Pro-government satirical magazine Misvak has removed a cartoon depicting Turkish President Recep Tayyip Erdoğan and ultranationalist Nationalist Movement Party (MHP) leader Devlet Bahçeli steering white Toros automobiles heading to the predominantly Kurdish northern Iraq, the Diken news website reported on Thursday.
The cartoon has Erdoğan and Bahçeli saying, "We can appear suddenly one night," in speech bubbles, referring to Erdoğan's threat towards the Kurdistan Regional Government (KRG) in northern Iraq regarding a referendum for independence it held in September. The provocative cartoon showed two cars with license plate numbers 82 KRK, referring to the northern Iraqi city of Kirkuk, and 83 MSL, short for the northern Iraqi city of Mosul.
Speaking at a parliamentary group meeting of his party and responding to the Kurdish referendum for independence from Iraq, Bahçeli said on Tuesday that "they," meaning Turkey, would have the right to annex Kirkuk and Mosul as its 82nd and 83rd provinces when the time comes.
The cartoon was deleted from the website of the magazine immediately after a public outcry erupted, Turkish media reported.
After many disappearance reports from the 1980s and 1990s, Renault's Toros station wagons became a symbol of unsolved murders and kidnappings for many Turks, particularly citizens of Kurdish origin. Especially in the '90s, it was allegedly used by Gendarmerie Intelligence (JİTEM) members in Turkey's eastern and southeastern regions. There were many murder and disappearance reports from that period, and white Toros were common in a number of instances. According to witnesses reports, many Kurdish businessman, some drug dealers and Kurdish opponents were abducted in these vehicles. The corpses of some of disappeared people were later found, but most of them remain missing.


Who doesn't like a Business/First Class Elite Mileage Run? Look what I found for you today; It is a First Class Delta Air Lines itinerary from Dallas to Las Vegas. You have a single day when this fare is the lowest; Depart on Sunday, December 20th and return the next day, Monday.
I really tried to make this work through Detroit both ways, but it just isn't price-friendly using that route. So, let's connect through Minneapolis on the outbound and we can still get the Detroit connection on the return. You do have to spend a night in Las Vegas, but that can be cheap…or get another stay towards a hotel elite status you have/need. I recently stayed at a property in Vegas and they had a shuttle from the airport, a room rate of $29 and also gave me a $20 dining credit!
You can do other days, but you pass the 8 Cents Per Mile (CPM) threshold. The pickings are getting slim around the end of the year. If you need to get one last Elite Mileage Run in and pick up 7,333 MQM's for $533 here is a great deal! I see that the first class cabin from Las Vegas to Detroit is wide open (only one seat taken.) Book now as I think once this deal hits it will be scooped up quickly by those who see the value.
Have fun playing with your day and a half you get to spend in Las Vegas with this run!
I will continue to press on looking for these great values and hoping to help you find the perfect Mileage Run before the month is over. As I find them, I shall also be posting the best runs for early 2016.
Here is the Direct Link to book this Dallas-Detroit-Las Vegas-Detroit-Dallas itinerary.
Choose the flights shown above and then press SELECT (on the Kayak site) which will take you directly to Delta.com's booking engine. If you really want the MQM's and you can afford a day and a half to get them in, here is a way to get a bunch!
← Important travel info you may forget to update. Don't make simple mistakes that can cost you time and get you to the Sky Club faster!


Agents are human. At least that's the rumor. I know several and count some of them (including my own) as friends. The ones I know are professional, care about their clients and truly want what's best for them.
I believe the majority of agents are like this.
But in every barrel there is an apple or two that has, shall we say, spots.
I have no way of knowing how widespread the following behaviors are. And certainly there is no gauge that measures motivations. But if agents are human (that dang rumor just won't go away) then I suspect they are subject human frailties as well.
Which is not an excuse for bad behavior. Our great task in life is to do battle with our frailties and overcome them. That is especially true for those who hold themselves out as professionals and in whom clients entrust their hopes and dreams.
I have heard over the past few months from some writing friends with agent problems. They never anticipated these contingencies and wonder what to do. Everything was so positive when they signed! What happened? They feel like they've taken a two-by-four to the head.
I advise as I can, but now there comes a time for advice to agents. Here it is: If you are doing any of the following things, stop it.
Some years ago I was at a writers conference where a new agent was taking appointments. This was a guy who had been in the business for a long time as an acquisitions editor. He had worked for a reputable publisher and, by all accounts, was someone with abundant contacts inside the walls of the Forbidden City.
During the conference I kept hearing from newbie writers that this agent was interested in seeing their full manuscript! And, in a several cases, signing with him right then and there!
Only later did I find out what this guy's MO was. He was signing up just about everybody. In only a few months he had a roster of 70 writers.
Seventy! How could he give these writers the attention they thought they were going to get?
He couldn't. What he did was throw all these proposals against a publishing wall, hoping some would stick and get him a percentage of the advance money and downstream sales.
Rather than nurture the truly deserving, helping them shape a manuscript or proposal into something that had a real chance in the marketplace, he was operating an impersonal volume grinder.
Guess what happened? Two years later he was out of the agenting business. Gone.
And his clients? Cast adrift. Good luck. Thanks for playing. Two years of their writing lives down the dumper.
One thing I've always said to writers is: a bad agent is worse than no agent. The writers who signed with this fellow found that out the hard way.
LESSON: Only sign with an agent who has a track record or comes highly recommended by a trusted source.
I've gotten two emails from writer friends recently who have said the same thing: All of a sudden their agent has stopped communicating with them.
Their profile is similar. They signed on as new authors, with all the attendant happiness of the writer who finally has representation. A first deal was made! Smiles and good wishes all around!
Then the marketplace brought down its unsentimental fist. The debut novel didn't take off. The second novel was given scant attention by the publishing house. The third novel (if there was one) was kicked to the curb.
With a dismal track record hung around their necks, the authors' prospects for a new contract with a publisher were severely dimmed.
But the writers kept their hopes alive. New ideas, new proposals sent to the agents.
Only the agents stopped returning emails. Or phone calls.
This behavior is mostly economic. Agents are in this business to make a living and will naturally put their energies behind the cash-cow clients. An author whose prospects have dwindled won't get the same attention.
There's also a personal aspect. It's easier to avoid a hard conversation with the unpleasant prospect of a breakup.
Finally the agent, by saying nothing, may be hoping the client will "pull the plug" and leave of her own volition. Problem solved.
Such behavior is unprofessional and uncivil. You, agent, have a lot of clients. But the writer has only one agent, and to be treated like a discarded McDonald's wrapper makes them feel like a world is ending, a career is dying, and long-nurtured dreams are turning into nightmares.
So do the right thing even if it's uncomfortable. Have that talk with the client. She has placed her very heart in your hands. She deserves your communication.
The brave new world of digital publishing has put agents in a bit of an uncomfortable position. Early on there was talk that helping a client go indie (for a percentage) was a conflict of interest. That chatter has died down as more and more agents get into the hybridization game.
A situation has arisen, however, with a couple of writers I know. Way back when some of their books went out-of-print, they got the rights back. At that time such rights were considered nearly worthless.
Oh, how times have changed. Digital self-publishing has made it possible to give those old books new and lasting life. And a welcome revenue stream for the writer struggling to get a new contract.
But not so fast, some of their agents say. We still get a piece of your pie. Even if you self-publish. So go ahead! Only you will have to be exclusive on Amazon so we can have our share of the royalties come directly to us.
There actually may be plenty of muss and quite a bit of fuss over this. Putting on my dusty lawyer hat for a moment (it's been sitting in the corner over there by my vinyl records), I say that unless a client signed a contract that specifically gives the agent a share of their independently held rights in OOP books, this won't fly. And even if there weresuch a contract provision there is a chance it would not stand up in court if muss came to fuss.
The agent made the deal with the trad publisher and deserved the 15%. But when that deal is over it's a whole new ballgame. If a client is self-publishing backlist and does not ask for an agent's services in this regard, there is no new deal and no percentage due. Agents should not act as if they are rights holders.
As I said up top, I'm privileged to know several agents personally. I do believe that the majority of agents have good intentions and professional practices.
This entry was posted in agents by Joe Moore. Bookmark the permalink.
It's a scary world out there in publishing land. It's a shame there's a need for such sage advice, but as you say, the rumor is true: agents are human.
The last bit is very nasty.An agent bullying a client into paying a fee the agent didn't earn. That relationship is ruined no matter which decision the author makes, only one way the author gets to keep their money by walking. Agents who haven't developed a plan for ways to earn money in the future of this changing world often scramble for a foothold, but coercion is not the answer. It's best to continue to be human & treat people the way that allows everyone to sleep nights & keep a clear conscience. No bullying required.
Jim, frightening (but, unfortunately, true-to-life) stories about what's happening in this brave new world of publishing. Some may not know of your own background in law and your experience as a writer (including both traditional and self-publishing). In addition, you've acted as your own agent and are now represented by one of the best in the business. Because of all this, you're uniquely qualified to pass on this information, and I hope writers of all persuasions will heed it. Thanks for sharing.
Thanks, Doc. The law degree has to be good for something, doesn't it?
This is a great article, something I will bookmark. Thanks!
Thanks for the great advice, Jim. And how timely.
I'll give you my experience for purposes of discussion. I would value any of your sage words of wisdom. I would be interested in your readers' thoughts.
I found an agent about a year ago at a conference. I had received an offer for my first book from a small publisher, prior to finding the agent. My agent asked me to not accept the offer. He wanted to try the big five. I merrily worked on improvements to the manuscript over the winter. By this spring I was concerned that I had not heard from him. I tried twice before I got an answer back. Then I had to remind him that I was actually already a client. He had "lost" my manuscript on his computer. He had not sent it out to any agents. At that point I informed my agent that I was going to recontact the small publisher. I did. I made some additional edits. And they offered me a contract two days ago. I intend to accept it.
Now my dilemma: I don't want to burn bridges. I never like to be the one to end a relationship. I suppose I owe my agent the 15%, even though he did nothing to get the contract, in fact delayed it. Do I look for another agent for the next book? Do I give him another chance. He certainly will remember me after this escapade. I hope. Any words of advice?
Did you sign an representation contract with the agent? If so, you might have issues. If not, I say you are a free agent, so to speak.
It seems this agent did nothing for you; in fact, you lost valuable time because of his negligence. I don't see where you owe this agent one dime or any loyalty.
As for not being the one to end a relationship: You must approach this as a business relationship. Thus you must be prepared to end it if it proves unfruitful to you. As Jim says, it is better to have no agent than a bad one.
Good agents know this is a profession. They make business decisions all the time. Writers should make them, too. You "owe" an agent when they make a deal. No deal was made. There is nothing owed.
Re: the small publisher. You made all the contacts. You don't need an agent to sign this contract. Hire an IP lawyer to look it over for a fee.
If I were looking for an agent, I think I would add adaptability to the list of qualifications. We're still in the early stages of a major technological disruption. Traditional publishing can't continue in it's current form. Indie publishing will look totally different in ten years. Those are givens. What changes to expect? I dunno, the ol' crystal ball rolled off the table and shattered. Scared the heck out of the dog.
I think some of the bad behavior out there is panic from agents who don't have a clear line on the future of the industry and are resorting to short-term tactics rather than putting in the hard work of identifying how they will serve their clients best, for years in the future.
Creative adaptability is a rare skill and a valuable one.
Just ran across a decent story in Forbes on how agents fit into the new publishing eco-system. Also, follow the imbedded link in the Forbes story for an interesting interview with a "hybrid" agent.
Your posts invariably demonstrate how persuasive restraint and clarity can be–thank you for this valuable summary of agent misdeeds. My experience with agents–two in succession–is characterized by #1 on your list–the throw-it-against-the-wall type. But unlike the agent you describe, both of those who took me on are still in business, and one is high-profile.
In my view, here's the worst thing about such agents: they either don't know enough to help writers refine their manuscripts before sending/throwing them into the marketplace, or they don't care enough to bother. They just keep taking on new clients, throwing at the wall and hoping something sticks. Either way, it's the writer who gets stuck. And when this kind of thing happens to you–twice–you decide life's too short (literally), and turn to indie publishing.
Writers need to do a lot more now before seeking representation, including making sure the book is the best it can be (e.g., paying for editorial).
And that bothers me. Investing up to $1K in editing when an agent is going to have their own vision and then sitting on that investment for up to 5 years.
Terri Lynn–There you go–thank you. Agents are supposed to be able to distinguish between what's not worth representing, what is worth, but after changes (and what those changes should be), and what's ready to go. They have to know the difference, and that I am sorry to say has not been my experience.
When I first started writing I sent a manuscript to a agent that I met at a conference. The reply I got was all of one line. And I quote "What do I do with this?" I was crushed, I didn't know if it was a comment on my writing. Or if she didn't know what she was doing. It has hurt my confidence and my faith in good agents.
I want to add that I have published a short story since.
Gwyn, it's always been true writers have to grow Rhino skin. Don't let one bad experience set you back. The best antidote: keep writing.
These stories are sobering and I am ever thankful my agent hasn't done any of these things! He remains ever professional and I trust his feedback and am grateful he has stuck with me:) I have a friend from my writers group, however, whose first agent did a #1 and could potentially have doomed her project for every more. It's such a difficult decision to make regarding choosing an agent and I agree, a bad agent is worse than no agent at all.
Great post, as always, Mr. Bell.
Thanks for flooding light onto the weird and wonky places within the writer's world.
I knew that agent too. The behavior was appalling. And when he quit, the abandoned refugees searched far and wide for new representation…it was not pretty.
It is hard enough as an agent, much worse when one bad egg stinks up the joint.
What annoys me are agents who garner invitations to conferences with no intention of acquiring anyone. Ditto for editors. The least they can do, especially after a personal pitch session, is to give the courtesy of a rejection instead of ignoring the authors who have submitted to them. This silent treatment is unprofessional but all too common these days.
It's really heartbreaking to hear stories like this. Aspiring writers (maybe too enthusiastically) have this mythos, that once they get an agent their life will be so much better. Sure, more work starts, but it's better to have one than to not. That's what the rat race with querying is all about, after all.
This leads to writers accepting agents that maybe they shouldn't, or being more forgiving of bad behavior. After all, if it's your first agent, it's hard to know what's normal.
A very good friend of mine, who is a very talented writer, got an agent almost two years ago. She queried and had multiple offers of representation, but went with this agent because she seemed to get her book the best.
To make a long, horrible story short, this agent sucked. She strung her clients along, couldn't make contacts inside the industry, and after a year or so of stringing my friend along, she stopped replying to her emails. It took another few months for my friend to discover from someone else this agent had quit. Quit. Last my friend heard, she was very hopefully shopping her manuscript.
My friend is heartbroken. Years with this lady with nothing but heartbreak to show for it. She and the other clients were cut off, so now she's back at the querying stage, with a book she's not sure which editors have or have not seen, since her agent didn't keep her informed of those details.
I don't have an agent yet, but I'm glad I can read stories like the one you posted today, and know what's to be expected and what's not. Thanks for the post!


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text:
Тартакай — річка в Україні, в межах Березівського району Одеської області та Веселинівського району Миколаївської області. Ліва притока Тилігулу (басейн Чорного моря).

Опис
Довжина бл. 21 км (в межах Одеської області — 9,7 км). Долина вузька, глибока, порізана балками і ярами. Річище слабозвивісте, влітку пересихає. Споруджено кілька ставків. Тартакаївський ставок (с. Роздол) без води з початку 2000-х р.р. Нижче нього в межах с. Роздол (стара назва Тартакай (Картакай)) тече річка Тартакай (або Тартакайка), далі тече по Березівці і впадає в Тилігул. В межах Березівки, щоб запобігти пересиханню, зроблено декілька каскадів, заглиблено і розчищено.

Розташування
Тартакай бере початок на північний схід від села Новогригорівки. Тече спершу на південний схід, у середній та нижній течії — на південь. Впадає до Тилігулу біля південної околиці міста Березівки.

Річка протікає через місто Березівку.

Джерела
 Екологічний паспорт Одеської області (2010)

Малі річки України
Річки Одеської області
Річки Миколаївської області
Березівка
Річки Вознесенського району
Річки Березівського району
Статті про річки Одеської області без зображення в картці
Статті про річки Миколаївської області без зображення в картці

redpajama_set_name: RedPajamaWikipedia


text:
- Travel -
Whether you want to learn the ropes or just feel the wind in your hair, sailing is an exhilarating – and affordable – getaway for the whole family.
By Sarah Tuff Dunn | May 2008
I'm standing at the helm of a 51-foot sailboat in the Caribbean Sea, approaching the island of St. Lucia, where my companions and I will anchor for the evening. As I spin the wheel slightly, the sails flutter and snap to attention. With the water beneath my feet and the wind at my back, I've never felt such an intoxicating blend of power, possibility and relaxation.
I also feel extraordinarily lucky to have been invited on this monthlong sailing trip, an experience that's becoming more popular — and affordable — than you might think.
Community boating centers and inexpensive sailing opportunities abound. Deckhands of every age are learning the ropes (known on a boat as lines or sheets). And according to The Sailing Company, in Middletown, R.I., 1.6 million sailboats were used in 2006, many of them filled with first-timers on brand-new adventures.
"The reasons for sailing are as varied as the individuals and boats out there," says Susan Peterson Gateley, who teaches sailing on Lake Ontario. "One big draw is the sense of freedom."
And once you're hooked, it can become a lifelong passion. "Sailing is something that gets in your blood," says Dave McGinnis, manager and senior captain of Michigan's Traverse Tall Ship Company. "Flying along with everything set in a perfect breeze, when the vessel comes alive in a balance of power and grace — it touches something deep in the core of your being."
Sure, sailing takes skill, quick thinking and physical prowess. But thanks to hundreds of sailing schools and outfitters around the country, just about anyone can set sail, whether it's for a three-hour tour — or a three-week voyage.
Though you don't need lessons to participate in many sailing adventures, learning to sail can be one of the most rewarding ways to get on the water. The American Sailing Association certifies more than 270 facilities around the world to teach sailing basics. Classes range from two-hour primers to longer courses in racing, cruising, navigation, and more. (Some experienced sailors enroll in refresher classes so they can "bareboat," or charter a vessel without a crew or provisions.)
"You can learn the basics in a couple of hours," says Steve Mink, co-owner of the Liberty Sailing School of Philadelphia and a U.S. Coast Guard–licensed captain. "And then spend the rest of your life developing those skills."
In Liberty's two-day "Basic Keelboat" class, students split their time between the classroom and the water. They learn key sailing knots, names of boat parts (including tiller, boom and mast), how to rig and hoist sails, terms such as "beam reach" and "close hauled," how to turn the boat by tacking or jibing, and much more.
When Laurie Davis of Indianapolis signed up for a sailing class in Florida last June, she had no experience on a boat. All the new terminology was confusing at first, says the 60-year-old retiree, but she soon gained the confidence to steer the 26-foot sailboat on her own. "It was so exciting to take the tiller and try to find that perfect point on a beam reach where you're just hanging over the water and going so fast."
Typically, the only gear you need to bring to class is weather-appropriate clothing, boat shoes and personal refreshments. Handling the sheets and pushing the tiller take minimal strength, and unlike many sports, sailing has virtually no restrictions on gender, age or abilities. Most marinas, including the Geneva Lake Sailing School in Fontana, Wis., even have special programs for kids. Rhode Island's nonprofit Shake-A-Leg organization promotes its Adaptive Sailing Program with specialized boats.
Many community boating centers — on ocean bays, lakes and rivers — offer deeply discounted programs. In Boston, for example, children pay $1 for membership in ˙ the Junior Program at Community Boating, Inc., while the adult 30-day intro to sailing and kayaking is just $90. Many instructors are thrilled to donate extra hours to teaching. "When I see people enjoying that experience for the first time, it charges my batteries," says Mink.
Don't want to hit the classroom before hitting the water? No problem. There are plenty of other sailors who are happy to steer while you sit back, relax and enjoy the ride.
Sailing adventures offer a wide range of activities: from short, relaxing cruises on a river to multiday excursions on the high seas. While the crew sails the boat, you can learn to paint, watch for whales, fish, cook, study a new language or simply kick back. Or, if you want to feel like part of the crew, they'll let you help hoist the anchor, trim the sails and even steer.
Most companies also allow on-shore time. Maine Adventure Sails, based in Rockland, Maine, offers three- to six-day trips on its schooners Timberwind and J. & E. Riggin that include beach lobster bakes and island hiking (the eco-friendly sailors even pick up litter along the trail).
"I love feeling the wind in my face, the fog — out of which appear islands, birds and seals — the stars at night, and hearing the crew sing," says Louisa Enright of Camden, Maine, a regular passenger on the J. & E. Riggin.
Maureen Riley has also sailed on the J. & E. Riggin — 34 times. Onboard, the 54-year-old nurse anesthetist from Royal Oak, Mich., has taken a photography seminar, seen the Northern Lights, raised the anchor, heard steel-drum bands and met friends for life, all while blissfully cut off from cell-phone calls, television and radios.
"Most weeks," she says, "you just forget that the world is out there."
Sailing Dos & Don'ts
Do wear sunscreen, since rays reflected off the water can increase the risk of sunburn and sun damage.
Don't risk dehydration. There may be "water, water everywhere," but it's best to bring your own potable liquid in a reusable, unbreakable bottle.
Do leave the flip-flops at home. Many sailing schools recommend nonskid boat shoes and frown upon black soles, which leave marks on the sailboat decks.
Don't ignore the captain or instructor. "You can capsize and drown even on a tiny lake," says Susan Peterson Gateley, who teaches sailing on Lake Ontario. Tuning in will help prevent you from getting tossed out.
Do avoid seasickness by trying ginger, Sea-Bands and MotionEaze, alternative remedies suggested by Sailing magazine. Or, ask your doctor about prescription treatments.
Do know where life jackets are stowed in case of rough waters or an emergency. Nonswimmers and children under 12 should always wear a life jacket (check your local boating regulations for requirements).
Explore these sailing resources for classes and getaways that suit your schedule and budget. Most sailing lessons cost from $75 for a two-hour class to more than $4,000 for a weeklong class; trips can range anywhere from $40 for a one-hour cruise to thousands of dollars for a multiday adventure.
U.S. Sailing: The national governing body for the sport maintains an online database of nationwide sailing schools and community sailing programs. 800-877-2451; www.ussailing.org
American Sailing Association: This association has accredited more than 270 sailing schools around the world. 310-822-7171; www.american-sailing.com
Offshore Sailing School: More than 100,000 sailors have graduated since 1964; choose from 10 locations and more than a dozen different courses for all sailing levels. 800-221-4326; www.offshore-sailing.com
OCSC Sailing: With a fleet of more than 50 boats on San Francisco Bay, this school arranges lessons and trips around the world. 800-223-2984; www.ocscsailing.com
Sailing Adventure Outfitters
Maine Adventure Sails: Full crews steer up to 24 passengers on three- to six-day trips on the schooners Timberwind and J. & E. Riggin; rates of $495 to $939 include bunks, meals and more. 877-300-3377.
Lakeshore Sail Charters: Board a 36-foot sloop ($140 to $165 per hour for up to six guests) or a 77-foot schooner ($550 to $675 per hour for up to 49 passengers) to see Chicago from Lake Michigan during happy hour; night or day sails. 708-769-4220; www.lakeshoresail.com
Seneca Sailing Adventures: Relax on a three-hour cruise ($160 per couple) aboard the 38-foot Lee Sea Anne around Seneca Lake in New York's wine country; trips are at 10 a.m. and 2 p.m. each day. 607-742-5100; www.senecasailingadventures.com
Monterey Bay Sailing: Choose from nature excursions, corporate team-building yacht races and three-day cruises on the bio-diverse Monterey Bay. 831-372-7245; www.montereysailing.com
Sailing Ship Adventures: Book a trip to Denmark, Italy or beyond; this company works with a fleet of more than 100 tall ships, some longer than 400 feet, that can accommodate as many as 225 passengers. 877-882-4395; www.sailingshipadventures.com
Traverse Tall Ship Company: Chill on the 114-foot-long Manitou, a "floating bed & breakfast" that accommodates up to 24 guests in 12 private cabins; two-hour to four-day sails on Lake Michigan and its bays. 800-678-0383; www.tallshipsailing.com
The Moorings: This yacht charter company allows you to sail a boat yourself or hire a captain, crew and cook; destinations range from the islands of the Caribbean to the Mediterranean to the Kingdom of Tonga. 888-952-8420; www.moorings.com
WEB EXTRA!
Sailing Terminology
Bow: The front of the vessel
Stern: The rear of the vessel
Port: The left side of the vessel (when you're standing at the stern, looking at the bow)
Starboard: The right side of the vessel (when you're standing at the stern, looking at the bow)
Sloop: A vessel with a mast and two sails; the most common type of sailboat
Jib: The front sail or headsail
Mainsail: The aft sail in a sloop rig (at or near the stern)
Halyard: The rope or line that hoists up the sails
Sheets: Ropes or lines that hold the sails in position
Trim: To adjust the sails
Tacking: Changing course or direction by steering a vessel into the wind
Come About: Turning the vessel's bow through the wind
Jibing: Turning the vessel's stern through the wind
Bowline: A temporary, nonslipping loop in a line
Cleat: A fitting to which lines on a vessel are secured
Tiller: A lever attached to the rudder for steering the vessel
Downwind: With the direction of the wind
Upwind: Opposite the direction of the wind
Spinnaker: A light, kite-like sail used when sailing downwind
Sarah Tuff Dunn Sarah Tuff is the coauthor of 101 Best Outdoor Towns: Unspoiled Places to Visit, Live & Play (Countryman Press, 2007); she writes from Burlington, Vt.
By Laurel Kallenbach
Not into conventional sailing cruises? Climb aboard a historic schooner for an unplugged, old-fashioned adventure at sea.
STRONG BODY, STRONG MIND: Adventure Quest
By Maggie Fazeli Fard
Our fitness editor tests the waters on a paddleboard — and discovers the benefits of leaving her comfort zone.
By Heidi Wachter
New editions of kayaking pioneer Audrey Sutherland's classic books provide inspiration for anyone looking to make a solo journey.
- Environmental Health -
4 Ways to Be a Good Water Citizen
By Courtney Helgoe
Simple tips to help you break the bottled-water habit and protect our groundwater.

redpajama_set_name: RedPajamaCommonCrawl


You should organize your own ride to and from the course. If you need to store clubs with me, bring them to my room in the morning, can keep in my truck overnight.
You are expected to be at the course by 3:50. Check in with me if no ride.
Eligibility packets to be completed before you can practice.
On Play days we will play 9 holes and be done when you are finished (can be as late as 6:30 pm). On practice days we will go until 5:30pm. Please have rides at the end…call on cell phone after 7th green….
Expectations: We are to act like Champions at all times. You are expected to represent us in and out of school.
Classes: Do well, take care of school outside of golf….
Speed of play : need to play 9 holes under 2hrs….
Cuts: Depends on the number of girls who show up. Cuts will be a combination of playing; range work; short game tasks; grades; and attitude. Come ready to work and play! Cannot miss more than 2 practices without prior arrangements or may forfeit your spot on our team.
Missing practice without prior arrangements will forfeit your spot in the next match.


Having the First Aid Made Easy Booklet is essential to have nearby in case of a medical emergency. Using this, you can ensure you provide the right emergency treatment to a large variety of ailments. This ranges from burns, seizures, heart attacks, frostbite and bone breaks. It also helps should you ever need to resuscitate someone.
Thankfully, you don't need a medical degree to understand this booklet and it uses concise language, with the help of handy images and diagrams. This A5, 67-page booklet would complement a first aid course or as a handy resource to refer back to.


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Beware of repeated infections from Corona.. Here are the most important risks
A new scientific study has found that repeated infections with COVID-19 after an initial infection carry multiple health risks, as repeated infections can cause new and sometimes persistent health problems.
After examining people who had been infected once, those who had been infected more than once, and a third group who had never been infected, the researchers identified 7 main risk factors.
The study showed that all those exposed to a new infection were at increased risk of medical complications, such as hospitalization or a longer stay before recovery or death.
Also, according to the information published by Poltsky website, this study has compiled 7 important points.
Exposure to health problems
The first point revealed an increase in the number of infectious substrains of the omicron variant BA.4 and BA.5, which would again be expected to increase rates of COVID-19 infection.
The second point indicates that a resurgence of SARS-CoV-2 infection may have a less severe outcome than the initial infection, but each infection presents a new opportunity for the virus to harm the body, which is more likely with each infection. Exposure to health problems.
Regarding the third point, the risk of developing medical problems in the first 30 days after infection with Covid-19, such as lung and heart disease, is high.
Contagious effect
In most cases, these risks persist for up to six months and increase with each subsequent injury. Although rebooting is mild, it can still be dangerous.
In parallel, doctors could not be sure how the infection affects the body, while point 4 revealed that the immune system is aware of the virus and is better able to deal with it the second or third time after a previous infection or vaccination. The severity of the covid infection can be reduced.
See also NBK calls for a balanced distribution of mental health services
The fifth point is that the first infection of Covid-19 weakens the immune system and weakens one or more organs in the patient's body, causing complications that are not noticeable at first, and subsequent infections may cause more damage to those organs. Clearly for the appearance of signs of damage.
Meanwhile, point 6 revealed that the risk of re-infection with Covid-19 was seven times higher when omicron variants were prevalent than when the delta variant was dominant.
Treating a Corona patient – iStock
Elderly patients
The last point concluded that elderly patients have multiple conditions.
Repeated infections are less likely to increase health risk in a healthy 18-year-old than in an older person with underlying health problems.
Furthermore, patients who required medical attention when the infection recurred were more likely to develop symptoms than those who did not receive medical treatment and were not included in the study.
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NEW VIDEO: Whyte Lytes – Go Get It [Premiere]
Filed Under: Premiere, Video — By: Elke Nominikat
"Go Get It" by U.K. indie-rockers Whyte Lytes, is a catchy guitar driven song, with an edgy vibe that got me after the first listen – roughly three months ago. Much to my chagrin, I forgot about it again, surrounded by a constant flow of new music. The more I am thrilled about the opportunity to feature the track as it deserves: turns out, Whyte Lytes created a video, which won't come officially out until next Monday but we got chosen to premiering it today ahead of time.
"Go Get It" is the debut video of emerging newcomers Josh Rawle (bass, vocals), Alex Rawle (guitar, vocals), Jonny Morrison (guitar) and Jamie Langford (drums), who simply -and not so simply- show themselves as a band. They are passionately playing their instruments and sing – in short perform the super cool "Go Get It" and throw in a few effects to make the video more aesthetically pleasing.
Personally, I have a weakness for firsts, and "Go Get It" is such a strong song, with ace vocals, and cool guitar work and the video to go with is charming, well done and should please every fan Whyte Lytes already have and get them new ones too. They are onto something…!
Watch "Go Get It" now, follow Whyte Lytes and check out their SoundCloud page for more of the good.
For your playlist:
Go see Whyte Lytes live:
Whyte Lytes Tour Dates


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The Festival Hall is an event center with a long history. As early as 1906, the hall was built of wood in the Annaberg of the time at Kätplatz and was popular for its exhibits, receptions and balls.
During World War I the Festival Hall was used by the army as a mess hall for the recruits. In the twenties, meals were provided for the masses of unemployed and poor at reduced prices. Eventually it began offering a wide range of different events once more. During the early years of the GDR, the building fell increasingly into disrepair and was condemned in the seventies. In 1985, however, a new, larger building was opened and became a cultural center in the Ore Mountains. After the reunification, the Festival Hall served as a conference center up until 1996.
It almost seemed as if the Festival Hall would again be left to decay, but a dedicated association came together with the major district town in order to tackle the necessary renovation work. This started in 2010 with the demolition of the old bowling alley and the restaurant. May 16, 2012 marked the embarkation into a new era: Head mayor Barbara Klepsch presented the "Festhalle Annaberg-Buchholz eG" association with the key to the cultural and event center in the upper Ore Mountains. Since that time, numerous concerts, company parties, trade shows, and much more have been hosted in the new Festival Hall.
Organizers can put together fully individualized events - the Annaberg-Buchholz Festival Hall offers a variety of options. Lined with chairs, the modern hall seats more than 1,000 visitors, for standing room only variations, there is room in the building for up to 1,400 guests.
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Festhalle (Festival Hall)
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ADJUSTABLE SLEEP APNEA ORAL APPLIANCE
Document Type and Number:
WIPO Patent Application WO/2016/100577
Kind Code:
An oral appliance having an upper tray, a lower tray, and axial inserts attached to either the upper tray or lower tray to adjust the relative position of a user's upper jaw and lower jaw in order to treat sleep apnea and/or snoring while at the same time allowing orthodontic treatment of the subject.
VEIS ROBIN (US)
US2015/066209
Export Citation:
Click for automatic bibliography generation
SELANE PRODUCTS INC (US)
International Classes:
A61C7/00; A61F5/56
Foreign References:
US20130284184A1 2013-10-31
Other References:
See also references of EP 3232980A4
Attorney, Agent or Firm:
FEDRICK, Michael (LLP305 N. Second Ave., #12, Upland CA, US)
View/Download PDF PDF Help
Claims:
1. An oral appliance for treating snoring and/or sleep apnea in a subject, comprising:
(1) an upper tray having an anterior portion, a posterior portion, a right side, a left side, a buccal side, a lingual side, an inner surface, and an outer surface, the upper tray comprising:
(a) a receptacle bounded by the inner surface of the upper tray;
(b) a right side upper bite pad connected at an upper end to the lower surface of the right side of the upper tray, wherein the bite pad comprises a lower surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending anteriorly from a posterior portion of the right side of the upper tray, wherein the lower surface of the bite pad is lower than the lower, coronal surface of an anterior portion of the right side upper tray;
(c) a right side insert comprising an upper surface, a lower surface, an anterior surface, a posterior surface, a right side, and a left side, wherein the upper surface faces and/or contacts the lower surface of the right side of the upper tray anteriorly with respect to the right side upper bite pad, and wherein the posterior surface is configured to be reversibly attached to the anterior surface of the right side upper bite pad;
(d) a left side upper bite pad connected at an upper end to the lower surface of the left side of the upper tray, wherein the bite pad comprises a lower surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending anteriorly from a posterior portion of the left side of the upper tray, wherein the lower surface of the bite pad is lower than the lower, coronal surface of an anterior portion of the left side upper tray;
(e) a left side insert comprising an upper surface, a lower surface, an anterior surface, a posterior surface, a right side, and a left side, wherein the upper surface faces and/or contacts the lower surface of the left side of the upper tray anteriorly with respect to the left side upper bite pad, and wherein the posterior surface is configured to be reversibly attached to the anterior surface of the left side upper bite pad; and (f) a buccally facing anterior right side anchor on the outer buccal surface of the anterior portion of the right side of the upper tray, and a buccally facing anterior left side anchor on the outer buccal surface of the anterior portion of the left side of the upper tray; and
(b) a lower tray having an anterior portion, a posterior portion, a right side, a left side, a buccal side, a lingual side, an inner surface, and an outer surface, the lower tray comprising:
(b) a right side lower bite pad connected at a lower end to the upper surface of the right side of the lower tray, wherein the bite pad comprises an upper surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending posteriorly from an anterior portion of the right side of the lower tray, wherein the upper surface of the bite pad is higher than the upper, coronal surface of a posterior portion of the right side lower tray;
(c) a left side lower bite pad connected at a lower end to the upper surface of the left side of the upper tray, wherein the bite pad comprises an upper surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending posteriorly from an anterior portion of the left side of the lower tray, wherein the upper surface of the bite pad is higher than the upper, coronal surface of a posterior portion of the left side lower tray;
(d) a buccally facing anterior right side anchor on the outer buccal surface of the anterior portion of the right side of the lower tray, and a buccally facing anterior left side anchor on the outer buccal surface of the anterior portion of the left side of the lower tray; and
(e) a buccally facing posterior right side anchor on the outer buccal surface of the posterior portion of the right side of the lower tray, and a buccally facing posterior left side anchor on the outer buccal surface of the posterior portion of the left side of the lower tray,
wherein the anterior surface of the right side insert comprises an engagement surface which contacts the posterior surface of the right side lower bite pad, and wherein the anterior surface of the left side insert comprises an engagement surface which contacts the posterior surface of the left side lower bite pad, thereby limiting the forward positioning of the upper tray with respect to the lower tray, thereby alleviating snoring and/or apnea when the oral appliance is used by a subject; and
wherein the receptacles of the upper tray and the lower tray are each configured to receive and retain an orthodontic tray, or wherein the receptacles of the upper tray and the lower tray are each configured to reposition one or more teeth of a subject and/or to change the configuration of a subject's mandible and/or maxilla when the appliance is worn by the subject.
(b) a right side upper bite pad connected at an upper end to the lower surface of the right side of the upper tray, wherein the bite pad comprises a lower surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending posteriorly from an anterior portion of the right side of the upper tray, wherein the lower surface of the bite pad is lower than the lower, coronal surface of a posterior portion of the right side upper tray; and
(c) a left side side upper bite pad connected at an upper end to the lower surface of the left side of the upper tray, wherein the bite pad comprises a lower surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending posteriorly from an anterior portion of the left side of the upper tray, wherein the lower surface of the bite pad is lower than the lower, coronal surface of a posterior portion of the left side upper tray;
(d) a buccally facing anterior right side anchor on the outer buccal surface of the anterior portion of the right side of the upper tray, and a buccally facing anterior left side anchor on the outer buccal surface of the anterior portion of the left side of the upper tray; and (b) a lower tray having an anterior portion, a posterior portion, a right side, a left side, a buccal side, a lingual side, an inner surface, and an outer surface, the lower tray comprising:
(b) a right side lower bite pad connected at a lower end to the upper surface of the right side of the lower tray, wherein the bite pad comprises an upper surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending anteriorly from a posterior portion of the right side of the lower tray, wherein the upper surface of the bite pad is higher than the upper, coronal surface of an anterior portion of the right side lower tray;
(c) a right side insert comprising a lower surface, an upper surface, an anterior surface, a posterior surface, a right side, and a left side, wherein the lower surface faces and/or contacts the upper surface of the right side of the lower tray anteriorly with respect to the right side lower bite pad, and wherein the posterior surface is configured to be reversibly attached to the anterior surface of the right side lower bite pad;
(d) a left side lower bite pad connected at a lower end to the upper surface of the left side of the lower tray, wherein the bite pad comprises an upper surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending anteriorly from a posterior portion of the left side of the lower tray, wherein the upper surface of the bite pad is upper than the upper, coronal surface of an anterior portion of the left side lower tray;
(e) a left side insert comprising a lower surface, an upper surface, an anterior surface, a posterior surface, a right side, and a left side, wherein the lower surface faces and/or contacts the upper surface of the left side of the lower tray anteriorly with respect to the left side lower bite pad, and wherein the posterior surface is configured to be reversibly attached to the anterior surface of the left side lower bite pad;
(f) a buccally facing anterior right side anchor on the outer buccal surface of the anterior portion of the right side of the lower tray, and a buccally facing anterior left side anchor on the outer buccal surface of the anterior portion of the left side of the lower tray;; and
(g) a buccally facing posterior right side anchor on the outer buccal surface of the posterior portion of the right side of the lower tray, and a buccally facing posterior left side anchor on the outer buccal surface of the posterior portion of the left side of the lower tray,
3. The oral appliance of claims 1 or 2, further comprising an elastic band connecting the anterior left side anchors of the upper tray and the lower tray, an elastic band connecting the anterior right side anchors of the upper tray and the lower tray, an elastic band connecting the anterior left side anchor of the upper tray with the posterior left side anchor of the lower tray, and an elastic band connecting the anterior right side anchor of the upper tray with the posterior right side anchor of the lower tray.
4 The oral appliance of claims 1 or 2, wherein the anchors are selected from the group consisting of a button, a hook, and a Herbst screw.
5. The oral appliance of claims 1 or 2, wherein each insert is connected to a respective bite pad with an interference fit.
6. The oral appliance of claim 1, wherein the anterior surface of each upper bite pad comprises a recess and the posterior surface of each insert comprises a projection adapted to fit within the recess and thereby secure the insert to the upper bite pad.
7. The oral appliance of claim 6, wherein the projection comprises a wedge having sides that extend laterally and posteriorly and the recess is wedge-shaped and configured to receive and retain the projection.
8. The oral appliance of claims 1 or 2, further comprising a first orthodontic tray and a second orthodontic tray, wherein the orthodontic trays can be received within the receptacles of the oral appliance.
9. The oral appliance of claim 8, wherein the orthodontic trays comprise a series of first orthodontic trays and a series of second orthodontic trays, and wherein each of the orthodontic trays in the series comprises a different configuration in order to change the position of subject's teeth and/or the shape of the subject's jaw.
10. The oral appliance of claim 9, wherein the receptacles of the upper tray are shaped to receive all of the first orthodontic trays, and the receptacles of the lower tray are shaped to receive all of the second orthodontic trays.
11. The oral appliance of claims 1 or 2, wherein the anchors of the first tray are mechanically connected to the anchors of the second tray with connectors selected from the group consisting of orthodontic rubber bands, telescoping shims, and plastic connectors.
12. Use of the oral appliance of any of claims 1-14 to treat sleep apnea.
13. Use of the oral appliance of any of claims 1-14 to treat snoring.
This application claims the benefit of priority under 35 U.S.C. § 120 from U.S. Patent Application No. 62092761, filed on December 16, 2014 and titled ADJUSTABLE SLEEP APNEA ORAL APPLIANCE. The disclosure of the foregoing application is incorporated herein by reference in its entirety.
Sleep apnea is a disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes (typically lasting 20 to 40 seconds) and may occur 5 to 30 times or more an hour. Sleep apnea results from a partial-to-complete blockage of a subject's airway. Increased air speed through the airway causes an increase in dynamic pressure and a corresponding drop in static pressure. The decreased static pressure can in some instances draw back the lower jaw and tongue and thereby block the airway. This blockage can increase to the point of becoming complete, which at least temporarily interrupts breathing.
Subjects are generally at greater risk for sleep apnea if they are overweight or have conditions such as diabetes, hypertension, or chronic nasal congestion. There are a variety of factors, however, which can lead to sleep apnea. One factor is the presence of a narrow maxilla and/or mandible in a subject. Maxillary constriction may increase nasal resistance and alter the tongue posture, leading to narrowing of the retroglossal airway. Constriction of the maxilla and/or the mandible generally reduces intraoral air volume and tends to force the tongue back into the posterior airway space, leading to obstructive sleep apnea during sleep.
Orthodontics is a field of dentistry which focuses on the repositioning of a subject's teeth and jaws for aesthetic or other reasons, for example due to the
"overcrowding" of a subject's teeth. Orthodontic methods typically require a subject to make continuous use of a dental appliance for a period of time in order to achieve results. The use of such appliances precludes the concurrent use of currently available oral appliances for treating sleep apnea. There remains a need therefore for improved devices and methods for treating sleep apnea in users of orthodontic appliances who experience sleep apnea.
The present oral appliance comprises an upper tray and a lower tray which are respectively configured both to treat snoring and/or sleep apnea in a subject and to effect orthodontic treatment of the subject. In one embodiment, the upper tray comprises:
(d) a left side upper bite pad connected at an upper end to the lower surface of the left side of the upper tray, wherein the bite pad comprises a lower surface, an anterior surface, a posterior surface, a right side, and a left side, the bite pad extending anteriorly from a posterior portion of the left side of the upper tray, wherein the lower surface of the bite pad is lower than the lower, coronal surface of an anterior portion of the left side upper tray; (e) a left side insert comprising an upper surface, a lower surface, an anterior surface, a posterior surface, a right side, and a left side, wherein the upper surface faces and/or contacts the lower surface of the left side of the upper tray anteriorly with respect to the left side upper bite pad, and wherein the posterior surface is configured to be reversibly attached to the anterior surface of the left side upper bite pad; and
(f) a buccally facing anterior right side anchor on the outer buccal surface of the anterior portion of the right side of the upper tray, and a buccally facing anterior left side anchor on the outer buccal surface of the anterior portion of the left side of the upper tray.
In this embodiment, the lower tray comprises:
With the foregoing arrangement, the anterior surface of the right side insert forms an engagement surface which contacts the posterior surface of the right side lower bite pad, and the anterior surface of the left side insert forms an engagement surface which contacts the posterior surface of the left side lower bite pad. This limits the forward positioning of the upper tray with respect to the lower tray, thereby alleviating snoring and/or apnea when the oral appliance is used by a subject.
Another unique feature of the present appliance is that it allows orthodontic treatment of a subject while simultaneously treating snoring and/or apnea. In one embodiment, the receptacles of the upper tray and the lower tray are each configured to receive and retain orthodontic trays, preferably a series of orthodontic trays. In another embodiment, the receptacles of the upper tray and the lower tray are each configured to reposition one or more teeth of a subject and/or to change the configuration of a subject's mandible and/or maxilla when the appliance is worn by the subject.
In an alternative embodiment, the positions of the upper and lower bit pads can be reversed, so that the lower bite pad is positioned in a posterior portion of the lower tray, and the insert can be attached to the anterior end of the lower bite pad. In this case, the upper bite pad is positioned anteriorly, and the anterior surface of the insert engages the posterior surface of the upper bite pad.
Figure 1 is a left side, top perspective view of an embodiment of the present oral appliance, including elastic bands.
Figure 2 is a top plan view of the upper portion of the appliance of Figure 1.
Figure 3 is a left side, bottom perspective view of the upper portion of the appliance of Figure 1.
Figure 4 is a left side, bottom perspective view of the upper portion of the appliance in another embodiment.
Figure 5 is a top plan view of the lower portion of the appliance of Figure 1. Figure 6 is right side, top perspective view of the lower portion of the appliance of Figure 1.
Figure 7 is a left side, top perspective view of an embodiment of the oral appliance of Figure 1.
Figure 8 is a left side, top perspective view of another embodiment of the present oral appliance.
Figure 9 is a left side, top perspective view of the embodiment of Figure 8, including elastic bands.
Figure 10 is a front, top and front, bottom perspective view of an insert used with the present oral appliance.
Figure 11 is a front, top perspective view of three inserts used with the present oral appliance.
Figure 12 is a top plan view of the inserts of Figure 11.
Figure 13 is a left side, bottom perspective view of the upper portion of the appliance of Figure 1, showing the placement of an insert.
Figure 14 is an exploded, top left side perspective view of an alternative embodiment of the present appliance for use with dental trays.
As used herein, the following terms and variations thereof have the meanings given below, unless a different meaning is clearly intended by the context in which such term is used.
"Anchor" refers to a component of the present appliance which is secured to a portion of the appliance and assists in connecting that portion to another portion of the appliance.
"Anterior" means in the direction of or toward or adjacent the front portion (opening) of a subject's mouth. "Apnea" and "sleep apnea" refer to a temporary cessation of breathing and/or to instances of shallow or infrequent breathing during sleep, generally caused by a blockage of a subject's airway (referred to as obstructive sleep apnea).
"Buccal" means in the direction of or toward a subject's cheek. In relation to a subject's teeth, this refers to the side of the teeth facing the cheek.
"Coronal plane" refers to a hypothetical planar surface that extends through the body from the head to the feet, and divides the body into front and rear halves.
"Coronal" refers to a position or direction which is on or toward the distal end of a tooth (i.e., where the biting surface is located). A coronal surface is thus the biting surface of a tooth, which in posterior teeth is generally referred to as an occlusal surface and on anterior teeth is called an incisal surface. "Coronal surface" may also refer to the corresponding surface of a dental tray which contacts the other dental tray when the present device is worn by a user, i.e. to a lower surface of an upper dental tray or to an upper surface of a lower dental tray.
"Dental tray" refers to a structure comprising a receptacle for receiving the teeth of a subject. In some embodiments, the receptacle has an opening for receiving teeth and an interior surface which contacts the subject's teeth directly. In other embodiments, the receptacle receives an orthodontic tray.
"Downward" and "downwardly" mean in the direction of or toward a lower portion of a subject's body. "Upward" and "upwardly" mean in the opposite direction, i.e. in the direction of or toward an upper portion of a subject's body.
"Elongated" refers to a configuration or shape having a length which is longer than its width.
"Forward" means in a direction toward the anterior (front portion) of a subject's mouth.
"Horizontal," with respect to the present appliance, refers to disposition in a plane approximately perpendicular to the sagittal and/or the coronal plane of a subject, i.e. within 15 degrees of such a perpendicular plane.
"Labial" means in the direction of, toward, or adjacent to a subject's lips. In relation to a subject's teeth, this refers to the side of the front teeth facing the lips.
"Lateral" means away from the sagittal plane of a subject. "Left" means to the left of the center sagittal plane of a subject, from the perspective of the subject.
"Lingual" means in the direction of, toward, or adjacent to a subject's tongue. In relation to a subject's teeth, this refers to the side of the teeth facing the tongue.
"Lower" refers to the relative position of a component in the present appliance which is closer to or toward a lower portion of a subject's body when being used. For example, and upper tray in the present appliance is positioned above (higher than) a lower tray when the appliance is worn by a user, i.e. such that the upper tray is fitted over the maxillary dentition and the lower tray is fitted over the mandibular dentition.
"Mandibular" refers to the lower jaw.
"Mandibular dentition" refers to the teeth of the lower jaw.
"Maxillary" refers to the upper jaw.
"Maxillary dentition" refers to the teeth of the upper jaw.
"Mechanically connected" means physically connected, either through a connection based on direct physical contact or via another mechanical structure.
"Medial" means toward the center sagittal plane of a subject.
"Orthodontic" refers to a feature or an appliance which repositions the teeth and/or jaw(s) of a subject.
"Orthodontic tray" refers to a dental tray for receiving the upper or lower dentition of a subject. An interior surface of an orthodontic tray contacts the subject's teeth directly with sockets or depressions sized to receive a subject's teeth.
"Post" refers to a component which protrudes from a surface and functions as a point of attachment for another component, such as an elastic band.
"Posterior" and "rearward" means in the direction of or toward or adjacent the rear portion of a subject's mouth.
"Right" means to the right of the center sagittal plane of a subject, from the perspective of the subject.
"Sagittal plane" refers to an imaginary plane that travels vertically from the top to the bottom of the body of a subject, dividing it into left and right portions.
"Subject" refers to a user of the present appliance, usually a human user. "Thermoplastic" refers to a material, generally a polymer material, which may be softened by heat and hardened by cooling in a reversible physical process. The thermoplastic materials used in some components of the present appliance retain their shape at 100°F and preferably become soft (deformable) at a temperature of 212°F or below.
"Tray" and "dental tray," as used herein, refer to a generally U-shaped portion of the present appliance comprising an open area for receiving the maxillary or mandibular teeth of a subject, as the case may be.
"Upper" refers to the relative position of a component in the present appliance which is closer to or toward an upper portion of a subject's body when being used.
"Vertical," with respect to the present appliance, refers to disposition in a plane approximately parallel to the sagittal and/or the coronal plane of a subject, i.e. within 15 degrees of such a parallel plane. Preferably, vertical refers to a direction toward or away from a subject's head or feet.
The term "comprise" and variations of the term, such as "comprising" and "comprises," are not intended to exclude other additives, components, integers or steps. The terms "a," "an," and "the" and similar referents used herein are to be construed to cover both the singular and the plural unless their usage in context indicates otherwise. With regard to relative terms, such as left and right, the term is to be interpreted from the perspective of a user of the present appliance when the appliance is being worn by the user, if no other orientation is indicated.
Oral Appliance
The present appliance 10 generally comprises a pair of dental trays 15, an upper tray 100 and a lower tray 200, which cooperate to position a subject's jaws so as to avoid sleep apnea. The upper tray 100 is fitted onto a subject's maxillary dentition, while the lower tray 200 is fitted to the subject's mandibular dentition. The tray portions 15 of the present device have an interior surface 21, an exterior surface 23, a right side 12, a left side 14, an anterior portion 16, and a posterior portion 18, and each comprise a generally U-shaped tooth-receiving receptacle 20 formed on one horizontal side of the tray 15 to fit over a subject's dentition.
In one embodiment, the receptacle 20 is configured to receive the teeth of a subject and to contact the teeth on an interior surface 21 of the tray 15. The receptacle 20 comprises lateral contiguous walls extending from a bottom surface facing the coronal surfaces of a subject's teeth toward the maxilla or mandible, respectively, i.e. buccal wall 22 and labial wall 24, so as to cover some or all of the buccal and labial sides of some or all of a subject's teeth. The trays 15 can be formed to conform to a subject's pre-existing dentition, or in a preferred embodiment can be formed to accomplish a change in the existing dentition and/or in the shape of a subject's mandible and/or maxilla, as described further below.
The exterior portions of the trays 15 comprise a coronal surface 30 formed on the horizontal side of the tray opposite the receptacle 20, i.e. on the exterior surface 23 of the tray 15. Each tray 15 further comprises a pair of respective bite pads 35 located on each lateral side of the tray 15, either a lower bite pad 40 or upper bite pad 50, which may be formed integrally with a respective tray 15 or may be bonded thereto. In the illustrated embodiments, the bite pads 35 separate the upper and lower jaws, to help treat apnea, and in addition provide an opening 5 between the upper incisal surface 101 and lower incisal surface 201 of the upper tray 100 and the lower tray 200, respectively, to allow air flow through a subject's mouth. Maintaining a subject's mouth in a slightly open position by separating the upper and lower jaws in this way also helps to treat apnea. In other embodiments, however, the upper incisal surface 101 and lower incisal surface 201 can contact each other.
In the illustrated embodiments, each lower bite pad 40 comprises a projection that extends distally with respect to the coronal surface 30 of the lower tray 200, i.e. upwardly when worn by subject wearing the present appliance 10. The lower bite pad 40 is located in an anterior portion 16 of each side 12, 14 of the lower tray 200, anterior to a lower occlusal surface 30 of the tray 200 in the illustrated embodiments, but in other embodiments (in which the upper bite pad 50 is located anteriorly) the lower bite pad 40 could be located in a relatively posterior position. The lower bite pad 40 comprises a generally horizontal coronal surface 42 for contacting a corresponding occlusal surface 30 in an anterior portion of the upper tray 100. Lower bite pad 40 further comprises a rearward-facing engagement surface 44 in the posterior portion of the bite pad 40 extending downwardly from the coronal surface 42 to the occlusal surface 30 of the exterior surface 23 of the lower tray 200.
The upper tray 100 likewise comprises a pair of upper bite pads 50, each of which extends downwardly from the exterior surface 23 of the upper tray 100. The upper bite pad 50 comprises a generally horizontal coronal surface 52 for contacting a
corresponding occlusal surface 30 in a posterior portion of the lower tray 200, and a forward-facing connecting surface or connecting end 54 in the anterior portion of the upper bite pad 50. Each upper bite pad 50 comprises a projection that extends distally from the coronal surface 30 of the upper tray 100, i.e. downwardly when worn by subject wearing the present appliance 10, and includes a generally horizontal coronal surface 52 for contacting a corresponding occlusal surface in a posterior portion of the lower tray 200. The present appliance 10 is preferably configured such that when worn by a user, the coronal surface 52 of the upper bite pad 50 contacts the exterior, coronal surface 30 of the posterior portion of the lower tray 200 such that the coronal surface 42 of the lower bite pad 40 is simultaneously in contact with the coronal surface 30 of an anterior portion of the upper tray 100.
A unique feature of the present oral appliance 10 is the use of axial inserts 300. The inserts 300 are configured to attach to one of the trays 15 and to engage a bite pad 35 on the other tray 15 of the present appliance 10. In the illustrated embodiments, the inserts 300 are attached to the upper tray 100 and engage the lower bite pad 40 of the lower tray. The bite pads 35 and inserts 300 together cooperate to limit and define the relative anterior-posterior positions of the maxilla and mandible of a user of the present appliance 10. As shown best in Figures 10-12, each insert 300 comprises an engagement surface 302, a right lateral side 304, a left lateral side 306, and an attachment end 310 opposite the engagement surface 302. The insert 300 further comprises a coronal surface (lower surface when attached to an upper tray 100) 330 and a tray contact surface (upper surface) 332 opposite the coronal surface 330. When the attachment end 310 of the insert 300 engages the connecting end 54 of the upper tray, the tray contact surface of the insert 300 abuts the occlusal surface 30 of the upper tray 100 and the coronal surface 330 of the insert 300 faces outwardly (downwardly). The coronal surface 330 is preferably parallel to the coronal surface 52 of the upper bite pad 50, and more preferably is configured in the same plane.
The attachment end 310 and the connecting end 54 are preferably provided with mutually fitting locking elements in order to retain the insert 300 on the upper tray 100. In the illustrated embodiments, the attachment end 310 of the insert 300 engages with the connecting end 54 of the upper tray 100 in a tongue-and-groove fashion, such that a laterally flaring wedge 312 fits within a recess 56 formed in the connecting end 54. As will be apparent to one of skill in the art, the insert 300 could alternatively be provided with a groove and the connecting end 54 could be configured with a forwardly projecting "tongue," or a differently configured projection could be used, such as a rounded sphere adapted to fit in a corresponding rounded hole. Other configurations can also be used to mechanically attach the insert 300 to the upper tray 100. In one alternative, an insert 300 could be attached to the upper bite pad 100 with an expansion screw, thereby allowing the length of the insert 300 to be further adjusted, as desired. It will also be apparent to those of skill in the art that the insert 300 could alternatively be attached to the lower tray 200, such as to the lower bite pad 40. In the illustrated embodimentsnts, the sides 311, 313, and 315 of the wedge 312 preferably form an interference fit with the groove or recess 56 in order to securely retain the insert in the present appliance 10. In a preferred embodiment, the insert 300 and/or the upper bite pad 50 are formed from an elastomeric material, and the tongue of the attachment end 310 is formed with slightly larger dimensions than the recess 56, so that when the tongue is urged into the recess 56, it exerts an outward force that helps to retain it within the recess 56.
Once attached to the upper tray 100, the forward-facing engagement surface 302 of the insert 300 is positioned to contact the rearward-facing engagement surface 44 of the lower bite pad 40 when the present appliance 10 is worn by a user. As shown for example in Figure 1, the insert's engagement surface 302 contacts the lower bite pad's engagement surface 44 so as to limit the rearward movement of the user's mandible with respect to the maxilla, and thereby assist in alleviating sleep apnea.
The insert engagement surface (anterior surface) 302 and lower bite pad engagement surface (posterior surface) 44 are preferably angled, opposed surfaces that interact to serve as advancement engagement surfaces for the mandible. Both the posterior face (engagement surface) 44 of the lower bite pad 40 and the anterior face (engagement surface) 302 of the insert may be angled, as shown in the illustrated embodiments, to assist in advancing the mandible as the trays 15 vertically close, employing a camming action. The engagement surface 44 is preferably disposed at a non-vertical angle with an upward and forward slant. The engagement surface 44 may employ an irregular, non-flat, arcuate, concave or convex surface or surface features that nonetheless allow the described sliding engagement. A vertical interface between the insert engagement surface 302 and lower bite pad engagement surface 44 is also possible.
In order to be able to adjust the relative position of a user's maxilla and mandible when the present appliance 10 is worn, inserts 300 of different lengths can be used. As shown in Figure 8, the inserts 300 can be formed with lateral sides 304, 306 of different lengths, such that the engagement surfaces 302 of different inserts extend further forward or rearward, depending on the need of the user. In Figures 11 and 12, the inserts labeled 321, 322, and 323 comprise lateral sides 304, 306 of increasing length. As a result, a user's mandible can be positioned relatively anteriorly through the use of longer inserts, i.e. with longer lateral sides 304, 306, or can be positioned relatively posteriorly through the use of inserts with shorter sides. A set of inserts can be provided for use with the present appliance 10 having lateral sides that differ in increments of 1 mm, increments of 0.5 mm, or increments of 0.25 mm, for example. For this reason, attachment of the inserts 300 to the upper tray 100 via a mechanical connection is preferred, so that the attachment is reversible, and can be changed as needed. However, other means of engagement, such as through chemical means (e.g., glue) are also possible.
The upper and lower appliance trays 100, 200 are mechanically connected via anchors 60 in order to maintain the upper tray 100 in a predetermined position with respect to the lower tray 200. In particular, the anchor 162 of the left side portion of the upper tray 100 is mechanically connected to the anchor 262 of the left side portion of the lower tray 200, and the anchor 162 of the right side portion of the upper tray 100 is mechanically connected to the anchor 262 of the right side portion of the lower tray 200. The anchors can be, for example, a button 62, a hook 64, or a Herbst screw, and can be mechanically connected by appropriate connectors, such as orthodontic rubber bands, telescoping shims, and/or plastic connectors.
As shown in the illustrated embodiments, once the trays 100, 200 have been fitted for a particular subject, elastic bands 400 are placed on buccal buttons 62 as shown in Figures 1 and 9. The buccal buttons 62 are posts or projections which extend buccally from the outer surfaces 23 of the upper tray 100 and lower tray 200, respectively. As seen in Figure 5, they comprise a laterally extending portion 152 to which an elastic band 400 can be secured and a circumferential "button" portion 154 extending away from the axis of the laterally extending portion 152 at the distal end of the buccal button 62, in order to better secure an elastic band 400 on the buccal button 62.
In the illustrated embodiments, an anterior-posterior (diagonal) elastic band 420 extends from the anterior of the upper tray 100 to the posterior of the lower tray 200, between an upper anterior anchor 162 and a lower, relatively posterior anchor 264. The force exerted by this elastic urges the mandible forward in relation to the maxilla. A second, vertically extending elastic 440 extends between the upper anterior anchor 162 and a lower anterior anchor 262, generally between the first bicuspid region on both trays 50 and generally in vertical alignment. The vertically extending elastic 440 provides a "closed-mouth" posture during sleep. This combination of elastic bands gently holds the mandible in the position determined by the present appliance 10 and also encourages nasal breathing by preventing the mandible from opening and dropping back.
The present appliances 10 can be formed from a variety of orally compatible materials, typically polymers. In one embodiment, acrylic is used to form the present appliance. Thermoplastic polymers are typically used in the present appliance, but thermosets, thermoplastic elastomers, and other materials can also be used. The thermoplastic materials that are used must be capable of retaining their shape when used by a subject, and thus preferably remain solid at least at about 100°F, and preferably remain solid at somewhat higher temperatures, such as at 110°F, 120°F, or higher. When thermoplastic materials are used to form the present trays, they preferably become deformable at a temperature of 212°F or less, so that they can be made plastic by being placed in boiling water. Preferably, the material is not deformable at less than 120°F, preferably at not less than 145°F. Orthodontic Trays
In one embodiment, the trays 15 can be formed as a series of orthodontic dental trays for use by a subject. In this embodiment, trays 15 having differently-configured receptacle portions 20 are applied to the subject over time in order to reposition individual teeth in successive steps and/or to change the configuration of a subject's mandible and/or maxilla. The successive use of a number of such dental trays 15 permits each appliance to be configured to move individual teeth in small increments, typically less than 2 mm, preferably less than 1 mm, and more preferably less than 0.5 mm
(referring to the maximum linear translation of any point on a tooth as a result of using a single appliance). The use of the inserts 300 of the present appliance 10 provides a great advantage when orthodontic trays are used in the present invention, because an optimum relative position of the mandible and maxilla of a user can be provided using an insert having a desired length, thereby addressing a user's sleep apnea while allowing orthodonture.
The tooth-receiving receptacle portions 20 of the dental trays 15 typically have a geometry corresponding to an intermediate or end tooth arrangement intended for a subject. When such a tray 15 is first worn by the subject, certain of the teeth will be misaligned relative to an undeformed geometry of the receptacle portion 20 of a tray 15. In this embodiment, the tray 15 is formed from a material that is sufficiently resilient to accommodate or conform to the misaligned teeth, but will apply sufficient resilient force against such misaligned teeth to reposition the teeth to the intermediate or end arrangement desired for that treatment step. The appliance will preferably, but not necessarily, fit over all teeth present in the upper or lower jaw. In some cases only certain teeth will be repositioned while will provide a base or anchor region for holding the repositioning appliance in place as it applies the resilient repositioning force against the tooth or teeth to be repositioned
A subject's teeth are repositioned from an initial tooth arrangement to a final tooth arrangement by placing a series of incremental position adjustment appliances in the subject's mouth. The first tray appliance of the series will have a geometry selected to reposition the teeth from the initial tooth arrangement to a first intermediate arrangement. After the first intermediate arrangement is approached or achieved, one or more additional (intermediate) appliances will be successively placed on the teeth, where such additional appliances have geometries selected to progressively reposition teeth from the first intermediate arrangement through successive intermediate arrangement(s). The treatment will be finished by placing a final appliance in the subject's mouth, where the final appliance has a geometry selected to progressively reposition teeth from the last intermediate arrangement to the final tooth arrangement.
In order to design a series of dental trays 15 that will reposition a particular subject's teeth, a digital data set representing an initial tooth arrangement and a final tooth arrangement can be determined. The initial data set representing the initial tooth arrangement, which can be presented as a visual image, is manipulated to reposition individual teeth. A final digital data set is then produced which represents the final tooth arrangement with repositioned teeth. The initial digital data set may be provided by conventional techniques, including digitizing X-ray images, images produced by computer-aided tomography (CAT scans), images produced by magnetic resonance imaging (MRI), and/or by other methods known to the art for producing three- dimensional digital representations of a subject's teeth. Alternatively, the initial digital data set may be provided by producing a plaster cast of the subject's teeth (prior to treatment) by conventional techniques, for example, and the plaster cast can then be scanned using laser or other scanning equipment to produce a high resolution digital representation of the plaster cast of the subject's teeth.
Once the initial and final data sets have been determined, a series of intermediate data sets, representing intermediate tooth positions for a subject's teeth, are determined. The successive intermediate digital data sets are preferably produced by determining positional differences between selected individual teeth in the initial data set and in the final data set and interpolating the differences. Such interpolation may be performed over at least three discrete stages, embodied in three different dental trays, more often at least ten, sometimes at least twenty-five, and occasionally forty or more. The interpolation can be a linear interpolation for some or all of the positional difference, or alternatively may be nonlinear. The positional differences will correspond to tooth movements where the maximum linear movement of any point on a tooth is preferably 2 mm or less, usually 1 mm or less, and preferably 0.5 mm or less.
Once the intermediate and final data sets have been determined, the appliances can be fabricated, such as with a rapid prototyping device or digital printer. Preferably, the appliance is polymeric and is formed from a thin sheet of a suitable elastomeric polymeric, such as Tru-Tain 0.03 in. thermal forming dental material (Tru-Tain Plastics, Rochester, Minn. 55902). One structure corresponding to each of the dental tray appliances is produced.
The foregoing dental tray appliances and their use in orthodontic treatment are described in US Patent No. 5975893 and in other patents assigned to Align Technology, Inc., including US Patent Nos. 621562, 6217325, 6398548, 6626666, 6629840, 6699037, 7134874, 7474307, 8105080, and 8562340.
In embodiments in which tooth or jaw repositioning is not needed or desired, such as following a successful orthodontic treatment, the upper and lower dental trays 15 can be formed in ways known to the art. For example, when the present appliance is formed from a thermoplastic polymer, the upper dental tray 100 and lower dental tray 200 can be first evaluated for their fit with a subject's mouth, after which the trays can be softened, preferably by placing the appliance in near-boiling water for between several seconds and one minute. The softened appliance is then placed in the subject's mouth in alignment with the subject's upper and lower teeth, and the subject is instructed to bite into the softened material to make an impression of the teeth in the softened material. The tray material is then allowed to cool in the mouth for approximately one minute, after which the appliance is preferably soaked in cold water for an additional minute. Creating a customized dental impression in the trays of the present appliance in other ways and using other materials can be accomplished by one of skill in the art using known methods.
In another embodiment, shown in Figure 14, the present trays 15 can be designed to be used in combination with a set of separately formed orthodontic trays 400, typically formed from a polymer material. As shown in Figure 14, each of such orthodontic trays 400 usually comprises an upper orthodontic tray 402, a lower orthodontic tray 404, an inner surface 403 for contacting at least some of a subject's teeth, an outer surface 405, an anterior portion 416, a posterior portion 418, a right side 412, and a left side 414. In this embodiment, the receptacle 20 of the present appliance 10 is sized to receive and reversibly retain an orthodontic tray 400, generally by contacting an outer surface 405 of an orthodontic tray 400. In this way, a subject can use the orthodontic trays 400 during the day and then continue using them at night in combination with the present appliance 10 in order to obtain relief from sleep apnea.
Although the present invention has been described in considerable detail with reference to certain preferred embodiments, other embodiments are possible. The steps disclosed for the present methods, for example, are not intended to be limiting nor are they intended to indicate that each step is necessarily essential to the method, but instead are exemplary steps only. Therefore, the scope of the appended claims should not be limited to the description of preferred embodiments contained in this disclosure.
Recitation of value ranges herein is merely intended to serve as a shorthand method for referring individually to each separate value falling within the range. Unless otherwise indicated herein, each individual value is incorporated into the specification as if it were individually recited herein. All references cited herein are incorporated by reference in their entirety.
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In Hong Kong, one in four children in our city lives in poverty, with one in three children going without three meals a day. In 2015, there were almost 4,000 children living without families in Hong Kong.
These children live in the residential care system in Hong Kong, in institutions, foster care, and small group homes. At least 400-600 more children are on a waitlist at any one time, waiting an average of 31 months trying to get into the residential care system, while still living in unsafe environments or in hospital.
90% of the children living in residential care have a formalized plan to be reunited with their parents. However, in reality, children spend an average of 42 months in care, and half of them will age out of the system at age 18 without a family to call their own. Children who grow up in residential care are more likely to struggle with antisocial behaviour, engage in harmful activities and if they are a girl, they are more likely to face a teenage crisis pregnancy.
This leaves many children "stuck" in the system, without a safe, loving, and permanent family.
At Mother's Choice, we are a champion for children and a voice for them to be in a family. Our goal is to see every child in a safe, loving, and permanent family, and we work hard to ensure that every child can either be reunited with their birth family, or join an adoptive family as soon as possible.
Can you help us care for a child without a family?
Referrals should be made by a registered social worker.
For enquiries, please call us at 2313 5648.
Our Child Care Home changes the life stories of children without families. We have space for up to 32 typically developing babies (Baby Care) and 12 children with special needs (Wee Care). Our early intervention care helps children flourish and reach their full potential now and in the years to come. Each year, we serve over 100 children at our Child Care Home.
Our Foster Care Services provides loving and safe foster families to care for children who do not have a safe home to live in. Through Project Bridge, we connect nurturing volunteer families to children in need of temporary care while they wait to join their permanent family. We empower our foster parents to create an enriching environment for children through regular training, workshops, and peer support.
We support those who care for the children in our care. This includes our staff, our team of over 450 volunteers, and our foster families. We make sure that every child is able to receive individual, loving care from trusted adults.
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Our hope is that no child in Hong Kong waits for a family. We are working towards a day when no child needs to spend time in an institution, not even Mother's Choice.


Actor and comedian Hannibal Burress has confirmed his role in Spider-Man: Homecoming, saying he plays a gym teacher who doesn't realize that Peter Parker is Spider-Man.
Though Burress did not refer to his character by name, a purported leaked callsheet from the set of the movie lists him as "Coach Wilson." This may lend credence to the other characters listed on the sheet, including Bokeem Woodbine as Shocker.
Spider-Man: Homecoming is due out in theater July 5, 2017.
Has a Leaked SPIDER-MAN: HOMECOMING Cast List Revealed SHOCKER, BETTY BRANT, Others?