|Publication number||US6929609 B2|
|Application number||US 10/446,028|
|Publication date||Aug 16, 2005|
|Filing date||Jan 18, 2002|
|Priority date||Jan 18, 2001|
|Also published as||CN1292813C, CN1487845A, US20040059219, WO2002056957A1|
|Publication number||10446028, 446028, PCT/2002/339, PCT/JP/2/000339, PCT/JP/2/00339, PCT/JP/2002/000339, PCT/JP/2002/00339, PCT/JP2/000339, PCT/JP2/00339, PCT/JP2000339, PCT/JP2002/000339, PCT/JP2002/00339, PCT/JP2002000339, PCT/JP200200339, PCT/JP200339, US 6929609 B2, US 6929609B2, US-B2-6929609, US6929609 B2, US6929609B2|
|Original Assignee||Hitachi Medical Corporation|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (7), Referenced by (23), Classifications (15), Legal Events (5)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application is the U.S. National Phase under 35 U.S.C. § 371 on International Application PCT/JP02/00339, filed on Jan. 18, 2002, which claims priority of 2001-10607, filed Jan. 18, 2001.
The present invention relates to an ultrasonic diagnostic/treatment device and a method therefor, and in particular to an ultrasonic diagnostic/treatment device and a method therefor that are suited for intensively administering medicine to a diseased part in an organism.
In recent years, ultrasonic diagnostic/treatment devices used to treat diseased parts of bodies are being developed. There are several kinds of devices that use ultrasonic waves to treat diseased parts of organisms. A first kind of device uses ultrasonic waves to create an image of a diseased part and uses that image as a guide image for inserting a catheter or a needle into an organism. A second kind of device uses energy of ultrasonic waves emitted into the organism as energy to destroy the diseased tissue. A third kind of device irradiates ultrasonic waves to a medium administered inside the organism, the resulting change in the state of the medium causing destruction of the diseased tissue.
As an example of the third kind of conventional device, an ultrasonic diagnostic/treatment device is disclosed in JP-A-2000-189521 that is disposed with collecting means that irradiates the organism with a first ultrasonic wave signal for obtaining an echo image and collects received signals corresponding to the echo signals, image acquisition means that processes the echo signals to obtain image information, and irradiation means that sends to the organism a second ultrasonic signal for destroying microcapsules so that medicine included inside the microcapsules or microbubbles which have been administered to the organism is activated in a diseased part of the organism.
However, with respect to this conventional device, although there is description in regard to setting the emission direction of the second ultrasonic wave for destroying the microcapsules, no consideration is given in regard to controlling the second ultrasonic wave irradiation means in association with diagnostic information obtained by the first ultrasonic wave irradiation means.
The present invention was devised with the object of providing an ultrasonic diagnostic/treatment device that improves treatment efficiency.
The present invention was also devised with the object of providing an ultrasonic diagnostic/treatment device with which the destruction status of microcapsules can be visually confirmed, and the amount of medicine sealed in the microcapsules which is administered to the diseased part can be confirmed.
The present invention was also devised with the object of providing an ultrasonic diagnostic/treatment device with which the efficiency of treatment can be further improved by the administration of plural microcapsules.
In order to achieve the above-described objects, an ultrasonic diagnostic/treatment device according to the invention includes: first ultrasonic wave irradiation means that transmits to an organism a first ultrasonic wave signal for obtaining an image and receives wave signals corresponding to echo signals of the first ultrasonic wave signal; means that processes the received wave signals to obtain diagnostic information; second ultrasonic wave irradiation means that irradiates the organism with a second ultrasonic wave signal for destroying microcapsules containing medicine and administered to the organism; and control means that controls the second ultrasonic wave irradiation means on the basis of the diagnostic information obtained by the first ultrasonic wave irradiation means.
In order to administer to a diseased part medicine encapsulated in microcapsules by destroying the microcapsules, ultrasonic waves are transmitted to the microcapsules at the time that the microcapsules have arrived at the diseased part, and the microcapsules are destroyed. An operator confirms that the microcapsules are concentrated near the diseased part and based on ultrasonic waves received for image diagnosis controls ultrasonic wave radiation that destroys the microcapsules. Thus, treatment efficiency, including treatment time, is improved. Also, the amount of time that the patient must be restrained is also reduced due to the treatment time being reduced, and the amount of microcapsules administered to the patient can be reduced. Here, the time at which the microcapsules have arrived at the diseased part may be considered to be the time at which the concentration of microcapsules that have circulated to the diseased part reaches an optimum level.
Image display means which display undestroyed microcapsules as detected by the first ultrasonic wave signals when the the second ultrasonic wave signal is switched to the first ultrasonic wave signal are also disposed.
The destruction status of the microcapsules is visually confirmed by a doctor. The destruction status of the medicine-containing microcapsules is visually confirmed, and the extent to which the medicine encapsulated in the microcapsules has been administered to the diseased part can be confirmed.
Also included are: first ultrasonic wave irradiation means that transmits, to an organism to which at least two different types of medicine-containing microcapsules have been administered, a first ultrasonic wave signal for obtaining an image and that receives a received wave signal corresponding to the echo signal of the first ultrasonic wave signal; means that processes the received wave signal to obtain diagnostic information; second ultrasonic wave irradiation means that irradiates the organism with a second ultrasonic wave signal for destroying the microcapsules administered to the organism; and control means that controls the second ultrasonic wave irradiation means on the basis of the obtained diagnostic information.
When numerous types of microcapsules in which different medicines have been encapsulated are used, the second ultrasonic waves are irradiated to one type of microcapsules at the time at which those microcapsules have arrived at the diseased part so that those microcapsules are destroyed. By administering plural types of microcapsules, the efficiency of treatment is further improved.
An embodiment of the invention will be described in detail below on the basis of the attached drawings.
A received wave amp 6 amplifies signals that are received by the probe 5 as the echo signals from the organism. An AD converter (ADC) 7 AD—converts the echo signal outputted from the received wave amp 6. A phasing unit 8 conducts phasing in which a received wave beam signal is formed. The number of channels of the received wave amp 6, the ADC 7 and the phasing unit 8 are equivalent to the number of oscillators that are operated when the ultrasonic probe 5 receives the waves, and an adding circuit is disposed at a terminal end of the phasing unit 8. The received wave beam signal is formed by these portions. It should be noted that the ADC 7 can also be considered to be part of the phasing unit 8.
A signal processing unit 9 administers preprocessing—namely, logarithmic compression, detection, filtering and enhancement—for imaging the echo signals inputted from the phasing unit 8. A digital scan converter 10 conducts conversion between the scan of the ultrasonic wave beam and a scan for image display. A display-use memory 11 stores the output of the digital scan converter 10. A color display device 12 comprises, for example, a color CRT display or a color liquid crystal display device. A control unit (CPU) 13 controls the above-described configuration requirements. The above configuration is substantially the same as the configuration of known ultrasonic diagnostic medical image devices.
The ultrasonic diagnostic/treatment device according to the invention has, in addition to the function of obtaining a diagnostic image as described above, the function of destroying microcapsules inside the body of a patient, the function of detecting and imaging the destruction status of the microcapsules, and the function of determining the timing for destroying the microcapsules. Next, component parts of the present embodiment that are added to the above-described configuration in order to achieve the latter three functions will be described.
First, the component part that fulfills the function of destroying the microcapsules will be described.
Generally, the transmission wave intensity P1 used in ultrasonic diagnosis is 0<P1 1[W/cm2]. A transmission wave intensity P2 that can destroy microcapsules is 0<P2 5[W/cm2]. The relation between the transmission wave intensities is P1=m×P2 (where m is 0<m 0.2).
Next, the configuration for observing the destruction status of the microcapsules will be described. Prior to destroying the microcapsules, their concentration in the diseased part was detected, and after the microcapsules have been destroyed, the destruction status can be seen by the extent to which microcapsules remaining that have not been destroyed. When undestroyed microcapsules are irradiated with the ultrasonic waves, a resonance phenomenon arises, capsule films are destroyed, and a frequency that is different from the frequency of the ultrasonic waves transmitted at that time is generated. The “frequency that is different” referred to here includes many harmonic components having frequencies with different from the frequency of the transmitted ultrasonic waves. By imaging the harmonic components, the destruction status of the microcapsules can be observed. The configuration by which the harmonic components are imaged will be described using FIG. 1. In
Next, an example of the detailed configurations of the harmonic detection unit 14 and the frequency analysis unit 15 will be described using FIG. 3. The harmonic detection unit 14 comprises a local oscillator 141, multipliers 142 and 143, and low-pass filters (LPF) 144 and 145. Here, the local oscillator 141 is configured by a memory and a counter and outputs two local signals—i.e., sin(2
The frequency analysis unit 15 comprises a fast Fourier transform (FFT) computing unit 151 and an absolute value (ABS) computing unit 152. The FFT computing unit 151 includes a well-known butterfly multiplier, and converts the echo signal from a real-time array to a frequency array, and the ABS computing unit 152 comprises a squaring computing unit, an addition computing unit and a square root computing unit, and calculates the signal intensity of each frequency outputted from the FFT computing unit 151.
Next, the configuration for achieving the function of calculating the time of the destruction of the microcapsules will be described. Microcapsules injected into a vein are circulated inside the organism and carried to the diseased part by the flow of blood. At this time, the concentration of microcapsules that have reached the diseased part becomes greater with time and, thereafter, becomes less with time. Therefore, when the concentration of microcapsules changing with the elapse of time is observed, the proper irradiation timing of the ultrasonic waves to destroy the microcapsules can be calculated. In the present embodiment, the color mapping (CM) unit 16 is disposed in order to grasp changes in the concentration of the microcapsules in the diseased part. As shown in
Next, the configuration for achieving the function of grasping the destruction status and the flow status of the microcapsules to the diseased part will be described. In the present invention, it is easy for a doctor to grasp the destruction status and the flow status of the microcapsules to the diseased part by not only displaying these for that moment, but also changes in these over time. In the present embodiment, the time intensity detection unit 17 is disposed for this purpose as one configuration example. As shown in
By establishing a switch for adjusting the transmission intensity of the ultrasonic waves for destroying the microcapsules in the form of an operation mode selection switch, the transmission intensity can be adjusted to match the physical constitution of the patient while observing the destruction status of the microcapsules. Because by the adjustment switch makes it possible to control the transmission intensity as much as possible while the treatment is being carried out, ultrasonic treatment that reduces the burden on the patient resulting from the treatment is possible.
Next, the operation of the ultrasonic diagnostic/treatment device configured set forth above will be described. Initially, the doctor makes preparations for injecting the microcapsulated medic ine into a vein of the patient. An automatic injector can be used to inject the medicine. When the preparations have been finished, the doctor turns on the power to the ultrasonic diagnostic/treatment device and uses the imaging function of the device to display an ultrasonic tomogram of the treatment area on the monitor of the device, and, by observing the tomogram, specifies the position of the probe at which the treatment area is best displayed.
Imaging of the ultrasonic tomogram for this purpose is conducted as follows. The doctor first selects a tomogram imaging mode with an operation mode selection switch 18 of the device disposed on the control panel of the ultrasonic diagnostic/treatment device. Then, the doctor touches the probe 5 to the outer surface of the treatment area of the patient, operates ultrasonic scanning initiation switch (not illustrated) and operates a focus depth setter in order to set the focus depth of the ultrasonic waves transmitted from the probe. In doing so, a command is sent from the CPU 13 to the transmission wave signal generation unit 1, and the transmission wave signal generation unit 1 generates digital transmission wave pulse signals for imaging the tomogram to which are added a predetermined delay time for the pulse supplied to each oscillator so that these ultrasonic wave pulses will be concentrated (meaning the same as “be in phase”) at the set focus depth.
The transmission wave pulse signals outputted from the transmission wave signal generation unit 1 are converted to analog signals in the DAC 2 and inputted to the transmission wave amp 3. The transmission wave pulse signals are amplified by the transmission wave amp 3 to a voltage necessary to induce piezoelectric vibration in the oscillators, and supplied to the probe 5 by the transmission/reception switching unit 4. The transmission wave pulse signals that have been delayed by the predetermined delay time are applied to the oscillators of the probe 5, and the ultrasonic waves are transmitted to the subject organism from the oscillators time intervals corresponding to these delay times. Thus, the ultrasonic waves transmitted inside the subject organism are propagated inside the subject organism so that they concentrate (meaning the same as “come in phase”) at the set focus depth, and also some of the ultrasonic waves are reflected back toward the probe as an echo at the boundaries of different acoustic impedances inside the subject organism.
The probe 5 receives the echo, converts it to an electrical signal, and outputs it. The receiving operation of the probe 5 is conducted by all of oscillators conducting the transmission operation or a part thereof, and the signals received by the oscillators are individually inputted to the received wave amp 6 via the transmission/reception switching unit 4, amplified in the received wave amp 6, and thereafter converted to digital signals in the ADC 7 and outputted to the received wave phasing unit 8. The received wave phasing unit 8 is controlled by the CPU 13 and conducts dynamic focusing by addition processing and delay control with respect to each received wave signal. In this way it continuously changes its focal point along a predetermined path inside the organism and captures the ultrasonic wave echoes from each focal point. Ultrasonic wave beam signals on a predetermined line inside the subject organism are obtained by the above transmission and receiving operations.
The ultrasonic wave beam signals outputted from the received wave phasing unit 8 are inputted to the Raster signal processing unit 9, undergo logarithmic compression, detection, dynamic filtering and enhancement, and are outputted to the DSC 10. Harmonic signals of a weak intensity including a frequency of an integral multiple of the ultrasonic wave frequency transmitted from the probe 5 into the organism is included in the signals inputted to the Raster signal processing unit 9, but these are removed by filtering. The signals inputted to the DSC 10 are stored at a predetermined address in the memory for the purpose of image formation. When the above ultrasonic wave transmission and receiving operations are repeatedly conducted while successively shifting the ultrasonic wave beam direction and an image is formed in the memory of the DSC 10, the image data thereof is read in synch with scanning of the color display device 12 via the display memory 11 and preferably displayed in black and white on the display screen of the color display device 12 as an ultrasonic tomogram. The ultrasonic scanning inside the subject organism is continuously conducted even after one frame image is obtained, and acquisition and display of a tomogram at a frame rate of about 30 frames per second are conducted.
While continuing the ultrasonic scanning, the doctor changes the position and the contact angle of the probe 5 with respect to the surface of the organism to locate the diseased part that is to be treated. Then, the doctor retains the probe 5 at the position at which the diseased part to be treated is best displayed on the color display device 12, operates a freeze switch (not shown) and freezes the image display. It should be noted that a retaining tool can be used to retain the probe.
The doctor observes the frozen image displayed on the color display device 12 and designates the treatment area. A technique for setting the scanning range using color flow mapping (CFM) which gives a two-dimensional display of the flow of blood can be applied for the designation of the treatment area, and the designation of the treatment area is set by a treatment range setter 19 by designation of the scanning range of the ultrasonic beam during treatment, and this designation signal is stored in the CPU 13. The reason for setting the ultrasonic wave beam scanning range for treatment using the frozen tomogram is because there is no spare time for conducting that operation when moving from graphing of the microcapsules, which is conducted next, to the treatment.
In this state, the doctor or an assistant injects the microcapsules in which the medicine is encapsulated into a vein of the patient using an injector. Because the microcapsules injected into the vein flow to the diseased part circulating through the patient's body in a few seconds after the injection, the doctor operates the operation mode selection switch 18 and switches from the tomogram acquisition mode used up to that time to a graphing mode. When this switching signal is inputted to the CPU 13, the CPU 13 sends an activation command to the harmonic detection unit 14, the frequency analysis unit 15, the color mapping unit 16, and the time intensity (TI) detection unit 17. When the mode has been switched from the tomogram acquisition mode to the graphing mode, is it preferable for the frequency of the ultrasonic waves transmitted from the probe 5 to the inside of the patient's body to be changed to a value that can best detect the microcapsules injected into the patient's body.
When this changing command is received, the transmission wave signal generation unit 1 out puts a transmission wave pulse. This transmission wave pulse is successively supplied to the DAC 2, the transmission wave amp 3, the transmission/reception switching unit 4, and the probe 5, and the ultrasonic waves are transmitted from the probe 5 to the diseased part. Similar to the imaging of the tomogram above, scanning is repeatedly conducted while changing the direction of each transmission wave so that the entire region is scanned. Below, the receiving operation thereof will next be described.
The received wave echo signal of the ultrasonic wave transmitted in a certain direction from the probe 5 is inputted to the Raster signal processing unit 9 and the harmonic detection unit 14 via the probe 5, the transmission/reception switching unit 4, the received wave amp 6, the ADC 7, and the received wave phasing unit 8. As shown in
After the signal A and the harmonic signal B inputted to the Raster signal processing unit 9 have undergone preprocessing for imaging similar to the echo signal processing during imaging for locating the diseased part, they are inputted to the memory of the DSC 10 in order to form a tomogram resulting from the signal A.
Then, the beam signal comprising the harmonic signal B inputted to the frequency analysis unit 15 is frequency-analyzed by sequential Fourier conversion in the FFT computing unit 15. The output of the frequency analysis unit 15 represents a frequency distribution of the harmonic signal B from a shallow part to the deep part of one signal beam. Because the harmonic signal generated at the time the microcapsules are irradiated with the ultrasonic waves is already known in advance by measurement, it can be known whether or not the microcapsules are flowing in the beam direction by observing the output of the frequency analysis unit 15. Then, the output of the frequency analysis unit 15 is inputted to the ABS computing unit 25, the signal intensity of the harmonic signal B successively inputted by the aforementioned configuration is calculated, the signal is separated according to frequency, and the signals are outputted to the TI detection unit 17.
The signal representing the signal intensity for each harmonic frequency calculated by the ABS computing unit 152 in this manner is outputted to the TI detection unit 17, added to each frequency as shown in
The harmonic echo signal outputted from the harmonic detection unit 14 to the color mapping unit 16 is inputted to the MTI filter 161 and temporarily stored in a storage unit such as an internal register. The MTI filter is well known in the field of radars and the field of ultrasonic Doppler measurement, and is used in order to cancel information of a stationary part and detect only information of a moving object. In the present invention, the MTI filter 161 is for detecting moving information of the microcapsules or flow of blood flowing through the diseased part. In the MTI filter 161, it is necessary to transmit the ultrasonic wave beam in the same direction at least two times in order to detect only the movement of the microcapsules or the flow of blood.
Thus, when the receiving operation is concluded, the CPU 13 repeats the transmission and receiving operations without changing the ultrasonic wave transmission and reception direction. When the echo signal resulting from the second reception is inputted to the MTI filter 161 via the harmonic detection unit 14, computation of the difference between the data temporarily retained in the storage unit such as the register and the newly inputted data is conducted in the MTI filter 161, and the movement of the microcapsules or the flow of blood between these two transmissions and receptions is measured. Then, this information is provided for autocorrelation computation in the autocorrelation computing unit 162, and respective data of the moving speed, speed distribution, and signal intensity of the microcapsules or flow of blood is computed. These computed data are outputted to the color mapping unit 163, and information of the three primary colors of R (red), G (green) and B (blue) light is added to each of the data and stored in the memory of the DSC 10. Thus, through the transmission and reception of the ultrasonic wave beam in one direction, the frequency distribution along the beam and the moving information of the moving body are obtained.
Next, in order to two-dimensionally expand the acquisition of the information on movement of the moving bodies and the frequency distribution, transmission and reception are repeatedly conducted while successively shifting the direction of the ultrasonic wave beams, and a cross section including the diseased part is ultrasonically scanned. Due to this ultrasonic scanning, the TI detection unit 17 measures the frequency distribution in the cross section, and the color mapping unit 16 measures the movement of the microcapsules or the flow of blood in the cross section. Of these, the frequency distribution data detected by the TI detection unit 17 and stored in the memory of the DSC 10 are counted up for each frequency by the counting function of the CPU 13. The data counted for each frequency represent the integrated value of luminance per frequency with regard to a signal appearing in the ultrasonic scanning surface in a certain time of the time intensity curve shown in FIG. 9.
The movement information of the microcapsules or the flow of blood measured by the color mapping unit 16 is made into two-dimensional image data in the memory of the DSC 10, read out in order to visualize the moving status of the fluid in the cross section, outputted from the Raster signal processing unit 9, synthesized in the display memory 11 with the black-and-white image data made into two-dimensional image data in the memory of the DSC 10, and displayed on the color display device 12. By viewing this image, an operator can observe, virtually in real time, the microcapsules mixed in the flow of blood and flowing to the diseased part by color changes on the image.
The above transmission and receiving operations are repeatedly conducted thereafter, and the display of the tomogram and the color mapping image is updated each time the transmission and reception of the ultrasonic wave beam in one direction is completed and the memory content of the DSC 10 is updated. At the same time, the measurement data of the TI detection unit 17 are tallied each time scanning of one frame is completed, and the time intensity curve is created to match the measurement data of the preceding frames. The time intensity curve uses time for the horizontal axis, luminance for the vertical axis, and frequency as the parameter, and, as shown in
The operator observes this graph, pays attention to the curve of a certain frequency generated when the microcapsules in which the medicine is encapsulated continuously flow to the diseased part, and when the doctor determines that the time has been reached when the microcapsules should be destroyed, the doctor switches the operation mode selection switch 18 on the ultrasonic diagnostic device to the treatment mode. Upon doing so, the CPU 13 sends a command for generating ultrasonic waves for treatment to the transmission wave signal generation unit 1 and the transmission wave amp 3. The transmission wave signal generation unit 1 receiving this command of the CPU 13 outputs a transmission wave pulse for transmitting ultrasonic waves having an ultrasonic frequency for destroying the microcapsules from the probe 5 to the inside of the patient's body, and the transmission wave amp 3 amplifies the transmission wave pulse inputted via the DAC 2 to a level that can destroy the microcapsules and outputs the transmission wave pulse. Because the amplified transmission wave pulse is delay-controlled in the transmission wave signal generation unit 1 so that the ultrasonic waves are focused at the endmost portion of the scanning range set as the treatment area in the ultrasonic wave transmission/reception direction (initial direction), the ultrasonic waves radiated from the oscillators of the probe 5 are focused at the treatment area of the patient.
As shown in
r: shell radius
k: specific heat ratio
P: internal pressure of shell
ñ: specific gravity
Here, the behavior of the microcapsule 200 when the ultrasonic wave is irradiated to the microcapsule 200 will be described using
When the transmission and reception of the ultrasonic waves in the initial direction is concluded, the CPU 13 repeats the transmission and reception and scanning while successively shifting the transmission and reception direction of the ultrasonic waves with respect to the treatment range. Then the fundamental wave echo signal and the harmonic echo signal obtained by the transmission and reception are processed by the Raster processing unit, the CM detection unit and the TI detection unit, and displayed on the color display device as a tomogram, a CM image, and a time intensity curve.
The doctor observes the CM image and the time intensity curve, and stops the ultrasonic scanning for treatment at the point in time when it is confirmed that the flow of the microcapsules to the treatment area has decreased.
Although an embodiment of the invention has been described above, various modified examples of the invention are also possible.
Also, in the embodiment shown in
Moreover, other modified examples of the invention are possible. For example, in the above embodiment, although an example was described where one type of medicine used for the treatment was used and the microcapsules were injected into the patient, it is also possible to configure a mode that can treat the diseased part using plural types of microcapsules in which respectively different medicines are encapsulated. In this case, treatment is possible so that the intensity and frequency of the transmitted ultrasonic waves are set and stored in advance in the CPU in accordance with the injection order of the medicines, plural treatment modes can be selected with the operation mode selection switch, the doctor determines the concentration of each type of microcapsule flowing to the diseased part with the time intensity curve and the color mapping image, and an operation that switches the intensity and the frequency of the ultrasonic wave following the destruction timing for the respective microcapsules is conducted by selective switching of the treatment mode.
Although an example was described where the intensity and the frequency of the ultrasonic waves used in the treatment were switched and set, it is also possible to operate a setting that varies the focus range of the transmitted ultrasonic wave depending on the size and nature of the diseased part. For example, for a diseased part present over a relatively wide range, the focus range of the ultrasonic waves is set to match the size of the diseased part and the ultrasonic waves are transmitted so that the medicine inside the microcapsules acts on the diseased part in that wide range. For a diseased part requiring that medicine of an even concentration be administered thereto, the focus range that is a conventional sphere may be set to be non-spherical to match the diseased part. In cases where the diseased part is small or side effects of the medicine are strong, the focus range may be set to be smaller so that administration of the medicine is kept at a minimum.
Although an example was described where the diseased part can be treated using, as the microcapsules, plural types of microcapsules in which respectively different medicines are encapsulated, plural ultrasonic diagnostic/treatment devices and injectors of the respective microcapsules may be coordinated so that the plural types of microcapsules are injected at the same time or alternatingly. Due to this control, the doctor need only determine the timing for transmitting the ultrasonic waves for treatment while watching the display unit and can concentrate on operations for the treatment.
As described above, according to the invention, the microcapsules reach the diseased part, and the doctor conducting the ultrasonic treatment can easily determine, by observing the time intensity curve, that the microcapsules have reached an optimum concentration in the diseased part. Also, because the status of movement of the microcapsules to the diseased part is color-mapped and displayed in the ultrasonic diagnostic/treatment device according to the invention, the destruction status of the microcapsules can visually and easily be confirmed by the doctor. Moreover, according to the ultrasonic diagnostic/treatment device of the invention, the administration timing of numerous types of microcapsules becomes easily estimable.
Also, although an example was described where the doctor can determine that the microcapsules have reached an optimum concentration by the display of the time intensity curve, the invention is not limited to the time intensity curve, and all types of representations of information are included, such as schematic drawings representing ultrasonic wave generation after microcapsule destruction, messages, and numerical values of luminance, as long as they are information conveyance means with which the doctor can determine that the microcapsules have become an optimum concentration. Examples informing the doctor by sensory means are also included, for example audio generation means such as a speaker disposed together with the color display unit and generating a chime or other audio message. These modes are all conducted on the basis of monitoring temporal changes in the echo signal amount and comparing the temporal change value with a preset, predetermined standard echo signal value.
Also, when the information conveyance means representing that the microcapsules have reached an optimum concentration are combined as needed, the information representing that the microcapsules have reached an optimum concentration is reliably conveyed to the doctor.
Also, with respect to the display mode of the time intensity curve, the time intensity curve may also be displayed independently, or the tomogram of the organism or an image in which the high-frequency wave from the microcapsules is depicted may be displayed together with the time intensity curve, or switched or superposed with the time intensity curve.
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|International Classification||A61M37/00, A61B8/00, A61B8/08, A61B8/06, A61B19/00, A61B17/22|
|Cooperative Classification||A61M37/0092, A61B2090/378, A61B2017/22088, A61B8/0833, A61B2017/22082, A61B8/481|
|European Classification||A61B8/48B, A61B8/08H|
|Jul 11, 2003||AS||Assignment|
Owner name: HITACHI MEDICAL CORPORATION, JAPAN
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ASAFUSA, KATSUNORI;REEL/FRAME:014717/0836
Effective date: 20030627
|Dec 29, 2008||FPAY||Fee payment|
Year of fee payment: 4
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text:
Welcome back everyone.
Nursing care has certainly progressed
since the days of Florence Nightingale.
In fact, Florence Nightingale herself was a pioneer
in the beginning stages of the advancements
of infection control and healthcare by using
one important skill - critical thinking.
In nursing, critical thinking for clinical-decision making
is the ability to think in a systematic and logical manner
with openness to question and
reflect on the reasoning process
used to ensure safe nursing
practice and quality care.
Critical thinking is more complex than the
everyday thoughts that fill our heads.
Critical thinking implies an active
application of analysis to thought processes.
Now, there are a number of standards related to critical
thinking and questions people may pose to themselves
to aid in the critical
Clarity is simply the ability to think clearly and
logically and to express and understand an idea
in more than one medium such as in
the spoken or the written word.
For example, if new guidelines are
being developed, the steps involved
and the supporting evidence
should be clearly outlined.
In seeking clarity, one might ask
for more information or examples.
Accuracy is carrying out tasks and treatments
correctly, obtaining evidence from appropriate sources
and evaluating the
For example, hospital policy may require marking
a surgical site in advance with permanent ink
to ensure the surgery is
conducted on the proper site.
In seeking accuracy, one might ask
how to verify or test information.
Precision is taking the time
to follow steps exactly.
If for example, the nurse fails to check insulin dose
with the second nurse, an error may go unnoticed.
Lack of precision often occurs as a result
of healthcare personnel being rushed
or attempting to take
shortcuts in procedures.
In seeking precision, one might
ask for more specific details.
Achieving relevance means sorting through
all of the available information and data
and determine which is relevant
to the situation at hand.
For example, when assessing a
patient with a stabbed wound,
the fact that that the patient
is homeless is not relevant.
This does not mean that the
homeless condition is irrelevant,
it may be very relevant to the
police or to his general health
but it's simply not relevant
to this particular assessment.
In seeking relevance, one may ask how this
information relates to the problem at hand.
Depth - sometimes what
people do is superficial.
Dealing with the problem at hand
without looking deeper at the cause.
But healthcare providers must always try to look at the
complexity of a situation to determine root causes.
For example, if an adolescent is repeatedly
hospitalized for failing to take asthma medications,
stabilizing the teen and sending her home without trying
to determine the underlying reason for her failure
to take medications does
little to solve the problem.
In seeking depth, one might ask what
factors are involved in this problem
and what is the best way to seek solutions?
Situations may be very complicated in medical care,
so one should look at the breadth of a situation
from numerous perspectives rather than
just looking from one perspective only.
For example, a person dying of cancer
may want a "Do Not Rescucitate" order
while the spouse or the children
may be adamantly opposed.
Now, while an adult patient has the right to make
this decision, family dynamics usually require
that the feelings of other
members also be considered.
Now, the healthcare provider may be in the position to
provide support and really help people arrive at a decision.
In seeking breadth, one might ask if other perspectives
should be considered or perhaps even alternative actions.
Logic is simply the application of
reason and following of logical steps.
For example, the nursing process is followed in a logical
progression from assessment to diagnosing the problem
to planning an intervention to implementing the
plan and then finally, to evaluating the results.
Conclusions are arrived at
by reviewing the evidence.
In seeking logic, one may ask if something
makes sense or if it seems logical.
Some information or actions are more
critical or significant than others.
The healthcare provider must be able to exercise reasonable
judgement about the significance of the information.
For example, if a patient receiving a transfusion
suddenly shows signs of anaphylaxis,
stopping the transfusion immediately
is far more significant
than reporting the
reaction to the physician.
Issues related to significance
are very common in nursing.
In seeking significance, one might ask what the
most important problem or central issue is.
Fairness is being open to new ideas and willing
to consider new or different approaches.
Many of the problems in healthcare derive
from the unwillingness to make changes.
People become really familiar
with procedures or processes
and they don't want to learn new ways of
doing things, even if they're better.
For example, a switch to computerized charting
will decrease the incidence of medication errors
but it's going to require the healthcare
personnel to learn to use the new system
and to learn new ways
to chart information.
Now, while this change would impose a burden to
the staff, applying the principles of fairness
meant that the benefits to the patients
outweigh the inconvenience to the staff.
In seeking fairness, one might ask if selfishnes or
personal views are interferring with fairness to others.
Decision making and development of guidelines
often begin with the review of the literature.
Healthcare providers must read critically
using care to evaluate the evidence
while keeping an open mind
to other possibilities.
The first step in the critical reading is
to consider the source of the material.
Juried medical journals or peer-reviewed nursing journals
are always a more valid source than the popular press.
Now while this is not a guarantee
that the information is correct,
having the material reviewed by a number of different
people really helps ensure that the most journal or articles
are based on solid research and
that the reasoning is sound.
Next, you're gonna review
the author's credentials.
Ask yourself these questions,
Who is the author
or the authors?
Is it a reporter? A nurse?
A doctor? A researcher?
Once you always review the author's credentials to determine
if the person is an expert in the field of study.
Determine the central thesis.
The thesis or central claim of research
should be clearly stated in the introduction.
One way to quickly evaluate
an article or book
is to read the introduction and the
conclusion before the body of the text.
The conclusion usually provides the summary
of the thesis and the main supporting points.
This is also a quick and
efficient way to determine
whether the material is worth reading for the
purpose of study or it should be eliminated.
Examine the organization
The methodology used to research or reach
conclusion should be clearly outlined.
If the article or book is based on a
particular theory, this should also be stated.
The organization of the article itself should also be reviewed
to determine if it corresponds with the usual practice.
Ask yourself these question:
Does it have a clear introduction?
Is it organized in a logical manner?
Is there a concluding summary?
Is the language and terminology
appropriate for the intended reader?
And next, review the evidence.
Evidence is critical.
The evidence provided should always
support the main points of the article.
And finally, evaluate.
The overall article should be evaluated to determine
if the content seems credible and useful.
During evaluation, all the other steps in the critical
review of the literature should be considered
in determining if the article
is sufficiently valid.
So remember, critical thinking includes adherence to
intellectual standards, proficiency in using reasoning,
a commitment to develop and maintain intellectual
traits of the mind and habits of thought
and the competent use of thinking skills and abilities
for sound clinical judgements and safe decision making.
So, in thinking of what we've learned today,
I'd like you to consider this question.
When conducting a review of the literature,
what are the most important steps to follow?
You're going to consider the source,
you're going to review the
determine the central thesis,
examine the organization and
methodology of the study,
review the evidence,
and then fully evaluate the article
to see if it makes sense for you.
I hope you've enjoyed today's
video on critical thinking.
Thanks so much for watching.

domain: medical


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text:
Organic Shelled Hempseed 8 Ounces
Save 35% off retail
Usually Ships in 1-2 Business Days
$0.50/each heavy item surcharge.
Shelled hempseeds (or hempnuts) taste similar to sesame or sunflower seeds, and can be added to almost any recipe.
2 tablespoons (19g), 15 servings per container
Does Not Contain
Certified organic seeds are grown without any chemical pesticides, herbicides or chemical fertilizers.
To ensure freshness, it is best to keep seeds refridgerated and air tight.
Serving Size is 2 tablespoons (19g)*Daily Value (DV) not established.
Customers who bought this item also bought
Write a Review
Have you tried Nutiva Organic Shelled Hempseed? Share your experience with others; Review this product here!

domain: agronomy


The 26 Quart Impact Galvanized Steel Mop Bucket is ideal for those who need something that’s heavy duty. With a reinforced rim, heavy duty casters, and thick galvanized steel, it’s insured to work just as hard as you do.
- 24-mil galvanized steel
- 2” ball-bearing casters
- 6.5 gallon bucket
- Hand soldered seams for leak proof cleaning
- Measurements are embossed for easy reading
- Reinforced rim with ¼” steel wire
Instructions for use:
Fill with water, place mop in, ring out, and start to clean.
Manufacturer: Impact Products
Product # 750355
Experience the heavy duty construction with a 26 Quart Impact Galvanized Steel Mop Bucket


A great opportunity to join our forward thinking sheet metalwork company, due to an ongoing increase in the volume of orders we are looking for multiple full time Welder Fabricators to join our fantastic team. JC Metalworks are a well established family business that operate from a 60,000sq ft state of the art facility based in Loughborough, Leicestershire.
- £10.50 – £12.50 per hour (dependent upon experience)
- Profit Share Scheme
- Loughborough based
- Varied sheet metal work in a clean and safe environment.
- Health cashback plan
- Shift rotation – 6am – 2pm / 2pm – 10pm
- Good attitude with a positive outlook.
- MIG Welding experience
- Ability to read manufacturing drawings
- Works with pride and has attention to detail.


text:
Does Cushing’s disease shorten a dog’s life?
Generally, if the activity of the adrenal gland can be controlled, many dogs with this form of Cushing’s disease can live normal lives for many years, as long as they take their medication and stay under close medical supervision.
What are the final stages of Cushing’s disease in dogs?
Signs of Cushing’s Disease in Dogs
- Increased thirst and/or appetite.
- Hair loss or thinning.
- Thinning, fragile skin.
- Lack of energy.
- Excessive panting.
- Skin infections.
- Bloated appearance; “pot-belly”
How long can a dog live with Cushings untreated?
For pituitary-dependent Cushing’s disease, the median survival time of patients treated with trilostane or mitotane is about two to two and a half years. If a pituitary tumor is large and affects the brain and surrounding structures, the prognosis is poorer.
What happens if Cushing’s is left untreated in dogs?
If Cushing’s disease is left untreated, dogs tend to become progressively lethargic and weak. They have an increased susceptibility to contracting infections (particularly urinary infections) and the skin is slow to heal after any injury.
Do dogs with Cushing’s suffer?
Excessive thirst is commonly observed in Cushing’s syndrome dogs. Loss of hair is common along the back, tail and rear legs. A thinning coat or complete hair loss, except for the heads and feat occurs. Dogs with Cushing’s syndrome commonly develop muscle weakness.
What happens if Cushing’s is left untreated?
Left untreated, Cushing syndrome can result in exaggerated facial roundness, weight gain around the midsection and upper back, thinning of your arms and legs, easy bruising and stretch marks. Cushing syndrome occurs when your body is exposed to high levels of the hormone cortisol for a long time.
Should I treat my old dog for Cushings?
Usually treatment for Cushing’s is not even recommended unless the dog has clinical signs because treatment does not necessarily change their overall life span – it just keeps them from being polyuric (urinating a lot), polydypsic (drinking a lot), losing their hair, etc.
Is excessive licking a sign of pain in dogs?
If your pet is licking their paws constantly, it’s likely they’re trying to soothe themselves. When a dog is hurt, its first instinct is often to clean and care for the wound by licking it. Cuts are more obvious, however, sometimes the pain can be internal.
What do you feed a dog with Cushings disease?
Highly Digestible Protein
The protein in the food should be highly digestible. Some qualifying examples include: egg whites, muscle meats (chicken, beef, lamb) and organ meat.
How much does it cost to treat a dog with Cushing’s disease?
Cushing’s Syndrome is not an inexpensive condition
It could be more. For an 80-pound dog, it will cost over $2,000 a year, perhaps well over $2,000. It is wise to count the costs before beginning treatment.
Does Cushings cause blindness dogs?
If a dog is noted to have Cushing’s disease during its workup for SARDS, Cushing’s disease can be treated with a variety of medications. Treating Cushing’s disease, however, will not help restore the dog’s vision. “Most dogs will adjust to their blindness over a period of 6-8 weeks.”
Why do dogs with Cushing’s pant?
The basis for increased panting in dog’s with Cushing’s disease is multifactorial. First, Cushing’s disease results in increased fat deposits in the abdominal cavity and around the chest. Second, an increase in liver size impedes the diaphragm from being able to expand with ease.

domain: pet


text:
Trips back to Atlanta are such a tornado of activity. Friends to see. Family to visit. Everything to eat!! I’m barely a quarter through this year’s travel schedule and I’m already incredibly thankful for my trusty travel pillow and new Southwest cards (companion pass, here we come!). In the middle of putting miles and miles on my zippy little rental car, I was so glad to get some quiet time in Inman Park with this wonderful pair.
Kathryn Ruth and Allen live in the COOLEST neighborhood in Atlanta. Features include:
I was so pumped to hear that their wedding is taking place at Inman Park, and it was only appropriate to take their engagement photos all around the nearby shops and the Beltline. Walking around the area with KR and Allen (plus their ridgeback pup, Chloe – see official Instagram feed here) felt like taking a new walking tour of the city. We took a winding route through the storefronts and even discovered a mini hideaway park with a lake at a nearby residential complex. It’s insane how much Atlanta grows and changes each year!
Despite the busy streets and weekend crowds (nice weather tends to do that), with the right amount of patience and angling, I felt like we were able to keep our photos intimate and close while still featuring the open spaces and environment of Inman Park. One of my favorite tricks is to crouch just right until any possible distractions – strolling pedestrians, kids on bikes, etc. – are hidden just right behind my subject(s). Or in this case, behind the Beltline rhino bust.
Hope you guys enjoy!
Took a quick “serious faces” break to almost dump KR into the lake.. lovingly, of course.

domain: geography


P30 hike too small, say Metro workers
The Trade Union Congress of the Philippines (TUCP) yesterday appealed the Metro Manila wage board’s recent order increasing the daily minimum wage by P30, saying the hike fails to narrow the gap between the workers’ P426 daily basic pay and the daily minimum family “living wage” of P993.
“The wage board committed a grave error by failing to completely respond to the minimum requirement of P993 that the National Wage and Productivity Commission (NWPC) set as the daily amount needed by a family of six to survive and live decent lives in urbanized Metro Manila. This is why we ask them to reconsider,” said TUCP assistant general secretary Hernan Nicdao who filed the appeal before the Regional Tripartite Wages and Productivity Board (RTWPB)-National Capital Region 10 days after the new wage order was published.
This is the second appeal of the wage order to come from the TUCP faction headed by TUCP president Democrito Mendoza and secretary general Victorino Balais. The other TUCP faction led by Ernesto Herrera filed its own appeal with the NWPC on May 24.
The TUCP petitioned the RTWPB on March 16 to increase the daily minimum pay of Metro Manila workers by P90 in two tranches, citing the rising cost of basic services and prices of commodities.
Mendoza said that if the wage board granted the P90 petition, “it [would have] narrowed the gap between the P993 family living wage and the daily minimum basic pay of P426 and reduced the misery that confound the thousands of minimum wage earners and their families to cope with the rising prices of commodities and services.”
“Hence, we could have happy workers motivated to be more productive employees,” he said.
Balais also criticized the “failure” of the wage board to rationalize in the new wage order how they came up with the amount of P30 and the board’s “hasty” decision hours after the third and last day of the public consultation.
“There were new and fresh ideas and numbers introduced on the last day by pro- and anti-wage increase groups yet the board came out with the decision just a few hours after the consultation was closed. Perhaps, the board might have missed important inputs in the equation. This must be explained to the TUCP as the petitioner and most especially to the workers,” Balais said,
The RTWPB conducted three public consultations, the last one in Quezon City on May 17.
Subscribe to INQUIRER PLUS to get access to The Philippine Daily Inquirer & other 70+ titles, share up to 5 gadgets, listen to the news, download as early as 4am & share articles on social media. Call 896 6000.


text:
Brian P. Kennedy
Distributed by University Press of New England
2010, 144 pages, cloth
ISBN# 978-0-944722-39-8, $45.00
Although based on simple geometries, the Irregular Polygons (1965–66) constitute one of the most complex artistic statements of Frank Stella’s career. The eleven compositions combine different numbers of shapes to create daringly irregular outlines. Stella made four versions of each composition, varying the color combinations. They mark a radical shift from the artist’s earlier striped works in their use of large fields of color. The asymmetric canvases play with illusion, confronting Stella’s previous emphasis on flatness while anticipating his career-long exploration of space and volume in both painting and sculpture. This volume is valuable resource for scholars, curators, and aficionados of modern art, fans and practitioners of the art of painting, and anyone else who enjoys insight into the cultural turning points of the modern age.

domain: artistic


Older sibling Venus was swept off her feet by Gerbine Murguruza in a one sided Centre Court final at SW19.
The Spanish ace thrashed her American rival 7-5, 6-0 to lift her second Grand Slam title - having won the French Open last summer.
And after tasting defeat Williams admitted she misses her sister - who absent from her first Wimbledon in 10 years.
World No.4 and 23 time Grand Slam champ Serena, who won the Australian Open in January despite being pregnant, is due to give birth in October.
"I miss Serena," Venus Williams said.
"I tried my best to do the things you do - but I think there will be other opportunities."
After the match, Muguruza paid tribute to Venus Williams and revealed Serena Williams had told her she would win at Wimbledon
"She is an incredible player," the Spaniard said. "I grew up watching her play.
"I feel incredible to play her here.
"Two years ago Serena told be one day I would win here."


text:
With the blues leading 1-0, Rodri looked to have handled the ball inside the City penalty area. The fans saw it, the players saw it. Even those watching at home had their hearts in their mouths as the ball bounced up onto the Spaniard’s arm.
The referee waved away the claims, only for VAR to take a second look at it. What seemed like an eternity later, VAR concluded it wasn’t handball and allowed play to continue, much to the anger of the home support, and the derision of the Liverpool fans, who continually claim watching City is boring, yet still watch the blues regardless of them being a visual sedative.
The anger was clear after the match as fans took to social media demanding to know why the penalty wasn’t given and claimed Everton were denied a point. Someone even had the time to create a montage of penalty decisions that City have had this season, while others referred to Raheem Sterling being offside when the blues beat the reds 2-1 back in 2013! Some people have far too much time on their hands.
But some took issue with the apparent fact that Everton were denied a point when VAR decided not to award a penalty. Whilst it should have been a penalty, the home side would still have to score it, so rather than being denied a point, Everton were denied the chance of claiming a point. Bit of a difference there.
However, another issue was raised in relation to Everton’s precarious position near the bottom of the Premier League table, and Liverpool’s hopes of winning the league for the second time since 1990. The Mirror’s David Maddock asked the following question:
“What if #EFC are relegated by a point? Or City win title by 2 pts? When the decision is so crassly, abysmally wrong, and when the stakes are so high, what happens? The ref even said after it was a pen. So what are the consequences?”
Well David, the consequences are that a whole season is not defined by one incident in one match. All teams have thirty-eight matches. That’s thirty-eight chances to get three points or more points than those around them over the course of the season. If Everton are relegated by one point, should they really look at one VAR decision in February?
What about losing to 5-2 at home to Watford, 1-0 at Brentford or 2-1 at Norwich? Everton have had plenty of opportunities this season to claim three points but haven’t taken them. Are you really going to blame Everton’s demise on one decision when there have been, so far this season, eighteen chances for the Toffees to pick up more points than they have?
And what of Liverpool? The Mersey reds have drawn six and lost two matches so far this season, giving them eight games where they could have won more points but failed to do so. If Liverpool ultimately finish second and if Everton are relegated, then both really only have themselves to blame for not being better. It is as simple as that. If City don’t win the league, we only have ourselves to blame and won’t look at a decision or two and say that’s why we lost.
All teams have benefitted from dodgy VAR decisions since its inception and all teams have had decisions made to their detriment. Both Liverpool and United have had some odd decisions go for them in the same way they’ve been left scratching their heads wondering why one went against them. Again, it happens to all teams. The only difference is when it’s City, it seems to get blown out of all proportion.
Of course, being dirty oil cheats and passing brown envelopes to officials in the darkened alleyways of Manchester must be the only explanation why VAR can’t get it right!
The crux of the matter is that VAR’s only consistency is that fact they are consistently crap and it simply isn’t good enough. The FA need to come up with a solution to VAR or take the decision to scrap it altogether.
How many clubs would actually miss the technology if it wasn’t there?

domain: sports


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domain: design


In A minor, and written in 1863, though not premiered until 1867 by violinist Pablo de Sarasate to whom it is dedicated and conducted by the composer, INTRODUCTION AND RONDO CAPRICCIOSO was originally intended to be the rousing finale to Saint-Saëns' first violin concerto, Op. 20. Its success as a solo composition convinced Saint-Saëns to publish the work separately. This version has been edited by Clinton Nieweg and Nancy Bradburd and is part of the Nieweg Performance Editions series. Instrumentation: 220.127.116.11: 18.104.22.168: Timp: Str (9-8-7-6-5 comes with the set): Solo Violin. The clarinet, horn, and trumpets include both the original key and part transposed for more common contemporary keys.


text:
Holding of inquiry Order of the Adjudicating Officer and matters relating thereto Appellate Tribunal
Qualification and duties Designated Officer Food Safety Officer Food Analyst Procedure of taking extracts of documents and matters connected therewith Seizure of articles of food by the Food Safety Officer and matters connected therewith Sampling and Analysis
Use of food additive or processing aid. Contaminants, naturally occurring toxic substances, heavy metals, etc. Pesticides, veterinary drugs residues, antibiotic residues and microbiological counts. Genetically modified foods, organic foods, functional foods, proprietary foods, etc. Packaging and labelling of foods. Restrictions of advertisement and prohibition as to unfair trade practices.

domain: health


Getting over 2016 is not proving easy for Hillary Clinton.
The former first lady, senator and secretary of state, whose presidential campaign was perpetually plagued by the FBI investigation into her use of a private email server, couldn’t help but weigh in on the Justice Department’s new report on how her case was handled.
“But my emails,” Clinton tweeted along with a post from Politico’s Kyle Cheney saying that the report reveals former FBI Director James Comey used a personal gmail account to conduct FBI business “on numerous occasions.” (Essentially, the exact thing Clinton was being investigated for.)
Clinton’s tweet referenced the often-derided refrain of “but her emails” that was heard on the trail and on social media during the 2016 campaign to justify support for Donald Trump over Clinton. The remark was often attributed to Clinton opposers who were searching for a way to offset the latest negative news about Donald Trump.
More: Ex-FBI director James Comey defends Clinton probe despite Justice IG’s searing critique


text:
Thiruvananthapuram: A scientist working at an Indian health major has won a USD 100,000-grant from the Bill and Melinda Gates Foundation for developing next-generation condoms using polyester raw material as an eco-friendly alternative to conventional prophylactics.
Lakshminarayanan Ragupathy, of HLL Lifecare Limited, has won the grant for the project, among 50 ideas selected as a part of the Grand Challenges Explorations (GCE) Round-12 funded by the Foundation, company`s Chairman and Managing Director M Ayyappan said in a statement today.
Commenting on the award, Ragupathy, who works at HLL`s state-of-the-art Corporate R&D Centre, said it would be his endeavour to develop extremely thin and bio-degradable condoms, which will ensure increased use in the days to come.
The grant will enable him to pursue an innovative global health and development research project, titled `polyester materials to produce better, green and cheaper condoms.`
The GCE funds individuals worldwide to explore game-changing ideas that can break the mould in resolving persistent global health and development challenges.
A polymer scientist, Ragupathy joined HLL in 2012.
Earlier, he had worked as a post-doctoral fellow at University of Ulm, Max Planck Institute for Polymer Research, Germany; and University of Manchester, UK. He obtained his PhD from Heriot-Watt University, UK in 2006.

domain: chemistry


text:
America’s greatest living novelist is at it again: re-editing the country’s Puritan heritage, while obsessing over his own sexual psyche. What is this novel, Roth’s twenty-eighth? His thirtieth? I’ve lost count. All I remember is that back in the dark ages of my own life, I stumbled across a paperback reprint of Philip Roth’s first work, Goodbye, Columbus (1959), and ran my fingers over the lipstick image on the cover certain that it would smudge. When it didn’t, I forked out $1.45 for the book—a collection of five short stories which I then read pretty much in one gulp. I still have the book.
I’ve read Roth’s The Humbling just as quickly–swept away with his most recent work as I was with the first and most of the others. It’s hard to forget Letting Go (1962) or Portnoy’s Complaint (1969) all these years later, but the true wonder with Roth is the string of incredible novels he’s published in the maturity of his career, especially American Pastoral, The Human Stain, The Plot against America, and Indignation. And now The Humbling, which doesn’t have the stature of any of those afore-mentioned titles, but second-tier Roth is usually better than first-tier others. How does the guy keep writing like this? What keeps him going? His productivity has probably annoyed most of the other writers in the country, especially those suffering from writer’s block.
There is, in fact, a blocked character in The Humbling, but the blockage is not with writing or, as one might anticipate, with sex, but with acting. Simon Axler—Roth’s protagonist, somewhere in his early sixties—has been a leading actor on the American stage for decades, but suddenly when he gets in front of an audience he loses his confidence. Acting has become empty, without meaning, even frightening. To make things worse, his wife leaves him at the same time. His life, he knows, is in full retreat.
Then something strange happens. There’s an unexpected encounter with the forty-year-old daughter of a couple he grew up with. Her parents are still in regional theater; Axler’s known Pegree, their daughter, since she was a child. And what so often happens in Roth and in real life is the sexual relationship which grows out of a chance meeting. But the real surprise is that Pegree has been a lesbian all of her adult life. Axler is the first man she’s ever been with and, to make matters worse, her parents who have never really approved of her sexual orientation, aren’t very happy that she’s sexually involved with the man they knew all those years ago when they were young.
Neither Axler nor Pegree can quite fathom her parents’ disapproval. Does their condemnation mean that they preferred her as a lesbian? It hardly matters, since they’re all adults. Clearly, they can do whatever they want. So Axler and Pegree continue living together and after more than a year determine that the time is right to get married. Both decide that it’s appropriate that they have a child, which seems like even more of a commitment to Axler than to Pegree. He’s the one who’s been trapped in a fatherless life. He’s so excited about their future that he believes he will be able to return to the stage. He’s been rejuvenated in just about every possible way. That’s what their relationship has done for him.
Happy ending? Well no, we’re not likely to get that with Roth. I’ve intentionally not mentioned a couple of minor characters who are significant in the plot as well as in a rather startling sub-story—all in this tightly sprung novella. With Roth when you turn the page or begin a new chapter, you can rarely predict what’s going to happen. I thought that for once I had figured everything out, but then the master craftsman once again took over and shifted his characters around.
What’s missing from The Humbling are the menacing social and political contexts. There are absorbing characters and erotic regeneration, but Roth’s greatest novels typically depict Americans brought down by the forces of the country’s hypocrisy. This time, Roth keeps everything in plain sight, reducing much of the fear of the unknown, leaving little for the reader to ponder.
By Philip Roth
Houghton Mifflin Harcourt, 140 pp., $22
CHARLES R. LARSON is Professor of Literature at American University, in Washington, D.C.

domain: literature


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Linda de Mol will again collaborate with director Will Koopman, with whom she previously made Gooische Vrouwen . This time it is a remake of the Italian comedy Perfetti sconosciuti , which appeared in 2016, De Mol tells AD on Friday.
The story of that film revolves around friends who challenge each other to put all smartphones on the table during a dinner. Every call or text message must be shared openly to prove that the friends have no secrets for each other. An idea that gradually gets out of hand.
In recent years, Perfetti sconosciuti has received remakes in various countries, including Germany and France. The scenario for the Dutch version comes from Frank Houtappels, who was previously involved in the Gooische Vrouwen series and the film April, May and June .
The names of the other cast members have not yet been announced. The shooting of the still untitled film should start next spring.
Koopman and De Mol have been working together regularly since the appearance of the Gooische Vrouwen television series, which was shown between 2005 and 2009. The two cinema films based on the series are their greatest successes. With over two million visitors, Gooische Vrouwen 2 became one of the most visited Dutch films ever.


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Madhuri Dixit Shares Unseen Picture Of Mom And Elder Sisters, Fan Says, “You And Your Sisters Look-Alike”
Bollywood stunning actress ‘Dhak Dhak girl Madhuri Dixit shared a rare picture of her mother and two elder sisters to celebrate Mother’s Day 2022. The gorgeous actress who had ruled Bollywood in the 90s is peppered as the ‘Madhubala’ of her time. Madhuri Dixit has become one of the most talented actresses in Hindi cinema.
On the occasion of Mother’s Day on May 9, 2022, Madhuri shared a rare picture of her mother and her two elder sisters, and the netizens reacted to their unreal resemblance. In an old interview with ETimes, Madhuri had spoken about her raising and had shared: “Even when I was working in films, my mom used to scold me if my room was messed up and things like that. So that’s how I was brought up. And that’s how I am.”
On May 8, 2022, Madhuri Dixit celebrated Mother’s Day with her mommy, Snehalata Dixit. On a remarkable day, the actress posted a rare picture with her mommy and two elder sisters, Bharati Dixit and Rupa Dixit. They were seen combined in black-coloured dresses in the picture, while their mommy looked adorable in a floral yellow-hued kurta-salwar. Alongside it, Madhuri Dixit wrote a heart-touching note and wrote: “All that I am, all that I will ever be, it’ll be all your reflection Aai. Happy Mothers Day #MothersDay #Mother #MotherLove #Motherhood #Maa.”
Once, Madhuri posted the family portrait, fans started to flood love on their picture into the comments section. While one user wrote, “You and your sister look alike a lot.” The other commented, “Your sisters are more beautiful than you. Mom is the most beautiful woman.” Another fan wrote, “Mam..you all three sisters look totally different..may God bless to all the beautiful n careful mothers on this earth.”
On May 8, 2020, Madhuri had shared a post on her Instagram handle and had shared a throwback picture from her childhood, spotlighting the uncanny likeness that she shares with her sister. We could see the candid sister dancing at a school function in the same attire in the picture. In the picture, it is quite impossible to differentiate between Madhuri and her sister. The actress had captioned the picture as:
“This is one of my favourite memories that I have with my sister. We used to always take part in school competitions. Here’s sharing a #MajorThrowback childhood memory with my favourite dance buddy. Let me know what is your favourite childhood memory! P.s. Can you tell us apart?”

domain: entertainment


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Man Utd need three big transfers to compete with Liverpool next season with Sancho deal in works, claims Ryan Giggs
MANCHESTER UNITED icon Ryan Giggs reckons his former employers still three big transfers to challenge for the Premier League title.
United are on an 19-match unbeaten run in all competitions and up to fifth spot in the top-flight, pushing for a Champions League place.
The Red Devils have looked like a completely different team since the January transfer window, having signed Bruno Fernandes and secured Odion Ighalo on a loan deal.
MAN UTD NEWS LIVE: Follow for the latest United news
Fernandes has particularly impressed since completing his £47million switch from Sporting Lisbon – with his stats speaking for themselves.
He is yet to taste defeat for United, having bagged an impressive seven goals and seven assists to catapult his side into Champions League contention.
The 25-year-old also now boasts a higher goal involvement in his first 11 league games than any other Old Trafford legend, all while spurring a spike in form among his teammates.
United's scintillating form this year has left fans hopeful of the club challenging City and Liverpool for the title next term.
But Ole Gunnar Solskjaer's side face a fight to secure a top four finish with just three Premier League matches left to play.
And Old Trafford icon Giggs, who won 34 trophies with the club during his 24-year spell, believes his former side are still lagging behind the champs.
He feels the club needs to splash the cash this summer to be in with a chance of nabbing the title – despite Ed Woodward ruling out big-money transfers in the wake of the coronavirus crisis.
He told Premier League Productions: "I still think we're off City and Liverpool by two or three players,
"Good characters are coming in. You see [Bruno] Fernandes, he looks like a leader, he looks like a character. [Harry] Maguire, he's their captain.
"It's not just about having the players, it's about having that culture, that character that can improve not only the starting eleven but the squad and the overall feeling around the club.
"They're certainly moving in the right direction. But, I still believe we need three new players."
Jadon Sancho is one of Solskjaer’s top summer transfer targets as he looks to continue rebuilding the Red Devils.
And Borussia Dortmund are reportedly expecting a bid of £109million from United for the England international.
Old Trafford chiefs are said to be on red alert for Napoli defender Kalidou Koulibaly after the Serie A side reportedly slashed the £80m transfer fee.
However, the Senegal international still has three years remaining on his deal with the Italian outfit.
The Red Devils are rumoured to be leading the race to sign Jack Grealish who has netted seven league goals so far in an impressive term.
But Giggs reckons his former club will need more than the Aston Villa ace to help them keep up with rivals City.
Source: Read Full Article

domain: news


Hussein Chalayan Shows A New Image Of The Body
[Part 2 below]
We’ve seen what avant-garde British fashion designer Hussein Chalayan can do with technology and clothing—we’ll never forget that feeling of awe and fascination when we first saw his S/S 2007 line of animatronic dresses (which zipped, flipped and reconfigured right before our eyes), or the pixelated LED dresses from F/W 2007 and the laser dresses from S/S 2008, the latter two of which were made in collaboration with Creator Moritz Waldemeyer.
Then again, perhaps it comes as no surprise that in the forward-thinking world of fashion, designers would be experimenting with technology. After all, as Chalayan says, “Technology is really the only thing through which you can do new things.”
What we hadn’t seen Chalayan explore in his shows before is how technology can be used to enhance the presentation of garments, and in this case, as a mechanism to literally “show a new image of the body.” For his S/S 2012 presentation in Paris this September, The Creators Project collaborated with the fashion mogul in order to shake things up a bit.
We caught up with the designer and his fashion show director Alex de Betak who talked us though the visual trickery that was to roll out on the runway the day of the presentation. Chalayan’s inspiration centered around the idea of self-image, so his engineer Robert Davis rigged tiny battery-powered wireless cameras with tilt switches inside champagne flutes, which when tipped 15 degrees, would light up and capture the inside of the models’ mouths.
Dressed as a waiter during the show (a move Style.com dubbed Hitchcock-esque), Chalayan passed out the camera-rigged flutes to each model as they sashayed down the runway, creating an intimate gallery-esque setting where his models appeared to be looking at art while mingling and drinking champagne. (If only seeing yourself in artwork was always this easy!). The voyeuristic audience watched the models become the focal point, in a sort of unexpected way, as their lips, teeth and throats were projected onto the canvas behind the runway in real time.
The clothing, mostly monochromatic, structured garments with curved asymmetrical silhouettes, jazzed up with a few fun prints here and there, found the happy medium between traditional and contemporary. Ruffles poured through a slit in a sheath dress, boxy cutouts accentuate (or allude to) a model’s curves, and capes and veils made a subtle comeback.
With this collection Chalayan blurred the line between art and fashion, giving us a runway presentation that could have been confused with performance art, and successfully created a new environment for showcasing the clothing. Watch the behind-the-scenes prep in Part 1 of our documentary above and witness the fashion show for yourself in Part 2 below.
View the entire Hussein Chalayan S/S 2012 Sip collection here.


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1. (1) Using the yeast, water and flour, follow the recipe for unleavened bread below.10. Remove. 11. (8) Repeat stages 5-8 with the other three naan. 12. Serve at once. 13. LEAVENED BREAD: (1) Dissolve the fresh yeast in a little lukewarm water. Jump to recipe. Sharing today, one of my favorite Indian Bread, Garlic Butter Naan which is easy to cook, and dont need yeast or lengthy fermentation time. In India, everyone still dont feel comfortable using yeast in everyday cooking. (uses your location). 2 (0.6 ounce) cakes compressed fresh yeast.easy recipe for bread, i made it. i substituted a whole cup of sugar for the 3/4 cups, a stick of butter for the shortning, and poured in a little bit of corn oil. i used two packs of dry yeas Indian Naan Bread recipe using a cast iron skillet.Indian Curry Baking Breads Indian Recipes Naan Bread Recipe No Yeast Garlic Butter Bread NannThis caprese pizza is so easy to make and its got so much flavour from fresh basil, fresh mozzarella, and a drizzle of balsamic reduction! You can also make the naan breads using warm water instead of milk, but I think it tastes better with milk.Recipe for cooking beef steak Healthy snack trends 2014 winter Fresh pasta recipe 00 flour.
Rubric: Easy Italian Recipes. Comments to «Easy recipe naan bread no yeast». Easy naan bread with or without yeast. This recipe has been submitted by the Good Food community.1 tsp fresh yeast (can be omitted if you use self-raising flour). 150 ml warm water. 1 tbsp ghee (note: use vegetable oil or butter if you prefer vegetarian). Share. Naan Bread Recipe.Use a bread machine to bake aroma filled, fresh bread Share. How to Make Italian Bread. A meal pertaining to Italy that does not include a baked yeast loaf is generally considered incomplete. The possibilities are endless! I love fresh homemade bread.
And though I bake bread with yeast more frequently nowadays, I still find it easier and a6. Use this for: Gyros, Souvlaki, as naan for curries like Butter Chicken, Chickpea Curry or Beef Rendang. 7. Recipe source: Flatbread by Julie Goodwin. Homemade Naan Bread. January 19, 2016. Naan is a cornerstone of Indian cuisine.Leavening agent Traditionally, yeast is used as a rising agent when making Naan but some modern recipes use3 tablespoons fresh cilantro, chopped. 1/2 teaspoon salt. 1 tablespoon nigella seeds, can be Explore our Indian recipe ideas, including this homemade naan bread.Stir in the nigella seeds, if using, and the dried yeast.Chopped herbs, such as fresh coriander, also make good additions, for mint and chilli naan bread, add 2tbsp chopped fresh mint and a pinch of dried chilli to the dough Kalonji Seed Naan. This easy yeast-leavened bread only takes about an hour to prepare and uses ingredients you likely already have in your pantry. (Recipe Courtesy: Marc Matsumoto from the Fresh Tastes blog). My naan recipe uses a regular home oven and a clay pizza stone to give the naan same exposer as a clay oven.This is a table to convert Fresh Yeast to Orginal Dry Yeast or Quick Yeast. This can be used for making breads and anything using yeast. : good recipe for bread using fresh yeast in reviews: Amazon.co.uk: Bluebells review of Fresh Yeast (8 x mini blocks). Food Based Lye vs. Baking Soda for making authentic German Pretzels? | The Fresh Loaf. The Fresh Loaf. News Information for Amateur Bakers and Artisan Bread Enthusiasts.I use plain yoghurt, butter, whole wheat flour, all-purpose flour, water, salt, active dry yeast and a pinch of sugar. Here is our naan recipe. Naan Bread. Posted on April 29, 2014. Pin It. Watch the video for this recipe: There are few people that I know who are making their own bread.1/8 tsp (1g) baking soda. 1 tsp (4g) kalonji seeds (black cumin). 20 g fresh yeast (2 tsp active dry yeast). Find lots of bread recipes that require no yeast, including quick and easy soda breads, naan breads, flour tortilla wraps, yeast free pizza bases, fruit loaves and much more.I usually fry half an onion and use that along with half a can of chopped tomatoes, a fresh tomato, some peppers and tuna. I want to bake a simple loaf of white bread using my newly bought fresh yeast. Ive never worked with fresh before so Id love some recipes and advice.If your bread comes out tasting too yeasty, use less yeast and let raise longer. I love fresh bread, theres nothing better. The smell is what gets me every single time.But beyond these recipes, you can use to the naan to make gyros, wraps, the sky is the limit.Recipe Notes. Always check the expiration date on your yeast and make sure it hasnt expired. wow! very nice i have searched for this trying without using yeast and oven. really thanx i liked thisPingback: Naan bread recipe | Chronicles of a cookbookworm().Renu. Perfect Naan, so soft and so easy to digest. Especially when had fresh. Thanks a lot, ,y whole family enjoyed this recipe. Naan Bread (with Yeast). Posted on April 17, 2015April 20, 2015by Kavitha Ramaswamy.While I still love that recipe, Ive also discovered that using yeast in the Naan dough definitely pays off.I wanted something light, fresh and  IMPORTANT: Incorrect use (wrong recipe, excessively long baking times) could cause the bread to overheat and produce smoke or Yeast.NAAN BREAD (Makes 4). 200g (8 oz) Gluten Free Flour. 1 tsp dried yeast or oz fresh yeast. Bread Recipes S2 E16. Naan Bread Recipe. Home Cooking Adventure.Makes 10-12 Naans 4 cups (500g) all-purpose flour 1 1/2 tsp (7g) salt 1/8 tsp (1g) baking soda 1 tsp (4g) kalonji seeds (black cumin) 20 g fresh yeast (2 tsp active dry yeast) 1 tsp (5g) sugar 1/2 cup (120ml) warm water 5 tbsp Naan Bread.If you encounter a recipe that calls for fresh cake yeast you can easily substitute instant yeast by dividing the weight of the cake yeast by 3. This is the amount of instant yeast you should use in that recipe. Creative Yeast Bread Recipes To Try Enliven Your Basket. Fresh Active Yeast Breadworld By Fleischmann S. Yeast Baking Lessons Types Usage Cake Fresh. Which Yeast To Use Flourish King Arthur Flour. Homemade naan bread (yeast-free). 03.08.12. Making homemade bread is on my bucket list.By using a (simple) sourdough starter, this naan recipe brings me so much closer to my eventual goal of baking a crispy on the outside, fluffy on the inside, loaf of delicious bread in my dutch oven. Fresh homemade garlic naan bread. It doesnt get much tastier and easier than this recipe.If you like to use a bread machine, then keep at it but I find that they dont give you the same texture and crumb as naturally risen yeast does. Modern recipes sometimes substitute baking powder for the yeast. Milk or yogurt may also be used to impart distinct tastes to the naan. Milk used instead of water will, as it does for ordinary bread, yield a softer dough. Also, when bread starter (which contains both yeast and lactobacilli) is used Anjum Anands simple naan breads, flavoured with garlic and fresh coriander, are quick and easy to make.See more Brilliant breads recipes (13). This recipe is from Indian Food Made Easy. All in all, this is a great quick, yeast-free recipe for naan. But yeast is definitely the key to getting the right naan texture and flavor.Nothing smells better than the scent of fresh naan! Reply.The result was just like a Naan bread, so I checked recipes and here I am! I used water and not milk, and Naan Bread Recipe. Based on a recipe by Cheesefood.About the flour. Use all-purpose flour if that is all you have. The recipe will still turn out some tasty bread.Discard and start fresh. 2) Stir the milk, egg, salt, bread flour, and butter into the yeast mixture. When the dough starts to come together, knead it with your hands in the bowl. 2 oz fresh yeast, or 3 tablespoon yogurt 1 1/2 lb fine whole wheat flour 1 teaspoon wild onion seeds 1 lukewarm water 1 melted butter or ghee.

domain: food


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We have kittens, kittens, kittens just waiting for you to snatch them up!
Darling little Chihuahua mix, Mia, would love to be your very best girlfriend.
Melody is a special-needs senior Beagle who’s full of affection!
Spring is kitten season – learn what to do if you’ve found kittens in your area.
Can you guess… how many different vocal sounds dogs & cats have?
CCHS endeavors to educate the public to foster compassion, responsibility and respect toward all animals by providing information and resources on a variety of animal and people related topics.