text:
We have the professional technology and the first- rate equipment. Our products of Fan and Motor is lower noise, less vibration, long life time, good reliability and intelligence in operation.
We seek the aim of excellent quality forever. Nowadays, our products are all passed the CCC,CE,UL and CUL certification. And we are also passed the ISO9001:2000 of quality management system and the RoHS certification for material of environment.
SHENZHEN S&T MOTOR CO.,LTD. , founded in 2006, is located in Shenzhen city China. It is a manufacturer specialized in research, development and production of brushless DC Fan , AC Fan and Fan blower.The total site areal of manufacture is 11000 square meters and is located in Shangyuan industrial zone,Chashan town ,Dongguan city ,Guangdong province.

lowercased:
we have the professional technology and the first- rate equipment. our products of fan and motor is lower noise, less vibration, long life time, good reliability and intelligence in operation.
we seek the aim of excellent quality forever. nowadays, our products are all passed the ccc,ce,ul and cul certification. and we are also passed the iso9001:2000 of quality management system and the rohs certification for material of environment.
shenzhen s&t motor co.,ltd. , founded in 2006, is located in shenzhen city china. it is a manufacturer specialized in research, development and production of brushless dc fan , ac fan and fan blower.the total site areal of manufacture is 11000 square meters and is located in shangyuan industrial zone,chashan town ,dongguan city ,guangdong province.


text:
Many owners of companies are beginning to understand the advantages of using online business systems. Any corporation that is active in internet-based activities will experience a much lower operating cost than the one that functions exclusively in a specific place. There are many benefits of having an internet section added to one’s business. There is however the inclusion of punctual delivery of products or services to the consumers.
A lean supply chain is the operational technique that a corporation applies so as to ensure that the consumers are satisfied through the provision of quality products which are delivered efficiently. Businesses which use this technique in their daily operations have a high probability of satisfying their customers having in mind that modern customers require their products to be delivered as fast as possible. With higher levels of consumer satisfaction, these corporations are likely to enjoy consumer loyalty.
The fundamental plan behind a lean supply chain is to regulate all areas of the corporation methods. Thus, any frail or incompetent department of production, sale and transport of goods must be known and eliminated on a regular basis so as to ensure that there are high levels of performance. This involves getting rid of or changing areas of production which might act to underrate the final products or goods or which does not satisfy the consumers’ requirement. Businesses that use these techniques effectively understand that maintaining the supply chain lean is not just about making the customer happy but it’s about saving the businesses’ revenues as well.
Online business systems are made to improve the competence of processes that are major components of escalating the yield of a corporation. These are made to assist companies to measure the instability of consumer demand, build consumer appreciation and relations and come up with performance techniques which can be utilized during upcoming development procedures. It is important to learn about the best ways of building thriving online business systems so as to succeed in today’s corporate world.

lowercased:
many owners of companies are beginning to understand the advantages of using online business systems. any corporation that is active in internet-based activities will experience a much lower operating cost than the one that functions exclusively in a specific place. there are many benefits of having an internet section added to one’s business. there is however the inclusion of punctual delivery of products or services to the consumers.
a lean supply chain is the operational technique that a corporation applies so as to ensure that the consumers are satisfied through the provision of quality products which are delivered efficiently. businesses which use this technique in their daily operations have a high probability of satisfying their customers having in mind that modern customers require their products to be delivered as fast as possible. with higher levels of consumer satisfaction, these corporations are likely to enjoy consumer loyalty.
the fundamental plan behind a lean supply chain is to regulate all areas of the corporation methods. thus, any frail or incompetent department of production, sale and transport of goods must be known and eliminated on a regular basis so as to ensure that there are high levels of performance. this involves getting rid of or changing areas of production which might act to underrate the final products or goods or which does not satisfy the consumers’ requirement. businesses that use these techniques effectively understand that maintaining the supply chain lean is not just about making the customer happy but it’s about saving the businesses’ revenues as well.
online business systems are made to improve the competence of processes that are major components of escalating the yield of a corporation. these are made to assist companies to measure the instability of consumer demand, build consumer appreciation and relations and come up with performance techniques which can be utilized during upcoming development procedures. it is important to learn about the best ways of building thriving online business systems so as to succeed in today’s corporate world.


text:
Katie Price and her new baby return home after holidaying in Europe.
Alex Reid has tweeted a message of support for his ex-wife Katie Price.
Price gave birth to her first child with current husband Kieran Hayler eight weeks early last month.
She was rushed to hospital while holidaying in Europe, and was told her labour would be induced early as her baby was at risk of infection and had a dangerously low heart rate.
The model confirmed that she and Hayler arrived home with son Jett Riviera last week.
She tweeted on Tuesday (September 10): "It's been a week since me @kieran0322 and Jett been home haven't told people we are home as wanted to settle in! Thankyou to all tweets x"
Reid messaged her directly in reply, stating that he was happy to hear her family was safe.
Very glad to hear @kieran0322 @MissKatiePrice & baby Jet are all home safe & sound!
Alex Reid and Katie Price have not been on good terms since their split in 2011.
He recently sold his wedding ring to Now magazine to give away in a reader competition.
Katie Price recently told Digital Spy that her latest pregnancy had "been more difficult" than those before.

lowercased:
katie price and her new baby return home after holidaying in europe.
alex reid has tweeted a message of support for his ex-wife katie price.
price gave birth to her first child with current husband kieran hayler eight weeks early last month.
she was rushed to hospital while holidaying in europe, and was told her labour would be induced early as her baby was at risk of infection and had a dangerously low heart rate.
the model confirmed that she and hayler arrived home with son jett riviera last week.
she tweeted on tuesday (september 10): "it's been a week since me @kieran0322 and jett been home haven't told people we are home as wanted to settle in! thankyou to all tweets x"
reid messaged her directly in reply, stating that he was happy to hear her family was safe.
very glad to hear @kieran0322 @misskatieprice & baby jet are all home safe & sound!
alex reid and katie price have not been on good terms since their split in 2011.
he recently sold his wedding ring to now magazine to give away in a reader competition.
katie price recently told digital spy that her latest pregnancy had "been more difficult" than those before.


text:
Welcome to another HUGE HeroesCon guest list update! We hope you can join us for 3 days of everything we love about comic books along with the people who make them at the Charlotte Convention Center June 20-22, 2014. Tickets for Heroes Convention 2014 are on sale now!
HEROESCON 2013 GUEST LIST UPDATE :: GLAPION! LEONARDI! TIERI! & MORE!
We’ve got another great guest list announcement for you today! Time is running out to purchase your discounted 3-day passes and to receive all the goodies that come along with that! We’ll see you soon!
Heroes Convention is in Charlotte, North Carolina, June 7-9 2013. Get your 3 day passes today! Our full guest list (so far) is here.
Please note: Several guests have had to cancel their appearances due to unforeseen circumstances. Cancellations are always listed at the right/bottom sidebar of the guest list page here.

lowercased:
welcome to another huge heroescon guest list update! we hope you can join us for 3 days of everything we love about comic books along with the people who make them at the charlotte convention center june 20-22, 2014. tickets for heroes convention 2014 are on sale now!
heroescon 2013 guest list update :: glapion! leonardi! tieri! & more!
we’ve got another great guest list announcement for you today! time is running out to purchase your discounted 3-day passes and to receive all the goodies that come along with that! we’ll see you soon!
heroes convention is in charlotte, north carolina, june 7-9 2013. get your 3 day passes today! our full guest list (so far) is here.
please note: several guests have had to cancel their appearances due to unforeseen circumstances. cancellations are always listed at the right/bottom sidebar of the guest list page here.


text: Arkon’s APRM2T adapter converts any mount with a 25mm ball pattern into a mount that’s compatible with an Arkon Dual-T smartphone or tablet holder, including the Slim-Grip Ultra Universal Smartphone and Midsize Tablet Holder (SM060-2), Slim-Grip Universal Smartphone Holder (SM050-2), Slim-Grip Universal Tablet Holder (TAB001), and Mega Grip Universal Smartphone Holder (SM040-2). This package includes only the adapter (holders sold separately). Attach the adapter to any 25mm ball compatible pedestal (also sold separately), then insert the Arkon holder into the bracket and adjust accordingly.

lowercased: arkon’s aprm2t adapter converts any mount with a 25mm ball pattern into a mount that’s compatible with an arkon dual-t smartphone or tablet holder, including the slim-grip ultra universal smartphone and midsize tablet holder (sm060-2), slim-grip universal smartphone holder (sm050-2), slim-grip universal tablet holder (tab001), and mega grip universal smartphone holder (sm040-2). this package includes only the adapter (holders sold separately). attach the adapter to any 25mm ball compatible pedestal (also sold separately), then insert the arkon holder into the bracket and adjust accordingly.


text:
Let’s say you have an established practice. A “suit” could literally just walk in and offer to purchase your practice. Maybe your office was recommend to Heartland by colleague. If that sale goes through, your colleague will be themselves a tidy bonus…let’s call it a finders fee – $2500 to $5000 or there about.
Heartland professes your office just becoming an “affiliate” – a term used quite loosely in the the world of corporate dentistry. But it has to be true, right? It’s everywhere! It’s all they say, they never mention owning dental clinics, just Heartland Affiliated Dental Centers.
They offer you a large sum of money to “affiliate”. A sum which is likely much more than the practice is actually worth if it were for sale.
But you’re not selling, right? You are simply becoming “affiliated” with Heartland so they can help you with your day to day operations – marketing, advertising, software, billing, etc.
For whatever reason, you decided to take their offer. and become a Heartland Dental “affiliated” dental center. What happens then?
In the employment agreement, they will agree to a not so bad salary, $120K –$150K a year, plus a percentage of profits. By profits, I mean “net” profits.
Contrary to what Heartland said, you just sold your practice and you just became their employee.
Yes, that is what is said, but it’s a lie. You are simply their employee forever more, or until you can get fired.
So you are now “affiliated” with Heartland Dental. What happens next?
You and your entire staff are whisked off to Effingham, IL for training. I say entire staff, but that might not be the staff you planned on keeping around. That staffing choice is no longer yours to decide – it’s Heartland Dental’s. There just went all that control of your practice promised!
Heartland Dental didn’t need that new $7.7 million training facility – HDC Institute. for nothing. They are going to be training you!
In fact, it’s likely any future training you get will be right there in Effingham at Heartland Dental.
While your office is closed, not producing income, and you and your staff are away at training camp, things maybe happening back at the office. A team may be invade what was once your office. This team is there to strip out your equipment and replace it with Heartlands. What was once your equipment, will be replace Heartland’s own – which could, and likely will, be of lesser quality. But hey, it’s got their software already loaded and ready to go.
Chop! Chop! Get to work!
What happens at the 1 to 2 week training sessions, other than your balance sheet taking a dive – remember, if you are in Effingham, you ain’t workin’. You and staff are learning the Heartland Way, that’s what.
Mr. Dentist, you are now to do nothing but procedures. You will do them as we are teaching you, it’s the only way you can meet the goals we are setting for your “affiliated” clinic. We might throw in some orthodontics training on a three day trip, if other revenue sources are needed, who knows.
Oh and the “partnership” plan mention in the propaganda piece, it’s really an Employee Stock Ownership Plan (ESOP). While most ESOP’s are stock given to the employee at no cost, you might be asked to “contribute” a $100K to Heartland’s ESOP. Doesn’t that just sound yummy. You get $100k worth of Heartland Stock. Rick get’s money for lunch.
It’s called a PA, not Public Address System nor, Physician's Assistant, but Practice Administrator. These little jewels go through extensive training at HDC Institute and are taught how to “handle” unruly dentists, so don’t be unruly.
Continuing Education? That will be done right at HDC Institute. You will get what they are serving. No matter if you could get it locally, for 1/3 the fee, less time away from the office.
Ms. Office Manager, you are now in charge of all treatment plans, presenting said plans to patients and pricing. [Nothing like a medically untrained office staff talking tell a patient about complicated medical procedures to make said patient safe!] If you can’t handle it, Ms. Office Manager, we have someone trained to step in at any time, but under no circumstance will Mr. Dentist being doing treatment plans. He’s to produce, nothing more.
Nothing is for free, ya know.
That training Heartland demands, costs money and your clinic’s revenues is going to pay for every dime of it. Could be as much as $3k-$5k per day. A Friday, Saturday, Sunday, pep rally, well, that may be $10k.
The Heartland brand continuing education, well that will come off your “affiliated” clinic’s bottom line. too. Not only that, but you pay, what Heartland wants to charge. So what if you could get it cheaper and closer to your home. So what your office could be seeing patients those days.
If Rick Workman has to fly someone in to get you lined back out, for under production. It is going to cost ya. Every business mile driven, every night in a hotel, every meal they eat, your clinic picks up that tab. The college educated psychology grad - who is really just a company dental hygienist - sent to assess your nonproductive ways, will also be expensed out to your clinic.
Prizes and gifts for company wide employees, those are expensed out among the “affiliated” clinics too. Remember that bonus your colleague got for recommending your practice to Heartland, yeah, it will be charged to your “affiliated” clinic.
Monthly seminars to Effingham,IL, are going to cost you as well. Every night in the hotel, every chicken leg you eat, it’s coming out of your “affiliated” clinic’s account. Think you will be given a breakdown of what Heartland Headquarters has expensed to your “affiliated” clinic, think again! Those are not for your eyes.
You know the new HCD Institute will be expensed out to each Heartland Dental “affiliated” dental center as well. It has to be, everything else is.
Last but not least, your “affiliated” clinic has to pay Heartland for all the administrative services as well.

lowercased:
let’s say you have an established practice. a “suit” could literally just walk in and offer to purchase your practice. maybe your office was recommend to heartland by colleague. if that sale goes through, your colleague will be themselves a tidy bonus…let’s call it a finders fee – $2500 to $5000 or there about.
heartland professes your office just becoming an “affiliate” – a term used quite loosely in the the world of corporate dentistry. but it has to be true, right? it’s everywhere! it’s all they say, they never mention owning dental clinics, just heartland affiliated dental centers.
they offer you a large sum of money to “affiliate”. a sum which is likely much more than the practice is actually worth if it were for sale.
but you’re not selling, right? you are simply becoming “affiliated” with heartland so they can help you with your day to day operations – marketing, advertising, software, billing, etc.
for whatever reason, you decided to take their offer. and become a heartland dental “affiliated” dental center. what happens then?
in the employment agreement, they will agree to a not so bad salary, $120k –$150k a year, plus a percentage of profits. by profits, i mean “net” profits.
contrary to what heartland said, you just sold your practice and you just became their employee.
yes, that is what is said, but it’s a lie. you are simply their employee forever more, or until you can get fired.
so you are now “affiliated” with heartland dental. what happens next?
you and your entire staff are whisked off to effingham, il for training. i say entire staff, but that might not be the staff you planned on keeping around. that staffing choice is no longer yours to decide – it’s heartland dental’s. there just went all that control of your practice promised!
heartland dental didn’t need that new $7.7 million training facility – hdc institute. for nothing. they are going to be training you!
in fact, it’s likely any future training you get will be right there in effingham at heartland dental.
while your office is closed, not producing income, and you and your staff are away at training camp, things maybe happening back at the office. a team may be invade what was once your office. this team is there to strip out your equipment and replace it with heartlands. what was once your equipment, will be replace heartland’s own – which could, and likely will, be of lesser quality. but hey, it’s got their software already loaded and ready to go.
chop! chop! get to work!
what happens at the 1 to 2 week training sessions, other than your balance sheet taking a dive – remember, if you are in effingham, you ain’t workin’. you and staff are learning the heartland way, that’s what.
mr. dentist, you are now to do nothing but procedures. you will do them as we are teaching you, it’s the only way you can meet the goals we are setting for your “affiliated” clinic. we might throw in some orthodontics training on a three day trip, if other revenue sources are needed, who knows.
oh and the “partnership” plan mention in the propaganda piece, it’s really an employee stock ownership plan (esop). while most esop’s are stock given to the employee at no cost, you might be asked to “contribute” a $100k to heartland’s esop. doesn’t that just sound yummy. you get $100k worth of heartland stock. rick get’s money for lunch.
it’s called a pa, not public address system nor, physician's assistant, but practice administrator. these little jewels go through extensive training at hdc institute and are taught how to “handle” unruly dentists, so don’t be unruly.
continuing education? that will be done right at hdc institute. you will get what they are serving. no matter if you could get it locally, for 1/3 the fee, less time away from the office.
ms. office manager, you are now in charge of all treatment plans, presenting said plans to patients and pricing. [nothing like a medically untrained office staff talking tell a patient about complicated medical procedures to make said patient safe!] if you can’t handle it, ms. office manager, we have someone trained to step in at any time, but under no circumstance will mr. dentist being doing treatment plans. he’s to produce, nothing more.
nothing is for free, ya know.
that training heartland demands, costs money and your clinic’s revenues is going to pay for every dime of it. could be as much as $3k-$5k per day. a friday, saturday, sunday, pep rally, well, that may be $10k.
the heartland brand continuing education, well that will come off your “affiliated” clinic’s bottom line. too. not only that, but you pay, what heartland wants to charge. so what if you could get it cheaper and closer to your home. so what your office could be seeing patients those days.
if rick workman has to fly someone in to get you lined back out, for under production. it is going to cost ya. every business mile driven, every night in a hotel, every meal they eat, your clinic picks up that tab. the college educated psychology grad - who is really just a company dental hygienist - sent to assess your nonproductive ways, will also be expensed out to your clinic.
prizes and gifts for company wide employees, those are expensed out among the “affiliated” clinics too. remember that bonus your colleague got for recommending your practice to heartland, yeah, it will be charged to your “affiliated” clinic.
monthly seminars to effingham,il, are going to cost you as well. every night in the hotel, every chicken leg you eat, it’s coming out of your “affiliated” clinic’s account. think you will be given a breakdown of what heartland headquarters has expensed to your “affiliated” clinic, think again! those are not for your eyes.
you know the new hcd institute will be expensed out to each heartland dental “affiliated” dental center as well. it has to be, everything else is.
last but not least, your “affiliated” clinic has to pay heartland for all the administrative services as well.


text:
An angiographic catheter is described with a valve covering the end-hole on the distal end. The valve will allow the catheter to be passed over a guidewire but will prevent an injected fluid (e.g., a contrast medium) from being discharged from the end hole. The valved-end catheter has side-holes near the distal end that provide for lateral discharge of the fluid thereby preventing the creation of an end-hole jet and the resulting undesirable effects of the jet.
Angiographic catheters are very small but long thin-walled tubes that are inserted into the human vascular system for diagnostic or therapeutic purposes. At the present time, almost all such catheters have an end-hole at the distal end so that the catheter can be passed over and guided by a wire which has been inserted into the vascular system through a hollow needle placed in a blood vessel. Also, because these catheters are open at both ends to allow passage over the guidewire, one catheter can be exchanged for another by replacing the wire and withdrawing the catheter over the wire.
When used in diagnostic procedures, the primary purpose of these catheters is to allow injection of radiopaque contrast material into the blood stream so as to produce an image of the blood vessel (an angiogram) on x-ray film. During the process of diagnostic angiography, the contrast medium is usually injected at a rapid rate using a power injector, and the contrast medium is forcefully discharged from the distal end-hole of the catheter creating a jet effect. This produces undesirable recoil of the catheter and can also produce a dangerous complication, subintimal injection of the contrast medium, in which the jet tunnels into the wall of the blood vessel sometimes resulting in acute occlusion of the vessel.
To minimize the undesirable effect of recoil and the potential complication of subintimal injection, some early catheter designs had sealed distal ends with side-holes near the distal end to allow injection of the contrast medium into the blood vessel laterally and symmetrically thereby reducing subintimal injections. Of course, with the sealed distal end, these catheters cannot be inserted into a blood vessel over a guidewire, and therefore this design is not widely used. Most catheters presently used for rapid flush angiography are configured with a circular loop or "pigtail" at the distal end. Although the end-hole is open, these pigtail type catheters are provided with side-holes through which approximately 40% of the contrast medium is discharged. Although the looped end of the catheter decreases somewhat the chance of subintimal injection, the open end-hole still allows approximately 60% of the contrast medium to exit the end-hole in a strong jet. During left ventriculography, this jet has been associated with the production of ventricular arrhythmias which can be dangerous to the patient and which can lessen the accuracy of the acquired physiologic data. To overcome the limitations of the pigtail catheter in cardiac angiography, various modifications have been attempted to the pigtail configuration, such as a multiple loop configuration or formation of a bend at an acute angle in the distal portion of the catheter. However, these modifications have not satisfactorily alleviated the problems associated with the use of any catheter which has an open end-hole.
Moreover, when catheters of this type are used during abdominal aortography, it is sometimes desirable to have the contrast medium injected in a lateral fashion to opacify the renal arteries which arise at right angles to the abdominal aorta. The pigtail catheter, including known modifications of it, tends to inject the contrast medium in a superior direction through the superiorally directed end-hole. This produces the undesirable effect of filling the blood vessels superior to the renal arteries which can obscure visualization of the anatomic structures being observed.
There is therefore a need for a catheter which can be inserted into the vascular system by passing it over a guidewire but which catheter will have the advantages of a closed-end catheter.
The catheter of the invention has formed over the end-hole at its distal end a two-way valve which opens to allow passage of a guidewire and closes upon removal of the guidewire to prevent discharge of fluid from the end-hole of the catheter. In one embodiment, the catheter is formed with side-holes for discharge of the fluid, such as a contrast medium, and the principles of the invention can be utilized in a balloon occlusion catheter because all of the fluid will be discharged proximally to the balloon through the end-holes. When used with a ballon for coronary or small vessel peripheral angioplasty, no side holes are formed in the catheter, thus creating a single lumen over-the-wire angioplasty ballon catheter. The valve at the distal end of the catheter may be formed by several slits along radial lines in a solid tubular piece of material similar to the material used in the catheter itself. However, the material must have sufficient elasticity so that the valve remains normally closed and is opened only when a guidewire is advanced in either direction against the valve.
FIG. 4 is a perspective view that illustrates the principles of the invention as applied to a balloon occlusion catheter.
The intravascular catheter of the invention has an elongated tubular wall 10 that defines a longitudinally extending lumen or passageway 12 extending throughout the length of the catheter. The catheter is constructed of any suitable material that has the required strength and flexibility which will permit the catheter to be inserted into a blood vessel for use in various diagnostic and therapeutic applications where it is necessary to inject a fluid, such as a contrast medium, into the body. There are a number of plastic materials presently available that are suitable for this use, such as various forms of soft polyurethanes, soft polyesters guidewire. When the guidewire is removed, the resiliency of the flaps 22 will once again close off the distal end 14.
The distal end 14 may be either normally straight as shown in the drawings, or distal end 14 may be shaped into a circular pigtail configuration similar to that of presently used catheters which have a closed distal end. The principles of the invention therefore can be applied to pigtail catheters which are used extensively in ventriculography.
In FIG. 4 there is illustrated a balloon occlusion catheter to which the principles of the invention have been applied by positioning valve 16 at the distal end. In this balloon occulsion catheter, there is in addition to the outer wall 10 an interior tube 24 that provides a passageway or lumen 26 which carries fluid, such as air, to an expandable wall or balloon 28 formed in the wall 10 near its distal end 14 downstream from the side-holes 18. The expandable wall or balloon 28 can therefore be inflated using lumen 26 so as to occlude flow through the blood vessel. As in the other embodiments of the invention, when the catheter is inserted into the blood vessel using a guidewire, as soon as the end of the guidewire engages the flaps 22 of valve 16, the flaps 22 will flex to permit passage of the guidewire until such time as it is withdrawn. When the guidewire is withdrawn, valve 16 will close and remain closed, thus allowing for all of the fluid flowing through passageway 12 to be discharged through side-holes 18.
The principles of the invention also can be applied to balloon catheters with no side holes, thereby allowing guidewire insertion and low density polyethylenes. The passageway 12 normally terminates in an end-hole or discharge opening at the distal end 14 of the catheter, but the invention provides a valve, indicated generally by the reference numeral 16, that covers the end-hole. Valve 16 may be formed in any suitable manner. For example, valve 16 may be formed at the outer end of a solid tubular end piece 20 of relatively short length which is fused or otherwise suitably attached at the distal end 14 of the wall 10 of the catheter.
The desired action of valve 16 may be created by a plurality of flaps 22 formed by one or more cuts, such as radially extending slits, in the outer end of end piece 20. In the alternative, a pin hole could be formed in the outer end of the end piece 20, the pin hole being just large enough to permit the passage of a guidewire. The flaps 22 are preferably formed of the same basic material as the material that forms the wall 10 of the catheter, but the material forming flaps 22 must have sufficient elasticity to perform the valve function in the manner described herein.
In one embodiment of the invention, upstream from the valve 16 are a plurality of side-holes 18 formed in the wall 10 of the catheter to provide for lateral discharge of fluid flowing through the passageway 12 of the catheter. The flaps 22 normally close the end-hole at distal end 14 and substantially seal off distal end 14 so that any fluid introduced into the passageway 12 is discharged through the side-holes 18. However, when the end of a guidewire (not shown) strikes the flaps 22 from either direction, the flaps 22 will bend a sufficient amount to permit the passage of the and balloon inflation through a single passageway. Similarly, the valved end construction utilizing the principles of the invention will allow an angioplasty balloon to be inflated through the same lumen used to pass the catheter over a guidewire thus creating a single lumen over-the-wire angioplasty balloon. This would allow the catheter diameter to be reduced significantly which would be useful in coronary angioplasty and small vessel peripheral angioplasty.
The operation and use of the catheter of the invention is evident from the foregoing description. When the catheter of the invention is properly used, catheter recoil will be greatly reduced if not eliminated since the contrast medium, for example, will be discharged from the catheter laterally in a symmetrical fashion through the side-holes. Also, use of the valved distal end will greatly reduce the chance of subintimal contrast injections since there will no longer be any jet effect from the end-hole. The catheter of the invention will also provide more accurate contrast injection in the aorta, since contrast medium is injected laterally through the side-holes. Also, infusion of other fluids, such as thrombolytic agents, is improved since these fluids can be infused evenly through multiple side-holes rather than a single end-hole of the catheter. Moreover, the catheter of the invention may be useful in nonvascular catheter applications, such as in biliary and renal catheterization procedures.
It will be thus evident to those skilled in the art that there are numerous applications for the principles of the invention and that various revisions and modifications can be made to the preferred embodiments disclosed herein without departing from the spirit and scope of the invention. It is my intention, however, that all such revisions and modifications as are obvious to those skilled in the art will be included within the scope of the following claims.
1. A catheter insertable over a guidewire for introducing a fluid into a vessel of the human body, said catheter comprising a long hollow flexible tube of the desired length having a small diameter and a proximal end and a distal end, said tube having a thin wall extending between said ends to define a passageway extending throughout the length of the tube and terminating at the distal end, a plurality of side holes extending through the wall of the tube near its distal end to provide for the discharge of fluid from the passageway through the holes in the wall and into the vessel, and means closing the distal end and preventing the discharge of fluid from the passageway through the distal end, said means opening during the passage of the guidewire through the distal end.
2. The catheter of claim 1 in which the means closing the distal end is comprised of a plurality of resilient flaps that normally close off the distal end but which will flex to allow the passage of the guidewire.
3. The catheter of claim 2 in which the flaps are formed by a plurality of radial slits.
4. The catheter of claim 1 in which there is an opening in the means closing the distal end which opening is small enough to allow the passage of the guidewire without allowing the passage of fluid from the distal end.
5. A catheter for introducing a fluid into the body, said catheter comprising a tube of the desired length having a proximal end and a distal end, a thin wall extending between said ends to define a passageway extending throughout the length of the tube, the distal end terminating in an end hole that is in communication with the passageway, a plurality of side holes extending through the wall of the tube near its distal end to provide for the flow of fluid from the passageway through the wall, an inflatable means near the distal end between the side holes and the end hole, said inflatable means being normally not inflated, pressure means to controllably inflate the inflatable means from the proximal end, and valve means comprised of a plurality of resilient flaps formed by a plurality of radial slits that normally close off the end hole to prevent the discharge of fluid from the passageway through the end hole but which will flex to allow the passage of a guidewire through the valve means.
6. The catheter of claim 5 in which the pressure means includes a tube positioned inside of the passageway and extending from the proximal end terminating at the inflatable means.
EP0608609A3 (en) * 1992-12-01 1995-05-24 Cardiac Pathways Corp Catheter for RF ablation with cooled electrode and method.
EP0599065A3 (en) * 1992-10-29 1994-08-17 Sachse Hans Tubelar ureteral conduit.

lowercased:
an angiographic catheter is described with a valve covering the end-hole on the distal end. the valve will allow the catheter to be passed over a guidewire but will prevent an injected fluid (e.g., a contrast medium) from being discharged from the end hole. the valved-end catheter has side-holes near the distal end that provide for lateral discharge of the fluid thereby preventing the creation of an end-hole jet and the resulting undesirable effects of the jet.
angiographic catheters are very small but long thin-walled tubes that are inserted into the human vascular system for diagnostic or therapeutic purposes. at the present time, almost all such catheters have an end-hole at the distal end so that the catheter can be passed over and guided by a wire which has been inserted into the vascular system through a hollow needle placed in a blood vessel. also, because these catheters are open at both ends to allow passage over the guidewire, one catheter can be exchanged for another by replacing the wire and withdrawing the catheter over the wire.
when used in diagnostic procedures, the primary purpose of these catheters is to allow injection of radiopaque contrast material into the blood stream so as to produce an image of the blood vessel (an angiogram) on x-ray film. during the process of diagnostic angiography, the contrast medium is usually injected at a rapid rate using a power injector, and the contrast medium is forcefully discharged from the distal end-hole of the catheter creating a jet effect. this produces undesirable recoil of the catheter and can also produce a dangerous complication, subintimal injection of the contrast medium, in which the jet tunnels into the wall of the blood vessel sometimes resulting in acute occlusion of the vessel.
to minimize the undesirable effect of recoil and the potential complication of subintimal injection, some early catheter designs had sealed distal ends with side-holes near the distal end to allow injection of the contrast medium into the blood vessel laterally and symmetrically thereby reducing subintimal injections. of course, with the sealed distal end, these catheters cannot be inserted into a blood vessel over a guidewire, and therefore this design is not widely used. most catheters presently used for rapid flush angiography are configured with a circular loop or "pigtail" at the distal end. although the end-hole is open, these pigtail type catheters are provided with side-holes through which approximately 40% of the contrast medium is discharged. although the looped end of the catheter decreases somewhat the chance of subintimal injection, the open end-hole still allows approximately 60% of the contrast medium to exit the end-hole in a strong jet. during left ventriculography, this jet has been associated with the production of ventricular arrhythmias which can be dangerous to the patient and which can lessen the accuracy of the acquired physiologic data. to overcome the limitations of the pigtail catheter in cardiac angiography, various modifications have been attempted to the pigtail configuration, such as a multiple loop configuration or formation of a bend at an acute angle in the distal portion of the catheter. however, these modifications have not satisfactorily alleviated the problems associated with the use of any catheter which has an open end-hole.
moreover, when catheters of this type are used during abdominal aortography, it is sometimes desirable to have the contrast medium injected in a lateral fashion to opacify the renal arteries which arise at right angles to the abdominal aorta. the pigtail catheter, including known modifications of it, tends to inject the contrast medium in a superior direction through the superiorally directed end-hole. this produces the undesirable effect of filling the blood vessels superior to the renal arteries which can obscure visualization of the anatomic structures being observed.
there is therefore a need for a catheter which can be inserted into the vascular system by passing it over a guidewire but which catheter will have the advantages of a closed-end catheter.
the catheter of the invention has formed over the end-hole at its distal end a two-way valve which opens to allow passage of a guidewire and closes upon removal of the guidewire to prevent discharge of fluid from the end-hole of the catheter. in one embodiment, the catheter is formed with side-holes for discharge of the fluid, such as a contrast medium, and the principles of the invention can be utilized in a balloon occlusion catheter because all of the fluid will be discharged proximally to the balloon through the end-holes. when used with a ballon for coronary or small vessel peripheral angioplasty, no side holes are formed in the catheter, thus creating a single lumen over-the-wire angioplasty ballon catheter. the valve at the distal end of the catheter may be formed by several slits along radial lines in a solid tubular piece of material similar to the material used in the catheter itself. however, the material must have sufficient elasticity so that the valve remains normally closed and is opened only when a guidewire is advanced in either direction against the valve.
fig. 4 is a perspective view that illustrates the principles of the invention as applied to a balloon occlusion catheter.
the intravascular catheter of the invention has an elongated tubular wall 10 that defines a longitudinally extending lumen or passageway 12 extending throughout the length of the catheter. the catheter is constructed of any suitable material that has the required strength and flexibility which will permit the catheter to be inserted into a blood vessel for use in various diagnostic and therapeutic applications where it is necessary to inject a fluid, such as a contrast medium, into the body. there are a number of plastic materials presently available that are suitable for this use, such as various forms of soft polyurethanes, soft polyesters guidewire. when the guidewire is removed, the resiliency of the flaps 22 will once again close off the distal end 14.
the distal end 14 may be either normally straight as shown in the drawings, or distal end 14 may be shaped into a circular pigtail configuration similar to that of presently used catheters which have a closed distal end. the principles of the invention therefore can be applied to pigtail catheters which are used extensively in ventriculography.
in fig. 4 there is illustrated a balloon occlusion catheter to which the principles of the invention have been applied by positioning valve 16 at the distal end. in this balloon occulsion catheter, there is in addition to the outer wall 10 an interior tube 24 that provides a passageway or lumen 26 which carries fluid, such as air, to an expandable wall or balloon 28 formed in the wall 10 near its distal end 14 downstream from the side-holes 18. the expandable wall or balloon 28 can therefore be inflated using lumen 26 so as to occlude flow through the blood vessel. as in the other embodiments of the invention, when the catheter is inserted into the blood vessel using a guidewire, as soon as the end of the guidewire engages the flaps 22 of valve 16, the flaps 22 will flex to permit passage of the guidewire until such time as it is withdrawn. when the guidewire is withdrawn, valve 16 will close and remain closed, thus allowing for all of the fluid flowing through passageway 12 to be discharged through side-holes 18.
the principles of the invention also can be applied to balloon catheters with no side holes, thereby allowing guidewire insertion and low density polyethylenes. the passageway 12 normally terminates in an end-hole or discharge opening at the distal end 14 of the catheter, but the invention provides a valve, indicated generally by the reference numeral 16, that covers the end-hole. valve 16 may be formed in any suitable manner. for example, valve 16 may be formed at the outer end of a solid tubular end piece 20 of relatively short length which is fused or otherwise suitably attached at the distal end 14 of the wall 10 of the catheter.
the desired action of valve 16 may be created by a plurality of flaps 22 formed by one or more cuts, such as radially extending slits, in the outer end of end piece 20. in the alternative, a pin hole could be formed in the outer end of the end piece 20, the pin hole being just large enough to permit the passage of a guidewire. the flaps 22 are preferably formed of the same basic material as the material that forms the wall 10 of the catheter, but the material forming flaps 22 must have sufficient elasticity to perform the valve function in the manner described herein.
in one embodiment of the invention, upstream from the valve 16 are a plurality of side-holes 18 formed in the wall 10 of the catheter to provide for lateral discharge of fluid flowing through the passageway 12 of the catheter. the flaps 22 normally close the end-hole at distal end 14 and substantially seal off distal end 14 so that any fluid introduced into the passageway 12 is discharged through the side-holes 18. however, when the end of a guidewire (not shown) strikes the flaps 22 from either direction, the flaps 22 will bend a sufficient amount to permit the passage of the and balloon inflation through a single passageway. similarly, the valved end construction utilizing the principles of the invention will allow an angioplasty balloon to be inflated through the same lumen used to pass the catheter over a guidewire thus creating a single lumen over-the-wire angioplasty balloon. this would allow the catheter diameter to be reduced significantly which would be useful in coronary angioplasty and small vessel peripheral angioplasty.
the operation and use of the catheter of the invention is evident from the foregoing description. when the catheter of the invention is properly used, catheter recoil will be greatly reduced if not eliminated since the contrast medium, for example, will be discharged from the catheter laterally in a symmetrical fashion through the side-holes. also, use of the valved distal end will greatly reduce the chance of subintimal contrast injections since there will no longer be any jet effect from the end-hole. the catheter of the invention will also provide more accurate contrast injection in the aorta, since contrast medium is injected laterally through the side-holes. also, infusion of other fluids, such as thrombolytic agents, is improved since these fluids can be infused evenly through multiple side-holes rather than a single end-hole of the catheter. moreover, the catheter of the invention may be useful in nonvascular catheter applications, such as in biliary and renal catheterization procedures.
it will be thus evident to those skilled in the art that there are numerous applications for the principles of the invention and that various revisions and modifications can be made to the preferred embodiments disclosed herein without departing from the spirit and scope of the invention. it is my intention, however, that all such revisions and modifications as are obvious to those skilled in the art will be included within the scope of the following claims.
1. a catheter insertable over a guidewire for introducing a fluid into a vessel of the human body, said catheter comprising a long hollow flexible tube of the desired length having a small diameter and a proximal end and a distal end, said tube having a thin wall extending between said ends to define a passageway extending throughout the length of the tube and terminating at the distal end, a plurality of side holes extending through the wall of the tube near its distal end to provide for the discharge of fluid from the passageway through the holes in the wall and into the vessel, and means closing the distal end and preventing the discharge of fluid from the passageway through the distal end, said means opening during the passage of the guidewire through the distal end.
2. the catheter of claim 1 in which the means closing the distal end is comprised of a plurality of resilient flaps that normally close off the distal end but which will flex to allow the passage of the guidewire.
3. the catheter of claim 2 in which the flaps are formed by a plurality of radial slits.
4. the catheter of claim 1 in which there is an opening in the means closing the distal end which opening is small enough to allow the passage of the guidewire without allowing the passage of fluid from the distal end.
5. a catheter for introducing a fluid into the body, said catheter comprising a tube of the desired length having a proximal end and a distal end, a thin wall extending between said ends to define a passageway extending throughout the length of the tube, the distal end terminating in an end hole that is in communication with the passageway, a plurality of side holes extending through the wall of the tube near its distal end to provide for the flow of fluid from the passageway through the wall, an inflatable means near the distal end between the side holes and the end hole, said inflatable means being normally not inflated, pressure means to controllably inflate the inflatable means from the proximal end, and valve means comprised of a plurality of resilient flaps formed by a plurality of radial slits that normally close off the end hole to prevent the discharge of fluid from the passageway through the end hole but which will flex to allow the passage of a guidewire through the valve means.
6. the catheter of claim 5 in which the pressure means includes a tube positioned inside of the passageway and extending from the proximal end terminating at the inflatable means.
ep0608609a3 (en) * 1992-12-01 1995-05-24 cardiac pathways corp catheter for rf ablation with cooled electrode and method.
ep0599065a3 (en) * 1992-10-29 1994-08-17 sachse hans tubelar ureteral conduit.


text: Do as I did, started my own business and see how much work it takes and then go from there. I have had all kinds of workers over the years; too many are just lazy wanting money. That young black girl was my best worker.

lowercased: do as i did, started my own business and see how much work it takes and then go from there. i have had all kinds of workers over the years; too many are just lazy wanting money. that young black girl was my best worker.


text:
Комментарий автора: After finishing my The Signal trailer with Akira I decided I wanted to do a comedy trailer. I recently watched Knights of Badassdom and never heard of it before... I thought it was hilarious and liked the idea of making AoT like they are a bunch of larpers considering how many anime fans cosplay with it.
After coming in second during AWA pro voting I was really excited to see how crowds would respond to it and it won Best Trailer as well as Best in Show at Anime USA.
Справка: Пародия на трейлер фильма Рыцари королевства Крутизны (Knights of Badassdom).

lowercased:
комментарий автора: after finishing my the signal trailer with akira i decided i wanted to do a comedy trailer. i recently watched knights of badassdom and never heard of it before... i thought it was hilarious and liked the idea of making aot like they are a bunch of larpers considering how many anime fans cosplay with it.
after coming in second during awa pro voting i was really excited to see how crowds would respond to it and it won best trailer as well as best in show at anime usa.
справка: пародия на трейлер фильма рыцари королевства крутизны (knights of badassdom).


text:
Stopping nearsightedness in kids and more.
This week, Dr. Sydney Spiesel discusses a way to stop the progression of nearsightedness in kids, a better method of hormone replacement therapy for women after menopause, and new developments in the search for a cause for autism. His column will start appearing a couple of times a month.
Condition: Nearsightedness, or myopia, is the most common eye problem. In the United States and Europe, about 25 percent of the adult population is nearsighted, and in much of Asia the condition is more common still. Significant myopia can have serious medical consequences. It has long been understood that the condition has a strong genetic component: Nearsighted parents are more likely to have nearsighted children. But recent research has shown that other factors contribute. For example, just as our mothers warned us, there is now evidence that doing close-up work, like reading, seems to promote the condition.
How it progresses: The eyeball of a nearsighted person is deeper than the eyeball of a person with normal vision and becomes deeper as nearsightedness progresses. Myopia often begins to develop between the ages of 6 and 8. As children grow, their nearsightedness worsens, continuing to do so long after they have stopped growing taller. Though we know a lot about factors associated with nearsightedness and its progression, we have no good ideas yet about the mechanism. But can we stop it?
New research: A recent study by Wei-Han Chua and colleagues at the Singapore National Eye Center elegantly built on older research and successfully used atropine eye drops to treat myopia in children. Atropine is a longer-lasting version of the pupil-dilating drops your doctor uses when you go for an eye exam. Available by prescription in the United States, the drops are mainly used to treat amblyopia (lazy eye) instead of the older treatment, patching, which children often hate.
Dr. Chua and his co-workers studied the progression of nearsightedness in 400 children between 6 and 12 years of age. Half the children were treated with atropine eye drops, and the other half were treated with placebo eye drops. Both kinds of drops were administered nightly to one eye, so the untreated eye could be compared with the treated one. The children were followed for two years. All used eyeglasses to correct their nearsightedness, and because atropine dilates the pupil, the lenses of the glasses self-darkened in bright light, to avoid discomfort for the children whose pupils were dilated.
Findings: The effects were extraordinary: After two years, on average, the children’s nearsightedness had not progressed in the atropine-treated eyes but had dramatically worsened in the placebo-treated and untreated eyes. Similarly, atropine-treated eyes did not become deeper, while placebo-treated and untreated eyes did. No serious adverse effects were observed in the course of the research.
Conclusion: This is extremely promising. Further work needs to be done to determine the ideal concentration of atropine in the eye drops, to find out how long the treatment needs to last, and if the effects are permanent. Because atropine interferes with close focusing, children will probably need to wear bifocals while they’re using the atropine drops. Much more research must be done to help us understand why nearsightedness develops and progresses. But in the meantime, we may have a way to head off this common problem.
Treatment: Hormone replacement therapy was introduced in 1941, when the FDA approved the use of estrogen for this purpose. Early on, HRT was prescribed with great enthusiasm. It relieved troublesome symptoms associated with menopause, including hot flashes, sleep problems, and, for some women, difficulty in concentration. And HRT (usually estrogen plus a progestin) was shown to improve the bone density of elderly women and decrease their risk for fractures.
Downside: Time and further research has shown that these gains come at a cost, however: increased risk for cardiovascular problems, stroke, and blood clots in the veins and lungs. Postmenopausal women on HRT also seem to be an increased risk for breast cancer and possibly dementia. This made many women feel they had to choose between improved quality of life and a risk of ill health and early death.
New study: Now research reported in the journal Circulation suggests a way around the blood clotting problem, at least. The researchers studied about 270 women who had developed blood clots in their veins, almost all of them postmenopausal. They were compared with more than 600 women who did not suffer from blood clots but similar in age, smoking status, and age at menopause. Among women in either group who used HRT, the study tracked whether the estrogen medication was taken orally or applied through the skin as a patch or a gel. The nature of the progestin component, if any, was also studied.
Findings: Estrogen HRT increased the risk for blood clots in the veins—but only if it was administered orally. This result is not as surprising as it might seem. A medication that’s given orally collects in the blood supply of the intestines and passes through the liver before it is distributed to the rest of the body. This causes changes in the proteins synthesized by the liver, some of which are known to increase the clotting of blood. When the estrogen in HRT is administered through the skin, by contrast, it bypasses the liver. The study also established that some progestins (there are many kinds) increase the risk of blood clotting and that others do not.
Conclusion: If these findings are confirmed, HRT skin patches or gels and careful choice of the progestin component could normalize the risk of blood clots in the veins, and also blood clots that migrate to the lungs, causing pulmonary embolism, and to the brain, causing stroke. Unfortunately, other studies suggest that administering HRT through the skin won’t affect the rate of heart disease or risk of breast cancer associated with it. HRT will still be a difficult choice. But this study at least lowers the risk and may well shift the balance for many women.
Search for a cause: It has long been clear that autism is primarily genetic in origin. The disorder is almost certainly the result not of a single abnormal gene, but rather the interaction of several. In the past, a few locations on human chromosomes have been suspected of playing a role for a scattering of patients. Now researchers have identified a genetic location on a specific chromosome that seems to be associated with the expression of autism in many patients.
Newresearch: Described in a paper with 137 authors representing 67 worldwide institutions, this finding is the first result of an audacious project conducted by the Autism Genome Project Consortium. The project started with a set of almost 1,500 families with at least two people who fall on the autism spectrum. Of this group, DNA samples from about 1,200 families could be analyzed for chromosomal similarities.
Findings: This analysis points to a hitherto unsuspected “hot spot” on chromosome 11, which seems to be related to an increased risk for the expression of autism. (The genetic function of the hot-spot location is still unclear.) Besides identifying the chromosome 11 hot spot, the data also tantalizingly hint that flaws in the gene coding for a material called neurexin, which plays a role in the development of certain cell-to-cell transmission sites (synapses), can cause autism in some cases. This trigger for autism is probably quite rare. But it suggests that the disorder is somehow related to abnormalities in the connections between nerve cells that make use of glutamate for information transmission, and defects in those transmissions. How (or even if) these two observations—the hot spot and the neruexin flaws—fit together is as yet unknown.
Conclusion: This study doesn’t tell us exactly which gene on chromosome 11 is important, but it does tell us just where to focus our attention. And the neurexin-related discovery hints at the mechanism of what might go wrong in neurodevelopment to lead to autism. These discoveries reinforce the value of collaborative work that puts together information about patients with a relatively rare disorder, from many locales, to create a pool large enough for serious research.

lowercased:
stopping nearsightedness in kids and more.
this week, dr. sydney spiesel discusses a way to stop the progression of nearsightedness in kids, a better method of hormone replacement therapy for women after menopause, and new developments in the search for a cause for autism. his column will start appearing a couple of times a month.
condition: nearsightedness, or myopia, is the most common eye problem. in the united states and europe, about 25 percent of the adult population is nearsighted, and in much of asia the condition is more common still. significant myopia can have serious medical consequences. it has long been understood that the condition has a strong genetic component: nearsighted parents are more likely to have nearsighted children. but recent research has shown that other factors contribute. for example, just as our mothers warned us, there is now evidence that doing close-up work, like reading, seems to promote the condition.
how it progresses: the eyeball of a nearsighted person is deeper than the eyeball of a person with normal vision and becomes deeper as nearsightedness progresses. myopia often begins to develop between the ages of 6 and 8. as children grow, their nearsightedness worsens, continuing to do so long after they have stopped growing taller. though we know a lot about factors associated with nearsightedness and its progression, we have no good ideas yet about the mechanism. but can we stop it?
new research: a recent study by wei-han chua and colleagues at the singapore national eye center elegantly built on older research and successfully used atropine eye drops to treat myopia in children. atropine is a longer-lasting version of the pupil-dilating drops your doctor uses when you go for an eye exam. available by prescription in the united states, the drops are mainly used to treat amblyopia (lazy eye) instead of the older treatment, patching, which children often hate.
dr. chua and his co-workers studied the progression of nearsightedness in 400 children between 6 and 12 years of age. half the children were treated with atropine eye drops, and the other half were treated with placebo eye drops. both kinds of drops were administered nightly to one eye, so the untreated eye could be compared with the treated one. the children were followed for two years. all used eyeglasses to correct their nearsightedness, and because atropine dilates the pupil, the lenses of the glasses self-darkened in bright light, to avoid discomfort for the children whose pupils were dilated.
findings: the effects were extraordinary: after two years, on average, the children’s nearsightedness had not progressed in the atropine-treated eyes but had dramatically worsened in the placebo-treated and untreated eyes. similarly, atropine-treated eyes did not become deeper, while placebo-treated and untreated eyes did. no serious adverse effects were observed in the course of the research.
conclusion: this is extremely promising. further work needs to be done to determine the ideal concentration of atropine in the eye drops, to find out how long the treatment needs to last, and if the effects are permanent. because atropine interferes with close focusing, children will probably need to wear bifocals while they’re using the atropine drops. much more research must be done to help us understand why nearsightedness develops and progresses. but in the meantime, we may have a way to head off this common problem.
treatment: hormone replacement therapy was introduced in 1941, when the fda approved the use of estrogen for this purpose. early on, hrt was prescribed with great enthusiasm. it relieved troublesome symptoms associated with menopause, including hot flashes, sleep problems, and, for some women, difficulty in concentration. and hrt (usually estrogen plus a progestin) was shown to improve the bone density of elderly women and decrease their risk for fractures.
downside: time and further research has shown that these gains come at a cost, however: increased risk for cardiovascular problems, stroke, and blood clots in the veins and lungs. postmenopausal women on hrt also seem to be an increased risk for breast cancer and possibly dementia. this made many women feel they had to choose between improved quality of life and a risk of ill health and early death.
new study: now research reported in the journal circulation suggests a way around the blood clotting problem, at least. the researchers studied about 270 women who had developed blood clots in their veins, almost all of them postmenopausal. they were compared with more than 600 women who did not suffer from blood clots but similar in age, smoking status, and age at menopause. among women in either group who used hrt, the study tracked whether the estrogen medication was taken orally or applied through the skin as a patch or a gel. the nature of the progestin component, if any, was also studied.
findings: estrogen hrt increased the risk for blood clots in the veins—but only if it was administered orally. this result is not as surprising as it might seem. a medication that’s given orally collects in the blood supply of the intestines and passes through the liver before it is distributed to the rest of the body. this causes changes in the proteins synthesized by the liver, some of which are known to increase the clotting of blood. when the estrogen in hrt is administered through the skin, by contrast, it bypasses the liver. the study also established that some progestins (there are many kinds) increase the risk of blood clotting and that others do not.
conclusion: if these findings are confirmed, hrt skin patches or gels and careful choice of the progestin component could normalize the risk of blood clots in the veins, and also blood clots that migrate to the lungs, causing pulmonary embolism, and to the brain, causing stroke. unfortunately, other studies suggest that administering hrt through the skin won’t affect the rate of heart disease or risk of breast cancer associated with it. hrt will still be a difficult choice. but this study at least lowers the risk and may well shift the balance for many women.
search for a cause: it has long been clear that autism is primarily genetic in origin. the disorder is almost certainly the result not of a single abnormal gene, but rather the interaction of several. in the past, a few locations on human chromosomes have been suspected of playing a role for a scattering of patients. now researchers have identified a genetic location on a specific chromosome that seems to be associated with the expression of autism in many patients.
newresearch: described in a paper with 137 authors representing 67 worldwide institutions, this finding is the first result of an audacious project conducted by the autism genome project consortium. the project started with a set of almost 1,500 families with at least two people who fall on the autism spectrum. of this group, dna samples from about 1,200 families could be analyzed for chromosomal similarities.
findings: this analysis points to a hitherto unsuspected “hot spot” on chromosome 11, which seems to be related to an increased risk for the expression of autism. (the genetic function of the hot-spot location is still unclear.) besides identifying the chromosome 11 hot spot, the data also tantalizingly hint that flaws in the gene coding for a material called neurexin, which plays a role in the development of certain cell-to-cell transmission sites (synapses), can cause autism in some cases. this trigger for autism is probably quite rare. but it suggests that the disorder is somehow related to abnormalities in the connections between nerve cells that make use of glutamate for information transmission, and defects in those transmissions. how (or even if) these two observations—the hot spot and the neruexin flaws—fit together is as yet unknown.
conclusion: this study doesn’t tell us exactly which gene on chromosome 11 is important, but it does tell us just where to focus our attention. and the neurexin-related discovery hints at the mechanism of what might go wrong in neurodevelopment to lead to autism. these discoveries reinforce the value of collaborative work that puts together information about patients with a relatively rare disorder, from many locales, to create a pool large enough for serious research.


text:
Brad Proctor is the Regional Lead Partner for Labour and Employment based out of the Halifax, Nova Scotia office.
Brad advises clients to take a proactive approach to management labour and employment relations through the formulation and implementation of employment contracts, workplace policies as well as the creation of training programs for managers and supervisors with respect to performance management, workplace accommodations, harassment prevention and health and safety.
Brad appears regularly before labour arbitrators, human rights tribunals, Labour Boards, Workers’ Compensation Tribunals as well as various levels of court throughout the Atlantic Canadian provinces.
Brad’s dedication to his clients and his practice has earned a number of accomplishments. In 2015, he was named one of Lexpert® Rising Stars: Leading Lawyers under 40. Having gained a national reputation for his experience in occupational health and safety and workers’ compensation counsel, Brad has also been listed in the Best Lawyers® in Canada directory since 2016. Brad also actively volunteers for various community groups and is currently a Director of Safety Services Nova Scotia.
Brad Proctor featured in Chronicle Herald "Legal pot raises corporate questions"

lowercased:
brad proctor is the regional lead partner for labour and employment based out of the halifax, nova scotia office.
brad advises clients to take a proactive approach to management labour and employment relations through the formulation and implementation of employment contracts, workplace policies as well as the creation of training programs for managers and supervisors with respect to performance management, workplace accommodations, harassment prevention and health and safety.
brad appears regularly before labour arbitrators, human rights tribunals, labour boards, workers’ compensation tribunals as well as various levels of court throughout the atlantic canadian provinces.
brad’s dedication to his clients and his practice has earned a number of accomplishments. in 2015, he was named one of lexpert® rising stars: leading lawyers under 40. having gained a national reputation for his experience in occupational health and safety and workers’ compensation counsel, brad has also been listed in the best lawyers® in canada directory since 2016. brad also actively volunteers for various community groups and is currently a director of safety services nova scotia.
brad proctor featured in chronicle herald "legal pot raises corporate questions"


text:
Join the SAP Activate Methodology Jam Group - Get Access!
SAP Methodologies is a collaborative group on SAP Jam, created to bring you a new way to engage with SAP Activate Methodology content for all your SAP projects. Access resources, interact with SAP experts, and find the answers you need to start your SAP implementation and delivery projects.
The e-mail address you provide will be used to give you exclusive access and will not be shared for any other purposes.
Please allow up to 24 business hours for access approval to the SAP Jam group.
Note: If you do not see the invitation in your provided email address, please check your spam folder.

lowercased:
join the sap activate methodology jam group - get access!
sap methodologies is a collaborative group on sap jam, created to bring you a new way to engage with sap activate methodology content for all your sap projects. access resources, interact with sap experts, and find the answers you need to start your sap implementation and delivery projects.
the e-mail address you provide will be used to give you exclusive access and will not be shared for any other purposes.
please allow up to 24 business hours for access approval to the sap jam group.
note: if you do not see the invitation in your provided email address, please check your spam folder.


text:
St Munchin’s Catholic School aspires to reﬂect the life and love of Christ for His people.
We trust that your association with the school will be both happy and rewarding. The time your child will spend in primary education is a most signiﬁcant period in your child’s life and in the life of your family.
St. Munchin’s Gosnells recognises the unique contribution made by parents to the life of the school and to the learning of the children. Education today demands parents are seen as partners and active contributors in the task of enabling children to reach their full potential.
Our mission is to proclaim and witness the Gospel in a Catholic environment. We aim to integrate these values into the entire curriculum and life of the school. Our school motto, ‘Follow Truth’, helps us to focus on what is truly important to us at St Munchin’s. The learning programme which is offered at our school attempts to address the needs of all students and aims to provide the broadest range of educational experiences so that every person can enjoy challenge, achievement and success.
The Faction Swimming Carnival held on Monday 25th March was once again a wonderful success due to Mr Marino’s great organisation, parent and teacher helpers and the positive and co-operative attitude of the students.
Mrs Margaret Crowley will be leaving St Munchin’s at the end of the term as she has a full time position at JohnX X111. On behalf of the staff, students and parents I wish Margaret all the very best and thank her for her commitment, contributions and the gifts she has brought to St Munchin’s.
As Anzac Day also falls during the school holidays the school will participate in a service on Monday 29th April the first day back for term two.

lowercased:
st munchin’s catholic school aspires to reﬂect the life and love of christ for his people.
we trust that your association with the school will be both happy and rewarding. the time your child will spend in primary education is a most signiﬁcant period in your child’s life and in the life of your family.
st. munchin’s gosnells recognises the unique contribution made by parents to the life of the school and to the learning of the children. education today demands parents are seen as partners and active contributors in the task of enabling children to reach their full potential.
our mission is to proclaim and witness the gospel in a catholic environment. we aim to integrate these values into the entire curriculum and life of the school. our school motto, ‘follow truth’, helps us to focus on what is truly important to us at st munchin’s. the learning programme which is offered at our school attempts to address the needs of all students and aims to provide the broadest range of educational experiences so that every person can enjoy challenge, achievement and success.
the faction swimming carnival held on monday 25th march was once again a wonderful success due to mr marino’s great organisation, parent and teacher helpers and the positive and co-operative attitude of the students.
mrs margaret crowley will be leaving st munchin’s at the end of the term as she has a full time position at johnx x111. on behalf of the staff, students and parents i wish margaret all the very best and thank her for her commitment, contributions and the gifts she has brought to st munchin’s.
as anzac day also falls during the school holidays the school will participate in a service on monday 29th april the first day back for term two.


text:
Welcome to my wonderful class for Science! The 2017-2018 school year will be my 4th year teaching here at Furman Middle. It has been such a pleasure to educate the youth here in Sumter County. I am a SC licensed educator of Middle Level Science. I received my BS degree from Morris College and recently completed my Gifted and Talented Endorsement from USC-Upstate. Looking forward to working with my future students every year!
Please remember to purchase Chromebook for student usage throughout the year. Thank you.

lowercased:
welcome to my wonderful class for science! the 2017-2018 school year will be my 4th year teaching here at furman middle. it has been such a pleasure to educate the youth here in sumter county. i am a sc licensed educator of middle level science. i received my bs degree from morris college and recently completed my gifted and talented endorsement from usc-upstate. looking forward to working with my future students every year!
please remember to purchase chromebook for student usage throughout the year. thank you.


text:
As a globally acclaimed and award-winning provider of piping stress engineering services, Rishabh Engineering offers practical solutions basis their decades’ worth of field and design experience.
As a pipe stress analysis consultant, we perform pipe flexibility and stress analysis for the following piping systems.
Application of Industry best practice and adherence to and many more to conduct the successful stress analysis of piping systems.

lowercased:
as a globally acclaimed and award-winning provider of piping stress engineering services, rishabh engineering offers practical solutions basis their decades’ worth of field and design experience.
as a pipe stress analysis consultant, we perform pipe flexibility and stress analysis for the following piping systems.
application of industry best practice and adherence to and many more to conduct the successful stress analysis of piping systems.


text:
Jacob Morgan is a well-known voice in field of OpenWork thanks to a multimedia approach that includes two books, the Future of Work podcast, a regular column on Forbes and an engaging YouTube channel. We spoke with Jacob to get his read on the current state of the future of work.
OpenWork: How did you come to be interested in the future of work?
Jacob Morgan: Basically, I had bad jobs working for other people. My first job out of college, I went to work for a technology company in Los Angeles. When I interviewed for this job, they told me I was going to be doing all these great things and working on fun projects and traveling. Of course, I took the job. My commute was an hour and a half each way every day, and a couple months into the job, I was still doing data entry, cold calling, PowerPoint and just really boring, mundane type of work. Then one day, the CEO came into the office and handed me a $10 bill, and he said, “Go get me a cup of coffee.” That was one of two experiences I’ve had that led me to go off on my own.
I really felt trapped, stuck, like a cog in the machine, so to speak. That was the last full-time job I had working for anybody else. I actually quit and went to that conference anyway, which is the best decision I’ve ever made.
Those were two things in my life that helped me realized that there’s something very wrong with the way that we think about work — our expectations, our values, the way companies think about work. Ever since then, I’ve become very fascinated with what the future of work is going to look like. How do we prevent these types of experiences from happening? Why do they happen? That was about nine years ago, and I’ve been in the space ever since.
OW: What do you think is the most pressing challenge for employers and workplaces to address right now regarding the evolution of work?
JM: I think the biggest challenge is a mindset shift. The big assumption that organizations have always had is that people need to work there. They need money, they need jobs, they are working at your company because they need to. And because they need to work there, you can treat them however you want, and you can do whatever you want. Nobody cared about engagement, inspiration, creativity or health and wellbeing. All of this stuff is relatively new. What we’re realizing is that we now live in a very, very different world where you don’t need to work for a company anymore. In fact, not only do people have a lot of choices about where we can work — freelance, Uber, Airbnb, create stuff and sell it on Etsy, raise money on GoFundMe or Kickstarter — but also, technology has made it very, very competitive. If you’re working at an organization you don’t enjoy, very quickly you’ll find there are other opportunities out there.
The biggest challenge companies have is: how do we change from creating an environment where people need to show up to creating an environment where people actually want to show up? That is where we’re seeing all these changes and shifts happening.
OW: As a workplace futurist, what are the most interesting forecasts about workplace change or innovation you’ve seen come to fruition?
JM: The biggest and best prediction that we’re starting to see is that all the assumptions we’ve always had about how work gets done are being challenged. Everything we had assumed to be true over the past hundred years since modern organizations were created, we’re starting to challenge and question. These are basic things like: does our office have to have walls? Do people need to show up to the office? Do managers have to have all the information and make all of the decisions on behalf of everyone else? Do we all have to use the same technologies and use the same tools? Do we need dress codes? All of these very basic things that have gone unquestioned, organizations are now starting to think about. I think that is the most amazing thing to see.
OW: Are there any companies or industries that are, perhaps unexpectedly, great at addressing the evolving needs of the workplace?
JM: I have seen organizations in pretty much every industry that are doing well and are forward-thinking, as well as those that aren’t.
In our Future of Work Community, it’s interesting to see that we have a lot of organizations that are quite old and doing some very interesting things. And we also have a lot of financial institutions that are part of the Community that are thinking very differently about how work is getting done. I definitely don’t think the future of work is focused on technology companies. I think every organization around the world is aware that change is starting to happen, and they are making shifts towards acting on that change. I haven’t seen any really large industry disparities, and that’s what’s really cool about the future of work — it’s impacting pretty much every organization you can think of.
OW: You mentioned your Future of Work Community. What were the key takeaways from the group’s Fall Future of Work Forum event held in New York earlier this month?
JM: The Future of Work community includes companies from around the world that are all thinking differently about how the workplace is changing. Throughout the year, they have a digital community where they interact, they share what they’re working on, what their challenges are and what they’re struggling with. And these senior-level leaders provide feedback and help each other and support each other.
There were several themes that I thought resonated at this month’s event. One was the idea of focusing on employee experiences [which] I define as a combination of three distinct environments: the physical environment, the cultural environment and the technological environment. For the first time, organizations are realizing how the combination of these three things really has amazing and positive impact for employees. Another theme is people analytics, which is huge. How do we take data and analytics from employees and start making sense of data to improve the workplace? That’s been a fascinating area. Another theme I noted is that HR and IT are building stronger relationships than ever before. HR is realizing they cannot propel organizations into the future of work without technology, and the technology professionals are realizing that they need to leverage HR to drive change.
Jacob Morgan’s latest book is “The Future of Work: Attract New Talent, Build Better Leaders, and Create a Competitive Organization.” He can be reached at [email protected].

lowercased:
jacob morgan is a well-known voice in field of openwork thanks to a multimedia approach that includes two books, the future of work podcast, a regular column on forbes and an engaging youtube channel. we spoke with jacob to get his read on the current state of the future of work.
openwork: how did you come to be interested in the future of work?
jacob morgan: basically, i had bad jobs working for other people. my first job out of college, i went to work for a technology company in los angeles. when i interviewed for this job, they told me i was going to be doing all these great things and working on fun projects and traveling. of course, i took the job. my commute was an hour and a half each way every day, and a couple months into the job, i was still doing data entry, cold calling, powerpoint and just really boring, mundane type of work. then one day, the ceo came into the office and handed me a $10 bill, and he said, “go get me a cup of coffee.” that was one of two experiences i’ve had that led me to go off on my own.
i really felt trapped, stuck, like a cog in the machine, so to speak. that was the last full-time job i had working for anybody else. i actually quit and went to that conference anyway, which is the best decision i’ve ever made.
those were two things in my life that helped me realized that there’s something very wrong with the way that we think about work — our expectations, our values, the way companies think about work. ever since then, i’ve become very fascinated with what the future of work is going to look like. how do we prevent these types of experiences from happening? why do they happen? that was about nine years ago, and i’ve been in the space ever since.
ow: what do you think is the most pressing challenge for employers and workplaces to address right now regarding the evolution of work?
jm: i think the biggest challenge is a mindset shift. the big assumption that organizations have always had is that people need to work there. they need money, they need jobs, they are working at your company because they need to. and because they need to work there, you can treat them however you want, and you can do whatever you want. nobody cared about engagement, inspiration, creativity or health and wellbeing. all of this stuff is relatively new. what we’re realizing is that we now live in a very, very different world where you don’t need to work for a company anymore. in fact, not only do people have a lot of choices about where we can work — freelance, uber, airbnb, create stuff and sell it on etsy, raise money on gofundme or kickstarter — but also, technology has made it very, very competitive. if you’re working at an organization you don’t enjoy, very quickly you’ll find there are other opportunities out there.
the biggest challenge companies have is: how do we change from creating an environment where people need to show up to creating an environment where people actually want to show up? that is where we’re seeing all these changes and shifts happening.
ow: as a workplace futurist, what are the most interesting forecasts about workplace change or innovation you’ve seen come to fruition?
jm: the biggest and best prediction that we’re starting to see is that all the assumptions we’ve always had about how work gets done are being challenged. everything we had assumed to be true over the past hundred years since modern organizations were created, we’re starting to challenge and question. these are basic things like: does our office have to have walls? do people need to show up to the office? do managers have to have all the information and make all of the decisions on behalf of everyone else? do we all have to use the same technologies and use the same tools? do we need dress codes? all of these very basic things that have gone unquestioned, organizations are now starting to think about. i think that is the most amazing thing to see.
ow: are there any companies or industries that are, perhaps unexpectedly, great at addressing the evolving needs of the workplace?
jm: i have seen organizations in pretty much every industry that are doing well and are forward-thinking, as well as those that aren’t.
in our future of work community, it’s interesting to see that we have a lot of organizations that are quite old and doing some very interesting things. and we also have a lot of financial institutions that are part of the community that are thinking very differently about how work is getting done. i definitely don’t think the future of work is focused on technology companies. i think every organization around the world is aware that change is starting to happen, and they are making shifts towards acting on that change. i haven’t seen any really large industry disparities, and that’s what’s really cool about the future of work — it’s impacting pretty much every organization you can think of.
ow: you mentioned your future of work community. what were the key takeaways from the group’s fall future of work forum event held in new york earlier this month?
jm: the future of work community includes companies from around the world that are all thinking differently about how the workplace is changing. throughout the year, they have a digital community where they interact, they share what they’re working on, what their challenges are and what they’re struggling with. and these senior-level leaders provide feedback and help each other and support each other.
there were several themes that i thought resonated at this month’s event. one was the idea of focusing on employee experiences [which] i define as a combination of three distinct environments: the physical environment, the cultural environment and the technological environment. for the first time, organizations are realizing how the combination of these three things really has amazing and positive impact for employees. another theme is people analytics, which is huge. how do we take data and analytics from employees and start making sense of data to improve the workplace? that’s been a fascinating area. another theme i noted is that hr and it are building stronger relationships than ever before. hr is realizing they cannot propel organizations into the future of work without technology, and the technology professionals are realizing that they need to leverage hr to drive change.
jacob morgan’s latest book is “the future of work: attract new talent, build better leaders, and create a competitive organization.” he can be reached at [email protected].


text: My name is Cameron and I'll start by saying I am a born and raised Washingtonian! In my free time other than taking photos for incredible individuals I love to hike, camp, go to concerts, play with my dog and search for the best place to eat that I can find!! I have worked in the child care industry for the last 4 years which has given me very many adorable models to develop more skill for my true passion- portraits! I enjoy family sessions, senior shoots, children's sessions, maternity, special events and more! I love to work with each client and go off of what they prefer! If they are not sure on what they like then, I have plenty of ideas and love to give them a variety of shots. Please feel free to get a hold of me if you are interested in my work or even if you would just like to get to know more about me!

lowercased: my name is cameron and i'll start by saying i am a born and raised washingtonian! in my free time other than taking photos for incredible individuals i love to hike, camp, go to concerts, play with my dog and search for the best place to eat that i can find!! i have worked in the child care industry for the last 4 years which has given me very many adorable models to develop more skill for my true passion- portraits! i enjoy family sessions, senior shoots, children's sessions, maternity, special events and more! i love to work with each client and go off of what they prefer! if they are not sure on what they like then, i have plenty of ideas and love to give them a variety of shots. please feel free to get a hold of me if you are interested in my work or even if you would just like to get to know more about me!


text:
Gary Slater – President and owner of Slater Flooring & Design – has been in the floor covering business for more than 40 years.
After his discharge from the military in 1970, Gary was hired by a national flooring retailer in Fort Worth. He was quickly encouraged by management to take on the role of hiring staff and opening new stores throughout the south. After several years of this work, Gary was recruited by a local Fort Worth retailer to come to work as a senior sales associate. Five years later, Gary was approached by the area’s largest independent flooring retailer to take a management position with the company.
Gary stayed there for more than 30 years – and took on an ever- increasing set of responsibilities with the company, eventually rising to the position of company Vice President.
In 2006, Gary realized a life-long dream and started his own company – Slater Flooring & Design. His goal was simple – to bring the highest level of service and support to residential and commercial clients. The company has received individual and community recognition for his unique approach, outstanding customer care and is a proud member of the Ft. Worth Better Business Bureau. Joined in the business by his wife, Faye, who provides design expertise and back-office support, the company has expanded to include kitchen and bath remodeling in its portfolio of services.
Thanks for visiting Slater Flooring & Design. We look forward to working with you to realize your design goals.
Recently Slater Flooring & Design did a marvelously meticulous installation of carpeting in several rooms of our home. We could not be more pleased with their work.
Thanks to their expertise, we are very happy with our new flooring, cabinets and remodeled kitchen. Each one worked patiently with us as we changed our minds almost daily. The results were great!
Cheers to Gary Slater for Outstanding service when another company refused to take responsibility for the vinyl flooring it had installed. Gary immediately identified the problem and spent several months working with the manufacturer to get the flooring replaced under warranty.

lowercased:
gary slater – president and owner of slater flooring & design – has been in the floor covering business for more than 40 years.
after his discharge from the military in 1970, gary was hired by a national flooring retailer in fort worth. he was quickly encouraged by management to take on the role of hiring staff and opening new stores throughout the south. after several years of this work, gary was recruited by a local fort worth retailer to come to work as a senior sales associate. five years later, gary was approached by the area’s largest independent flooring retailer to take a management position with the company.
gary stayed there for more than 30 years – and took on an ever- increasing set of responsibilities with the company, eventually rising to the position of company vice president.
in 2006, gary realized a life-long dream and started his own company – slater flooring & design. his goal was simple – to bring the highest level of service and support to residential and commercial clients. the company has received individual and community recognition for his unique approach, outstanding customer care and is a proud member of the ft. worth better business bureau. joined in the business by his wife, faye, who provides design expertise and back-office support, the company has expanded to include kitchen and bath remodeling in its portfolio of services.
thanks for visiting slater flooring & design. we look forward to working with you to realize your design goals.
recently slater flooring & design did a marvelously meticulous installation of carpeting in several rooms of our home. we could not be more pleased with their work.
thanks to their expertise, we are very happy with our new flooring, cabinets and remodeled kitchen. each one worked patiently with us as we changed our minds almost daily. the results were great!
cheers to gary slater for outstanding service when another company refused to take responsibility for the vinyl flooring it had installed. gary immediately identified the problem and spent several months working with the manufacturer to get the flooring replaced under warranty.