text:
Search Results for insurer
Journal Article (2414)
European Studies (35)
Medicine and Health (2358)
Public Health and Health Policy (2358)
Political Science (1990)
Public Policy (2340)
Science and Technology Studies (4)
Journal of Health Politics, Policy and Law (2445)
Research Article (1363)
Books Received (7)
1-20 of 2445 Search Results for
Medical Malpractice Reform and Insurer Claims Defense: Unintended Effects?
Jan M. Ambrose, Anne Carroll
Journal of Health Politics, Policy and Law (1 October 2007) 32 (5): 843–865.
...Jan M. Ambrose; Anne Carroll In response to recent and past medical malpractice insurance crises, most states have implemented reforms meant to stabilize premiums and coverage availability. The importance of understanding whether these reforms implicitly affect the behavior and incentives of...
Financing Universal Health Insurance: Taxes, Premiums, and the Lessons of Social Insurance
Thomas Bodenheimer, Kevin Grumbach
Journal of Health Politics, Policy and Law (1 June 1992) 17 (3): 439–462.
...Thomas Bodenheimer; Kevin Grumbach In a society with strong antitax sentiment and large government deficits, the enactment of universal health insurance is blocked by an impasse over financing. The two chief mechanisms for funding universal health insurance are taxes and insurance premiums. Taxes...
Employer-Based Health Insurance
Jacqueline Wallen, Sherman R. Williams
Journal of Health Politics, Policy and Law (1 April 1982) 7 (2): 366–379.
DOI: https://doi.org/10.1215/03616878-7-2-366
...Jacqueline Wallen; Sherman R. Williams Employer-based health insurance (insurance that is purchased by employers for their employees and financed through employer or joint employer-employee contributions) is currently subsidized in part by the federal government through tax exclusions for employer...
Notes from the Insurance Underground: How the Chronically III Cope
Eleanor D. Kinney, Suzanne K. Steinmetz
...Eleanor D. Kinney; Suzanne K. Steinmetz Abstract This report from the field is an account of the experience of individuals with multiple sclerosis (MS) in Indiana in getting and keeping private health insurance. The report presents the findings of a telephone survey of individuals with MS in...
Has Solidarity Survived? A Comparative Analysis of the Effect of Social Health Insurance Reform in Four European Countries
Hans Maarse, Aggie Paulus
Journal of Health Politics, Policy and Law (1 August 2003) 28 (4): 585–614.
...Hans Maarse; Aggie Paulus Social health insurance reform has evolved as an important public policy issue in several European countries. Some of the most important reform programs have been the introduction of managed competition, a shift from full retrospective reimbursement of health insurers to...
The Impact of German Health Insurance Reforms on Redistribution and the Culture of Solidarity
Karl Hinrichs
...Karl Hinrichs The statutory health care scheme represents the most ambitious branch of the German social insurance system because it entails interpersonal redistribution on a large scale. The stability of this centerpiece of the German welfare state thus depends on a "culture of solidarity" to...
Framing Incremental Expansions to Public Health Insurance Systems: The Case of Canadian Pharmacare
Jamie R. Daw, Steven G. Morgan, Patricia A. Collins, Julia Abelson
Journal of Health Politics, Policy and Law (1 April 2014) 39 (2): 295–330.
...Jamie R. Daw; Steven G. Morgan; Patricia A. Collins; Julia Abelson Abstract Canada is the only country in the world to offer universal comprehensive public health insurance that excludes outpatient prescription medicines. Few scholars have attempted to explain this policy puzzle. We study media...
Relative Value Health Insurance
Russell Korobkin
...Russell Korobkin Abstract Increases in health costs continue to outpace general inflation, and implementation of the Patient Protection and Affordable Care Act will exacerbate the problem by adding more Americans to the ranks of the insured. The most commonly proposed solutions — bureaucratic...
Empire and the Business of Health Insurance
Harvey M. Sapolsky
...Harvey M. Sapolsky I examine the development of privately provided insurance since World War II, giving special attention to Empire Blue Cross, and argue that the competition between employers and unions for the loyalty of workers after the passage of the Taft-Hartley Act helped diffuse private...
Expanding Health Insurance Coverage: Who Will Pay?
Joel C. Cantor
...Joel C. Cantor Recent discussions on extending health insurance to the more than thirty million uninsured Americans have focused on two strategies: expanding the Medicaid program and mandating that employers sponsor coverage for their employees. This analysis, using a microsimulation model of the...
Why Requiring Employers to Provide Health Insurance Is a Bad Idea
Katherine Swartz
...Katherine Swartz There is mounting pressure at the federal (and state) level to require employers to provide health insurance to their employees. However, two quite different groups of workers could be affected by such a mandate. In addition, there are at least five major problems with requiring...
Health Benefits at Work: An Economic and Political Analysis of Employment-Based Health Insurance
Paul Fronstin
...Paul Fronstin Mark Pauly. Health Benefits at Work: An Economic and Political Analysis of Employment-Based Health Insurance . Ann Arbor: University of Michigan Press, 1997. 187 pp. $39.50 paper. Copyright © 1999 by Duke University Press 1999 388 Journal of Health Politics, Policy and Law...
The Wages of Sickness: The Politics of Health Insurance in Progressive America
David A. Moss
...David A. Moss Beatrix Hoffman. The Wages of Sickness: The Politics of Health Insurance in Progressive America. Chapel Hill, NC: University of North Carolina Press, 2001. 261 pp. $39.95 cloth; $17.95 paper. © 2002 by Duke University Press 2002...
Impeding Earl Warren: California's Health Insurance Plan That Wasn't and What Might Have Been
Daniel J. B. Mitchell
Journal of Health Politics, Policy and Law (1 December 2002) 27 (6): 947–976.
...Daniel J. B. Mitchell It is widely believed that the turning point for U.S. health insurance came in 1949 when Congress failed to adopt President Harry Truman's proposal for a national system. The possibility that a system of state-level health plans might have emerged before Truman's plan has...
Mandating Insurance Offers for Low-Wage Workers: An Evaluation of Labor Market Effects
Amy Wolaver, Timothy McBride, Barbara Wolfe
...Amy Wolaver; Timothy McBride; Barbara Wolfe Employing a simultaneous model of part-time status, health insurance offers, and wages, we examine the impacts on employment and health insurance coverage of nondiscrimination rules in the tax code governing employer-sponsored health insurance. Using 1988...
Enrolling Children in Public Insurance: Schip, Medicaid, and State Implementation
Karl Kronebusch, Brian Elbel
...Karl Kronebusch; Brian Elbel The Balanced Budget Act of 1997 established federal grants to the states to create the State Children's Health Insurance Program (SCHIP). This presented the states with a number of implementation choices concerning administrative models for the new programs, as well as...
Private Insurance for Medicaid Recipients: The Texas Experience
Penny H. Feldman, Margaret Gerteis
...Penny H. Feldman; Margaret Gerteis Shifting financial risk from the public to the private sector is an increasingly attractive option to policymakers seeking to constrain Medicaid costs. This paper discusses the potential advantages and disadvantages of private insurance arrangements for Medicaid...
The Effect of State Regulations on the Quality and Sale of Insurance Policies to Medicare Beneficiaries
Nelda McCall, Thomas Rice, Arden Hall
Journal of Health Politics, Policy and Law (1 February 1987) 12 (1): 53–76.
DOI: https://doi.org/10.1215/03616878-12-1-53
...Nelda McCall; Thomas Rice; Arden Hall This paper examines the effects of state regulations on the quality of insurance policies sold to Medicare beneficiaries and on the amount of sales abuse reported in the sale of such policies. State regulations regarding such policies relate to policy content...
Medical Care, Medical Costs: The Search for a Health Insurance Policy
Uwe E. Reinhardt
Journal of Health Politics, Policy and Law (1 February 1988) 13 (1): 182–189.
...Uwe E. Reinhardt Rashi Fein, Medical Care, Medical Costs: The Search for a Health Insurance Policy (Cambridge, MA: Harvard University Press, 1986), 240 pp., $20.00. Copyright © 1988 by Duke University Press 1988 182 Journal of Health Politics, Policy and Law Under what...
Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance, 1911–1966
Ellen M. Immergut
...Ellen M. Immergut C. David Naylor, Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance, 1911–1966 (Kingston and Montreal: McGill-Queen's University Press, 1986), 324 pp., $35.00 cloth, $ 15.95 paper. Copyright © 1988 by Duke University Press 1988...


Pedagogies for lifelong learning: building bridges or building walls?
This reader examines the practices of learning and teaching which have been developed to support lifelong learning, and the understanding and assumptions which underpin them. The selection of texts included trace the widening scope of academic understandings regarding learning and teaching, and considers the implications for those who develop programmes of learning. It examines in great depth those theories which have had the greatest impact in the field, theories of reflection and learning from experience and theories of situated learning. The implications of these theories are examined in relation to themes which run across the reader, namely, workplace learning, literacies, and the possibilities offered by information and communication technologies.


The scale was large and the scene was magnificent; all troops participating in the parade were elite troops. Such scale and array were unprecedented in New China's history, and were also rarely seen in the world. Over 11,000 officers and soldiers and a giant array formed by over 400 fighting vehicles stretched as long as two kilometers. The "iron army", one division from Jinan Military Area Command, drove new-style wheeled infantry fighting vehicles. This army's predecessor was the famous "Yeting independent regiment" of the Northern Expeditionary Army, which was the first armed force led by the CPC. The "combat hero battalion" was equipped with a new type of self-propelled anti-craft guns; the battalion's predecessor was the famous "first company of the Red Army", the guard company of the second regiment of the first division under the first army of the Red Army. Mao Zedong carried out experiments to "establish branches of the CPC at the level of companies" in this famous company during the Sanwan Reorganization, and the CPC accumulated experience in building a new type of PLA under the leadership of the CPC. The unit driving advanced antitank missile vehicles from Nanjing Military Area Command was a Red Army troop created during the Huangma Uprising. The "Red Army Regiment" driving caterpillar infantry fighting vehicles was a troop created during the Pingjiang Uprising. There were also other hero groups including "the regiment being awarded great merit citation in the Huai-Hai Campaign", "the company being awarded top-grade merit citation in the Battle of Triangle Hill", "Huang Jiguang squad", "Dong Cunrui squad", "Wang Jie squad" and "Wang Hai Unit"; as well as merit troops like those with Zhang Side and Qiu Shaoyun as soldiers, "the hero battalion" which shot down US-made U-2 high-altitude reconnaissance aircraft, and a bomber aviation division of the PLA air force which successfully completed the experiment of dropping an atomic bomb for the first time.
The armed forces line-up, comprising over 100 fighting vehicles from tank, infantry fighting vehicle and armored vehicle divisions, was the largest of all the military parades in the history of New China.
With its four missile divisions formed by the conventional surface-to-surface missiles, medium-range surface-to-surface nuclear missiles and long-range surface-to-surface nuclear missiles from the strategic missile troops, this parade had more Second Artillery Force missiles than any other National Day military parade in the history of New China.
At this parade, the 25 vehicle divisions comprised over 400 Army, Navy, Air force, and Second Artillery Force vehicles. Both the number of divisions and the number of vehicles set new records in the history of the New China National Day military parades.
In a new stage and a new century, facing the overall situation of national security and development strategies, Chairman of the Central Military Commission Hu Jintao explicitly requires overall planning for economic and national defense construction and the unification of building a prosperous nation and strengthening the army in the process of constructing an all-round well-off society. He emphasized the implementation of military strategic principles in the new era, and the acceleration of military reforms with Chinese characteristics. He also put emphasis on good preparation for military struggles and enhancement of the army's ability to cope with multiple security threats and complete diversified military tasks, so as to firmly safeguard the state sovereignty, security and territorial integrity as well as contribute to the preservation of world peace. Efforts should be made to strengthen the army through science and technology and, in accordance with the strategic goal of building an informationized army and winning information wars, speed up the combined development of mechanization and informatization. Efforts should also be made to actively carry out military training based on informatization, accelerate the training of a large number of high-quality military personnel of a new type and practically change the generation mode of fighting capacity. The people's army has, with a focus on the historic mission in a new stage and in a new century, thoroughly practiced the theory of Scientific Outlook on Development and steadily promoted military reforms with Chinese characteristics and preparations for military conflict. The drive for modernization of national defense has accomplished historic achievements. With the theme of presenting national prestige and military spirits, invigorating the national spirit and inspiring patriotism, the National Day military parade on the 60th anniversary of the founding of New China will fully display the tremendous achievements of military reforms with Chinese characteristics, reflect the army's military strength to safeguard world peace and regional stability and show the good spirit of the PLA. The Central Military Commission clearly required the PLA to display the aspiring face by showing first-class organization and leadership, weapons and equipment, as well as training achievement and good spirit.


Project Description:The Sabarimala Pilgrimage comprises various stakeholders with varied interests and priorities. The Outline Report or Concept Plan was developed through extensive research and consultations with over 45 stakeholders associated with the pilgrimage to the Holy Shrine. It considered all previous reports on streamlining pilgrimage to Sabarimala and unlike most previous reports, not only identifies solutions but also, prioritises and recommends feasible interventions that will improve facilities by the 2005 pilgrim season. The Company has been able to broadly build consensus between all relevant stakeholders including the Travancore Devaswom Board, State Government and the Central Government. The identified interventions include development of a base camp at Nilakkal, provision of civic amenities such as drinking water, resting areas, toilets, hospitals etc, provision of a comprehensive solid waste management system, and various transportation interventions.
Services Provided: A detailed assessment of the existing situation, issues and suggested probable interventions required as part of development of concept plan was undertaken. The Sabarimala Pilgrimage comprises various stakeholders with varied interests and priorities. The Outline Report or Concept Plan was developed through extensive research and consultations with over 45 stakeholders associated with the pilgrimage to the Holy Shrine. It considered all previous reports on streamlining pilgrimage to Sabarimala and unlike most previous reports, not only identifies solutions but also, prioritises and recommends feasible interventions that will improve facilities by the 2005 pilgrim season. The Company has been able to broadly build consensus between all relevant stakeholders including the Travancore Devaswom Board, State Government and the Central Government. The identified interventions include development of a base camp at Nilakkal, provision of civic amenities such as drinking water, resting areas, toilets, hospitals etc, provision of a comprehensive solid waste management system, and various transportation interventions. Essential interventions for immediate improvement of the facilities to the pilgrims as well as for environmental improvement and the land area required for implementation of these has been suggested. Based on this, the implementing agency namely, Travancore Devaswom Board and Government of Kerala proceeded on the sanctions for transfer of land from the Periyar Tiger reserve and the surrounding Forest division. Following the direction in the Concept Plan, the hon'ble Supreme Court of India sanctioned required forest land (110 ha at Nilakal and 12.675 ha at Sabarimala) for implementation of works.


text:
<?php

namespace Wallabag\CoreBundle\Event\Listener;

use Symfony\Component\HttpFoundation\Session\Session;
use Symfony\Component\Security\Http\Event\InteractiveLoginEvent;

/**
 * Stores the locale of the user in the session after the
 * login. This can be used by the LocaleListener afterwards.
 *
 * @see http://symfony.com/doc/master/cookbook/session/locale_sticky_session.html
 */
class UserLocaleListener
{
    /**
     * @var Session
     */
    private $session;

    public function __construct(Session $session)
    {
        $this->session = $session;
    }

    /**
     * @param InteractiveLoginEvent $event
     */
    public function onInteractiveLogin(InteractiveLoginEvent $event)
    {
        $user = $event->getAuthenticationToken()->getUser();

        if (null !== $user->getConfig()->getLanguage()) {
            $this->session->set('_locale', $user->getConfig()->getLanguage());
        }
    }
}

redpajama_set_name: RedPajamaGithub


Whenever I write (or read or watch TV or a movie), I am always torn between my unquenchable thirst for a sum total statement on humanity- a zen takeaway that changes my actual personality, and a story so tightly knit that it doesn't need a sum-total-anything other than what is or isn't the story. Firefly was that story, for me. Breaking Bad. Haroun and the Sea of Stories. The Phantom Tollbooth was both. Ayn Rand's stuff was the former, but then she turned out to be a moist statue of actual corn laced turds so, oh well. It's hard for me to be ok with writing or cinema that isn't one or both of those things. I want every last drop from whatever I'm reading, writing, or watching.
I like a sum total. I tend to do it even when it isn't necessary. I've wondered if my compulsion for a sum total has to do with my yen for fairy tales. I have had a vague obsession with fairy tales and fables since I was a kid. I have a loosely formed plan to make my next year on Medium (after the daily challenge) be formatted around ideas I have for modern fairy tales. They'll probably be crass and twisted. Whatever so were most fairy tales. YES THEY WERE you hush.
My feeling is that writing the stories that give me my sum total satisfaction will either lead me to realize why I want the sum total, or they won't, but will at least trick me into writing more short stories, and so basically, it's a win-win either way.
Maybe I feel like a sum total is fairy tale.
It's a beautiful perfect package that never happens because nothing that is worth anything in life is tidy enough to be totaled. And, maybe I love sum total writing because it makes the facets of life that do shine with perfect light catch the sun a little more readily. Maybe I need the sum total in writing because I need to remind myself that those facets are on prisms everywhere around me, even if I can't always see them; even if they aren't constants. Maybe I want the sum total fiction because it helps me practice striving for it, exquisitely fleeting as it is, in my non-fiction grind.
Categories: Uncategorized | Tags: fairy tale, Idealism, Purpose, Subjectivity, Writing | Permalink.


text:
Q: Including multiple treatment and multiple endpoint studies in meta-analysis using metafor I am running a random-effects multivariate meta-analysis with the package metafor. I have binary data with one treatment and one control group. I am interested in the overall effect of the treatment. I did not want to average the effect sizes, but use all effect sizes I have, as of by now I just include 15 effect sizes. This post comes close to this one here, however, I am not quite sure if I do it correctly. So I would be more than happy if someone could help. Please see the generic data below.
Regarding the dataset: Study 5 has 3 different treatment groups always compared to the no treatment group, therefore these effect sizes are correlated. For study 6 the effect sizes are also correlated, as the same participants are measured 2 weeks later again.
data <- structure(list(es_id = c(1, 2, 3, 4, 5, 6 ,7 ,8, 9, 10, 11, 12, 13, 14, 15),
                       study = c(1, 1, 2, 2, 3, 4, 5, 5, 5, 6, 6, 6, 6, 7, 7),
                       obs= c(1L, 1L, 1L, 1L, 1L, 1L, 1L, 2L, 3L, 1L, 2L, 1L, 2L, 1L, 2L),
                       ai = c(22, 10, 16, 17, 19, 124, 15, 9, 9, 27, 14, 14, 13, 70, 79),
                       n1i = c(32, 20, 26, 27, 29, 134, 25, 19, 22, 37, 24, 24, 23, 80, 90),
                       ci = c(18, 6, 12, 13, 15, 120, 5, 5, 5, 23, 10, 10, 9, 66, 66),
                       n2i = c(31, 19, 24, 24, 30, 144, 25, 25, 25, 38, 29, 38, 29, 80, 80)),
                  .Names = c("Number", "Study", "obs", "ai", "n1i", "ci", "n2i"), row.names = c(NA, -15L), class = "data.frame")

library(metafor)
d1.1 <- escalc(measure = "OR", ai = ai, n1i = n1i, ci = ci, n2i = n2i, data = data)

I am running 2 different options.
The problem with Option #1 are the profile plots, which have a gap for sigma 2:
Option1 <- rma.mv(yi = yi,
                        V = vi,
                        random = list(~ 1 | obs,
                                      ~ 1 | Number,
                                      ~ 1 | Study),
                        tdist = F,
                        data = d1.1,
                        method = "REML")
summary(Option1)
robust(Option1, cluster = Study)

par(mfrow=c(3,1))
profile(Option1, sigma2=1, xlim=c(0,.6))
profile(Option1, sigma2=2, xlim=c(0,.6))
profile(Option1, sigma2=3, xlim=c(0,.6))
par(mfrow=c(1,1))

For the second option, I was thinking of just including Study/obs, which does not show any gaps in the profile plots
Option2 <- rma.mv(yi = yi,
                     V = vi,
                     slab = Study,
                     data = d1.1,
                     random =  ~ 1 | Study/obs)
summary(Option2)
robust(Option2, cluster = Study)

par(mfrow=c(2,1))
profile(Option2, sigma2=1, xlim=c(0,.6))
profile(Option2, sigma2=2, xlim=c(0,.6))
par(mfrow=c(1,1))

I was also thinking of changing it to a long format as I saw in the example section of the GitHub page by Prof. Viechtbauer (here). Option 1 does not show any profile plots however almost no heterogeneity for sigma2 and sigma3.
dat.long <- to.long(measure="OR", ai=ai, bi=n1i, ci=ci, di=n2i, data=data)
dat.long$obs <- c(rep(1,14), 1, 2, 1, 3, 1, 1, 2, 2, 1, 1, 2, 2, 1, 1, 1 , 2) # reassigning number of observations
dat.long[,c("ai","n1i","ci","n2i","study")] <- NULL # deleting variables which are not needed any longer
dat.long <- escalc(measure="PLO", xi=out1, mi=out2, data=dat.long)
res <- rma.mv(yi, vi, mods = ~ group, random = ~ 1 | Study/group/obs, data=dat.long)
par(mfrow=c(3,1))
profile(res, sigma2=1, xlim=c(0,.6))
profile(res, sigma2=2, xlim=c(0,.6))
profile(res, sigma2=3, xlim=c(0,.6))
par(mfrow=c(1,1))

Another option would also be to delete the reference groups that are included multiple times and to average the results of study 6, as this is the only study that includes measures with a time gap in between. Not quite sure, if this is ok, as it is the only study that would be averaged.
I hope someone could help me out.
Update:
I tried to construct the variance-covariance matrix as described on the metafor page here by the following code. However, I am not quite sure if this takes care of the dependent effect sizes (same control group and one time participants got measured two weeks after the first measurement).
data$pti <- with(data, ai / n1i)
data$pci <- with(data, ci / n2i)

data <- escalc(measure = "OR", ai = ai, n1i = n1i, ci = ci, n2i = n2i, data = data)
calc.v <- function(x) {
  v <- matrix(1/(x$n2i[1]*x$pci[1]*(1-x$pci[1])), nrow=nrow(x), ncol=nrow(x))
  diag(v) <- x$vi
  v
}
V <- bldiag(lapply(split(data, data$Study), calc.v))

res <- rma.mv(yi, V, random = ~ 1 | Study/Number, data=data)
summary(res)
robust(res, cluster = Study)

Thanks again in advance for any help.

As I am quite new to meta-analysis, so is the following approach also correct, if I stick to metafor:
data <- structure(list(es_id = c(1, 2, 3, 4, 5, 6 ,7 ,8, 9, 10, 11, 12, 13, 14, 15),
                       study = c(1, 1, 2, 2, 3, 4, 5, 5, 5, 6, 6, 6, 6, 7, 7),
                       obs= c(1L, 1L, 1L, 1L, 1L, 1L, 1L, 2L, 3L, 1L, 2L, 1L, 2L, 1L, 2L),
                       ai = c(22, 10, 16, 17, 19, 124, 15, 9, 9, 27, 14, 14, 13, 70, 79),
                       n1i = c(32, 20, 26, 27, 29, 134, 25, 19, 22, 37, 24, 24, 23, 80, 90),
                       ci = c(18, 6, 12, 13, 15, 120, 5, 5, 5, 23, 10, 10, 9, 66, 66),
                       n2i = c(31, 19, 24, 24, 30, 144, 25, 25, 25, 38, 29, 38, 29, 80, 80)),
                  .Names = c("Number", "Study", "obs", "ai", "n1i", "ci", "n2i"), row.names = c(NA, -15L), class = "data.frame")

library(metafor)
data$pti <- with(data, ai / n1i)
data$pci <- with(data, ci / n2i)

data <- escalc(measure = "OR", ai = ai, n1i = n1i, ci = ci, n2i = n2i, data = data)
calc.v <- function(x) {
  v <- matrix(1/(x$n2i[1]*x$pci[1]*(1-x$pci[1])), nrow=nrow(x), ncol=nrow(x))
  diag(v) <- x$vi
  v
}
V <- bldiag(lapply(split(data, data$Study), calc.v))
res <- rma.mv(yi, V2, random = ~ Number | Study, struct = "UN", data=data)
summary(res)
robust(res, cluster = Study)

I also saw the vcalc function by metafor. I get the same final results as well as the same results on the diagonal, however, when constructing the covariance matrix I get the following warning for all my clusters: 1: The var-cov matrix appears to be not positive definite in cluster 1.
V2 <- vcalc(vi, cluster = Study, data = data)

Can I use this and does it take care of my problem that I sometimes have the same control group (study 5 and 7) and for one study, the same participants are measured two weeks after the first one (study 6)?

A: You either need to construct the covariance matrix, as stated, which you could quite easily do by a) analyzing the data from each study e.g. using logistic regression and outputting the estimates along with their covariance matrix, or b) based on theoretical asymptotic considerations, which should give you a very similar results with a reasonable number of events.
Alternatively, you can just switch to logistic regression instead of trying to figure out the correlations, for which the input format would be one record per study arm (containing a studyid, the number of cases and the denominator). E.g. a (exact, if you worry about small sample size effects with very few events in some arms of some studies) logistic regression with treatment main (fixed) effects and study main (fixed) effects is a way of doing a fixed effects meta-analysis for binomial data. If you want a random effects meta-analysis, you would additionally specify a study random effect on the treatment effect.

redpajama_set_name: RedPajamaStackExchange


The Latest with David Jay: OSP PartnerCon Party!
I can't even begin to describe how incredible it was to see everyone tonight. Wow. I love you guys so much...we need to do this way more often!
yea seeing everyone was a blast! thanks for coming out man!
Couldn't agree more. I didn't get around to you tonight DJ, but hopefully I'll corner you tomorrow.
I'm so excited. Things went really great yesterday. It's great just to hang out and talk with all these other great photographers. Takes the edge off a little in the middle of a busy season. Talk to ya later today.


text:
Q: Arrange array according to object property Morning!
I made the function in order to organize the array according to the property that the user passes by parameter. But don't run, why?
I want sort by some parameter that exists in the object, like ordering by "wheel" or "id", for example.

const data = [
    {
         "color": "Blue",
         "door": 3,
         "wheel": 3,
         "year": 2005,
         "brand": "GMC",
         "sold": false,
         "owner": "Chalmers Boobyer",
         "motor": 1.7,
         "assembled": "09/08/2022"
     },
     {
         "color": "Indigo",
         "door": 4,
         "wheel": 4,
         "year": 1996,
         "brand": "Lincoln",
         "sold": true,
         "owner": "Morten Coffin",
         "motor": 1.7,
         "assembled": "26/08/2021"
     }
];

function bubbleSort(arr, ord='asc', property){
    if(ord === 'asc'){
        for(let i = 0; i < arr.length; i++){
            for(let j = 0; j < arr.length; j++){
                if(arr[j].property > arr[j+1].property){
                    let temp = arr[j];
                    arr[j] = arr[j+1];
                    arr[j+1] = temp;
                }
            }
        }
    } else if(ord === 'desc'){
        for(let i = 0; i < arr.length; i++){
            for(let j = 0; j < arr.length; j++){
                if(arr[j].property < arr[j+1].property){
                    let temp = arr[j];
                    arr[j] = arr[j+1];
                    arr[j+1] = temp;
                }
            }
        }
    }
    return (arr);
}

console.log(bubbleSort(data));

A: *

*Since you're accessing the index j + 1, you should loop up to arr.length - 1.

*Use bracket notation to access properties dynamically.

const data = [
    {
         "color": "Blue",
         "door": 3,
         "wheel": 3,
         "year": 2005,
         "brand": "GMC",
         "sold": false,
         "owner": "Chalmers Boobyer",
         "motor": 1.7,
         "assembled": "09/08/2022"
     },
     {
         "color": "Indigo",
         "door": 4,
         "wheel": 4,
         "year": 1996,
         "brand": "Lincoln",
         "sold": true,
         "owner": "Morten Coffin",
         "motor": 1.7,
         "assembled": "26/08/2021"
     }
];

function bubbleSort(arr, ord='asc', property){
    if(ord === 'asc'){
        for(let i = 0; i < arr.length; i++){
            for(let j = 0; j < arr.length - 1; j++){
                if(arr[j][property] > arr[j+1][property]){
                    let temp = arr[j];
                    arr[j] = arr[j+1];
                    arr[j+1] = temp;
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console.log(bubbleSort(data, 'desc', 'door'));


Cooking With Love! Valentines Day Cooking Class for Couples!
Perfect Valentine's Day Celebration Date Night in Nashville!
Is there anything more romantic than cooking together?
We're cooking up something special for your Valentine's Day special celebration! Bring your partner and a bottle of your favorite wine and join us for a memorable night of cooking and dining.
Torched crème brulee for dessert!
We look forward to providing a unique and wonderful time for your Valentine's Day celebration!


Each year the New Victory theater on 42nd st holds a fundraising gala. HGLD has lit 3 of the last 4 events. It's always a pleasure to work with our friends at New 4snd st. This year's event was in the lobby of Broadway's Lyric Theater.


At the 2018 Toronto Garlic Festival, My Crème Caramel will serve dessert specialties all with Ontario garlic. Check back for details.
We are French from Paris.We are certified pastry chefs. We are gourmets. In Canada for many years, we have learned to love this great country and its amazing people… the largest cities and the racoons as well…and we don't want to leave! We are thrilled to share our delicious desserts… Handcrafted, chic et bon!


text:
Home / Resources
Helpful Lawyers Resources
We want you to have the most current information available on topics that are of interest to you. For your convenience, we will be posting relevant articles on the research page.
What to do after a car accident: lawyers instructions
When you first started driving, you likely learned the basics of what to do after a car accident. You know to call the local authorities, seek medical help if needed, and begin the insurance claims process.
However, many drivers do not know that they should avoid saying and doing certain things after an accident, both at the scene and afterward. In this resource, we provide a list of common things you may want to do or feel like you should do that you should avoid.
Why a car speeding is too dangerous: lawyers advice
Speeding isn't the first crime you think of as "criminal", and most people have been ticketed for it at one time or another.
Breaking the law is one thing, acting against the laws of physics is another. It's easy to forget about the energies at work when you give the car a little gas. Let's say that a car is only doing 30 miles an hour when it slams into a brick wall.
Do All Car Accidents Require an Attorney?
According to the most recent statistics from the Texas Department of Transportation (TDOT), in 2018, 3,639 people died
In An Uber or Lyft Accident In DFW? You Need An Auto Accident Lawyer
You may notice that vehicle accidents involving Lyft or Uber drivers are often in the news. For example, just before Chr
How mobile texting affects on pedestrian accidents
At AM Law Group we are dedicated to helping people understand the risks of being pedestrians and to encouraging them not
Latest Truck (18-wheeler) Accidents Statistics
AM Law Group is dedicated to assisting those who were involved in an accident with a large truck in collecting the damag
What to do after a truck accident: lawyers help
If you were injured in a trucking accident, contact the AM Law Group for help in collecting all the damages to which you
How to File a Personal Injury Claim in Texas
Before filing your Texas personal injury claim for compensation, contact the Texas AM Law Group for a free case evaluati
What can a lawyer do about your Personal Injury
A competent and passionate personal injury attorney, like the one you will find at Almasri & Marzwanian Law Group, will
Letter of Protection: What is it and How can it help you
If you are suffering from injuries you received in an accident caused by the negligence of another, read this article...
Types of Damages in Personal Injury Cases
Here's what you need to know if you have or are about to file a personal injury lawsuit.
WHEN TO FILE A PERSONAL INJURY LAWSUIT?
When you first started driving, you likely learned the basics of what to do after a car accident.

redpajama_set_name: RedPajamaCommonCrawl


Blackwater Engines specializes in Remanufactured Diesel and Gas Engines for Truck, Marine, Industrial, and Agricultural Applications. We Are Also a Distributor of Ford Complete Diesel Engines.
We use no Welded Crankshafts, No Welded or Repaired Cylinder Heads or Cylinder Blocks, and No Cylinder Sleeves in Cracked Cylinders. All Long Blocks are Blueprinted to OEM Specifications with all OEM Updates Included.
Blackwater Engines Replaces, not repairs Damaged Cranks, Blocks, and Cylinder Heads.
All Diesel and Gas Engines are Remanufactured Long Blocks using Materials from the same Suppliers as the OEM and Machined on CNC Equipment to meet or exceed OEM Specifications.


text:
Prominent economist to offer guide to 'Israel at Crossroads'
Shoresh's head says crises pose existential threat to future growth
By NJJN Staff October 24, 2018, 12:00 pm Edit
Prof. Dan Ben-David says challenges facing Israel "must be addressed now, while it is still possible to do so."
What kind of country will Israel become? Prof. Dan Ben-David said his presentation, "Israel at a Crossroads: Shaping the Future of a Nation," will offer a signpost pointing to a hopeful route away from crisis.
His talk, on Wednesday, Oct. 31, at 7:30 p.m. at New Jersey Performing Arts Center in Newark, is part of the center's ongoing series of Israel- and Jewish-themed programs.
Ben-David — president of the nonpartisan Shoresh Institution for Socioeconomic Research at Tel-Aviv University and a senior faculty member in its Department of Public Policy — is among the most prominent voices in the field of economics today.
Outside of Israel, he said, much of the discourse on the country "continues to focus on an outdated set of paradigms." But within Israel, "there is a growing realization that the country's core challenges have shifted [and] an internalization that Israel is at a crossroads."
While it is home to "some of the world's most innovative private-sector companies [and] leading universities and medical centers," Ben-David said, "a very large — and increasing — share of the population is being left behind," ill-equipped to meet the demands of a global competitive economy.
"Israel's labor productivity is below that of most developed countries," he said, and the country "is beset by some of the highest rates of poverty and income inequality in the developed world."
These gaps and a sorely lagging educational system threaten Israel's "future economic sustainability — and consequently survival in the world's most dangerous region."
How the country faces these challenges will determine the direction that Israel's society and economy are headed. This threat, he said, "must be addressed now, while it is still possible to do so."
Ben-David was among Israel's top academics who founded Shoresh in 2015 as the country's only policy research institution whose sole focus is on long-term existential threats to Israel. The wide dissemination of the institution's evidence-based analyses, said Ben-David, "spans the spectrum" — including briefings to cabinet ministers, members of Knesset, other top policy makers, editorial staffs in the media, and organizations in Israel and abroad — and has earned it widespread respect and trust throughout Israeli government and society.
He noted that Shoresh's material — including, and particularly relating to his talk, the "Shoresh Handbook" — can be accessed on its website.
The writer of a regular column for the Haaretz newspaper, Ben-David has served as an adviser to the World Bank and to the director-general's office of the World Trade Organization.
He has garnered many honors throughout the years, among them Tel-Aviv University's Outstanding Teacher Award, being named "Person of the Year" by the "Calcalist" newspaper, and twice earning a place among "Haaretz-TheMarker" newspaper's "100 most influential people in Israel."


text:
U.S. steps up disclosure pressure on Chinese companies
WASHINGTON , December 03, 2021 13:47 IST
The rule steps up a long-running standoff between Washington and Beijing over how much information companies with U.S.-traded shares must disclosed.
Separately, the U.S. government earlier barred Americans from investing in the stocks, bonds and other securities of Chinese companies deemed to be linked to the ruling Communist Party's efforts to upgrade its military technology. File Image. | Photo Credit: AP
Chinese companies will have to disclose more information about audits and whether they are controlled by a government or else leave U.S. stock markets under a rule approved by securities regulators.
The rule approved Thursday by the Securities and Exchange Commission steps up a long-running standoff between Washington and Beijing over how much information companies with U.S.-traded shares must disclosed.
Companies that used an auditor in a foreign jurisdiction will be required to confirm they are not "owned or controlled by a government entity" there, according to the SEC. Companies also will be required to disclose additional information in annual reports.
"Trading prohibitions" can be imposed on some companies, the SEC said.
Other governments cooperate with U.S. demands for more financial details from companies to prevent false reporting. But Beijing, citing security concerns, refuses to allow the U.S. Public Companies Accounting Oversight Board to review work of Chinese auditors.
Hundreds of Chinese companies have raised tens of billions of dollars in U.S. financial markets, but their status is a matter of growing dispute with Beijing.
The latest rule applies to audit firms the PCAOB is "unable to inspect or investigate," the SEC said, a group that would be mostly Chinese.
Separately, the U.S. government earlier barred Americans from investing in the stocks, bonds and other securities of Chinese companies deemed to be linked to the ruling Communist Party's efforts to upgrade its military technology.
Nepal civil society figures call for Minister's removal after hate speech
Printable version | Jan 22, 2022 8:27:30 AM | https://www.thehindu.com/news/international/us-steps-up-disclosure-pressure-on-chinese-companies/article37819353.ece


Sometimes blessings come in the weirdest ways. For months my mom has been asking me, "Are you coming to the family reunion this year?" Every time she asked I'm like, "Yes mom," but deep down inside I knew I really didn't want to go. Part of me wanted to just stay home and work, and the other part of me was getting a little weirded out because, well, you know how family reunions as can be. Or maybe it was the 16 hour bus ride to and from New York City to Myrtle Beach that had me thinking this family reunion wasn't for me. I kept thinking– it's going to be sooo hot, and what about the Wi-Fi?!
Well, this past weekend I put all that aside and went to Myrtle Beach for what turned out to be an amazing family reunion. I got to hang out with family that I knew, and meet new family members and I've never met before. I also experienced the tastiest crab meal dinner of my life at Boardwalk Beach in SC.
All and all, I am really glad that I made it and as you can probably tell by the pictures, I had a great time.


A fluid delivery cannula which provides an interface between an access point or port site in the body of a patient and a working channel which may receive tools or instruments used during surgical procedures which may be less invasive surgical procedures than traditional open procedures. The cannula allows introduction of fluid(s) into the port site and then into tissue generally at or near that location within the body of the patient. The fluid delivery cannula includes an expandable sleeve that may itself comprise a cannula through which a needle, or trocar assembly is inserted. At least one fluid passageway, is defined, for example, in either the expandable sleeve itself, or defined, by the combination of the needle or trocar assembly and the expandable sleeve. Visual identifiers are used with the fluid delivery cannula to visually distinguish the location of the fluid passageway relative to an adjacent area.
This application is a continuation-in-part of prior application Ser. No. 10/786,647, filed Feb. 25, 2004 (pending) which is a continuation of prior PCT Serial No. PCT/US02/29356 filed on Sep. 17, 2002 (expired) which claims the benefit of U.S. Provisional Patent Application Ser. No. 60/325,806, filed on Sep. 28, 2001 (now abandoned) and 60/341,032, filed on Dec. 12, 2001 (now abandoned), and which is a continuation-in-part of prior U.S. Ser. No. 09/934,399, filed on Aug. 21, 2001 (now U.S. Pat. No. 6,695,815) which is a continuation of prior U.S. Ser. No. 09/511,100 filed on Feb. 23, 2000 (now U.S. Pat. No. 6,302,873). The disclosures of each of these prior related applications are hereby fully incorporated by reference herein.
This invention generally relates to cannulas and, more specifically, to cannulas used during surgery for allowing the introduction of instruments, such as laparoscopic, endoscopic, arthroscopic or other tools, during surgical procedures.
Various levels of less invasive surgery are popular alternatives to more traditional open surgical procedures. Such less invasive techniques are generally referred to herein as "minimally invasive," however, some techniques are more invasive than others. Minimally invasive surgery generally results in less pain and shorter hospital stays for the patient. Also, performing a surgical procedure through less invasive techniques can be substantially less costly than more traditional surgical approaches.
Minimally invasive surgical techniques require access into the body of a patient through a small working channel of an apparatus, such as a trocar-cannula assembly, also known in various forms as a "trocar-cannula complex." A relatively small access incision is made in the patient at the appropriate location on the patient to receive the trocar-cannula assembly. When the trocar-cannula assembly is combined with long, narrow instruments, the resulting assembly allows a surgeon to work at various locations inside the body through the small access incision or port site. For example, the location may be an abdominal cavity, joint cavity or other cavity or location in the body of the patient. This approach has resulted in the aforementioned clinical advantages and extensive health care cost savings.
Traditionally, the trocar-cannula complex has been configured with three parts. The first part is the top portion and is referred to in the medical industry as the hub. The hub defines the entrance to the trocar-cannula complex and also includes various seals and air insufflation components. The second part is the trocar, which is a long, narrow blade extendable through an inner cannula to allow smooth penetration into the body of the patient through the tissue layers. The third portion is an outer cannula which is a tubular member of the complex adapted to pass into the body cavity. The outer cannula provides an interface between the patient's tissue at the access incision or port site and the trocar assembly.
Minimally invasive surgery has grown in popularity in recent years and many new types of trocar-cannula products have been proposed and introduced to address different surgical needs and procedures. The various trocar-cannula complexes include reusable and disposable cannulas and trocars, as well as hybrid varieties that comprise combinations of reusable and disposable components of the trocar-cannula complexes. A complex which is a combination of reusable and disposable components is known as a resposable device. Such devices continue to improve surgical outcomes and economics.
Animal studies on cancer treatments involving the performance of minimally invasive surgery point to a growing body of evidence which supports the concept of delivering an irrigant to the port site after the surgical procedure. In these studies, the irrigants were delivered by a syringe and needle and included substances such as betadine, saline and lidocaine. These studies showed that irrigating the port site with such substances immediately after the surgical procedure beneficially resulted in a lower incidence of infection or less pain, depending on the irrigant. However, the technique also resulted in increased operative time and increased exposure of the surgical staff to needle sticks. In addition, the potential for contaminants to spread to the port site during the surgery has been well documented. Irrigation performed only at the end of the surgical procedure unfortunately cannot reduce patient exposure to contaminants during the procedure nor adequately reduce pain at port site.
In view of the above-mentioned drawbacks in the field, there is a need for more effective delivery of fluids to an access point or port in the body of a patient before, during, and/or after the performance of minimally invasive surgery. Such delivery of fluid(s) could assist in patient treatment, such as through the delivery of cancer treatment medication or other medication, as well as reduction of port site contamination and infection, and further reduction of post-operative pain as compared to injection at the end of the case. Other uses of the invention may be made in connection with delivering any desired fluid substance to a patient.
One form of the present invention is a method for administering fluid directly to a port site located in a section of tissue. A radially expanding tubular structure is introduced into the port site. The radially expandable tubular structure includes an outer surface adapted to interface with the port site and defines a lumen. The fluid is delivered to the port site via at least one fluid passageway in fluid communication with the outer surface. The at least one fluid passageway includes a portion at least defined in part by the radially expandable tubular structure.
Another form of the invention includes a method of administering fluid directly to a port site located in a section of tissue. The method includes placing an insert into a lumen defined in the radially expandable tubular structure having an outer surface adapted to interface with the port site. The radially expandable tubular structure and insert is introduced into the port site. The fluid is delivered to the port site via at least one fluid passageway in fluid communication with the outer surface. The at least one fluid passageway includes a portion at least defined in part by the radially expandable tubular structure.
In another form, the invention includes an apparatus to administer fluid into a port site formed in an area of tissue from a location outside of the port site via at least one fluid passageway. The apparatus includes a radially expandable tubular structure defining a lumen. The radially expandable tubular structure includes an outer surface constructed and arranged to interface with tissue. The at least one fluid passageway is in fluid communication with the outer surface and includes a portion at least defined in part by the radially expandable tubular structure. The apparatus also includes an insert passing into the lumen.
A further form of the invention is a kit for administering fluid into a port site formed in a section of tissue from a location outside of the port site. The kit includes a radially expandable tubular structure defining a lumen. The radially expandable tubular structure includes an outer surface adapted to interface with the port site and a distal end. The kit further includes a needle for insertion into the lumen that assists with implanting the radially expandable tubular structure. A cannula is included having an external diameter greater than the diameter of the lumen of the tubular structure in its unexpanded state. Insertion of the cannula into the lumen radially expands the radially expandable tubular structure. A fluid pathway is in fluid communication with a location outside of the port site and at least one of the outer surface and the distal end.
Another form of the invention is a method for directing the application of fluid into a port site formed in a patient. A fluid delivery device defining at least one fluid passageway in fluid communication with the port site is introduced into the port site. A visual identifier located on the fluid delivery device is observed to visually distinguish the location of the at least one fluid passageway relative to an adjacent area of the fluid delivery device.
Various objects, advantages and features of the invention will become more readily apparent to those of ordinary skill upon review of the following detailed description of the illustrative embodiments taken in conjunction with the accompanying drawings.
FIG. 1 is a perspective view showing a trocar-fluid delivery cannula complex constructed in accordance with the invention and being used during a minimally invasive surgical procedure.
FIG. 2 is a cross sectional view taken generally along the longitudinal axis of the trocar-fluid delivery cannula complex of FIG. 1 for showing the irrigant flow path.
FIG. 3 is an enlarged cross sectional view similar to FIG. 2, but more clearly showing the flow path for the delivery of fluid through the cannula.
FIG. 4 is a cross sectional view taken along line 4-4 of FIG. 2.
FIG. 5 is a plan view of the fluid delivery cannula with the outer layer or sheath removed for clarity.
FIG. 6 is a plan view of another embodiment in which the fluid delivery cannula is integrally formed with a portion of a trocar hub.
FIG. 7 is a cross sectional view taken along line 7-7 of FIG. 6.
FIG. 8 is a longitudinal cross sectional view similar to FIG. 2, but illustrating an alternative embodiment of the invention incorporating an expandable fluid delivery sleeve.
FIG. 9 is a perspective view of another alternative embodiment of an expandable fluid delivery sleeve or cannula.
FIG. 10 is a cross sectional view taken along line 10-10 of FIG. 9.
FIG. 11 is an enlarged perspective view of the distal end of another expandable fluid delivery sleeve or cannula.
FIG. 12A is an elevational view illustrating inserting a needle into the expandable fluid delivery sleeve of FIG. 9.
FIG. 12B is a elevational view illustrating introducing the expandable fluid delivery sleeve of FIG. 9 into a port site and administering fluid.
FIG. 12C is an elevational view illustrating removing the needle from the expandable fluid delivery sleeve of FIG. 9.
FIG. 12D is an elevational view illustrating a trocar cannula assembly being inserted into the implanted expandable fluid delivery sleeve of FIG. 9.
FIG. 12E is an elevational view illustrating that fluid can optionally be administered after the trocar cannula assembly has been inserted into the expandable fluid delivery sleeve.
FIG. 13A is a cross sectional view of the combination of the expandable fluid delivery sleeve of FIG. 9 and the needle illustrated in FIG. 12B highlighting a fluid pathway through the sleeve.
FIG. 13B is a cross sectional view of the combination of the expandable fluid delivery sleeve of FIG. 9 and the trocar cannula assembly illustrated in FIG. 12E highlighting a fluid pathway through the sleeve.
FIG. 14 is a cross sectional view of the combination of the expandable fluid delivery sleeve and needle illustrated in FIG. 12B highlighting a fluid pathway through the area defined between the needle and the sleeve.
FIG. 15 is a partial cross section view through the expandable fluid delivery sleeve of FIG. 9 highlighting a fluid pathway through the area between the trocar cannula assembly and the sleeve.
FIG. 16 is an enlarged cross sectional view of an alternative embodiment of the insert of FIG. 12A illustrating a fluid passageway through a lumen in the needle.
FIG. 17 is a perspective view of the expandable fluid delivery sleeve and needle of FIG. 12A illustrating a color coding technique to highlight a zone containing perforations on the sleeve.
FIG. 1 illustrates a trocar-fluid delivery cannula complex 10 constructed in accordance with one preferred embodiment of the invention. Complex 10 includes a trocar assembly 12 which may include a conventional hub assembly 14. Representative trocar assemblies are shown and described in previous patents, such as my previous U.S. Pat. Nos. 6,063,060; 6,039,725; 5,865,817; and 5,865,809, the disclosures of which are hereby fully incorporated by reference herein. In accordance with the invention, a cannula 16 is positioned on the outside of trocar assembly 12 and includes a base portion 16 a. A syringe 18 couples to base portion 16 a of cannula 16 through a fluid coupling, such as a standard luer connector assembly 20. A plunger 18 a of syringe 18 is used to manually inject a fluid into base portion 16 a of cannula 16. An outer layer or sheath 24, preferably formed of PTFE (Teflon®), is secured to the outer surface of an inner tube 26 of cannula 16 and includes apertures 22. In the preferred embodiment, sheath 24 is a tube which is heat shrunk onto inner tube 26 but it may take other forms and may be secured in other ways. As will be described below, cannula 16 includes appropriate fluid passages communicating with an inlet passage in base portion 16 a to allow the fluid to be dispensed through apertures 22 as shown by arrows 28. Hub assembly 14 further includes an insufflation valve 30 and a gas inlet 32 for receiving a pressurized gas, such as CO2.
As further shown in FIGS. 2 and 3, base portion 16 a of cannula 16 is threaded onto hub assembly 14 by threads 34. Thus, cannula 16 may be easily coupled to and decoupled from hub assembly 14. In the preferred embodiment, cannula 16 is disposable, however, it also may be manufactured as a reusable device intended to be sterilized between uses. Trocar assembly 12 more specifically comprises a trocar 50 received by a protective shield 52. It will be appreciated that other instruments and tools may be inserted through the working channels formed by either irrigating cannula 16 or other tubular member(s) positioned within cannula 16. This includes many other configurations of trocars or trocar assemblies as generally recognized in the art.
More specifically referring to FIGS. 3-5, irrigation fluids are introduced through luer connector 20 a (FIG. 3) into fluid inlet 60 and groove or channel 62 formed in inner tube 26 of cannula 16. Groove 62 communicates with an annular, circumferential groove 64 and groove 64 communicates with three separate longitudinal grooves 66 which are spaced in 120° increments about inner tube 26. Grooves 66 respectively communicate with three partially annular grooves 68 which, in turn, each communicate with two longitudinal grooves 70. Longitudinal grooves 70 communicate with apertures 22 in sheath 24 and apertures 22 thereby dispense the fluid at the port site 40 or, if cannula 16 is appropriately inserted and positioned, elsewhere within the patient.
As mentioned above, the outer sheath 24 of the cannula 16 is preferably formed of PTFE and, more preferably, the outer sheath 24 is transparent or at least translucent. In addition, the area of sheath 24 containing apertures 22 may be formed with a distinct color, texture or other visually identifiable indicia which allows the surgeon to accurately position the apertures 22 with respect to the tissue to be infused with irrigation fluid. The various grooves in the outside surface of the inner tube 26 may be substituted with one or more passages within the walls of the inner tube 26 and may be of any suitable configuration and shape so long as the function of delivering fluid through the wall of the cannula 16 is facilitated by the configuration. The outer wall or sheath is a heat shrinkable material, such as an elastomeric material, however, this may also be substituted by other components or even eliminated, for example, if the passages and apertures are in the wall of an integrally formed cannula or if another fluid delivery structure is carried on the outer cannula. The inner tube in the preferred embodiment is preferably formed from aluminum with the various grooves in its outer surface being machined, however, it may instead be formed of other materials, such as plastic materials, and formed by other techniques such as molding. The preferred embodiment is especially advantageous in that it is simple to manufacture and the outer sheath forms a seal at the upper and lower ends of the inner tube while, at the same time, defining walls of the internal passages formed by the various grooves.
FIGS. 6 and 7 illustrate a second illustrative embodiment of the invention comprising a fluid delivery cannula 100 which includes an irrigating portion 102 and a hub or housing portion 104 formed in one piece. For example, the entire structure shown in FIGS. 6 and 7 may be molded from a polymeric material, such as conventional medical grade polymers, using Mu-cell technology or other appropriate molding techniques. In FIGS. 6 and 7, the outer layer or sheath containing the one or more perforations has been removed for clarity. Housing portion 104 includes a port 106 for receiving valving and gas input components as are known in the art. A fluid input 108 is formed on cannula 100 and communicates with a passage 110 for the introduction of the necessary or desired fluids to irrigation portion 102. A space 112 is provided for the necessary valving, sealing components, etc., typically used in trocar hubs. A lumen 114 extends along an axis 116 for receiving the trocar (not shown) and other working instruments. A system of fluid delivery passages is formed on the outside surface of irrigation portion 102 in the same illustrative pattern as discussed with respect to the first embodiment. This includes an annular groove 120 which communicates with passage 110 and delivers the fluid to three separate longitudinal passages 122 positioned at 120° increments around the outside surface of irrigation portion 102 relative to axis 116. Grooves 122 communicate with respective partially annular grooves 124. Again, while only two grooves 124 are shown in the drawings, a total of three grooves are formed in the outer surface of irrigation portion 102 positioned at 120° increments about axis 116. Each partially annular groove 124 communicates with two separate longitudinal grooves 126. Although only two grooves 126 are shown in FIG. 6, it will be appreciated that a total of six such grooves are formed in the outer surface of irrigation portion 102 in this particular embodiment. As in the first embodiment, grooves 126 communicate the fluid to perforations in the outer sheath (not shown) which then deliver the fluid to the patient. The outer sheath, as in the first embodiment, is preferably heat shrunk onto irrigation portion 102 so as to seal all of the grooves in the same manner as shown, for example, in FIGS. 2 and 3 of the first embodiment. As mentioned above, it will be appreciated that many other configurations of fluid delivery passages may be utilized in the cannula within the spirit and scope of this invention.
In FIG. 8, like reference numerals refer to like elements of structure between the two embodiments. In the alternative trocar-cannula complex 150 of FIG. 8, the outer sleeve or layer 24 (not shown) which was affixed to the grooved cannula 26 has been removed and replaced by an expandable sleeve 152. Expandable sleeve 152 may be a layered construction including a mesh layer 154 and an outer elastomeric layer 156. Layer 156 is uniformly perforated about its entire periphery, such as in a circumferential zone 158 as shown in FIG. 8, so that at least some of the perforations 160 line up with the longitudinal grooves 70 of the cannula 26. Thus, fluid is delivered through input 20 a and into grooves 66, 68, 70 as described previously with respect to the first embodiment and this fluid is transferred through the expandable inner mesh layer 154 and expandable outer elastomeric layer 156 containing perforations 160. It will be appreciated that many other forms than the layered mesh construction shown may be used in place of the expandable sleeve 152 shown in FIG. 8. FIG. 8 illustrates the use of the expandable sleeve 152 in connection with a 10 mm trocar assembly, however, in accordance with this aspect of the invention, the expandable fluid delivery sleeve 152 may alternatively be used with other trocars having larger or smaller diameters. A rigid handle portion 162 is provided at the proximal end of sleeve 152 to allow application and removal of sleeve 152 to and from trocar 12. In order to seal the distal end of the expandable sleeve, a seal 164 may be provided distally of the mesh layer 154 as generally illustrated in FIG. 8. Alternatively, this seal 164 may be eliminated and the mesh layer 154 could then allow additional fluid to be delivered from the distal end of the sleeve 152.
FIGS. 9 and 10 illustrate another embodiment of an expandable fluid delivery sleeve 200 which does not need the separate cannula 26 (FIG. 8) for fluid delivery as in the embodiment of FIG. 8. Instead, this sleeve 200 is formed in a manner allowing fluid delivery to take place via an input 202 and sleeve 200 alone. Sleeve 200 is formed of a layered construction including an outer perforated layer 204, an intermediate mesh layer 206, and an inner layer 208. Each layer 204, 206, 208 is expandable such that sleeve 200 may be used effectively on trocars having different diameters. The intermediate mesh layer 206 allows fluid to travel through the interstices therein from an appropriate fluid passageway extending through input 202 and an upper handle portion 210. Alternatively, other types of fluid passages may be utilized. A trocar (not shown) is inserted through the bore 212 at the proximal end such that it extends through the distal end 214 of the expandable sleeve 200. Perforations 216 are preferably formed in a desired zone 218 of sleeve 200 generally as described with respect to the previous embodiments. This zone 218 may be formed of a different color or in any other manner which indicates the positioning of the perforations to the doctor during the surgical procedure. Although not shown in FIGS. 9 and 10, this sleeve 200 may also have a seal at the distal end 214 to prevent fluid from leaking out the distal end 214.
As exemplified in FIG. 11, a distal end 230 of the expandable sleeves may be formed so as to allow fluid delivery to take place directly at the distal end. This aspect is shown in FIG. 11 schematically by indicating that the intermediate mesh layer 206 extends slightly beyond the other layers or is otherwise unsealed and, therefore, the fluid pathway through the mesh material 206 remains unblocked at the distal end 230. This general aspect of fluid delivery from the distal end 230 may be used alone or in conjunction with fluid delivery from surface perforations as previously described.
Referring now to FIGS. 12A through 12E, a method for administering fluid directly to a port site using the expandable fluid delivery sleeve 200 is illustrated. Identical reference characters refer to identical aspects of the embodiments that have already been described. This method is illustrated to apply to a laparoscopic surgery, however, it can apply to other medical procedures. Initially, the expandable fluid delivery sleeve 200 is introduced into the port site 40. FIG. 12A illustrates placing a needle or other insert 232 into the bore or lumen 212 of the expandable fluid delivery sleeve 200. The form of the needle 232 can vary in alternate embodiments. For example, the needle 232 could be the Step™ Insulflation/Access Needle, 14 gauge size available from Autosuture located in Norwalk, Conn. This needle 232 is compatible with Versastep™ Plus Access systems. The Step™ needle is a blunt headed needle and does not form the incision. However, those skilled in the art recognize that in other embodiments the needle 232 can be designed to form the incision to introduce the expandable fluid delivery sleeve 200 into the patient. The Step™ needle is composed of a metallic material, however, in other embodiments other materials can be used. Moreover, the gauge of the needle 232 can vary from embodiment to embodiment.
FIG. 12B illustrates the expandable fluid delivery sleeve 200 inside the port site 40. The combination of the needle 232 and the expandable fluid delivery sleeve 200 is implanted into the port site 40 formed in the patient. As FIG. 12B illustrates, fluid is then delivered to the port site 40 via a fluid passageway that connects an area outside of the port site 40, such as, but not limited to, the fluid input 202 to the outer surface 234 of the outer perforated layer 204.
Note that the fluid can be applied at different times in different embodiments. For example, FIG. 12E described herein below, illustrates delivering the fluid after the needle 232 has been removed and a trocar and cannula assembly 236 has been inserted. Alternatively, the fluid could be delivered after the needle 232 has been removed but before the trocar cannula assembly 236 has been inserted. Accordingly, those skilled in the art recognize that the fluid could be delivered any time the expandable fluid delivery sleeve 200 has been introduced into the port site 40 in differing embodiments.
Referring now to FIG. 12C, the needle 232 is illustrated as being removed from the expandable fluid delivery sleeve 200. At this point in the process, the expandable fluid delivery sleeve 200 is now lodged in the port site 40 but has not yet been dilated to allow access by the medical professional.
FIG. 12D illustrates a trocar and cannula assembly or other second insert 236 being inserted into expandable fluid delivery sleeve 200. Insertion of the trocar cannula assembly 236 achieves two purposes. First, the cannula 236 a is easily slid into the expandable fluid delivery sleeve 200 because of the shape of the trocar 236 b. Second, the cannula 236 a radially expands the expandable fluid delivery sleeve 200 and provides a working opening or channel for the medical professional.
Referring now to FIG. 12E, an alternative step is illustrated. In this step, fluid is delivered to the port site 40 using a fluid passageway that is in communication between the inlet 202 and outer surface 234 after the trocar and cannula assembly 236 has already been inserted. A fluid is applied through the desired zone 218 because of the perforations 216 formed in the outer surface 234. In this embodiment, the fluid passes through outer surface 234 using perforations 216, however, in other embodiments, alternative methods and fluid paths may be used.
FIGS. 13A and 13B illustrate one technique for delivering fluid from the inlet 202 to the outer surface 234. In these embodiments, the inlet 202 is a port which is in fluid communication with a channel 238 that is defined between the outer layer 204 of the expandable fluid delivery sleeve 200 and the bore or lumen 212 of the expandable fluid delivery sleeve 200. The channel 238 begins at the inlet 202 and communicates with an annular groove or path 239 defined in the upper handle portion 210. The channel 238 then proceeds down through the area defined between the outer surface 234 of the expandable fluid delivery sleeve 200 and the bore or lumen 212 defined therein. The bore or lumen 212 of the expandable fluid delivery sleeve 200 is illustrated in this embodiment as being occupied by the needle 232. This channel 238 could be filled with a mesh layer 206 as illustrated in FIG. 10 or could be simply an open layer with nothing contained therein. Alternatively, the channel 238 can be defined in alternate manners besides layers. In some embodiments, the channel 238 is sealed at the distal end 214 to ensure that the fluid passes through perforations 216 defined in the outer layer 204. In other embodiments, a sufficient seal is formed when the expandable fluid delivery sleeve 200 is passed into the port site 40, therefore obviating the need for the channel 238 to be closed at the distal end 214. FIG. 13B illustrates a very similar cross sectional view to FIG. 13B. The difference between the figures lies in the fact that a trocar and cannula assembly 236 is inserted into the expandable fluid delivery sleeve 200 in FIG. 13B. As in FIG. 13A, the channel 238 delivers the fluid from inlet 202 to the outer surface 234 of the expandable fluid delivery sleeve 200. As with the embodiment illustrated in FIG. 13A, the distal end 214 of the expandable fluid delivery sleeve 200 can be open or closed.
Referring now to FIG. 14, an alternative technique for delivering the fluid to the outer surface 234 of the expandable fluid delivery sleeve 200 is illustrated. Initially, the fluid enters into the expandable fluid delivery sleeve 200 through inlet 202. In the illustrated embodiment, inlet 202 is a port designed to receive a syringe, however, in other embodiments it could be an alternative passageway enabling fluid to pass into the expandable fluid delivery sleeve 200. Moreover, in other embodiments, the fluid is delivered using a suitable medical pump or other device. In this embodiment, the fluid enters into inlet 202 and then passes down into the annular groove 239 and then into the area defined between the bore or lumen 212 of the expandable fluid delivery sleeve 200 and the needle 232. The outer layer 204 of the expandable fluid delivery sleeve 200 has perforations 216 defined thereto that allow the fluid to reach the outer surface 234. Again, as in FIGS. 13A and 13B, the distal end 214 of the expandable fluid delivery sleeve 200 can be closed or open. FIG. 15 illustrates the same technique except with a trocar and cannula assembly 236 inserted into the expandable fluid delivery sleeve 200.
The bore or lumen 212 of the expandable fluid delivery sleeve 200 includes the mesh layer 206 in the embodiment illustrated in FIG. 15, however, in other embodiments the mesh layer 206 is not included in the lumen 212. Moreover, in some embodiments, an additional cannula or any other structure defining a fluid flow path can be used and positioned anywhere between an inner surface or structure defining lumen 212 and the outer surface or structure of the structure positioned therein.
FIG. 16 illustrates another technique for delivering a fluid to the outer surface 234 of the expandable fluid delivery sleeve 200. In this embodiment, the needle 232 is shown placed into sleeve 200 and the needle 232 has a lumen 240 defined therein. A fluid can therefore pass from the inlet 202 at the top, or along another portion of the needle 232, and down through the lumen 240. The fluid passing through lumen 240 flows through cross bores 242 that deliver the fluid outside of the needle 232 and into the lumen 212 of the expandable fluid delivery sleeve 200. From there, the fluid flows out the perforations 216 to the outer surface 234 of the expandable fluid delivery sleeve 200. Those skilled in the art will recognize that instead of forming a lumen or fluid path in a needle one could be formed in a trocar and cannula assembly. A lumen or fluid path can be defined through the trocar with cross bores through the trocar. In addition, cross bores through the cannula could be formed as well to provide a fluid path. Other fluid paths could be used as well.
Referring now to FIG. 17, a color coding system is illustrated. FIG. 17 includes a plurality of identifiers 244 that are visibly recognizable. The visual identifiers 244 visually distinguish the desired zone 218 from the areas adjacent to the desired zone 218. Setting off the desired zone 218 from the areas adjacent to the desired zone 218 allows the medical professional to place the sleeve 200 correctly into the port site 40. In this illustrated embodiment, the visual identifiers 244 are located on the outer surface 234 of the expandable fluid delivery sleeve 200, however, those skilled in the art recognize that the visual identifiers 244 could be located upon any fluid delivery member, including, but not limited to, the expandable fluid delivery sleeve 200, the needle 232, the trocar and cannula assembly 236, or any other fluid delivery member usable for visualization purposes during the fluid delivery procedure. In some embodiments, the visual identifier(s) 244 may be one or more different colors. In other embodiments, the visual identifiers 244 are markings made upon the expandable fluid delivery sleeve 200. Other embodiments use stripes, dots, or even shades of the same color. Moreover, in some alternative embodiments, small raised bumps or other physical constructions are used as visual identifiers 244. Those skilled in the art will recognize that the visual identifiers 244 can vary between different embodiments so long as they visually distinguish the desired zone 218 from the adjacent areas.
In this embodiment, the visual identifiers 244 are three different colors. Those skilled in the art recognize, however, that only one color would be necessary to distinguish the desired zone 218 from the adjacent areas. The first one is a red/pink area 246 to describe the area just above the desired zone 218 containing the perforations 216. The other visual identifier 244 is the blue colored area 248 to indicate the location of the desired zone 218 containing the perforations 216. The yellow/gold area 250 indicates the area right below the desired zone 218 containing the perforations 216.
During introduction of the expandable fluid delivery sleeve 200 into the port site 40, the medical professional will observe the color coded zones in the port site or the patient's body cavity (e.g., the abdominal cavity or a joint cavity, etc.). This enables one skilled in the art of laparoscopy or arthroscopy to specifically identify where the zone of fluid delivery or infusion is located relative to the anatomy. This visual clue enables accurate fluid delivery via the expandable sleeve of a biologically active substance into the appropriate area. In this illustrative embodiment, if a portion of the blue area 248 is visible, whether from outside the patient through the naked eye, or by an endoscope inside the body cavity, the medical professional can adjust the position of the expandable fluid delivery sleeve 200 to ensure the fluid is delivered directly to the port site 40. Accordingly, use of the visual identifiers 244 assists the medical professional in precisely placing the expandable fluid delivery sleeve 200 into the port site 40.
Moreover, the lengths of these identifiers 244 vary in alternate embodiments depending on the intended patient. For example, a patient with a higher body fat percentage may require a longer desired zone 218 therefore requiring a longer blue area 248. The other visual identifiers 244 above and below the desired zone 218 may also need to be changed in length. Conversely, a patient with a low body fat content or a pediatric patient may need a shorter desired zone and accordingly, the length of the visual identifiers 244 would be different.
Many different types of irrigation fluids may be introduced through the fluid delivery devices of this invention. These include, but are not limited to, saline solutions, lidocaine-containing fluids, betadine-containing fluids, cancer treatment fluids, or any other fluid necessary or desired for a particular medical procedure. In addition, fluids other than irrigation fluids or treatment fluids may be delivered through the devices of this invention. As one additional example, bioadhesives may be delivered to an incision site or any other necessary tissue repair site to provide for quicker and more effective administration of the adhesive to the desired site. Many different types of trocars and cannulas may be utilized within the scope of this invention. These trocars and cannulas may be inserted through a port site of a patient together in one operation or separately, for example, by using a needle introducer for an expandable cannula and subsequently introducing the trocar and cannula assembly as illustrated.
b) delivering said fluid to said port site via at least one fluid passageway in fluid communication with said outer surface, said at least one fluid passageway including a portion at least defined in part by said radially expandable tubular structure.
c) delivering said fluid to said port site via at least one fluid passageway in fluid communication with said outer surface, said at least one fluid passageway including a portion at least defined in part by said radially expandable tubular structure.
3. The method of claim 2, further including expanding said radially expandable tubular structure.
e) inserting a second insert into said lumen.
5. The method of claim 4, wherein said insert is a needle and said second insert is a trocar and cannula assembly.
6. The method of claim 5, wherein said trocar and cannula assembly dilates said radially expandable tubular sleeve.
7. The method of claim 2, wherein said insert is a needle.
8. The method of claim 2, wherein said portion includes an area defined between the lumen and the insert.
9. The method of claim 2, wherein said at least one fluid passageway includes a lumen defined in said insert.
10. The method of claim 2, wherein said portion includes a channel defined between the outer surface of said radially expandable tubular structure and the lumen of said radially expandable tubular structure.
an insert passing into said lumen.
12. The apparatus of claim 11, wherein said insert is a needle.
13. The apparatus of claim 11, wherein said insert is a trocar and cannula assembly.
14. The apparatus of claim 11, wherein said at least one fluid passageway includes a lumen defined through said insert and perforations formed through at least said outer surface.
15. The apparatus of claim 11, wherein said at least one fluid passageway includes the area located between said insert and said lumen and perforations formed through at least said outer surface.
16. The apparatus of claim 11, wherein said at least one fluid passageway includes a channel defined in said radially expandable tubular structure and perforations formed through at least said outer surface.
17. The apparatus of claim 11, wherein said outer surface of said radially expandable tubular structure includes a visual identifier, on said outer surface, said visual identifier visually distinguishing the location of said fluid passageway relative to an adjacent area of said outer surface.
18. The apparatus of claim 17, wherein said visual identifier comprises a color.
19. The apparatus of claim 17, wherein said visual identifier identifies a portion of said outer surface of said radially expandable tubular structure defining a plurality of perforations in communication with said fluid passageway.
wherein at least one fluid pathway is in fluid communication with said location outside of said port site and at least one of said outer surface and said distal end.
observing a visual identifier on said fluid delivery member to visually distinguish the location of the at least one fluid passageway relative to an adjacent area of said fluid delivery member.


A couple of weeks ago, I was invited to attend the launch of new Spring Summer products of none other than the super talented, Sophie Conran. Not only am I a huge fan of Sophie's work, but I see her as such an inspirational lady, somebody I admire so much. Not only does she design and create the most gorgeous homeware, (most of which I already own and I'm still adding), she can bake and cook and have a few books under her name, to mention just a few of her accomplishments. She is a working mother and seem to juggle all of these talents brilliantly. I have met Sophie a few times before over the years and I can honestly say, she is always so friendly, down to earth and approachable.
At this latest launch, I only expected to see a new range of china, her original white range being updated with a cobalt blue pattern. So you can image my delight at the new addition of hand blown glass bowls, colourful lampshades with bauble trims (gasp), woven baskets, and more. Just look at these striking blue patterns adorning our favourite white china. Just note the cute "# Sophie Conran" cookie stamps, on homemade biscuits of course. Here are the latest and newest products from Sophieconran.com.
Oh, and please do read my interview with Sophie, further below….
Woven placemats and lamp shades, all new additions to the collection.
Meet Sophie Conran, the woman behind out most loved home wares.
I am interior designer, cookery writer and mother of two.
How would you describe your work to a stranger?
I work with lots of different companies, and their fantastic design teams, creating products for my online shop. My aim is to design practical homeware items that are a joy to use every day.
My family does. My son Felix – with what he is doing and the energy that he applies to his work. He is incredibly positive. My daughter Coco, who is super organised and meticulous – working on some gorgeous things. Also my mother (on the opposite end of the spectrum!) who is in her 70's. First and foremost, she is happy. She is busy gardening, cooking and writing her books, as well as doing beautiful paintings. She has an incredible creativity.
I would like them to be cherished in every household.
The dressing gown in my bed linen collection. It is comfortable and chic.
I love your White china range and it seems to be as popular as the day it was launched in 2006. The longevity of your products is just one reason that makes them so popular, what is your design secret with regards to this?
I think the products are familiar, tactile and they aren't over-powering. They are super practical so they fit in to today's hectic pace of life.
When my son Felix was born. I couldn't believe they were going to let me take him away from the hospital! I had always wanted to be a mum. In terms of my career, they are still coming thick and fast! I must say am thrilled with the incredible success of the Sophie Conran for Portmeirion range. I am proud that people love what we have created together.
I am also proud to be working with HP Sprout, with their ground-breaking new computer. It is my favourite new toy and it is brilliant for creating story boards for interior design projects. I have just received it, and the possibilities are endless. I am beginning to find out what it can do and it is incredible.
If you were not a designer (and excellent cook), what would you be in your next life?
A duck! Then I could fly and swim, and they have super cute babies.
I'm guessing your favourite colour is blue, am I right?
Today my favourite colour is yellow. It really depends on where I am and what the mood is. Today I am feeling sunny and positive!
Do you have a favourite flower, or what do you usually buy or pick for your home?
The tulips at the moment are unbelievable. I once flew over Schiphol airport and saw the tulip fields in bloom, which is definitely one of the wonders of the world.
I have a deerhound called Otis. He is the size of a small horse!
PS: Meeting up with Sophie in her home and having her personally showing me around and talking me though the ranges, definitely counts as the highlight of my month.
Feature, Interview and Photos of new products by Theoda Solms Iles.
This entry was posted in Interiors, Uncategorized and tagged colourful candles, colourful lampshades, dinner candles, hand blown glass bowls, hand blown glass hanging decorations, Interview with Sophie Conran, pink napkin, pink placemat, pink table linenep, red dot bedding, red dot dressing gown, rippled glass ware, Sophe Conran, Sophie Blue china, Sophie Conran White china, Sophie white saucepan, sophieconran.com, tapered candles, Theoda Solms Iles Sophie Conran, turquoise napkins, turquoise placemat, turquoise table linen, White china by Portmerion, white china casserole, white china teapot, wooden chopping bords, wovan placemats, woven baskets by Theoda. Bookmark the permalink.
Ursie, you should have seen the pretty lampshades….
Thanks Wendy, as you can imagine I loved it all.


No brand of Lipitor found.
Lipitor (Atorvastatin) is an Rx treatment and is used together with a good healthy diet to help lower "bad" cholesterol and fats (such as LDL and triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as HMG CoA reductase inhibitors, or "statins'' and works by reducing the amount of cholesterol made by the liver and, as a result, the liver picks up more cholesterol from the bloodstream and lower levels of cholesterol end up in the bloodstream. Lowering "bad" (LDL) cholesterol and triglycerides and raising "good" cholesterol (HDL) reduces the risk of heart disease, thereby helping to prevent strokes and heart attacks or other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors.
In addition to eating a healthy diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if you need to and stopping smoking. Consult your doctor for more details. Lipitor is for use in adults and children who are at least 10 years old.
has been studied in more than 400 ongoing and completed clinical trials.
Lipitor oral is used to treat the following: High Cholesterol, Homozygous Inherited High Blood Cholesterol, Heterozygous Inherited High Blood Cholesterol, High Amount of Triglyceride in the Blood, Combined High Blood Cholesterol and Triglyceride Level, Increased Triglycerides and Cholesterol, High Amount of Fats in the Blood, Treatment to Prevent a Heart Attack, Slow Progression of Disease of the Arteries of the Heart, Primary Prevention of Heart Attack, Stroke Prevention, Changes Involving Fatty Deposits in the Blood Vessels. And may also be used to treat: Prevention of Transient Ischemic Attacks.
Lipitor (Atorvastatin) comes from Canada and is manufactured by Apotex. This medication – Atorvastatin - is available from us in doses of 10mg, 20mg, 40mg and 80mg all in quantities of 100 tablets. No brand of Lipitor is available.
It is worth noting, that many people using this medication do not have serious side effects. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Before using this medication, tell your doctor or pharmacist your medical history, especially about: liver disease, kidney disease and alcohol use. Before having surgery, tell your doctor or dentist about all the products you use - including prescription drugs, non-prescription drugs, and even herbal products. Limit alcoholic beverages. Daily use of alcohol may increase your risk for liver problems, especially when combined with atorvastatin. Ask your doctor or pharmacist for more information. Older adults may be more sensitive to the side effects of this drug, especially muscle problems.
This medication must not be used during pregnancy. Atorvastatin may harm an unborn baby - therefore, it is important to prevent pregnancy while taking this medication. Consult your doctor for more details and to discuss the use of reliable forms of birth control (such as condoms, birth control pills) while taking this medication. If you become pregnant or think you may be pregnant, tell your doctor immediately. It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This information leaflet does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/non-prescription drugs and herbal products) and share it with your doctor and pharmacist. Some products that may interact with this drug include: cyclosporine, gemfibrozil, telaprevir, tipranavir plus ritonavir. Other medications can affect the removal of atorvastatin from your body, which may affect how atorvastatin works. Examples include colchicine, telithromycin, certain azole antifungals (such as itraconazole, ketoconazole, posaconazole), among others.
Do not take any red yeast rice products while you are taking atorvastatin because some red yeast rice products may also contain a statin called lovastatin. Taking atorvastatin and red yeast rice products together can increase your risk of serious muscle and liver problems. Laboratory and/or medical tests (such as blood cholesterol/triglyceride levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Do not share this medication with others.
All content is generated from third-party sources that are independent from our web site. Always seek the advice of your doctor or a health care professional.


Home › Blog › Intro to Knitting Class!
March 15, 2016 Intro to Knitting Class!
November 05, 2015 Why do you knit?
October 19, 2015 We've Finally Launched!
The Intro to Knitting video series that was previously sent last fall via email is now available as a class so that you can come back again and again to review without having to search for the emails!
Yay! That's good news, right?
So, if you want to take this class again, or sign up for the very first time, grab your needles and sign up for the free Intro to Knitting class here!


text:
Andrew Johnson Vetoed Bills
Discrimination based on the style or texture of a person's hair would be forbidden in New Jersey under a bill introduced in.
Brenda Wineapple's riveting new account of the impeachment of President Andrew Johnson contains. the freedom of former slaves. In 1866, Johnson moved aggressively to block the Republican Party.
On May 16, 1868, President Andrew. country. Johnson vetoed the legislation, but the radicals and their allies were able to overturn the veto and pass the law anyway. That same year, Congress voted.
President Andrew Johnson vetoed legislation to give the freed slaves the land. tenants and domestic workers. All the pension bills died in committee. The modern reparations current – and I call it.
79 Martin Luther King Ave Morristown Nj 07960 BERKELEY HEIGHTS, NJ – It may be a bit too early to be thinking of Christmas. Schools will be closed for Martin Luther King, Jr. Day, on Monday, Jan. 21. Mid-winter Recess begins on Friday, Feb. 15. PARAMUS, N.J. — A Bergen County-based organization will host a Day of Service on Martin Luther King Jr.
Although some of his vetoes were overridden. To snub poor modest me, just because I dare speak well of Andrew Johnson." The bill went to the Senate, where it was amended and sent back to the House.
The heroes of Brenda Wineapple's riveting "The Impeachers: The Trial of Andrew Johnson and the Dream. the freedom of former slaves. In 1866, Johnson moved aggressively to block the Republican Party.
Lincoln's vice president Andrew Johnson was a racist, who did everything he could to undercut the abolition of slavery. Congress passed bills to protect freed slaves, but Johnson would veto the.
Congress has undertaken impeachment proceedings against only three presidents—Richard Nixon, who resigned; and Andrew Johnson. policy, he vetoed a string of important bills, only to be overridden.
Johnson vetoed every bill that came to his desk from the Republican-dominated Congress aimed at reorganizing the rebel states to protect the former slaves. Brenda Wineapple's The Impeachers: The Trial.
On this day in 1866, Congress overrode a veto by President Andrew Johnson. Virginia. Johnson vetoed the legislation because, he said, he opposed the use of the military during peacetime. Moreover,
Two United States presidents have been impeached by the House of Representatives and tried by the Senate, Andrew Johnson in 1868 and Bill Clinton in 1998-1999. who held a majority. Johnson vetoed.
Founding Fathers Foreign Policy Search the history of over 366 billion web pages on the Internet. In the run-up to this country's 243rd birthday, there will be much talk of freedom, recalling the efforts of the Founding. Apr 17, 2002 · The Framers' Foreign Policy. It's hypocritical and childish to dismiss certain founding principles simply because a convenient rationale is
The ghost of Andrew Johnson, America's 17th president and the first. One hundred and fifty-one years ago, Johnson vetoed a bill renewing the charter of the Freedmen's Bureau, which was created to.
History Of The Warner Theater Washington Dc WASHINGTON, D C , UNITED STATES – 2019/07/04: Military flyover while President Donald Trump speaks at the National Mall in. Find all tickets for all Warner Theatre upcoming shows. Discover Warner Theatre details and information. Explore Warner Theatre photos, videos, and more from past shows. Washington, District of Columbia 20004. Venue Details. Day of Show
Another curious fact — Andrew Johnson vetoed the Civil Rights Act of 1866 only to be overridden. challenges facing Lyndon Johnson when he assumed office — a stalled tax bill, an education bill.
It was only the third veto of a civil rights bill in history; Andrew Johnson and Ronald Reagan cast the others. In August, after Mr. Bush delivered a speech before the National Urban League in which.
President Bush escalated his battle with Congress yesterday by vetoing a $23 billion water resources bill stuffed. Ford, who vetoed 66 bills, and Harry S. Truman, who vetoed 250, each had 12.
Andrew Johnson and his impeachment and trial. endangering all of them. Johnson's impeachment was the country's first, conducted, like Bill Clinton's, on a pretext, because in the view of the 19th.
The impeachment of Andrew Johnson (Theodore R. Republicans hurriedly passed a number of bills to reverse Johnson's actions. To their astonishment, he vetoed them. Infuriated, they overturned his.


CAE announced today at the 2018 Asia Pacific Airline Training Symposium (APATS) the signature of a new exclusive agreement with AIR BUSAN to support the airline's Airbus A320 pilot training needs in the region. CAE will train the airline's pilots starting in the fall of 2018 at the CAE Korea training centre.
"AIR BUSAN's philosophy is to provide the highest level of safety to its customers. As such, we are honoured to select CAE as our training partner of choice to ensure our pilots receive a world-class training experience, leveraging the expertise of CAE instructors," said Tae-Keun Han, Chief Executive Officer of AIR BUSAN.
AIR BUSAN is low-cost airline based in Busan, South Korea, and is a subsidiary of Asiana Airlines. Asiana Airlines and CAE share a long-standing relationship of more than 20 years, with the provision of training equipment and services as well as aviation recruitment services.