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All News Releases By Date
Six New England Communities Will Get EPA Smart Growth Assistance
Release Date: 02/07/2012
Contact Information: David Deegan, (617) 918-1017
(Boston, Mass. – Feb. 7, 2012) – Six New England communities will benefit from EPA technical assistance through the "Building Blocks for Sustainable Communities" program. The communities, Simsbury, Conn., Fall River, Holyoke, Northampton and Roxbury, Mass., and Burlington, Vt. were among 56 communities in 26 states that will receive technical assistance under this program.
Each community will receive the assistance from EPA-funded private-sector experts. The technical experts will work with the communities on actions they can take to improve the economy, the environment, and quality of life. Some examples may include improving pedestrian access and safety, incorporating green infrastructure, or conducting an economic and fiscal health assessment.
"EPA is very pleased to be part of a coordinated effort to help these six New England communities develop practical and sustainable approaches that can lead to quality of life improvements for citizens, and which can help bolster our economy," said Curt Spalding, regional administrator of EPA's New England office.
Building Blocks for Sustainable Communities is a project of the Partnership for Sustainable Communities among EPA, the U.S. Department of Housing and Urban Development (HUD), and the U.S. Department of Transportation (DOT). The interagency collaboration coordinates federal investments in infrastructure, facilities, and services to get better results for communities and use taxpayer money more efficiently. The partnership is helping communities across the country create more housing choices, make transportation more efficient and reliable, reinforce existing investments, and support vibrant and healthy neighborhoods that attract businesses.
In 2010, in a different Smart Growth program, EPA selected the Rhode Island-based KeepSpace program as one of eight recipients nationwide to receive targeted technical assistance on growth and development issues.
More information:
- Building Blocks for Sustainable Communities: https://www.epa.gov/smartgrowth/buildingblocks.htm
- Partnership for Sustainable Communities: http://www.sustainablecommunities.gov
# # #
Learn More about the Latest EPA News & Events in New England (https://www.epa.gov/region1/newsevents/index.html)
Follow EPA New England on Twitter (http://twitter.com/epanewengland)
More info on EPA's Environmental Results in New England (https://www.epa.gov/region1/results/index.html)
*** Edited on Feb. 08, 2012:
The final sentence was edited to make clear that the 2010 selection of the Rhode Island-based KeepSpace program was under a different Smart Growth program than the Building Blocks for Sustainable Communities effort.
Search this collection of releases | or search all news releases
View selected historical press releases from 1970 to 1998 in the EPA History website.


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This stylish ralph lauren men's wool blend sportcoat has a classic fit fit and is suitable for year round wear. With it's two button closure and blue color, this is a classic style to add to your wardrobe. It is the perfect option to wear with a dress shirt and slacks for work, or with jeans and a tshirt for a fashionable yet casual look.
Items ship Monday-Friday.
Please add one business day handling time to your order. Friday orders ship out on Monday.
Shipping via USPS:
FREE standard shipping, Priority ($10.95) or Express ($35) shipping for US orders.
International orders are shipped with USPS. International rates are weight-based and calculated at checkout.
We offer free returns on domestic orders. Items accepted for refund within 30 days, with all tags still attached and in unworn and unaltered condition.
Shipping fees are not refunded.
See Returns Policy

subset: commoncrawl


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10 Waterproof Smartphone Cases to Prevent Disaster
10 Waterproof Smartphone Cases
The weather is warming up, which means you're ready to take on the elements. In preparation for summer swimming, cycling and singing in the rain, make sure to keep your smartphone well-protected.
We've gathered 10 waterproof smartphone cases that'll help prevent many an accident. Looking for an everyday waterproof iPhone cover? Or maybe a kooky dry bag for a number of smartphone devices? We've got you covered — literally.
Have you ever wished you had a waterproof cover? For instance, when you accidentally left your phone in your jeans pocket and then did the laundry? Yeah, we've been there.


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PTFE, often referred to as Plumbers Tape, is actually a Polytetrafluoroethylene film used for sealing threads on pipe fittings, typically within the plumbing trade. By wrapping small amounts around a thread before connecting, the thin film can help stop liquid and gas leaks.
The use of PTFE tape can also lubricate as it is a deformable filler and helps to seat the thread deeper without hardening. This gives prolonged protection over leaks as well as protecting from long term seizing. Providing these numerous benefits with very little work PTFE tape is a must for almost any pipe work. You can read more information about its uses in our PTFE Tapes Guide.


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Road Less Traveled Strapback
- Brushed 100% Cotton Twill Upper
- Vtg. Style Felt Patch
- Leather Adj. Strapback
- Unstructured Vtg. Style Crushable Upper
- Cotton Micro-herringbone Under Brim & Inside Lining
To start a return, please visit this page.
Summer Sale (August 9th-22nd) Return Policy:
Returns on unwashed/unworn items at/under 25% off can be returnable during the extent of our Summer Sale (August 9-22).
COVID Updates:
Each order shipped will be packaged by someone from our team who is not experiencing any symptoms related to COVID-19. Our team will carefully handle all goods and packages by continually washing our hands, sanitizing work surfaces, and/or wearing gloves and masks. We have limited the capacity in our storefront and work spaces during this time, until further notice.
Curbside Pick-Up:
1. Place your order on our website.
2. Select 'Local Pick-up' at check-out as your delivery option.
3. Finish your order as normal.
4. You will receive an email notification when your item is ready for pick-up. Most orders are ready for pick-up within 24 hours, during business hours.
When will my order be ready?
Most orders are ready within 24 hours. You will receive an email notification when your order is ready. We are currently able to offer curbside pick-ups during our business operating hours, Monday - Friday.
Where do I pick-up my order?
Your order will be ready for pick up at our Ponce City Market location.
675 Ponce de Leon Ave NE
Atlanta, GA 30308
When you place your order, you'll receive an email confirmation from our team with detailed instructions on how to pick-up your order on the designated day.
International Shipping:
Citizen Supply is not responsible for any customs charges due to international shipping at time of receipt of order. Please research your country's specific customs charges before placing an international order.
Standard Return Policy:
Citizen Supply accepts returns and exchanges of any unwashed, unworn, undamaged, or defective item in its original packaging. Your item(s) must be in salable condition upon return or exchange to be eligible for a refund.*** We will accept online returns and exchanges within 15 days of the arrival date of your package.
To start a return, please visit this page.
Gift Cards:
All gift cards are non-returnable. Online gift cards are only redeemable in the Citizen Supply online shop.
Thank you for shopping with us!
***Salable condition means items are not in the following condition:
- strong odor
- pet hair, glitter, or other substances that love to stick to garments
- stains or spills
- any other condition that causes the item to not be salable after the return
Any items not in salable condition will either incur a restocking + cleaning fee or be returned to the customer.
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The cost of downtime for midsize companies can be devastating. Out-of-date systems and equipment, inconsistent implementations, and unevenly applied data and security policies all can result in significant business risk, impacting everything from operations and CSR to fulfillment, HR and accounting. This directly translates into lost revenue and a jump in costs related to damage control and impact on customer retention.
These risks are exponentially increased in today's business climate, where SMB executives have to deal with ongoing external security threats, volatile economic conditions, new competitors, customers that suffer financial reversals, changing government requirements, and increasing raw material and transportation costs.
Our unique approach of delivering enterprise-grade best practices in ways that are affordable and responsive to SMB executives has consistently proven to reduce downtime risks by as much as 85%.


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DOVER -- Federal Savings Bank's long-standing support of Wentworth-Douglass Hospital continues with their recent and donation of $25,000 to name a conference room in the Hospital's new Garrison Wing. Both the Hospital and Federal Savings Bank have served the same communities for over a century.
Hospital President & CEO Gregory Walker, FACHE, acknowledged this tight community connection and thanked Federal Savings Bank for their support of hospital programs and services for many years.
"Federal Savings Bank has always been there to sponsor a Hospital event, participate in Foundation activities and give their time to benefit a cause when needed," Walker said. "We are so grateful for their commitment to our hospital and the community we serve."
Federal Savings Bank President James J. O'Neill, Jr. believes it is important to support the Hospital's efforts to provide more space for community education in the new building and improve the overall health of the community. "We've made this donation for all the things the hospital has done in the community for people who are struggling - the Care-Van, the Community Dental Center and charity care," O'Neill said. "These are services many people are unaware of. The hospital is trying to make our community a better place to live and, I think, Wentworth-Douglass Hospital is a real asset to this community."
Both O'Neill and Kelly Glennon, Federal Savings Bank Vice President, emphasized the Bank's role in encouraging other businesses to give back. "This area of Dover has a great, diverse set of strong, community-minded businesses that have been here a long time," O'Neill said. "We try to encourage others to give back and we see it working everyday."
Glennon added, "Federal Savings Bank has been in Dover since 1890 and seen the Hospital transform into a real community resource," she said. "The Hospital's helped so many people including our employees and our customers and we really appreciate what they've done to be a community resource, especially for low to moderate income families. Federal Savings Bank is proud to support the Hospital as they work to expand these important services."
The Federal Savings Bank Conference Room is one of four conference rooms and a large auditorium in the new Conference Center on the first floor of Wentworth-Douglass Hospital's four-story Garrison Wing. The Center, opening in the spring of 2013, will accommodate community education programs for groups of up to 300 participants. The Women & Children's Center on the second level and private patient rooms on levels three and four will open in January/February 2013.


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ATHENS, Greece (AP) -- Greece's deep, six-year recession is likely to end in 2014, but growth will be weak and unemployment will remain above 20 percent for another three years, the country's international debt inspectors said.
The European Commission issued the gloomy predictions Friday in a 237-page assessment of Greece's bailout agreement, as the country formally received its latest emergency loan payout, worth 4.2 billion euros ($5.4 billion).
The report cited progress by Greece's year-old coalition government in reforming the economy and public finances, but warned against complacency.
"The implementation of wide-ranging structural reforms remains the prerequisite for stabilizing the economy and laying the foundations for economic growth ... Further efforts are needed."
Greece has been dependent on rescue loans from euro partners and the International Monetary Fund since it got locked out of international bond markets in 2010. So far it has received some 200 billion euros ($257 billion), pledging in return to overhaul its economy.
While the government has said it aims to resume borrowing from bond markets in early 2014, a European Union official involved in the Greek bailout said Friday that Athens was only likely to regain "partial market access, possibly next year."
The official did not elaborate and asked not to be named due to his direct involvement in confidential negotiations with Greece.
Stringent budget austerity measures -- including relentless pay and benefit cuts -- have slashed high deficits but also hurt economic growth. Unemployment has reached 27 percent, with a staggering 64 percent of those aged 15-24 are without a job.
The Commission estimates that Greece's economy, after contracting 4.2 percent in 2013, will next year grow for the first time since 2008, by 0.6 percent. It warned, however, the recovery remains fragile.
"Should product and services market reforms not accelerate as foreseen under the program, positive economic growth could not return in 2014 as foreseen," it said in its report, which was based on data by representatives of Greece's debt inspectors -- the Commission, IMF, and European Central Bank.
"A failure to implement these reforms in time would thus amplify the social distress coming from very high unemployment and from the pressure exerted on the population by the prolonged recession and the wide-ranging economic and social adjustment."
The jobless rate is projected to peak at 27 percent this year before dropping gradually to 26 percent in 2014 and 21 percent in 2016, the report showed.
While stressing that progress had been made and public finances were improving, the Commission said more must be done to improve Greece's tax collection system and shrink its still oversized public sector.
A survey published Friday by private broadcaster Skai television found 29 percent of Greeks believed the country's financial crisis would last another six to 10 years. Another 27 percent think it will last more than another 10 years.
The Public Issue poll of 1,031 people conducted May 10-15 also found a slight rise in support for the extreme right Golden Dawn party, at 11.5 percent.


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Uncorked! Wine, Objects & Tradition
April 28, 2012–January 6, 2013
This exhibitions was created to explore the stunning range of objects associated with the history of wine drinking, especially in Britain and America. It shared a fascinating and incredibly broad range of wine-related materials—from wineglasses and cellarettes to song sheets and paintings—and, in total, will include more than 300 objects.
Uncorked! began with classical references by providing an insightful look into Greek and Roman wine vessels as inspirations for many later objects and ornamental motifs. The exhibition then explored the business of marketing wine, bottles, glasses, and other objects and considers some "tricks of the trade" by which unscrupulous merchants increased profit margins.
The largest portion of the exhibition focused on consumption and equipage and considered vessels associated with different types of wine, settings where beverages were consumed, and the role wine played in social life. Uncorked! also delved into the politics, patriotism, and taxes associated with wine. The religion and temperance sections encompassed both serious and, to modern eyes, humorous issues relating to such topics.
Raise a glass in toast to this fascinating exhibition!
Additional Information
- View the online exhibition.
- Take a virtual tour through the exhibition.
- Enjoy articles by Senior Curator Leslie B. Grigsby in County Lines Magazine and Antiques & Fine Art.
- Read related blog posts on Winterthur Unreserved, the museum and library blog.
Major funding for Uncorked! provided by
With support from
Bouchaine Vineyards
Gerret & Tatiana Copeland, Proprietors
Potter Anderson & Corroon LLP Wente Family Estates
Dixie and David De Luca; Judy and John Herdeg; Kristin and Frank Hohmann; Laurel Riegel; Coleman and Susan Townsend; Linda Wiseman
Adelphi Paper Hangings, LLC
Image at top of the page: print of A Midnight Modern Conversation, made by William Hogarth, London, England, 1733. Gift of Gordon Rust. 1975.0219.


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Mike Tyson: CJ Ross 'Should Have License Revoked'
In this excerpt of a Big Interview with WSJ's Lee Hawkins, boxing legend Mike Tyson says boxing judge CJ Ross -- who scored Floyd Mayweather's victory against Saul "Canelo" Alvarez as a 114-114 draw and believed Timothy Bradley beat Manny Pacquiao last year –- should have her licensed revoked.
This transcript has been automatically generated and may not be 100% accurate.
... CJ Ross the judge handed to the grant me ... the fight over many Nacchio ... the other night ... ruled that ... the fight with Mayweather was one fourteen one for the team that I didn't see the flavor and can lead to a shutout inning one simple ... really eating well ... you know we that good ... integrating me for my grief whether ... the ministry the J man ... you going to build animosity ... that should see him entry in the put this on to produce ... animosity Josie in the midst ... of ... chaos ... and aam ... they hadn't from animosity ... then you know I know where it is nowhere for her that could lead to shut it would shut out it was for the to do that was it ... maybe a license to be ... evil I want to go um one of the time the chance to ... win freedom of flight ... well I mean really I mean ... that the boxing promoter that is a concern ... about that you must have and I do believe that this is just my opinion you can tell me if I'm wrong ... that Mayweather now bitter win every fight ... by knockout when the aluminum I'm not in the ... style of fighting for I have to be themselves clearly that is ... to get from ... there's no doubt that he was so these are most vulnerable to ... the possibility of having the fight to confirm leash in our view that ... if I get the full fledged member promises so hard to beat him ... Nokia is is really hard to beat him ... in the dollar the ... employee ... is used to differ with a B them in empty without his Reno give love away in the Phil Hartman be how would you can actually that that when he ... sold the rule ... well I will fight and if analogy is I who Will fighting dialing me um ... fluid if only if you have the way ...


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Hand Loomed Mercato Bag
Hand-loomed wide panels of traditional Peruvian Iconography are woven together bringing a playful oversized transformation to the classic Market bag.
The result is a super cool, reversible looking style with unusual soft texture, finished with smooth woven handles.
Light weight, machine washable and folds conveniently for packing, elevate your look with this oversized style.
Colour: Coral/Cream
Dimensions: 50cm x 56cm x 12cm
Material: 100% Acrylic


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< Features
m (update feature name)
(add lcms)
|Line 58:
|Line 58:
* gnome-settings-daemon from git master for the profile-set-on-hotplug functionality
* gnome-settings-daemon from git master for the profile-set-on-hotplug functionality
* small patch to comps/kickstart bringing in the package by default
* small patch to comps/kickstart bringing in the package by default
== Contingency Plan ==
== Contingency Plan ==
Revision as of 08:52, 11 December 2009
Color Management
GNOME Color Manager is a session framework that makes it easy to manage, install and generate color profiles in the GNOME desktop.
- Name: Richard Hughes
- email: email@example.com
Current status
- Targeted release: Fedora 33
- Last updated: 2009-12-08
- Percentage of completion: 70%
Detailed Description
This project has the following features:
- Setting output gamma tables (with local brightness and adjustments) to any Xrandr output (falling back to the per-screen methods for drivers that do not yet support Xrandr 1.3) to make all windows look the 'correct' color.
- Setting of settings at session start, and when monitors are hotplugged.
- Easy install of vendor supplied ICC or ICM files, just by double clicking on the file.
- Easy display calibration using an external calibration device, and scanner calibration using a inexpensive IT 8.7 target. For calibration, the ArgyllCMS package is required.
- Integration X11 by setting the per-screen and per-output _ICC_PROFILE atom, which makes applications such as the GIMP use a color managed output.
- Easy to use DBus interface for applications to query what ICC profiles should be used for a specific device or device type. This is session activated and is only started when it is needed, and quits after a small period of idleness.
Benefit to Fedora
Fedora, and Linux in general is severely lacking when it comes to using color management in key applications by default. OSX and Windows 7 clearly show by making color management easy for the end user, it can be integrated into their working pattern to great affect. By providing a way to manage and assign profiles in Fedora we can make it easy for creative people to see the same color they just scanned, and also then see the same color when the document is printed. Only by making this stuff easy to use we'll actually get people to achieve this.
- Mainly isolated package
- Minor changes in gnome-settings-daemon that are already upstream
- Minor addition in shared-mime-info that are already upstream
How To Test
Need to test:
- Assigning profiles to devices, which bluish test and AdobeGamma can be used (screen should go blue and then pink)
- Creating profiles using external colorimeter devices (you'll need hardware such as a Pantone Huey)
- make check on the sourcecode to exercise the self test program
- Nuking the config file and starting from a new install (rm /home/hughsie/.config/gnome-color-manager/device-profiles.conf)
User Experience
From a user experience point of view, they'll just be:
- A new icon in preferences "Color Profiles"
- Now the user can double click ICC and ICM profile to preview and install
- Now more color-aware applications are automatically setup for color management
- shared-mime-info from git master for the icc double clicking
- gnome-settings-daemon from git master for the profile-set-on-hotplug functionality
- small patch to comps/kickstart bringing in the package by default
- lcms (which is already in the repos, and *tiny*)
Contingency Plan
- Remove the package, and continue like we always have with no color manager.
For more information, please see http://projects.gnome.org/gnome-color-manager/ and http://live.gnome.org/GnomeColorManager
Release Notes
- Fedora now ships GNOME Color Manager by default, which allows end users to better manager thier color workflow.


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There is 1 and only 1 leak (thank God) that is driving me crazy. When the wind blows from the south and hits the house from that side, there is a drip that develops and comes from above the top of the window (the little 3 " overhang inside the window). The water is not coming from the window, this I know. I believe that the water is being forced into the soffit and somehow drips down along the cinder block wall where it comes out over the window. I hope that makes sense.
There is NO water on the ceiling or along the inside wall above the window.
There is absolutely no access into the attic as the roof slopes to almost meet the inside ceiling, so I can't even get to that side of the house.
When it rains, even pours straight down there is absolutely no leaking.
Can rain be forced into the soffits by the wind, or should I be looking for the leak elsewhere?


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Pyle 7in Window Suction Mount LCD Monito...
See All
WIRELESS AP, OUTDOOR 10DBI 802.11a 150mW
PicoStation ships standard with the powerful and intuitive AirOS by Ubiquiti Networks. It also is supported by a Linux SDK to encourage open source development.
In addition to the LSDK support, PicoStation ships with 32MB RAM and 8MB Flash to encourage developers to customize Pico Firmware to create their own applications such as Hot-Zone deployments, mesh networking, and metering applications.


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There are 7 item(s) tagged with the keyword "Local democracy".
Many ingredients go into making a community a place where people are proud to live and work, so is there a danger of eroding local government's ability to place-shape effectively as a result of a series of policy decisions and funding cuts?
Previous governments' strategies for neighbourhood renewal seem a distant memory, alongside the levels of accessible funding that went alongside them. Whilst criticism existed of approaches being overly centralist, 'funding with strings attached', local government remains at the mercy of central government policy decisions and delivering budget cuts is the only thing in which it seems to have more freedom.
The recent report by the Local Government and Social Care Ombudsman, 'Lifting the lid on bin complaints', has reignited the debate around outsourced services and whether local government gets value for money from such contracts.
To my mind what the report highlights is the disconnect that can sometimes take place between the council, the contractor and the service user, when a contract is outsourced. Just because a service is outsourced it doesn't mean that the public don't think that the council isn't responsible for it or should have democratic oversight of the service and when they complain they expect their issues to be addressed by the council and blame them if there is a slow response, rather than the contractor.
Former speaker of the US House of Representatives, Tip O'Neill, is credited with the quote 'All politics is local' and I think that adage has never been more apt than at present.
Having spoken at and attended a number of packed fringes at all of the main party conferences recently I couldn't help but reflect on the fact that there is a reawakening by the political parties that many of the most pressing policy issues are best resolved at a local government level.
Collaboration, often translated as partnership working, has become in recent years one of the cornerstones of 'good governance'. Better coordinating the engagement and participation of various actors and agents who operate in and around local governance has promised better designed services, 'joined up' provision and resource savings, but was this model of collaborative governance more fit for times of plenty than times of austerity?
APSE's recent publication Two Tribes? Exploring the future role of elected members, has proven timely given some of the recent governance challenges that have been thrown at local government.
More than a decade on from modernisation of political management structures, which replaced the existing committee system with a formal cabinet, overview and scrutiny system, one of the main issues emerging from the research is the feeling of disillusionment amongst non-executive elected members, who feel marginalised from real decision making with little influence over issues that affect their local areas.
Over the past few months, APSE and our academic partners have been looking at what the future role of elected members will be between now and 2020 - and sadly the forecast is for stormy waters.
Taking a long hard look at what 'democracy', 'citizenship' and 'ethics' really mean in local government in the second decade of the 21st Century may seem like a luxury when councils are struggling to empty the bins, house the homeless, care for elderly residents and meet a million other demands with ever fewer resources. But reclaiming the vital connection between the mightiest of principles upon which local government was founded and day to day actions that matter to local people is the best way for local authorities to take control in these difficult times.


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Search Finding Aids
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Finding Aids by Repository
Currently Used Filters
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Penn Museum Archives [Contact Us]
Date added: 2017-03-01
(Bulk: 1915-1923)
Fisher, Clarence Stanley, 1876-1941
Extent: 7 linear foot
Clarence S. Fisher was born in Philadelphia in 1876 and attended the University of Pennsylvania, attaining a degree in architecture in 1897 but devoting his entire life to archaeology. His first archaeology field experience was as the architect for the initial Babylonian expedition to Nippur from 1898 to 1900. This was followed by a research fellowship in Babylonian archaeology at the University Museum. Fisher also gained experience as an assistant to Harvard Archaeologist, George Andrew Reisner in Egypt and Samaria. From Reisner, Fisher learned archaeological techniques and the methods of meticulous record keeping he would use in his later work. Fisher was appointed a curator of the Egyptian section of the University of Pennsylvania Museum by George B. Gordon in 1914. He spent the next nine years in the field collecting data in Dendereh, Giza, Memphis, and Dra Abu el-Naga. The Clarence S. Fisher Memphis excavation records consist of six archival boxes of correspondence, notes, field cards, diaries, catalogues and photographs. In addition there is a card file with object notes. Oversize drawings, maps, plans, watercolors and financial records complete the collection.


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Matthias Heutger
Senior Vice President
Global Head of Innovation & Commercial Development
DHL Customer Solutions and Innovation
Matthias Heutger leads the commercial development and innovation area of DHL's cross-divisional unit Customer Solutions & Innovation (CSI). He drives the development of sector strategies for DHL's five focus sectors - Automotive, Energy, Engineering & Manufacturing, Life Sciences & Healthcare and Technology. In addition, he also leads marketing and sales steering & development for DHL's top 100+ accounts, next to the customer-centric innovation activities across the DHL divisions. He reports to DHL's Chief Commercial Officer and is a member of the CSI Board. Also part of his customer centric innovation approach, Matthias is coordinating closely the activity of the DHL Innovations Centers in Germany, Singapore and soon in Chicago, USA.
Dr. Markus Kückelhaus
Vice President
Innovation & Trend Reserach
DHL Customer Solutions and Innovation
Markus Kückelhaus is heading the global research and innovation activities of Deutsche Post DHL and is in charge of the DHL flagship Innovation Center near Bonn. He joined DHL in 2012 as Director Trend Research monitoring and leveraging trends with his team that will impact the logistics industry in the future. Previously he worked as a free-lance consultant for DHL, supporting the development of a group wide innovation system and implementing strategies and business models for innovation initiatives.
Gina Chung
Head of Innovation
Americas and Trend Research at DHL
Gina Chung leads the research and innovation activities of DHL and is in charge of the DHL Americas Innovation Center: a state-of-the-art platform to engage startups and industries on the future of logistics. Since 2012, she has shaped DHL's global innovation agenda by driving a portfolio of projects focused on the rapid testing and adoption of technologies such as collaborative robotics and artificial intelligence across DHL's operations. Prior to her current role, she also led the development of DHL's trend research series including co-authoring publications such as IoT in Logistics together with Cisco and the DHL Logistics Trend Radar. Gina is based in Chicago and holds two degrees from the University of Auckland.
Mei Yee Pang
Vice President
Innovation, Asia Pacific
Mei Yee Pang leads the DHL Asia Pacific Innovation Center (APIC). APIC is part of a DHL global innovation platform with a mission to inspire, connect and engage industries with the future of logistics. Under Mei's leadership, a team of innovators seed ideas to link businesses and relevant partners; bringing innovative solutions to life.
An entrepreneur in a global company, Mei is known to bring innovation and entrepreneurship to the teams she leads. As Partner at DHL Consulting and head of office for Asia-Pacific until 2015, Mei doubled the business size of DHL Consulting by spearheading a new service portfolio. DHL Consulting advises senior management of Deutsche Post DHL Group on management topics and customers on supply chain strategy. She led a team of consultants across Asia Pacific and has a keen focus on improving supply chain effectiveness for DHL's customers in Asia.
Ben Gesing
Senior Innovation Manager, Trend Research
DHL Customer Solutions & Innovation
Ben Gesing is a global innovation leader with 7+ years of experience developing technical solutions in the logistics, telecommunications, and consumer electronics industry. Today he leads the Trend Research activities at the DHL Innovation Center near Bonn, Germany. He and his team are responsible for shaping the overall innovation agenda at Deutsche Post DHL Group through producing industry trend reports and piloting cutting edge technologies like artificial intelligence, computer vision, and robotics in live logistics operations together with startups.
Julian Bröcheler
Project Manager - Robotics Accelerator Program
Trend Research at DHL
Julian is an enthusiastic roboticist and problem solver. In his role, he is shaping the automation agenda at DHL by introducing novel robotics technologies such as self-driving robots, drones or robotic articulated arms to the business. Within the Robotics team, he successfully drives the adoption and scaling of robotics technologies such as order picking and cleaning robots in logistics operations globally. Julian joined DHL in 2017 as a graduate intern and contributed with his simulation study to a larger robotics project involving self-driving tugger vehicles. Prior to joining DHL, Julian has gathered experience in IT consulting by doing various internships and student jobs. He is native German, has lived for a year in Mexico and obtained his Master degree abroad in the Netherlands – next to these countries Julian likes to call Italy his second home.


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Systems and methods for posterior dynamic stabilization of the spine
Devices, systems and methods for dynamically stabilizing the spine are provided. The devices include a radially expandable spacer having an undeployed configuration and a deployed configuration, wherein the spacer has axial and radial dimensions for positioning between the spinous processes of adjacent vertebrae. The systems include one or more spacers and a mechanical actuation means for delivering and deploying the spacer. The methods involve the implantation of one or more spacers within the interspinous space.
Latest Patents:
This application is a continuation-in-part of U.S. patent application Ser. No. 11/052,002, filed on Feb. 4, 2005, which is a continuation-in-part of U.S. patent application Ser. No. 11/006,502, filed on Dec. 6, 2004, which is a continuation-in-part of U.S. patent application Ser. No. 10/970,843, filed on Oct. 20, 2004, incorporated herein by reference in their entireties.FIELD OF THE INVENTION
The present invention is directed towards the treatment of spinal disorders and pain. More particularly, the present invention is directed to systems and methods of treating the spine, which eliminate pain and enable spinal motion, which effectively mimics that of a normally functioning spine.BACKGROUND OF THE INVENTION
The superior vertebra with its inferior facets, the inferior vertebra with its superior facet joints, the intervertebral disc, and seven spinal ligaments (not shown) extending between the superior and inferior vertebrae together comprise a spinal motion segment or functional spine unit. Each spinal motion segment enables motion along three orthogonal axes, both in rotation and in translation. The various spinal motions are illustrated in
Traumatic, inflammatory, metabolic, synovial, neoplastic and degenerative disorders of the spine can produce debilitating pain that can affect a spinal motion segment's ability to properly function. The specific location or source of spinal pain is most often an affected intervertebral disc or facet joint. Often, a disorder in one location or spinal component can lead to eventual deterioration or disorder, and ultimately, pain in the other.
Spine fusion (arthrodesis) is a procedure in which two or more adjacent vertebral bodies are fused together. It is one of the most common approaches to alleviating various types of spinal pain, particularly pain associated with one or more affected intervertebral discs. While spine fusion generally helps to eliminate certain types of pain, it has been shown to decrease function by limiting the range of motion for patients in flexion, extension, rotation and lateral bending. Furthermore, the fusion creates increased stresses on adjacent non-fused motion segments and accelerated degeneration of the motion segments. Additionally, pseudarthrosis (resulting from an incomplete or ineffective fusion) may not provide the expected pain-relief for the patient. Also, the device(s) used for fusion, whether artificial or biological, may migrate out of the fusion site creating significant new problems for the patient.
Various technologies and approaches have been developed to treat spinal pain without fusion in order to maintain or recreate the natural biomechanics of the spine. To this end, significant efforts are being made in the use of implantable artificial intervertebral discs. Artificial discs are intended to restore articulation between vertebral bodies so as to recreate the full range of motion normally allowed by the elastic properties of the natural disc. Unfortunately, the currently available artificial discs do not adequately address all of the mechanics of motion for the spinal column.
It has been found that the facet joints can also be a significant source of spinal disorders and debilitating pain. For example, a patient may suffer from arthritic facet joints, severe facet joint tropism, otherwise deformed facet joints, facet joint injuries, etc. These disorders lead to spinal stenosis, degenerative spondylolithesis, and/or isthmic spondylotlisthesis, pinching the nerves that extend between the affected vertebrae.
Current interventions for the treatment of facet joint disorders have not been found to provide completely successful results. Facetectomy (removal of the facet joints) may provide some pain relief; but as the facet joints help to support axial, torsional, and shear loads that act on the spinal column in addition to providing a sliding articulation and mechanism for load transmission, their removal inhibits natural spinal function. Laminectomy (removal of the lamina, including the spinal arch and the spinous process) may also provide pain relief associated with facet joint disorders; however, the spine is made less stable and subject to hypermobility. Problems with the facet joints can also complicate treatments associated with other portions of the spine. In fact, contraindications for disc replacement include arthritic facet joints, absent facet joints, severe facet joint tropism, or otherwise deformed facet joints due to the inability of the artificial disc (when used with compromised or missing facet joints) to properly restore the natural biomechanics of the spinal motion segment.
While various attempts have been made at facet joint replacement, they have been inadequate. This is due to the fact that prosthetic facet joints preserve existing bony structures and therefore do not address pathologies that affect facet joints themselves. Certain facet joint prostheses, such as those disclosed in U.S. Pat. No. 6,132,464, are intended to be supported on the lamina or the posterior arch. As the lamina is a very complex and highly variable anatomical structure, it is very difficult to design a prosthesis that provides reproducible positioning against the lamina to correctly locate the prosthetic facet joints. In addition, when facet joint replacement involves complete removal and replacement of the natural facet joint, as disclosed in U.S. Pat. No. 6,579,319, the prosthesis is unlikely to endure the loads and cycling experienced by the vertebra. Thus, the facet joint replacement may be subject to long-term displacement. Furthermore, when facet joint disorders are accompanied by disease or trauma to other structures of a vertebra (such as the lamina, spinous process, and/or transverse processes) facet joint replacement is insufficient to treat the problem(s).
Most recently, surgical-based technologies, referred to as "dynamic posterior stabilization," have been developed to address spinal pain resulting from more than one disorder, when more than one structure of the spine have been compromised. An objective of such technologies is to provide the support of fusion-based implants while maximizing the natural biomechanics of the spine. Dynamic posterior stabilization systems typically fall into one of two general categories: posterior pedicle screw-based systems and interspinous spacers.
Examples of pedicle screw-based systems are disclosed in U.S. Pat. Nos. 5,015,247, 5,484,437, 5,489,308, 5,609,636 and 5,658,337, 5,741,253, 6,080,155, 6,096,038, 6,264,656 and 6,270,498. These types of systems involve the use of screws that are positioned in the vertebral body through the pedicle. Certain types of these pedicle screw-based systems may be used to augment compromised facet joints, while others require removal of the spinous process and/or the facet joints for implantation. One such system, the Zimmer Spine Dynesys® employs a cord which is extended between the pedicle screws and a fairly rigid spacer which is passed over the cord and positioned between the screws. While this system is able to provide load sharing and restoration of disc height, because it is so rigid, it does not effective in preserving the natural motion of the spinal segment into which it is implanted. Other pedicle screw-based systems employ articulating joints between the pedicle screws. Because these types of systems require the use of pedicle screws, implantation of the systems are often more invasive to implant than interspinous spacers.
Where the level of disability or pain to the affected spinal motion segments is not that severe or where the condition, such as an injury, is not chronic, the use of interspinous spacers are preferred over pedicle based systems as they require a less invasive implantation approach and less dissection of the surrounding tissue and ligaments. Examples of interspinous spacers are disclosed in U.S. Pat. Nos. Re. 36,211, 5,645,599, 6,149,642, 6,500178, 6,695,842, 6,716,245 and 6,761,720. The spacers, which are made of either a hard or compliant material, are placed in between adjacent spinous processes. The harder material spacers are fixed in place by means of the opposing force caused by distracting the affected spinal segment and/or by use of keels or screws that anchor into the spinous process. While slightly less invasive than the procedures required for implanting a pedicle screw-based dynamic stabilization system, implantation of hard or solid interspinous spacers still requires dissection of muscle tissue and of the supraspinous and interspinous ligaments. Additionally, these tend to facilitate spinal motion that is less analogous to the natural spinal motion than do the more compliant and flexible interspinous spacers. Another advantage of the compliant/flexible interspinous spacers is the ability to deliver them somewhat less invasively than those that are not compliant or flexible; however, their compliancy makes them more susceptible to displacement or migration over time. To obviate this risk, many of these spacers employ straps or the like that are wrapped around the spinous processes of the vertebrae above and below the level where the spacer is implanted. Of course, this requires some additional tissue and ligament dissection superior and inferior to the implant site, i.e., at least within the adjacent interspinous spaces.
With the limitations of current spine stabilization technologies, there is clearly a need for an improved means and method for dynamic posterior stabilization of the spine that address the drawbacks of prior devices. In particular, it would be highly beneficial to have a dynamic stabilization system that involves a minimally invasive implantation procedure, where the extent of distraction between the affected vertebrae is adjustable upon implantation and at a later time if necessary. It would be additionally advantageous if the system or device was also removable in a minimally invasive manner.SUMMARY OF THE INVENTION
The present invention provides devices, systems and methods for stabilizing at least one spinal motion segment. The devices include an expandable spacer or member having an unexpanded configuration and an expanded configuration, wherein the expandable member in an expanded configuration has a size, volume and/or shape configured for positioning between the spinous processes of adjacent vertebrae in order to distract the vertebrae relative to each other.
In certain embodiments, the expandable member is a balloon made of either non-compliant or compliant material which may be porous or non-porous, or may include a mesh material which may be coated or lined with a porous or non-porous material. The device may further include a port for coupling to a source of an inflation and/or expansion medium for inflating and/or expanding the expandable member. In certain embodiments, the port may be used to deflate or evacuate the expandable member. The devices may further include one or more tabs for anchoring the expandable member to the spinous processes. Optionally, the device may include one marker on a surface of the expandable member to facilitate fluoroscopic imaging.
In other embodiments, the expandable members are cages, struts, wires or solid objects having annular, spherical, cylindrical or elliptical shapes when in an expanded condition. The expandable members may be self-expanding or adjustably expandable depending on the extent of distraction required.
The invention further includes systems for stabilizing at least one spinal motion segment which include one or more expandable members and an expansion medium for injection within or for filling the interior of the expandable member via the port. The subject systems may further include at least one means for anchoring or securing the expandable member to the spinal motion segment.
The invention further includes methods for stabilizing at least one spinal motion segment which involve the implantation of one or more devices or expandable spacers of the present invention, in which the expandable member is positioned between the spinous processes of adjacent vertebrae in an unexpanded or undeployed condition and then subsequently expanded or deployed to a size and/or shape for selectively distracting the adjacent vertebrae. The invention also contemplates the temporary implantation of the subject devices which may be subsequently removed from the patient once the intended treatment is complete. Many of the methods involve the percutaneous implantation of the subject devices from either an ipsolateral approach or a mid-line approach into the interspinous space.
These and other objects, advantages, and features of the invention will become apparent to those persons skilled in the art upon reading the details of the invention as more fully described below.BRIEF DESCRIPTION OF THE DRAWINGS
The invention is best understood from the following detailed description when read in conjunction with the accompanying drawings. It is emphasized that, according to common practice, the various features of the drawings are not to-scale. On the contrary, the dimensions of the various features are arbitrarily expanded or reduced for clarity. Included in the drawings are the following figures:
Before the subject devices, systems and methods are described, it is to be understood that this invention is not limited to particular embodiments described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.
It must be noted that as used herein and in the appended claims, the singular forms "a", "an", and "the" include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to "a spinal segment" may include a plurality of such spinal segments and reference to "the screw" includes reference to one or more screw and equivalents thereof known to those skilled in the art, and so forth.
Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limits of that range is also specifically disclosed. Each smaller range between any stated value or intervening value in a stated range and any other stated or intervening value in that stated range is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included or excluded in the range, and each range where either, neither or both limits are included in the smaller ranges is also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.
All publications mentioned herein are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited. The publications discussed herein are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Further, the dates of publication provided may be different from the actual publication dates which may need to be independently confirmed.
The present invention will now be described in greater detail by way of the following description of exemplary embodiments and variations of the devices and methods of the present invention. The invention generally includes an interspinous spacer device as well as instruments for the percutaneous implantation of the interspinous spacer. A key feature of the interspinous spacer device is that it is expandable from a low profile configuration to a higher profile or operative configuration. This design allows the device, when in the low profile condition, to be delivered by percutaneous means without requiring the removal of any portion of the spinal motion segment into which the device is implanted.
Referring now to the drawings and to
Those spacers made of an inflatable non-porous material, i.e., balloon type spacers (see
Other embodiments of the subject spacers are made of an expandable mesh or cage (see
In certain embodiments of present invention, either during the implant procedure or in a subsequent procedure, the size or volume of the implanted expandable spacer may be selectively adjusted or varied. For example, after an initial assessment upon implant, it may be necessary to adjust, either reduce or increase, the size or volume of the spacer to optimize the intended treatment. Further, it may be intended to only temporarily implant the spacer for the purpose of treating a temporary condition, e.g., an injured or bulging or herniated disk. Once the repair is achieved or the treatment completed, the spacer may be removed, either with or without substantially reducing the size or volume of the spacer. In other embodiments, the spacer as well as the inflation/expansion material may be made of biodegradable materials wherein the spacer degrades after a time in which the injury is healed or the treatment completed.
When unexpanded or deflated, as shown in
For those embodiments of expandable bodies which comprise a balloon configuration, balloon 34 has an inflation or injection port 32 at a sidewall 30 for coupling to a source of inflation or expansion material or medium. Port 32 may consist of a one-way valve which is self-sealing upon release from an inflation mechanism or tube 76. Port 32 is further configured to releasably engage from tube 76, where such engagement may be threaded or involve a releasable locking mechanism. Where the expandable body comprises a mesh or cage, port 32 simply acts as an exit port, however, where an expansion material is used, it also functions as an injection port for the expansion material.
Optionally, device 24 may include a pair of tabs 36 which may be positioned on one side of the device where the tabs 36 are preferably situated at the apexes 28 of expandable body 34. Pins or screws (not yet shown) may be used to secure the tabs against the spinous process to further ensure long-term retention of device 24 within the implant site. Tabs 36 are made of a biocompatible material, such as latex, acrylate, rubber, or a metal, and may be made of the same material used for the expandable member 34. Shown here attached to tabs 36 are tethers 38 which are used in part to manipulate the positioning of expandable body 34 upon implantation into the targeted spinal motion segment. The tethers may be made of any suitable material including but not limited to materials used to make conventional sutures. They may also be made of a biodegradable material. While two tabs and associated tethers are provided in the illustrated embodiment, one, three or more may be employed, where the respective tabs are located on the expandable body so as to be adjacent a bony structure of the vertebra suitable for anchoring thereto. In embodiments which do not employ securing tabs 36, tethers 38 may be attached directly to the expandable body itself.
Optionally still, device 24 may further include radiopaque markers 40 on the surface of expandable body 34 visible under fluoroscopic imaging to facilitate positioning of the expandable body. Any number of markers 40 may be employed anywhere on expandable body 34, however, as few as four markers, one at each apex, may be sufficient. With embodiments employing cage or mesh expandable bodies, the cage or mesh material itself may be radiopaque.
A system of the present invention includes a cannula device 70 having an outer sheath 72, a proximal hub 78 and preferably at least two interior lumens 74, 76 for the percutaneous delivery the device and other tools for implanting the device, which tools may include a cutting instrument 62 (see
As illustrated in
The preloading of device 24 to delivery instrument 76 involves providing expandable body 34 in an unexpanded or deflated state and releasably coupled, as described above, by way of inflation or injection port 32 of expandable body 34 to the distal end of delivery instrument 76. In addition to functioning as a pusher, instrument 76 may act as an inflation lumen for balloon type embodiments through which an inflation medium is transported to within expandable body 34.
Depending upon the material used to fabricate expandable body 34, the expandable body may have a degree of stiffness in an unexpanded or deflated state such that it may maintain an elongated configuration so as to be directly insertable and pushable through cannula 70. This may the case where the expandable member 34 is made of a cage or mesh material. Alternatively, a pusher or small diameter rod (not shown) may be inserted through inflation port 32 to within expandable body 34 to keep it in an elongated state so as to prevent expandable body 4 from bunching within cannula 70 and to provide some rigidity to more effectively position the expandable body in the target implant site. The rod is then removed from expandable body 34 and from delivery device 76 upon positioning the expandable body at the target implant site. In either case, expandable body 34 is folded or compressed about its minor axis with the side wall opposite the inflation port 32 defining a distal end 25 (see
Once interspinous device 24 is preloaded to delivery device 76 as just described, device 24 is then inserted into a lumen of cannula 70 with tethers 38 pulled back and trail proximally so that the tether ends 38a extend from hub 78 of cannula 70. Expandable body member 34 is translated through cannula 70 to within opening 58 within spinous ligament 54 as best illustrated in
Once centrally positioned, expandable body 34 is inflated or expanded, as illustrated in
With embodiments in which the expandable body is initially inflated with air and then filled with a solid or fluid medium, the latter is preferably not delivered or injected into the interior of the expandable body until the position of the expandable body within the interspinous space has been verified and optimized. This is beneficial in situations where, upon inflation, it is found that the expandable body is misaligned within the interspinous space and requires repositioning. The expandable body may simply be deflated of air to the extent necessary and repositioned in a less inflated or deflated state. If necessary, for example where it is found that the maximum spacer or expandable body size is insufficient for the particular application at hand, expandable body 34 may be completely deflated and removed and replaced with a more suitably sized unit.
For balloon spacers and those mesh spacers which are not by themselves sufficiently self-retaining, once the position and extent of inflation or expansion of expandable body 34 are optimized, the expansion medium, e.g., polyurethane, is allowed to flow or injected into the interior of the expandable body via port 32. As illustrated in
The extent of possible distraction maybe limited by the capacity of expandable body 34 and the type of expandable body material employed. In certain embodiments, such as expandable bodies made of non-compliant or semi-compliant balloons, the requisite volume of the inflation medium may be substantially fixed whereby the balloon achieves its fully expanded configuration upon filling it with the fixed volume of medium. In other embodiments, such as with balloons made of a compliant material, the extent of expansion may be variable and selectable intraoperatively depending on the extent of lordosis or distraction to be achieved between the spinous processes in which balloon 34 is now interposed.
Upon achieving the desired distraction between the vertebrae, inflation/expansion lumen 76 is disengaged from expandable body port 32 which then becomes sealed by means of a one-way valve that is closed upon disengagement of lumen 76. Inflation/expansion lumen is then removed from cannula 70. While the opposing compressive force exerted on expandable body 34 by the distracted spinous processes 18, 22 may be sufficient to permanently retain expandable body 34 therebetween, the interspinous device may be further secured to the spinous processes 18, 22 to ensure that the expandable body does not slip or migrate from its implanted position. To this end, tabs 36 are anchored to the spinous processes as illustrated in
To ensure accurate placement of screws 90, along with instrument 88, can be tracked and translated over respective tethers 38, which function as guide wires. By manipulating instrument 88, the screws are driven or screwed into the respective spinous process. Screwdriver 88 is then disengaged or unscrewed from screw 90. After both tabs 36 are securely anchored to the spinous processes, the screwdriver and the cannula may be removed from the patient's back.
While certain of the expandable spacers are intended to be permanently implanted within a spine, certain others may be implanted only temporarily to facilitate the healing of an injury or the treatment of a reversible or non-chronic condition, such as a herniated disk. For such temporary treatments, the expansion material most likely is a fluid, such as saline, which may be easily aspirated through port 32 or may be allowed to drain out via a penetration or cut made in the expandable member. In those embodiments in which the expansion material is a flowable solid, which may or may not subsequently harden within the expandable member, the material may be one that is reconstitutable into a liquid form which may then be subsequently aspirated or evacuated from the expandable member. For percutaneous removal of the expandable member, a cannula such as cannula 70 may be used and an aspiration instrument delivered therethrough and coupled to port 32. After deflation and/or evacuation of the expandable member, and removal of the tacks, sutures, staples, etc. if such are used to secure tabs 36, the expandable member may be easily removed through cannula 70. With biodegradable spacers, removal of the spacer is obviated.
It should be noted that any of the above-described steps or procedures, including but not limited to cannulation of the target area, dissection of the spinous ligament, insertion of the expandable body within the dissected opening of the spinous ligament, inflation and/or expansion of the expandable body, adjustment or readjustment of the expandable body, and anchoring of the tabs, etc., may be facilitated by way of a scope 62 delivered through a lumen of cannula 70 to the open distal tip of cannula 70. Alternatively, a second cannula delivered through another percutaneous penetration may be employed for use of an endoscope and any other instruments needed to facilitate the procedure.
After the desired amount of distraction is achieved between vertebrae 2 and 4, an implantable expandable member 110 of the present invention is delivered adjacent the distracted spinal motion segment. Expandable member 110 may be delivered from the same incision and side as distraction mechanism 100 (ipsolateral approach) and as well as through the same working channel, or may be delivered through a different incision on the same or opposing side of the spinal motion segment being treated (bilateral approach) using two different working channels. In the illustrated embodiment, expandable member 110 is delivered from the same side of the spinous process as distraction mechanism 100. Expandable member 110 may delivered through a separate designated lumen in cannula 70 and translated distally of hub 104b of distraction mechanism 100.
As shown in
In addition to the expandable balloon spacers, the present invention further provides for mechanically expandable spacers such as those illustrated in
In the undeployed state, as illustrated in
In the deployed state, as illustrated in
Any suitable materials may be used to provide a spacer 160 which is provided in a first state or configuration, e.g., the undeployed state illustrated in
Referring now to
As mentioned above, spacer 160 may be provided with an integrated core member or the core member may be detachably provided on the distal end 182 of inner shaft 178. In the first embodiment, distal end 182 of inner shaft 178 is configured to temporarily couple with a proximal end (i.e., the end closest to handle 174) of the core member. In the latter embodiment, the distal end 182 of inner shaft 178 is configured to be inserted into the lumen of tubular member 162, as illustrated in
With either embodiment, retraction of inner shaft 178, as described above, retracts distal hub 166b towards proximal hub 166a and/or advancement of outer shaft 172 advances proximal hub 166a towards distal hub 166b, thereby causing tubular member 162 to be compressed axially, and thus expanded radially, as shown in
The reconfiguration of spacer 160 may be further facilitated by selectively configuring the wall of tubular member 162. For example, the interior or luminal surface of tubular member 162 may be contoured or incorporated with divets or spaces 180 where, upon compression of tubular member 162, the walls of the uncovered portions 164a, 164b of tubular member 162 will more readily fold inward to provide the resulting configuration shown in
As with the previously described spacer, end portions 192a, 192b may be made of a polymer based material or any other material which allows for simultaneous axial shortening and radial expansion when compressed. Blocks 200, 202 have a more rigid configuration in order to distract the adjacent spinous processes which define the interspinous space into which spacer 190 is positioned without substantial compression of central portion 194. As such, the blocks may be made of a rigid polymer material, a metal, or the like. In order to effect radial expansion and axial shortening of central portion 194, the blocks are selectively sized, shaped and arranged such that an inwardly compressive force on end blocks 202 along the longitudinal axis of the spacer forces end blocks 202 together which in turn forces side or lateral blocks 200 outward and away from each other, as illustrated in
When in an undeployed state, as shown in
Another interspinous spacer 210 of the present invention is illustrated in an undeployed/unexpanded state, in an intermediate state during deployment and in a deployed/expanded state in
In an undeployed state, as shown in
Interspinous spacer 230 of
In an undeployed state, as shown in
The end portions and central portions of the compressible spacers described above may be used in any combination. For example, the polymer-based central portion of
In an undeployed state, as shown in
Each of the expandable and or inflatable interspinous spacers described thus far is particularly configured to be delivered minimally invasively, even percutaneously, from a single incision located laterally to one side (left or right) of the spinal motion segment to be treated. However, the present invention also includes interspinous spacers which are deliverable through a mid-line incision made directly into the interspinous ligament. Examples of such spacers are now described.
Each strut 284 includes one or more blocks 288. Where more than one block 288 per strut is employed, such as with spacer 280 which employs two blocks 288 per strut 284 and spacer 290 of
Spanning between each strut pair 284a and 284b is a strap 286a and 286b, respectively, affixed to the outermost blocks. Straps 286 may be made of any suitable material which is strong enough to maintain distraction between adjacent spinous processes and to endure any frictional wear which it may undergo due to natural spinal motion. The straps may be flexible such that they act as slings, or may be conformable to the spinous processes once in situ. Alternatively, the straps may be non-conforming and rigid with a planar or curved shape depending on the application at hand. Suitable strap materials include but are not limited to polyester, polyethylene, etc.
With reference to
The initial steps of creating a percutaneous puncture and subsequent penetration into the skin 30 and the dissection of the spinous ligament 54 involve many of the same instruments (e.g., K-wire, trocar, cutting instrument, delivery cannula, etc.) and surgical techniques used in the ipsolateral implantation approach described above with respect to
As best illustrated in FIGS. 28A′ and 28A″, when in an undeployed state, spacer 280 has a relatively low profile to facilitate entry into the interspinous space. Once properly positioned within the interspinous space, deployment of the spacer 280 is initiated, as illustrated in
As the struts are radially extended, straps 286a and 286b emerge and they become tauter as the slack in them is gradually reduced by the extension of the struts. Continued deployment of spacer 280 causes straps 286a, 286b to engage with opposing surfaces of spinous processes 18 and 22. The radial extension of the struts is continued, as illustrated in FIGS. 28C, 28C′ and 28C″, until the desired amount of distraction between the vertebra is achieved. This selective distraction of the spinous processes also results in distraction of the vertebral bodies 2, 4 which in turn allows the disk, if bulging or distended, to retract to a more natural position. The extent of distraction or lordosis undergone by the subject vertebrae can be monitored by observing the spacer under fluoroscopy.
At this point, the delivery instrument 300 is released from spacer 280 by unscrewing threaded screw 302 from threaded lumen 285 and removing it from the implant site, as illustrated in
Spacer 280 may configured such that the struts are not retractable without active manipulation of delivery instrument 300 to ensure that their extension, and thus the distraction on the spinal motion segment, is maintained. As configured, spacer 280 may be easily repositioned or removed by subsequent insertion of instrument 300 into the interspinous space and operative engagement with the spacer. Instrument 300 is then manipulated to cause retraction of the struts and the straps, reducing the spacer's profile to allow repositioning or removal of the spacer.
Spacer 310 is implantable and deployable by way of a mid-line approach similar to that described above with respect to the spacer of
After the necessary space is created within the interspinous space as described above, spacer 310, which is releasably connected to delivery shaft 320 as described above, is inserted into the space in a fully undeployed sate (see FIGS. 29A and 29A′). Deployment of the spacer is accomplished by proximally pulling on shaft 320 which compresses rear block 312b towards front block 312a. This in turn causes the linkages 314 to pivot about their respective attachment points with superior and inferior lateral structures or blocks 318a and 318b forced away from each other, as illustrated in FIGS. 29B and 29B′. Continued pulling of instrument 320 further expands linkages 314 in a direction transverse to the central axis of spacer 310 and extend straps 316a, 316b towards respective surfaces of the spinous processes. As front and rear blocks 312a and 312b are centrally tapered, defining a bowtie or hourglass configuration, the strut pairs define a centrally tapered profile as the align to their fully deployed position, as best shown in FIGS. 29C′ and 29D′. In the fully deployed state, the spacer's axial member is positioned within the opening of front block 312a and locked to it. Additionally, straps 316a and 316b are firmly engaged against the spinous processes and the contacted vertebra are distracted from each other. Delivery instrument 320 may then be released from spacer 310 and removed from the implant site.
The proximal end 342 of central member 332 is provided with ratcheted grooves which are releasably engaged within the distal end of 352 of delivery instrument 350 (see
Spacer 330 is implantable and deployable by way of a mid-line approach similar to that described above with respect to the spacer of
The subject devices and systems may be provided in the form of a kit which includes at least one interspinous device of the present invention. A plurality of such devices may be provided where the devices have the same or varying sizes and shapes and are made of the same or varying materials. The kits may further include instruments and tools for implanting the subject devices, including but not limited to, a cannula, a trocar, a scope, a device delivery/inflation/expansion lumen, a cutting instrument, a screw driver, etc., as well as a selection of screws or other devices for anchoring the spacer tabs to the spinous processes. The kits may also include a supply of the expandable body inflation and/or expansion medium. Instructions for implanting the interspinous spacers and using the above-described instrumentation may also be provided with the kits.
The preceding merely illustrates the principles of the invention. It will be appreciated that those skilled in the art will be able to devise various arrangements which, although not explicitly described or shown herein, embody the principles of the invention and are included within its spirit and scope. Furthermore, all examples and conditional language recited herein are principally intended to aid the reader in understanding the principles of the invention and the concepts contributed by the inventors to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Moreover, all statements herein reciting principles, aspects, and embodiments of the invention as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents and equivalents developed in the future, i.e., any elements developed that perform the same function, regardless of structure. The scope of the present invention, therefore, is not intended to be limited to the exemplary embodiments shown and described herein. Rather, the scope and spirit of present invention is embodied by the appended claims.
1. An interspinous device for stabilizing at least one spinal motion segment comprising a first vertebra having a first spinous process and a second vertebra having a second spinous process, the device comprising:
- an axial dimension and a radial dimension substantially transverse to the axial dimension, wherein the axial dimension is greater when the device is in an undeployed configuration and the radially dimension is greater when the device is in a deployed configuration.
2. The interspinous device of claim 1, wherein the axial dimension is defined by a central member and the radial dimension is defined at least in part by a plurality of radially expandable members.
3. The interspinous device of claim 2, comprising a first strap extending between a first pair of the radially expandable members and a second strap extending between a second pair of the radially expandable members.
4. The interspinous device of claim 2, wherein the radially expandable members comprise linkages.
5. The interspinous device of claim 2, wherein the radially expandable members comprise deformable struts.
6. The interspinous device of claim 2, wherein the radially expandable members comprise a compressible material.
7. A system for stabilizing at least one spinal motion segment comprising a first vertebra having a first spinous process and a second vertebra having a second spinous process and an interspinous space defined between the first and second spinous processes, the system comprising:
- the interspinous device of claim 1; and
- a device for delivering the interspinous device in the undeployed state within the interspinous processes and for axially reducing and radially expanding the device from the undeployed state to the deployed state.
8. The system of claim 7, wherein the interspinous device is configured for delivery by the delivery device through a midline incision.
9. A method for stabilizing a vertebrae relative to another vertebrae wherein the vertebrae define an interspinous space, the method comprising:
- introducing the interspinous device of claim 1 within the interspinous space when in the undeployed state; and
- radially expanding and axially shortening the device to engage with the spinous processes.
10. The method of claim 9, further comprising forming an incision along the midline above the interspinous space, wherein the introducing the interspinous device comprises inserting the device within the midline incision.
Type: Application
Filed: Mar 10, 2005
Publication Date: Apr 20, 2006
Patent Grant number: 8012207
Inventor: Daniel Kim (Mountain View, CA)
Application Number: 11/079,006
International Classification: A61B 17/70 (20060101); A61F 2/44 (20060101);


text:
Update: Congrats to Cherilyn!
You are the winner!
Lady bugs and chevrons - too cute!ReplyDelete
If I'm lucky (hope I am!) then I would like Ladybug GardenReplyDelete
Tough choice, but I think I'd go with the Tonal small dot. I'm a sucker for polka dots.ReplyDelete
AWESOME - love them all but I am drawn to all the dots and spots !!! Fingers crossed!!! You guys ROCK!!ReplyDelete
Love them all but especially the maritime modern and the little tonal dots, the ribbon is gorgeous as well! Thanks for the chance to win!ReplyDelete
Maritime modern looks cute!:)ReplyDelete
I like the small dots! You can never have enough dots!ReplyDelete
The little matryoshkas are so cute!
I like Ladybug Garden. Bright, beautiful flowers make me smile! The ribbon is delightful. Thanks for a wonderful Giveaway!ReplyDelete
Love the little matryoshka dolls and small gingham! That ribbon is so cool, love it too! Thanks for the giveaway :)ReplyDelete
Hard choice but I think I would go the small tonal dots and I can see that ribbon in my little girls hair :o)ReplyDelete
I like the small dots!
I love the Ladybug Garden,beautiful! Thanks:)ReplyDelete
Tonal medium dots for sure :)ReplyDelete
How sweeet of you for a giveaway. I'd like the Ladybug Garden for a little girl who needs a quilt. Thank you so much.ReplyDelete
Love all of them but I think the small dots are awesome!ReplyDelete
That ribbon is gorgeous!ReplyDelete
my favorite is Ladybug Garden, it's going to my little daughter stash for her future quilt ^_^
thank you so much for this new opportunity <3
I love them all but I really would like Little Matryoshka, thanks for the chance :)ReplyDelete
I like Saltwater & Tonal Dots.ReplyDelete
They are all so great. I would chose maritime modern. I love all things nortical.
What a great giveaway.
Oh that Lady bug charm pack is really cute Thanks for having a give away.ReplyDelete
I think I would have to go with the tonal medium dots. I'm a sucker for polka dots.ReplyDelete
Corrie, I like lady bug lovingly named after my lovely grandaughterReplyDelete
I like them all, but I love that whale so I'd say Maritime ModernReplyDelete
I love the look of maritime modern. It would make a great baby boy quilt.
The little gingham is so sweet.
Thank you Corrie!! :0)
I love the Ladybug Garden and so would my little girl. I am sure that some of it would end up being hair accessories and dolls clothes unless I used it really quickly.ReplyDelete
I just can't resist the Ladybug Garden! Thanks for the chance to win!ReplyDelete
I love Little Matryoshka and Chevron ribbons!
Thanks for the giveaway!
Even though I love the little matryoshkas, I would have to pick Get a Clue w/ Nancy Drew - it would make cute reading pillows for my bookclub gals -a mystery book club and well we used to all read NancyD! Thank you for the lovely giveaway!ReplyDelete
Love love love the lady bug charms!!ReplyDelete
I really like the Medium Tonal Dots. But all of it looks good. The ribbon really looks like a fun accent.ReplyDelete
I love the Little Matryoshka!ReplyDelete
I'm loving the tonal dots. thank you for a chance to win.ReplyDelete
They're all beautiful!
Little Matryoshka would be my favorite or the Tonal Dots. =) Thank you.
I'm smitten with the maritime modern.ReplyDelete
I love Lady Bug Garden.
Thanks for the chance.
I'm a sucker for dots -- love the small dot charms.ReplyDelete
I love love polka dots, the small tonal ones are my favoritesReplyDelete
I love the Ladybug Garden. I have a thing about ladybugs. Not to many around lately.
The small dots would be perfect. I'm on a dot kick lately and adding them whenever possible. Thanks!ReplyDelete
I love Ladybug Garden!ReplyDelete
I love them all! Favorite would be ladybug garden.ReplyDelete
Ohhhhh...tonal medium dots!ReplyDelete
Loving it all, but I'd have to say the gingham is my favorite!ReplyDelete
The Little Lady bugs is the cutest!ReplyDelete
In love the ladybug garden it's just so pretty. Thanks for the chance to win . ClaireReplyDelete
I really like the Maritime Modern. I'm really fascinated with woodgrain and polka dots and it has both (plus those cute whales).ReplyDelete
It's that sweet gingham for me, all the way!
Cute fabric! Ladybug Garden is my favorite.ReplyDelete
Gingham! I love gingham! In fact in my kitchen I have red gingham wallpaper, that's how much I love gingham!ReplyDelete
You're making us pick?!
How can I choose just one!!!
I like Maritime modern :)
I would love the small gingham!ReplyDelete
I'm seeing spots! Just love the polka dots, big or smalle, don't really care! They're so yummy!ReplyDelete
I love the Little Matryoshka! Thanks for the giveaway.ReplyDelete
They are all pretty but The Ladybug Garden is for me, we call them Bishy Barney Bees.ReplyDelete
I would so love to win the Little Matryoshka fabric - I have a friend who loves them and I would like to make her something with that fabric :)ReplyDelete
Love the small gingham...and all of them Ü Thanks!ReplyDelete
Love Lady Bug Garden. We get so many lady bugs during the summer! Thanks for the chance!ReplyDelete
All lovely, but I pick small dots. Thanks.ReplyDelete
love love love the lady bug garden it would make the most wonderful tote bag for my quilting on the go.
Thanks for the chance
thank you
Robin in Wasington State
assweetaspeaches hotmail
Love Little Matryoshka!! Thank you for a chance to win.ReplyDelete
I love the Maritime Modern - great for all these boys around here!
I love ladybug garden...it would be perfect for a project for my little one!ReplyDelete
great fabrics all ---love Little Matryoshka!
Maritime modern. Thanks for the chance!ReplyDelete
I love Ladybug Garden. I have the perfect small project for it.ReplyDelete
OOh!! Wouldn't a hexie bag be so cute with those dots!! I think I could do that!ReplyDelete
I love them all and since I don't own any Riley Blake it would be a real treat to own some now! I think Maritime Modern is my favorite!ReplyDelete
I would want to tonal medium dots -- such good colors! Thanks for the chance to win!ReplyDelete
I was just admiring Ladybug Garden yesterday... love it! thanks for a great give-away~ReplyDelete
Little Matryoshka would be my first choice! I just bought 2 charms packs of it so a third would be great:)ReplyDelete
I like the Ladybug Garden and Chevron Ribbon. Thanks for the giveaway!ReplyDelete
Ooooh, that ribbon is AWESOME! But then, I love it all!ReplyDelete
I just adore the Little Matryoshka pattern! I reminds me of cabinet full of them we had when I was a child. So wonderful!ReplyDelete
Cool choices for today. Love the Little Matryoshka Dolls. You always have such fun things. That ribbon is to die for.ReplyDelete
I like the Ladybug Garden pack best. Thanks for the chance!ReplyDelete
You made picking just one really hard. I think Lady Bug Garden would be my first choice followed by Small Ginghams.ReplyDelete
Little Matryoshka, please!ReplyDelete
Difficult choice, but I would probably go for the big dots. Thanks, Corrie!ReplyDelete
Love the Little Matryoshka! It would be perfect for a little baby girl quilt I need to make :) Thanks!!
I'm in love with Little Matryoshka. Thanks for the chance to win some!ReplyDelete
I like the tonal medium dots and I love the ribbon! Thanks Corrie!ReplyDelete
Hi!!! I love the Lady Bug Garden!!! Thanks for the fun give away!!!!ReplyDelete
Little Matryoshka is so cute. My 4yo daughter is sitting beside me and loving it too!ReplyDelete
Lady bugs are my favorite, thanks for the chance to win!ReplyDelete
Today I'm going to deviate from my love of dots and choose the Small Ginghams. Thank you for a chance to win.ReplyDelete
Love the maritime and the small dots!ReplyDelete
I love them all, but the Ladybug Garden is my fave. And that ribbon is the bomb.
I love the matroyshka dolls! But I love the maritime modern too! Too hard to pick :)ReplyDelete
Such cute patterns, makes choosing just one difficult. They would be great prints for baby quilts.ReplyDelete
I love the small dots. firstname.lastname@example.com
Love the small dots! Thanks again.ReplyDelete
i would get a ton of use out of the small or medium dots. email@example.com
I like ladybug garden, BUT I LOVE MARITIME MODERN!ReplyDelete
I would love the Little Matryoshka charms. My daughter traveled to Russia and brought home the little stacking dolls. They are so cute. Thanks for the giveaway!ReplyDelete
Oh so cute - love the small gingham.ReplyDelete
My favorite would be the medium dots, even though I like them all!ReplyDelete
It's all about the polka dots for me...ReplyDelete
Fun! I am seriously getting into the dots!ReplyDelete
I love the small tonal dots!ReplyDelete
Would love to win the Ladybug Garden charm pack. Thank you for the giveaway.ReplyDelete
I really love the Matryoshka dolls!ReplyDelete
I love the matryoshkas! Thanks for the chance to win : )ReplyDelete
wow.. have a crush on the ladybug garden.. so cute for a little girl quilt! thank's for the chance to winReplyDelete
This is a hard decision, they are all so good! I think the nested dolls so I could make something for my daughter who speaks Russian! Thanks.ReplyDelete
Love the tonal dots, but the Ladybug fabric is also too cute. Decisions, decisions. Thanks for the great choices. :)ReplyDelete
I love the Little Matryoshka! I have a little girl who is very into dolls right now! Great giveaway!ReplyDelete
I love the gingham! I think that ribbon is pretty neat too.ReplyDelete
I'd love any of those cheery fabrics to play with. Thanks so much.ReplyDelete
Such a fun choice, thanks for sharing the giveaway fabric. I would love Little Matryoshka please, the dots look fabulous too.
What's not to love about all of it? But, I'm especially loving the ladybugs!!ReplyDelete
Little matryoshka. I have been eyeing that one lately. Thanks!ReplyDelete
Small ginghams for sure!!! Loving the chevron ribbon, must get some ASAP!ReplyDelete
I love the ladybug garden and the big dots. What a decision. Thanks for the chance.ReplyDelete
I would love the ladybug charm pack and LOTS of chevron ribbon!!! It is so cute. thanks, kathyReplyDelete
Wow! Hard to choose. I like Little Matryoshka, Ladybug Garden, and Medium Dots. Thanks! raybanfandango at hotmail dot comReplyDelete
I love all of them but if I had to chose one it would be small tonal dots!ReplyDelete
I love the matryoshka print!ReplyDelete
Ohhhh! If I had to choose just one I'd have to choose Ladybug garden. The others are wonderful too though!ReplyDelete
Wonderful prints, but I think I would love the Maritime Modern, it would be perfect to make something for my sister's place.
Thanks for the chance, it is hard to pick but I think I would do the medium dots, they would be great in so many things!!!!ReplyDelete
I'd pick the Little Matryoshka - thanks for the chance!ReplyDelete
I love either of the tonal dots -- if I am the lucky winner, surprise me! Thanks for the chance to win!ReplyDelete
I love the Little Matryoshka prints thanks for the chance!ReplyDelete
Ladybird garden for me :)ReplyDelete
My girls would love the ladybug garden.ReplyDelete
I love Ladybug Garden :)
Thank you for the chance!
It is between the Ladybug Garden and the little Gingham.ReplyDelete
Ladybug Garden is definitely my favourite. Also love the chevron red ribbon, so cute.ReplyDelete
The fabrics are all great, but my favorite today is Ladybug Garden. Love the ribbon, too!ReplyDelete
LOVE Little Matryoshka! Thanks for the chance!ReplyDelete
I'd love Little Matryoshka! Thanks!ReplyDelete
Oh, I'd be THRILLED with any one them!! And the ribbon...so cute!
Oh, love those medium dots! Lovely colours. Thanks
(Kissed by a dog = ROTFLMAO! Glad I was looking on the right side of the screen at just the right time, hehe. Yesterday I visited my neighbour and her dobie gave me some kisses - that's a first - usually she's more reserved around me :) If you're going to have a neighbour with a dobie than it's a mighty fine idea to make friends with said dog, LOL!)
Ladybug garden = ooOOOOOOOOOOOOOOooooo adorable! I just added 2 items to my sewing gift list for June, for a soon-to-be-2-years-old little girl - I want to make her a ladybug apron and a ladybug tulip hat - ladybugs are just so adorable for little girls!!!
Love lady bird garden thanksReplyDelete
I would love the medium dots and the chevron ribbon. Thanks for the chance to win.ReplyDelete
They are all so cute! I think I would pick the small dots. Thanks for the giveaway.ReplyDelete
I would love any of them but my favorite is the Ladybug Garden. Thanks for the great giveawayReplyDelete
I would love the medium polka dots - so many possibilitiesReplyDelete
Tonal small dots would be perfect for an appliqué quilt I have on my to-do list.ReplyDelete
Love the tonal small dots ... something about dots lately, they've been calling my name :) Thanks for the chance.ReplyDelete
I love the Ladybug Garden! And the ribbon is so cute!ReplyDelete
The small tonal dots pack is great.ReplyDelete
I would have to pick the small dots. It would worl perfect with some other fabric I have. email@example.com
I love the ginghams!ReplyDelete
i like the tone on tone dots! Overall fun stuff - thanks and have a great day.ReplyDelete
I like the med tonal dots. the ribbon looks so fun!ReplyDelete
I love the Ladybug Garden!ReplyDelete
I want all of them! If I win then I will pick :)ReplyDelete
Ohhh, look at all those fab fabrics!! My favorite is the Ladybug Garden. LOVE the ribbon; I'm working on Christmas stockings and that ribbon would look so cute on them.ReplyDelete
I really like them all, but I would pick the small dots.ReplyDelete
hard choice, but i think i'd be most likely to use the small dots!ReplyDelete
That is a tough question, but I'd probably go with Ladybug Garden. My daughter loves all things ladybug and was a ladybug for Halloween last year. I saw that print and I could just hear her saying "Imma WADYbug!!" at every door instead of "Trick-or-treat". :ReplyDelete
I really like the dots but my favorite is the Ladybug Garden. Thanks for the fun giveaway!ReplyDelete
Maritime modern and Ladybug Garden.Thanks for the giveaway!ReplyDelete
OMG - those Little Matryoshka dolls are my FAVORITE!!!!ReplyDelete
ladybug garden is my favorite ... love whimsical prints! it would be nice to cut butterflies and flowers fromthe charm pack and applique them to a nice background piece for a little girl's quilt. thanx for the chance to win a pack and trim ribbon.ReplyDelete
Difficult choice they are all great I am going to go with Ladybug Garden.ReplyDelete
I love the Maritime Modern, I hadnt seen it until this very moment but I MUST have some whales! Thank you for the giveaway :)ReplyDelete
the matryoshka (sp?) ones--my 4 sisters and I used to be called matryoshka dolls because we all looked so similar!ReplyDelete
I love the tonal medium dots. :)
carol_busse at yahoo dot com
All are cute, If I'm chosen then the Little Matryoshka would be my pick. Thanks for the chance. JaneReplyDelete
Lady Bugs! But I always called my daughter "Katie Bug Lady Bug". Those tonal dots are neat too.ReplyDelete
Little Matroyska, hard to spell but love it!ReplyDelete
Love the smaller pokey dots and Ladybug Garden, so cute. ;-> Toni AnneReplyDelete
I like the small tonal small dots, they would be very useful in many quiltsReplyDelete
Mmmmm....which one....that is a hard one....love them all...but will go with the tonal small dots they are very useful in any project. GayleReplyDelete
Maritime Modern!!!! I've been eyeing that collection and I can't wait to get my hands on it!!! Thanks!!ReplyDelete
I would just have to have Ladybug garden, because my daughter is my little ladybug. http://grecomara.blogspot.gr/2012/11/ur-priceless.htmlReplyDelete
Maritime Modern is my pick! Perfect for a little something summery.:)ReplyDelete
http://www.etsy.com/listing/122698052/21-5-inch-charm-squares-little?ga_search_query=dolls I would want this one. thanks for the chanceReplyDelete
Tonal small dots!ReplyDelete
These are all adorable, I love them all. But if I had to pick Just one it would be ladybug garden. Thanks for the chance.
Ladybug garden. Linda gerigReplyDelete
Tough choice....! I think I would go with tonal medium dots. Many thanks for the chance!
Hard to choose -- all would be fun to use. But I think I will choose the Ladybug GardenReplyDelete
Love the maritime! Thanks for the chance!ReplyDelete
The little Matryoshka is just darling!ReplyDelete
I think today I would like to win Ladybug Garden. So dang cute. cmt
Love them all!! But if I had to choose it would be Maritime Modern. Thanks for the chance!!ReplyDelete
I had not seen Maritime Modern before, so I had to go check out the whole line. Love it!!ReplyDelete
I love polka dots so the tonal small dots are my favorite. Thanks.ReplyDelete
I love them all, but I really like Ladybug Garden. I also like the Little Dots. Thanks for the chance to win....firstname.lastname@example.com
I pick the Ladybug Garden pack! So bright and colorful, and ladybugs are my favorite bugs--perhaps because they are beneficial to gardening. Hugs!ReplyDelete
The ginghams makes my heart sing!ReplyDelete
Hi, My name is Tracey but I don't have an account with any of the other options so I used anonymous. :-) I'm a gardener so I absolutely love the Ladybug Garden fabric. Thanks for the chance!ReplyDelete
Loving the Ladybug Garden and that red chevron ribbon. Mmmmmmmmm :DReplyDelete
OOOOOOOOOoooooooooooo I like the little ginghams. And I could take the chevron ribbon, let it trail behind me and dance "gingham" style LOL thanks for the giveaway.ReplyDelete
I LOVE the tonal dots (and the ribbon, too!!). Thanks for the giveaway!ReplyDelete
Love the gingham and the small tonal dots. And that ribbon made me drool all over my keyboard!ReplyDelete
Oh, it's so hard to chose, but I love, love Ladybug Garden!! The ribbon is wonderful too!ReplyDelete
It's gotta be the ladybug garden although the Matroyshka dolls are a close second. Thanks for sharing and for the opportunity on the draw.
I love the dots.ReplyDelete
gingham has my heart lately:)ReplyDelete
I love the Matryoshka dolls! My son bought me a set of these when he went to Russian in his junior year of high school.ReplyDelete
The tonal medium Dots are my favorite!ReplyDelete
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Report on teacher training raises concern, skepticism
Group gives Kansas a D+ rating, Missouri a D
A new report about how teachers are trained is giving low scores to programs in Missouri and Kansas.
The National Council on Teacher Quality, an outside group unaffiliated with those who accredit state teacher training programs, gave Kansas a D+ grade and Missouri a straight D.
These teacher training programs provide about two-thirds of all the teachers for the two states.
The report criticizes both states for the way it trains teachers to teach read and math. It also says student teachers don't get as much training as they need.
People in Kansas blasted the report. The head of the teaching program at the University of Kansas said if the report had been produced by a student, it would get a failing grade because it lacks impact data to back up the claims.
The highly regarded teaching program at Emporia State University received two stars in the report.
Gene Neely, the NEA representative for the Olathe Public Schools, which uses student teachers from Emporia State, said it's wrong to make a blanket statement that student teachers aren't ready.
"They're right there on the front line, learning first-hand and incorporating what they're getting in their own class work as well," said Neely.
Central Missouri State University, which has an extensive teaching program, only got one star overall. The University of Missouri-Columbia, University of Missouri-Kansas City, Avila University, Park University and Rockhurst University all got no stars.
Neely, a longtime classroom veteran, said he thinks there needs to be more perspective.
"What you have at the end of that teacher preparation program is significantly more important than what you have coming in," he said.
The National Council on Teacher Quality has evaluated teaching standards in the past, but this is its first look at the teacher training programs that schools and colleges use.
The report may serve as ammunition for critics who contend states aren't getting their money's worth for the millions they spend on education.


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