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Opioid crisis: Childhood friends die on same day, half a mile apart
Posted 10:37 AM, October 31, 2017, by Tribune Media Wire
LAWRENCEVILLE, Ga. — Twenty seconds is all it took to kill 19-year-old Dustin Manning.
His devastated parents, Greg and Lisa Manning, said the toxicology report found he had taken a toxic mix of heroin and fentanyl, a synthetic opioid so powerful it's often fatal.
"The amount of fentanyl in his body was the equivalent to three grains of salt. That's all it took to kill a 180-pound guy," said Greg Manning.
Dustin died on Friday, May 26, in Lawrenceville, a suburb on the outskirts of Atlanta.
At 6:09 a.m., paramedics were called to a home with reports of an unresponsive teenager. Dustin was dead.
"I had told him I'd get him up early for work, and I came up around 5:45 to wake him up, and when I opened the door, he looked like he was tying his shoes. Very quickly I realized, grabbed him and he was cold," said Greg Manning.
Lisa Manning was at the gym when she got the call from her husband. "He said, 'Oh my God, oh my God, call 911.' I didn't ask any questions. I knew."
Less than an hour later, at 6:53 a.m., another phone call was placed to 911.
Half a mile down the road, 18-year-old Joseph Abraham was found slumped on the floor by his parents, Dave and Kathi Abraham. He had no pulse.
"I started yelling and yelling and yelling, 'Joe, Joe — wake up, man!' And then I realized there was something really wrong," said Dave Abraham.
"As soon as I saw him, I knew and I just ran and I just started holding him and I could tell he was cold," said Kathi Abraham.
"Dave was on the phone to 911 and I said, 'It's too late. We can't fix this,'" she added, as tears welled in her eyes.
Dustin Manning and Joseph Abraham were childhood friends. They played on the same Little League team. For two years, Joseph's father coached them.
But in middle school, both began to dabble in drugs.
The Abrahams believe their son had his first dose of opioids when he had his wisdom teeth removed. He was prescribed the drugs again when he broke his ankle — and later, his hand — playing sports.
"When you're given a prescription from a doctor, we often just trust that," Kathi Abraham said.
She believes Joseph turned to drugs after dealing with two major tragedies at a young age.
"He lost two of his really good friends in eighth grade — one to cancer and one to a drowning. He really had a hard time. He struggled with that," she said.
At the age of 12, Dustin told his parents he felt like he was suffering depression. He soon started drinking beer and taking drugs.
"He told us the drugs are what gave him 'the out' and made him feel good," Lisa Manning said.
Both parents sought help from treatment centers, not once, but time and time again. Lisa Manning even began working at one of the centers to keep an eye on her son and better understand addiction.
But Dave Abraham says the treatments weren't enough to fight his son's battle.
"Once they take (opioids), there's a switch in their brain that gets flipped on — and to get that switched flipped back could take up to five years, and most treatments are 35 days and they're back out," he said.
According to both sets of parents, Dustin and Joe hadn't been in touch in recent years, yet it appears they may have bought the drug that killed them from the same dealer. According to police records, some of the pill wrappings were almost identical.
There were fears in the community that other kids may have bought the same drugs.
Lost potential
As the parents started to gain insight into the world of opioid addiction, they realized that getting the drug is fast and easy.
Like most parents, they had high hopes for their beloved sons and their great potential.
Walking through her son's bedroom, Lisa Manning pointed at a US flag on the wall. "This flag was a symbolic thing for him. He always wanted to go in the service. He always wanted to be a Marine. He would have made a great Marine," she said, breathing a deep sigh.
"Joe was a sensitive young man, he was funny, he had a big heart", Kathi Abraham recalled. "He loved to fish, he loved to be outside and hike. He could have done anything he wanted. He was very smart, in advanced classes."
Dave Abraham added: "He could watch a video on YouTube and go and play it on the piano. … Most dads teach their kids how to fish. Joe taught me how to fish."
Community in shock
Hopes for their children's futures were dashed in an instant.
"This happened within 18 houses of each other to two young men on the same morning. The community was in total shock," said Kathi Abraham.
The parents now attend a support group for people who have lost children to opioids. And in a sign of the times, the support group grows in size each month.
Last year, about 64,000 Americans died from opioids, according to the first government account of nationwide drug deaths. That is more than the number of Americans killed in car accidents or by guns, combined.
Fentanyl, which is 50 to 100 times more powerful than morphine, was devised to treat chronic pain. A tiny amount can be fatal.
The number of people killed by fentanyl has risen from 3,000 to more than 20,000 in just three years — a 540% increase.
President Trump has declared opioid addiction a public health emergency, which officials say will allow the federal government to waive some regulations and give states more flexibility in how they use federal funds. It does not provide any additional funding to deal with the crisis.
Like many critics, the Manning and Abraham families say it doesn't go far enough.
"This is a just a step, a small step," said Greg Manning.
"The problem with treatment right now is there is a very low percentage of success. The longer they stay in treatment, that success rate goes up," said Dave Abraham.
They also want tougher punishment for dealers.
"These drugs are killing people and there's a lot of drug dealers around," Kathi Abraham said.
"To me it's poison or murder — anyone who sells fentanyl should have a life sentence," her husband added.
These parents believe prevention is key and education needs to start as early as fifth grade.
They have started spreading awareness in their community in the hope it will save another family from suffering the loss of a child.
As they tried to hold back tears, Lisa Manning and Kathi Abraham conceded their lives are forever changed.
"You change. You're never going be the same. I'll never be the person I was. It's like a knife deep in your heart," said Lisa Manning.
"We wanted to have two children because we wanted them to have each other," said Kathi Abraham as she cried. "Now (our son) Matthew is an only child."
Topics: death, opioid crisis, opioid epidemic, opioids
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Five years are passed since their historical drum & Bass/dubstep Essential debuts, five years in which Nero has grown step after step gaining a well-deserved place in the Olympus of the music world as one of the most intriguing and qualitative electronic duo of our days.
Now, with the release of their second studio album 'Between II Worlds' right in these days, the wise Pete Tong didn't miss the opportunity recalling them behind the BBC's decks for another two-hour show spectacular journey across several decades of music history.
The trip starts with some old-style pills from legendary names like Underworld, Jon Hopkins, Kraftwerk, Depeche Mode, Radiohead and continues as a return to present, passing through some cornerstones such Daft Punk and Chemical Brothers, till some extracts from their brand new aforementioned album as the conclusion.
It seems pointless to reiterate that the listen of this Essential Mix is strongly encouraged, then, you can enjoy it on the BBC's website for the next twenty days on right below whenever you want.


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Articles| Are you your job and nothing more?
Comments Off on Are you your job and nothing more?
What do you do? I'm a mechanic; I'm a horticulturalist. It's the first question we ask others, and the way we define ourselves. What's your job?
A group of kindergarten students were asked to write down who they were. "I am a…" was the sentence to complete. At just five years of age, over half of the students saw themselves as a job – a policeman, a pilot, a hairdresser, a bus driver. Two children saw themselves as an animal – a snake and a dog. One was a speed camera (yes, you read that correctly). Only a few children replied that they were simply themselves: "I am a little girl", "I am Luca", "I am Ethan".
Are we our jobs? Is our identity in life tied to how we support the human colony, whether we add up numbers, pile bricks, dig holes or fly planes? And if we aren't our jobs, then who are we?
British-born Samuel Smiles was one of the first self-help gurus back in the mid-1800s. Smiles, a government reformer, used self help – and in particular the "rags to riches" narrative – for the purposes of rallying the working and middle class in support of industry. Smiles' 1859 book self-Help was stuffed with examples of poor people from humble origins who were propelled to success through hard work, diligence and a commitment to the work ethic.
Smiles' advice was clear for those seeking a clear path up the social order: rise early, keep your head down, and work, work, work. Self-Help sold over a quarter of a million copies.
Professor of history Peter Stearns reflects on the sheer volume of newspaper columns, books, magazines and pamphlets dedicated to the virtue of hard work from the 1800s onwards. Example after example appeared of go-getters whose successful lives were shaped by work; like Robert Douglass, who started a business in candy making and was widely known for his 'efficiency'.
Self-help reformer Smiles referred to workers as noble soldiers, whose work – on the factory floor or wherever they ended up – contributed to the well-being and progress of a nation in equal measure to the great men of history. "National progress is the sum of individual industry, energy, and uprightness, as national decay is of individual idleness, selfishness, and vice." Industry is righteous, idleness is evil and selfish. A new reverence of industry and work was born.
The views of Smiles and other publicists in the early days of the industrial revolution (a time when workers were very much needed in factories) contrasted markedly to philosophers in classical Greece and Rome who advised avoiding 'work' at all costs. For Greek philosophers idleness was a virtue, not work. The aim of life was to employ leisure time for self-development activities such as learning, the arts and political activity. In fact, the Greek word for leisure, skholē, is the root for the English word for 'school'. Leisure time was time to discuss, time to study.
Although the English-speaking world has rallied behind the industry line that hard work can propel one up the social ladder, Europeans are less convinced. "By the late 19th century, and still today, Americans were far more likely than Europeans to exaggerate opportunities for upward mobility based on diligence and efficiency," writes Stearns. Many Europeans continue to believe that social barriers cannot be overcome by individual effort alone.
While it's true that longer hours at the factory, laboratory, office floor or studio don't grant you social power of any sort – such as influence on society's values, wars, infrastructure, schooling and so forth – it does offer a kind of pseudo-social power, or prestige, through the mass-produced items that you buy. More hours on the job means more stuff, and some of that stuff – like expensive cars, or inner-city pads – can make someone 'appear' more socially powerful even when they're not. And for most people in modern society, this seems to be a good enough trade-off.
It's called 'instrumentalism' when, rather than defining life, work becomes an instrument with which to achieve a better life. So work may no longer have a point, it may not develop you personally, it may not be useful, you may not even know exactly what you are doing, but that's not the point. Work is money and money can be spent on things.
And because of our fixation on a 'better life' – the antidote to the drudgery of work – leisure time really has to do it for us. More than ever before, we plunge into the escapism of movies, the challenge of marathons, the luxury and comfort of five-star hotels. We need fine wine, we need dinners out (at least two a week) – we need it all just to survive. Just to get through.
"If one asks these people who are today consuming liquor, travel vacations, and books whether they feel unhappy and bored, then they answer 'Not at all, we're completely happy.
We go on trips, we drink, we eat, we buy more and more for ourselves. You aren't bored doing that!'" said German psychologist and psychoanalyst Erich Fromm in his lecture Problems of surplus in 1970.
It's true that work is often unpleasant, dull, automated and uninspiring. But does work really have to 'do it' for us? Can't the ends justify the means?


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Science Review
Editorial structure
Shoreline habitats
Archived reports
Removal of creosote-treated pilings may assist herring recovery
Posted 07/11/2018 by Megan Feddern
Researchers are analyzing the harmful effects of creosote-treated wood pilings on Pacific herring and shellfish in Puget Sound. Studies show that piling removal projects can ease the impacts, but only if carefully done.
Creosote removal project in Puget Sound. Photo courtesy of the Washington State Department of Natural Resources.
Thousands of abandoned wood pilings — the ghosts of piers and docks past — are located throughout Puget Sound. Most of them are treated with creosote, a toxic chemical used to preserve wood that contains polycyclic aromatic hydrocarbons (PAHs), a class of chemicals that are also associated with oil spills and burning of fossil fuels.
While creosote-treated pilings are used less for construction of new piers, scientists at the Washington State Department of Ecology and the Washington Department of Fish and Wildlife are now studying the impacts of existing pilings on herring and shellfish populations along with the effectiveness of removal projects.
In 2017 about 8,500 old pilings in Port Gamble were removed along with tens of thousands of cubic yards of sediment. Prior to the cleanup, researchers at the state agencies conducted a herring embryo mortality study to understand the impacts of the cleanup on herring populations.
That study showed that prior to cleanup herring embryos were at highest risk of elevated PAH contamination in areas near mill sites with high piling density. Similar research found elevated PAH and PCB concentrations in bay mussels at the same locations. Preliminary work in 2018 has demonstrated a reduction of PAHs in shellfish since cleanup, and researchers are optimistic the cleanup will yield similar results for herring embryos now being analyzed.
While the Port Gamble cleanup has yielded promising results so far, not all cleanup projects are created equal. In Quilcene Bay, herring embryos were studied before piling removal, just after the removal project, and one year after removal. Embryos incubated before removal contained five times the amount of PAHs than those from control sites but did not exceed health effects thresholds. During removal, pilings were cut at the sea floor leaving debris and freshly exposed surfaces of the pilings. PAH concentrations during and after the removal were 25 to 85 times higher than reference embryos and many exceeded health effects thresholds.
Researchers say these studies demonstrate creosote-treated pilings have health effects for herring embryos, and piling removal projects have the potential for reducing PAH concentrations during this critical life stage. However, removal projects must adhere to strict protocols to ensure they do not increase contaminant loads rather than reduce them.
Megan Feddern is a graduate student at the University of Washington School of Aquatic and Fishery Sciences.
SSEC 2018
Salish Sea Currents
Story licensed under Creative Commons. You are free to copy and redistribute per CC BY-NC-ND 4.0.
Megan Feddern
Originally Published:
Posted in EoPS:
Topic Editor:
Tessa Francis, University of Washington Puget Sound Institute
Water quality, Nearshore habitat, Toxic contaminants, Fishes, Herring, Invertebrates, Forage fish
Pacific Herring (Clupea pallasii)
© 2012-2018. Encyclopedia of Puget Sound is published by the Puget Sound Institute at the UW Tacoma Center for Urban Waters.
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The majority of adults today will spend over 1/3 of their life at work. While the tasks of most jobholders may vary over the years, almost all of the work we do involves our upper limbs.
Whether your job involves practical work or simply sitting at a computer all day, you can be sure that your hands, wrists, fingers and arms are almost certainly engaged.
However, with jobs demanding so much from our hands and fingers, it's no wonder that these limbs can often become strained from overuse. Regular computer use is even one of the most common causes of RSI (repetitive strain injury), a type of musculoskeletal disorder that affects millions of workers worldwide each year.
Work-related musculoskeletal disorders are injuries that develop over a long period of time and primarily affect the muscles, joints & tendons. Muscle overuse and constant repetitive movements in the workplace are two of the largest causes of WMSD.
Common workplace activities, such as bending, reaching, twisting or pulling are not exactly harmful when carried out in everyday life. However, if these actions are repeated on a regular basis over time, it's enough to have a debilitating effect.
What's more, due to job constraints, these actions are almost always carried out with too much speed or exertion and not enough time is taken for recovery. These disorders can severely impact daily life and may cause pain during work and at rest. Other common causes of WMSD, such as poor work posture and RSI can also cause damage that may affect your ability to work.
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Typing and using a computer mouse are one of the biggest causes of RSI today. Both actions demand hundreds of small, repetitive moments from your hands and fingers that may cause irritation in the muscles and joints over time. If left untreated, this irritation can quickly develop into a painful repetitive strain injury. Common types of RSI, such as carpal tunnel syndrome, tendinitis and tennis elbow can have a serious impact on your muscles and may even affect your ability to work.
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In this way, using Powerball soothes and relieves pain in the muscle and joint, while simultaneously rehabilitating injury, such as a work-related RSI. Not only that, but Powerball effectively prevents long-term damage, cutting recovery times and preventing further injury in the process.
Some say that 'rest' is the only way to treat an RSI. While that may be true, not many people can afford to take weeks off work to recover. Spinning Powerball at slow speeds repairs damaged muscle tissue, while gently strengthening the surrounding muscle and joint. This combination of active rehabilitation and strengthening encourages a quick and reinforced healing process – meaning shorter recovery times and the ability to get back to work healthy and pain-free.
Keep your employees healthy & pain-free with our Powerball products. Powerball should be on the desk of every office worker and available to any staff member who undertakes tasks of a repetitive nature (manual labour, line work, machine work etc).
Repetitive strain injuries (RSI) affect millions of workers worldwide and there has recently been a rise in "no win, no fee" claims against employers for repetitive strain injuries that occurred at work. Regular computer use and repetitive work practices are the most common causes of RSI in the workplace and can interfere with your staff's ability to carry out their jobs.
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Lumina Foundation awards Indy Achieves $100,000 grant for postsecondary support
Posted on July 10th, 2019 in Organizational Updates, Press Releases Tags: grant, indy achieves, postsecondary
Indy Achieves lands grant to support students at Ivy Tech Community College and IUPUI
Indianapolis – July 10, 2019 – In the fall of 2018, Indy Achieves was awarded a $100,000 grant from Lumina Foundation to support the hiring of two Student Success Coaches, one who would be based at Ivy Tech Community College and another at IUPUI. These coaches will work closely with the students at each location in order to provide them with additional academic resources and tools to ensure a meaningful postsecondary experience and completion.
Indy Achieves will be utilizing this funding to mirror best practices of Lumina's adult promise work to improve education levels beyond high school and guiding career pathways for individual success. With the constant struggle of retention and on-time completion, schools are looking for new ways to improve the number of graduates while also giving them the skills to succeed after graduation as they enter the workforce.
"We're pleased to support Indy Achieves' efforts to guide students to success beyond high school as a key effort in increasing our nation's attainment rate," said Tim Robinson, assistant vice president of operations and grants administration at Lumina. "We hope that lessons learned here and from other Lumina-supported efforts for mentoring will provide a model for others across the country."
The two Student Success Coaches, Alina Zayas (embedded at IUPUI) and Caitlin Diehl (embedded at Ivy Tech), will be joining teams providing academic and career support at each campus as they oversee 200 Indy Achieves Promise Scholarship recipients. The Promise Scholarship provides additional needs-based funding in order to remove financial barriers to retention and graduation.
"The career connections that Indy Achieves and EmployIndy bring to the table are game-changers for our students and reinforce IUPUI's position as Indiana's premier urban public university," said Amy Conrad Warner, IUPUI Vice Chancellor for Community Engagement. "We are committed to providing educational opportunities that transform the lives of our students, our community, and the changing world around us."
In addition to providing financial assistance, the Student Success Coaches will be assisting students by navigating campus systems, identifying internal and external resources, and exploring career pathways. This will provide much needed support to those in the cohort to grow their skill sets, obtain a postsecondary credential, and prepare them for the workforce.
"Retention and on-time completion are top priorities at Ivy Tech Community College," said Kathy Lee, Chancellor of Ivy Tech Community College Indianapolis. "Adding the student success coaches will help take our support to the next level so our students are set up for great careers to meet the demands of our employer partners."
EmployIndy, the organization that houses Indy Achieves, will support programmatic growth by introducing students to different work-based learning opportunities, thus establishing and furthering employer connections. Indy Achieves aims to not only assist students in earning their credential on time, but to arm them with the skills needed to make them more marketable to employers post-graduation.
"EmployIndy and Indy Achieves are doing more than encouraging students to graduate," said Yecenia Tostado, Associate Director of Indy Achieves. "We are providing them the skills and connections to excel far beyond graduation. These individual experiences will have a direct impact on the Indianapolis community at large as each student discovers where the needs of employers and their talents overlap – ultimately leading to personal and professional success."
By providing academic supports such as playing the role as advisor and assisting with co-requisite remediation, the Student Success Coaches are working to remove barriers and more as they establish pathways for individual success, falling in line with EmployIndy's strategic goal of creating positive trajectories for young adults to achieve and maintain promising careers.
Learn more about Indy Achieves at indyachieves.org.
About Indy Achieves
Indy Achieves is an initiative created by Mayor Joe Hogsett that aims to ensure that every Indianapolis resident has the ability to pursue and complete a postsecondary credential or degree program. To accomplish this, Indy Achieves seeks to increase the number of individuals who apply for existing financial aid programs such as 21st Century Scholars and FAFSA as well as provide Indy Achieves Promise Scholarships and wraparound support services for Marion County students who attend Ivy Tech Indianapolis and IUPUI. Learn more about the Indy Achieves initiative at indyachieves.org.
About EmployIndy
EmployIndy guides the local workforce ecosystem and makes strategic investments to remove barriers to quality employment for underserved and underrepresented residents. As the workforce development board for Marion County, guided by 21 business, civic, education and nonprofit community leaders, EmployIndy invests $20 million in public, private and philanthropic funds for both youth and adults annually. Learn more about EmployIndy at employindy.org.
About Lumina Foundation
Lumina Foundation is an independent, private foundation in Indianapolis that is committed to making opportunities for learning beyond high school available to all. We envision a system that is easy to navigate, delivers fair results, and meets the nation's need for talent through a broad range of credentials. Our goal is to prepare people for informed citizenship and for success in a global economy.
EmployIndy Receives Multiple New Grants Entering its New Fiscal Year with a Bold Strategic Plan
Posted on July 27th, 2017 in Press Releases Tags: grant
INDIANAPOLIS, IN – EmployIndy, Marion County's regional workforce development board, has received a grant totaling $81,000 from the Nina Mason Pulliam Charitable Trust, coming just days after receiving $15,000 from UIndy's Center of Excellence in Leadership of Learning (CELL) and the Education Workforce Innovation Network (EWIN). These awards come at the turn of a new fiscal year in which EmployIndy is launching a strategic plan designed to amplify the impact of workforce development initiatives in the most needed areas of Marion County.
The Nina Mason Pulliam Charitable Trust grant represents one of 26 awarded to nonprofit organizations in Indiana during the first of two grant cycles this year. Funds will allow EmployIndy to create a new staff position whose role is coordination of training and development for workforce development service providers around Indy. This will provide more consistency across community organizations and help EmployIndy's service provider network to leverage best practices for quality service to residents.
"Community-, faith-, and neighborhood-based organizations often have limited capability to manage federally funded contracts, and this grant will help bridge our guidance with their expertise in the community," Marie Mackintosh, EmployIndy's COO said.
The CELL/EWIN Education-Workforce Planning Grant will directly support a partnership between EmployIndy, Indianapolis Public Schools, Ivy Tech, the University of Indianapolis, American Senior Living, United Home Healthcare and Trilogy Health Services. It will fund the creation of a Health Sciences Career Academy within Crispus Attucks Medical Magnet High School and Longfellow STEM and Medical Magnet Middle School, designed to ensure IPS students are prepared for an in-demand career pathway upon graduation.
These awards fit within EmployIndy's new strategic plan which places heavy emphasis on youth services and target impact areas in most need of workforce development support. "There are promising careers now and in the future for Indianapolis residents, and EmployIndy is part of a coordinated effort to ensure people in our city are skilled and prepared for these in-demand jobs," said Mackintosh.
EmployIndy will be publicly launching their five-year strategic plan on August 16th alongside Indianapolis Mayor Joe Hogsett and Indiana Department of Workforce Development Commissioner Steven Braun.
Contact: Joe Backe
Title: Communications Manager
Email/Phone: jbacke@nullemployindy.org; (317)713-7601
Nina Mason Pulliam Charitable Trust
Contact: Teri Walker
Title: Manager of Communications and External Relations
Email/Phone: twalker@nullnmpct.org; (480) 887-0083
EmployIndy drives growth in Indianapolis by investing in innovative jobs-to-careers strategies that ensure ALL residents have access to employment and training services to gain the skills needed to enter into jobs, and ultimately careers, that Marion County employers have available. As the workforce development board for Marion County, guided by 21 business, civic, education and non-profit community leaders, EmployIndy invests $20 million in public, private and
philanthropic funds for both youth and adults annually.
About the Nina Mason Pulliam Charitable Trust
The Nina Mason Pulliam Charitable Trust was established upon the death of Nina Mason Pulliam in 1997 to support the causes she loved in her home states of Arizona and Indiana. The Trust seeks to help people in need, protect animals and nature, and enrich community life in metropolitan Indianapolis and Phoenix. Since its inception the Trust has distributed more than $283 million. For more information visit www.ninapulliamtrust.org.
Honorees Recognize Successes at the October YES Indy Power Huddle Celebration
Organizational Updates


New to the 3d printing game, work as a draughtsman/estimator in a pre-cast company where we normally make everything from timber but recently tried some 4mm thick printed numbers and was really impressed at the results.
Looking forward to using this a bit more & getting some training on 3d programmes as I currently draw everything out using AutoCad.
Haven't bought my printer yet but looking at the Ultimaker 2.
tbh GR5 I have been using it for nearly 10 years now so pretty good at it, just thought a dedicated 3d programme would make things a bit quicker. Actually starting a revit course next month so maybe able to use that.
My latest pattern using Autocad.....took about an hour to draw.
If your good at AutoCAD then your learning curve for 3D programs shouldnt be too bad. I think all of us "older" ones started with AutoCAD.
You`ll read and here all sorts of advice about which 3D package is best, but the best one is usually the one that you put more time and effort into... just like your 10 years experience with AutoCAD.
I also newbie here, please help us, i just start using um2.
but in my first run wizard i got error about the z switch was broken.


Ideal for backpacking, but versatile enough for every sleeping situation, the WildyDown 35 bag is constructed with 600 fill duck down for supreme warmth. Compressing quickly, this bag comes in at just over two pounds, but packs in tones of features. Constructed with ripstop nylon for long lasting durability and a horizontal baffle system, you can rest assured this bag will defy your expectations as to what a sleeping bag can provide for less than $150.


Among her many passions, Liz is an avid reader. While working as a coordinator at Scott Arboretum in Swarthmore, Liz started a garden-inspired monthly book club.
Nature's Narratives is entering it's eighth year and continues to strengthen as each month passes. The club meets Wednesday evenings throughout the school year. Below is the book list for 2017-2018, come join us for interesting conversation!
If you'd like some great book recommendations, check the list of prior year's books below.


In this role you will help plan and implement the transfer of connectivity data and models onto our servers, will identify opportunities to improve and streamline the models, and will create data visualizations. The ideal candidate will be passionate about social media and global connectivity. You will have strong technical, data, and project management skill set, as well as a knowledge of data visualization. You will have a background in a related quantitative or technical field, have experience working with large data sets, be a great communicator and have experience in creating data-driven insights.
* Work closely with the team to understand our data models and to transform them into modular SQL/Python based models. Develop pipelines from numerous external sources which the models run on. Apply your expertise in data analysis and scripting to identify areas to improve the models both in terms of reliability and enhanced data sources.
* Create data visualizations that communicate key data insights to the team, programs, and to our broader cross-functional stakeholders.
* Collaborate with the program' s SMEs and data scientists.
* 5+ years of relevant experience in data science & analytics. Understanding of statistical analysis.
* Strong interpersonal skills. Ability to turn vague concepts and asks into well-documented and effective SQL models and data visualizations.
* Development experience particularly in Python, SQL, CLI with an expert working knowledge of SQL.
Education: BS/MS in Computer Science, Statistics, Engineering or a related technical field.


A reinforcement device for a biological valve includes an arrangement of supports configured to establish a double-trigone geometry in the valve and coupled to a base upon which the valve may be mounted. A plurality of commissural supports establish the geometry of a commissural trigone, and a plurality of intercommissural supports establish the geometry of an intercommissural trigone. A method for reinforcing a biological valve includes using commissural supports in conjunction with intercommissural supports, both sets of supports coupled to a base upon which the valve is mounted.
This application generally relates to biological valve reinforcement devices, and, more particularly, to unstented biological heart valve reinforcement devices.
Cardiac surgery often involves replacement of the patient's native valve with either a mechanical or biological (e.g., porcine, bovine, or homograft) valve.
A mechanical valvular prosthesis consists essentially of a mechanical valve device, such as a metal ball-and-cage or carbon bileaflet valve device, placed inside a ring covered by synthetic fabric. The ring facilitates incorporation of the device into the periphery of the orifice receiving the device. While mechanical prostheses have extremely long service lives, they present a significant clotting (thrombosis) risk and thus require the patient to undergo lifelong anticoagulation therapy. Furthermore, when mechanical valves do fail, the failure is likely to be catastrophic.
Biological valvular prostheses, on the other hand, comprise biological tissue taken from animals and treated by a suitable process so as to prepare them for implantation in the human body. Examples of biological valves include porcine aortic and mitral valves, porcine pulmonary valves, and aortic and mitral tissue valves that are reconstructed from a bovine pericardium. These valves have the advantage of a lower incidence of thrombosis, and thus minimize the need for prolonged anticoagulation therapy. Biological replacement valves further reduce the risk of catastrophic failure, as any problems that may occur tend to manifest symptomatically.
Biological valvular prostheses may either be stented or unstented. A stented valve comprises a biological tissue valve mounted on a metal or plastic frame (stent) which is covered by synthetic cloth. A stented design facilitates implantation of the biological prosthesis in that it requires only a single level of suture around its annular periphery. The tissue valve's position and configuration within the valve seat are maintained by the stent. An unstented biological valvular prosthesis, on the other hand, is not mounted on an external frame, but may be provided with synthetic cloth around the inflow opening. Implantation of unstented valves requires a more exacting surgical procedure than implantation of stented valves, due at least in part to the fact that unstented valves require more complex suturing in order to preserve the valve configuration once implanted. Furthermore, due to the geometry of the heart, unstented valves are generally restricted to use in the aortic position and are thus of limited application.
In accordance with one embodiment, a reinforcement device comprising a plurality of commissural supports, a plurality of intercommissural supports, and a base is described. Each commissural support is configured to stabilize a valve wall of a biological valve at a commissure of the biological valve. Each intercommissural support is configured to stabilize the valve wall at a location circumferentially between two of the commissures. The base is attached to the plurality of commissural supports and the plurality of intercommissural supports, and is configured to receive the biological valve mounted thereon at an inflow region of the biological valve. In one aspect of this embodiment, the commissural supports are configured to stand substantially within the valve wall. In the preceding aspect, the intercommissural supports may also be configured to stand substantially within the valve wall. In a further aspect, the commissural supports are configured to stand outside the valve wall. In the preceding aspect, the commissural supports may be configured to be sutured to the valve wall. In another aspect, the base is continuous around the valve wall in the inflow region of the biological valve. In another aspect, the commissural supports and intercommissural supports are discontinuous around the valve wall in an outflow region of the biological valve. In yet another aspect, the commissural supports and intercommissural supports are disposed at discrete locations of the valve wall in the outflow region of the biological valve. In another aspect, the commissural supports and the intercommissural supports comprise metal wire. The metal wire may comprise titanium. In another aspect, each of the commissural supports comprises first and second straight portions. The first and second straight portions may be spaced apart by a distance sufficient to avoid damaging a marking zone near the commissure when the commissural support is affixed to the valve wall. The first and second straight portions may be substantially parallel. Further, the first and second straight portions may be joined together by a curved portion. The curved portion may have a constant radius of curvature equal to half the distance between the first and second straight portions. The first and second straight portions may be configured to stand within the wall of the biological valve. The curved portion may be configured to stand at least partially outside the wall of the biological valve. In another aspect of the embodiment, each of the intercommissural supports comprises substantially parallel first and second straight portions. The first and second straight portions may be joined together by a curved portion. In yet another aspect, the plurality of commissural supports includes three commissural supports disposed generally symmetrically about the base. In a further aspect, the plurality of commissural supports includes three commissural supports disposed asymmetrically about the base. In the preceding aspect, the plurality of intercommissural supports may include three intercommissural supports, each one disposed between a pair of commissural supports. Each intercommissural support may be disposed approximately midway between each pair of commissural supports. In another aspect, the base comprises a ring and a cover. In the preceding aspect, the ring may be as thick or thicker than the valve wall. In another aspect, the base includes a first plurality of holes configured to closely receive the commissural supports and a second plurality of holes configured to closely receive the intercommissural supports. The first plurality may comprise five holes for each commissural support, for adjustable placement of the commissural supports with respect to the base. In a further aspect, the reinforcement device comprises a crimping wall configured to secure the commissural supports and intercommissural supports to the base when the crimping wall is pressed against the supports. In another aspect, the base comprises metal. The metal may comprise titanium. In these and other aspects, the biological valve may be an aortic or mitral valve.
In another embodiment, a reinforced prosthetic valve is described. This reinforced prosthetic valve comprises a biological valve mounted on a base, a plurality of commissural supports extending from the base, and a plurality of intercommissural supports extending from the base. The biological valve has leaflets attached to an external wall at commissures, and has an inflow and an outflow region. Each commissural support is configured to stabilize the external wall at one of the commissures. Each intercommissural support is configured to stabilize the external wall at a location circumferentially between two of the commissures. In one aspect of this embodiment, the commissural supports and intercommissural supports do not continuously surround the valve in the outflow region. In a further aspect, the commissural supports and the intercommissural supports are disposed substantially within the external wall. In another aspect, the commissural supports and the intercommissural supports are disposed outside the external wall. In the preceding aspect, the commissural supports and the intercommissural supports may be secured to the external wall with sutures.
In another embodiment, a method of reinforcing a biological valve is described. The biological valve has leaflets attached to an external wall at commissures. The method comprises securing a commissural support to the external wall at or near each commissure and coupling the commissural supports to a base. The method also comprises securing an intercommissural support to the external wall between each pair of commissural supports and coupling the intercommissural supports to a base. In one aspect of this embodiment the securing of the commissural supports to the external wall comprises inserting the commissural supports into the external wall in a generally longitudinal direction. In a further aspect, the securing of the commissural supports to the external wall comprises suturing the commissural supports to the external wall. In another aspect of the embodiment, the method further comprises the step of adjusting tension in the biological valve by adjusting the location of the commissural supports with respect to the base. In yet another aspect, the base is provided with a first plurality of holes configured to receive the commissural supports and a second plurality of holes configured to receive the intercommissural supports. The first plurality of holes may include five holes configured to allow adjustable placement of the commissural supports. The coupling of the commissural supports and intercommissural supports to the base may comprise crimping the commissural supports and intercommissural supports to the base.
In a further embodiment, a method of making a reinforced biological valve is described. A biological valve is provided which has a valve wall and a plurality of commissures. The biological valve comprises biological tissue that has been fixed in a physically unconstrained state. The method comprises securing a commissural support to the valve wall near each commissure and securing an intercommissural support to the valve wall between each pair of commissural supports. In one aspect of this embodiment, the method further comprises providing a base configured to couple with the commissural supports and intercommissural supports and adjusting tension in the biological valve by adjusting the location of the commissural supports with respect to the base. The biological valve may have an inflow region and an outflow region, and the commissural and intercommissural supports may be discontinuous around the valve in the outflow region. The commissural supports may be secured to the valve wall by inserting them, longitudinally, into the valve wall.
Yet another embodiment is a method of making a reinforced biological valve. The biological valve has a valve wall, a plurality of commissures, an inflow region, and an outflow region. The method comprises fixing biological tissue in a physically unconstrained state, forming a biological valve from the biological tissue, attaching a commissural support to the valve wall near each commissure, and attaching an intercommissural support to the valve wall between each pair of commissural supports. In one aspect of this embodiment, the commissural and intercommissural supports do not continuously surround the biological valve in the outflow region. The commissural supports may be attached to the valve wall by placing them substantially within the valve wall.
Still another embodiment is a method of replacing a malfunctioning valve in a subject. The method comprises removing the malfunctioning valve from the subject, providing a reinforced biological valve comprising a plurality of commissural supports and a plurality of intercommissural supports, and implanting the reinforced biological valve in the subject in place of the malfunctioning valve. Each commissural support is configured to stabilize a commissure of the biological valve and each intercommissural support is configured to stabilize a wall of the biological valve between each pair of commissural supports. The commissural supports and intercommissural supports are disposed at discrete locations about an outflow region of the biological valve.
FIG. 1 is a perspective representation of a reinforcement device according to an embodiment, placed within the walls of a biological tissue valve (valve leaflets not shown).
FIG. 2 is a perspective representation of the intramural reinforcement device of FIG. 1.
FIG. 3 is a perspective drawing of a reinforced biological valve according to a further embodiment and showing the direction of flow through the valve.
FIG. 4 is a bottom plan view of the reinforced biological valve of FIG. 3, showing the valve inflow and illustrating the commissural and intercommissural trigone geometries.
FIG. 5A is a perspective view of a ring portion of a base according to an embodiment.
FIG. 5B is a bottom plan view of the ring of FIG. 5A.
FIG. 5C is a cross-sectional view of the ring shown in FIG. 5A taken along line 5C-5C of FIG. 5B.
FIG. 5D is a cross-sectional view of the ring shown in FIG. 5A taken along line 5D-5D of FIG. 5B.
FIG. 6A is a perspective view of a cover portion of a base according to an embodiment.
FIG. 6B is a cross-sectional view of the cover of FIG. 6A taken along line 6B-6B of FIG. 6A.
FIG. 7 is a perspective representation of a reinforcement device according to an alternative embodiment (valve leaflets not shown).
The features, aspects and advantages of the present invention will now be described with reference to the drawings of several embodiments, which are intended to be within the scope of the invention herein disclosed. These and other embodiments will become readily apparent to those skilled in the art from the following detailed description of the embodiments having reference to the attached figures, the invention not being limited to any particular embodiment(s) disclosed.
As mentioned in the Background section, stented valves comprise an external frame (stent) on which a biological tissue valve is mounted. The stent continuously surrounds and supports the outflow region of the valve (the region beyond the leaflet plane, in the direction of flow) to hold the valve wall in an open configuration. While stented valves offer relative ease of implantation and configurational stability after implantation, stented designs also add bulk to a replacement valve device. Stented designs can result in a significant (on the order of 3-8 mm) reduction in the diameter of the ventricular outflow tract, thereby artificially increasing the pressure gradient in the valve. Stented designs can also decrease the effective orifice area (EOA) of a valve. Stented designs may thus offer relatively poor hemodynamics as compared with unstented designs.
Because unstented valves introduce little or no added bulk, the pressure gradient in the replacement valve more closely resembles the natural value. Unstented designs can also offer increased flexibility over stented designs. Unstented designs thus offer an advantage in terms of hemodynamics. Conventional unstented designs, however, are more difficult to orient during implantation and require more complex suturing in order to preserve the valve configuration after implantation. This undesirably leads to longer surgery times and adds both risk and expense to procedures. Furthermore, complex intra-operative suturing can alter the intended geometry of the valve.
Another disadvantage of conventional biological replacement valve designs is that, in order to establish the root geometry, they require some artificial external stress (axial, radial, and/or circumferential) to be placed on the valve leaflets during the crosslinking (fixation) process. This undesirably affects both the biomechanical properties of the leaflet tissue and the anatomical configuration of the leaflets with respect to each other, because the tissue is effectively fixed in a somewhat pre-stressed state. This diminishes the leaflets' ability to function normally and negatively impacts the valve's performance characteristics. Conventional methods also compensate for tissue shrinkage—which tends to occur during fixation—by starting (pre-fixation) with an oversized valve. Post-fixation, this results in extra tissue bulk, reducing the EOA of conventional reinforced valves.
Various embodiments of the invention advantageously provide a device for and method of supporting and stabilizing a biological heart valve without adding significant bulk or reducing the operative diameter of the valve. Embodiments thus allow for replacement of a native valve with an optimally-sized prosthesis. Embodiments of the invention additionally provide a reinforced prosthetic valve which may be prepared in advance of surgery and installed in a relatively quick and simple manner, without the need for complex suturing during implantation. Certain reinforced prosthetic valves are described in U.S. patent application Ser. No. 10/550,297 entitled "Intraparietal Aortic Valve Reinforcement Device and Reinforced Aortic Valve," and PCT Application No. PCT/IB2005/000573 entitled "A Reinforcing Intraparietal Device for a Biological Cardiac Prosthesis and a Reinforced Biological Cardiac Prosthesis," the disclosures of which are incorporated by reference herein in their entireties.
Additionally, the commissural and intercommissural supports used in these and other embodiments can provide points of reference for the surgeon, aiding the surgeon in marking the proper orientation of a prosthesis and facilitating its implantation. Thus, these and other embodiments combine the advantages of conventional stented and unstented valves, while reducing or eliminating their related disadvantages.
Embodiments also desirably allow for the reestablishment of the natural heart valve root configuration—which will be further described below as a "double-trigone" geometry—without the need for mechanical, hydrostatic, or other external stabilization means during crosslinking. Instead, the biological tissue may be fixed in a zero-stress environment, without affecting the morphology of the collagen or elastin of the tissue, thereby fixing the tissue in a natural, unstressed state. The root geometry may then be re-established (and manipulated if necessary) post-fixation, using supports placed close to or inside the valve walls at the commissures and in the intercommissural spaces. Stabilizing the valve wall at discrete locations, discontinuously about the outflow region, reinforces the root geometry while allowing some flexibility in the non-reinforced portions of the valve wall during operation of the valve.
Furthermore, as mentioned above, the fixation process may cause a certain amount of shrinkage in the biological tissue. Providing zero-stress fixation, according to embodiments of the invention, allows for optimal sizing of the valve tissue with a reinforcement device, because the slightly shrunken (fixed) tissue can be stretched back to approximately its original size post-fixation. This reduces or eliminates undesirable added tissue bulk, increasing the EOA of the valve as compared to conventional configurations. Providing zero-stress fixation also minimizes the introduction of undesirable artificial stresses on the valve leaflets during operation of the valve. Embodiments thus require less work to open the leaflets, minimizing energy loss across a reinforced valve.
With reference now to FIG. 1, an embodiment of a reinforced biological valve 50 is illustrated. The reinforced valve 50 includes a biological valve reinforcement device 10 having commissural supports 14(a)-14(c) and intercommissural supports 16(a)-16(c) disposed largely within an external wall 24 of a biological valve 20 (the valve leaflets are not shown in FIG. 1). Alternatively, the device 10 may include commissural and intercommissural supports disposed just outside the valve 20 and secured to the valve tissue, for example by suturing. As better illustrated in FIG. 3, the biological valve 20 includes three leaflets 22(a)-26(c) attached laterally to the external wall 24 at three commissures 26(a)-26(c). At the intersection of each of the commissures 26(a)-26(c) with the wall 24 is a "marking zone" having a complex fortified anatomy. The marking zone 36(c), corresponding to commissure 26(c), is illustrated in dashed lines. A native channel 30 into which the reinforced valve 50 may be implanted is also illustrated with dashed lines. The native channel 30 may, for example, be an aortic channel. The direction of flow through the valve 20 is indicated by arrows 32 (inflow) and 34 (outflow).
In the embodiment illustrated in FIG. 1, the device 10 generally includes a base 12 (upon which the biological valve 20 may be mounted), a plurality of commissural supports 14(a)-14(c) (shown largely in hidden lines), and a plurality of intercommissural supports 16(a)-16(c) (also shown largely in hidden lines). The commissural supports 14(a)-14(c) may be disposed generally at the commissures of the valve 20, and the intercommissural supports 16(a)-16(c) may be disposed in or near the valve wall 24. In some embodiments the intercommissural supports 16(a)-16(c) are positioned approximately midway between each pair of commissures. However, it will be appreciated that the intercommissural supports may be positioned anywhere consistent with their intended function. Both the commissural and intercommissural supports 14(a)-14(c) and 16(a)-16(c) may be coupled to the base 12.
With continued reference to FIG. 1, the base 12 may have an internal diameter which is substantially equivalent to an internal diameter of the biological valve 20. Thus, the inflow region of the valve 20 (the region before the leaflet plane, moving in the direction of flow) may be mounted directly on top of the base 12, as shown in the figure, with the inner wall of the valve 20 being essentially flush with the inner surface of the base 12. The base 12 may further have a thickness which may preferably be substantially equivalent to a thickness of the wall 24 of the biological valve 20. Accordingly, the base 12 may have an external diameter which may preferably be substantially equivalent to an external diameter of the wall 24 of the biological valve 20. The thickness of the base 12 may also be greater than or smaller than the thickness of the biological valve 20. With a smaller sized valve, for example, the base 12 may have a thickness slightly larger than the thickness of the valve wall.
As shown in FIG. 2, the base 12 may be provided with a plurality of holes 13. The holes 13 may be disposed on the top surface of the base 12 midway between the inner and outer walls of the base 12 (as shown in FIG. 2) or at the outer edge of the top surface of the base (see FIG. 7). The holes 13 may also be disposed at any other position consistent with their intended use. The holes 13 may be configured to receive the commissural and intercommissural supports 14(a)-14(c) and 16(a)-16(c) (which will be described in further detail below).
As better illustrated in FIGS. 5A-5B, one or more holes 13(a) may be provided for each commissural support 14(a)-14(c) to allow for adjustable placement of the commissural supports 14(a)-14(c) around the base 12. For example, if the supports 14(a)-14(c) have legs spaced 4 mm apart, five holes may be provided and spaced 2 mm apart so that a support may fit in the first and third holes, the second and fourth holes, or the third and fifth holes. The holes 13(a) or sets of holes 13(a) may be disposed somewhat asymmetrically around the base 12; for example, in some embodiments, they may be spaced approximately 120°, 105°, and 135° from each other. The holes 13(a) or sets of holes 13(a) may alternatively be disposed generally symmetrically around the base 12, depending upon the requirements of the particular application.
Additionally, one or more holes 13(b) may be provided for each intercommissural support 16(a)-16(c). As illustrated in FIG. 5B, each hole 13(b) or set of holes 13(b) may be disposed approximately midway between each set of commissural support holes 13(a). Of course, the commissural support holes 13(a) and the intercommissural support holes 13(b) may be disposed in any other configuration consistent with their intended use. For example, the base 12 may be provided with evenly spaced holes 13 to allow for maximum adjustability, or may be provided with holes 13 located in discrete positions to ensure precise positioning of the supports 14(a)-14(c) and 16(a)-16(c).
With reference now to FIGS. 5A-5D and 6A-6B, in some embodiments, the base 12 may comprise a ring 60 and a cover 70. The ring 60 may be provided with a plurality of holes 13 as described above. As shown in FIGS. 5C-5D, the ring 60 may have an inner wall 62, a crimping wall 64, and an outer lip 66. The crimping wall 64 may be configured to provide a friction crimp against a support 14, 16 inserted into one of the holes 13 when the wall 64 is pressed against the support 14, 16. As shown in FIGS. 6A-6B, the cover 70 may have an inner lip 72, configured to mate with the inner wall 62 of the ring 60, and an outer wall 76, configured to mate with the outer wall 66 of the ring 60. The outer wall 76 may be provided with a chamfer 73 configured to allow the cover 70 to slip over the crimped surfaces of the crimping wall 64 of the ring 60. The outer wall 76 may further be provided with an annular groove 75 configured to clip to the crimped surfaces of the crimping wall 64. In alternative embodiments, the base 12 may have any other configuration allowing it to secure the supports 14, 16 and to support a biological valve mounted thereon.
The base 12 may comprise any suitable material for receiving and/or securing the supports 14(a)-14(c) and 16(a)-16(c). For example, the base 12 may be formed from a metal such as titanium. Alternatively, the base 12 may be formed from a rigid, semi-rigid, or flexible polymer.
Referring once again to the embodiment depicted in FIG. 2, the commissural supports 14(a)-14(c) may be disposed at each of the commissures 26 and coupled to the base 12. The commissural supports 14(a)-14(c) may each comprise two legs connected by a curvilinear portion at an end of the support distal of the base 12. The two legs may be generally straight and generally parallel (as illustrated in the figure) or may be curved or angled apart somewhat. The two legs may also be spaced apart by a distance sufficient to avoid damaging the biological tissue in the marking zones 36(a)-36(c) (marking zone 36(c) is illustrated in FIG. 3) of the biological valve 20, thereby preserving the structural integrity of the biological valve 20. For example, the legs may be separated by a distance of 4 mm, or 3 mm (especially in the case of smaller-sized valves). The legs may also be separated by any distance compatible with the valve's intended use. In some embodiments, the curvilinear portion may have a constant radius of curvature, which may be equivalent to half the distance between the parallel legs.
In the embodiment shown in FIG. 1, the commissural supports 14(a)-14(c) may be configured to stand largely within the external wall 24 of the biological valve 20. Alternative embodiments may include commissural supports having any configuration capable of providing adequate support to the commissures during exposure to physiological flow pressures and rates. For example, the embodiment illustrated in FIG. 7 has commissural supports 84(a)-84(c) disposed external to the valve wall 24 around the outer periphery of a base 82, the valve 20 being disposed on top of the base 82 and having its inner wall essentially flush with the inner periphery of the base 82. An external commissural support may comprise a single straight rod, a T-shaped rod, a curved wire, or a narrow blade or plate which may be sutured to or otherwise attached to biological valve tissue at the valve commissures (see FIG. 7). Depending upon the geometry of the biological valve 20, the commissural supports may be disposed somewhat asymmetrically around the base, as described above in connection with FIGS. 5A-5B. The commissural supports may also be disposed about the base in any other configuration consistent with their intended use.
Referring again to the embodiment depicted in FIG. 1, the commissural supports 14(a)-14(c) may be disposed in a direction substantially parallel to the direction of flow 32 through the valve 20. The legs of the commissural supports 14(a)-14(c) may be disposed entirely within the tissue of the wall 24, while the curvilinear portions of the commissural supports 14(a)-14(c) may extend partially or entirely outside of the tissue at an end distal of the base 12. The commissural supports 14(a)-14(c) may each comprise a continuous wire, such as a titanium wire, for example. Alternatively, the commissural supports 14(a)-14(c) may comprise a rigid, semi-rigid, or flexible polymer.
With reference now to the embodiment depicted in FIG. 4, which illustrates a bottom plan view of the device 10 incorporated into the reinforced biological valve 50, the commissural supports 14(a)-14(c) may together define a commissural trigone 44 (shown in dashed lines).
Referring once again to the embodiment depicted in FIG. 1, the intercommissural supports 16(a)-16(c) (shown largely in hidden lines) may be disposed in the intercommissural spaces, preferably approximately midway between each pair of commissural supports 14(a), 14(b); 14(b), 14(c); and 14(c), 14(a). The intercommissural supports 16(a)-16(c) may also be coupled to the base 12. In the embodiment in FIG. 1, the intercommissural supports 16(a)-16(c) may be configured to stand largely within the external wall 24 of the biological valve 20. Alternative embodiments may include intercommissural supports disposed externally to the biological valve tissue, which supports may be sutured or otherwise attached to the valve tissue in the intercommissural spaces (see FIG. 7).
Referring again to the embodiment depicted in FIG. 2, the intercommissural supports 16(a)-16(c) may each comprise two legs connected by a curvilinear portion at an end of the support distal of the base 12. The two legs may be generally straight and generally parallel (as illustrated in the figure) or may be curved or angled apart somewhat. The curvilinear portion may have a constant radius of curvature equivalent to half the distance between the parallel legs. Alternatively, because the intercommissural spaces include no especially fragile marking zones, the intercommissural supports may each comprise a single straight rod, a T-shaped rod, or a narrow blade or plate. Embodiments may include intercommissural supports having other shapes, such as helical shapes, which may aid in insertion of the support into the valve tissue.
In the embodiment depicted in FIG. 1, the intercommissural supports 16(a)-16(c) may be disposed in a direction substantially parallel to the direction of flow 32. The legs of the intercommissural supports 16(a)-16(c) may be disposed entirely within the tissue of the wall 24, while the curvilinear portions of the intercommissural supports 16(a)-16(c) may extend partially or entirely outside of the tissue at an end distal of the base 12. In the embodiment depicted in FIG. 2, because the wall 24 is typically cut shorter in the intercommissural spaces than near the commissures 26, the intercommissural supports 16(a)-16(c) may be shorter than the commissural supports 14(a)-14(c). The intercommissural supports 16(a)-16(c) may each comprise a continuous wire, such as a titanium wire, for example. Alternatively, the intercommissural supports 16(a)-16(c) may comprise a rigid, semi-rigid, or flexible polymer.
Referring once again to FIG. 4, the intercommissural supports 16(a)-16(c) may together define an intercommissural trigone 46 (shown in dashed lines). The intercommissural trigone configuration 46 may serve to resist radial forces on the intercommissural spaces when the valve leaflets 22 close. Thus, the commissural supports 14(a)-14(c) and intercommissural supports 16(a)-16(c) together define a double-trigone geometry (see lines 44, 46) which closely resembles the natural geometry of the biological valve 20.
Referring now to FIG. 3, the reinforced biological valve 50 may be provided with a suture ring 52, which may comprise a flexible synthetic fabric. The entire outside periphery of the valve 50 may also be covered by a synthetic fabric 54.
A method of reinforcing a biological valve is also provided. The method may include placing a commissural support at or near each commissure of a biological valve and securing the commissural supports to the valve tissue. The method may also include placing an intercommissural support approximately midway between each pair of commissural supports and securing the intercommissural supports to the valve tissue. The method may further include coupling the commissural supports and intercommissural supports to a base, which may be disposed underneath the biological valve.
In some embodiments, after biological material to be used for the replacement valve is first harvested, it may be stored in a preservative solution. The biological material may then be subjected to one or more pre-fixation treatments, such as a decellularization treatment to reduce the risk of post-implantation mineralization. Such pre-fixation treatments are more fully described in U.S. Pat. Nos. 5,595,571; 5,720,777; and 5,843,181; the entire disclosures of which are herein incorporated by reference.
The biological material may then be subjected to a fixation (crosslinking) treatment to preserve the structural integrity of the biological valve. Such fixation may include exposing the biological material to gluteraldehyde. Such fixation may occur without any mechanical, hydrostatic, or other external stress placed on the valve leaflets. Fixing the biological tissue in a "relaxed" state allows for some shrinkage of the material to occur without affecting the orientation of collagen or elastin in the tissue, and thus without affecting the biomechanical properties of the tissue. The tissue may be then be dissected and composited into a composite biological valve, according to known practices. Embodiments of the invention may also use an intact biological valve.
Next, commissural supports may be inserted into the wall of the biological valve. Each commissural support may comprise two legs, each leg being provided with a sharp tip for piercing the wall of the tissue valve at either side of the commissural marking zone. The legs may have differing lengths to facilitate insertion. The legs may enter the valve wall at the outflow region of the valve and be pushed through the wall in a direction generally parallel to the central axis of the valve until the legs exit the tissue at the inflow region of the valve. Alternatively, the commissural supports may be placed outside the valve wall at each commissure and secured to the valve tissue in any suitable fashion, for example by suturing.
Once each commissural support is inserted through (or otherwise coupled to) the valve wall, the supports may be coupled to a base. The commissural supports may be removably coupled to the base at first, to allow a practitioner to choose a differently-sized base if necessary. In view of the size of the biological tissue, the commissural supports may also be adjustably positioned on the base to allow a practitioner to adjust the height of the supports and to adjust tension among the valve leaflets as necessary. As noted above, the valve tissue may have shrunken to a certain extent (on the order of one valve size, that is, approximately 2 mm in diameter) during the zero-stress fixation. Thus, the process of coupling the commissural supports to the base may involve stretching the valve tissue slightly to re-establish the original valve size.
After the proper sizing and positioning has been determined, the commissural supports may be more permanently fixed to the base to establish the commissural trigone. The commissural supports may be fixed by crimping a wall of the base against the legs of the supports. The supports may be fixed using a friction crimp, allowing adjustment of the height of supports, or may be fixed using a fixed crimp so that the supports become firmly positioned with respect to the base. The commissural supports may alternatively be fixed by any other manner consistent with the valve's intended use. Once the commissural supports are secured to the base, the supports may be bent at an approximately 90° angle (tangentially from the base) and trimmed.
After the commissural trigone has been established, the intercommissural supports may be inserted into the valve wall. Each intercommissural support may comprise one or more legs, each leg being provided with a sharp tip for piercing the wall of the tissue valve. The legs may enter the valve wall at the outflow region of the valve and be pushed through the wall until the legs exit the tissue wall at the inflow region of the valve. As with the commissural supports, the intercommissural supports may alternatively be placed outside the valve wall at each intercommissural space and secured to the valve tissue in any suitable fashion, for example by suturing. The intercommissural supports may then be coupled to the base and trimmed in a similar manner as the commissural supports. Where a base comprising a ring and a cover is used, a cover may then be placed on the ring and secured to the ring.
Finally, the reinforced valve may be covered or partially covered with a flexible synthetic fabric. The reinforced valve may also be encircled by a suture ring, such as a flexible fabric ring, which can be used to facilitate implantation of the device.
During an aortic valve replacement surgery, a diseased or malfunctioning native valve is removed from the native aortic annulus. The aortic annulus is then sized, and a pre-manufactured reinforced biological valve of the appropriate size is selected for implantation. As mentioned earlier, providing reinforcement of the double-trigone geometry for a biological valve allows for optimal sizing of the replacement valve, thereby maintaining a more natural pressure gradient and reducing or eliminating the need to perform root enlargement or other such procedures. The surgeon then sutures the replacement valve within the aortic annulus or supra-annularly, using the commissural reinforcement points as markers to properly orient the reinforced valve. Since the double-trigone geometry of the valve is reinforced at discrete locations around the circumference of the valve, no complex suturing is required to secure the valve's configuration.
Although the hemodynamic characteristics of bioprosthetic heart valves measured in flow testing have not been proven to be proportional to their in situ clinical performance, there is a general agreement that for a particular cardiac output, expressed as liters of blood passing through in any one minute, the degree to which the valve opens and the effort necessary to accomplish adequate flow during flow tests are most likely related to the clinical outcome. In flow tests, embodiments of the invention have demonstrated enhanced hemodynamics when compared with even the most hemodynamically efficient conventional bioprostheses. For example, flow testing has shown that a 25 mm diameter valve, configured in accordance with embodiments of the invention, has an approximately 20 to 25% greater EOA than a conventional stented bioprosthetic valve of the same size. An increased BOA results in more blood flow per heart beat, and also results in a lower total energy loss during valve operation. Thus, to accommodate a given cardiac output, the 25 mm valve mentioned above only requires about half the work as a conventional stented bioprosthetic valve of the same size. This indicates that, for aortic applications, the left ventricle of the heart will be required to perform less work, resulting in an accelerated return of normal function.
Although illustrated within the context of a prosthetic aortic valve, the present invention may also be used with other prosthetic valves, such as a mitral valve, tricuspid valve, or any other valve for which unobstructing reinforcement is desirable. It will be understood by those of skill in the art that numerous and various modifications can be made without departing from the spirit of the present invention. Therefore, it should be clearly understood that the forms of the invention described herein are illustrative only and are not intended to limit the scope of the invention.
a base disposed at the inflow region of the biological valve, the base being attached to the plurality of commissural supports and the plurality of intercommissural supports, the base further being configured to receive the biological valve mounted thereon, wherein the commissural supports and intercommissural supports are discontinuous around the valve wall in the outflow region of the biological valve.
2. The reinforcement device of claim 1, wherein the commissural supports are configured to stand substantially within the valve wall.
3. The reinforcement device of claim 2, wherein the intercommissural supports are configured to stand substantially within the valve wall.
4. The reinforcement device of claim 1, wherein the commissural supports are configured to stand outside the valve wall.
5. The reinforcement device of claim 4, wherein the commissural supports are configured to be sutured to a valve wall.
6. The reinforcement device of claim 1, wherein the base is continuous around the valve wall in the inflow region of the biological valve.
7. The reinforcement device of claim 1, wherein the commissural supports and intercommissural supports are disposed at discrete locations of the valve wall in the outflow region of the biological valve.
8. The reinforcement device of claim 1, wherein the commissural supports and the intercommissural supports comprise metal wire.
9. The reinforcement device of claim 8, wherein the metal wire comprises titanium.
10. The reinforcement device of claim 1, wherein each of the commissural supports comprises first and second straight portions.
11. The reinforcement device of claim 10, wherein the first and second straight portions are spaced apart by a distance sufficient to avoid damaging a marking zone near the commissure when the commissural support is affixed to the valve wall.
12. The reinforcement device of claim 11, wherein the first and second straight portions are substantially parallel.
13. The reinforcement device of claim 12, wherein the first and second straight portions are joined together by a curved portion.
14. The reinforcement device of claim 13, wherein the curved portion has a constant radius of curvature equal to half the distance between the first and second straight portions.
15. The reinforcement device of claim 10, wherein the first and second straight portions are configured to stand within the wall of the biological valve.
16. The reinforcement device of claim 13, wherein the curved portion is configured to stand at least partially outside the wall of the biological valve.
17. The reinforcement device of claim 1, wherein each of the intercommissural supports comprises substantially parallel first and second straight portions.
18. The reinforcement device of claim 16, wherein the first and second straight portions are joined together by a curved portion.
19. The reinforcement device of claim 1, wherein the plurality of commissural supports includes three commissural supports disposed generally symmetrically about the base.
20. The reinforcement device of claim 1, wherein the plurality of commissural supports includes three commissural supports disposed asymmetrically about the base.
21. The reinforcement device of claim 20, wherein the plurality of intercommissural supports includes three intercommissural supports, each one of the intercommissural supports being disposed between each pair of commissural supports.
22. The reinforcement device of claim 21, wherein each of the intercommissural supports is disposed approximately midway between each pair of commissural supports.
23. The reinforcement device of claim 1, wherein the base comprises a ring and a cover.
24. The reinforcement device of claim 23, wherein the ring has a thickness substantially equivalent to a thickness of the valve wall.
25. The reinforcement device of claim 23, wherein the ring has a thickness greater than a thickness of the valve wall.
26. The reinforcement device of claim 1, wherein the base includes a first plurality of holes configured to closely receive the commissural supports and a second plurality of holes configured to closely receive the intercommissural supports.
27. The reinforcement device of claim 26, wherein the first plurality comprises five holes for each commissural support for adjustable placement of the commissural supports with respect to the base.
a crimping wall configured to secure the commissural supports and intercommissural supports to the base when the crimping wall is pressed against the supports.
29. The reinforcement device of claim 1, wherein the base comprises metal.
30. The reinforcement device of claim 29, wherein the metal comprises titanium.
31. The reinforcement device of claim 1, wherein the biological valve is an aortic valve.
32. The reinforcement device of claim 1, wherein the biological valve is a mitral valve.
a plurality of intercommissural supports extending from the base, each intercommissural support being configured to stabilize the external wall at a location circumferentially between two of the commissures, wherein the commissural supports and intercommissural supports do not continuously surround the valve in the outflow region.
34. The reinforced prosthetic valve of claim 33, wherein the commissural supports and the intercommissural supports are disposed substantially within the external wall.
35. The reinforced prosthetic device of claim 33, wherein the commissural supports and the intercommissural supports are disposed outside the external wall.
36. The reinforced prosthetic device of claim 35, wherein the commissural supports and the intercommissural supports are secured to the external wall with sutures.
MX2010000184A MX2010000184A (en) 2007-07-09 2008-07-07 An intraparietal aortic valve reinforcement device and a reinforced biological aortic valve.
Amendment Accompanying Request for Continued Examination dated Feb. 19, 2008 in Response to the Final Office Action dated Nov. 20, 2007 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2009.
Amendment filed on Jul. 16, 2008 in response to Office Action dated Apr. 17, 2008 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Amendment filed on Jul. 18, 2007 in Response to Office Action dated Apr. 19, 2007 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Final Office Action dated Feb. 17, 2010 in U.S. Appl. No. 11/814,155, filed Jul. 17, 2007.
Final Office Action dated Jan. 28, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Final Office Action dated Oct. 30, 2008 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Final Office Action in U.S. Appl. No. 10/550,297, dated Nov. 20, 2007.
International Search Report for International Application No. PCT/IB2004/000707, dated Jun. 30, 2004.
International Search Report for International Application No. PCT/IB2005/000573, dated Dec. 14, 2005.
Interview Summary dated Apr. 2, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Interview Summary dated Jan. 31, 2008 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Interview Summary dated Jul. 7, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Interview Summary dated May 5, 2010 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Interview Summary dated Oct. 23, 2009 in U.S. Appl. No. 11/814,155, filed Jul. 17, 2007.
Notice of Non-Compliant Amendment dated Jul. 27, 2007 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Office Action dated Apr. 13, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Office Action dated Dec. 9, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Office Action dated Jun. 16, 2009 in U.S. Appl. No. 11/814,155, filed Jul. 17, 2007.
Office Action in U.S. Appl. No. 10/550,297 dated Apr. 17, 2008.
Office Action in U.S. Appl. No. 10/550,297, dated Apr. 19, 2007.
Partial International Search Report dated Feb. 11, 2010 in International Application No. PCT/US/2008/069344.
Response filed on Aug. 8, 2007 to Notice of Non-Compliant Amendment dated Jul. 27, 2007 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Response filed on Dec. 29, 2008 to Final Office Action dated Oct. 30, 2008 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Response filed on Jul. 13, 2009 to Office Action dated Apr. 13, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Response filed on Mar. 30, 2009 to Final Office Action dated Jan. 28, 2009 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Supplemental Response filed on Aug. 27, 2007 to Notice of Non-Compliant Amendment dated Jul. 27, 2007 in U.S. Appl. No. 10/550,297, filed Sep. 21, 2005.
Free format text: THE PATENTABILITY OF CLAIMS 19, 35 AND 36 IS CONFIRMED.CLAIMS 1, 6, 7, 10-13, 16-18, 20-23, 29-31 AND 33 ARE CANCELLED.CLAIMS 2-5, 8, 9, 14, 15, 24-28, 32 AND 34 WERE NOT REEXAMINED.


I used the Denim & Friends collection for both cards. For the card for grandma I used the turqouise hues of the collection, using also some Monochromes sheets.
Other: stamps: Lemonade; chipboard pieces: Egocraft; brads: Craftmania, Rayher; dies: Rosy Owl, Spellinders; flowers: Prima, Wild Orchid Crafts; button: Lemoncraft; crystal gems: Prima; ribbon: my stash.
And that is all for today – see you soon!


text:
Hesperocharis nera, the Nera white, is a butterfly of the family Pieridae. It is found in Trinidad, Ecuador, Peru, Colombia, Suriname, the Guianas, Brazil and Bolivia.

Subspecies
H. n. nera (Ecuador)
H. n. aida Fruhstorfer, 1908 (Peru, Bolivia)
H. n. amazonica Fruhstorfer, 1907 (Peru, Ecuador)
H. n. lamonti Kaye, 1920 (Trinidad)
H. n. nereis C. & R. Felder, 1865 (Colombia)
H. n. nerida Zikán, 1940 (Brazil: Amazonas)
H. n. nymphaea Möschler, 1876 (Surinam, Guyana, Brazil: Amazonas)

References

Butterflies described in 1852
Anthocharini
Fauna of Brazil
Pieridae of South America
Taxa named by William Chapman Hewitson

redpajama_set_name: RedPajamaWikipedia


text:
Khau Pha House
"Khau Pha House is now the most beautiful house in the village and we are very happy about that. Even though our family doesn't live there, we are proud that everyone loves it, especially the children who have a place to read and play together."
– Notes from the owners of Khau Pha House –
About Khau Pha House
Khau Pha House by KPF is the 4th accommodation in Ít Thái village, opened in July 2020. This is the first private stilt house with a capacity of 4-6 guests. When staying at Khau Pha House, guests can enjoy a cozy space exclusively for their family or group of friends while immersing themselves in the green natural scenery and peaceful local life around the house.
After the KPF's first three traditional homestays in the village went into operation and brought positive results, KPF tested a new accommodation model – a private stilt house with high-class amenities exclusively for groups of friends or small families. In addition, the space on the ground floor of Khau Pha House is also where KPF founded a community library so that the people in the village can freely come read books and interact with each other, especially local children.
The story of Khau Pha House by KPF
Khau Pha House was leased and renovated by KPF from an old stilt house of Vinh Giót's family. During the reconstruction and design process, the KPF's architect team combined both comfort and modern elements to create a small cozy house with more advanced amenities than the other homestays. The result is a small stilt house with surrounding cobblestone fence, cottage roof and wooden framed glass windows that stands out among the picturesque green rice fields in the village.
Vinh Giót family still operates Khau Pha House and serves meals to the guests when they come and stay there. Normally, the family lives with their parents in a house nearby or spends the time in the shack on the hill to look after their fields and farm.
By local people, Khau Pha House is often called "nhà Hau" because "hau" in the Thái language means "we". Thus the original name of the "House" coincidentally brought a deeper meaning to the local community making Khau Pha House the place where people can come to play, read books and share together.
How has Vinh Giót's family's life changed after operating Khau Pha House?
Before operating Khau Pha House, Vinh Giót's family lived and depended on farming as everybody else. The family owns fields and farms in the upper part of the hill above the village which they have to take care of and look after every day. The first two children are grown up, one going to school, the other working far away. Only the youngest son named Doi still lives with his parents, having a difficult life with Vinh drinking often while the family was struggling to have just enough money to eat.
When KPF offered to rent the Vinh Giót's family's house, they were very excited and agreed right away. Partly because they wanted to have a new livelihood, partly because the house is rarely cared for so if it will be renovated into an accommodation facility, it would be more convenient in general. Since the day Vinh started repairing his house to serve tourists, Mr. Vinh was no longer drunk. Instead, he worked very hard in carpentry and joined hands with his wife to decorate the house according to the idea and guidance of KPF's architects.
From an old wooden house, in 3 months it was repaired and redecorated with local materials such as wood, stone, rock and straw and became a beautiful little house on stilts. Both Vinh and Giót being very skillful, they tiled each pebble and planned each plank by themselves making the Khau Pha House how it looks like today.
In July 2019, Khau Pha House opened and welcomed the first group of guests. At first, Vinh and Giót were quite confused as they didn't know how to welcome guests, how to cook or how to take care of them when not living in the same house. However, after the first few guests being welcomed, the couple also got used to this work and every time they had new guests, they would arrange their regular farming work to be more dedicated to spending time with them.
From a farming family which works year-round and cannot afford to feed their three children enough, Vinh Giót's family has ultimately become more confident and keeps actively learning how to do tourism to earn extra income. Thanks to that, the family is more peaceful and united.
Facilities & Pricing
House: 1 private house
Capacity: 6 persons
Accomodation price:
1.500.000 VND/4 persons/night (breakfast included)
Every extra person surcharges 150.000 VND/person/night
Meal price:
For a group of 6 persons and below: starting at 150.000 VND/meal.
BBQ on the hill: Starting at 250.000 VND/meal.
À la carte: The price depends on the food demands. Guests can use a shared kitchen to cook their own meals.
Feedback from Guests
"An accommodation facility with traditional architecture combining modern amenities, unique decoration style, in harmony with nature."
Thảo Nguyên
"Enthusiastic host, clean & beautiful stilt house, nice to take photos."
Hoa Phạm


text:
El güllaç es un postre tradicional turco hecho con leche, agua de rosas, granada y un tipo especial de masa con almidón. Se consume especialmente durante el Ramadán.

El güllaç es mencionado por Charles Perry (1994) como la primera versión de baklava (él lo llama proto-baklava). Las similitudes entre los dos postres son muchas, como el uso de capas finas de masa con frutos secos entre ellas. Sin embargo, la masa de güllaç se prepara con almidón de maíz y harina de trigo. El güllaç contiene nueces en las capas, que se ponen en leche.

Fue mencionado por primera vez en un libro del siglo XIV, Yin-Shang Chen-Yao, un manual de cocina y salud escrito en chino por Hu Szu-Hui, un médico turco de la corte mongola en la era Yuan. El libro documenta principalmente platos mongoles y turcos que exhiben una limitada influencia china. Yin-Shang Chen-Yao fue traducido al inglés por Paul Buell y Eugene Anderson, con abundantes notas y análisis, y publicado con el título A Soup for the Qan (2000). Incluye un artículo sobre platos turcos de cereal, pan y pasta escrito por Charles Perry, que menciona el güllaç.

El güllaç se usaba para preparar güllaç lokması y güllaç baklavası, unos postres arcaicos elaborados durante el período otomano en Turquía.

Véase también

 Postres en la cocina turca

Referencias

Postres y dulces de Turquía