + ABS Interface Type EU plug Application Power cable for Computer Other Cable length: 90cm Packing List 1 x Cable
HDMI Male to Male Video Connecting Adapter for TVs / Projector / Computer + More - Black + Golden
connecting cables w devices, such as computer, digital TV, plasma TV, LCD TV and projector, etc. Packing List 1 x Adapter
Kingston MobileLite G4 Computer Memory Card Readers FCR-MLG4
two-year warranty, free technical support Packing List 1 x Kingston MobileLite Computer Memory Card Readers FCR-MLG4
» Card Adapters
Nylon Magic Tape Organizers for Computer Wire Cord Cable - Multicolored (12 PCS / 1 x 8cm)
Brand N A Model N A Quantity 12 Piece Color Multicolored Material Nylon Features Magic tape cable organizers, suitable for computer cables, cellphone cable, wire etc
(6 Reviews)
» Cable Management
M.2(NGFF) to 2 USB 3.0 19-pin Converter Adapter Board Module for Desktop Computer - Red + Blue
Color: Red + Blue Model: N A Quantity: 1Piece Material: PCB
Syllable G08L-001 Hi-Fi Headphone w/ Microphone for Iphone 4S / 5 / Laptop Computer
battery 1 x 3.5mm audio cable 120cm 1 x 3.5mm audio cable with mic 120cm 1 x USB charging data cable 110cm 1 x Cleaning cloth 1 x 2-Pin aviation plug 1 x 6.35mm adapter 1 x
» Headphones
B-JY69 Computer Companion USB Anion Ozone Air Purifier - White + Green
Color: White + Green Brand: N A Model: B-JY69 Quantity: 1Piece Material: ABS Interface: USB 2.0 Powered By: USB Supports System: Universal Other Features: Working tempera
» USB Gadgets
Ultrathin HD VGA Male to Male Connecting Cable for Computer / Projector / HDTV + More - Black (15m)
Color: Black Brand: N A Quantity: 1Set Material: PVC + gold-plated + brass Interface: VGA
25-in-1 DIY Computer Power 4Pin Female End w/ Terminal Connectors - Black
Quantity 1 Color Black Interface 4pin Material PVC Features Great for DIY computer power Packing List 5 x 4pin female ends 20 x Female terminals
JiaHui 3-Pin Computer CPU Fan Deceleration Cable - White + Black (2 PCS)
Color: White + Black + Multi-Colored Brand: JiaHui Quantity: 2Piece Material: Plastic + electronic components Shade Of Color: Multi-color Interface: CPU fan power supply
Retractable RJ45 Male to Male Network Cable for Computer - Black (3m)
; Transmission speed up to 100Mbps; Suitable for network testing, switcher, router connected with computer.
Portable RJ45 Male to Male Retractable Cable for Computer - White
Color: White Brand: N A Quantity: 1Set Material: Environmental ABS Interface: RJ45 Powered By: Power Free Other Features: Retractable cable design, length up to 120cm; Tr
LINE5 M303 Computer High Quality Digital USB Coaxial Optical Decoder - Grey
Color: Grey Brand: LINE5 Model: M303 Material: Aluminum material Quantity: 1Set Cable Length: 100cm Connector: Others,USB,3.5mm Plug Specifications: USB Other Features: U
4pin to 8pin Power Extension Cable for Computer - White + Yellow + Black
Brand N A Quantity 1 Color White + yellow + black Material Plastic Interface Type 4pin to 8pin Application Extension cable Packing List 1 x Extension cable 20cm
CAT 6 RJ45 Flat Network Cable for Computer / Router - White (210cm)
Brand N A Quantity 1 Color White Interface CAT 6 Features Thin,firm and durable; Suitable for connecting computer and hub router; Space-saving and dost; High speed, up
DIY Computer 4-Pin to SATA Power Supply Wire - Silver (40cm)
power connectors for one cable, free installation according to the location of the computer's HDD Packing List 1 x Wire 3 x SATA power supply connectors
CHEERLINK CT-12 Desktop Computer PCI 4-Bit Test / Diagnostic / Debug Card w/ USB
Brand CHEERLINK Model CT-12 Quantity 1 Color Red + black + silver Material PCB Application Computer motherboard diagnostic card; PCI parallel port 4-bit desktop test
» DIY Tools
DIY Computer HDD Power Supply Wire Cover Terminals - Black (5 PCS)
Quantity 5 Color Black Interface SATA Material PVC + alloy Features DIY Computer SATA cable, 1 cover and 1 tip for group 1, comes five groups; It is pressed at the end
Computer Fitness Sport One-person Dance Pad / Mat - Multi-color
170 cm Features Suitable for home, fitness place and game center; Link to AV port and get into game directly; Should install CD driver when playing on computer Packing List
» PC Game Controllers
Jiahui 4-pin Computer Case Power Supply to 3-pin Cooler Fan Adapting Wire - Black + White (2 PCS)
can convert computer case power supply to 12V 3-pin cooler fan connector; Suitable for CPU fan, graphics fan.
Retractable RJ45 Network Cable for Computer / Router - Black + Silver (146.5cm)
Please refer to:
http: dx.com p retractable-rj45-network-cable-1-5m-length-25115 Quantity 1 Color Black + Silver Material Plastic Compatible Devices Computer router
Lexar 25-In-1 USB 3.0 Multi-Card Reader (LRW025URBAS) PC, Computer, Hardware
Color White + Black + Multi-Colored Brand Lexar Model LRW025URBAS Quantity 1 Piece Specification Lexar Multi-Card 25-In-1 USB 3.0 Reader LRW025URBAS PC, Computer
Flexible Computer QQ / MSN / Skype Microphone - White (3.5mm Plug)
Quantity 1 Color White Material ABS Impedance Sensitivity -55dB + - 2dB Working Voltage 1.5V V Features 3.5mm stereo plug fit fro all kinds of PC, noisy cancellation; Hig
» Microphone
Universal US Plug AC Power Cable for Computer (135cm-Length)
Quantity 1 Color Black Material Plastic housing Interface Type US plug Application Computer, monitor etc. Other Cable length: 135cm Packing List 1 x Cable
Smiling Face Style Warm Fingerless Computer Tying Woolen Gloves for Woman - Green (Pair)
hands warm as you are computer typing in the cold winter Packing List 2 x Gloves
» Gloves
DIY Protective Knit Mesh Cable Cover Shield for Computer Power / Audio Cable + More - Black (30m)
- Fireproofing grade: UL94V-2 UL VW-1
- Temperature: -50'C~+125'C
- Melting point: 230'C + - 5'C
- Application: Can be as protective and beautified for computer power cable, audio
4-pin Male to 6-pin Female to Computer Power Extension Cable - Multicolored (15cm)
Brand N A Quantity 1 Color White + yellow + black Material Plastic Interface Type 4-pin male to 6-pin female Application Computer power extension cable Packing List 1 x
Computer Case 20-Pin to USB 2.0 + USB 3.0 Dual Female + Audio Front Panel Extension Cable
64 , Win8 32 , Win8 64 Other Features: Interface: 20-Pin, USB 3.0, HD audio, audio interface; Computer case built-in wire, 20-Pin to USB 2.0 + USB 3.0 dual female + audio
8-Pin Male to Female Computer Power Extension Cable - White + Yellow + Black (20cm)
Brand N A Quantity 1 Color White + yellow + black Material Plastic Interface Type 8-pin male to female Application Computer power extension cable Packing List 1 x
4-Pin Male to Female Computer Power Extension Cable - Black + Yellow + White (20cm)
Brand N A Quantity 1 Color White + yellow + black Material Plastic Interface Type 4pin to 8pin Application Computer power extension cable Packing List 1 x Extension
DIY Computer Red Light Decoration Strip w/ 3M Sticker + 4Pin Power Cable - Black + White (60cm)
Quantity 1 Color Black + white Material Rubber Interface Type 4pin computer power supply port Application Computer chassis beautification Packing List 1 x Light strip
1-to-2 24-Pin Power Supply Cable for Computer Mining Machine
Features: Suitable for computer power supply within 2000w
DIY Protective Knit Mesh Cable Cover Shield for Computer Cable - Fluorescent Green (8.0mm / 16m)
for computer graphics card 8p 6p cable, CPU 8p cable etc., suitable for 6~8 PCS 18AWG cable, computer power cable, audio cable, car, aviation, electric wire and cable
LINE5 Pink A830 External Drives USB CD-ROM Sharing File Recording Notebook External Sharing Computer
Color: Pink Brand: LINE5 Model: A830 Quantity: 1Set Material: Aluminum material Interface: USB 2.0 Powered By: USB Other Features: Cable length: 110cm
Winyao WY580T PCI-e X1 2 x RJ45 RJ45 Gigabit LAN for Desktop Computer
design, integrate 2 x RJ45 network card interface; Designed for desktop computer; Optimize the performance; Adapters have an integrated hardware acceleration that performs TCP
Aluminum 2-Channel Digital Audio Power Amplifier for Car / Home / Computer + More - Golden
pre-amplification, it can be widely used Packing List 1 x Car amplifier 1 x 100~240V power adapter 100cm cable 1 x Audio cable 130cm 1 x Power cable 100cm 3-flat-pin plug
» Car Amplifiers
NC 690 Multi-User Win CE 6.0 Network Computer PC Terminal w/ 3 x USB / LAN / Video - Black (128MB)
Chinese Spanish French Swedish German English Italian Korean Japanese Dutch Portuguese
- Accessories include:
- 1 x 100~240V Power adapter 2-flat-pin plug 150cm-cable
- 1 x
» Other Network Gadgets
Insulated Cover Tube Heat Shrink Tubing for Computer Power Wire - Black (3.4M)
Quantity 1 Color Black Material Polyolefin Interface Type Wire Application Widely used in electronic equipment; Features water resistant, leak-proof, insulated etc. Other
Cosonic CM-222 Desktop Wired Flexible Microphone w/ Switch / 3.5mm Plug for PC / Computer - Black
Brand Cosonic Model CM-222 Quantity 1 Color Black Material Engineering plastic Impedance 2.2K Microphone Frequency Response 20~16000Hz Sensitivity 58+ -3dB Interface Type
Get great weekly deals and offers like:
© 2006~2014 DX.com. All rights reserved.
Note:Stock and Availability shown on this site is for your reference only. While
we strive to provide the most accurate and timely stock and availability information,
availability information may become out of date and may change between the time
you added an item to cart and the time your order is received.
Quantities on clearance items are limited. Prices are current at time of posting. DX Reserves the right to change prices at any time without notice.
Partners: DXLISTING l
Volumerate l
MadeinChina l


text:
Celebrating a rad kickstarter victory from Utah tonight. Appreciate everyone who pledged, tweeted and prayed.
#vscocam #rainier20twelve #rainier #utah
Celebrating a rad kickstarter victory from Utah tonight. Appreciate everyone who pledged, tweeted and prayed.
#vscocam #rainier20twelve #rainier #utah
It's finally here! After hours and hours of writing, editing, chopping, and refining, Jeff and Brad (with the help of many other warriors) finished the #Rainier20Twelve documentary film and article.
Please take a few minutes to watch and read, as I believe it will entertain, inspire, and encourage you.
To reiterate, this was a massively life changing experience for me personally, so I'm extremely grateful that the guys took the time and love to put this together.
January 1, 2012: A gunman drove into Mount Rainier National Park and murdered an on-duty law enforcement ranger. Margaret Anderson leaves behind a husband and 2 young children.
June 21st, 2012: Climbing Ranger Nick Hall accidentally fell to his death while performing an on-mountain rescue of 4 injured climbers near the summit of Mount Rainier.
August 13, 2012: A group of 5 entrepreneurs, creatives and adventure-enthusiasts set out to summit Mount Rainier to raise funds for Margaret's husband and two children, and for Nick Hall's family. For 4 of the climbers, Ryan, Paul, Bradley and Jeff, this was their "first ascent".
Michael Rowley, Founder of 14,4 Foundation, has built his foundation on a passion for helping those whom have been injured in the outdoors, or families who have lost loved ones to the outdoors. This climb marks the first fundraising effort by 14,4 Foundation to help a family who lost a loved one in the line-of-duty.
Michael Rowley – Founder – 14,4 Foundation - FourteenFour.org
Ryan Frederick – Founder – Crux Watches - CruxWatches.com
Paul Blackmon
Brad Castaneda – Creative Director – TwentyFiveThree - TwentyFiveThree.com
Jeff Marsh – Owner/ Director – 5 Mile Films - 5MileFilms.com
Directed by Jeff Marsh - 5milefilms.com
Produced by Fourteen Four Foundation - FourteenFour.org
Filmed by Bradley Castaneda and Jeff Marsh
Edited by Bradley Castaneda - BradleyCastaneda.com
Editing and Coloring by Jeff Marsh
Edited in FCPX
Colored in LR4 using VSCO Film presets - VisualSupply.co
GEAR provided by Borrow Lenses - BorrowLenses.com
Canon 5d Mark 3
Canon 5d Mark 2
Canon 7d
Canon 5d
iPhone 4s
Canon 16-35mm 2.8 L lens
Canon 35mm 1.4 L lens
Canon 24mm 1.4 mark 2 L lens
Canon 24mm 1.4 mark 1 L lens
Rode Video Mic Pro
Visual Supply Co - VisualSupply.co
Apple Physical Therapy - ApplePT.com
Rhino Camera Gear - RhinoCameraGear.com
Borrow Lenses - BorrowLenses.com
Die Cut Stickers - DieCutStickers.com
Makin Music - MakinMusic.com
Outdoor Research - OutdoorResearch.com
Crux Watches - CruxWatches.com
5 Mile Films - 5MileFilms.com
Bradley Castaneda - BradleyCastaneda.com
REI - REI.com
Arc'teryx - Arcteryx.com
Whittaker Mountaineering - WhittakerMountaineering.com
Petzl - Petzl.com
Making donations is simple. Just navigate to Rainier20Twelve.com and enter the amount of money you would like to donate. The donations are tax-deductible and receipts are available upon request. Feel free to email us if you have any questions.
All proceeds are given to the memorial funds set up by the families of Margaret and Nick.
All donations will be processed through the 14,4 Foundation 501(c)3 account.
Mission accomplish. Have been wanting this shot for years. #rainier20twelve #vscocam #mtrainier (Taken with Instagram)
The Snowfield.
#vscocam #mtrainier #rainier20twelve
Turn up the toasty in casual outfits with these ultra-cozy scarves. Up to 60% Off! Limited time only: Ends 11/27! Shop Today!
WE MADE IT! Summit at 515. Sunrise was perfect. #rainier20twelve #vscocam (Taken with Instagram)
Fitting for the feat. #rainier20twelve @ryanfred #rainierbeer #vscocam (Taken with Instagram)
Tomorrow We summit. #vscocam #rainier20twelve (Taken with Instagram)
Snuggled up with @bradcastaneda and @ryanfred for the night. #rainier20twelve #littletahoma #vscocam (Taken with Instagram)
A crew headed for home. #rainier20twelve #littletahoma #vscocam (Taken with Instagram)
#Rainier20twelve documentary is up on Vimeo!
This is a foreword I wrote for a short story written by my best friend Jeff about our recent Mt. Rainier summit. I wanted to include it here because it documents a my heart surgery story and captures some of the emotion felt when we reached the summit.
When we summited Rainier, it was a far more emotional experience than I had prepared for. It wasn't until Jeff and I climbed the final feet side by side that it hit me. I cried more intensely than I ever had. Exactly seven years prior I was undergoing physical therapy in Switzerland and struggling to climb just three simple stairs.
A few months after we graduated from the University of Washington in 2005, my wife Selena and I moved to Zurich to work at a private equestrian showjumping farm. We were young, relatively burdenless, and looking for adventure; we had no idea of how adventurous the journey would actually be.
When we arrived, I was already sick. I had pushed too hard during my last month of school, working too much, sleeping too little. The combination of an overwhelmed immune system and a congenital heart defect resulted in a bacterial infection of my mitral valve - of which I was completely unaware. My only symptom was a persistent cough.
In Switzerland, the bacteria gained momentum and prevented me from working. What started as a cough evolved into chronic fatigue and fevers. After the first three weeks on the farm, our jobs were at risk because of my inability to perform. When my boss informed me of our likely termination, I determined that I wouldn't let my "light fevers and weakness" keep us from this incredible opportunity.
The next day, despite my sickness, I started my job demolishing and reconstructing stalls for show horses. This involved the very unsanitary and strenuous task of removing urine soaked stall mats and the underlying bricks, releveling the foundation, and replacing the bricks and mats. I worked a solid week until my symptoms became unmanageable.
Through a wild chain of events, I ran out of my medicine on Friday evening just before a Swiss holiday that would prevent me from refilling and seeing my doctor until the following Tuesday. The infection flourished; my light shivers evolved into seizure-like convulsions and my mild fevers turned into mattress soaking sweat episodes.
When Tuesday rolled around, I didn't realize it but I was at serious risk of dying. I couldn't muster a ride to the local clinic, so I walked 3 miles in the rain to see my physician who had taken the week off for the holiday. When they tried to turn me away for lack of an appointment, I scrapped my broken German and insisted in English, "I need help, now!". Seeing my condition, they allowed me to wait for the only other doctor on a metal table in a back room. I remember shivering and shaking so wildly, it was a significant effort just to stay on the table.
God was watching over me that day. The new doctor looked at my chart with fresh eyes and immediately recognized a problem. He listened to my heart and identified a murmur that warranted urgent attention. When he told me that I would need to go to a larger regional clinic right away, my only response was, "Well, how much will that cost?". He responded, "It's that, or your life." Needless to say, we left for the clinic soon after.
Upon arrival, doctors soon identified a 2.5 centimeter long growth that was waving like a flag off one flap of my mitral valve. If left untreated, it was likely that the infection would overwhelm my immune system and/or break off and cause a stroke or loss of limb. The local doctors called the State Hospital of Zurich to see if they had room as the care I needed was well outside of their scope.
Within hours I was consulting with the head of cardiology and within one week I was undergoing open heart surgery with a real chance of not surviving.
It was in the month afterward that I realized how fragile and precious health and life are. It took weeks for me to regain the ability to perform simple activities like sitting up, walking, and climbing stairs. With every step, my heart would beat uncontrollably, my lungs were overwhelmed (they were compressed by 1.5 liters of fluid in my thoracic cavity). I didn't feel like I'd ever be able to run or climb or do anything I loved ever again.
As we stood atop the 14,400+ summit of Rainier, brought there by the same heart and lungs that had been so frail 7 years prior, I couldn't help but cry and thank God for a body to get me there. It is an experience I will never forget, and one I hope to commemorate with many more physical feats. As you read our story, I hope you are encouraged, empowered, and emboldened to tackle mountains of your own. Remember that you can overcome obstacles that are seemingly insurmountable, even if it's not until 7 years later!
Ingraham flats looking east during sunset. #vscocam #rainier20twelve (Taken with Instagram)
From the summit looking north east. #vscocam #rainier20twelve (Taken with Instagram)
Good morning! Summit route. #rainier20twelve (Taken with Instagram)
Little Tahoma. #vscocam #rainier20twelve (Taken with Instagram)
The crater rim of the summit. #vscocam #rainier20twelve #mtrainier (Taken with Instagram)
On the summit with the team. #vscocam #mtrainier #rainier20twelve (Taken with Instagram)
Sharing this shot @jeffkmarsh took of me and Paul coming down off the summit. Love this shot, good work @jeffkmarsh! #vscocam #rainier20twelve #mtrainier (Taken with Instagram)
"Keep away from people who belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great." #vscocam #mtrainier #rainier20twelve #blackandwhite (Taken with Instagram)
Sunset over Gibralter. #vscocam #rainier20twelve (Taken with Instagram)


text:
LuAnn thinks George's gf has a screw loose, Sonja needs to move on, and that Kristen and Josh are headed for trouble.
Kristen says her "pimp daddy" is just being funny and focuses on what Millou's funeral really means.
Ramona admits that LuAnn has her pegged, but wishes Kristen would have accepted her apology.
Sonja knows Ramona isn't going into anger management -- and she knows Kristen needs to buck up and appreciate what she has with her husband.
Heather explains why it was important to confront Ramona, what she thought of that apology, and reflects on the choices we make.
Kristen believes what's happening with Josh is normal, but thinks Ramona might have some issues to deal with.
LuAnn understands why Kristen called Ramona a monster and thinks once again Ramona is out-of-line.
Carole wonders when one should stop splashing, why she's a bullsh-- bisexual, and how many times one can say "Who does that?"
LuAnn doesn't think a leopard can change his spots -- and that Ramona should have been smart enough to not get photographed.
Sonja explains that no one is feeling Ramona's pain -- and tells you what happened with that young captain.
Heather wouldn't have cared if Ramona wanted to flee the Berkshires, she just wished she had told her the truth about it.
Kristen wants Ramona to know that she's sorry for what happened in her past -- but that it's no excuse for how she behaved.
Ramona explains her "knee-jerk reaction" and how many air conditioners she tried to gift to Heather.


text:
rosinLine breaks: rosin
Pronunciation: /ˈrɒzɪn /
Definition of rosin in English:
noun[mass noun]
Resin, especially the solid amber residue obtained after the distillation of crude turpentine oleoresin, or of naphtha extract from pine stumps. It is used in adhesives, varnishes, and inks and for treating the bows of stringed instruments: they will also supply crushed colophony rosin [as modifier]: liquid rosin flux
More example sentences
- Linoleum, made from all-natural materials including linseed oil and pine rosin, is a low-cost and maintenance-free choice.
- Marina was only half-listening as she took Shell's rosin box and ran the hard, translucent, amber colored rosin along the hairs.
- In the aquatint process, areas covered by rosin powder become pitted when immersed in an acid bath.
verb (rosins, rosining, rosined)[with object] Back to top
Rub (something, especially a violin bow or string) with rosin: island musicians are rosining their bows
More example sentences
- Once open she proceeds to pull out the violin and rosin her bow.
- As Shelley talked happily about the viola player and rosining her bow, Marina plucked the strings softly - A, D, G, up to E - tuning quietly with the fine tuners.
- An instrument with strings sounded by a rosined wheel instead of a bow.
Middle English: from medieval Latin rosina, from Latin resina (see resin).
Definition of rosin in:
- US English dictionary
What do you find interesting about this word or phrase?
Get more from Oxford Dictionaries
Subscribe to remove adverts and access premium resources
Top searches
= trending
Word of the day Sprachgefühl
Pronunciation: ˈʃprɑːxɡəˌfuːl
intuitive understanding of a language's natural idiom…


text:
Mosquito Genomes Galore
November 27, 2014|
Whole-genome sequences of 16 different mosquito species reveal rapid evolution and could inform malaria research.
November 27, 2014|
Whole-genome sequences of 16 different mosquito species reveal rapid evolution and could inform malaria research.
November 24, 2014|
The cold-tolerant cereal crop allowed humans to live and farm higher than ever starting more than 3,000 years ago.
November 17, 2014|
Improved methods to grow patients' tumor cells in a dish offer opportunities to find durable therapies.
November 13, 2014|
Many social factors contributed to the evolution of male infanticide in mammal societies.
November 12, 2014|
Researchers show that patterned coloration can be an effective means of distracting predators from vital body parts.
November 11, 2014|
A round-up of recent discoveries in behavior research
November 11, 2014|
The Internet search giant joins a number of other companies offering cloud computing and genome storage.
November 6, 2014|
A newly described method linearizes circular chromosomes in yeast and caps them with telomeres to mimic natural chromosomes.
November 6, 2014|
Researchers create a phylogenetic tree of insects by comparing the sequences of 1,478 protein-coding genes among species.
November 5, 2014|
The genitalia of mammals and reptiles develop from two different tissues, but the structures share common genetic programs and molecular induction signals.


text:
Do you want to find a intimate encounter when the christmas is near by ? You can go this site --casualchats.com,It's a nice place for people who wanna start a short-term relationship .The members are diverse and located in the U.S., U.K., Canada, Australia, Europe and worldwide.No hesitation to find your true love in your area.
Originally written on roundballchat.com | Last updated 11/19/14
The North Carolina Tar Heels looked like the best team in the country Wednesday night, when they defeated the young Texas Longhorns 82 to 63 . The Tar Heels had many high flying dunks on the night. There is no question that the dunk of the night goes to Tar Heel freshman P.J. Hairston. Hairston literally posterizes the Texas defender. The defender tried to take a charge but just got dunked on. Hairston threw down an impressive one hand slam. Hairston is known more for his shooting ability but he really showed off his jumping ability on that dunk. Hairston doesn't look like a freshman physically. Check out video of the dunk below. Follow me on twitter @ScottBasketball http://twitter.com/#!/ScottBasketballAlso like the Roundballchat site on facebook. http://www.facebook.com/#!/pages/roundballchatcom/191263564258333
Original Story: http://www.roundballchat.com/2011/12/...
PLAYERS: P.J. Hairston
TEAMS: North Carolina Tar Heels, Texas Longhorns
TEAMS: North Carolina Tar Heels, Texas Longhorns
1 Comment:
comment below viewing threshold
Comments are closed.
What do you think?To leave a comment, you can:
Tar Heels News
Delivered to your inbox
You'll also receive Yardbarker's daily Top 10, featuring the best sports stories from around the web. Customize your newsletter to get articles on your favorite sports and teams. And the best part? It's free!
Follow us on Twitter
|Latest Rumors
|Best of Yardbarker
Youth Football Referee Wins $275K Settlement After Being Attacked By Irate Coaches And Parents During Game
Today's Best Stuff
For Bloggers
Join the Yardbarker Network for more promotion, traffic, and money.
Company Info
What is Yardbarker?
Yardbarker is the largest network of sports blogs and pro athlete blogs on the web. This site is the hub of the Yardbarker Network, where our editors and algorithms curate the best sports content from our network and beyond.


text:
Results per page:
Motorhome License Fees in Michigan
- 1
- of
- 1
Compare Auto Insurance Quotes in 3 Steps
1. Enter Your Zip:
Search Results - 7 found
Michigan RVs and Motor Home SOS RegistrationMichigan procedure for registering your RV or Motor Home.
Michigan - Register Off-Road Vehicles, Snowmobiles, Motorhomes, RV and More With The MI DMV | DMV.orgFind MI Title & Registration Information for Other Types of Vehicles at DMV.org: The MI DMV Made Simple.
Michigan Boat Registration, Licenses, Forms, & InformationInformation regarding Michigan boat registration, operating licenses and boating safety courses.
Michigan - Replacing a Lost Registration - Duplicate MI RegistrationCan't find your MI car registration? Find out how to get a replacement from the Michigan DMV at DMV.org: The MI DMV Made Simple.
Michigan Relocation Guide - MI Moving GuideMichigan Moving Guide. Relocating to MI. How to update your licence and other driver Information at DMV.org: The MI DMV Made Simple.
Michigan SOS Registration for Custom Built, Kit Cars, & MoreMichigan procedure for registering your custom built car.
Michigan Salvaged Vehicle Regulations and Consumer ProtectionsInformation, regulations, and resources regarding salvaged vehicles in the state of Michigan.
- 1
- of
- 1


text:
Joe Fisher, Voice of the Commodores, talks with head coach Kevin Stallings following Vanderbilt's 66-55 win over Texas A&M Saturday.
Click here for the original story.
Welcome to SECTalk.com
|Welcome to SECTalk.com -- The Home of 6 Straight National Titles!
You are currently accessing our site as a guest which means you can't access all of our features such as social groups, sports betting, and many more. By joining our free community you will have access to all of these great features as well as to participating in our forums, contacting other members, and much more. Registration only takes a minute and SECTalk.com is absolutely free, so please join today!
If you have any problems registering or signing in, please contact us.
Latest Topics
Latest News
Top Bettors
Top High Fived
Joe Fisher's postgame report, Texas A&M
Started by SECTalk.com, Jan 25 2014 02:05 PM
Similar Topics
|Started By
|Last Post Info
Texas A&M's DC.....
Started by Maroonblood, Yesterday, 09:19 PM In: SEC Sports → SEC Football Talk
- 6 replies
- 83 views
Vanderbilt-Rutgers postgame quotes
Started by SECTalk.com, Yesterday, 09:14 PM In: The East → Vanderbilt Sports → Vanderbilt News
- 0 replies
- 13 views
Pinned Week 14: LSU at Texas A&M
Started by GAMECOCK_FAN, 23 Nov 2014 In: SEC Sports → Official Game Threads
- Hot 44 replies
- 712 views
Police Report: Johnny Manziel Involved In Massive Fight Late Friday Night at The 9 in Downtown Cleveland
Started by The Joker, 25 Nov 2014 In: Other Leagues → The Pros
- 5 replies
- 97 views
GameDay: Football Ready for Thanksgiving in Texas
Started by SECTalk.com, 26 Nov 2014 In: The West → LSU Sports → LSU News
- 0 replies
- 47 views
0 user(s) are reading this topic
0 members, 0 guests, 0 anonymous users


text:
Jason Alexander
Pretty Little Liars: Could Aria Be A?! Lucy Hale Spills 'It Would Make Sense'
If you're like us, you're probably anxiously awaiting the Pretty Little Liars...MORE
13 Hilariously Horrible Horror Movies To Watch On Halloween
Halloween is arguably the greatest of all holidays. First off, as an adult, Halloween is the perfect excuse to marathon-watch... MORE
Michelle Monaghan's 11-Month-Old Son Will Be Magic Mike for Halloween
There are a lot of options for adorable baby Halloween costumes, but Michelle Monaghan is getting her inspiration from...MORE
Barbra Streisand Tops Chris Brown, Sets Record With Chart-Topping New Album
By any measure, Barbra Streisand is one of the most successful entertainers in history, period. She''s won eight Grammys, two Oscars (one for Best Song and one for Best Actress), she''s won five Emmy awards, and even a Tony, making her one of only...MORE
20 Years Later And We Still Love You 'ER'!
It''s hard to believe, but today marks 20 years since ER debuted... MORE
Chris Brown's 7 Most NSFW Lyrics on 'X'
After more than a year of delays, Chris Brown''s sixth studio album X was released on Tuesday. So what has Brown been up to in the two years since his last album hit shelves? Well, in between court dates and co-writing...MORE
'Pretty Little Liars': The 100 Most Terrifying 'A' Threats in 'PLL' History—Ranked!
Scared yet? You should...MORE
Ed Sheeran Talks New Album & Takes The Ultimate Cat Quiz!
Among Ed Sheeran''s long list of superlatives which include talented and down-to-earth, Ed is also a cat lover! ET caught up with UK singer at the Sirius/XM Sidewalk Session in New York to talk about his new album and his penchant... MORE


text:
Tying It All Together
Even though the Bible is filled with a variety of voices and was written over the span of nearly two thousand years, its inspiration by God the Holy Spirit has given it a unity that transcends its variety. There is ...Read More
Jesus Our Cornerstone
Even believers are not immune to the temptation that calls us to treat the commands of God as ends in themselves. But God's law is not in itself the end; rather, it always points us to Christ and is ...Read More
Rock of Ages
We are accustomed to identifying our enemies solely as those who hate us here on earth and whose opposition is easy to see and experience. Yet we should never forget that we come into this world at enmity with God ...Read More
Our Everlasting Light
One of the greatest blessings we have to look forward to in Christ is the ability to dwell in a new heaven and earth with Him as our light. On that day, we will no longer stumble but will see ...Read More
Our Shepherd and Overseer
It is a great thing indeed to know Christ as the Good Shepherd. While His under-shepherds will fail us at times, His care for us is perfect, and it is impossible for Him to fail in tending to our needs ...Read More
In the Bosom of the Shepherd
Israel's God is the transcendent Lord over all, but He is not a deity who is far off and inaccessible. Instead, He delights to carry us in His arms and finds great joy in caring for our needs. Like ...Read More
The Sure Blessings of David
Being faithful and true, God must keep His covenant promises, so His pledge to give David's greater son the holy and sure blessings of David is a pledge to bring Him back to life that He might, as the ...Read More
Holiness Incarnate
Because He is the Holy One of Israel, Jesus can, through the power of His Holy Spirit, make us into His holy people. As we grow older, we should be seeing this work of holiness progress in our lives, as ...Read More
The True Love of God
Dr. Joel Beeke writes in his Epistles of John that "the great motivation for practical, Christlike living is the doctrine of the cross; hence, every failure to love can be traced back to a failure to understand the cross. When ...Read More
Atoning for Iniquity
Discussions of Daniel 9 often focus on calculating years, the delay of the seventieth week, and so on. All should agree, however, that the number 490 is at least partly symbolic of God's determination in the fullness of time ...Read More
A Sworn Oath to David
We do not serve a king who is far off and unacquainted with our creaturely state. Rather, we have a Priest-King who has shared the human condition and has experienced the things we have experienced, albeit without sin (Heb. 2 ...Read More
The Son Versus the Servant
Like Moses, we too are servants of God, and we want the Lord to pronounce us as good and faithful servants on the last day. While our service can by no means earn us a place in the kingdom and ...Read More
Anticipating Heaven
Reflect on this truth as you face your problems today: Jesus overcame the world and has given you the power to do likewise.Read More
Looking to the Future
Where is your focus today: on the temporal circumstances of your life or on the glorious hope of the return of Jesus Christ?Read More
Reflecting His Image
Pray this prayer: "Dear God, reveal to me the depth and riches of the nature of Your Son, Jesus."Read More


text:
Missions in GTA San AndreasTalk0
10,299pages on
this wiki
this wiki
Category page
Pages in category "Missions in GTA San Andreas"
" This is a comprehensive list of storyline missions in Grand Theft Auto: San Andreas. There are...
Missions in GTA San Andreas
" Beat The Cock! are two triathlon events in Grand Theft Auto: San Andreas that take place only on...
Beat the Cock!
Media in category "Missions in GTA San Andreas"
Posted in: Small Town Bank
Posted in: Mike Toreno (mission)
Posted in: Life's a Beach
Posted in: Home Invasion
Posted in: Cesar Vialpando
Posted in: Amphibious Assault
Posted in: Amphibious Assault
Posted in: Sweet Johnson
Posted in: Stowaway
Posted in: Nines and AKs
Posted in: House Party
Posted in: Madd Dogg's Rhymes
Posted in: OG Loc (mission)
Posted in: Robbing Uncle Sam