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We Built, We Bought, We Shared: The Costs of Administrative Service Systems vs. the Academic Mission, EDUCAUSE Review, July 2014. In this article, CIOs talk candidly about three strategies: building-your-own in the modern era; buying and implementing in smarter ways; and joining a higher education consortium that shares processes and software.
2013 CDS Executive Summary Report February 2014. This report provides higher education CIOs and senior IT leaders with the benchmarks they need to make strategic decisions about IT at their institutions. Each year, more than 750 institutions (both within and outside the United States) participate in a survey about IT financials, staffing, and services. This report provides a glimpse into the breadth of CDS data and summarizes the most important findings from this year's survey.
Technology and the Broken Higher Education Cost Model: Insights from the Delta Cost Project, September 5, 2012. The Delta Cost Project has drawn attention to the need for a new focus on institutional spending and has provided a number of useful metrics for thinking about how different types of institutions spend money, about the relationships between costs and revenues, and about the declining public subsidies in public higher education.
The EDUCAUSE 2011 Core Data Service Report: Highlights and Insights into Higher Education Information Technology, January 2012. "The IT Organization, Budgets, and Funding" chapter provides statistics on where IT funding sources are from and what the budget is being spent on.
Expert Discussion Session: Unexpected Outcomes from the Cost-Cutting Era. EDUCAUSE 2011 presentation. Two CIOs share their experiences and some of the outcomes from these belt-tightening measures.
Funding-Model Archetypes for Central Information Technology Functions. ECAR research bulletin, January 2012. This CDS Spotlight ECAR research bulletin focuses on EDUCAUSE Core Data Service survey results related to funding models for IT functions.
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- Web Accessibility Toolkit
May 16, 2014
This Association of Research Libraries (ARL) toolkit was created to promote the principles of accessibility, universal design, and digital inclusion. As well as help research libraries achieve di…
- Toolkit for Developing an Identity and Access Management (IAM) Program
May 7, 2013
The IAM Program Outline has been created as a roadmap for institutions to use in developing an IAM program (or to address gaps in their current offerings) including: Providing a structure o…
- Information Security Program Assessment Tool
February 3, 2014
This self-assessment tool was created to evaluate the maturity of higher education information security programs using as a framework the International Organization for Standardization (ISO) 2700…
- Data Protection Contractual Language
August 18, 2009
The purpose of this resource is to provide sample contract language for common themes related to data protection as well as practical guidance as to when and how to consider the themes when draft…
- E-Discovery Guideline and Toolkit
August 14, 2009
This E-Discovery Guideline and Toolkit was developed by one of the Higher Education Information Security Council Sub Working Groups. This E-Disco…
- Electronic Records Management Toolkit
August 14, 2009
Members of the Higher Education Information Security Council crated this toolkit to provide a practical set of resources that will assist members of the higher education community in addressing r…
- Compliance Assessment Template
September 24, 2008
This sample Harvard University questionnaire is designed to assist people in understanding if the setup and operation of their systems are in compliance with the Harvard Enterprise Information …
- Data Classification Toolkit
August 18, 2008
The Data Classification Toolkit is a compilation of resources pertaining to data classification in higher education. Although data classification is just one component of a comprehensive program …
- Payment Card Industry Data Security Standard (PCI-DSS): Self-Assessment Questionnaire
December 1, 2004
The PCI Self-Assessment Questionnaire (SAQ) is an important validation tool that is primarily used by smaller merchants and service providers to demonstrate compliance to the PCI DSS. …
- Data Incident Notification Toolkit
January 1, 2005
The Data Incident Notification Toolkit includes resources that cover a range of issues that commonly arise in the heat of the moment when responding to data incidents. If your institution has a d…


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MALE, Ourense, Galicia, Spain
Posted 05/21/2015 09:40:11 EDT
I prefer listening to progressive radio AIR AMERICA.
Posted 04/30/2015 09:57:26 EDT
... Last night in Chicago, 10 shot, 2 dead... Who cares, blacks shot by blacks. Where is the outrage? Do black lives really matter?
Posted 04/30/2015 09:57:24 EDT
Posted 04/28/2015 11:25:04 EDT
Mayor Stephanie Rawlings-Blake ( DEMOCRAT )... did say, âWe also gave those who wish to destroy space to do that as well.â What a great Democrat leader.
Posted 03/28/2015 10:29:40 EDT
We should have a conversation about race at a Starbucks in Ruxbury...
Posted 03/05/2015 11:40:53 EST
On June 20, 2007, Hillary Clinton complained about Bush officials shredding the US Constitution by having secret email accounts.
Posted 10/24/2014 08:26:54 EDT
Baker a political hack ? How!
Posted 10/24/2014 08:24:46 EDT
Economics according to Hillary :â Donât let anybody tell you itâs corporations and businesses create jobs,â Clinton said. Ok. Let me ax you. Who does create yobs?
Posted 07/01/2014 08:44:33 EDT
Great job team USA. Howard you were outstanding. Thank you.
Posted 07/01/2014 01:59:56 EDT
Can anybody sit down for 4 hours and watch a Red Sox game, NO way. USA USA USA
Posted 06/28/2014 09:16:00 EDT
Great entertaining game.
Posted 06/28/2014 09:15:04 EDT
Congratulations to all the Colombians, you have a young energetic team. Really fun to watch.
Posted 06/26/2014 04:00:22 EDT
Moonbat Facebook PALE and MALE... Go figure.
Posted 06/17/2014 11:29:45 EDT
Eric W: another predictable boring copy and paste article on a sport you know absolutely nothing about. Stay Boring my friend, stay boring... Viva USA.
Posted 06/15/2014 08:34:54 EDT
Cadel. Excellent comment comment.
Posted 06/15/2014 07:11:13 EDT
Bill. This is a predictable boring copy and paste article. When did you write this article 10, 20 years ago. 99 % of American sports writers have absolutely no passion for futbol so your type of artic more »
Posted 06/15/2014 07:07:03 EDT
Outstanding more »
Posted 06/12/2014 01:57:28 EDT
President Obama's "great achievements" ... BIDEN 2010 CNN more »
Posted 04/08/2014 08:46:09 EDT
I am sure Rev Al ( CI 7 ) will probably be honored by President BHO and Att Gen Holder...
Posted 03/19/2014 10:02:16 EDT
John. Edwards. democrat. Fugetaboutit.
Posted 01/17/2014 11:13:06 EST
CNN, MSDNC would love one tenth of DD ratings... Love that show.
Posted 01/07/2014 08:50:16 EST
Presidente B H Obama Nov 1 , 2013. " Excessive high temperatures are already harming public health nationwide." About 2 months before record LOW temperatures. Go figure.
Posted 12/06/2013 09:19:26 EST
Congressman Joe Wilson calls El Presidente Obama a LIAR. He was proven correct.
©2015 Boston Globe Media Partners, LLC
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William & Mary v Purdue
Jacob Lawson of the Purdue Boilermakers and Terry Tarpey of the... Nieuwsfoto'sBasketbal,Basketball - Men's College,Beweging,Indiana,Mackey Arena,NCAA,Purdue Boilermakers,Sport,Ten voeten uit,Terugkomen,Verenigde Staten,Verticaal,West Lafayette,William & Mary TribePhotographer Michael HickeyCollection: Getty Images Sport 2012 Michael HickeyWEST LAFAYETTE, IN - DECEMBER 29: Jacob Lawson #34 of the Purdue Boilermakers and Terry Tarpey #25 of the William & Mary Tribe battle for a rebound at Mackey Arena on December 29, 2012 in West Lafayette, Indiana. Purdue defeated William & Mary 73-66. (Photo by Michael Hickey/Getty Images)


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prints, fine art drawing portrait charcoal original nude female realism woman figurative anatomy black and white beautiful image modern beauty classic design images contemporary picture natural imagery pictures decorative office light expressive pretty people canvas closeup macro strokes back prints bright lines texture vivid reflection romantic print girl modern gallery decor usa indoor still life intense tasteful delicate pinup back view torso naked lady pose reaching stretching standing muscular prints
"Nude Female Study of Back" print by Neal Luea. Ships within 3 - 4 business days and arrives rolled in a tube. Choose from multiple print sizes, papers, mats, and frames.
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Prints ship within 3 - 4 business days in durable cardboard tubes.
Fine Art Charcoal Drawing by LUEA 2004. 11" x 14" with an overall dimension of 18" x 22" Professionally Framed and Matted with Black Wooden Frame and Glass. Stunning Portrayal of the Female Form in Charcoal.
My name is Neal Luea and I studied Fine Art at Fort Hays State University and Wichita State University. My Favorite materials are Acrylics, Oil, Charcoal, Pastel, and Graphite Pencil on Canvas and High Quality Museum Archival Paper. The emphasis of my work mainly focuses on figurative drawings and paintings of the female form in both nude and other casual settings. The purpose of my art work is to express the inherit beauty of the feminine form in its artistic nature and uniqueness. I try to capture the shapes, shadows, contours, and lines of the lady as well as convey a mood or sense of contemplation within the figure and her surroundings. I hope you enjoy viewing these images for it is always my goal as an artist to provoke some...
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Sir Clifford John Norton
1 of 3 portraits of Sir Clifford John Norton
Sir Clifford John Norton
by Walter Stoneman
bromide print, 26 August 1948
5 3/4 in. x 4 in. (145 mm x 103 mm) image size
Commissioned, 1948
Photographs Collection
NPG x186891
Click on the links below to find out more:
Sitterback to top
- Sir Clifford John Norton (1891-1990), Diplomat; Ambassador in Athens. Sitter in 3 portraits.
Artistback to top
- Walter Stoneman (1876-1958), Photographer. Artist associated with 18496 portraits, Sitter in 8 portraits.
Portrait setsback to top
Tell us moreback to top
Can you tell us more about this portrait? Spotted an error, something missing, or do you know anything that we don't know? If you have any information to share please complete the form below


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NH Today with Jack Heath
Mid-Morning Meltdown
Food For Thought
Cail & Company
Laura Ingraham
Clark Howard
Money Basics
NE Delta Dental Radio
Half Hour To Health
Brattleboro Retreat
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NH Today with Jack Heath
Mid-Morning Meltdown
Food For Thought
Cail & Company
Laura Ingraham
Clark Howard
Money Basics
NE Delta Dental Radio
Half Hour To Health
Brattleboro Retreat
Boot Camp
Dying To Talk
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Detailed Forecast
Dying To Talk: Tributes.com
Buddy Phaneuf interviews John Heald of Tributes.com
Dying To Talk: Celebrants
Host Buddy Phaneuf interviews Victoria Schneider about her role as a celebrant
Sports News
Hall of famer helps unveil hockey-themed lottery ticket
Boston Bruins legend Ray Bourque is helping Gov. Maggie Hassan unveil New Hampshire's latest lottery ticket.
Click to read more
Top 25 roundup: Watson leads No. 12 Clemson over No. 6 Irish
Clemson's Deshaun Watson threw for two touchdowns and ran for a third Saturday night as No. 12 Clemson held off No. 6 Notre Dame 24-22.
Click to read more
Smith bolts to Xfinity win at Dover
Regan Smith charged from fourth to first during a Lap 121 restart and went on to win the Hisense 200 NASCAR Xfinity Series race at Dover International Speedway Saturday, posting his second victory this season.
Click to read more
Schedule for Oct. 9, 10
Friday, Oct. 9
Click to read more
Aguero scores five against Newcastle in EPL
Without defensive standout Vincent Kompany, Manchester City struggled in the first half against lowly Newcastle in the English Premier League on Saturday. But City still had striker Sergio Aguero to call upon and the Argentine international terrorize...
Click to read more
Scherzer no-hits Mets
Hey Nolan Ryan, Virgil Trucks, Allie Reynolds and Johnny Vander Meer: Make room for Max Scherzer. The Washington Nationals' right-hander made history Saturday night, when he struck out a franchise-record 17 in throwing his secon...
Click to read more
Red Sox shut out against Indians
Travis Shaw and Sandy Leon were the only Red Sox to get hits Saturday night in a 2-0 loss to Cleveland.
Click to read more
Players, parents oppose Saint Anselm moving down to Division 3
Saint Anselm College has applied to move its athletics program from Division 2 to Division 3 of the NCAA, but the decision isn't sitting well with many athletes and their families.
Click to read more
Friday Night Football scores: Week 5
Here are the scores for New Hampshire high school football games on Oct. 2-3, 2015.
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Williams close to WTA Finals spot
One Williams sister has shut it down in 2015 but another is still going. And strong.
Click to read more
Entertainment News
David Cassidy charged in Florida mishap
'The Martian' opening rockets near October box office record
Hillary Clinton does Trump impression on 'SNL'
Clinton gushes about SNL alter egos ahead of appearance
Colbert on UCC shooting: 'I honestly don't know what to do or say'
Ridley Scott thrilled to scratch surface of possibilities with 'The Martian'
Olympic diver Tom Daley engaged to Dustin Lance Black
'Laces out, Dan!': Prince Harry plays catch with Marino
Clinton reportedly to make 'SNL' surprise appearance
Taylor Swift donates $50,000 for sick baby
Upcoming Play-By-Play
Saturday October 3
1:00pm---College Rugby---UMASS at New England College
3:00pm---College Football---Boston College at Duke
6:25pm---MLB---Boston Red Sox at Cleveland Indians
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Sunday October 4
2:25pm---MLB---Boston Red Sox at Cleveland Indians
7:30pm---NFL---Dallas Cowboys at New Orleans Saints
2:25pm---MLB---Boston Red Sox at Cleveland Indians
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7:00pm---UNH Coach Show with Mike Murphy and Sean McDonnell
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Local News
School shooting drill held at Goffstown High
Joaquin could bring high surf to NH coast
Webster man rescued from Muise Mountain
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Moose seen running through Manchester streets
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Romanian man charged with sexual assault
5 arrested, police use pepper spray to disperse crowd at Mass. club
Republicans speak at American Principles Project forum
Rain water helps ski areas prepare for upcoming season
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Frost likely across central and northern New Hampshire Saturday night
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Remember Smarties? The retro candy is thriving
LinkedIn to pay $13 million for unwanted emails, lawyers could get $3.3 million
Brace for worst year on Wall Street since 2008
Sweden flirts with six-hour work day
Walmart to lay off 450 employees at headquarters
15 million T-Mobile customers' info breached
Volkswagen scandal may cost up to $87 billion
Debt ceiling deadline is now November 5
In setback, U.S. adds only 142,000 jobs
Money Matters: When more risk equals less risk
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« June 15 June 17 » Thursday, June 16, 2005
garden calendar
June 16, 2005 in Home on Page Z16 Iris Garden - Fridays-Sundays, 10 a.m.-6 p.m. through June, with 2,500 varieties of iris. 40 miles north of the Y, 200 N. Quail Ave., Newport. Free. (509) 447-2552. Perennial, Grass, …
Learn the inner-workings of bulbs
June 16, 2005 in Home on Page Z17 Before your spring flowering bulbs melt back into the soil until next year, take a last look at their dying leaves. You might want to note their locations so that …
Caution: Read the paint book first
June 16, 2005 in Home on Page Z17 Remember, you've got that long list of projects you promised yourself you'd get to this summer. If your to-do (or honey-do) list includes experimenting with a decorative painting technique, or …
Garden of the month
June 16, 2005 in Home on Page Z20 The Inland Empire Gardeners have announced the winner of the May Garden of the Month Contest: Charlie and Terry Klement of Airway Heights. The Klements' garden is no ordinary garden.
Help pets adjust before baby comes
June 16, 2005 in Home on Page Z22 WICHITA, Kan. — Two years ago, my husband and I adopted our first baby — a little girl we named Abby. She weighed 8 pounds and was covered in black …
June 16, 2005 in Home on Page Z22 For 06-16-2005
Cat-robots not yet purrfect
June 16, 2005 in Home on Page Z23 WASHINGTON – There is something just so tomorrow about the Russian robo-therapists with their mechanical cats. Alexander Libin softly strokes the orange-cream fur of NeCoRo – a semi-realistic cat-robot packed …


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Breeders Cup
The 2015 Breeders Cup will be held at Keeneland Race Course in Lexington, Kentucky. Our inclusive tour packages are available including Breeders Cup tickets, hotel accommodations, VIP service. .
Breeders Cup Travel Packages
Reserve your Breeders Cup Ticket Package at Keeneland Race Course. Packages includes hotel accommodations in the Lexington area, Breeders Cup race tickets, and much more.
4 night Lexington Hilton DowntownTickets: Grandstand Reserved - Both Days (Upgrades available)
Enjoy two-days of racing at historic Keeneland Race Track with private dining, after a Thursday Horse Farm Tour in the Lexington area.from $4,510.00
|Date & Time
|Breeders Cup - 2 Day Pass
|October 30, 2015 - Time: TBA
|Breeders Cup
|October 30, 2015 - 11:00 AM
|Breeders Cup
|October 31, 2015 - 11:00 AM
The Breeders Cup
Announced in April of 1982 by leading Thoroughbred owner and breeder John R. Gaines, the Breeders' Cup has served as a positive step toward not only promoting racing, but uniting the industry itself. Breeders' Cup Limited enjoyed immediate and widespread support from the industry through annual nomination payments for stallions and one-time nomination payments for those stallions' offspring.
Since the inaugural running at Hollywood Park 24 years ago, the Breeders' Cup has established itself as the season-ending championship of Thoroughbred racing. It is now firmly entrenched in American racing lore with a history and tradition all its own. The Breeders' Cup World Championships has also served as a deciding factor in Eclipse Award voting. The Eclipse Awards, which honor Horse of the Year and other champions in the sport, are voted on annually by representatives of Daily Racing Form, the National Turf Writers Association and the National Thoroughbred Racing Association. In 2006, we witnessed every Eclipse Award winner (including Steeplechase Champion McDynamo) participate in the Breeders' Cup, something not ever achieved previously.
Sports Traveler has Breeders Cup Tickets and Travel Package Trips available! Tours packages can include Breeders Cup Tickets, hotel lodging, event transfers plus VIP options.


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Medical emergency results in tie vote, killing soda-tax bill
MONTPELIER — A Vermont House committee has killed legislation that would have levied a new tax on sugary soft drinks and used the money to pay for public health education and to help smooth the transition to a health care overhaul.
In a move that drew the comment "Holy Smokes!" from a member of the Senate Health and Welfare committee, the House panel voted 5-5 on the measure. The tie vote killed the bill the committee had spent weeks drafting.
The tie vote came after committee members said a supporter of the bill, Rep. George Till, who is an obstetrician-gynecologist, had to leave for a medical emergency.
The vote appears to mean there won't be a new tax on sugar sweetened beverages.MORE IN This Just In
Local hockey team
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what is the format of writing a diary entry.
Asked by Ashish Kumar (student) , on 27/4/13
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Start Now with Video Lessons, Sample Papers, Revision Notes & more for Class-IX - CBSE
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Canonizing AIDS History: What Will We Learn?
BY Frank Pizzoli
March 31 2014 6:26 PM ET
History should always trump nostalgia because "nostalgia isn't what it used to be." Whoever first said these words — baseball icon Yogi Berra, French actress Simone Signoret, or New Yorker magazine writer Peter De Vries — they apply to the history of AIDS activism.
That said, I think each of us should be nostalgic for our own past because it's our past, not because it's more illuminating than the experiences of another era. Our past includes AIDS. When reflecting on AIDS history, we have an obligation to be honest about our conclusions without regard for political correctness.
Some shorthand is helpful when looking into our past.
First let's acknowledge that the "told" history of AIDS in the U.S. is, so far, largely the history of gay, urban, white, middle-class men. It's a statement of who had the resources during those horrible times to organize and apply pressure. Of course others were involved — women, minority activists — however, not many in leadership roles under the spotlight. There is an entire history yet to be told about the courageous roles played by men of color and the women of ACT UP.
A steady release of films has presented a partial, evolving perspective on AIDS history.
Gay Sex in the '70s by Joe Lovett is about the obvious. How to Survive a Plague by David France is about white men taking up the mantle, for which we are all grateful. But it is not a complete history. Sex Positive, a film by Daryl Wein, about Richard Berkowitz, is a lucid delineation of New York City's sexual revolution, mimicked in all major U.S. cities but, again, only about men. Sex in an Epidemic by Jean Carlomusto more fully covers various constituencies involved in ACT UP, for example, the courageous women, but we must tell more of their stories. Positively Naked, in which I participated, commemorates the 10th anniversary of Poz magazine and is a stunning visual portrayal by Spencer Tunick embracing most demographics affected by the virus. I have yet to screen United in Anger by Jim Hubbard and Sarah Schulman.
Each of these fine films covers only a portion of what is still a foggy history that is slowly being pieced together by survivors. To say so does not diminish their importance. They are not a complete AIDS history, and acknowledging that isn't politically incorrect. It's the truth.
Next, let's admit that in the telling of any story gay men love to parse more than they love to shop. AIDS history is no exception. We're the captains of "yes, but what about" knee-jerk reactions.
Finally, good men do the best they can when tested by events while others are immobilized. It's part of the human condition. That's why I do not have an AIDS ennoblement theory. All we know for sure is that untreated HIV makes you sick, then you die. HIV doesn't make you a hero. If you were a reasonably well-adjusted individual before infection, you are likely a reasonably well-adjusted person after infection. If you were a big a-hole SOB before infection, you are likely a big a-hole SOB after infection. Sure, some people have an "AIDS epiphany," i.e., stop abusing drugs, stop selling their bodies for sex, stop beating their girlfriends or boyfriends, start being faithful to mental health counseling, get honest about their sexual habits and why. Some do not have that epiphany. Whether or not a person has an "AIDS epiphany" has to do with what the individual brings to and/or learns from the experience. It has nothing to do with the virus. The virus doesn't care about its host.
When people say, "My life is better with AIDS," what I think they mean is that their diagnosis brought them face-to-face with some ugly, negative realities of their life .In that case, getting into housing, removing themselves from all sorts of risk — violence, sexual abuse, drug abuse — was an improvement in their life. Their life is better. Not because they got infected, but because infection forced them into a corner in which they face reality and acted accordingly.
Me, well, I was 18 in 1969 (Stonewall) and moving forward didn't miss a thing. Hit New York City as often as possible, had lots of freelance sex, failed miserably at relationships because I didn't have a clue about what a relationship between two men was all about or could be like. We had no role models. Each of us does the best we can with what life hands us, and with what we hand ourselves by our decisions, whether informed, uninformed, stoic or silly. In the end, we are all worthy human beings who deserve respect.
At left: How to Survive a Plague
Still others use tragedies like AIDS to gain power through evil deeds, like Jerry Falwell, the religious right, then and now home to more closeted, self-hating gay homophobes than there are stars in their heaven. They are also part of the human condition. When I was a young man, a mentor told me the biggest homophobe is a gay homophobe. I didn't understand then, but do now. Homophobia had a great deal to do with the spread of AIDS in the epidemic's early years. Until recent years, and certainly before and immediately after Stonewall, the heterosexual dictatorship was in full control of the culture. Up against this oppression, gay men went underground and created an elaborate and efficient system of creating community, mostly a sexual community.
Post-Stonewall, we moved the underground labyrinth above ground and defiantly defined our liberation as sexual liberation. Since nothing happens in isolation, these twin forces — the sexual dictatorship and our response to it — created the perfect mechanisms for a public health storm. We did in closed and open spaces what our oppressors defined as a criminal act, a mental illness, or a sin. We fucked with pride.
For many, participation in the gay sexual revolution was the first time they felt connected and loved. For many, when AIDS first hit and activist groups formed all across the nation, many of those same gay men said the same thing — they finally felt connected to a community.


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Posted November 23, 2012 on AP on Fox
Penn State cornerback Stephon Morris doesn't believe the rumor about Montee Ball, the one about the Wisconsin tailback having a ''down year.'' If 1,400 rushing yards and 17 touchdowns are disappointing, imagine what the Wisconsin star senior can do in a good season. This is the predicament facing the Nittany Lions (7-4, 5-2 Big Ten) when Ball and the Badgers (7-4, 4-3) roll into Happy Valley in the regular-season finale n Saturday. ''I looked at his stats and was like, `He's having a down year?''' Morris said. ''You can't take anything away from that. He might make some big plays on Saturday. We're going to have our plays, too.'' One more touchdown would give Ball 79 career scores, breaking a tie for the major college record set by Travis Prentice of Miami (Ohio) in 1999. With two straight games of at least 191 yards rushing, Ball might be the best player on the cold Beaver Stadium turf. Temperatures aren't expected to rise past the mid-30s and should fall throughout a game, st...
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Star Trek Online Discussion Thread (now free to play!)
View Single Post
November 7 2011, 08:01 PM
Location: Rhode Island, USA
Re: Star Trek Online Discussion Thread (now free to play!)
DC Online also appears to be getting some good buzz in their F2P model, was thinking of checking that one out. Was a huge fan of KOTOR games, so definitely interested in that, as well.
As more and more games switch towards the F2P model, it'll come down to things like content, end-game, crafting, socializing, value... Areas that sadly, STO doesn't seem to be focusing on at the moment. Doubt that grind and micro-transactions are going to be the big draw they seem to think. If STO was an early adopter of the F2P model, they might have had a chance, but they seem to have missed the boat there...
Really has the feel of something that's going to just fall flat at relaunch, at which time they'll try to come crawling back towards a fanbase they just spent the last 8 months or so pissing off and driving away.
STO has been my first real experience with MMOs, and while it was fun at first, I'm afraid it's really leaned more towards regret lately. I've enjoyed the limited amount of group participation in this game, and while this has been kind of a hybrid, I think I'm happier with single-player games. Much cheaper, with a known set cost upfront, and it is what it is. Play it until you're bored or beat it, replay it occasionally if it was good, and move on. Not a big fan of the "give us $300 upfront and hope you get what you pay for later, and we don't fold up the game or change it to drive you away" model that seems to be running here.
Perhaps, if I am very lucky, the feeble efforts of my lifetime will someday be noticed and maybe, in some small way, they will be acknowledged as the greatest works of genius ever created by man. ~Jack Handey
STO: @JScout33
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Building on less successful efforts, Swanson coined the term "TV dinner" in 1954. Ironically, the very first TV dinner they ever sold was a Thanksgiving meal, perhaps the most traditionally elaborate American homemade meal.
Sources: on TV dinners and Found in Mom's Basement.Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on Twitter, Facebook, and Instagram.


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Fray Review
July 3, 2012 - Disastrous technical issues render this promising squad-based tactical game a dud.
Brain Candy Enters the Fray at GDC 2011
February 9, 2011 - Brain Candy, an independent French game developer, today revealed the first details for its upcoming sci-fi title, Fray, coming to PC and Mac in 2011. Fray is a turn-based, multiplayer, real-time strategy game that eliminates the waiting involved with most turn-based games by introducing simultaneous play.
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Face the challenge once again in this sequel to the hardcore action RPG.


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Michigan football's small chance at Big Ten title a big motivation
11:05 PM, Nov. 6, 2013
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Michigan football's small chance at Big Ten title a big motivation
After losing to Michigan State on Saturday, the Wolverines would have to win all four of their games ? two on the road and one over No.4 Ohio State ? while the Spartans would have to lose all three
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Anti Essays offers free essay examples to help students with their essay writing.
Below is a free essay on "The Great Gatsby: Jay Gatsby and Tom Buchanan" from Anti Essays, your source for free research papers, essays, and term paper examples.
"The Great Gatsby: Jay Gatsby and Tom Buchanan". Anti Essays. 13 Oct. 2015
The Great Gatsby: Jay Gatsby and Tom Buchanan. Anti Essays. Retrieved October 13, 2015, from the World Wide Web: http://www.antiessays.com/free-essays/Great-Gatsby-Jay-Gatsby-Tom-Buchanan-23955.html


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With compassionate words and a clear social message, Pope Francis was earning points for the Catholic Church in the world's most populous Catholic continent as he visited Brazil.
On his first foreign trip since his election in March, the pontiff was returning to the style he favored while he served as Buenos Aires' archbishop: direct contact with crowds, jokes, impromptu gestures and listening to all who approach him.
The 76-year-old Argentine was clearly delighted to be back on his native continent, which is home to 40 percent of the world's 1.2 billion Catholics -- and people here seemed equally receptive to his presence.
When he arrived in Rio Monday, his little Fiat car was repeatedly swarmed by throngs of well-wishers in the city center.
Despite security concerns among his entourage, a smiling Francis lowered his car's window to shake hands with hundreds of pilgrims.
Over the past five days, through nonstop television coverage of the visit, the pope has strengthened his popularity across the region, winning people over with his humble gestures.
His German predecessor, Benedict XVI, was respected, but unlike Francis, he did not fire up crowds in Latin America.
He was seen as too European and was criticized for neglecting the region, making only two visits during his eight-year papacy.
"Benedict XVI was cerebral; Francis is a man of contact," said Joao, a young Franciscan friar.
"He is the pope next door," Joao said, adding, it was just what the church needed.
Francis has also sent clear social and political messages during his visit.
In a speech Thursday, the pontiff urged young Catholics to shun the trappings of materialism and put Jesus Christ at the heart of their lives.
He insisted that the "pacification" of slums -- under which Rio police restored security by forcibly evicting drug gangs -- will not work unless it is coupled with social inclusion of the poor.
And he waded into Brazil's tense political and social debate over corruption and social injustice that erupted into massive protests when hundreds of thousands of people took to the streets last month to demand an end to corruption and better public services
Yet Francis was careful to offer encouragement, praising Brazil's success in reducing poverty and taking pains not to take sides in the social turmoil.
Many priests and church people have been delighted by his message, Vatican spokesman Federico Lombardi said, recounting that "nuns in a convent got all excited" in the pope's presence during the visit to Aparecida.
"Each one of them insisted on being photographed with the pope, whom they hugged," he said with a smile.
Francis also toured a shantytown and hugged a former drug addict in a Rio hospital.
The love of Christ, the pope explained, was something "concrete" for Saint Francis of Assisi "when he embraced a man with leprosy" because "this brother, suffering and excluded, was a mediator of (God's) light."
Such words signal a marked difference for a Catholic church perceived as arrogant and distant by many Latin Americans that have been lured by Evangelical Protestant churches.


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There were 10-12 boys throwing stones, from all directions, from about age 10 to 20. You can see two kids that looked about 14 to 15 years olds lunge directly in front of the oncoming car which wasn't going that fast and throw rocks directly at the driver. The driver continues going straight. He didn't aim at the kids. He just kept going in the correct direction although at least one rock thrower hadn't gotten out of the way. The kid looked like he was trying to kill the driver. The car wasn't going that fast. It doesn't take that much speed to hit someone so they get injured. Figure auto versus body. Who's going to win? The kid ended up on the windshield and fell off. He didn't appear to be very injured. He sat up and rubbed his nose. Some photographer who looked to be about 20 ran up to the kid to see if he was okay. If this is the incident, the settler was innocent. I would have probably kept on going. The settler even slowed down the car to see if the kid was okay. Case closed. Self defense!
Wreckage of missing Indonesian airplane found (AP)
from the article: Life in Silwan: Unbearable for Jews and Palestinians alike


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Wednesday, November 30
- This Is the Official New Term for the Pre-Engaged State
- APW Happy Hour
- Open Thread: How Do You Know When You're an "Adult"?
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"Because if I can follow this tutorial, on my hotel room floor, while drinking champagne in my pajamas on the morning of my wedding, so can you!"
"These clouds look more magical in real life than in photos, and that's saying something. Also, #lazygirl approved."
"A mantra for anyone feeling like they might lose themselves in marriage (or otherwise)."
"No one should be guilting you into a more indie wedding. But no one should be guilting you out of a WIC one, either. Do what you want!"
"Because sometimes it's nice to be reminded."


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Lord of the FliesPenguin Publishing Group 1959; US$ 9.99
Before The Hunger Games there was Lord of the Flies Lord of the Flies remains as provocative today as when it was first published in 1954, igniting passionate debate with its startling, brutal portrait of human nature. Though critically acclaimed, it was largely ignored upon its initial publication. Yet soon it became a cult favorite among both... more...
Getting to YesPenguin Publishing Group 2011; US$ 17.00
The key text on problem-solving negotiation-updated and revised Since its original publication nearly thirty years ago, Getting to Yes has helped millions of people learn a better way to negotiate. One of the primary business texts of the modern era, it is based on the work of the Harvard Negotiation Project, a group that deals with all levels... more...
GreyKnopf Doubleday Publishing Group 2015; US$ 15.95
See the world of Fifty Shades of Grey anew through the eyes of Christian Grey. In Christian's own words, and through his thoughts, reflections, and dreams, E L James offers a fresh perspective on the love story that has enthralled millions of readers around the world. Christian Grey exercises control in all things; his world is neat, disciplined,... more...
The E-Myth RevisitedHarperCollins 2009; US$ 11.99
An instant classic, this revised and updated edition of the phenomenal bestseller dispels the myths about starting your own business. Small business consultant and author Michael E. Gerber, with sharp insight gained from years of experience, points out how common assumptions, expectations, and even technical expertise can get in the way of running... more...
Self-Assessment in Respiratory MedicineEuropean Respiratory Society 2012; US$ 65.00
Self-Assessment in Respiratory Medicine is an invaluable tool for any practitioner of adult respiratory medicine. The 111 multiple-choice questions cover the full breadth of the specialty, using clinical vignettes that test not only readers? knowledge but their ability to apply it in daily practice, making it the perfect revision aid for candidates... more...
MacbethThe Floating Press 2008; US$ 3.95
Macbeth is Shakespeare's shortest tragedy and one of his best-known plays. Often referred to as an archetypal tale, it warns against lust for power and the betrayal of friends. Shakespeare based the play loosely on a King Macbeth of Scotland. The play is traditionally considered "cursed", and thus many actors refer to it as "The... more...
One Second AfterTom Doherty Associates 2011; US$ 10.99 US$ 8.79
An end-of-the-world novel to rank with The Stand and Lucifer's Hammer more...
A Crime So MonstrousFree Press 2008; US$ 16.99
To be a moral witness is perhaps the highest calling of journalism, and in this unforgettable, highly readable account of contemporary slavery, author Benjamin Skinner travels around the globe to personally tell stories that need to be told -- and heard. As Samantha Power and Philip Gourevitch did for genocide, Skinner has now done for modern-day... more...
Fifty Shades of GreyRandom House 2012; US$ 12.78
MORE THAN 100 MILLION COPIES SOLD WORLD WIDE. When literature student Anastasia Steele interviews successful entrepreneur Christian Grey , she finds him very attractive and deeply intimidating. Convinced that their meeting went badly, she tries to put him out of her mind ? until he turns up at the store where she works part-time, and invites... more...
Fifty Shades DarkerRandom House 2012; US$ 12.78
Romantic, liberating and totally addictive, the Fifty Shades trilogy will obsess you, possess you, and stay with you for ever ... Daunted by the dark secrets of the tormented young entrepreneur Christian Grey , Ana Steele has broken off their relationship to start a new career with a US publishing house. But desire for Grey still dominates... more...


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Econo Lodge Kalkaska
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Quilt Camp begins for Jen
Welcome to Quilt Camp! I've been at Higgins Lake this weekend with 33 women from my quilt guild (Across the Square Quilters from Charlotte, MI) and friends of the guild. We have laughed, laughed so hard we cried, sewed A LOT, offered and accepted quilting advice, shared many stories of our lives, sewed some more, played quilt ...
Traverse City Michigan to Mackinaw, Michigan
Today was to be a short day of traveling. It is a short trip to Mackinaw, Michigan from Traverse City. Traveling north, enjoying my McDonald's coffee, A moose sculpture caught my eye as I was entering a small community as well as a city park sign. I was thinking the park would be on Lake Michigan and give me the opportunity to paddle lake no 4 on this trip. The moose sculpture was on the edge of beautiful gardens full of metal art like I had ...
Be BOLD!
So tomorrow my adventure begins. I'm leaving at 7:30am January 12, 2015 Eastern Standard Time, and arriving at 5pm January 14, 2015 Auckland Time. I will never see the day January 13, 2015. How weird is that?! It's a long time to be traveling, but it will all be worth it when the wheels hit the tarmac in Auckland. There are so many lovely people to meet and so many incredible places to see!
I'm excited to WWOOF ...
Boundless Love
... never looked forward to going to a funeral home before in my entire life. But this time it was all about the love of my life, Bill, and the celebration of the life that he so enjoyed. Sister Judy thankfully joined me at the beautiful historic Victorian "Reynolds-Jonkhoff Funeral Home" to make preparations for the celebration. So many decisions to make and things to do before September 27th! I had to write the obituary with Judy's help with info about ...
Day 51 Boyne City to Mabel/Acme, MI Mile: 2,722
... we set up the Kelty. Then there was the OUTHOUSE. It's easy to mouth breath to avoid stinky situations, but we were shocked when we realized that the putrid stench permeated our clothing.The gagging odor was nauseating. We both felt sick as we settled into our sleeping bags for the night. Visions of Clorox danced in our heads.


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My first course with Lynda.com went live today: Accessibility for WordPress. It's an introduction to accessibility topics, understanding accessibility in themes and plug-ins, and writing accessible code. Does it cover everything? It sure doesn't – you can't cover the entirety of either WordPress or Accessibility in an hour and a half; but it'll give you a great introduction to what you need to know to work accessibility in the WordPress ecosystem. Not a Lynda.com member? It's never too late to […]Continue reading "Accessibility for WordPress at Lynda.com" »
Be a power user: Access Monitor & Tenon.io
I just published an update to Access Monitor, and based on some of the feedback I've gotten, I want to talk about a handy trick for using Access Monitor more effectively. The feedback amounts to concerns about the amount of processing time Access Monitor can consume. This is fair – after all, if you want to test 50 pages of your site every day, that could be a lot of queries to Tenon, and those can each take a healthy […]Continue reading "Be a power user: Access Monitor & Tenon.io" »
WP Accessibility Update:
alt enforcement
I released an update to WP Accessibility today, that adds some limited enforcement on alt attributes for images. It's not as sophisticated as I'd like it to be, but it's a start. This includes five separate pieces: In the media manager, images include an indication that shows whether they have an alt text set or have been marked as decorative. If neither is true, it shows a link that points directly to the alt attribute field for editing. In the […]Continue reading "WP Accessibility Update:
alt enforcement" »
One year of
On December 12th, 2013, WordPress 3.8 was released. With that release, the accessibility-ready tag was added to the WordPress theme repository. This addition was the result of over a year of planning and organization to make sure that we had buy-in from the WordPress theme review team, a set of guidelines to follow that the WordPress accessibility team could get behind, without creating demands on theme developers that would make conformance impractical. It's been one year today since finding WordPress […]Continue reading "One year of
accessibility-ready" »
Good Coding Habits for Accessibility
This is the written version of my talk at WordCamp San Francisco 2014. Watch the video at WordPress.tv. Do you think web accessibility is hard? You're right. Web Accessibility is hard in the same way that everything else in development is hard: designing and building any perfect product is always tough – even impossible. But getting 90% of the way there is easy. But I'm an advocate for practicality. So don't set perfection as your goal. Just make things better. […]Continue reading "Good Coding Habits for Accessibility" »


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Dedicated to Excellence
1525 West Frye Road | Chandler, AZ 85224 Google Map
Here is the Casteel High School dedication video.
Two CUSD Teachers Named Rodel Exemplary Teacher Semifinalists
Earlier this month two CUSD teachers were selected as semifinalists for the 2016 Rodel Exemplary Teacher Award -- Sylvia Wilson of Hartford Sylvia Encinas Elementary School and Lauren Delfino-Karl of San Marcos Elementary School. In the coming weeks, Rodel will be conducting classroom visits and personal interviews with the semifinalists. Good luck to Sylvia and Lauren!
CUSD Community Relations Department has been nominated for six Emmy Awards. The honor comes after the district's media production department, under the direction of Michael Holland, entered a documentary video about district history into the Rocky Mountain Southwest Regional Emmy Awards competition. The program, called The History of Chandler Schools, Part 3: Summary of a Century, was judged by members of the National Academy of Television Arts and Sciences and deemed worthy of nominations for the coveted award. Emmy trophies will be handed out to selected recipients at an awards event on October 17.
The program is narrated by John Prothro, teacher at Perry High.
The nominated video is the last of a three-part series on the history of the district. The CUSD production team took home three awards for part 2 of the series in 2014. All three parts can be seen on the CET99.org Youtube channel.


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2002 Ford F-150 Chrome Tailgate Handles
1 - 11 of 1101 of 01
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- Putco® Chrome Tailgate Handle CoverFord F-150 with Keyhole 2002, Chrome Tailgate Handle Cover by Putco®, 2 Pieces. High grade ABS plastic ensures extreme durability, while the shiny mirror-like chrome finish enhances the entire style of your vehicle. The...Designed specifically for your vehicleEnhances the look of your tailgate handle$26.99
- RI® Chrome Replacement Tailgate HandleFord F-150 2002, Chrome Replacement Tailgate Handle by RI®. Replace your dull, painted or black plastic tailgate handle with this elegant Chrome handle.Triple Chrome finishNot a cover, completely replaces the OEM handle assembly$52.50
- RI® Chrome Tailgate Handle CoverFord F-150 2002, Chrome Tailgate Handle Cover by RI®. Get a custom looking Tailgate Handle without the hassle or expense of replacing the entire unit. This cover will enhance the style of your truck.Manufactured from high impact plasticTriple Chrome finish$20.63
- CCI® Standard Chrome Tailgate Handle CoverFord F-150 2002, Standard Chrome Tailgate Handle Cover by CCI®, 1-Piece. Customize your vehicle by applying CCI chrome trim, which is made of high quality ABS plastic, triple chrome-plated and easy to install. The products are also...Drastically enhances the look of your vehicleMade of high quality durable ABS plastic$29.70
- Marquee® Chrome Tailgate Handle CoverFord F-150 2002, Chrome Tailgate Handle Cover by Marquee®. Installing custom style tailgate handle cover is one of the hottest modifications for cars and trucks, but they can be so expensive! Now you can customize your vehicle at...Made from automotive-grade ABS plasticCustom designed for each application$39.90
- AMI® Billet Tailgate HandleFord F-150 2002, Billet Tailgate Handle by AMI®. Package contains 1 Item. Customize your door handles with these CNC-machined handles and buckets from AMI. Although they're wild-looking, they're a direct bolt-on replacement for...Direct replacement for your factory handlesMachined from aluminum billet$143.05 - $216.69
- AVS® Chrome Tailgate Handle CoverFord F-150 2002, Chrome Tailgate Handle Cover by AVS®. Basic black is fine for the masses, but not for you. Customize and personalize your vehicle with bright, shiny chrome trim from AVS. Made from tough ABS plastic and then chrome...Custom made for a precise fitLooks factory installed$22.71
- Spec-D® Chrome Tailgate Handle CoverFord F-150 2002, Chrome Tailgate Handle Cover by Spec-D®. Spec-D figuratively has their finger on the pulse of the automotive aftermarket, so they can bring you the latest style and best performing parts and accessories. No matter...Custom style lighting parts for a unique appearance and better visibilityHigh-tech engine parts for the most power and best performance$39.16
- IPCW® Tailgate Handle with Red LEDsFord F-150 2002, Tailgate Handle with Red LEDs by IPCW®. If you're looking to really light up your vehicle with LEDs, this is a great accessory to buy! The IPCW LED tailgate handle adds some extra flash to the rear of your car and...Perfect replacement for the OE tailgate handleGives a sleek, modern look to your vehicle$144.34
- Paramount® Restyling™ABS Carbon Fiber Tailgate Handle CoversFord F-150 2002, Restyling™ ABS Tailgate Handle Covers by Paramount Automotive®. Overlay. Want to change the look of your car without replacing any parts? Paramount Restyling has just the solution for you! ABS trim products are...Made from injection-molded ABS plasticDesigned from O.E. specs$25.20 - $28.80
- Bully® Chrome Tailgate Handle CoverFord F-150 2002, Chrome Tailgate Handle Cover by Bully®, 2 Pieces. Bully stainless steel tailgate handle cover greatly enhances the look of your vehicle with a finish that matches the manufacturer's chrome. The overlay easily...Gives your vehicle a serous off-road lookCustom-crafted for a perfect fit on your vehicle$22.60
2002 Ford F-150 Chrome Tailgate Handles Reviews
Average rating: 4.8 - 5 reviews
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2015 Ford F-150 | Posted by Wayne | (Tallapoosa, GA)
Ordered the cover for 2015 Ford F-150. It was delivered in a timely manner. The quality and appearance were great and installation was a breeze except for one problem it did not fit, It was not cut properly to fit into the space for the tailgate cover. The 2015 F-150 Lariat has a camera and a light beside the tailgate handle so the cover needed two holes in it and was shown to have two holes but only came with one. It was also a bit pricey for a small piece of chrome. Return was easy and CARiD refunded money promptly. This is the second item I have ordered from CARiD that did not fit. I would reorder once fit problem is corrected.
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A Hip-Hop Town Hall
8 of 10
Londell McMillan is an entertainment lawyer who represents well-known artists like Prince, Stevie Wonder, Usher and Lil' Kim. He says record companies have a responsibility about what they choose to release. "The companies are the owners of the product. They also, in these contracts, have rights to define and determine what product they would like to distribute," Londell says. "That doesn't mean they should jump into the creativity of artists, but certainly there is responsibility there."
Londell says there are a number of legal issues the industry needs to consider:
Londell says there are a number of legal issues the industry needs to consider:
- Corporate Responsibility: "[It's] having fiduciary duties to do what's in the best interest of the business," Londell says. Companies put out what they think will sell, he says.
- Constitutionality: "Not all speech is free speech and acceptable speech," he says. "However, we should be very careful when we want to censor. All cultures and families—they have censorship amongst the group. But not by government."
- Creativity: "Most [artists] are under pressure to be in a box. To produce a certain type of content that they're being told sells," Londell says. "There are a number of people who have the kind of integrity, the education and the support where they don't succumb. It's our job to create an environment where they don't have to succumb to what's worst in us and the pain in us—but the progress and the creativity in us."
Published on July 13, 2009


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Results 1 to 3 of 3
- 01-09-2013, 11:32 AM Thread Author #1
- Posts
- 1 Posts
4.2.1 Jellybean Update Problems
I have a nexus 7 tablet and i am experiencing issues trying to upgrade to the newest o.s.
I'm currently running 4.1.2 and am being prompted that there is a new software update to 4.2.1 i confirm the update the unit powers up attempts to install the update gets approx 30% complete and flashes up an error message and aborts the download i've attempted this 5 times now with the same results everytime. Getting slightly frustrating someone please help.
- Posts
- 17,193 Posts
- Global Posts
- 17,714 Global Posts
Re: 4.2.1 Jellybean Update Problems
There is a thread going in the N7 forums concerning this. I haven't had the time to personally read over it but there maybe some solutions in there for you.
Moderator @ Android Central
I am the Tegra Champ. What this means is that from time to time NVIDIA might send me new products to try out. This will not affect my thoughts, ideas, or opinions about any product that are discussed in the forums. Those are still my own.
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- 5 Posts
- Global Posts
- 18 Global Posts
Re: 4.2.1 Jellybean Update Problems
Just a quick (and probably dumb) one:
I recently upgraded my Galaxy Note II to JB 4.1.2. I noticed that my phone input (when dialing numbers) goes from the standard (I am in Singapore):
From: XXXX-XXXX
to now : XXX-XX-XX
Is there anyway to change this back? I've been searching high and low but no luck. Many thanks!
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Fall Festival
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What is the Difference between m16, ar-15, sks, m4, ak-47 and ak-74
The use of guns is not new, as this is a very old invention. However, many remarkable changes have been brought about in the model, designs and functions of guns. On behalf of such designs and different ranges, guns can be categorized in different names. Some famous guns are like m16, ar-15, sks, m4, ak-47 and ak-74. Here are some key differences between them.
A 5.56mm rifle that has light weight, magazine-fed, air-cooled and gas-operated features is known as M-16. A direct gas impingement operation activates the rotating bolt of this rifle.
Another semi-automatic rifle that has 5.56mm, magazine-fed, light weight, gas-operated and air-cooled features is known as AR-15. Again, gas impingement system operates the rotating clock belt of rifle.
Having chamber capacity of 7.62 x 39 mm, a Soviet rifle that is semi-automatic is called SKS. It is featured with 10 fixed internal round magazines that is loaded from the upper part of rifle.
A famous weapon that is characterized with its magazine-fed, air-cooled, selective fire, gas-operated and shoulder fire features is called M-4.
An assault rifle with gas-operated and selective fire features having chamber capacity 7.62 x 39 is called AK-47. Due to its remarkable wounding effects in case of penetrating projectile in to tissues, it is very popular and widely adopting weapon all over the world.
A version of AKM assault rifle that has special features like improved design, the cartridge of intermediate caliber means 5.45 x 39 is called AK-74.
M-16 vs AR-15 vs SKS vs M-4 vs AK-47 vs AK-74
The M16 is the United States Military designation for the AR-15 rifle. You can say that AR-15 is a selective fire assault rifle which was adopted by United States armed forces as the M16 rifle. While, SKS was one of the first weapons chambered for the 7.62x39 mm M43 round, later used in the AK-47. On the other hand, M4 carbine is a family of firearms tracing its lineage back to earlier carbine versions of the M16, all based on the original AR-15. Similarly, AK-74 is itself a refined version of the AK-47.
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|Publication number
|Publication type
|Application number
|Publication date
|13 Nov 2007
|Filing date
|29 Apr 2004
|Priority date
|29 Apr 2004
|Fee status
|Also published as
|Publication number
|Patrick M. McCarthy
|Original Assignee
|Edwards Lifesciences Corporation
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (23), Non-Patent Citations (4), Referenced by (70), Classifications (6), Legal Events (3)
|External Links: USPTO, USPTO Assignment, Espacenet
The present invention refers to a prosthetic annuloplasty ring for a mitral valve, in particular for correcting pathologies associated with Barlow's syndrome or myxomatous disease.
In the operation of the heart, returning blood enters the right atrium and passes through the tricuspid valve into the right ventricle. From there, blood is pumped through the pulmonary valve and the pulmonary artery to the lungs. Oxygenated blood enters the left atrium and passes into the left ventricle through the mitral valve. Healthy mitral valve leaflets "coapt" or meet near the middle of the blood flow path and are attached to the interior of the left ventricle by a number of stringy chordae tendinae CT. During systole, the mitral valve closes and the aortic valve opens, thus preventing blood from regurgitating into the left atrium and forcing blood into the aorta, and from there throughout the body. Because of the high pressures associated with the left ventricle during systole, proper mitral valve function to prevent back flow through the system is extremely important.
Mitral regurgitation is one of the most common valvular malfunctions in the adult population. Mitral valve prolapse is the most common cause of mitral regurgitation in North America and is believed to affect at least 5 to 10 percent of the population in the U.S. Women are affected about twice as often as men. Mitral valve prolapse has been diagnosed as Barlow's disease, billowing or balloon mitral valve, floppy mitral valve, floppy-valve syndrome, myxomatous mitral valve, prolapsing mitral leaflet syndrome, or systolic click-murmur syndrome. Some forms of mitral valve prolapse seem to be hereditary, though the condition has been associated with Marfan's syndrome, Grave's disease, and other disorders.
Barlow's disease is characterized by myxoid degeneration and appears early in life, often before the age of fifty. Patients typically present with a long history of systolic murmur and may experience valve infection, arrhythmias and atypical chest pain. Some cases are asymptomatic, but a pronounced midsystolic click with or without late systolic murmur, usually indicates the presence of this disorder. South African cardiologist John B. Barlow was the first to interpret this auscultation syndrome, known for decades as an expression of a mitral valve prolapse. In Barlow's disease, one or both leaflets of the mitral valve protrude into the left atrium during the systolic phase of ventricular contraction. The valve leaflets are thick with considerable excess tissue, producing an undulating pattern at the free edges of the leaflets. The chordae are thickened, elongated and may be ruptured. Papillary muscles are also occasionally elongated. The annulus is dilated and sometimes calcified.
In patients with degenerative mitral valve disease, valve repairs using mitral valvuloplasty valve reconstruction, or annuloplasty have been the standards for surgical correction of mitral regurgitation and have provided excellent long-term results. A rigid support ring (e.g., Carpentier-Edwards Classic™), a semi-flexible ring (e.g., Carpentier-Edwards Physio™), or a flexible ring (e.g., Cosgrove-Edwards™) may be used. Other repair techniques include: quadrangular resection of the prolapsing portion of the posterior leaflet; transposition of the posterior leaflet to the anterior leaflet to correct anterior-leaflet prolapse; commissurotomy combined with ring annuloplasty; replacement of a chordae tendinae with sutures; and plication (or resection) of the anterior leaflet. A commonly used repair is the so-called "sliding technique" introduced by Dr. Alain Carpentier, which involves quadrangular resection followed by cutting the posterior leaflet and reconstruction to shorten this leaflet. The advantages of repair over replacement have been widely demonstrated; however, studies have shown that mitral valve repair is performed in less than half of surgical procedures involving the mitral valve, and even fewer repairs are performed in patients with complex mitral regurgitation (e.g., Barlow's disease, bileaflet prolapse and annular calcification). Despite adequate tissue resection and placement of an annuloplasty ring or band, patients may have residual mitral regurgitation associated with systolic anterior motion (SAM) of the anterior leaflet. SAM occurs when the elongated leaflet is pulled into the left ventricular outflow tract (LVOT). This leads to partial LVOT obstruction and hemodynamic instability. This scenario is not an uncommon incident following an otherwise successful mitral valve repair and can be very difficult to treat with existing repair techniques and devices, and may require mitral valve replacement rather than the preferred of valve repair.
One example of a prior art surgical resection technique for correcting mitral valve prolapse, or Barlow's syndrome, is seen in the sequence of
In early 90's, Dr. Ottavio Alfieri introduced the concept of edge-to-edge heart valve repair. This repair technique consists of suturing the edges of the leaflets at the site of regurgitation, either at the paracommissural area (eg: A1-P1 segments: para commissural repair) or at the middle of the valve (e.g.: A2-P2 segments: double orifice repair). Three patents disclosing various devices for performing such edge-to-edge procedures are U.S. Pat. No. 6,165,183 to Kuehn, et al., U.S. Pat. No. 6,269,819 to Oz, et al., and U.S. Pat. No. 6,626,930 to Allen, et al. Recently, the edge-to-edge technique has been used in conjunction with annuloplasty procedures for treating the pathology seen with Barlow's disease. The underlying bases for these techniques are to eliminate the primary regurgitant area by suturing the leaflet edge and decreaseing leaflet mobility, and to correct leaflet redundancy, force coaptation, and restrict leaflet motion.
Despite accepted treatments for correcting mitral valve prolapse, in particular Barlow's syndrome, there is a need for a simpler and more effective approach, preferably one which avoids the need for sliding annuloplasty. Sliding annuloplasty adds technical and skill intensive barriers that limit widespread adoption of mitral valve repair.
The present invention provides a mitral annuloplasty ring comprising a ring body made of a material that will substantially resist distortion when subjected to the stress imparted thereon by an operating human heart. The ring body defines an anterior segment and a posterior portion opposite the anterior segment. Right and left sides are located between the anterior segment and posterior portion. A central flow axis has an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow through the mitral valve annulus when the annuloplasty ring is implanted. The ring body has a modified oval shape with a minor axis extending between the anterior segment and posterior portion, and a major axis extending between the sides. A bow in the posterior portion of the ring body extends both radially outward and axially upward.
In accordance with another aspect, a mitral annuloplasty ring of the present invention comprises a ring body made of a material that will substantially resist distortion when subjected to the stress imparted thereon after implantation in the mitral valve annulus of an operating human heart. The ring body defines a rounded ring body having an anterior segment and a posterior portion. The ring body is oriented about a central flow axis, the flow axis defining an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow through the mitral valve annulus. The posterior portion the ring body bows upward out of a plane perpendicular to the central flow axis and also has a radially outward curve more pronounced than adjacent sections.
In accordance with a still further aspect of the invention, a mitral annuloplasty ring comprises a ring body made of a material that will substantially resist distortion when subjected to the stress imparted thereon after implantation in the mitral valve annulus of an operating human heart, the ring body defines a modified oval-shaped ring body oriented about a central flow axis, the flow axis defining an upward direction and a downward direction, the downward direction corresponding to the direction of blood flow through the mitral valve annulus from the left atrium to the left ventricle, and wherein in plan view as seen along the flow axis the ring body has a major axis perpendicular to a minor axis, the major and minor axes being perpendicular to the flow axis. The ring body having in atrial plan view an anterior segment generally defined between an anterolateral trigone and a posteromedial trigone, and a posterior portion around the remaining periphery of the ring body and between the trigones, the posterior portion being divided into three sequential segments, P1, P2, and P3 starting from the anterolateral trigone and continuing in a counterclockwise direction, the segments generally corresponding to the size of the native posterior leaflet cusps, wherein the minor axis intersects both the anterior segment and the P2 segment of the posterior portion. The ring body lies substantially in a plane defined by the major and minor axes or in a saddle-shaped three-dimensional surface except for the P2 segment of the posterior portion located which is deflected upward and outward with respect to the adjacent sections of the ring body.
In a ring of the present invention, an axial height h of the upward bow or deflection exceeds about 3 mm, more preferably between about 3-10 mm. In atrial plan view as seen along the flow axis, the ring body has a major axis perpendicular to a minor axis, the major and minor axes being perpendicular to the flow axis, and the minor-major dimension ratio is preferably between about 3.3:4 (82.5%) and 4:4 (100%), more preferably about 3.5:4 (87.5%). The bow may be centered about the minor axis and have an angular extent of between about 90-110�, for example about 100�.
The ring body has an anterior segment generally defined between an anterolateral trigone and a posteromedial trigone, and a posterior portion around the remaining periphery of the ring body and between the trigones. The posterior portion is divided into three sequential segments, P1, P2, and P3, starting from the anterolateral trigone and continuing in a counterclockwise direction. Desirably, the bow in the posterior portion is wholly within the middle segment P2 of the posterior portion of the ring. Alternatively, the bow in the posterior portion may be within the middle segment P2 and extend into at least one other segment P1 or P3 of the posterior portion of the ring.
The present invention provides a novel annuloplasty ring for correcting pathologies associated with mitral valve prolapse, also known by a number of other names given above, including Barlow's syndrome. With this pathology, the mitral valve leaflets are distended, lengthened, thickened, or in general have become loose and floppy such that they do not properly coapt. In contrast to prior repair techniques, the annuloplasty ring of the present invention reduces or eliminates the need for a sliding annuloplasty. Furthermore, instead of attempting to constrict the mitral annulus by the addition of an annuloplasty ring that is under-sized with respect to the existing annulus, the present invention accommodates the excess material of the leaflets by providing a larger support ring than has previously been utilized. Typical annuloplasty support rings have a long or major dimension and a short or minor dimension, with the conventional ratio of the minor to major dimension being approximately 3:4 (75%). The present invention provides an annuloplasty ring that has a significantly increased minor to major dimension ratio of approximately 3.5:4 (87.5%).
Annuloplasty rings of the present invention are desirably made of material(s) that will substantially resist distortion when subjected to the stress imparted thereon by the mitral valve annulus of an operating human heart. In this sense, "distortion" means substantial deformation from a predetermined shape. Thus, at least the posterior aspect of the annuloplasty rings is relatively rigid, as opposed to flexible as those made substantially of silicone. A number of materials can be utilized that will perform this function, including various bio-compatible polymers and metals and/or alloys. Certain polyesters that resist distortion and also rapid degradation within the body may be used (a material that degrades more slowly, however, may provide the required initial support). In a preferred embodiment, at least an inner core of the annuloplasty rings of the present invention is made of a suitable metal, such as titanium or its alloys, or ELGILOY made by Elgiloy, L.P. of Elgin, Ill., U.S.A. The core may be one piece, or may include a plurality of concentric or otherwise cooperating elements. The addition of a silicone tube around the core and a suture-permeable fabric on the exterior of the ring are also contemplated.
With reference now to
A minor axis dimension 48 a is shown extending across the interior of the ring 40 in plan view. Likewise, the major axis dimension 48 b is shown extending horizontally across the interior of the ring. Desirably, the ratio of the minor axis dimension 48 a to the major axis dimension 48 b is about 3.5:4 (87.5%).
For purpose of further definition, a pair of trigone markers T1 and T2 are shown on the ring 40 corresponding to the approximate location of the fibrous trigones of the mitral annulus when the ring is implanted. An anterior segment extends around the upper portion of the ring 40 in
The remainder of the ring 40 aside from the anterior segment will be termed the posterior portion, and is shown broken up into three sequential segments denoted P1, P2, and P3 (moving counter-clockwise from the first trigone marker T1). The precise angular dividing line between these three segments is not standardized, though they are intended to generally correspond to the three visible cusps of the posterior leaflet of the mitral valve. In an exemplary embodiment, the three segments are approximately equal in angular dimension, and the middle segment P2 is symmetric about the minor axis 46.
The annuloplasty ring 40 has a modified oval shape in plan view because of an outward bow 50 within the middle segment P2 of the posterior portion of the ring. Stated another way, the middle segment P2 of the posterior portion of the ring has an outward curve (convexity) more pronounced than adjacent sections (which are also convex) (in this sense, "more pronounced" means an outward bow with a smaller radius than adjacent convex sections). A dashed outline 52 of a conventional 3:4 ratio annuloplasty ring is shown to illustrate the outward bow 50 of the present ring 40. As mentioned above, the outward bow 50 preferably results in a minor-major dimension ratio of 3.5:4 (87.5%), although the present invention encompasses rings having an outward bow 50 that produces ratios of between 3.3:4 (82.5%) and 4:4 (100%).
It is important to note that although the minor axis dimension 48 a increases relative to conventional rings (i.e., dashed outline 52), the major axis dimension 48 b will remain substantially the same. Furthermore, although the outward bow 50 is shown within the middle segment P2 of the posterior portion of the ring, the posterior portion below the major axis 44 may be affected. That is, the outward bow 50 may extend into one or both of the first and third segments P1 and P3 of the posterior portion. In a preferred embodiment, however, the annuloplasty ring 40 only diverges from a conventional oval- or D-shaped ring (such as the Carpentier-Edwards classic ring™) within the middle segment P2. In an exemplary embodiment, the angular extent of the outward bow 50 centered about the central axis 42 is between 90-110�, and more preferably about 100�.
In conjunction with the outward bow 50, the annuloplasty ring 40 also includes an upward bow 60 seen in
A height h of the upward bow 60 is indicated in
The annuloplasty ring 40 is believed to more effectively correct the pathology seen with Barlow's syndrome because it accommodates the longer and/or thicker leaflets instead of attempting to perform a sliding annuloplasty, which is more surgical art than an exact science. The combination of the outward bow and the upward bow on the posterior side of the ring is believed to provide rigid support for the posterior leaflet from which it can more effectively coapt with the anterior leaflet. The annuloplasty ring 40 essentially "pulls" the posterior leaflet outward and upward which reduces its slack or floppiness. Furthermore, the ring 40 should pull the coaptation point outward and upward and away from the LVOT. This should reduce the incidence of SAM and LVOT obstruction and mitral regurgitation post-repair.
It will also be appreciated by those of skill in the relevant art that various modifications or changes may be made to the examples and embodiments described without departing from the intended scope of the invention. In this regard, the particular embodiments of the invention described herein are to be understood as examples of the broader inventive concept disclosed.
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|8 Sep 2015
|Georgia Tech Research Foundation
|Papillary muscle position control devices, systems, and methods
|21 Apr 2011
|Edwards Lifesciences Corporation
|Mitral and Tricuspid Annuloplasty Rings
|15 Sep 2014
|8 Jan 2015
|Valtech Cardio, Ltd.
|Implant having multiple rotational assemblies
|U.S. Classification
|623/2.36, 623/2.38, 623/2.41
|International Classification
|Cooperative Classification
|European Classification
|8 Sep 2004
Owner name: EDWARDS LIFESCIENCES CORPORATION, CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MCCARTHY, PATRICK M.;REEL/FRAME:015114/0974
Effective date: 20040524
|13 May 2011
|Fee payment
Year of fee payment: 4
|28 Apr 2015
|Fee payment
Year of fee payment: 8


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Reverend says decision made Wichita Falls a tale of two cities
Wichita Falls Times Record News (TX) - Sunday, May 16, 2004
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