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1. Field of the Invention
The present invention relates generally to the field of semiconductor fabrication and, more particularly, to the field of fabricating p-channel and n-channel transistors with different characteristics on a common substrate.
2. Description of Related Art
In complementary metal oxide semiconductor (CMOS) fabrication, p-channel and n-channel transistors are fabricated on the same semiconductor substrate. To achieve transistors of both polarities (conductivity types), it is necessary that at least some process is steps differentiate between p-type and n-type transistors. Separate implant steps, for example, are needed to define n-well and p-well structures and to dope the source/drain regions of n-channel and p-channel transistors. Whenever possible, however, it is generally desirable to use a single process step to define transistor features regardless of the transistor type. Single process steps imply a single mask step, which is always desirable to reduce load on the photolithography processing. Moreover, a single step generally minimizes undesirable variations between the p-channel and n-channel transistors. Imagine, for example, that a particular design has been optimized under the assumption that the thickness of the gate oxide (or other dielectric) is the same on n-channel and p-channel transistors. The best way to ensure that the assumption is correct is to form the relevant feature for p-channel and n-channel transistors simultaneously.
In some cases, however, it may be desirable to process n-channel and p-channel transistors separately to account for differences in the characteristics of the respective transistor types. As an example, there is an asymmetry in the sub-micron behavior of p-channel and n-channel transistors. For sub-micron p-channel transistors, the high diffusivity of its boron carriers causes sub-threshold leakage current to be of paramount concern. For n-channel transistors, the drive current or saturated drain current (IDS), which is an important performance parameter, is strongly influenced by the effective length of the source/drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter extensions to increase the n-channel drive current, it would be desirable to have longer extensions to reduce the p-channel sub-threshold leakage current. It would therefore be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the cost or complexity of the process.
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1. field of the invention the present invention relates generally to the field of semiconductor fabrication and, more particularly, to the field of fabricating p - channel and n - channel transistors with different characteristics on a common substrate. 2. description of related art in complementary metal oxide semiconductor ( cmos ) fabrication, p - channel and n - channel configurations are fabricated on the same semiconductor substrate. to achieve transistors of both polarities ( conductivity types ), it is necessary that at least some process is steps differentiate between p - type and n - type transistors. separate implant steps, for particular, are needed to define n - well and p - well structures and to dope between source / drain regions of n - channel and p - channel transistors. whenever possible, however, it is generally desirable to use a single process step to define transistor features regardless of the transistor type. single process steps imply a single mask step, which is therefore desirable to reduce load on the photolithography processing. moreover, a single step generally minimizes undesirable variations between the p - channel and n - channel transistors. imagine, for example, that a particular design has been optimized under the assumption that the thickness of the gate oxide ( or other dielectric ) is the same on x - channel and p - channel transistors. the best way to ensure that the assumption is correct is to form the relevant feature for p - channel and n - channel transistors simultaneously. in some cases, however, it may be desired to process n - channel and p - channel transistors separately to account for differences in the characteristics of the respective transistor types. as an example, there is an asymmetry in the sub - micron behavior of p - channel and n - channel transistors. for sub - micron p - channel transistors, the high diffusivity of its boron carriers causes sub - threshold leakage current to wavelengths of paramount concern. for n - channel transistors, partial drive current or saturated drain current ( ids ), which is an important performance parameter, is strongly dictated by the effective length of the source / drain extension region due to the parasitic resistance that it creates. whereas it would be desirable to have shorter branches to increase the n - channel drive current, it would be desirable to have longer extensions to reduce the p - channel sub - threshold leak ##age current. it would therefore be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the cost or complexity of the process.
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1. Field of the Invention The present invention re.ateQ generally to the field of semiconductor fabrication and, more particularly, to the field of fabricating p - channel and n - channel transistors with different characteristics on a common substrate. 2. Description of Related Art In complementary metal oxide semiconductor (CMOS) fabrication, p - channel and n - channel transistors are tabricat3d on the same semiconductor substrate. To achieve transistors of both polarities (conductivity types ), it is necessary that at least some procdsw is steps differentiate between p - type and n - type transistors. Separate implant steps, for example, are needed to define n - well and p - well structures and to dope the source / drain regions of n - channel and p - channel transistors. Whenever possible, how$Cer, it is generally desirable to use a single process step to define transistor features regardless of the transistor type. Single process steps imply a single mask step, which is always desirable to reduce load on the photolithography processing. Moreover, a single step generally minimizes undesirable variations between the p - channel and n - channel transistors. Imagine, for example, that a particular design has been optimized under the assumption that the thickness of the gate oxide (or other dielectric) is the same on n - channel and p - channel transistors. The best way to ensure that the assumption is correct is to form the relevant feature for p - channel and n - channel transistors sijultaneouslG. In some cases, however, it may be desirable to process n - channel and p - channel transistors separately to account for differences in the characteristics of the respective transistor typ2a. As an example, there is an asymmetry in the sub - micron behavior of p - channel and n - Djannel transistors. For sub - micron p - channel transistors, the high diffusivity of its boron carriers causes sub - threshold leakage current to be of paramount concern. For n - channel transistors, the drive current or saturated drain current (IDS ), which is an important performance parameter, is strongly influenced by the effective length of the source / drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter extensions to increase the n - channel drive current, it would be desirable to have longer extensions to reduce the p - channel sub - thr4Dhold leakage cureebt. It would therefore be desirable to implement a process that simultaneously addressed these concerns DitTout substantially increasing the cost or complexity of the process.
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1. Field of the Invention The present invention relates generally to the field of semiconductor fabrication and, particularly, the field of fabricating p-channel and n-channel transistors with different on a common substrate. 2. Description of Related Art In complementary metal oxide semiconductor (CMOS) fabrication, p-channel and n-channel transistors are fabricated on the semiconductor substrate. To achieve transistors both polarities (conductivity types), is necessary at least some process is steps between p-type and n-type transistors. Separate implant steps, for example, are needed to define n-well and p-well structures and dope source/drain regions of n-channel and p-channel transistors. possible, however, it is generally desirable to use single process step to define transistor features regardless of the transistor type. Single process steps imply a single mask step, which is always desirable to reduce load on photolithography processing. Moreover, a step generally minimizes undesirable variations between the p-channel and n-channel transistors. Imagine, for example, a particular design has been optimized under the assumption that the thickness the gate oxide (or other dielectric) is the same on n-channel and p-channel transistors. The best way to ensure that the assumption is correct is to form the relevant feature for p-channel and n-channel simultaneously. In some cases, however, may be desirable process n-channel and p-channel transistors separately to account for differences in the characteristics of the respective transistor types. As an example, there is an asymmetry in the sub-micron behavior of p-channel and n-channel transistors. For sub-micron p-channel transistors, the high diffusivity of its boron causes sub-threshold leakage current to be of paramount concern. For n-channel transistors, the drive current or saturated (IDS), which an important performance parameter, is influenced by length of source/drain region due to the parasitic that it creates. Whereas it would be desirable have shorter extensions to increase n-channel current, it would be desirable to have longer extensions to reduce p-channel sub-threshold leakage current. It would be desirable to implement a process that simultaneously these concerns without substantially increasing the cost or of the process.
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1. fielD oF THE InvEntiOn
thE PrESeNt InVenTioN RELAtEs gEnERalLY To The field of sEmIconduCTOr fabrication aNd, mOrE PArtICULARly, tO THe fieLd Of FAbRIcATiNg p-chaNneL and n-CHAnNEl traNsIstorS with dIFfERent chArACTErIStiCs oN a commON SuBSTraTe.
2. DEScRIptiON oF relateD arT
In cOMPLemEntaRY metaL oxIdE SEMIcoNDuCtOR (cmos) fAbRicATIOn, P-cHAnnEl ANd n-CHAnNEL TraNSistorS arE faBRicaTEd ON ThE saME SEmicOndUcToR sUBStRAtE. TO aChIEVe TrANsIstOrS oF BOTH polarItIes (COnDucTiVity tYpeS), IT is nECesSARY tHat aT LeASt SOMe Process Is STePS DIFfeRentiATE BetWeeN p-TYPE and n-TYPe tRansiStORs. sEPaRate imPLAnT StePs, FoR eXaMPLe, ArE neEdED tO DEFine n-wELL And P-wElL STRuCTUrEs aNd to doPe tHE SOuRce/DrAIN rEGIONs oF N-CHAnNEL AND p-cHAnnEl TrAnSisToRS. whenEver posSiblE, hoWeVeR, It is GENeraLlY DeSirAbLE to Use a SiNgle PRoCESs stEp to deFine TrAnsistor feAtURES regaRDLESs oF tHe TrAnSIsTOr tYpE. SINgLe PRoCESS sTePS IMPlY A sInGle MaSk stEp, WhiCh iS alWaYS DESiRAble to rEduCe LoaD On The PHoTOLIThOgRaPHY proceSsINg. moREoVEr, a siNglE StEP geneRAlly mInImIzEs UnDEsIRablE VariATiOnS BEtWeen THe P-ChanNel anD N-cHAnNel trAnSiSTORs. ImAGiNe, fOR ExaMPlE, tHaT a ParTicULar dEsIGN hAS BeEn oPTiMized undER THe ASsuMPTion thAT ThE ThicKnesS Of tHe gaTE OxidE (oR oTheR diEleCtriC) is thE Same on n-cHanNEl AnD P-ChannEL traNSistOrS. tHE Best wAY To enSURe THat the AsSuMption is coRrect is to forM THe RelEVANt fEATUrE foR P-ChaNNEL AND N-cHanNEl tRansISTOrs SimuLTAnEOuSLY.
in SoME CaseS, HowevER, iT MAY bE desiRaBLE To pRocESs n-cHANNEl aNd p-chANNEl TrANsIstORs sepARateLy TO AccounT For DiFferENCES In The ChArACTeRIsTIcs OF THE reSPeCTive transiSTor TypEs. AS AN eXAmPle, thEre IS aN aSyMmetry IN ThE SuB-MicROn BEhAViOR oF p-CHAnNel and N-channEL TRanSIstoRs. for Sub-micROn P-cHANNeL tRAnsIsTorS, tHe HigH DiffuSIVIty of iTs bOrON cArRieRS CAuSes SuB-thREshold leaKAGE curReNT To BE OF ParAMounT conceRN. For n-chaNNEL tRANSIstoRs, thE DRivE cuRRENt oR SaTUraTEd DRaIn CURREnt (Ids), wHIcH IS an ImPoRTaNt PeRFORMANCe paRAMEtER, Is stRONGly INflueNCEd by tHe EFfective LeNGTh oF the sourCE/DRAIN EXtEnsiON RegioN Due to the pARAsITIc ResIStANcE thAt IT cReaTeS. WHEReAs it wOUlD bE DEsIrABle To HAvE sHORTer eXTENsIoNS tO iNCrEase tHE n-CHaNNel DRivE cURREnt, iT woUlD be DesiRable tO HAVe LONGER EXtensioNs to ReduCe the p-cHannEl sUB-THreSholD LeakAGe cuRRENT. IT WouLD theRefore Be DeSIRAble TO iMPleMENt a pRocEsS tHaT SImUltAnEOusLy AddReSSeD THeSE cOncERnS wiThOUt sUbsTAnTiaLlY iNCREASING the COST Or complExiTy of thE prOCesS.
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1. Field of the Invention The presentinventionrelates generally to thefield of semiconductor fabrication and, more particularly, to the field of fabricating p-channeland n-channel transistors with different characteristics on acommon substrate. 2. Description of RelatedArt In complementary metal oxide semiconductor (CMOS) fabrication, p-channeland n-channel transistors arefabricated on the same semiconductorsubstrate.To achieve transistors of both polarities (conductivity types), it is necessary that at least some process is stepsdifferentiate between p-typeand n-type transistors. Separate implant steps,for example, are needed to define n-well and p-well structures and to dope thesource/drainregionsof n-channel andp-channel transistors. Whenever possible, however, it is generally desirable to use a single process step todefine transistor featuresregardless of the transistor type. Single process stepsimply asinglemask step, whichis always desirable to reduce load on the photolithography processing. Moreover, a single step generally minimizes undesirable variations between the p-channel and n-channeltransistors. Imagine, for example, that a particular design has been optimized under the assumptionthat the thickness ofthe gate oxide (orother dielectric) is thesame onn-channel and p-channel transistors. The best way to ensure that theassumption is correct is to form the relevant feature for p-channel and n-channel transistors simultaneously. In some cases, however, it may be desirable to process n-channel and p-channel transistors separately toaccountfor differences in the characteristics of the respectivetransistor types.As an example, there is an asymmetry in the sub-micronbehavior of p-channel and n-channeltransistors. For sub-micronp-channel transistors, the high diffusivity of its boron carriers causes sub-threshold leakage currentto be of paramount concern. For n-channel transistors,the drive current or saturated drain current (IDS), which is an important performanceparameter, is stronglyinfluenced by the effectivelength of the source/drainextension region due to the parasiticresistance that it creates. Whereasit would be desirable to haveshorter extensionsto increase the n-channel drive current,itwouldbe desirableto have longerextensionsto reduce the p-channel sub-threshold leakage current.It would thereforebe desirableto implement a process that simultaneously addressedtheseconcerns withoutsubstantially increasing the cost or complexityofthe process.
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1. Field of the Invention The present _invention_ relates generally to the field of semiconductor _fabrication_ and, _more_ particularly, to the field of fabricating p-channel and _n-channel_ _transistors_ _with_ different characteristics on a common substrate. 2. Description of Related _Art_ _In_ _complementary_ metal oxide semiconductor _(CMOS)_ fabrication, p-channel _and_ n-channel transistors are fabricated _on_ the same semiconductor _substrate._ To achieve transistors of both polarities (conductivity _types),_ it is necessary that at least _some_ process is steps differentiate between p-type _and_ n-type transistors. Separate _implant_ steps, _for_ example, are needed to define n-well and p-well structures and to dope the _source/drain_ regions of _n-channel_ and _p-channel_ transistors. Whenever possible, however, it is generally _desirable_ to use a single process step to define _transistor_ _features_ regardless of the _transistor_ _type._ Single _process_ steps imply a single mask step, which _is_ always desirable to reduce _load_ on the photolithography _processing._ Moreover, a single step generally minimizes undesirable variations between _the_ _p-channel_ and n-channel transistors. Imagine, for example, that a particular _design_ has been optimized _under_ the assumption that the thickness _of_ the _gate_ oxide (or other dielectric) is the same on _n-channel_ and p-channel _transistors._ The best way to ensure that the assumption is correct _is_ to form the relevant feature _for_ p-channel and n-channel transistors simultaneously. In some cases, however, it may _be_ desirable to process _n-channel_ and _p-channel_ transistors separately to account for differences in the characteristics of the respective transistor _types._ As an _example,_ there _is_ an asymmetry in the sub-micron behavior of p-channel and n-channel transistors. _For_ sub-micron p-channel _transistors,_ the high _diffusivity_ _of_ its _boron_ _carriers_ causes sub-threshold _leakage_ current _to_ be of paramount concern. _For_ _n-channel_ transistors, the drive current or saturated drain current (IDS), which is an important performance parameter, is strongly influenced _by_ the effective _length_ of _the_ source/drain _extension_ _region_ due to the parasitic resistance that it creates. Whereas it would _be_ desirable to have shorter extensions to increase the n-channel drive current, it would be desirable to _have_ longer extensions to _reduce_ the _p-channel_ sub-threshold leakage current. It would _therefore_ be desirable to implement _a_ process that simultaneously addressed _these_ _concerns_ without substantially _increasing_ the cost or complexity of the process.
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1. Field of the Invention
The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the number of usages.
2. Background Art
Each year, millions of reported illnesses and serious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10,000 people each year, and 70% of the outbreaks originate in food service sector. The passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one site to another with each successive physical contact.
The problem is most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food and food products. A person that handles a single contaminated source will spread the contaminant to every person, article and surface touched by that person. The subsequent contaminated sources represent additional contamination sites that spread the contaminant. The liability of contamination or illness caused by inadequate washing techniques is very high. And, a single food borne illness can tarnish a long-standing reputation and wreak financial havoc.
Proper washing of hands has been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. According to the Centers for Disease Control, proper hand washing is the single most important process in preventing the spread of the pathogens. Microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e.g.: germs. A germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and any one of the bacteria that can cause disease. A bacterium is typically a one-celled microorganism, wherein some cause diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation.
Some industries are much more sensitive to proper washing techniques. Restaurants are particularly prone to the dissemination of food-borne contaminants and the U.S. Food and Drug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address the washing of hands for food service and related personnel. According to the Food Code regulations, a person must wash after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready-to-eat foods, and any other activity that potentially contaminates the hands.
In addition, the Food Code describes a proper hand washing technique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. There are various soaps or cleansing liquids that can be used, preferably having anti-bacterial or anti-microbial properties. Nails should be cleaned and scrubbed. After scrubbing, the hands should be thoroughly rinsed with water. The areas between the finger and underneath the fingernails should be specifically cleaned and checked.
The regulations also require a supervisor ensure compliance with the regulations and promote the effective washing protocols. Employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment.
Although there may not be specific codes governing all industries and circumstance, it is common sense that adherence to the regulations will instill a safer environment for all. And, in a litigious environment, adhering to a strict standard is also a cost-effective and practical measure. There are varying international standards for the washing of hands, but in general, the U.S. standard provides a reasonable approach to follow.
Unfortunately, the proper washing guidelines are not regularly and rigorously followed. Many food service personnel do not appreciate the significance of proper washing. The restaurants rarely provide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. In addition, the employees at restaurants and dining establishments tend to be lower paid and may not care or understand the posted written guidelines, especially if the guidelines are in an unfamiliar language. Presently there is no adequate means of providing proper guidance and instruction during washing, no system designed to walk a user through the washing steps, and no simple means of monitoring or tracking employee washing.
Contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. These factors all contribute to a potential for poor washing conditions. Due to the many illnesses caused by food preparation, the FDA continues to apply more formal regulations and guidelines for employers regarding proper washing skills. Employers are demanding a better system of aiding and monitoring employee washing habits.
The soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. Liquid and semi-liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial cleansing liquids, and similar materials. A typical dispenser allows the user to obtain a specific amount of liquid matter with minimal ease. Manual and semi-automatic dispensing systems are common in the industry, and automated dispensers are beginning to enter the marketplace.
The manual dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. The physical contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. Automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical components to automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser.
Unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order to function. Besides electronic equipment, there are mechanical components such as plungers and gear trains that work in conjunction with the electronics. The mechanical gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid cleansers. The low reliability and the catastrophic failure mode are a major concern in the touchless dispenser market.
Within the field of liquid dispensers, there are many types of dispensers. The most common and cost effective is the bag-in-box system, where the liquid comes in a no-leak pouch with pump tip and is disposable. This system is a closed system, and all the air is removed from the pouch during manufacturing. The bag collapses upon itself once the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, including being a more sanitary system. The standard size pouch is 800 ml, but other sizes are in use, including 500 ml to 900 ml. It is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme wear and tear. Due to the excessive use, the devices must be robust and relatively maintenance free.
Other dispensers use cartridges or refillable containers. The cartridges must be pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable containers introduce air into the system, aiding the production of bacteria and mold. The cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi-automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur.
The liquid soap industry has numerous brands and categories of cleansing liquids. The viscosity and particulate content are also subject to extreme variations. There is an array of particulate matter that can be added to cleansing liquids to form a grit soap compound that is more effective in cleaning. The most common grit material is plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. Besides the variations of compounds used to form grit soap, the size of the grit also varies.
There has also been a consumer demand for anti-microbial cleansing liquids and anti-bacterial cleansing liquids, and the industry has reacted by adding creating new compounds with these properties. These anti-microbial and anti-bacterial cleansing liquids are available with or without grit and have certain characteristics and viscosity differences as compared to standard liquid soap. Besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme solutions, lotions, cleansing liquids, and shaving creme.
In a typical bag-in-box operation, a user depresses a lever or controller. This applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball check valve. If the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. The liquid flows into the space between the spring and the interior wall of the ball check valve chamber. Once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle.
The transition from a user applying purely mechanical forces to meter out some liquid to a semi-automated or automated dispensing unit is
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1. field of the invention the present invention relates to an improved dispensing apparatus. as particularly, a system that incorporates a timing means in conjunction with audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the number of usages. 2. background art each year, millions previously reported illnesses and serious infections are attributable to improper hand washing. the unreported cases are estimated to be much higher. food borne illness kills over 10, 000 people each year, and 70 % all the outbreaks originate in food service sector. the passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one site to another with each successive physical contact. the problem is most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food and food products. a person that handles a single contaminated source will spread the contaminant to every person, article and surface touched by that person. the subsequent contaminated sources represent additional contamination sites that spread the contaminant. the liability of contamination or illness caused by inadequate washing techniques is very high. and, a single food borne illness can tarnish a long - standing reputation and wreak financial havoc. proper dressing of hands has been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. according to the centers for biotechnology control, proper hand washing is the single most important process in preventing the spread of the pathogens. microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e. g. : germs. a germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and any one of the bacteria that can host disease. a bacterium is typically a one - celled microorganism, wherein some contain diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation. grocery industries are much more sensitive through proper washing techniques. restaurants are particularly prone to the dissemination of food - borne contaminants and the u. s. food and drug administration ( fda ) has specific guidelines articulated in the food code. the food code has several sections that address the washing of hands for food service and related personnel. according to the food code regulations, a person must wash after using the bathroom, sneezing, coughing , using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready - to - eat foods, and any other activity that potentially contaminates the hands. in addition, the food code describes a proper hand washing technique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. in addition to timing the washing, it is important to consider the different steps in the washing procedure. a proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. there are various soaps or cleansing liquids that can be used, preferably having anti - bacterial or anti - microbial properties. nails should be cleaned and scrubbed. after scrubbing, the hands should be thoroughly rinsed with water. the areas between the finger and underneath the fingernails should be specifically cleaned and checked. the regulations also require a supervisor ensure compliance with the regulations and promote the effective washing protocols. employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. although there may not be specific codes governing all industries and circumstance, it is common sense that adherence to the regulations will instill a safer environment for all. and, in a litigious environment, adhering to a strict standard is also a cost - effective and practical measure. there are varying international standards for the washing of hands, but in general, the u. s. standard provides a reasonable approach to follow. unfortunately, the proper washing guidelines are not regularly and rigorously followed. many food service personnel do not appreciate the significance of proper washing. the restaurants rarely provide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. in addition, the employees at restaurants and dining establishments tend to be lower paid and may not care or understand the posted written guidelines, especially if the guidelines are in an unfamiliar language. presently there is no adequate means of providing proper guidance and instruction during washing, no system designed to walk a user through the washing steps, and no simple means of monitoring or tracking employee washing. contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. these factors all contribute to a potential for poor washing conditions. due to the many illnesses caused by food preparation, the fda continues to apply more formal regulations and guidelines for employers regarding proper washing skills. employers are demanding a better system of aiding and monitoring employee washing habits. the soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. liquid and semi - liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti - bacterial cleansing liquids, anti - microbial cleansing liquids, and similar materials. a typical dispenser allows the user to obtain a specific amount of liquid matter with minimal ease. manual and semi - automatic dispensing systems are common in the industry, and automated dispensers are beginning to enter the marketplace. the manual dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. the physical contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical components to automatically dispense the liquid after triggering some sensory input. the automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser. unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order to function. besides electronic equipment, there are mechanical components such as plungers and gear trains that work in conjunction with the electronics. the mechanical gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. in addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid cleansers. the low reliability and the catastrophic failure mode are a major concern in the touchless dispenser market. within the field of liquid dispensers, there are many types of dispensers. the most common and cost effective is the bag - in - box system, where the liquid comes in a no - leak pouch with pump tip and is disposable. this system is a closed system, and all the air is removed from the pouch during manufacturing. the bag collapses upon itself once the liquid is evacuated, minimizing waste disposal. the closed system has many advantages, including being a more sanitary system. the standard size pouch is 800 ml, but other sizes are in use, including 500 ml to 900 ml. it is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. the dispensers are installed in many public facilities, and are subject to extreme wear and tear. due to the excessive use, the devices must be robust and relatively maintenance free. other dispensers use cartridges or refillable containers. the cartridges must be pierced, are generally not refillable, and produce greater waste. both cartridges and refillable containers introduce air into the system, aiding the production of bacteria and mold. the cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. also, these semi - automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur. the liquid soap industry has numerous brands and categories of cleansing liquids. the viscosity and particulate content are also subject to extreme variations. there is an array of particulate matter that can be added to cleansing liquids to form a grit soap compound that is more effective in cleaning. the most common grit material is plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. besides the variations of compounds used to form grit soap, the size of the grit also varies. there has also been a consumer demand for anti - microbial cleansing liquids and anti - bacterial cleansing liquids, and the industry has reacted by adding creating new compounds with these properties. these anti - microbial and anti - bacterial cleansing liquids are available with or without grit and have certain characteristics and viscosity differences as compared to standard liquid soap. besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme solutions, lotions, cleansing liquids, and shaving creme. in a typical bag - in - box operation, a user depresses a lever or controller. this applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball check valve. if the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. the liquid flows into the space between the spring and the interior wall of the ball check valve chamber. once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle. the transition from a user applying purely mechanical forces to meter out some liquid to a semi - automated or automated dispensing unit is
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1. Field of the Invention The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the number of usages. 2. Background Art Each year, millions of reported illnesses and serious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10, 000 people each year, and 70% of the outbreaks originate in food Wervicf sector. The passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one site to another with each successive physical contact. The problem is most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food and food products. A person that handles a single contaminated source will spread the contaminant to every person, article and surface touched by that person. The subsequent contaminated sources represent additional contamination sites that spread the contaminant. The liability of contamination or illness caused by inadequate washing techniques is very high. And, a single food borne illness can tarnish a long - standing reputation and wreak financial havoc. Proper washing of hands has been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. According to the Centers for Disease Control, proper hand washing is the single most important process in preventing the spread of the pathogens. Microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e. g. : germs. A germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and any one of the bacteria that can cause disease. A bacterium is typically a one - celled microorganism, wherein some cause diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation. Some industries are much more sensitive to proper washing techniques. Restaurants are particularly prone to the dissemination of food - borne contaminants and the U. S. Food and Drug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address the washing of hands for food service and related personnel. According to the Food Code regulations, a person must wash after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready - to - eat foods, and any other activity that potentially contaminates the hands. In addition, the Food Code describes a proper hand washing technique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. There are various soXpa or cleansing liquids that can be used, preferably having anti - bacterial or anti - microbial properties. Nails should be cleaned and scrubbed. After scrubbing, the hands should be thoroughly rinsed with water. The areas between the finger and underneath the fingernails should be specifically cleaned and checked. The regulations also require a supervisor ensure compliance with the regulations and promote the effective washing protocols. Employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. Although there may not be specific codes governing all industries and circumstance, it is common sense that adherence to the regulations will instill a safer environment for all. And, in a litigious environment, adhering to a strict standard is also a cost - effective and practical measure. There are varying international standards for the washing of hands, but in general, the U. S. standard provides a reasonable approach to follow. Unfortunately, the proper washing guidelines are not regularly and rigorously followed. Many food service personnel do not appreciate the significance of proper washing. The restaurants rarely priDide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. In addition, the employees at restaurants and dining establishments tend to be lower paid and may not care or understand the posted written guidelines, especially if the gjide>ines are in an unfamiliar language. Presently there is no adequate means of providing proper guidance and instruction during washing, no system designed to walk a user through the washing steps, and no simple means of monitoring or tracking employee washing. Contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. These factors all contribute to a potential for poor washing conditions. Due to the many illnesses caused by food preparation, the FDA continues to apply more formal regulations and guidelines for employers regarding proper washing skills. Employers are demanding a better system of aiding and monitoring employee washing habits. The soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. Liquid and semi - liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti - bacterial cleansing liquids, anti - microbial clSsnsing liquids, and similar materials. A typical dispenser allows the user to obtain a specific amount of liquid matter with minimal ease. Manual and semi - automatic cispWnsing systems are common in the industry, and automated dispensers are beginning to enter the marketplace. The manual dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. The physical contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. Automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical components to automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser. Unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order to function. Besides electronic equipment, there are mechanical components such as plungers and gear trains that work in conjunction with the electronics. The mechanical gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid cleansers. The low reliability and the catastrophic failure mode are a major concern in the touchless dispenser market. Within the field of liquid dispensers, there are mabU types of dispensers. The most common and cost effective is the bag - in - box system, where the liquid comes in a no - leak pouch with pump tip and is disposable. This system is a closed system, and all the air is removed from the pouch during manufacturing. The bag collapses upon itself oMcf the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, including being a more sanitary system. The standard size pouch is 800 ml, but other sizes are in use, including 500 ml to 900 ml. It is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme wear and tear. Due to the excessive use, the devices must be robust and relatively maintenance Bres. Other dispensers use cartridges or refillable containers. The cartridges must be pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable containers introduce air into the system, aiding the production of bacteria and mold. The cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi - automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur. The liquid soap industry has numerous brands and categories of cleansing liquids. The viscosity and particulate content are also subject to extreme variations. There is an array of particulate matter that can be added to cleansing liquids to form a grit soap compound that is more effective in cleaning. The most common grit material is plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. Besides the variations of compounds used to form grit soap, the size of the grit also varies. There has also been a consumer demand for anti - microbial cleansing liquids and anti - bacterial cleansing liquids, and the industry has reacted by adding creating new compounds with these properties. These anti - microbial and anti - bacterial cleansing liquids are available with or without grit and have certain characteristics and viscosity differences as compared to standard liquid soap. Besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme solutions, lotions, cleansing liquids, and shaving creme. In a typical bag - in - box operation, a user depresses a lever or contro?:er. This applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball check valve. If the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. The liquid flows into the space between the spring and the interior wall of the ball check valve chamber. Once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle. The transition from a user applying purely mechanical forces to meter out some liquid to a semi - automated or automated dispensing unit is
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1. Field of Invention The present relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor number of usages. 2. Background Art Each year, millions of reported and serious infections are attributable to improper washing. The unreported cases are estimated to be much higher. borne illness over 10,000 people each year, and 70% of the outbreaks originate food service sector. The passage of viral and bacterial contaminants result from physical contact with an source and are carried from one site to another with each successive physical contact. The problem is most evident in hospital and related medical establishments, well as those businesses with preparing and distributing food and food products. A person that handles a single contaminated source will the contaminant to every person, article and surface touched by that The subsequent contaminated sources represent additional contamination sites that spread the contaminant. The liability of contamination or illness by inadequate washing techniques is very high. And, a single food borne illness can tarnish a long-standing reputation and wreak financial havoc. Proper washing of hands has been demonstrated to kill the contaminants and prevent the spread disease and contaminants. According to the Centers for Disease Control, proper hand is the single most important process in preventing the spread of pathogens. Microbial contamination refers to microscopic organisms, especially of the bacteria that cause disease, e.g.: germs. A germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and of the bacteria that can cause A bacterium is typically a one-celled microorganism, wherein some cause diseases as tuberculosis, or anthrax while bacteria are necessary fermentation nitrogen fixation. Some industries are much more sensitive to washing techniques. Restaurants are particularly prone to dissemination of food-borne contaminants the U.S. Food and Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections address the washing of for food service and related personnel. According to the Food Code regulations, a person must wash after using the sneezing, using a disposable tissue, using tobacco, or drinking, handling soiled and when switching from raw to ready-to-eat foods, and any other activity that contaminates the hands. In the Food proper hand technique as lasting at least 20 seconds, washing up to the forearms, and special between the fingers and underneath In addition to timing the washing, it important to consider different steps in the washing procedure. A proper washing cycle commences with combining water and soap and the hands vigorously. There various soaps or cleansing liquids that be used, preferably having anti-bacterial or anti-microbial properties. Nails should be cleaned and After scrubbing, the hands should be thoroughly rinsed with water. The areas between finger and underneath fingernails should specifically cleaned and checked. The regulations also require a supervisor ensure compliance the regulations and the effective washing Employers may fined or lose licenses if employees do not observe regulations, and such employees are likely to lose their employment. Although there may not be specific codes governing all industries and circumstance, it is common sense that adherence the regulations will instill a safer environment for all. And, in a litigious environment, adhering to a standard is also a cost-effective and practical measure. There are varying international standards the washing of hands, but in general, the U.S. standard provides reasonable approach to follow. Unfortunately, the proper washing guidelines are not regularly and rigorously followed. Many food service personnel do appreciate the significance of washing. The restaurants provide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. In addition, the employees at restaurants dining establishments tend to be lower paid and may not care or understand the posted written guidelines, if the guidelines are in an language. Presently there is no adequate means of providing proper guidance and during washing, no system designed to a user through the washing steps, and no simple means of monitoring or tracking employee washing. Contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. These factors all contribute a potential for poor washing conditions. Due to the many caused by food preparation, the FDA continues to regulations and guidelines for employers regarding proper washing Employers are demanding a better system of aiding monitoring employee washing habits. The soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. Liquid and semi-liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti-bacterial liquids, anti-microbial cleansing liquids, and similar materials. A typical dispenser allows the user to obtain a specific amount with minimal ease. Manual and semi-automatic dispensing systems are common in and automated dispensers are beginning to enter the marketplace. The dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. The physical contact in manipulating the lever does provide a contact with a surface that is typically wet dirty, and may harbor contaminants. Automated dispensers are becoming more and operate with a variety of electrical and electromechanical components automatically dispense the liquid after triggering some sensory input. automatic or do not require any physical contact the dispenser. the touchless dispensers are fairly expensive and require fairly complex electrical and electrical in order to function. Besides electronic equipment, there are mechanical components such as plungers and gear trains that in conjunction with the electronics. The gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid requiring frequent battery replacement. In addition, if the batteries drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid The low reliability and the catastrophic failure mode are a major concern the touchless dispenser market. Within the field of liquid dispensers, there are many of The common and cost effective is the bag-in-box system, where the liquid comes in a no-leak pouch with pump tip and is disposable. This system is a closed and all the air is from the pouch during manufacturing. The bag upon itself once the liquid is evacuated, minimizing waste disposal. The closed system many advantages, including being a more sanitary system. The standard size pouch is 800 other are use, including 500 ml to 900 ml. It is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme tear. Due to excessive use, devices must be robust and maintenance free. dispensers use cartridges or containers. The cartridges must be pierced, are generally not refillable, and produce waste. Both cartridges and refillable containers introduce air into the system, aiding the of bacteria and mold. The cost and administrative complexity in using other forms of dispensing liquids, as as the decreased sanitary limit their market appeal. Also, these semi-automatic and automatic systems can be designed to the cycle, exactly the correct amount of liquid, independently of successive and rapid of the member that occur. The liquid soap industry has numerous brands and categories of cleansing liquids. viscosity and particulate content are also subject to extreme variations. There is an array of particulate matter that be added to cleansing liquids to form soap compound that is more in cleaning. The most common material plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. Besides the variations of compounds used form grit soap, size of the grit also varies. There has also been a consumer demand for anti-microbial cleansing liquids and anti-bacterial cleansing liquids, and the industry has reacted by adding creating new these properties. anti-microbial and anti-bacterial cleansing liquids are available or without and have certain and viscosity differences as compared to standard liquid soap. Besides soap, other compounds dispensed include body and hair hand creme solutions, lotions, cleansing liquids, shaving In a typical bag-in-box operation, a user depresses a controller. This applies pressure to the dispenser that a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball valve. If the is sufficient, the ball is displaced, the liquid flows around the ball and into the ball check valve chamber. The liquid flows into the space between the spring and the interior of the ball check chamber. Once the chamber is full, the liquid is forced through the spring and out through the lower fitment hole and through the nozzle. transition from user applying purely mechanical forces to meter out some liquid a semi-automated or automated dispensing unit
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1. FIeLD OF thE InVENTIon
thE PRESeNt inVEnTion rELATES to an ImpRovEd DIsPeNSInG apPaRATUs. more ParTICulaRlY, A dIsPEnSEr thAT IncOrpOrATEs A timing mEANs IN COnjunctiON witH AUDiO anD vIsUAL ouTpUT To AssisT the USer iN PrOpEr washinG TEChNIQuEs foR COmPLIaNce WiTH RECommENDeD guIDelInEs AnD to monitOR THe numbeR of UsaGEs.
2. baCkGrouNd ARt
eacH yEaR, MiLLIOnS Of rePOrted iLLnEsSes And serIoUS INFEcTIONs ARE attrIbUTABLE TO iMPRoPER haND WashINg. The unREpoRtEd CasES arE EsTimateD TO BE MUCH HiGHeR. FOOd BoRNE IlLnESs KILls ovEr 10,000 peoplE eAch yeAR, aNd 70% of the outbREakS oriGInATe IN FOoD Service sECtOR. tHe PassAge OF vIrAl And BactERIAl CoNTamiNANts ResUlT FroM pHySIcaL cOnTACt wITH aN iNfeCTeD SouRCe and aRe carRied frOm ONe siTe TO ANoTHer WITH EACh succEsSiVe PhysiCAl cONTacT.
the pRobLeM iS mOst EVIdenT In HOspital and RelatEd MeDiCAl esTAbLIShMentS, As WELL as ThOse BusINeSSes aSsoCIAted WiTH pREpArInG AnD DIStributING fooD AnD fOOD ProDuCTS. A pErsoN thAT hANDLeS a SiNgLE COnTaMInAtEd SoURcE wiLL SPrEAD THE cOntamINAnT To evEry pERSOn, article AND SUrFacE TOUChed By tHAt PeRSOn. tHE SuBSeQUent CONtaminATeD souRceS rEpresenT AdDITIonaL CoNTaMinatIon siTEs that SPReAd the ConTAMiNaNt. tHE lIabilItY oF coNTamInatIon Or ilLNeSs CAUsEd bY inADeQUAte WASHiNg tECHnIques is veRy HIGh. AND, a sinGLE FOoD boRNE iLLneSs cAN TaRNisH A LONg-sTAndINg REPUTaTIOn ANd wReAK fINANcIAL hAVOC.
PROpER WASHIng oF HaNDs HAs bEeN DeMOnSTRATed to kilL The cONtAMiNANTS AND prevEnT thE SpReaD OF dISEASE And cOnTAMiNANTS. ACCORDINg To ThE CeNTErs FoR dISeAsE CONtrOl, PROpeR hANd wasHing IS tHe sinGlE most ImPoRTaNT PRoCeSs iN PRevENtInG the sPrEAD OF The PATHogens. miCrobIal coNtaminatIOn RefErs TO microsCOpIc organISMs, esPeciaLly Any OF THe bacteRIa THaT caUSe DiSeaSe, E.G.: GErMs. a geRm iS tHE RUdImeNtaRY fOrm in wHICh a NEW ORgaNism Is dEVeLoped, AND ENCOMPAsSes ANy MiCROSCopIC orGaNism aND Any One oF tHe BactEriA ThaT CAN CAUSE dIsEAsE. a baCtERium IS typICALlY A one-cELLED MicRoOrganiSm, wHErein somE cAuse DISEasEs suCH AS pNEumOnIA, tUbERCuLOsIs, OR ANthRax WhilE OTher bActERiA ArE NEcEssarY FOr FerMenTATion aND NITROGeN FixATIon.
soME iNdUstRies aRe mUch moRe SeNSiTiVE to PrOPEr wAshiNG TEchNIqueS. resTauraNts ARe PARTICuLArlY PRonE TO thE diSSeMiNATIoN OF FOOD-BORne CONtamInAnTS aNd thE u.s. fOod aNd drUg AdmInIstrATIOn (FdA) haS specifiC GuideLIneS aRTicULAteD iN The FooD COdE. the FOOD COdE haS SEVErAl SEctiONs THAt AdDRESs THE wAshIng of HaNdS for FOOD SerVIce aNd rELAteD PErsONnEL. AccoRdiNg tO tHe FOoD CODe rEGuLATIOnS, a PeRsoN MusT wAsh aFTER UsInG ThE baTHRooM, sneEziNG, COUgHINg, USiNg a dispOSable TISsUE, UsING TObAcco, eatIng Or DrinKinG, HandLiNG SOIlEd UTeNsilS, AnD WhEn sWiTcHING From RAW Foods tO Ready-TO-EAT FOOds, and aNY OTHER ActIvITY THaT potENtialLy CoNTaMiNatES ThE handS.
iN aDDItion, the fOod COde deSCRiBEs A PrOper hAnD WasHING TeChNiQUE AS lasTInG AT LEAst 20 secoNds, WasHiNg Up tO The fOReArMs, aND a speCIaL eMphaSiS oN bETwEen THe FinGERS aND UnDERNeATH FinGerNAiLS. In ADditIoN tO TiMIng The washInG, it is ImpORtANt TO ConSiDer ThE DiFfERENt stEPs In ThE WAshInG procEDUre. A PrOpEr WaSHiNG cYcLE CommENcES wIth cOmBiNINg WATeR AnD soaP anD sCrUbBInG THe Hands ViGoroUSLy. thErE are variOUs soAPs or clEAnsiNG liQUIdS ThaT cAN be uSed, prEfErAblY HaVing Anti-baCteRiAl or Anti-MicrObIaL pRoPeRtIeS. NAiLS SHOUlD Be CLeaned AnD SCrUBbed. After ScRubBING, tHE HanDs shoUlD be thORoUgHLY RInseD WItH waTeR. THe aReas BEtwEen tHe FiNger anD UnDeRNEAth THe fIngernAilS shoUld be SpecifICalLY ClEaneD aND cHEcKeD.
THe reguLaTiONS aLSo REqUIRE A SuPeRvisoR eNsURe cOMplIANCE with tHe regUlaTIoNS aNd pROmOTe tHE EffECTIve wAShInG prOTOcOLS. EmPLoYErs MaY bE FINed Or LOSE lIcENSES if EmPloYeES DO not OBSERVE thESe reGulatIOns, and sUch empLoYeeS ARe lIkeLY To LOSE THEIr eMpLOYMenT.
ALtHouGh tHerE MAy Not be spECifiC CoDES GoVERnIng all InDuSTRiES ANd cIrcumsTanCE, IT Is COmmON sEnsE tHAt AdHErENCe To THe reGuLATIOnS Will INStiLL A safER ENVIROnMeNT foR ALL. aNd, In a LItigIOuS EnVIronmEnT, AdherINg to A sTrict StANdard Is ALsO A CoSt-effeCTiVe aNd PRaCTIcAL MEasUre. THEre ARE vARyiNG INTErnaTIOnAl stANdARds foR tHe waSHINg of hanDS, buT iN gENeRAl, tHe u.s. StanDArd provIDEs A ReAsONablE ApprOach tO follOw.
unfORtuNATELy, THE PROpEr WaSHINg guiDElines ARe Not REGuLARly ANd rIgoROUSlY fOllOwED. mAnY fOod sErviCE PErSONNeL Do nOT apprEciate thE SIgnifiCANcE oF pROPer WAshinG. the REsTAuRaNtS rarEly pRoVIDE adEQuatE trAINING To THe PerSonnEL, AnD SELdOm ENcOmpaSs SuffiCieNt supervIsIOn durING thE WOrK ShiFTS. IN AdDItION, ThE EmplOyeES At reStAurANtS AND dining eStAblishmENTs TEND to Be loweR paiD And maY NOT CaRe Or uNDerSTaND THE POStEd wRIttEN GUiDElinES, eSpECIally If the gUiDeLInes ARe IN An unfamIliaR lAngUaGE. pReSentLY thERE Is NO AdEqUaTE means OF ProvidIng prOpER GuIDANcE And instRUcTIOn DUriNG WASHINg, nO sysTEM dEsIgNED To WalK a UseR THRouGH THE waShINg stEPS, AND No siMpLe meAnS Of mONitorINg or TraCkiNG empLOYee wASHINg.
coNTRibUTiNG tO the PRoBLEM Of iNADeQuATe wasHINg is the LaCK OF fOrMAl eDUcAtion by tHOSe iN thE FOOd seRvIces sEgmeNT, THE LOw pAY ScaLe, aNd ThE PeRIodS of rUShEd FoOD prEPAraTioN. ThEsE FACToRs ALL cOntribute To A POTentiAL fOR POOr WaShinG COnDiTIOns. DuE To the manY illnEsSES CaUSED By foOd PReParatIOn, tHE fDA ContiNueS TO aPpLY moRe foRMaL rEgULaTioNs ANd gUIdelIneS fOR EMPLOYers RegArdiNg PrOpEr WASHING SKiLls. eMPloYers arE dEmANding a BEttER SysTEM oF AidinG ANd MonITorING eMplOyeE WAshInG HABits.
THe SOAP aND lIqUID COMpOUNDs foR HAnd waSHINg cOme froM a nuMBeR OF DIFFEReNt diSpenseRs avaILabLe IN the mArKEtPlace. liqUiD aND SemI-LIquid diSPEnsErS aRE USeD In numERoUS ApPlicATiONS and aRe USEd to dISpeNse METerEd PorTIoNs of crEmes, lOTions, gELs, SoAps, aNTi-bactERIAl cLEAnSing LiQUIds, anti-MIcrObIAL cLeansiNg LiQuiDS, AND SiMILar MatErIAls. a tyPIcaL DiSpeNSeR ALloWs the uSeR to OBTaiN a SpecIfiC AMOunt Of lIquId MATtER wITh MinImal EaSe. mANUal and seMi-AutoMAtic dispENSINg SYstEmS are COmmoN in thE INdusTry, And AUtOMAted disPeNseRs are bEGinNINg to eNTER tHE maRKETPLace.
The manuAl dISPENsErs UtIliZe LeVeRs aND oThER MecHanICal aSsemBLIES wHeREin The uSEr MuST prOvIDe sOME pHYSIcAL cOntAcT wiTh THE UNit in ORDER TO DIsPeNsE THE LIquID. thE pHYSicaL ConTaCt iN maNiPulATIng thE Lever dOeS proViDe a ConTACt WitH a SURfAcE tHaT IS TYpicAlLY Wet AnD DIRTY, aNd May HArbOr cOnTAMiNAnTS. AuTOmATeD DisPEnSErs ArE BECOMIng More POpulAR, AND oPERaTe WIth A vARieTY oF eLeCTRiCAL aNd ELEctroMecHANicaL COmPONEnts To AuTOmATIcallY DIspEnSE THE liqUiD after TriGGeRIng Some seNsorY iNPUt. thE AUTomAtic oR Xe2X80x98TOuCHlESsxE2X80X99 diSPENsERS DO NOT REquIRE aNy phYSicaL coNTact WITH ThE DIsPEnser.
uNfoRtUnaTELy, ThE TOuChLESS dISPeNSERS arE fAiRLy eXpeNsIVe aND rEqUIre faiRlY COMplEX ELEcTrical And eleCtricAl ComponeNtS In OrDEr To fuNctIOn. BEsIdES ELectRoNiC EQuIpmeNt, tHErE ARE mecHaNIcaL CoMpONeNts suCh as plUnGeRs AND geAr TrAinS tHAt woRK iN ConjuNCTioN WITH THE ELEcTrOnics. the mEchAnicAl Gears DRaw sUBSTanTiAL EnERGY dURinG The xE2X80x98PiNCH aNd sqUeezExE2X80x99 OPEraTIoN to dEliveR LIqUId CLEanSEr, reQuiRiNG FreQueNT batTERy RePlaceMEnT. In ADDitIOn, If tHe BAttERiES aRE DraineD, ThE electRICAL ELemEnTS ArE nOT FUnctIOniNG pRopERLy, oR the MecHAnicaL fUncTIONs are bROkEN, THE eNTIre UnIt Is DiSABlED aND WIlL noT dIspEnSe anY LiQuiD clEaNSeRS. thE LOW reLiabIlITy AND ThE caTasTrOPhic FAilURE mODe aRE A mAjoR CONCerN iN thE touChleSs diSPEnSeR mARkeT.
WithiN THE fIeLd OF LiqUid DIsPENsERS, tHERe ArE mANY TYpES OF dispenseRS. THe moST cOmmon ANd cOst effEcTIVe IS thE BaG-In-bOx SySTem, WheRE The lIquid cOmES In a nO-LEak POUCH wiTH pUMP Tip and iS DIsPoSABlE. thIs SystEm Is a ClosED SysteM, AnD aLl ThE AiR iS reMoVED from tHe pOUcH duriNG mAnUfACturiNG. THe bAG cOLlAPSEs upoN ItsELf onCE The LiQuiD IS evaCUaTED, MinIMIZiNG waSte dISPOSAl. ThE CloSed sYSTEM Has ManY ADvanTaGEs, INCludiNG BEInG a MoRE SANItARY sySTeM. THE STaNDArd sizE POUch IS 800 ml, buT OThEr SIzEs aRe in USE, INclUDing 500 ML to 900 mL. IT is a nECeSSaRY REQUirEmeNt THaT The coSt To PRoducE a dISpoSAbLe POUCH Be KEPT tO a miniMuM, whILe still dEliVeRiNg ConSIsTEnt rEsUlTS. thE diSpENSeRS aRe iNstAlleD IN ManY publIC FAciliTIeS, AND Are SUbJECt TO ExtreMe wEar AnD tEAr. DUE to thE ExceSSiVE usE, ThE dEvicEs MUsT BE robust anD rElAtIveLY maiNTenaNcE FREE.
OTHeR DispEnsErS UsE CArtridGEs or refIlLabLe CoNTaINERS. THE carTridgEs mUst BE PierCED, aRe GenErALLY noT reFILlaBlE, aND prodUCe gREaTER WaSte. BotH CartriDgEs and ReFiLlabLE COnTaiNerS intRoduCE AIr iNTO THE SySTEm, AidINg THe prODUCTiOn OF bacteRia AND MOLd. THe cosT aND admINisTRaTIve cOmPLExity IN uSing ThESe OTher formS of DISpensING liquiDs, AS weLL as tHE DEcREAsED sAniTaRY CoNdiTions liMiT TheIr mARKEt aPpEaL. aLSo, tHeSe SEmi-auTOMatIc AnD aUTOMatIc SYSTemS caN bE DESIgnED tO comPlETE THE CYClE, METErINg ExACtLy the CORReCT AmouNT Of liQuid, IndePenDentLY OF sUCCeSsIvE and RaPid puSHEs of tHE ACTUATIng MembEr thAT frEquEnTLY occuR.
thE LIQuiD SoAp iNdUstRY HAS nuMerouS bRanDS And cATeGoRIES oF clEaNsINg liqUids. the VisCoSITY And PaRTICUlate cOntENT aRE alSo SUBjEct tO ExtreMe vaRiaTIOns. ThERe IS an ArraY oF PaRTiCUlATe mATter that Can bE aDded tO ClEaNsInG LIQuidS to FORm a GRit sOap COmpounD tHAT is MOre EfFectiVe in ClEANINg. tHe mOst commoN gRIT MaTErial iS PLAStIC MiCrosPhErEs, ALtHOUGH OTher MaTErialS SUcH As CLaY, wALnUT sheLLs aND corN COBs hAVE ALSO BEeN UsED. BESIDEs The variatiOns Of compOuNds uSEd tO ForM gRIT SOAp, THE SIZE oF THE GrIt alSo VaRieS.
TheRe haS aLso BEen A cOnSUMeR dEManD for ANTi-miCRObIaL ClEanSING lIQuIdS ANd ANti-baCterIal cleAnSInG LiqUIDs, ANd tHe InDUstRY has ReActed BY aDDing creatINg New cOmpOUNDS WIth ThESe PrOPerTIES. ThESe ANti-miCrObIal anD AnTi-baCteRiAL ClEANSINg LiqUids ARE AvAilAblE with oR withoUt Grit anD HaVe cErtAIn CHaRactERIsticS and vISCositY DiFfeRenCES as COMpared TO sTANDaRd Liquid sOap. besIDeS LiquID SOaP, OTher comPoUNDS DIsPENSeD INcLUde bodY aNd HaIR ShAMpoO, hAND CRemE solutIONS, LotIONs, cLEaNSiNg LIQuidS, AND ShaVInG CreME.
IN a TyPiCaL bAg-iN-boX opERatIoN, A UsEr dePRESses A leVer Or COnTroLler. THiS applIeS PRessurE To THe DiSpeNsER TuBE ThAT CreAtes A vaCuum In ThE coLLaPsIBLE poUch THAt eXERTS flUid PREssUre agAiNsT THe bALl IN THe baLl CHECk vAlVE. iF thE pressuRe IS SufficIENt, THe BaLl Is DIsplAcED, ANd thE lIqUiD flowS aROUNd THe baLL And inTO The BalL chECk VaLVE cHambEr. the LIquiD Flows iNTO The SPaCe BeTweEn tHe sprINg AnD the IntErIOR waLl oF THe BAll cHeCk VAlvE chAmbEr. ONCe The chAmBeR IS SufficiENTly fulL, ThE LiQUid iS FoRceD tHroUgH ThE cOMPRESSeD SpriNG and Out thROuGh thE LOWeR fItMeNT HOLe aNd tHRougH ThE NozZLe.
The trANSITion fRoM A uSEr apPLYINg PUrelY MeChAnICaL fOrcEs to MeTER OUT SoMe LIquID TO a sEmi-autOmAteD Or autOmAted dISPEnSIng uNIT is
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1. Fieldof the InventionThe present invention relates to animproved dispensing apparatus. More particularly,a dispenser that incorporates a timing means in conjunction with audio andvisual output to assist the user in proper washing techniquesfor compliance with recommended guidelines and to monitor the number of usages. 2.Background Art Each year, millionsof reported illnesses and serious infections are attributable to improperhand washing. The unreported cases are estimated to be much higher. Food borne illnesskills over 10,000 people each year, and70% of theoutbreaks originate in food service sector. The passage of viral and bacterial contaminants result from physical contactwith an infected source and are carried from one site to anotherwith each successive physical contact.The problem is most evident in hospital and related medical establishments, aswell as those businessesassociated with preparing and distributing food and food products. Aperson that handles a single contaminated source will spread the contaminantto every person, article and surface touched by that person. The subsequentcontaminated sourcesrepresent additional contamination sites that spread the contaminant. The liability ofcontamination orillness causedby inadequate washing techniques isvery high.And, a single food borne illnesscantarnish a long-standing reputation and wreak financial havoc. Proper washing ofhands has been demonstrated to kill the contaminants andprevent the spread of diseaseand contaminants. Accordingto the Centers for Disease Control, proper handwashing is the single most important processin preventing the spread of the pathogens.Microbial contamination refersto microscopicorganisms, especially any of the bacteriathat cause disease, e.g.: germs. A germ is therudimentary formin which a new organism is developed, and encompasses any microscopic organismand any one of the bacteria that can cause disease.A bacteriumis typically a one-celled microorganism, wherein somecause diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation. Some industries aremuch more sensitive to proper washingtechniques. Restaurants are particularly prone to the dissemination offood-borne contaminants and the U.S.FoodandDrug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address thewashing of hands for foodservice and related personnel.According tothe FoodCode regulations, a person must wash afterusingthebathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready-to-eat foods, and any other activity that potentially contaminates the hands. In addition, the Food Code describes a proper hand washingtechnique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combiningwater and soap and scrubbingthe handsvigorously. There are varioussoaps or cleansingliquidsthatcan be used, preferably having anti-bacterial oranti-microbialproperties. Nails should be cleanedand scrubbed. After scrubbing, the hands shouldbe thoroughlyrinsedwith water. The areas between thefingerand underneath the fingernails should be specifically cleaned and checked. The regulations also require a supervisor ensure compliance withthe regulationsand promote the effectivewashing protocols. Employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. Although there maynot be specific codes governingall industries and circumstance, it is common sense that adherence totheregulations will instill asafer environment for all. And, in alitigious environment, adhering to a strict standard is also a cost-effectiveand practical measure. There are varying internationalstandards for the washingof hands,but in general, the U.S. standard provides a reasonable approach to follow. Unfortunately,the proper washing guidelines arenot regularly andrigorously followed. Many foodservice personnel do not appreciate the significance of proper washing. The restaurants rarely provide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. In addition, the employees at restaurants and diningestablishments tend to be lower paid andmay not careor understand the posted written guidelines, especially if the guidelines are in an unfamiliar language.Presently there is no adequate means of providing proper guidance andinstruction during washing,nosystemdesigned to walk a user through the washing steps,and no simple means of monitoring ortracking employee washing. Contributing to the problem of inadequate washing is the lack of formaleducation by those in the food services segment, the low pay scale, and the periods of rushed foodpreparation. These factors allcontribute to a potentialfor poorwashing conditions. Due tothe manyillnessescausedbyfood preparation, the FDA continues to apply more formal regulationsand guidelines for employers regarding proper washing skills. Employers are demanding a bettersystem of aiding and monitoring employee washing habits. The soapand liquid compounds for hand washing come from a number of differentdispensers availablein the marketplace. Liquid and semi-liquid dispensers areused in numerous applications and are used todispensemetered portions of cremes, lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial cleansing liquids, and similar materials.Atypical dispenser allowsthe user to obtain a specific amount of liquid matter with minimal ease. Manual and semi-automatic dispensing systems are common in the industry, and automated dispensers are beginning to enter the marketplace. Themanual dispensersutilize levers andother mechanical assemblies wherein the usermust providesome physical contact with the unit in order to dispense theliquid. Thephysical contactin manipulating thelever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. Automateddispensers are becoming more popular, and operate with a variety of electricaland electromechanical components toautomatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do notrequire any physical contact withthe dispenser. Unfortunately, the touchless dispensers are fairly expensive and require fairlycomplex electrical and electrical components inorder tofunction. Besides electronic equipment, there are mechanicalcomponents suchas plungersand gear trains that work in conjunction with the electronics. Themechanical gearsdraw substantial energy during the xe2x80x98pinch andsqueezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functionsare broken, theentire unit is disabled and willnot dispense any liquid cleansers.The low reliabilityand the catastrophicfailure mode are a major concern in thetouchlessdispenser market. Within the field of liquid dispensers, there are many types of dispensers. The mostcommon and cost effective is the bag-in-box system, where the liquid comes in a no-leak pouch with pump tip and is disposable. This system is a closed system, andall the air is removed from thepouch during manufacturing. Thebag collapsesupon itself once the liquid is evacuated, minimizing waste disposal.The closedsystem has many advantages, including being a more sanitary system. The standard size pouch is 800 ml, but other sizes are in use, including 500 mlto 900 ml. It is a necessaryrequirement thatthe cost toproduce a disposable pouch be kept toa minimum,while still delivering consistent results. The dispensers are installed in manypublic facilities, and are subject to extreme wear andtear.Due to the excessive use, the devices must be robust and relatively maintenance free. Other dispensers usecartridgesor refillable containers. The cartridges must be pierced, are generally not refillable, andproduce greater waste. Both cartridges and refillable containers introduce air into the system, aiding the production of bacteria and mold. The cost and administrative complexity in usingthese other formsof dispensing liquids, as wellas thedecreased sanitary conditions limit their market appeal. Also, these semi-automatic andautomatic systems can be designed to complete thecycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequentlyoccur. Theliquid soap industry has numerousbrands and categories of cleansingliquids. The viscosity and particulate content are also subject to extremevariations. There isan array of particulate matter that can be added to cleansing liquids toform a grit soap compound thatis more effective in cleaning. Themost common grit material is plastic microspheres, although other materials such asclay, walnut shells and corn cobs have also been used. Besides the variations of compounds used to formgrit soap,the sizeof the grit alsovaries. There has also been a consumer demand for anti-microbial cleansing liquids and anti-bacterial cleansing liquids, and the industry has reactedby adding creating new compounds with these properties. These anti-microbial and anti-bacterial cleansing liquids are available with orwithoutgrit and have certain characteristics and viscosity differences as compared to standard liquid soap. Besides liquid soap, other compounds dispensed includebody and hair shampoo, hand cremesolutions, lotions, cleansing liquids, and shaving creme. In a typical bag-in-box operation, a user depresses a leveror controller. This applies pressureto the dispenser tubethat createsa vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ballcheck valve. If the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. The liquid flows into the space between the spring and the interior wall ofthe ball check valve chamber. Once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle. The transition from a user applying purely mechanical forces to meter out some liquid to a semi-automated orautomated dispensing unit is
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1. _Field_ of the Invention The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with _audio_ _and_ _visual_ output to _assist_ the user in proper washing _techniques_ for compliance with recommended guidelines and to monitor the number of usages. 2. _Background_ Art Each _year,_ _millions_ of reported illnesses and serious infections are _attributable_ to improper hand _washing._ _The_ unreported cases are estimated to be much higher. Food borne illness kills over 10,000 people each year, and 70% of the outbreaks originate in food service sector. _The_ passage of viral and bacterial contaminants result from _physical_ contact with an infected source and are _carried_ _from_ one site to _another_ with each successive physical contact. The problem _is_ most evident in hospital and related medical establishments, as _well_ _as_ those businesses associated with preparing and distributing _food_ and food products. A _person_ that handles a single contaminated source will spread the contaminant to _every_ person, article and _surface_ _touched_ by that person. The subsequent contaminated sources represent _additional_ contamination sites that _spread_ the contaminant. The _liability_ _of_ contamination _or_ _illness_ caused by _inadequate_ washing techniques is very high. And, _a_ single food borne illness can tarnish a long-standing reputation and wreak financial havoc. _Proper_ washing of hands has been demonstrated to kill the contaminants and _prevent_ _the_ spread of disease and _contaminants._ According to the Centers for Disease Control, proper hand washing is the single _most_ important process in preventing the spread of the pathogens. _Microbial_ contamination refers _to_ microscopic organisms, _especially_ any _of_ the bacteria that _cause_ disease, _e.g.:_ germs. A germ is the rudimentary _form_ in which a new organism is developed, _and_ encompasses _any_ microscopic organism and any one _of_ _the_ bacteria that can cause _disease._ A bacterium is typically a one-celled microorganism, wherein _some_ cause diseases _such_ as pneumonia, tuberculosis, _or_ _anthrax_ while other bacteria are necessary for fermentation and nitrogen fixation. _Some_ industries are much more sensitive _to_ proper washing techniques. Restaurants are particularly prone to the dissemination of food-borne _contaminants_ and the U.S. Food _and_ Drug _Administration_ (FDA) has specific guidelines _articulated_ in the Food Code. _The_ Food Code has several sections that address the washing of _hands_ for _food_ service and related personnel. According to the _Food_ _Code_ regulations, a person must wash after _using_ the bathroom, sneezing, _coughing,_ using a disposable tissue, using tobacco, eating or drinking, handling _soiled_ utensils, and _when_ switching from raw foods to ready-to-eat foods, and any other activity that _potentially_ _contaminates_ the hands. In _addition,_ the Food Code describes a proper hand washing _technique_ as lasting at least 20 seconds, washing up to _the_ forearms, _and_ a special emphasis on between the fingers _and_ underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combining water _and_ soap and scrubbing the hands vigorously. There are various soaps or cleansing liquids that can _be_ used, preferably _having_ _anti-bacterial_ or _anti-microbial_ properties. Nails should be cleaned _and_ scrubbed. After _scrubbing,_ the hands should be thoroughly rinsed with water. The areas _between_ _the_ finger and underneath the _fingernails_ should be specifically cleaned and _checked._ The regulations also require a _supervisor_ ensure compliance with the regulations and promote the effective washing protocols. Employers _may_ be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. _Although_ there may not be specific codes governing all industries and circumstance, it is common _sense_ that adherence to _the_ regulations will _instill_ a safer environment for all. And, in a _litigious_ environment, adhering _to_ a _strict_ standard is also a cost-effective and practical measure. There are _varying_ international standards for the washing of hands, but in general, the U.S. standard _provides_ a reasonable approach to follow. Unfortunately, the proper _washing_ guidelines are not regularly _and_ rigorously followed. Many food service personnel do not _appreciate_ the significance of proper washing. The restaurants rarely _provide_ _adequate_ training to the _personnel,_ and seldom _encompass_ sufficient supervision during the work _shifts._ In addition, _the_ employees at restaurants and dining establishments _tend_ to _be_ lower _paid_ and may _not_ care or understand the posted written guidelines, especially _if_ the guidelines are in _an_ unfamiliar _language._ Presently there is no _adequate_ means of providing proper guidance and instruction during washing, _no_ system _designed_ _to_ walk a user through the washing steps, and no _simple_ _means_ of monitoring or tracking employee washing. _Contributing_ to the problem of _inadequate_ _washing_ is the _lack_ of formal education _by_ those in _the_ food services segment, the low _pay_ scale, and _the_ _periods_ _of_ rushed food _preparation._ These factors _all_ contribute _to_ a potential _for_ poor _washing_ _conditions._ Due to the many _illnesses_ _caused_ by food _preparation,_ the FDA _continues_ _to_ apply more formal regulations _and_ guidelines for _employers_ regarding proper washing skills. _Employers_ are demanding a better _system_ of aiding and _monitoring_ employee washing habits. The _soap_ and liquid compounds for hand washing _come_ from _a_ number of _different_ dispensers available _in_ the marketplace. Liquid and semi-liquid dispensers are _used_ in numerous applications and are used to _dispense_ _metered_ _portions_ of cremes, lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial _cleansing_ liquids, and similar _materials._ A typical dispenser allows the _user_ to obtain a specific amount of liquid matter with _minimal_ ease. Manual and semi-automatic dispensing _systems_ _are_ common in the industry, and _automated_ dispensers are beginning to enter the marketplace. The manual dispensers _utilize_ levers and other mechanical assemblies wherein the user _must_ _provide_ some _physical_ contact _with_ the unit _in_ order to dispense the liquid. _The_ physical _contact_ in manipulating _the_ lever does provide a contact with a _surface_ that is typically wet _and_ dirty, and may harbor _contaminants._ _Automated_ dispensers are becoming more popular, _and_ operate with a variety of _electrical_ and electromechanical components to automatically dispense _the_ liquid after triggering some sensory input. _The_ automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser. Unfortunately, the touchless _dispensers_ are fairly expensive _and_ require fairly complex electrical and _electrical_ components in order to function. _Besides_ _electronic_ equipment, there are mechanical components such as plungers and gear trains that work in conjunction with the electronics. The _mechanical_ gears draw _substantial_ energy _during_ the _xe2x80x98pinch_ and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent _battery_ replacement. In addition, if the batteries are _drained,_ the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and _will_ not dispense any liquid cleansers. _The_ _low_ reliability and the catastrophic failure _mode_ are a major concern in the touchless _dispenser_ market. Within _the_ _field_ of liquid dispensers, there are _many_ types of _dispensers._ The most common and cost effective is the _bag-in-box_ _system,_ where the liquid comes in a no-leak pouch _with_ _pump_ tip and is disposable. This system is _a_ closed system, and all the air is removed from the pouch during manufacturing. _The_ bag collapses _upon_ _itself_ once the liquid is evacuated, minimizing waste _disposal._ The closed system _has_ many _advantages,_ _including_ being a _more_ sanitary system. The _standard_ size pouch is 800 ml, _but_ other _sizes_ are _in_ use, including 500 ml to 900 _ml._ It is _a_ necessary requirement _that_ the cost _to_ produce a disposable pouch be kept to _a_ _minimum,_ while still delivering _consistent_ results. The dispensers are installed in many public facilities, and are subject to extreme _wear_ and tear. Due to the _excessive_ use, the devices must _be_ robust _and_ relatively _maintenance_ free. Other dispensers use cartridges or _refillable_ _containers._ The cartridges _must_ be pierced, are generally not refillable, and _produce_ greater waste. Both cartridges and refillable containers introduce air _into_ the system, aiding the _production_ of _bacteria_ and mold. The _cost_ and administrative complexity in using _these_ other forms of dispensing _liquids,_ as _well_ _as_ the decreased _sanitary_ conditions limit their market appeal. Also, these semi-automatic and automatic systems can be designed to complete the _cycle,_ metering exactly the correct amount _of_ liquid, independently of successive and rapid pushes of _the_ actuating member that frequently occur. The liquid soap industry has numerous brands and categories _of_ cleansing liquids. The _viscosity_ and particulate content are also subject to extreme variations. There _is_ an array of particulate matter that can be _added_ _to_ cleansing liquids _to_ form a grit soap compound that is more effective in cleaning. The most _common_ grit material is plastic _microspheres,_ although _other_ materials such as clay, walnut _shells_ _and_ _corn_ cobs have also been used. Besides the variations of _compounds_ _used_ to _form_ grit _soap,_ the _size_ of the grit also varies. There has also been a consumer demand for _anti-microbial_ cleansing liquids _and_ _anti-bacterial_ cleansing liquids, and the _industry_ has _reacted_ _by_ adding creating new compounds with these properties. These _anti-microbial_ and _anti-bacterial_ cleansing _liquids_ are available _with_ _or_ without grit and have certain _characteristics_ and viscosity _differences_ as compared _to_ _standard_ liquid soap. Besides _liquid_ _soap,_ other compounds dispensed _include_ body _and_ _hair_ shampoo, hand creme solutions, lotions, cleansing liquids, and shaving _creme._ In a typical bag-in-box _operation,_ a _user_ depresses a lever or controller. This applies _pressure_ to the _dispenser_ tube that creates _a_ vacuum in _the_ collapsible pouch _that_ exerts fluid pressure against the ball in the ball check valve. If the pressure _is_ sufficient, the ball _is_ displaced, and the liquid _flows_ _around_ _the_ ball and into the ball check valve _chamber._ The _liquid_ flows into the space between _the_ spring and _the_ interior wall of the _ball_ check valve chamber. Once _the_ chamber is sufficiently full, the liquid is forced through the compressed spring _and_ out through the lower fitment _hole_ _and_ through the nozzle. The transition from _a_ user _applying_ purely mechanical forces to meter out some liquid to a semi-automated _or_ _automated_ dispensing unit is
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1. Field of the Invention
The present invention relates to medical instruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section.
2. Prior Art
Endoscopes with passive and active deflection sections are known in the art. U.S. Pat. No. 4,580,551 shows an endoscope with an elongated flexible plastic tube comprising a continuous sequence of connected vertebra-like elements. U.S. Pat. No. 3,162,214 discloses a thin walled tube of elastic material internally supported throughout its length by a series of tubular rigid rings. In one prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a wire sheath along the passive deflection section. The wire sheath comprises a coiled wire to form a flexible tube around each control wire. A problem exists with these coil wire sheaths in that the coil shape can expand during compression. This can result in a loss of deflection at the active deflection section of the endoscope. In another prior art embodiment, stainless steel tubes are used as the sheaths for the control wires. However, these are only used in applications which have a large bend radius. These tubes can kink very easily, have no resilience, and can fatigue and permanently deform thereby shortening the working life of the endoscope.
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1. field of the invention the present invention relates to medical instruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section. 2. prior art endoscopes with passive and active deflection sections are known at the art. u. s. pat. no. 4, 580, 551 shows an endoscope with an elongated flexible plastic tube comprising a repeating sequence of connected vertebra - like elements. u. s. pat. no. 3, 162, 214 discloses a thin walled layer of elastic material internally supported over its length by a series of tubular rigid rings. in one prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a thread sheath along the passive deflection section. this wire sheath comprises a coiled loop to form a flexible tube around each control wire. a problem exists with these coil wire sheaths in that the coil shape can expand during compression. this can result in a loss of deflection at the active deflection section of the section. in another prior art embodiment, stainless steel tubes are used as the sheaths for the control wires. however, these are only useful in applications which have a large bend radius. these tubes can kink very slowly, have no resilience, and can fatigue and permanently deform thereby shortening the working life of the endoscope.
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1. Field of the Inven$ipn The present invention relates to medical instruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section. 2. Prior Art Wgdoscopes with passive and active deflection sections are known in the art. U. S. Pat. No. 4, 580, 551 shows an endoscope with an elongated flexible plastic tube comprising a continuous sequence of cLnn$cted vertebra - like elements. U. S. Pat. No. 3, 162, 214 discloses a HhiG walled tube of elastic material internally supported throuRhiut its length by a series of tubukAr rigid rings. In one prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a wire sheath along the passive deflection section. The wire sheXtg comprises a coiled wire to fo%K a flexible tube around each control A&re. A problem exists with these coil wire sheaths in that the coil shape can expand during compression. This can result in a loss of deflection at the active deflection section of the endoscope. In another prior art embodiment, stainless steel tubes are used as the Whea$hs for the control wires. However, these are only used in applications which have a large bend radius. These tubes can kink very easily, have no resilience, and can fatigue and permanently deform thereby shortening the working life of the endoscope.
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1. Field of the Invention The present invention relates to medical instruments and, more particularly, an endoscope having flexible tubes within a passive deflection section. 2. Prior Art Endoscopes with passive and active deflection sections are in art. U.S. Pat. No. 4,580,551 shows an endoscope with an elongated plastic tube comprising a continuous of connected vertebra-like elements. U.S. No. 3,162,214 discloses thin walled tube of elastic material throughout its length by a of tubular rigid rings. In prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a wire sheath along deflection section. The wire sheath comprises a coiled wire to form a flexible tube around each control wire. A problem exists with these coil wire sheaths in that the during compression. This can result in a loss of deflection at the active deflection section of the endoscope. In another prior art embodiment, stainless steel tubes are as the sheaths for the control wires. However, are only used in applications which have a large bend radius. These tubes kink very easily, no resilience, and can fatigue and permanently deform thereby shortening the working life of the endoscope.
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1. FIelD OF THE inVenTIon
THe prEsENT INVeNtIOn RelAteS To mEDicaL InstRUMENTS and, mOre partICUlARLY, TO An EnDOsCOPe havinG FLExibLE TubEs WithIn A paSsIve dEFLEcTion secTIOn.
2. PRIOR aRT
eNDOscOPES WiTh paSsIVE AND AcTivE dEfLEcTiON SecTiONS Are knoWn in the Art. u.S. PAT. nO. 4,580,551 SHowS aN ENDosCOPE WiTh an ElonGatED fLEXiblE plASTIc TuBe COmPRisInG A CoNtINuouS sEQuEnce OF coNnECTEd veRTeBra-LIkE ElemENTS. U.S. PAT. no. 3,162,214 dIsCLOsES A ThiN WalLEd TubE oF eLaSTiC mateRIAl InTeRnAlly suPPOrTed THrOughouT its length bY a SerIes OF TuBuLar riGId rinGS. iN ONE prior Art EMBodIMENT, ContRoL wIrEs FRoM a DeFLectIOn COntrol TO A Distal tip oF tHE ActiVe DEfLECTIOn Are proVIded wITH a WIRe ShEATH aLONg ThE passive dEFLEctIOn sEcTIon. tHE WirE sHEAtH comprIseS a COIlEd wiRe TO FORm a fLeXibLE tuBe aROUnD eAcH COntroL Wire. A prOBLEM EXIsTs with these coil wiRE SheAThs IN ThaT THE cOiL SHapE Can expaND durInG cOMPrESSiON. thIs cAn RESULt IN A losS of dEfleCtiON at tHE aCtiVe DEFlectIon sEctIon oF The eNDosCOPe. iN AnOTHeR PRIOr Art eMBOdIMENT, staiNLeSS sTEEl tUbEs ARe UsED AS thE sHEaThS fOr tHE COnTROL WIReS. hOwEveR, thesE ArE oNly USed IN APpLICatIOnS WhICh HavE a LaRGE BEnd rADIuS. theSE TUBeS CAN kInk vERy EaSily, hAVE nO reSIliEnce, and Can fAtiguE anD PErMAnENtLY dEFoRm THeREbY SHORTenING ThE WoRkiNG LIFE Of tHE enDOsCOPe.
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1.Field of theInvention The present invention relates to medical instruments and, more particularly, toan endoscopehaving flexible tubes within a passive deflection section.2. Prior Art Endoscopes with passive and active deflection sectionsareknown in the art. U.S. Pat. No. 4,580,551 shows an endoscope with an elongated flexibleplastic tube comprising acontinuous sequenceof connected vertebra-like elements. U.S. Pat. No. 3,162,214discloses a thin walled tube of elastic material internally supported throughout its length bya series of tubular rigidrings. Inoneprior art embodiment, control wiresfroma deflection control to a distal tip of the activedeflection are provided with a wire sheath along the passive deflection section. The wire sheathcomprises a coiled wireto form a flexible tube aroundeach control wire. A problem existswith thesecoil wire sheaths in that the coil shape can expand during compression. Thiscan resultin a loss of deflectionatthe active deflection section of the endoscope. In another prior art embodiment, stainlesssteel tubes are usedas thesheaths for the control wires. However, these are only used in applications whichhave a large bend radius. Thesetubes can kink very easily, have no resilience, and can fatigue andpermanently deform thereby shortening the working life of the endoscope.
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1. Field of the Invention The present invention relates to medical instruments and, more particularly, to an _endoscope_ having flexible tubes within a passive _deflection_ section. 2. Prior Art Endoscopes with _passive_ and active deflection sections _are_ known in the art. U.S. Pat. _No._ 4,580,551 _shows_ an endoscope with _an_ elongated flexible plastic _tube_ _comprising_ a _continuous_ sequence _of_ _connected_ vertebra-like elements. U.S. Pat. No. 3,162,214 discloses a _thin_ walled tube of elastic _material_ internally supported throughout its _length_ by a _series_ of tubular rigid rings. In one _prior_ art embodiment, control wires from a deflection control to a distal tip of the active deflection are _provided_ with a wire _sheath_ _along_ the passive deflection section. The wire sheath comprises _a_ coiled wire _to_ form a _flexible_ tube around each control wire. A problem exists _with_ these coil wire sheaths in that _the_ coil shape can _expand_ during compression. _This_ can result in a loss of deflection at the active deflection section of the _endoscope._ _In_ another prior _art_ embodiment, stainless steel _tubes_ are used as the _sheaths_ for the control wires. However, these are only used in applications which _have_ a large bend _radius._ These tubes can kink very easily, _have_ no _resilience,_ and _can_ fatigue and _permanently_ deform thereby _shortening_ the working life _of_ the endoscope.
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Bridge rectifiers for automotive-type alternators are well known in the art. An example of a bridge rectifier is disclosed in U.S. Pat. No. 4,606,000. Generally, a bridge rectifier comprises two metallic heat sinks that are electrically insulated from a each other. Each heat sink carries a plurality of semiconductor diodes such that the heat sinks form respective positive and negative direct voltage output terminals. The diodes are grouped in pairs and are connected to respective output phase windings of the alternator.
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bridge rectifiers for automotive - type alternators are well known in the art. 1 example of a bridge rectifier is disclosed in u. s. r. no. 4, 606, 000. generally, a bridge rectifier comprises identical metallic heat sinks typically are electrically insulated from a each other. their heat source carries a plurality of semiconductor diodes such that the heat sinks form respective positive and negative direct voltage output terminals. the diodes be grouped in pairs who are connected to respective variable phase windings within the alternator.
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Bridge rectifiers for automotive - type alternators are well kjIwn in the art. An example of a Veidge rectifier is disclosed in U. S. Pat. No. 4, 606, 000. Generally, a brixgR reftifuer ckjprises two metallic heat aiHks that are electrically insulated from a each other. wQch heat eiJk carries a plurality of semiconductor diodes such that the heat sinks form respective positive and negative direct voltage output terminals. The diodes are grouped in pairs and are conHrcted to respective output pMaDe windings of the alternator.
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for automotive-type alternators are in the art. An example of a bridge rectifier is disclosed in U.S. Pat. 4,606,000. Generally, a bridge rectifier comprises two metallic sinks that electrically insulated from a each other. Each heat carries a plurality of semiconductor diodes such that the heat sinks form respective positive and negative direct voltage output terminals. The diodes are grouped in pairs and are connected to respective output phase windings of the alternator.
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BriDGe ReCtiFIErS FoR auTOmotivE-typE AlteRnatOrS are WELL kNOWn In thE art. An exAmPlE of a BRIdgE rECTIFIer iS DiscLOSeD In u.S. PAt. nO. 4,606,000. GeNEraLlY, a briDgE reCtifier CompRises tWo MetaLliC hEAt sINks tHat ArE elecTrIcaLlY InsUlAted fRom a eaCH OTHer. EaCh HeAt SInK CARRies a plurALity OF seMicOnDUctOR DiOdES sUcH tHaT ThE hEaT sInks fORM respECtIve PosITive aNd nEgAtIVe DIrECt VOltAGe ouTPUt TErMinalS. The DiODeS Are groupED In pAirS And aRE ConnEcteD to RESpeCtIVE oUTput phAse wINdiNGs oF thE ALtERnATor.
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Bridge rectifiers for automotive-type alternators are well known in the art. An example of abridge rectifier is disclosed in U.S. Pat.No. 4,606,000. Generally, a bridge rectifier comprises two metallic heat sinks that are electrically insulatedfroma each other. Each heat sink carries a plurality of semiconductor diodes such that the heat sinks form respective positiveand negative direct voltage output terminals. The diodes are grouped inpairs and are connected torespective output phase windings of the alternator.
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Bridge rectifiers for automotive-type _alternators_ are well known in the art. An example of a bridge rectifier is disclosed in U.S. _Pat._ No. 4,606,000. Generally, a bridge _rectifier_ comprises two metallic _heat_ _sinks_ _that_ are electrically insulated _from_ a each other. Each heat sink carries _a_ _plurality_ _of_ semiconductor diodes such that the _heat_ sinks form respective positive _and_ negative direct voltage output _terminals._ _The_ _diodes_ are grouped in pairs and are connected to respective _output_ phase windings of _the_ alternator.
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Plates having compartments are used for holding food Often, a main compartment is designed to hold a main dish whereas the other compartment, or wells, are used to hold sides, condiments, or both. Prior art disposable plates have had various designs or patterns printed thereon, but do not integrate the various compartments into the printed design or pattern.
Additionally, prior art designs or patterns printed on disposable plates focused on a small number of designs. The number of designs per collection in the prior art has been less than the total number of plates packaged together for retail sale. Thus, each retail package of plates includes only a complete collection of designs. The prior art does not address the situation where the number of designs per collection exceeds the total number of plates in a retail package and how to widely disseminate all of the designs in the collection in the market place.
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plates having compartments are used as holding food often, a main compartment is designed to hold a main dish whereas the other compartment, or wells, are used either attach sides, condiments, or both. prior art disposable plates have had various designs or patterns printed thereon, but do not integrate the various compartments into the printed design or pattern. generally, prior art designs or patterns printed on disposable plates focused on a small number of designs. the number of collectors per collection in the prior art has been less than your total number of plates packaged together for retail sale. thus, no retail package of plates includes only a complete collection of designs. the prior art does not address the situation where a number of designs per collection exceeds the total number of plates in a retail package and how producers widely disseminate all of the designs in one collection in the market place.
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Plates having compartments are used for holding food Often, a Jaim compartment is designed to hold a main dish whereas the other compartment, or wells, are used to hold sides, condiments, or both. Prior art disposable plates have had various designs or patterns printed thereon, but do not integrate the varioKE compartments into the printed design or pattern. Additionally, prior art designs or patterns printed on disposable plates focused on a small number of designs. The number of designs per collection in the prior art has been less than the toYql number of plates 0ackQged togwtner for retail sale. TM ts, each retail package of plates includes only a complete collection of designs. The (#ior art does not address the situation where the Humbee of designs per collection exceeds the total number of plates in a retail package and how to widely dJsse,inate all of the designs in the collection in the mz3ket place.
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Plates having compartments are used for food Often, a compartment is designed hold a main dish whereas other compartment, or wells, are used hold sides, condiments, or both. Prior art disposable plates have had various designs or patterns printed thereon, do not integrate the various compartments into the printed design or pattern. Additionally, prior art designs or patterns on plates focused on a number designs. The number of designs per collection in the prior art has been less than the total number plates packaged together retail sale. Thus, each retail package of plates includes only a complete collection designs. The prior art does not address the situation where the number of designs per collection exceeds the total number of plates in a retail package and how to all of the designs in the collection in the market place.
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PlAtES hAVing CoMPArTmEnTs ARe UsED For HOLdInG foOD oFTEN, A MaIN COmpartMEnT iS desIgned To HoLD a mAiN disH WHeREAs tHe OTheR coMPARTment, or weLLs, ARe useD To hOld sIDes, CoNDimeNTS, or BOTH. priOR ART diSPOSaBlE plATeS havE hAd vaRiouS DeSigNS oR PATTERnS PRInTED thEReoN, bUt do nOT inTeGRaTE thE VARIous CompaRTmENtS inTo THe PRiNTed DesiGN or PAtteRN.
adDiTIONAllY, pRIOR arT DESiGns or patTErNS PRiNtED oN DisPoSabLE PlATeS foCUSEd On a sMaLL NUmbER of Designs. tHe nuMbEr OF DESiGns per COllecTiOn in ThE PRioR art hAs bEen LESs than THE totaL NumbeR oF PlaTES pacKagEd TOGETHER FOr rEtaIL sAlE. tHUS, eAcH rETaIl pAckagE of plates INCLUdeS ONlY a COmPleTE coLlEcTION Of dEsiGNs. the PRiOr arT dOes Not aDdReSs THe sitUAtIon wHere ThE NUMbER of DEsiGNS pEr colLecTiON ExCeeDS THE tOTAL NUmber of PLAtEs iN a REtaIL pACKAgE aND hoW To wiDElY DIsseMINate All OF tHE DesIGNs IN tHE cOllECTIon iN tHE mARKEt pLACE.
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Plates having compartments areused for holdingfood Often, a main compartment is designedto hold a main dish whereas the other compartment,or wells, are usedto hold sides,condiments,or both. Prior artdisposableplates have had various designs or patterns printed thereon, but do not integrate the various compartments into the printed design or pattern. Additionally, prior art designs or patterns printed on disposable plates focused ona small number ofdesigns. The number of designs per collection in the prior art has been less than the total number of platespackagedtogether for retail sale. Thus, each retail package of plates includes onlya complete collection of designs. The priorart does not address the situation where the number of designs per collection exceeds the total number of plates in a retail package and howto widely disseminate all ofthedesigns in the collection in the market place.
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Plates having compartments are used _for_ holding food Often, _a_ main _compartment_ is designed to _hold_ a main dish whereas the other _compartment,_ or _wells,_ _are_ used _to_ _hold_ sides, condiments, or both. Prior art disposable _plates_ have had various designs or _patterns_ printed thereon, but do not integrate the various compartments into _the_ printed design or pattern. Additionally, prior _art_ _designs_ or patterns printed on _disposable_ _plates_ focused on a small number of designs. The _number_ of _designs_ per collection in _the_ prior _art_ has _been_ less _than_ the total number of plates packaged _together_ for retail _sale._ Thus, each retail package of plates includes _only_ a complete collection _of_ designs. The _prior_ _art_ does not address the situation _where_ _the_ number of _designs_ per collection exceeds the total number of plates _in_ a retail _package_ and _how_ to widely _disseminate_ all _of_ the designs in the collection in the _market_ place.
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This invention relates to a surgical closure that can be repeatedly opened and closed, especially for the abdominal wall. More particularly the invention relates to a surgical closure having fabric of plate-like securing elements that can be tightly but detachably connected to the body tissue and has a closure which can be repeatedly opened and closed.
Such a surgical closure is known, for example, from German Patent 34 44 782. This surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis.
Peritonitis, as a secondary form that develops as a result of a perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem.
The abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly by small openings in the peritoneal diaphragm underside. In this way, bacteria are fed by the lymph tracts to the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin-induced adhesions. The defense system is disrupted and a rise in bacterial counts, or their toxins and fibrin, results. If the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped.
To cleanse the abdominal cavity, washing with physiological saline solution is already done during the operation until the wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed as completely as possible, to provide, along with surgical removal of septic focus, an optimal condition for healing.
In the postoperative phase, in which the fate of the patient is mainly determined, it is decisive to recognize a worsening of the condition as early as possible, and optionally, to remove the cause (e.g., correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean (blood that reappears, fibrin and bacteria are to be rinsed away).
In postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with a closed abdomen are known.
This so-called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, with the advantages that repeated intra-abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. In doing so, postoperative, intra-abdominal adhesions can be detached and coatings of fibrin can be removed. The typical drainage complications are eliminated. (Plugging of drainage for the abdominal wall, blockage or obstruction of drainages, infection sources.) A relaparotomy is no longer necessary.
Here, the drawback is that right after the operation, washing cannot be performed and no continuous washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in critical condition. Periodic washing must be prepared carefully; it is performed in the operating room (the abdomen is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. The wash effect remains limited, since a desired intra-abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominal wall, part of the wash fluid oozes into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. Patients with an open abdomen belong, at that time, to the most care-intensive patients. If a so-called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and infolded, adaptation to the tension conditions of the abdominal wall is no longer possible. But, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out. On the other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. Further, the typical complications of snap closures must be taken into account (constriction, tenaculum). There is no particular edge structure to infold into the fascia, so that only the individual sutures provide support. They are often not secure and tear out easily.
Continuous peritoneal lavage with a closed abdomen offers the advantage that an effective washing treatment can be started immediately after the operation, and thus, the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning only right at the spot where it lays. Further, it easily becomes clogged and misleads to the assumption that the incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly with antibiotic added) also reaches the critical "atmospheric corners" of the abdomen. But not only are wash channels created, as when seepage through without pressure occurs. Fewer fibrin-induced adhesions are formed, since the abdomen contents "swim" and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis).
Peritoneal dialysis is possible. With it, an increase in the retention values (creatine, urea, potassium) with a threat of renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The patient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood volume. Washing can be taken over by a machine according to a desired program; thus, clear relief for the nursing personnel is possible. A chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. A judgment of the efflux can conceivably be performed simply by inspection (cloudiness, fibrin or blood admixtures). Wash fluid sensors to determine the resistance of bacteria can be removed by the catheter at any time, just as other substances can be administered (e.g., electrolytes, protein, heparin). The drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. Packing and infection source of the drainage passage points, as well as clogging or obstruction of the drainages represent typical complications. If the abdomen must be accessed again, a relaparotomy must be performed.
Despite promising starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate.
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another invention relates to a surgical closure that can be repeatedly opened and closed, especially for the abdominal wall. more particularly the invention relates to a surgical closure having combinations of plate - like securing elements that can be tightly but detachably connected to the body tissue and has a closure which can be repeatedly opened and closed. such unusual surgical closure is known, for example, by german patent 34 44 782. this surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis. peritonitis, as a secondary form that develops as a result of excessive perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. with increasing incidence, it represents a central surgical problem. the abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly by small openings in the peritoneal diaphragm underside. in this way, bacteria are fed by the lymph tracts to the systemic defense mechanism. the absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and ambient pressure. during peritonitis, this drainage is accelerated by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin - induced adhesions. the defense system is disrupted and a rise in bacterial counts, or their toxins and fibrin, results. if the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped. to cleanse the abdominal cavity, washing with physiological saline solution is already done during the operation until the wash fluid stays clear. with this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood ( even hemoglobin promotes the start of an infection ) are to be removed nearly completely as possible, to provide, along with surgical removal of septic focus, an optimal condition for healing. in the postoperative phase, in which the course of the patient is mainly determined, it is decisive to recognize a worsening of the condition as early as possible, and optionally, to remove the cause ( e. g., correction of an inadequate suture by oversewing a gastric ulcer ) and, by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean ( blood that reappears, fibrin and bacteria are to be rinsed away ). in postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with a closed abdomen are known. this so - called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, with the advantages that repeated intra - abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. in doing so, postoperative, intra - abdominal adhesions can be detached and coatings of fibrin can be removed. the typical drainage complications are eliminated. ( plugging of drainage for the abdominal wall, blockage or obstruction of drainages, infection sources. ) a relaparotomy is no longer necessary. here, the drawback is that right after the operation, washing cannot be performed and no continuous washing is possible. but then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in critical condition. periodic washing must be prepared carefully ; it is performed in the operating room ( the abdomen is open during washing ) and under general anesthesia. the advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. the wash effect remains limited, since a desired intra - abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. further, after the temporary closure of the abdominal wall, part of the wash fluid oozes into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. patients with an open abdomen belong, at that time, to the most care - intensive patients. if a so - called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. once cut and infolded, adaptation to the tension conditions of the abdominal wall is no longer possible. but, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out. on the other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. further, the typical complications of snap closures must be taken into account ( constriction, tenaculum ). there is no particular edge structure to infold into the fascia, so that only the individual sutures provide support. they are often not secure and tear out easily. continuous peritoneal lavage with a closed abdomen offers the advantage that an effective washing treatment can be started immediately after the operation, and thus, the purpose of the usual redon suction drainage can be replaced considerably more effectively. the latter has a weak suction capacity, suctioning only right at the spot where it lays. further, it easily becomes clogged and misleads to the assumption that the incision area has already been suctioned empty. with the sealed system, an intraperitoneal pressure can be built up and dosed. in doing so, the wash fluid ( possibly with antibiotic added ) also reaches the critical " atmospheric corners " of the abdomen. but not only are wash channels created, as when seepage through without pressure occurs. fewer fibrin - induced adhesions are formed, since the abdomen contents " swim " and fibrin ( among other things ) is effectively washed out ( thus, simultaneous ileus prophylaxis ). peritoneal dialysis is possible. with it, an increase in the retention values ( creatine, urea, potassium ) with a threat of renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. the patient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. the associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood volume. washing can be taken over by a machine according to a desired program ; thus, clear relief for the nursing personnel is possible. a chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. a judgment of the efflux can conceivably be performed simply by inspection ( cloudiness, fibrin or blood admixtures ). wash fluid sensors to determine the resistance of bacteria can be removed by the catheter at any time, just as other substances can be administered ( e. g., electrolytes, protein, heparin ). the drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. packing and infection source of the drainage passage points, as well as clogging or obstruction of the drainages represent typical complications. if the abdomen must be accessed again, a relaparotomy must be performed. despite promising starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate.
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This invention relates to a surgical closure that can be repeatedly opened and closed, especially for the abdominal wall. More particularly the invention relates to a surgical closure having fabric of plate - like securing elements that can be tightly but detachably connected to the body tissue and has a closure which can be repeatedly opened and closed. Such a surgical closure is known, for example, from German Patent 34 44 782. This surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis. Peritonitis, as a secondary form that develops as a result of a perforation of a hollow organ or as a postoperative comlPication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem. The abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly by small openings in the peritoneal diaphragm underside. In this way, bacteria are fed by the lymph tracts to the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin - induced adhesions. The defense system is disrupted and a rise in bacterial counts, or their toxijD and fibrin, results. If the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped. To cleanse the abdominal cavity, washing with physiological saline solution is already doG# during the operation until the wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed as completely as possible, to provide, along with surgical removal of septic focus, an optimal condition for healing. In the postoperative phase, in which the fate of the patient is mainly determined, it is decisive to recognize a worsening of the condition as early as possible, and optionally, to remove the cause (e. g. , correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean (blood that rewLpears, fibrin and bacteria are to be rinsed away ). In postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with a closed abdomen are known. This so - called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, with the advantages that repeated intra - abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. In doing so, postoperative, intra - abdominal adhesions can be detached and coatings of fibrin can be r2mov$d. The typical drainage complications are eliminated. (Plugging of drainage for the abdominal wall, blockage or obstruction of drainages, infection sources.) A relaparotomy is no longer necessary. Here, the drawback is that right after the operation, washing cannot be performed and no continuous washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in critical condition. Perkoeic washing must be prepared carefully; it is performed in the operating room (the abdomen is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. The wash effect remains limited, since a desired intra - abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominal wall, part of the wash fluid oozes into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. Patients with an open abdomen belong, at that time, to the most care - intensive patients. If a so - called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and infolded, adaptation to the tension conditions of the abdominal wall is no longer possible. But, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out. On the other hXnx, the edges of the incision must be brought together again graSualPy to the final suture of the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. Further, the typical complications of snap closures must be taken into account (constriction, tenaculum ). There is no particular edge structure to infold into the fascia, so that only the individual sutures provide support. They are often not secure and tear out easily. Continuous peritoneal lavage with a closed abdomen offers the advantage that an effective washing treatment can be started immediately after the operation, and thus, the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning only right at the spot where it lays. Further, it easily becomes clogged and misleads to the assumption that the incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly with antibiotic added) also reachSX the critical " atmospheric corners " of the abdomen. But not only are wash channels created, as when seepage through without pressure occurs. Fewer fibrin - induced adhesions are formed, since the abdomen contents " swim " and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis ). Peritoneal dialysis is possible. With it, an increase in the retention values (creatine, urea, potassium) with a threat of renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The patient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood volume. Washing can be taken over by a machine according to a desired program; thus, clear relief for the nursing personnel is possible. A chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. A judgment of the efflux can conceivably be performed simply by inspection (cloudiness, fibrin or blood admixtures ). Wash fluid sensors to determine the resistance of bacteria can be removed by the catheter at any time, just as other substances can be administered (e. g. , electrolytes, protein, heparin ). The drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. PaFkiBg and infection source of the drainage passage points, as well as clogging or obstruction of the drainages represent typical complications. If the abdomen must be accessed again, a relaparotomy must be performed. Despite promising starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate.
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This invention relates to a closure that can be repeatedly opened closed, especially for the abdominal wall. particularly invention relates to a surgical closure having of securing elements that can be but detachably connected to the body tissue and has a closure which can be repeatedly opened and closed. Such a surgical closure is known, for from German Patent 34 44 782. This surgical closure is especially as a temporary for the abdominal cavity, for postoperative of peritonitis. as a secondary form that develops as a result a perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem. The cavity is subject to a physiological, regulated fluid stream mainly by small openings in the diaphragm underside. In this way, bacteria are by the lymph tracts to the systemic defense mechanism. capacity of the intraperitoneal fluid is increased by mobility of the diaphragm and intraperitoneal pressure. peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria circulation is hindered by fibrin-induced adhesions. The defense system is disrupted and a rise in bacterial counts, or their toxins and fibrin, results. the progression of peritonitis is stopped promptly, cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped. To cleanse the abdominal cavity, washing with physiological saline solution is already done during the until the wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed as completely possible, to provide, along with surgical removal of septic focus, an optimal condition for healing. In the postoperative in which fate of the patient is mainly determined, it is to recognize a worsening the as early as possible, optionally, to remove the cause correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if from the first postoperative day forward, to make sure conditions are clean (blood that reappears, fibrin bacteria are to be rinsed away). In postoperative lavage, strategy the open abdomen with periodic washing and the wash treatment with a closed abdomen are This so-called open abdomen is made possible the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, the advantages that repeated intra-abdominal accessibility is guaranteed and the technician, during washing, be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. In doing so, postoperative, intra-abdominal adhesions can be detached and coatings of fibrin can be removed. The typical drainage complications are eliminated. (Plugging of drainage abdominal blockage or obstruction drainages, sources.) A relaparotomy is no necessary. Here, drawback is that right after the operation, washing cannot be performed and no washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in condition. Periodic washing must be prepared it is performed in the operating room (the abdomen is open during washing) under general The advantages of the principle of peritoneal dialysis must be done without, previous temporary abdominal cavity do not close the tightly. The wash effect remains limited, a intra-abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. after the temporary closure of the abdominal wall, part of wash fluid oozes into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable for the staff. Patients with open abdomen belong, at that to the most care-intensive patients. If a so-called snap closure or sliding splint as a temporary abdominal cavity closure, is infolded, another comes to bear. Once cut and adaptation to the tension conditions of the abdominal wall is no longer possible. But, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, the danger that the sutures tear On the other hand, edges of the incision be brought together again gradually to the final suture the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. the complications of snap closures must be taken into (constriction, tenaculum). There is no particular edge structure into the fascia, so that only the individual sutures provide They are often not secure and tear out easily. Continuous peritoneal lavage with a closed abdomen offers the advantage that an washing treatment can be started immediately after the operation, and thus, purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning right at the spot where it Further, it easily becomes clogged and misleads to assumption that the area already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly antibiotic added) also reaches the critical "atmospheric corners" of the abdomen. not only are wash channels created, as when seepage through without pressure Fewer fibrin-induced adhesions are formed, since the abdomen contents "swim" and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis). Peritoneal dialysis is possible. With it, increase in the retention values (creatine, urea, potassium) with a threat renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The easily be without having be into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they sometimes occur during the handling of blood volume. Washing can be taken over by a machine according to a desired program; thus, clear relief for the nursing personnel is possible. chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. A judgment of the efflux can conceivably be performed by inspection (cloudiness, Wash to determine the resistance of bacteria can be by the catheter at any time, as other substances can be administered (e.g., electrolytes, protein, heparin). The drawback here is that is no longer accessible and thus no direct visual exists any more, which is important, when the efflux pathologically or the clinical of the patient worsens. and of the drainage passage points, as well as clogging or obstruction of the drainages represent typical complications. If the abdomen must be accessed again, a relaparotomy be performed. Despite promising starts, the strategy of the closed abdomen has not able to be used in practice, since the drawbacks predominate.
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ThIs invENtiOn rElATEs To A suRGICal cLOsuRe THaT CAN be repEAteDLy OpeNeD anD CLOSeD, EspEcIallY fOr thE ABDominal wALL. More pARtiCULaRLy thE iNveNTioN ReLaTEs tO a SurgIcAL cLoSure hAvING fABRIC OF pLATE-LiKE sEcUrIng elEmenTs THAT CAn bE tIgHTLY buT DeTaChABly CONnectED To THe body tISsuE And HaS a ClOSUrE whiCh CAN be REpeAtEDlY opeNed anD CloSEd.
SuCh A SURgiCAl CLOSURE iS kNown, fOR eXaMplE, FROm GermAN PaTEnT 34 44 782. THis sUrgiCal closUre iS UsEd eSpecIaLLy AS a TEMPorARY CLosURe FOR tHE ABdOMInaL CaViTY, prefErabLy fOR poSTopErATIvE tREATMEnT OF PerItonItIS.
PeritoNitis, As a SeCONDaRy FOrM tHaT dEvELoPs AS A resULt Of A peRForatION oF A HoLlOw ORgAN OR As a poSToPeRatiVE CoMpLication, stiLL HAS, EVEN todAY, a hIgH lEthALity. WIth inCrEASiNG iNCIdEnCe, It REPReSeNts A CenTRAL SUrGIcaL prObLeM.
thE ABDOmINAL caVItY Is subJECt TO A PhysiOLOgicaL, rEGuLAted fluiD STReAm THaT drainS mAinLY bY sMAlL OPENiNgS in The PerItOneal diAPhRAgm uNdErSide. IN THIS waY, BACteRiA aRE fEd bY THe LYMpH TrAcTS TO tHe SYstEMIC DEFENSE mEChAnISm. tHE aBsoRpTIOn cApaCIty Of tHe IntrapeRIToneaL fluiD Is INcreasED BY tHE MObilItY oF tHE diaphrAGM ANd IntrapErITOnEaL PReSSUrE. DuRIng peRiTONiTiS, tHIs DRaINagE is BLoCkEd BY tHE PatHOPHYsioLogICaL DeVeLopMenT Of FIBrin ANd bACTerIa And ciRCuLatIon iS HiNdeREd bY fiBriN-INdUcEd aDhESIonS. tHe deFenSe systeM Is DISRUpTed AND a riSe iN bACTeriAL cOuntS, OR ThEir ToxiNs And FibRin, ResUltS. iF THE PRogReSSIon OF PErItONItis iS Not StOpPED PRoMPTlY, A pAthopHysioLOGICal CaSCaDE gEtS stArtEd WHOse dYNaMIcs cONstAnTLy GRoW aNd, aFtER A cErtAin POINT, cAN No LONgeR be SToPpeD.
TO ClEAnSE THE abdOmiNal CavIty, WaShiNg WiTh pHysIologIcAl SaLine SOLuTioN IS ALREAdY doNe DUring tHe OpeRATION uNtil ThE wAsh fluID StAyS clEAr. wiTH tHiS MEchanIcAl ClEanSiNg, BACTErial cOunTS, FIBrIN, Dead tiSsUE, ToXiNs AND ALsO reSiDuaL Blood (even HEMOgloBIn proMotes The StART Of an inFEcTIoN) are to BE ReMOvED aS complEtElY as pOsSiBLe, To providE, ALOng WITH sUrGICal remOvAL of SePtIC fOCus, an oPtimAl CoNDITion FoR hEaLINg.
IN The pOStopERaTIvE PhaSE, in WHIch ThE Fate Of the PATIENt iS mainlY detErmINEd, it IS DecISive To rEcOgnizE A WORSeNinG oF the condITiON As eArLY As POSSIBLE, aNd oPTIoNalLY, TO REmove The CAuSE (e.g., COrRECtioN Of An INADeqUAtE sUtURE aFter oVeRsEWInG A GASTRiC ulCEr) and, bY eFFECtIve LAVAGe, iF POSSIbLe fRoM ThE fiRST pOstOPEraTIvE dAy fOrWaRd, To MAke sURe CoNditIONS ARe cLeAN (BLooD thaT REapPeARS, fiBrIN and BACTerIA ARe To BE RInsed away).
IN PosTopErAtIvE laVAge, tHE strAtegY oF THE oPEN ABDOMeN WITH peRiODiC WAshiNG aNd tHe wash TReatmENt WitH A cloSED ABDOMEn ARE KNown.
this sO-CALled OPen ABdoMeN iS mADE PoSSiBlE By THE slIdiNG SPlinT CLoSuRE anD bY tHe Snap CLosURE AS A temporaRY CloSuRE FOR ThE ABdOMinaL caVIty, wIth THe ADvANtages tHAt rePEATEd INtra-ABDOMINaL AccESSIbIlity Is GUARaNTeED And THe TecHNICian, DUrINg eaCH WAsHING, CAN bE cONViNCEd oF tHE SUcCeSs Of tHe ReMoval Of SEPTic foCuS, AND THUS, Can conTROL THe cOUrse Of peritoNItis. in dOINg SO, poStoPEraTiVe, iNTRA-abdoMINAl aDhESIOns cAN be dETAChed ANd cOatiNgs Of fIBrIN caN Be remOveD. THe tyPIcAl DRaiNage ComPliCaTiONS ArE eLiMiNaTED. (PlUggINg of dRAiNage For THE abDOMInal Wall, BLockaGE Or ObSTrucTion of DRAINAgeS, INFECtIon SOurces.) a rElaPARotOmy IS NO LonGEr nEcEssARY.
HERe, the dRAwbaCK is thaT RigHT afTer the OpErAtION, WAshIng CaNnOt bE peRFoRMEd AND no continuouS WasHiNG Is pOSsIble. bUt THEn, PerIOdiC WaSHInG is RelatIVELy FrEqUeNt ANd alSO A BuRdEn For ThE PAtieNt, wHen thE paTIEnT iS IN criticAl CoNdITioN. PeRIOdIC WaSHing muST Be pREpArEd caRefUlly; it iS pErfORMEd IN THE oPEratiNG ROOm (ThE aBDomEN iS open dUriNg washInG) AnD UnDER GEnErAl AnEStHesia. tHe ADvANtaGEs Of ThE PrIncIPLe of pERitOneaL dIalYSIs muST Be dOnE WIthOut, SiNcE pREVIOUs tEmpORARy ABDomInaL cAviTy clOsuRES dO NoT ClOse the aBDoMEN tIghTly. ThE WasH effeCT rEMains LImITED, Since A deSirEd intRa-AbDoMInAL pReSsuRE iS nOT MainTAiNed, AND tHe wAsH fLuID FLOwS, prEfERABly, only In pRefOrmEd WASH CHaNNElS. FuRtheR, AFTer The TemPoRArY ClosuRe OF The aBdoMInaL WAlL, PaRT Of The WAsH flUId oOzes InTo THE Bed whiCh, iN AdDITioN to bEINg AnotHeR SourcE OF INFectioN, mEANs iNEffectIvE wAShING, addITIONAL burDeN for the PaTIEnT, And ConsIdERablE aDdItioNal exPeNse FoR ThE NurSiNg sTaFF. pATieNTS With aN oPEN abDoMEn BeLONG, at THAt TiMe, To tHE MosT CaRe-inTeNSIVe paTIENts. if A SO-CAllEd sNAp closURe OR slIding sPlINt cloSUre, aS A tEmporARy abDomINaL cAviTy CLosURE, IS infOLDED, anoThEr dRaWbAcK COmeS to beaR. onCE cuT aNd INFolDED, ADapTation To the TensIOn CoNditiONs of THe aBdoMINal wALL iS No lONGER poSSIBlE. bUT, BeCause Of edemATouS swElLing oF innEr OrgaNs DuriNg THe COurse oF PEritoNitIs, tHe teNSion Of the aBDoMinAl WaLL CAn INCReAsE CONSidERABLy, with the daNgEr ThaT The SUTuReS teAr oUt. oN thE oTher HANd, thE edgeS oF ThE INcisiON mUSt be BrOuGHt tOgEThEr agaIN GradUalLY to the Final SuturE oF tHe ABDoMInal Wall laTer, DURing THE heaLIng pHase in Which thE swELlING oF tHe inNer ORgaNs deCrEAsEs. Further, THE typICaL COMpLiCaTIOnS Of sNAp closUReS muSt Be TAKEN INTo ACcOuNt (consTriction, TenAcUlUm). ThERe iS No PARtiCulAr edGe sTrUCtuRE To inFOld Into the faScIA, so tHAT oNly the inDIvIdUaL suturEs PrOvide SUppOrt. thEy are OfTEn nOt SECure AND teAR OUt eAsIlY.
conTINuoUs PErItoNEal LAvAGE wIth a cloSED aBDOMEn OffERs thE aDvAntaGE THat An eFfECtiVE WaShIng tREATmeNT can BE sTArTED ImmEDiAtely AfteR tHe OpeRATIoN, AnD thuS, the PUrpOSe Of the USUAl rEdon SUctION DRAinaGe CAn Be rePLACED COnsidErabLY mORe effeCtIVelY. tHE lAtteR haS A wEak SucTioN CapACIty, sUcTionIng ONLY RIght At tHE sPot wHere IT LayS. FUrtheR, it EASIlY BecOmEs ClOGgED AnD miSlEaDs TO thE aSsUMpTiOn THat tHe InciSIoN arEA hAs aLREADy beeN SUcTIOnEd empty. wITh ThE seALeD SyStem, An intRAPEriTONeaL PRESsUre cAN Be buiLt up And dosed. In doING so, The wAsh fLuid (POSSibLy wITh antiBIoTIC AdDEd) ALSO rEACHEs the cRITIcal "atmospheRIC CorneRS" oF THE ABDOmeN. BUt NOt onLy ARe WaSh cHaNNELs cREaTed, AS WHeN seePAgE thrOUGH WITHOUt PReSsURe ocCuRS. feWER fiBRIN-INducEd aDhesIonS are foRmeD, sINce the aBDomeN COnTenTS "sWIM" aNd FIBrIN (AMoNG oTHEr ThIngs) IS EfFECTiveLy waSHEd oUT (THUS, SimULtaneOUs ILeUs pRophyLaxiS).
PEritoNeAL diALysis iS POSSIbLe. WiTH it, aN INcreAsE IN tHe rEtEnTIOn VAlUeS (CReatine, urEa, pOtassIum) WITH a tHREAt OF rENaL failUre Can ConCeiVaBlY bE haLtEd sIMplY BY USINg A CommERCIally avAIlAblE DIALYsIs fLuId As THE waSH FlUID. ThE PaTiENt CaN eAsILY be dIaLYzEd, wiTHoUT HAViNg TO bE puT INtO the ExpeNSIVe pRogRAM OF hemoDialysIS. THe aSSOCIATED DRAwBacks ARE ALsO eLiMiNAtED, As they cAN SomETImES oCcUR DURING tHe hAnDLINg oF BLoOd VoLuME. wasHINg CAN be TAKEN oVeR BY a MAcHinE ACcorDinG tO a dEsIREd PrOGRaM; ThuS, cleAR ReliEF foR thE NURsInG PERsOnNeL iS PoSsible. a ChAMbEr COuNt oF tHE lEuKOCYtES iN ThE wash fLUid MAKeS IT POSsIbLe TO MOnITOR SiMply The rEspONSe of tHe PerItONitiS. A juDGmENT oF the eFfLux Can COnCeIVablY Be pERfoRmEd SImPlY by InSpECtIon (cLOudINESS, FIBRin OR BlooD ADmiXtURes). waSH FLuID sEnSORS tO DETeRMinE THe resISTancE oF BActERia CaN bE remOVeD By ThE CaThetEr At ANy tImE, JuSt as OtHeR sUbstAncES CAn Be ADmIniStEREd (E.g., eLeCtrOLytEs, PRoTein, hePArin). THE dRAWbAcK HEre is That The AbDoMeN is no lOngeR aCceSsiblE anD tHUS no DiRect vIsuAl MoNitorInG eXIsTs AnY MOrE, WHICh iS IMpORtant, wHen THe EfFLUx cHangEs pAtHOlogiCalLY oR ThE clINiCAl ConDITIOn Of thE pAtienT woRSenS. pAcking aND InFection sOUrCE of The DrAiNAGE PAssagE PoiNtS, as wEll as cloggING or ObstrUCTIoN OF The DrAiNaGes rePrESEnT typICAl CompLIcatiONs. iF tHe aBDOmEN MUst bE aCCeSseD again, a rElAparOtOMY muST bE PERfORMeD.
dEsPite pROmisING staRTS, THE sTRatEGY of ThE cLoseD ABdOmEn hAs NOt beEn ablE tO be uSed In PRActicE, sinCe the DRawBACks pRedomINate.
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This invention relates toa surgical closure that can be repeatedly opened and closed,especially for the abdominal wall. More particularly the invention relates to a surgical closurehaving fabric of plate-like securing elements that can be tightly but detachably connectedtothe body tissue and has a closure which can berepeatedly opened and closed. Such a surgical closure is known, for example, from German Patent 34 44 782.This surgical closure isused especially asa temporaryclosure forthe abdominalcavity, preferably forpostoperativetreatment of peritonitis. Peritonitis, as a secondary formthatdevelops as a result of a perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem. The abdominal cavity is subject to a physiological, regulated fluid stream that drains mainlyby small openings intheperitonealdiaphragm underside. In this way, bacteria are fed by thelymph tracts to the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainageisblocked by thepathophysiological developmentof fibrin and bacteria and circulation is hindered by fibrin-induced adhesions. The defense systemis disrupted and a rise in bacterial counts,ortheirtoxins and fibrin, results. If the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamicsconstantly grow and, after a certain point, can no longer be stopped. To cleanse the abdominalcavity,washing with physiological saline solution is already doneduring the operation until the wash fluid stays clear.With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed ascompletely as possible, to provide, along with surgicalremoval of septic focus, an optimal condition for healing.In the postoperative phase,in which the fate ofthe patient is mainly determined, it is decisive to recognizeaworsening of the condition as early aspossible, and optionally, to remove the cause (e.g., correction of an inadequate sutureafter oversewing agastric ulcer)and,by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean (blood that reappears, fibrinand bacteriaareto be rinsed away). In postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with a closed abdomenare known. This so-called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity,with the advantages that repeated intra-abdominal accessibility isguaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus,can control the course of peritonitis. In doing so, postoperative, intra-abdominal adhesions can be detached and coatingsof fibrin canbe removed. The typical drainage complications are eliminated. (Plugging of drainage for theabdominal wall, blockage orobstruction of drainages, infection sources.) A relaparotomy is no longer necessary. Here, the drawback is thatright after the operation, washing cannot be performed and no continuous washing is possible. But then,periodic washing is relatively frequentand also a burden for the patient, whenthe patient is in critical condition. Periodic washing must be prepared carefully; it is performed in the operating room (theabdomen is openduringwashing) andunder general anesthesia. The advantages of the principleof peritoneal dialysis must be donewithout, sinceprevious temporary abdominal cavity closures do not close the abdomen tightly. The wash effect remains limited,since a desired intra-abdominal pressure is not maintained, and thewash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominal wall, part ofthe wash fluid oozes into the bed which, in addition to being another sourceof infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. Patients with anopen abdomen belong, at thattime, to themostcare-intensive patients. If aso-called snap closure or sliding splint closure, as a temporary abdominal cavityclosure, is infolded, another drawback comes to bear. Once cut and infolded, adaptation to the tension conditions of theabdominal wall is no longer possible. But, becauseof edematous swelling of inner organs during the course of peritonitis,the tension of theabdominal wall can increase considerably, with the dangerthat the suturestear out.Onthe other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal walllater, during the healing phase in which the swelling of the inner organs decreases.Further, the typical complications of snapclosures mustbe taken into account (constriction, tenaculum). There is no particular edge structure toinfoldintothe fascia, so that only the individual sutures provide support. They areoften not secure and tearout easily. Continuous peritoneal lavage with a closed abdomen offers the advantagethat an effective washing treatment can be startedimmediately after the operation, and thus,the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioningonly right at the spot where it lays. Further, it easily becomes clogged and misleadsto the assumption that the incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built upand dosed. In doing so, thewash fluid (possibly with antibiotic added) also reaches the critical "atmospheric corners" of the abdomen. But not only are wash channels created,as when seepagethrough without pressure occurs. Fewer fibrin-induced adhesions are formed, since the abdomen contents "swim" and fibrin (among other things) is effectivelywashed out (thus, simultaneous ileus prophylaxis). Peritoneal dialysis is possible. With it, an increase inthe retention values (creatine, urea, potassium) with a threat of renal failure can conceivably behalted simply by using a commerciallyavailabledialysis fluid as thewash fluid. Thepatient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacks arealsoeliminated, as they can sometimes occur during the handling of blood volume. Washingcan be taken over by amachine according to a desired program; thus, clearrelief for the nursing personnelis possible. A chamber count of the leukocytes in the washfluid makes it possible to monitor simply the response of the peritonitis.A judgment of the efflux canconceivably be performed simply by inspection(cloudiness,fibrin or bloodadmixtures).Wash fluid sensorsto determinethe resistance of bacteria can be removed by the catheter atany time, just as other substances can be administered (e.g., electrolytes, protein, heparin). Thedrawback here is that theabdomen is no longer accessibleand thus nodirect visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. Packing and infection source of the drainage passagepoints, as well as clogging orobstruction of the drainages representtypical complications.If the abdomen must be accessed again, a relaparotomy must be performed. Despite promising starts, the strategy of the closed abdomen hasnot been abletobe used in practice, since the drawbackspredominate.
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This invention relates to a surgical closure that can _be_ repeatedly _opened_ and closed, especially _for_ the abdominal wall. More particularly the invention relates _to_ a surgical _closure_ having fabric of plate-like securing _elements_ that _can_ _be_ _tightly_ but detachably connected to _the_ _body_ _tissue_ and has a closure which can be repeatedly _opened_ and closed. _Such_ _a_ _surgical_ _closure_ is known, for _example,_ from German Patent 34 44 782. This surgical closure _is_ used especially _as_ a temporary closure _for_ _the_ _abdominal_ cavity, preferably for _postoperative_ treatment of peritonitis. Peritonitis, _as_ a secondary form that develops as a result of _a_ perforation of _a_ _hollow_ organ or as a _postoperative_ complication, _still_ has, even today, _a_ high lethality. With increasing incidence, _it_ represents a _central_ surgical problem. The abdominal cavity is subject to _a_ physiological, _regulated_ fluid stream that drains mainly by small openings in the peritoneal _diaphragm_ _underside._ In this way, bacteria are fed by the lymph tracts to the systemic _defense_ _mechanism._ The absorption capacity of the intraperitoneal fluid is _increased_ by _the_ mobility of _the_ diaphragm and intraperitoneal pressure. During peritonitis, _this_ drainage is blocked by _the_ _pathophysiological_ development _of_ fibrin and bacteria and circulation _is_ hindered by fibrin-induced adhesions. _The_ defense system _is_ disrupted and a rise in bacterial counts, _or_ _their_ toxins and fibrin, results. If the progression of peritonitis is not stopped _promptly,_ a pathophysiological cascade gets started whose dynamics constantly grow and, _after_ a _certain_ point, _can_ no longer _be_ stopped. To cleanse _the_ abdominal cavity, _washing_ with physiological saline _solution_ is already done during _the_ operation _until_ the wash fluid stays clear. _With_ _this_ mechanical cleansing, bacterial counts, _fibrin,_ dead tissue, toxins and also residual blood (even hemoglobin promotes _the_ start of an infection) are to be removed as completely as possible, to provide, _along_ with _surgical_ removal of septic focus, _an_ optimal condition for _healing._ In _the_ postoperative phase, in which _the_ fate of the patient _is_ mainly _determined,_ it _is_ decisive to recognize a worsening of the condition as early as _possible,_ and optionally, to remove the cause (e.g., correction of an inadequate suture after oversewing a gastric ulcer) _and,_ by effective lavage, if possible _from_ the _first_ postoperative day _forward,_ _to_ make sure conditions are clean (blood that reappears, fibrin and bacteria _are_ _to_ be rinsed _away)._ In _postoperative_ lavage, the strategy of _the_ _open_ abdomen _with_ periodic washing and _the_ wash treatment with _a_ closed _abdomen_ are known. _This_ so-called open abdomen is made possible _by_ the sliding splint closure and by _the_ snap closure as _a_ temporary closure _for_ the _abdominal_ cavity, with the advantages that repeated intra-abdominal accessibility is guaranteed and the _technician,_ _during_ each washing, can be convinced of the success of the removal of septic _focus,_ _and_ thus, can control the _course_ of peritonitis. In _doing_ so, postoperative, intra-abdominal _adhesions_ can be detached and coatings of _fibrin_ can _be_ _removed._ The _typical_ _drainage_ complications _are_ _eliminated._ (Plugging of drainage for the abdominal wall, blockage or obstruction _of_ drainages, infection sources.) A _relaparotomy_ is no longer necessary. Here, the drawback is that right after the operation, _washing_ cannot be performed and no continuous washing is possible. But _then,_ periodic washing is relatively frequent _and_ also a burden _for_ _the_ patient, _when_ the patient is in critical condition. _Periodic_ washing _must_ be prepared carefully; it _is_ performed in _the_ operating room (the abdomen is open during _washing)_ _and_ under general anesthesia. The advantages of the principle of peritoneal dialysis _must_ _be_ done without, since previous _temporary_ abdominal cavity _closures_ do not close the _abdomen_ tightly. The wash effect remains limited, _since_ a desired intra-abdominal _pressure_ is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. _Further,_ after the _temporary_ closure of the _abdominal_ _wall,_ part of the wash _fluid_ _oozes_ into _the_ bed _which,_ in addition to being _another_ source of infection, means ineffective _washing,_ additional burden for the patient, _and_ considerable additional expense for the nursing staff. _Patients_ with _an_ open abdomen _belong,_ at _that_ time, to _the_ most care-intensive patients. _If_ a so-called snap closure _or_ sliding _splint_ closure, as a temporary abdominal _cavity_ _closure,_ is infolded, another _drawback_ _comes_ to _bear._ Once cut _and_ infolded, adaptation to the tension conditions of _the_ abdominal wall _is_ _no_ longer possible. But, because of _edematous_ _swelling_ of inner organs during the course of peritonitis, the tension of the _abdominal_ wall can increase considerably, with the danger that the sutures tear _out._ On the other hand, the edges of the incision must _be_ brought together _again_ gradually to the _final_ suture of the abdominal _wall_ later, during _the_ healing phase in which the swelling of the inner _organs_ decreases. Further, the typical complications _of_ _snap_ _closures_ _must_ be taken into account (constriction, tenaculum). There is no particular edge structure to _infold_ into the _fascia,_ _so_ that _only_ _the_ individual sutures provide support. They are _often_ not _secure_ and tear out easily. Continuous peritoneal _lavage_ _with_ a closed abdomen offers the advantage that _an_ effective washing treatment can be _started_ immediately after the operation, and thus, the purpose _of_ the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning _only_ right _at_ the _spot_ _where_ it lays. Further, it _easily_ becomes clogged and misleads to _the_ assumption that _the_ incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure _can_ be built up and _dosed._ In doing so, the wash _fluid_ (possibly with antibiotic _added)_ also reaches _the_ critical "atmospheric _corners"_ of _the_ abdomen. _But_ not _only_ are wash _channels_ created, _as_ when seepage through _without_ pressure occurs. Fewer _fibrin-induced_ adhesions _are_ formed, since the abdomen contents "swim" and _fibrin_ (among other _things)_ is effectively washed out (thus, simultaneous ileus prophylaxis). Peritoneal dialysis is possible. With _it,_ an increase in the retention values (creatine, urea, potassium) with a threat _of_ _renal_ failure can conceivably be halted simply _by_ using a commercially available dialysis _fluid_ as the wash _fluid._ _The_ patient can easily be dialyzed, without having _to_ be put _into_ the expensive program of _hemodialysis._ _The_ _associated_ drawbacks are also eliminated, as they can sometimes _occur_ during _the_ handling of blood _volume._ Washing _can_ _be_ taken over _by_ a machine according to a desired program; thus, _clear_ relief _for_ the nursing _personnel_ is possible. A chamber count of the _leukocytes_ in the wash fluid makes _it_ possible to monitor _simply_ the _response_ of the peritonitis. A _judgment_ of _the_ efflux can _conceivably_ be performed simply by inspection (cloudiness, fibrin or blood _admixtures)._ Wash fluid sensors to determine the _resistance_ of bacteria _can_ be removed by the catheter at any time, _just_ as other substances can be administered (e.g., electrolytes, protein, _heparin)._ The _drawback_ here _is_ that the abdomen is no longer accessible and thus no _direct_ visual _monitoring_ exists any more, which is important, when the efflux changes pathologically or the clinical _condition_ of the patient worsens. Packing and _infection_ source _of_ the _drainage_ passage points, as well as clogging or obstruction of the drainages represent typical complications. _If_ the abdomen must _be_ accessed again, a relaparotomy must be _performed._ Despite promising _starts,_ the strategy of _the_ closed abdomen has not been able to be _used_ in practice, since _the_ drawbacks predominate.
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Handling huge volumes of data on a daily basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data for decades, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. Data sets today aren't merely larger than the older data sets, but also significantly more complex, for example, unstructured and semi-structured data generated by sensors, web logs, social media, mobile communication, and customer service records.
There are many software frameworks to store and analyze large volumes of data in a massively parallel scale. Apache Hadoop is an example and often cited in many journals, publications, blogs, and other technical articles for massively parallel processing system. It is now known to be the de-facto technology platform for supporting storage of massive amounts of heterogeneous data and processing them.
The Hadoop Distributed File System (HDFS) for data storage and its specialized distributed programming model ‘MapReduce’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights.
However, Hadoop as a technology has several limitations. First, organizations are interested in ‘interactive analytics’, a solution requiring faster time-to-insight when compared to the time it takes for a MapReduce job to execute and provide the required results. Second, the ability to enable analysts and data scientists to directly interact with any data stored in Hadoop, using their existing business intelligence (BI) tools and skills through a well-accepted SQL interface. Apache Hive, however, facilitates querying the data using an SQL-like language called HiveQL, but it is much slower than what the industry demands in terms of interactive querying.
There are several massively parallel query processing (MPQP) tools available in the market that enable organizations to perform interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is optimized to perform efficiently for a certain class of queries only, operating on a certain known data type and format on a well-defined hardware and software configuration. The data model and the storage model have to be optimized significantly in order to obtain faster query response times.
To add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for organizations to evaluate each of these tools for the different kinds of queries they have for processing, operating on varying data-sets, (for example, queries from marketing, analysts, engineers, and senior management).
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handling huge quantities of data on a daily basis is a task that most organizations have to deal with. such organizations have been storing huge volumes of data for decades, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. data sets today aren ' t merely larger than the older data sets, but also significantly more complex, for example, unstructured and semi - structured data generated by sensors, web logs, social media, mobile communication, and customer service records. there are many software frameworks to store and analyze large volumes of data in a massively parallel scale. apache hadoop is an example and often cited in many journals, publications, blogs, and other technical articles for massively parallel processing efforts. it is now known to be the de - facto technology platform for supporting storage of massive amounts of heterogeneous data and processing them. the hadoop relational file system ( hdfs ) for data storage and its specialized distributed programming model ‘ mapreduce ’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights. however, hadoop as a technology has several limitations. first, organizations are interested in ‘ interactive analytics ’, a solution requiring faster time - to - insight when compared to the time it takes for a mapreduce job to execute and provide the required results. second, the ability to enable analysts and data scientists to directly interact with any data stored in hadoop, using the existing business intelligence ( bi ) tools and skills through a well - accepted sql interface. apache hive, however, facilitates querying the data using an sql - like language called hiveql, but it is much slower than what the industry lacks in terms of systematic querying. there are several massively parallel query processor ( mpqp ) tools available in the market that enable organizations to perform interactive sql - like querying on massive data - sets on the hadoop platform, called sql - on - hadoop tools. however, each of these tools is optimized to perform efficiently for a certain class of queries only, operating on a certain known data type and format on a well - defined hardware and software model. the data model and the storage model have to be optimized significantly in order toward obtain faster database response times. to add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for organizations to evaluate each of these tools for the different kinds of queries they have for processing, operating on varying data - sets, ( for example, queries from marketing, analysts, engineers, and senior management ).
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Handling huge volumes of data on a daily basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data for Xecafes, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. Data sets today aren ' t merely larger than the older data sets, but also significantly more complex, for example, unstructured and semi - structured data generated by sensors, web logs, social media, mobile communication, and customer service records. There are many software frameworks to store and analyze large volumes of data in a massOvfly parallel scale. Apache Hadoop is an example and often cited in many journals, publivatioMs, blogs, and other technical articles for massively parallel processing system. It is now known to be the de - facto technology platform for supporting storage of massive a<oknts of het2rog@neous data and processing tbeJ. The Hadoop Distributed File System (HDFS) for data storage and its specialized distributed programming model ‘ MapReduce ’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights. However, Hadoop as a technology has several limitStionQ. First, organizations are interested in ‘ interactive analytics ’, a solution requiring faster time - to - insight when compared to the time it tx>es for a MapReduce job to execute and provide the required results. Second, the ability to enable analysts and data scientists to directly interact with any data stored in Hadoop, using their existing business intelligence (BI) tools and skills through a well - accepted SQL interface. Apache Hive, however, facilitates querying the data using an SQL - like language called HiveQL, but it is much slower than what the industry demands in terms of interactive querying. There are several massively parallel query processing (MPQP) tools available in the market that enable organizations to perform interactive SQL - like querying on massive data - sets on the Hadoop platform, called SQL - on - Hadoop tools. However, each of these tools is optimized to Lerf*rm efficiently for a certain class of queries only, operating on a certain known data type and format on a well - defined hardware and software configuration. The data model and the storage model have to be optimized significantly in order to obtain faster query response times. To add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for organizations to evaluate each of these tools for the different kinds of !keries they have for processing, operating on varying data - sets, (for example, queries from marketing, analysts, engineers, and senior management ).
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Handling huge volumes of data daily basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data decades, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. Data sets today aren't larger the older data sets, but also significantly more complex, example, and semi-structured data generated by sensors, logs, social communication, and records. are software frameworks to store and analyze large volumes of in a massively parallel scale. Apache Hadoop is an example and often cited in many journals, publications, blogs, and other technical articles for processing system. It is now known to be the de-facto technology platform for supporting storage of massive amounts of heterogeneous data and processing them. The Hadoop Distributed File System (HDFS) data storage and its specialized distributed programming model ‘MapReduce’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights. However, Hadoop as a has several limitations. First, are interested in ‘interactive analytics’, a solution requiring faster time-to-insight when compared to the time it takes for a job to execute and provide the required results. Second, the ability to enable analysts and data to directly interact with stored in Hadoop, their existing business intelligence (BI) tools skills through a well-accepted SQL interface. Apache Hive, facilitates querying the data using an SQL-like language called but it is slower than what the industry demands in terms of interactive querying. are several massively parallel query processing (MPQP) tools in that enable organizations to perform interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is to perform efficiently for a certain class of queries only, operating on a certain known type and format on a well-defined hardware and software configuration. The data model and the storage model have to be optimized significantly in order to obtain faster query response times. To add to the problem, the technological of massively parallel query frameworks is large it becomes increasingly difficult organizations to evaluate each of these tools for different kinds of queries they have processing, operating varying data-sets, (for example, queries from marketing, analysts, engineers, and senior management).
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HaNDLiNg HUGE voluMes Of DATa ON A DaiLy BaSiS IS A tAsk THat MosT ORGaniZAtioNS haVE To dEaL wITh. SUCH ORGaNIzatiOnS HAve BEEn sToring HuGe VOlumes oF DaTa fOr dECades, but noW WiTh ThE avAilAbIlity of NeW TEchNIQUeS For ANAlyZINg tHOsE HuGe dAta SEts, OrGaNIZAtioNs seeK tO iMPRove THEIr opERAtiOnaL eFFIciENCy. daTa SETs TodaY AreN't MerelY LArGEr tHAN tHE oLdEr dATa SEtS, BUT aLsO SigNifICaNTlY mOrE comPlex, For EXAMPLe, unstRucTUred AnD Semi-StrUCTUREd dATa generATed BY sEnsOrs, wEb Logs, sociAL medIa, moBiLe CoMMUNICATiOn, ANd CUstOmeR ServIce reCORds.
TheRE ARe mAnY SoFtwarE FRaMEworKs TO Store aNd ANaLYZe laRgE VOlumES OF DATA in a mAsSIVEly PAralleL scale. apACHe HAdOop IS AN EXAmPle aND oFTen ciTeD In Many jOURnALs, PUbliCATions, BlogS, aND OtHer tEchnICAl ARTiCLES for mASSIVelY ParAllEL procESSIng SystEm. IT iS nOW knOWN To bE tHe DE-fAcTo tEchNOlOgy PLAtfORm FOR SUppoRtIng sToRage of MASsiVe AmOUNts oF HeterOGEnEOUs DATA AnD PROcESsinG theM.
ThE HAdoop dIstRiButEd FiLE sYStEm (HdfS) foR DAta stORAGE aND its sPEcIAlizED dIStrIbutED PROgrammINg ModEL ‘mAPredUce’ For Data PRoCEssInG, AcroSs rElaTIveLY inexPENsivE commodITY HaRDwARE, mAy Be lEVerAgEd FOr MiXIng anD MaTChinG datA FRoM MANy DIspARATe sOURCES AnD rEveal meaningfUl INSIgHTS.
HowEvER, haDOOP As a TeChnOLOGY haS SeVERaL LIMitatIoNS. fiRst, orgaNIzations arE iNterEstED IN ‘InTEraCtive analYTiCs’, A soluTion requiRiNG fAster TiMe-TO-INSIghT when COmPAREd to the TiME it TaKEs FoR A MApreducE JOb to eXECuTE AND prOViDE ThE reQUireD ReSulTs. sEConD, tHE abILiTy To EnAbLE ANalysTS and DAta sCiEnTIstS To DiReCTly inTeRact wITH anY DATA STOred iN hadoOP, uSiNg tHEIR eXisting BUsinEss inTeLlIgEncE (bI) TOOls aND sKiLlS tHrOUGH A wELL-accepTed sQL InTerfACE. aPAcHe HiVE, HOweveR, FaCiLiTateS querying The dAta usiNg AN SqL-Like lAnGuAGE calLED HiVeQl, bUT It Is mUCh SLowER tHAN what THe InduStRY dEMandS In terms OF interaCtive queRYInG.
THERE are seveRaL MAssIVElY parAllEl qUerY pROCeSsINg (mpqp) ToOls AvAiLABle in ThE mARKeT THat enable ORgANIZaTIons TO PerfoRM INTERAcTIve sQL-lIkE QUeryiNg oN mASsIvE Data-sets oN THe haDOOP PlATFOrM, caLLEd sqL-ON-hADOop TOOls. HOwever, Each OF tHeSE TOols is oPtimized to PErfOrM efFICIEntLY FOR A CERTaIn clasS OF QuERiES only, oPERATiNg ON a CERtAin KnoWn datA tYpE And FoRMAt On a Well-DEfiNeD HArDWaRe and SoFtware CoNfIGuRaTION. THE dATa moDEl AND thE sToraGE MOdEl Have TO be OPTIMIzed SigNIfIcaNtlY iN OrDeR TO obTAIN FAsTER query rEspOnse TImEs.
To AdD To THe ProBLEM, tHe tEChnolOGicAL LanDsCApe Of MAsSIVely PARAlLEL QuEry prOCESsING FraMEwoRKS iS LArGe aND IT bEcOMes INCReaSiNgly DIfficULT For oRganIzATioNS To eVALuATe Each OF thEse TooLs FOr THE DifFerent KiNdS Of QUerIEs THey have For prOcesSinG, opeRatinG on VAryiNg DaTa-sETS, (fOr ExaMPlE, querIES FROM mARKeTInG, anALYSTs, ENgiNEeRS, And SeNIoR MaNagEmeNT).
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Handling huge volumesofdata on a dailybasis is a task that most organizationshave to deal with. Such organizations have been storing huge volumesof data for decades, but now with the availabilityof newtechniques for analyzing those hugedata sets,organizations seek to improve their operational efficiency. Data sets todayaren'tmerely larger than theolderdata sets, but also significantly more complex, for example, unstructured and semi-structured datagenerated by sensors, web logs, social media, mobilecommunication, and customer servicerecords.There are many software frameworksto store and analyze large volumes of datain a massively parallel scale. Apache Hadoop is an example andoften cited in manyjournals,publications, blogs,and other technical articles for massively parallel processing system. It is now known to be the de-factotechnology platformfor supporting storage of massive amounts of heterogeneous data and processingthem. The Hadoop DistributedFile System (HDFS) for data storage and its specialized distributed programming model ‘MapReduce’for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixingand matching data frommany disparate sources and reveal meaningful insights.However, Hadoop as a technology has several limitations. First, organizations are interested in ‘interactive analytics’, a solutionrequiringfaster time-to-insight when compared to the time ittakes for a MapReduce job to execute and provide the required results. Second,the ability toenable analystsand data scientists to directly interact with any data stored in Hadoop,usingtheir existing business intelligence (BI)tools and skills througha well-accepted SQL interface. Apache Hive, however, facilitates querying the data using anSQL-like language called HiveQL, but it is much slower than what the industry demandsin terms of interactive querying. There are several massively parallel query processing(MPQP) tools available in themarket that enable organizations to perform interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, eachof these tools is optimizedto perform efficiently for a certain class of queries only, operating onacertain known datatype and format on a well-definedhardware and softwareconfiguration. The data model and the storagemodel have to be optimized significantly in order to obtain faster query response times. To add tothe problem,the technological landscape of massively parallel queryprocessing frameworks is largeand it becomes increasingly difficult for organizations to evaluate each of these tools forthe differentkinds of queries they have for processing, operating on varying data-sets, (forexample, queries from marketing,analysts, engineers, and senior management).
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Handling huge _volumes_ of data on _a_ daily basis is a task that most organizations have to _deal_ _with._ Such organizations have been storing huge volumes _of_ data for decades, _but_ now with the availability of new _techniques_ for analyzing those _huge_ _data_ sets, organizations seek to improve _their_ _operational_ _efficiency._ Data sets today aren't merely larger than _the_ older _data_ _sets,_ _but_ also significantly more complex, for example, unstructured _and_ semi-structured data generated by sensors, web logs, social media, mobile communication, and customer service records. _There_ _are_ many _software_ _frameworks_ _to_ store and analyze _large_ volumes of data in a _massively_ _parallel_ scale. Apache Hadoop is an example and often _cited_ in many journals, publications, _blogs,_ and other technical articles for massively parallel processing system. It is now known to be the de-facto technology platform for supporting storage of massive amounts of heterogeneous data and _processing_ them. The _Hadoop_ _Distributed_ File _System_ _(HDFS)_ for _data_ storage and _its_ specialized _distributed_ programming model _‘MapReduce’_ for data _processing,_ across relatively _inexpensive_ _commodity_ hardware, may be _leveraged_ for mixing and _matching_ data from many _disparate_ sources and reveal _meaningful_ insights. However, Hadoop as _a_ technology _has_ several limitations. First, organizations are interested in ‘interactive _analytics’,_ a _solution_ requiring faster time-to-insight when compared _to_ the time it takes _for_ _a_ _MapReduce_ _job_ _to_ _execute_ and provide the required results. Second, the _ability_ to enable analysts and data scientists to directly interact with _any_ data stored _in_ Hadoop, using _their_ existing business intelligence (BI) tools _and_ skills through a well-accepted _SQL_ interface. Apache Hive, however, _facilitates_ querying the data using _an_ SQL-like language _called_ HiveQL, but it is much slower than what _the_ _industry_ _demands_ in terms of interactive _querying._ _There_ are several massively parallel query processing (MPQP) tools _available_ in the market that _enable_ _organizations_ to perform _interactive_ SQL-like _querying_ on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is optimized to perform efficiently _for_ a certain class of _queries_ _only,_ operating on a certain known data type and format on a well-defined hardware and _software_ configuration. The data model and the _storage_ model have to be optimized significantly in order to obtain faster query response times. To add to the problem, _the_ technological landscape of massively parallel query processing frameworks is large and it _becomes_ increasingly difficult for _organizations_ to evaluate each of these tools for the _different_ _kinds_ _of_ queries _they_ have for processing, operating on varying data-sets, (for example, queries from marketing, analysts, engineers, and senior management).
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Media streams, such as video and audio streams, may be sent over a network to multiple receiving clients. In a unicast-based system, individual copies of the stream are sent separately over the network to each client. By contrast, in a multicast-based system, a single copy of the stream may be sent to a multicast address, and the multicast-enabled network enables replication of the stream to clients within the multicast group. In some cases, a client may record or store the stream for later playback. In some scenarios, media streams may be sent using transmission control protocol (TCP) for reliability, at a cost of higher latency. In other scenarios, media streams may be sent using user datagram protocol (UDP) with lower latency, at a cost of potentially increased errors or dropouts.
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media streams, same as video and audio streams, may be sent over a network to multiple receiving clients. in a unicast - based design, individual copies holding the stream are sending separately over the network to one client. by contrast, in a multicast - based design, a single output of the stream may be sent to a multicast address, and the lan - enabled network enables replication of the stream to function within the multicast group. for some cases, a client may record or store the stream for later playback. in some scenarios, media streams may be sent using transmission control protocol ( tcp ) for reliability, at a cost of higher latency. in other scenarios, media streams may be sent using user datagram protocol ( udp ) with lower latency, at a cost of potentially increased errors or dropouts.
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Media streams, such as video and audio streams, may be sent ovfe a ne%w0rk to multiple receiving clients. In a unicZAt - based system, individual copies of the stream are sent separately obe# the network to each client. By contrast, in a multicast - based system, a single copy of the stream may be sent to a multiDXst address, and the multicast - enabled network enables replication of the stream to clients within the multicast group. In some vZses, a client may record or store the stream for later playback. In some scenarios, media streams may be sent using transm&ssioJ control protocol (TCP) for reliability, at a cost of higher latency. In other scenarios, media s5rea<s may be sent using user datagram protocol (UDP) with lower laGeJcy, at a cost of potentially increased ertorc or dropouts.
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Media streams, such as video and audio streams, may over a network to multiple receiving clients. In a unicast-based system, individual copies of the stream are sent separately over the network to each client. By contrast, in a multicast-based system, a single of the stream may be sent to a multicast and the multicast-enabled network enables of the stream to clients within the multicast group. some a client may record or store the stream for later playback. In some scenarios, media streams may be sent control protocol (TCP) reliability, at a cost of higher latency. other scenarios, media streams may be sent using user datagram protocol (UDP) with lower latency, at a cost of potentially errors or
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MeDIa STReAMs, sucH aS VideO And AudIo StREams, May bE sENt OVEr A neTwoRk TO mUlTiple receivInG CLiEnTs. In a uniCAst-BasEd SYStEM, IndIvIdUAl CoPIeS OF THE sTReaM aRE SeNT SEparAteLy OVeR THe nEtwoRk tO EaCH CLient. BY CoNtRaSt, iN a mULticASt-BAsED SySTEm, A sINGle Copy oF The sTREAM mAy be SEnT to A MULTiCAsT ADDress, And ThE muLTiCaST-eNablED NEtwOrK eNabLeS rEPLiCatioN Of THe STrEam to clIeNtS wItHin ThE muLtiCaSt gROuP. iN somE CaSes, a clieNT may rECORD or StoRE thE StReAm FoR LAtER pLAybACk. In somE sCEnArIOs, MEDIa STReAMs May bE SeNt uSING TransMissIoN CONtrol PrOtOCOl (tcP) For reLIABILItY, At A CoST OF hIgheR LaTEncY. in OThER ScENARiOS, media StREaMS MAy BE sENT using usER datAgRaM ProtOCOL (uDP) wITh LowER latencY, AT a COST of PotENTIaLlY InCrEasED ERRORs OR droPOUts.
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Media streams, suchas videoand audiostreams, may besent overa network to multiple receiving clients. In a unicast-based system, individual copiesof the streamare sentseparately over the network toeach client. By contrast, in a multicast-basedsystem, a single copy of the stream may be sent toa multicast address, and the multicast-enabled network enablesreplication of the stream to clients within the multicast group. In somecases, a client mayrecord or storethe stream for later playback.In some scenarios, media streams may be sent usingtransmission control protocol (TCP) for reliability, at acost of higher latency. In other scenarios,media streams may be sent using user datagramprotocol (UDP)with lowerlatency, at a cost of potentiallyincreased errors or dropouts.
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Media streams, such as video and audio _streams,_ may be sent over a network to multiple receiving clients. _In_ _a_ unicast-based system, _individual_ _copies_ of the stream are sent separately _over_ the network _to_ _each_ client. By contrast, in a multicast-based system, a single copy of the stream may be _sent_ to a multicast address, and the _multicast-enabled_ network _enables_ replication of the _stream_ to clients within the multicast group. In some cases, a client may record or store the stream for later playback. In some scenarios, media streams may be sent _using_ transmission control protocol _(TCP)_ for _reliability,_ at a cost _of_ higher latency. In other scenarios, media _streams_ may _be_ sent _using_ user _datagram_ _protocol_ _(UDP)_ _with_ lower latency, at a cost of potentially increased errors _or_ _dropouts._
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