title: Advanced cardiac life support

text: Due to the rapidity and complexity of ACLS care, as well as the recommendation that it be performed in a standardized fashion, providers must usually hold certifications in ACLS care. Certifications may be provided by a few different, generally national, organizations but their legitimacy is ultimately determined by hospital hiring and privileging boards; that is, ACLS certification is frequently a requirement for employment as a health care provider at most hospitals. ACLS certifications usually provide education on the aforementioned aspects of ACLS care "except" for specialized resuscitation techniques. Specialized resuscitation techniques are not covered by ACLS certifications and their use is restricted to further specialized providers. ACLS education is based on ILCOR recommendations which are then adapted to local practices by authoritative medical organizations such as the American Red Cross, the European Resuscitation Council, or the Resuscitation Council of Asia"."


title: Advanced cardiac life support

text: BLS proficiency is usually a prerequisite to ACLS training; however the initial portions of an ACLS class may cover CPR. Initial training usually takes around 15 hours and includes both classroom instruction and hands-on simulation experience; passing a test, with a practical component, at the end of the course is usually the final requirement to receive certification. After receiving initial certification, providers must usually recertify every two years in a class with similar content that lasts about seven hours. Widely accepted providers of ACLS certification include, non-exclusively: American Heart Association, American Red cross, European Resuscitation Council or the Australian Resuscitation Council.


title: Advanced cardiac life support

text: Holding ACLS certification is a testament to a provider's education on ACLS guidelines. The certification does "not" superseded a provider's scope of practice as determined by state law or employer protocols; and does not, itself, provide any license to practice.


title: Advanced cardiac life support

text: Like a medical intervention, researchers have had to ask whether ACLS is effective. Data generally demonstrates that patients have better survival outcomes (increased ROSC, increased survival to hospital discharge and/or superior neurological outcomes) when they receive ACLS; however a large study of ROC patients showed that this effect may only be if ACLS is delivered in the first six minutes of arrest. This study also found that ACLS increases survival but does not produce superior neurological outcomes.


title: Advanced cardiac life support

text: Some studies have raised concerns that ACLS education can be inconstantly or inadequately taught which can result in poor retention, leading to poor ACLS performance. One study from 1998 looked at the ACLS use of epinephrine, atropine, bicarbonate, calcium, lidocaine, and bretylium in cardiac arrests and found that these medications were not associated with higher resuscitation rates.


title: Advanced cardiac life support

text: Research on ACLS can be challenging because ACLS is a bundle of care recommendations; with each individual treatment component being profoundly consequential. There is active debate within the resuscitation research community about the value of certain interventions. Active areas of research include determining the value of vasopressors in arrests, ideal airway use and different waveforms for defibrillation.


title: Advanced cardiac life support

text: Stemming from the need for standardized, evidence based ACLS guidelines, an international network of academic resuscitation organizations was created. The International Liaison Committee on Resuscitation (ILCOR) is the central, international institution that regional resuscitation committees strive to contribute to and disseminate information from. The centralization of resuscitation research around ILCOR reduces redundant work internationally, allows for collaboration between experts from many regional organizations, and produces higher quality, higher powered research.


title: Advanced cardiac life support

text: ILCOR serves as a way for international resuscitation organizations to communicate and collaborate. ILCOR publishes scientific evidence reviews on resuscitation known as "Continuous Evidence Evaluation (CEE) and Consensus on Science with Treatment Recommendations (CoSTRs)". ILCOR uses 6 international task forces to review over 180 topics through a structured systematic-review process. ILCOR traditionally published updates and recommendations every five years but now conducts continuous review work. ILCOR produces international recommendations which are then adopted by regional resuscitation committees which publish guidelines. Regional guidelines can have more medicolegal bearing than ILCOR recommendations. ILCOR is composed of the following regional organizations:


title: Advanced cardiac life support

text: The International Liaison Committee on Resuscitation (ILCOR) was established 1992 to serve as a way for international resuscitation organizations to communicate and collaborate.


title: Advanced cardiac life support

text: The ACLS guidelines were first published in 1974 by the American Heart Association and were updated in 1980, 1986, 1992, 2000, 2005, 2010, 2015. In the 2020 update the guidelines were restructured to align with ILCOR recommendations. These changes include the transition since 2015 away from the previous 5-year update cycle to an online format that can be updated as indicated by continuous evidence review.


title: Advanced cardiac life support

text: The first version of the European Resuscitation Council (ERC) guidelines were developed in 1992. The 2000 ERC guidelines were developed in collaboration with ILCOR. 5-year updates were published from 2000 to 2015 and annual updates have been published since 2017.


title: Multi-exposure HDR capture

text: In photography and videography, multi-exposure HDR capture is a technique that creates extended or high dynamic range (HDR) images by taking and combining multiple exposures of the same subject matter at different exposure levels. Combining multiple images in this way results in an image with a greater dynamic range than what would be possible by taking one single image. The technique can also be used to capture video by taking and combining multiple exposures for each frame of the video. The term "HDR" is used frequently to refer to the process of creating HDR images from multiple exposures. Many smartphones have an automated HDR feature that relies on computational imaging techniques to capture and combine multiple exposures.


title: Multi-exposure HDR capture

text: A single image captured by a camera provides a finite range of luminosity inherent to the medium, whether it is a digital sensor or film. Outside this range, tonal information is lost and no features are visible; tones that exceed the range are "burned out" and appear pure white in the brighter areas, while tones that fall below the range are "crushed" and appear pure black in the darker areas. The ratio between the maximum and the minimum tonal values that can be captured in a single image is known as the dynamic range. In photography, dynamic range is measured in exposure value (EV) differences, also known as "stops".


title: Multi-exposure HDR capture

text: This technique can be applied to produce images that preserve local contrast for a natural rendering, or exaggerate local contrast for artistic effect. HDR is useful for recording many real-world scenes containing very bright, direct sunlight to extreme shade, or very faint nebulae. Due to the limitations of printing and display contrast, the extended dynamic range of HDR images must be compressed to the range that can be displayed. The method of rendering a high dynamic range image to a standard monitor or printing device is called tone mapping. This method reduces the overall contrast of an HDR image to facilitate display on devices or printouts with lower dynamic range.


title: Multi-exposure HDR capture

text: One aim of HDR is to present a similar range of luminance to that experienced through the human visual system. The human eye, through non-linear response, adaptation of the iris, and other methods, adjusts constantly to a broad range of luminance present in the environment. The brain continuously interprets this information so that a viewer can see in a wide range of light conditions.


title: Multi-exposure HDR capture

text: Most cameras are limited to a much narrower range of exposure values within a single image, due to the dynamic range of the capturing medium. With a limited dynamic range, tonal differences can be captured only within a certain range of brightness. Outside of this range, no features are visible: when the tone being captured exceeds the range in bright areas, these tones appear as pure white, and when the tone being captured does not meet the minimum threshold, these tones appear as pure black. Images captured with non-HDR cameras that have a limited exposure range, referred to as low dynamic range (LDR), can result in the loss of detail in highlights or shadows.


title: Multi-exposure HDR capture

text: Modern CMOS image sensors have improved dynamic range and can often capture a wider range of tones in a single exposure reducing the need to perform multi-exposure HDR. Color film negatives and slides consist of multiple film layers that respond to light differently. Original film (especially negatives versus transparencies or slides) feature a very high dynamic range (in the order of 8 for negatives and 4 to 4.5 for slides).


title: Multi-exposure HDR capture

text: Multi-exposure HDR is used in photography and also in extreme dynamic range applications like welding or automotive work. In security cameras the term used instead of HDR is "wide dynamic range".


title: Multi-exposure HDR capture

text: A fast-moving subject (or unsteady camera) will result in a "ghost" effect or a staggered-blur strobe effect, as a result of the merged images not being identical, but each capturing the moving subject at a different moment in time, with its position changed. Sudden changes in the lighting conditions (strobed LED light) can also interfere with the desired results, by producing one or more HDR layers that do have the luminosity expected by an automated HDR system, though one might still be able to produce a reasonable HDR image manually in software by rearranging the image layers to merge in order of their actual luminosity.


title: Multi-exposure HDR capture

text: Camera characteristics such as gamma curves, sensor resolution, noise, photometric calibration and color calibration affect resulting high-dynamic-range images.


title: Multi-exposure HDR capture

text: High-dynamic-range photographs are generally composited from multiple standard dynamic range images, often captured using exposure bracketing. Afterwards, photo manipulation software merges the input files into a single HDR image, which is then also tone mapped in accordance with the limitations of the planned output or display.


title: Multi-exposure HDR capture

text: Any camera that allows manual exposure control can perform multi-exposure HDR image capture, although one equipped with automatic exposure bracketing (AEB) facilitates the process. Some cameras have an AEB feature that spans a far greater dynamic range than others, from ±0.6 at the low end to ±18 EV in top professional cameras, Images from film cameras generally are less suitable as the captured images require a prerequisite step of scanning and digitization so that they can later be processed using software HDR methods.


title: Multi-exposure HDR capture

text: The exposure value (EV) refers to the amount of light applied to the active element, whether film or digital sensor such as a CCD. An increase of one stop represents a doubling of the amount of light captured. Conversely, a decrease of one stop represents a halving of the amount of light. Therefore, revealing detail in the darkest of shadows requires an increased EV, while preserving detail in very bright situations requires very low EVs.


title: Multi-exposure HDR capture

text: EV is controlled using one of two photographic controls: varying either the size of the aperture or the exposure time. A set of images with multiple EVs intended for HDR processing should be captured only by altering the exposure time; altering the aperture size also would affect the depth of field and so the resultant multiple images would be quite different, preventing their final combination into a single HDR image.


title: Multi-exposure HDR capture

text: Multi-exposure HDR photography generally is limited to still scenes because any movement between successive images will impede or prevent success in combining them afterward. Also, because the photographer must capture three or more images to obtain the desired luminance range, taking such a full set of images takes extra time. Photographers have developed calculation methods and techniques to partially overcome these problems, but the use of a sturdy tripod is advised to minimize framing differences between exposures.


title: Multi-exposure HDR capture

text: Tonal information and details from shadow areas can be recovered from images that are deliberately overexposed (i.e., with positive EV compared to the correct scene exposure), while similar tonal information from highlight areas can be recovered from images that are deliberately underexposed (negative EV). The process of selecting and extracting shadow and highlight information from these over/underexposed images and then combining them with image(s) that are exposed correctly for the overall scene is known as exposure fusion. Exposure fusion can be performed manually, relying on the HDR operator's judgment, experience, and training, but usually, fusion is performed automatically by software.


title: Multi-exposure HDR capture

text: Information stored in high-dynamic-range images typically corresponds to the physical values of luminance or radiance that can be observed in the real world. This is different from traditional digital images, which represent colors as they should appear on a monitor or a paper print. Therefore, HDR image formats are often called "scene-referred", in contrast to traditional digital images, which are "device-referred" or "output-referred". Furthermore, traditional images are usually encoded for the human visual system (maximizing the visual information stored in the fixed number of bits), which is usually called "gamma encoding" or "gamma correction". The values stored for HDR images are often gamma compressed using mathematical functions such as power laws logarithms, or floating point linear values, since fixed-point linear encodings are increasingly inefficient over higher dynamic ranges.


title: Multi-exposure HDR capture

text: HDR images often do not use fixed ranges per color channel, other than traditional images, to represent many more colors over a much wider dynamic range (multiple channels). For that purpose, they do not use integer values to represent the single color channels (e.g., 0–255 in an 8 bit per pixel interval for red, green and blue) but instead use a floating point representation. Common values are 16-bit (half precision) or 32-bit floating-point numbers to represent HDR pixels. However, when the appropriate transfer function is used, HDR pixels for some applications can be represented with a color depth that has as few as 10 to 12 bits (8 to 14 values) for luminance and 8 bits (10 values) for chrominance without introducing any visible quantization artifacts.


title: Multi-exposure HDR capture

text: Tone mapping reduces the dynamic range, or contrast ratio, of an entire image while retaining localized contrast. Although it is a distinct operation, tone mapping is often applied to HDR files by the same software package.


title: Multi-exposure HDR capture

text: Tone mapping is often needed because the dynamic range that can be displayed is often lower than the dynamic range of the captured or processed image. HDR displays can receive a higher dynamic range signal than SDR displays, reducing the need for tone mapping.


title: Multi-exposure HDR capture

text: This is an example of four standard dynamic range images that are combined to produce three resulting tone mapped images:


title: Multi-exposure HDR capture

text: Several software applications are available on the PC, Mac, and Linux platforms for producing HDR files and tone mapped images. Notable titles include:


title: Multi-exposure HDR capture

text: As the popularity of this imaging method grows, several camera manufacturers are now offering built-in multi-exposure HDR features. For example, the Pentax K-7 DSLR has an HDR mode that take 3 or 5 shots and outputs (only) a tone mapped HDR image in a JPEG file. The Canon PowerShot G12, Canon PowerShot S95, and Canon PowerShot S100 offer similar features in a smaller format. Nikon's approach is called 'Active D-Lighting' which applies exposure compensation and tone mapping to the image as it comes from the sensor, with the emphasis being on creating a realistic effect.


title: Multi-exposure HDR capture

text: Some smartphones provide HDR modes for their cameras, and most mobile platforms have apps that provide multi-exposure HDR picture taking. Google released a HDR+ mode for the Nexus 5 and Nexus 6 smartphones in 2014, which automatically captures a series of images and combines them into a single still image, as detailed by Marc Levoy. Unlike traditional HDR, Levoy's implementation of HDR+ used multiple images at a short shutter speed; the resulting set of underexposed images were aligned and averaged by pixel, improving dynamic range and reducing noise. By selecting the sharpest image as the baseline for alignment, the effect of camera shake is also reduced.


title: Multi-exposure HDR capture

text: Some of the sensors on modern phones and cameras may even combine the two images on-chip so that a wider dynamic range without in-pixel compression is directly available to the user for display or processing.


title: Multi-exposure HDR capture

text: Although not as established as for still photography capture, it is also possible to capture and combine multiple images for each frame of a video in order to increase the dynamic range captured by the camera. This can be done via multiple methods:


title: Multi-exposure HDR capture

text: Some cameras designed for use in security applications can automatically provide two or more images for each frame, with changing exposure. For example, a sensor for 30fps video will give out 60fps with the odd frames at a short exposure time and the even frames at a longer exposure time.


title: Multi-exposure HDR capture

text: In 2020, Qualcomm announced Snapdragon 888, a mobile SoC able to do computational multi-exposure HDR video capture in 4K and also to record it in a format compatible with HDR displays.


title: Multi-exposure HDR capture

text: In 2021, the Xiaomi Mi 11 Ultra smartphone is able to do computational multi-exposure HDR for video capture.


title: Multi-exposure HDR capture

text: In recent years, even cheap models have been supplied with HDR capture, usually described as wide dynamic range (WDR) function, such as CarCam Tiny, Prestige DVR-390, and DVR-478.


title: Multi-exposure HDR capture

text: The idea of using several exposures to adequately reproduce a too-extreme range of luminance was pioneered as early as the 1850s by Gustave Le Gray to render seascapes showing both the sky and the sea. Such rendering was impossible at the time using standard methods, as the luminosity range was too extreme. Le Gray used one negative for the sky, and another one with a longer exposure for the sea, and combined the two into one picture in positive.


title: Multi-exposure HDR capture

text: Manual tone mapping was accomplished by dodging and burning – selectively increasing or decreasing the exposure of regions of the photograph to yield better tonality reproduction. This was effective because the dynamic range of the negative is significantly higher than would be available on the finished positive paper print when that is exposed via the negative in a uniform manner. An excellent example is the photograph "Schweitzer at the Lamp" by W. Eugene Smith, from his 1954 photo essay "A Man of Mercy" on Albert Schweitzer and his humanitarian work in French Equatorial Africa. The image took five days to reproduce the tonal range of the scene, which ranges from a bright lamp (relative to the scene) to a dark shadow.


title: Multi-exposure HDR capture

text: Ansel Adams elevated dodging and burning to an art form. Many of his famous prints were manipulated in the darkroom with these two methods. Adams wrote a comprehensive book on producing prints called "The Print", which prominently features dodging and burning, in the context of his Zone System.


title: Multi-exposure HDR capture

text: With the advent of color photography, tone mapping in the darkroom was no longer possible due to the specific timing needed during the developing process of color film. Photographers looked to film manufacturers to design new film stocks with improved response, or continued to shoot in black and white to use tone mapping methods.


title: Multi-exposure HDR capture

text: Color film capable of directly recording high-dynamic-range images was developed by Charles Wyckoff and EG&G "in the course of a contract with the Department of the Air Force". This XR film had three emulsion layers, an upper layer having an ASA speed rating of 400, a middle layer with an intermediate rating, and a lower layer with an ASA rating of 0.004. The film was processed in a manner similar to color films, and each layer produced a different color. The dynamic range of this extended range film has been estimated as 1:10. It has been used to photograph nuclear explosions, for astronomical photography, for spectrographic research, and for medical imaging. Wyckoff's detailed pictures of nuclear explosions appeared on the cover of "Life" magazine in the mid-1950s.


title: Multi-exposure HDR capture

text: Georges Cornuéjols and licensees of his patents (Brdi, Hymatom) introduced the principle of HDR video image, in 1986, by interposing a matricial LCD screen in front of the camera's image sensor, increasing the sensors dynamic by five stops.


title: Multi-exposure HDR capture

text: The concept of neighborhood tone mapping was applied to video cameras in 1988 by a group from the Technion in Israel, led by Oliver Hilsenrath and Yehoshua Y. Zeevi. Technion researchers filed for a patent on this concept in 1991, and several related patents in 1992 and 1993.


title: Multi-exposure HDR capture

text: In February and April 1990, Georges Cornuéjols introduced the first real-time HDR camera that combined two images captured successively by a sensor or simultaneously by two sensors of the camera. This process is known as bracketing used for a video stream.


title: Multi-exposure HDR capture

text: In 1991, the first commercial video camera was introduced that performed real-time capturing of multiple images with different exposures, and producing an HDR video image, by Hymatom, licensee of Georges Cornuéjols.


title: Multi-exposure HDR capture

text: Also in 1991, Georges Cornuéjols introduced the HDR+ image principle by non-linear accumulation of images to increase the sensitivity of the camera: for low-light environments, several successive images are accumulated, thus increasing the signal-to-noise ratio.


title: Multi-exposure HDR capture

text: Modern HDR imaging uses a completely different approach, based on making a high-dynamic-range luminance or light map using only global image operations (across the entire image), and then tone mapping the result. Global HDR was first introduced in 1993 resulting in a mathematical theory of differently exposed pictures of the same subject matter that was published in 1995 by Steve Mann and Rosalind Picard.


title: Multi-exposure HDR capture

text: On October 28, 1998, Ben Sarao created one of the first nighttime HDR+G (high dynamic range + graphic) image of STS-95 on the launch pad at NASA's Kennedy Space Center. It consisted of four film images of the space shuttle at night that were digitally composited with additional digital graphic elements. The image was first exhibited at NASA Headquarters Great Hall, Washington DC, in 1999 and then published in "Hasselblad Forum".


title: Multi-exposure HDR capture

text: The advent of consumer digital cameras produced a new demand for HDR imaging to improve the light response of digital camera sensors, which had a much smaller dynamic range than film. Steve Mann developed and patented the global-HDR method for producing digital images having extended dynamic range at the MIT Media Lab. Mann's method involved a two-step procedure: First, generate one floating point image array by global-only image operations (operations that affect all pixels identically, without regard to their local neighborhoods). Second, convert this image array, using local neighborhood processing (tone-remapping, etc.), into an HDR image. The image array generated by the first step of Mann's process is called a "lightspace image", "lightspace picture", or "radiance map". Another benefit of global-HDR imaging is that it provides access to the intermediate light or radiance map, which has been used for computer vision, and other image processing operations.


title: Multi-exposure HDR capture

text: In February 2001, the Dynamic Ranger technique was demonstrated, using multiple photos with different exposure levels to accomplish high dynamic range similar to the naked eye.


title: Multi-exposure HDR capture

text: In the early 2000s, several scholarly research efforts used consumer-grade sensors and cameras. A few companies such as RED and Arri have been developing digital sensors capable of a higher dynamic range. RED EPIC-X can capture time-sequential HDRx images with a user-selectable 1–3 stops of additional highlight latitude in the "x" channel. The "x" channel can be merged with the normal channel in post production software. The Arri Alexa camera uses a dual-gain architecture to generate an HDR image from two exposures captured at the same time.


title: Multi-exposure HDR capture

text: With the advent of low-cost consumer digital cameras, many amateurs began posting tone-mapped HDR time-lapse videos on the Internet, essentially a sequence of still photographs in quick succession. In 2010, the independent studio Soviet Montage produced an example of HDR video from disparately exposed video streams using a beam splitter and consumer grade HD video cameras. Similar methods have been described in the academic literature in 2001 and 2007.


title: Multi-exposure HDR capture

text: In 2005, Adobe Systems introduced several new features in Photoshop CS2 including "Merge to HDR", 32 bit floating point image support, and HDR tone mapping.


title: Multi-exposure HDR capture

text: On June 30, 2016, Microsoft added support for the digital compositing of HDR images to Windows 10 using the Universal Windows Platform.


title: Timeline of Brexit

text: This is a timeline of major events concerning Brexit, starting from the referendum, running through Brexit day on 31 January 2020 (when the United Kingdom ceased to be a member state of the European Union), and on to 1 January 2021 (the end of the transition period).


title: Rail Baltica

text: Rail Baltica (also known as Rail Baltic in Estonia) is a high-speed railway under construction between Warsaw, Poland and Tallinn, Estonia, with further connections to Finland via Baltic Sea cruiseferries or the proposed Helsinki–Tallinn Tunnel. Trains will operate at top speeds of 234 km/hour. Travel time between Vilnius and Tallinn is projected to be 3.5 hours and travel times between Riga and either Vilnius or Tallinn will be under 2 hours. It is projected to shift travel and transportation from roads to rail and have numerous benefits on economies and quality of life. Trains are predicted to begin operating on various sections of the route at various times between 2026 and 2030.


title: Rail Baltica

text: Passenger stations will include Ülemiste railway station in Tallinn, Pärnu railway station, Riga Central Station, Riga Airport, Panevežys, Kaunas railway station, and Vilnius railway station and there will be multimodal transport freight terminals in Muuga Harbour, Estonia; Salaspils, Latvia; and Kaunas, Lithuania.


title: Rail Baltica

text: Rail Baltica is one of the priority projects of the European Union. It is part of the North Sea–Baltic Corridor of the Trans-European Transport Network (TEN-T).


title: Rail Baltica

text: Rail Baltica will add the first large-scale mainline standard-gauge railway in the area, replacing Russian gauge railways built and operated mostly when the Baltic states were under Russian and later Soviet control.


title: Rail Baltica

text: The idea for the project was first raised during Pan-European transport conferences in Prague in 1991, Crete in 1994, and Helsinki in 1997.


title: Rail Baltica

text: The planning phase of Rail Baltica took place from 2010 to 2017. In 2011, the three Baltic states agreed on a route connecting Tallinn, Pärnu, Riga, Panevėžys, and Kaunas.


title: Rail Baltica

text: During the planning of the location of the project route in the Baltic States a conceptual agreement among the three Baltic States was reached that it should be as straight as possible as it provides the highest benefits at the lowest cost. The shorter and more direct the route is, the faster traffic it is possible to ensure, which economically has the highest advantage compared to its alternatives. This was confirmed by the AECOM study in 2013, analysing the four possible options of the location of the route in all three Baltic countries.


title: Rail Baltica

text: In October 2014, the three Baltic states established RB RAIL AS, a joint venture tasked with completion of the project overseen by the Ministry of Economic Affairs and Communications of Estonia, the Ministry of Transport in Latvia and the Ministry of Transport and Communications in Lithuania.


title: Rail Baltica

text: The design phase began in 2016, with design activities at the Riga Central Passenger Station and the Riga International Airport passenger station in Latvia to be continued until 2023.


title: Rail Baltica

text: Initially two options were considered. Both options included an upgrade of the existing railway (with standard gauge) to for the stretch that runs from Warsaw via Białystok and Ełk to Trakiszki, followed by a new railway with standard gauge Trakiszki–Kaunas. For the remainder of the route to Tallinn two different options were considered:


title: Rail Baltica

text: The name Rail Baltica is also sometimes used to mean the first phase of European gauge railway construction from the Poland-Lithuania border to Kaunas in Lithuania. It was inaugurated on 16 October 2015. The project, which built European standard-gauge one track alongside the existing Russian gauge tracks, cost €380 million. The 119 km line accommodates diesel trains, with passenger trains running at up to 120 km/h and freight trains at up to 80 km/h. Higher speeds will depend on future electrification, a new signal system and more level crossing gates. In June 2016, Lithuanian Railways and Polregio started weekend passenger train service between Kaunas and Białystok.


title: Rail Baltica

text: In Estonia and Latvia, implementation of the Rail Baltica I project included upgrades of the existing rail lines in the region.


title: Rail Baltica

text: The Šiauliai-to-Latvian border rail section (using broad gauge) was newly built. In Latvia, the existing railway upgrade between Riga and Valka was finished in 2016 at a cost of €97 million. The EU contributed about 25% of the cost for the three parts.


title: Rail Baltica

text: In 2017, the parliaments of the three Baltic States ratified the intergovernmental agreement on Rail Baltica stating "route shall be from Tallinn though Pärnu–Riga–Panevezys–Kaunas to the Lithuanian/Polish state border with a connection of Vilnius–Kaunas as a part of the railway" and defining the design speed 240 km/h for passenger travel. Now the Rail Baltica Global Project route is aligned from Tallinn till Kaunas with already built European gauge railway line section from Kaunas to Lithuanian/Polish border being subject to the results of the Upgrade Feasibility Study. Nevertheless, in April 2018 the Ministries of the three Baltic States approved the Design Guidelines of Rail Baltica, which states that the maximum design speed will be 249 km/h and maximum operational speed should be 234 km/h.


title: Rail Baltica

text: The Polish section of Rail Baltica is being upgraded to allow passenger trains to run at 200 km/h, the Ełk–state border section may be built to allow 250 km/h and may be electrified using the 25 kV AC system.


title: Rail Baltica

text: In 2017, all three Baltic parliaments ratified the Inter-Governmental Agreement for the Rail Baltica project, thereby confirming their long-term commitment to the Rail Baltica project. In addition, Rail Baltica Global Project's cost-benefit analysis was delivered by Ernst & Young and Atkins International experts, based on the European Union's CBA guidelines, proving that the project is financially feasible and viable, and its measurable benefits will outweigh the costs.


title: Rail Baltica

text: On 14 February 2018, the Ministry of Public Administration of the Republic of Estonia approved the spatial plan for the Rail Baltica railway in Estonia, setting the final route and preliminary design of the railway in Estonia. The spatial planning for the entire line was approved in Latvia by the decision of the Latvian Government in August 2016, and followed by the approval of the Lithuanian Government in January 2017 for their respective section from Kaunas to the Lithuanian-Latvian border in Lithuania. The route for the section Kaunas–Lithuania/Poland State border, known as Rail Baltica I, is subject to the results of the Upgrade Feasibility study. On 15 February 2018, the spatial territorial planning and preliminary technical design of the Rail Baltica railway in the Baltic States was finalised.


title: Rail Baltica

text: In January 2018, the long-term Business Plan, Operational Plan, the Upgraded Feasibility Study of the European gauge railway line from Kaunas to Lithuanian/Polish border, Infrastructure Management Study and other studies related to commercialisation and supply materials were finalized.


title: Rail Baltica

text: In March 2018, the first contract for the design, construction, and supervision of the Rail Baltic railway station and related infrastructure at Riga International Airport was signed.


title: Rail Baltica

text: In November 2019, the first cornerstone of Rail Baltica was laid in Estonia to mark the beginning of construction of Saustinõmme viaduct. Detailed technical design contracts for the sections Tallinn-Rapla and Pärnu-Rapla in Estonia, Kaunas-Ramygala and Ramygala-Latvian/Lithuanian border in Lithuania, Vangaži-Salaspils-Misa and main line through Riga in Latvia were signed. With the contracts signed, geotechnical research was started in different sections of the railway in order to gather information about the soil.


title: Rail Baltica

text: On 23 November 2020, the construction of a hub at Riga Central Station was officially started. On the 3rd of February 2021 the project implementer of Riga Airport Station has also been chosen and construction began in May 2021, construction will finish in early 2023. Technical with NGOs in Riga have been started, to discuss the project technical solutions, especially crossings, overpasses and other infrastructure elements in the city.


title: Rail Baltica

text: In July 2020, during the COVID-19 pandemic, discussions on the environmental impact of the project in Estonia took place electronically.


title: Rail Baltica

text: In April 2021, while the Helsinki–Tallinn Tunnel was still in the investigative state, the governments of Estonia and Finland signed a Memorandum of Understanding committing themselves to cooperation in the area of transport.


title: Rail Baltica

text: In May 2022, for the Kaunas (Jiesia) - Lithuanian-Polish border section, a 78.1 km route named "alternative 6A" was approved by the Lithuanian Ministry of Transport and Communications, taking into account the opinion of the majority of the local residents. This route is the shortest among the alternatives which were proposed and the most remote from the urban areas.


title: Rail Baltica

text: In May 2011, the feasibility study by AECOM estimated total costs at €3.6 billion. However, the 2017 study by Ernst & Young estimated total costs to be €5.8 billion. This factored changes to the scope including upgrades for better connectivity, passenger mobility and inter-modality such as passenger mainline through the Riga International Airport and construction of the airport passenger station (Latvia), the Kaunas–Vilnius connection (Lithuania), an improved connection in Kaunas (Lithuania), and construction of the tram line "Ülemiste-Tallinn airport" (Estonia). Moreover, the Environmental Impact Assessments, spatial planning and some preliminary designs have been prepared allowing for more accurate cost projections.


title: Rail Baltica

text: The project is financed by the member states and the European Union TEN-T budget, and the Structural and Cohesion Funds provided to the EU New Member States.


title: Rail Baltica

text: By the start of 2018, the three Baltic States and RB RAIL AS have received two grants under the Connecting Europe Facility for the construction of the Rail Baltica railway, having signed Grant Agreements with a total value of €765 million. As of 13 July, third Grant agreement was signed for the total amount of €130 million from which €110 million is CEF contribution.


title: Rail Baltica

text: In July 2020, another CEF funding was received, amounting to €216 million for construction, technical design and planning works, bringing the total received funding from the EU and national funds to €1.2 billion.


title: Rail Baltica

text: According to a study by Ernst & Young published in April 2017, the measurable socio-economic benefits are estimated at €16.22 billion. The assessed GDP multiplier effect that the Rail Baltica Global Project would create is an additional €2 billion. According to the same study, Rail Baltic is projected to save an estimated 400 human lives between 2026 and 2055 due to safer transport.


title: Rail Baltica

text: Rail Baltica will be built as a new, publicly owned, fast conventional double-track railway. If the railway runs freight trains it will be quadruple-track. It will be electrified and equipped with the European Rail Traffic Management System (ERTMS) for signalling and communications. The maximum design speed is for passenger trains, while the maximum operational speed will be . For freight trains, the maximum design speed is . The new railway line will be designed with a gauge. Other key technical parameters include the following:


title: Rail Baltica

text: Its parameters are in accordance with the EU Technical Specifications for Interoperability (TSI – P2, F1).


title: Rail Baltica

text: The section from Helsinki to Tallinn will be operated by existing commercial ferries. In the future, the proposed Helsinki–Tallinn Tunnel could provide a rail link between the two cities. The length of the railway between Tallinn and Warsaw will be at least . Total length of the Baltic railway part will be .


title: Lü Buwei

text: Lü Buwei (291–235 BCE) was a Chinese merchant and politician of the Qin state during the Warring States period. Originally an influential merchant from the Wei () state, Lü Buwei met and befriended King Zhuangxiang of Qin, who was then a minor prince serving as a hostage in the Zhao state. Through bribes and machinations, Lü Buwei succeeded in helping King Zhuangxiang become the heir apparent to the Qin throne. In 249 BCE, after King Zhuangxiang ascended the throne following the death of his father, King Xiaowen, he appointed Lü Buwei as his chancellor () and ennobled him as "Marquis Wenxin" (). After King Zhuangxiang's death in 247 BCE, Lü Buwei became the chancellor and regent to King Zhuangxiang's young son, Ying Zheng, who later became Qin Shi Huang (First Emperor of the Qin Dynasty).


title: Lü Buwei

text: In 235 BCE, after being implicated in a scandal involving the Queen Dowager Zhao (Ying Zheng's mother) and her illicit lover Lao Ai, Lü Buwei was stripped of his posts and titles and was banished to the remote Shu region in the south of Qin. While in exile, Lü Buwei committed suicide by consuming poison.


title: Lü Buwei

text: Apart from his political career, Lü Buwei is also known for sponsoring the "Lüshi Chunqiu", an encyclopaedic compendium of the ideas of the Hundred Schools of Thought that was published in 239 BCE.


title: Lü Buwei

text: The primary sources of information about Lü Buwei date from the first century BCE: Sima Qian's "Shiji" ("Records of the Grand Historian"), and Liu Xiang's "Zhan Guo Ce" ("Strategies of the Warring States") and "Shuoyuan" (, "Garden of Stories"). Since these three Han Dynasty texts openly criticise both Lü Buwei and the Qin Dynasty, some alleged stories (for example, Lü's private thoughts and conversations) can be discounted. Note that some of the following English translations come from John Knoblock and Jeffrey Riegel's scholarly study of the "Lüshi Chunqiu".


title: Lü Buwei

text: Lü Buwei's biography in the "Shiji" mentioned that he was from the Wei state and he became a successful travelling merchant earning "thousands of measures of gold". In 267 BCE, the first son of King Zhaoxiang of the Qin state died, so King Zhaoxiang named his second son, Lord Anguo, as his new heir apparent. Lord Anguo promoted his concubine, Lady Huayang (), who was childless, to the status of his primary spouse. Lord Anguo had over twenty sons. Among them, Yiren, who ranked somewhere in the middle in terms of age, was sent to the Zhao state to serve as a royal hostage. When Lü Buwei was trading in Handan, the capital of Zhao, he met Yiren and said, "This is a rare piece of merchandise that should be saved for later."


title: Lü Buwei

text: The "Zhan Guo Ce" recorded a story about Lü Buwei deciding to switch his career from business to politics.


title: Lü Buwei

text: Using bribes and machinations, Lü Buwei arranged for Yiren to return to Qin and successfully persuaded Lady Huayang to adopt Yiren as her son, thereby making Yiren the heir apparent to Lord Anguo. Lady Huayang renamed Yiren to "Zichu" (; "son of Chu") because she was from the Chu state.


title: Lü Buwei

text: The "Shiji" mentioned that Lü Buwei had a beautiful "dancing girl", Lady Zhao, in his household, with whom Zichu became so infatuated that he asked for her. Lü Buwei reluctantly presented Lady Zhao to Zichu, and they returned to Handan. In 259 BCE, Lady Zhao gave birth to a son, Ying Zheng, who eventually unified China under the Qin Dynasty and became historically known as "Qin Shi Huang" (First Emperor of Qin). After the death of King Zhaoxiang in 251 BCE, Lord Anguo was enthroned and became historically known as "King Xiaowen", but he died three days after his coronation in 250 BCE. Zichu succeeded his father and became historically known as "King Zhuangxiang". King Zhuangxiang appointed Lü Buwei as his chancellor (; or prime minister) and enfeoffed him as "Marquis Wenxin" () with a taxable fief covering 100,000 households in Luoyang. While in office, Lü Buwei oversaw Qin's military campaigns against neighboring states. When King Zhuangxiang died in 247 BCE, a 13-year-old Ying Zheng succeeded him, while Lü Buwei continued serving as a chancellor () and regent to the young king.


title: Lü Buwei

text: As the chancellor and regent, Lü Buwei dominated the Qin government and military. He invited famous scholars from all over China to Xianyang, the Qin capital, where they compiled the "Lüshi Chunqiu" ("Lü's Spring and Autumn [Annals]"), an encyclopedic compendium of the ideas of the Hundred Schools of Thought.


title: Lü Buwei

text: The "Shiji" says that Lady Zhao (who became the Queen Dowager after Ying Zheng ascended the throne) pursued many illicit sexual activities, and Lü Buwei,


title: Lü Buwei

text: The Queen Dowager fell in love with Lao Ai and had him enfeoffed as the "Marquis Changxin". After she became pregnant, he recklessly took control of the Qin government.


title: Lü Buwei

text: Ying Zheng learnt that Lao Ai was not really a eunuch, and had plotted with the Queen Dowager to make their illegitimate son become successor. In 238 BCE, Lao Ai launched a revolt in an attempt to seize power from Ying Zheng, but the rebellion was crushed and Lao Ai was executed along with three generations of his relatives. Ying Zheng stripped his mother of her position as the Queen Dowager and ordered the two sons she secretly had with Lao Ai to be put into sacks and beaten to death. Lü Buwei was implicated in the incident and was stripped of his posts and titles and banished to the remote Shu region in the south of Qin. Lü Buwei feared eventual execution so he committed suicide in 235 BCE by consuming poison. As a result of the Lao Ai affair, Ying Zheng removed power from most of Lü Buwei's retainers and followers (one notable exception being Li Si) and restored it to the hereditary Qin aristocracy. After Lü Buwei's death, the "Lüshi Chunqiu" fell out of favour with the Qin government, but was resurrected by the Han Dynasty later.


title: Lesley Joseph

text: Lesley Diana Joseph (born 14 October 1945) is an English actress and broadcaster, best known for playing Dorien Green in the television sitcom "Birds of a Feather" from 1989 to 1998, and again from 2014 to 2020. Other television credits include "Absurd Person Singular" (1985) and "Night and Day" (2001–2003).


title: Lesley Joseph

text: Her stage roles include UK touring productions of "Thoroughly Modern Millie" (2005), "Calendar Girls" (2011) and "Annie" (2015). In 2018, she was nominated for the Olivier Award for Best Supporting Actress in a Musical, for the original West End production of "Young Frankenstein".


title: Lesley Joseph

text: Joseph was born, on 14 October 1945, in Finsbury Park, Haringey, London, England. She grew up in Kingsthorpe, Northampton and attended Northampton School for Girls.


title: Lesley Joseph

text: Joseph appeared in "Cinderella" at Theatre Royal, Plymouth in 2008 and the Orchard Theatre in Dartford in 2009, and starred as Myra Wilson in the UK Tour of "Hot Flush!". In 2014, "Hot Flush!" embarked on its third UK tour.


title: Lesley Joseph

text: From 4 December 2010 to 22 January 2011, she appeared at The Grand Opera House, Belfast as the Wicked Queen in the pantomime "Snow White and the Seven Dwarfs".


title: Lesley Joseph

text: In the Summer of 2011, Joseph appeared as Chris in the stage show "Calendar Girls", based on the film of the same name.


title: Lesley Joseph

text: In 2014/15, she performed at the Theatre Royal Nottingham as the Wicked Queen in "Snow White and the Seven Dwarfs".


title: Lesley Joseph

text: In 2015, she appeared as Miss Hannigan in the stage production of "Annie" at certain venues, sharing the role with Jodie Prenger and Elaine C Smith she was cast as the fairy godmother in Cinderella at the cliffs pavilion (Southend on sea). In 2016/17, she was part of the cast in "Snow White and the Seven Dwarfs" at the Theatre Royal, Plymouth. Joseph then portrayed Frau Blucher in the West End production of "Young Frankenstein".


title: Lesley Joseph

text: From 1989 to 1998, Joseph played Dorien Green in the BBC One sitcom "Birds of a Feather", alongside Pauline Quirke and Linda Robson.


title: Lesley Joseph

text: Joseph starred in the ITV soap "Night and Day" from 2001 to 2003 playing the show's resident bitch, Rachel Culgrin. In 2002, Joseph appeared on a special edition of "What Not to Wear", where she was given a makeover by Trinny Woodall and Susannah Constantine. In 2004, she performed in "The Vagina Monologues" opposite Linda Robson and Mica Paris.


title: Lesley Joseph

text: Since 2009, she has been a regular newspaper reviewer on "This Morning". She appeared in the 2014 series "Secrets of the Asylum", a two-part series for ITV. In 2015, Joseph took part in ITV's celebrity sheep herding series "Flockstars", beginning on 30 July.


title: Lesley Joseph

text: In 2014, Joseph appeared with Forrest Dunbar on ITV2's "Freshers: A Year On". She makes frequent appearances on Channel 5's "Big Brother's Bit on the Side".


title: Lesley Joseph

text: On 22 August 2016, it was announced that Joseph would take part in the fourteenth series of "Strictly Come Dancing". She was partnered with Anton du Beke. In their first week, the couple scored 23 points for their waltz to "What'll I Do", in week two, 26 for their cha-cha-cha to "Perhaps, Perhaps, Perhaps", in week three, 27 for their quickstep for "A Couple of Swells" from "Easter Parade" and in week four, 31 for their Charleston to "Won't You Charleston with Me?" from "The Boy Friend". The couple left the series in week five, after scoring 24 for their tango to "Whatever Lola Wants".


title: Lesley Joseph

text: She was one of the four competitors who appeared in the special Christmas edition of " The Great British Sewing Bee" that was transmitted on New Year's Eve 2020 on BBC 1. Her fellow competitors in the programme were Sabrina Grant, Sally Phillips and The Vivienne.


title: Lesley Joseph

text: In 2022, Joseph appeared on the seventh series of "Celebrity Coach Trip" alongside her "Birds of a Feather" co-star Linda Robson.


title: Lesley Joseph

text: Joseph began a radio show in 2008 on BBC London 94.9 with Christopher Biggins, airing every Sunday between 9am to 12noon. Biggins left the show after a few months, but Joseph has continued to host. She also stands in for Vanessa Feltz on her weekday morning talk when Feltz is on holiday.


title: Rum baba

text: A rum baba or baba au rhum is a small yeast cake saturated in syrup made with hard liquor, usually rum, and sometimes filled with whipped cream or pastry cream. It is most typically made in individual servings (about a 5 cm tall, slightly tapered cylinder) but sometimes can be made in larger forms similar to those used for Bundt cakes.


title: Rum baba

text: The original form of the baba was similar to the or , a tall, cylindrical yeast cake ( is still baked in Lithuania, Belarus, Poland and Polish-influenced western Ukraine as well as in Polish communities over the world). The name means 'old woman' or 'grandmother' in most Slavic languages; is a diminutive of .


title: Rum baba

text: The modern (rum baba), with dried fruit and soaked in rum, was invented in the in Paris, France, in 1835 or before. Today, the word in France and almost everywhere else outside eastern Europe usually refers specifically to the rum baba.


title: Rum baba

text: The original baba was introduced into France in the 18th century via Lorraine. This is attributed to Stanislaus I, the exiled king of Poland. The has reported that Stanislaus had the idea of soaking a dried (a cake roughly similar to the baba and common in Alsace-Lorraine when he arrived there) or a baba with alcoholic spirit. Another version is that when Stanislaus brought back a baba from one of his voyages it had dried up. Nicolas Stohrer, one of his pâtissiers (or possibly just apprentice pâtissiers at the time), solved the problem by adding Malaga wine, saffron, dried and fresh raisin and crême pâtissière. The writer Courchamps stated in 1839 that the descendants of Stanislaus served the baba with a saucière containing sweet Malaga wine mixed with one sixth of Tanaisie liqueur.


title: Rum baba

text: Stohrer followed Stanislaus's daughter Marie Leszczyńska to Versailles as her pâtissier in 1725 when she married King Louis XV, and founded his pâtisserie in Paris in 1730. One of his descendants allegedly had the idea of using rum in 1835. While he is believed to have done so on the fresh cakes (right out of the mold), it is a common practice today to let the baba dry a little so that it soaks up the rum better. Later, the recipe was refined by mixing the rum with aromatized sugar syrup.


title: Rum baba

text: In 1844, the Julien Brothers, Parisian pâtissiers, invented the , which is strongly inspired by the but is soaked with a different alcoholic mixture and uses a circular (ring) cake mould instead of the simple round (cylindrical) form. The ring form is nowadays often associated with the as well, and the name is also sometimes given to the rum-soaked circular cake.


title: Mashriq

text: The Mashriq (), sometimes spelled Mashreq or Mashrek, is a term used by Arabs to refer to the eastern part of the Arab world, located in Western Asia and eastern North Africa. Poetically the "Place of Sunrise", the name is derived from the verb "sharaqa" ( "to shine, illuminate, radiate" and "to rise"), from sh-r-q root (ش-ر-ق), referring to the east, where the sun rises.


title: Mashriq

text: The region includes the Arab states of Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Sudan, Syria, the United Arab Emirates, and Yemen.


title: Mashriq

text: As the word "Mashriq" refers to Arab countries located between the Mediterranean Sea and Iran, it is the companion term to "Maghreb" (), the western part of North Africa. Libya may be regarded as straddling the two regions, receiving influences from both the Maghreb and the Mashriq, with its eastern part (Cyrenaica) being linked more to Egypt and the Mashriq, while western parts (Fezzan and Tripolitania) are tied to the Maghreb.


title: Mashriq

text: These geographical terms date from the early Islamic expansion. The Mashriq corresponds to the Bilad al-Sham and Mesopotamian regions combined. , the Mashriq is home to 1.7% of the global population.


title: Mashriq

text: All of the countries located in the Arab Mashreq area are members of the Arab League (although Syria's membership is currently suspended), the Greater Arab Free Trade Area, and the United Nations. The region cooperates in several projects including the Arab Mashreq International Road Network and the Arab Mashreq International Railway. Several nations are also members of the GCC and others have tried to achieve political unity in the past, such as the United Arab Republic in the 1960s and 1970s, which originally included both Egypt and Syria.


title: Drumlin

text: A drumlin, from the Irish word "droimnín" ("littlest ridge"), first recorded in 1833, in the classical sense is an elongated hill in the shape of an inverted spoon or half-buried egg formed by glacial ice acting on underlying unconsolidated till or ground moraine. Assemblages of drumlins are referred to as fields or swarms; they can create a landscape which is often described as having a 'basket of eggs topography'.


title: Drumlin

text: The low ground between two drumlins is known as a dungeon; dungeons have colder microclimates in winter from settling cold air.


title: Drumlin

text: Drumlins occur in various shapes and sizes, including symmetrical (about the long axis), spindle, parabolic forms, and transverse asymmetrical forms. Generally, they are elongated, oval-shaped hills, with a long axis parallel to the orientation of ice flow and with an up-ice (stoss) face that is generally steeper than the down-ice (lee) face.


title: Drumlin

text: Drumlins are typically 250 to 1,000 meters long and between 120 and 300 meters wide. Drumlins generally have a length:width ratio of between 1.7 and 4.1 and it has been suggested that this ratio can indicate the velocity of the glacier. That is, since ice flows in laminar flow, the resistance to flow is frictional and depends on area of contact; thus, a more elongated drumlin would indicate a lower velocity and a shorter one would indicate a higher velocity.


title: Drumlin

text: Drumlins and drumlin swarms are glacial landforms composed primarily of glacial till. They form near the margin of glacial systems, and within zones of fast flow deep within ice sheets, and are commonly found with other major glacially-formed features (including tunnel valleys, eskers, scours, and exposed bedrock erosion).


title: Drumlin

text: Drumlins are often encountered in drumlin fields of similarly shaped, sized and oriented hills. Many Pleistocene drumlin fields are observed to occur in a fan-like distribution. The long axis of each drumlin is parallel to the direction of movement of the glacier at the time of formation. Inspection of aerial photos of these fields reveals glacier's progress through the landscape. The Múlajökull drumlins of Hofsjökull are also arrayed in a splayed fan distribution around an arc of 180°. This field surrounds the current lobe of the glacier and provide a view into the past, showing the previous extent and motion of the ice.


title: Drumlin

text: Drumlins may comprise layers of clay, silt, sand, gravel and boulders in various proportions; perhaps indicating that material was repeatedly added to a core, which may be of rock or glacial till. Alternatively, drumlins may be residual, with the landforms resulting from erosion of material between the landforms. The dilatancy of glacial till was invoked as a major factor in drumlin formation. In other cases, drumlin fields include drumlins made up entirely of hard bedrock (e.g. granite or well-lithified limestone). These drumlins cannot be explained by the addition of soft sediment to a core. Thus, accretion and erosion of soft sediment by processes of subglacial deformation do not present unifying theories for all drumlins—some are composed of residual bedrock.


title: Drumlin

text: There are two main theories of drumlin formation. The first, "constructional", suggests that they form as sediment is deposited from subglacial waterways laden with till including gravel, clay, silt, and sand. As the drumlin forms, the scrape and flow of the glacier continues around it and the material deposited accumulates, the clasts align themselves with direction of flow. It is because of this process that geologists are able to determine how the drumlin formed using till fabric analysis, the study of the orientation and dip of particles within a till matrix. By examining the till particles and plotting their orientation and dip on a stereonet, scientists are able to see if there is a correlation between each clast and the overall orientation of the drumlin: the more similar in orientation and dip of the clasts throughout the drumlin, the more likely it is that they had been deposited during the formation process. If the opposite is true, and there doesn't seem to be a link between the drumlin and the till, it suggests that the other main theory of formation could be true.


title: Drumlin

text: The second theory proposes that drumlins form by erosion of material from an unconsolidated bed. Erosion under a glacier in the immediate vicinity of a drumlin can be on the order of a meter's depth of sediment per year, depending heavily on the shear stress acting on the ground below the glacier from the weight of the glacier itself, with the eroded sediment forming a drumlin as it is repositioned and deposited.


title: Drumlin

text: A hypothesis that catastrophic sub-glacial floods form drumlins by deposition or erosion challenges conventional explanations for drumlins. It includes deposition of glaciofluvial sediment in cavities scoured into a glacier bed by subglacial meltwater, and remnant ridges left behind by erosion of soft sediment or hard rock by turbulent meltwater. This hypothesis requires huge, subglacial meltwater floods, each of which would raise sea level by tens of centimetres in a few weeks. Studies of erosional forms in bedrock at French River, Ontario, Canada provide evidence for such floods.


title: Drumlin

text: The recent retreat of a marginal outlet glacier of Hofsjökull in Iceland exposed a drumlin field with more than 50 drumlins ranging from in length, in width, and in height. These formed through a progression of subglacial depositional and erosional processes, with each horizontal till bed within the drumlin created by an individual surge of the glacier. The above theory for the formation of these Icelandic drumlins best explains one type of drumlin. However, it does not provide a unifying explanation of all drumlins. For example, drumlin fields including drumlins composed entirely of hard bedrock cannot be explained by deposition and erosion of unconsolidated beds. Furthermore, hairpin scours around many drumlins are best explained by the erosive action of horseshoe vortices around obstacles in a turbulent boundary layer.


title: Drumlin

text: Recently formed drumlins often incorporate a thin "A" soil horizon (often referred to as "'topsoil'" which accumulated after formation) and a thin "Bw" horizon (commonly referred to as "'subsoil'"). The "C" horizon, which shows little evidence of being affected by soil forming processes (weathering), is close to the surface, and may be at the surface on an eroded drumlin. Below the C horizon the drumlin consists of multiple beds of till deposited by lodgment and bed deformation. On drumlins with longer exposure (e.g. in the Lake Ontario drumlin field in New York State) soil development is more advanced, for example with the formation of clay-enriched "Bt" horizons.


title: Drumlin

text: Besides the Icelandic drumlins mentioned above, the literature also documents extensive drumlin fields in England, Scotland and Wales, Switzerland, Poland, Estonia (Vooremaa), Latvia, Sweden, around Lake Constance north of the Alps, County Leitrim, County Monaghan, County Mayo and County Cavan in the Republic of Ireland, County Fermanagh, County Armagh, and in particular County Down in Northern Ireland, Germany, Hindsholm in Denmark, Finland and Greenland.


title: Drumlin

text: The largest drumlin fields in the world formed beneath the Laurentide Ice Sheet and are found in Canada — Nunavut, the Northwest Territories, northern Saskatchewan, northern Manitoba, northern Ontario and northern Quebec. Drumlins occur in every Canadian province and territory. Clusters of thousands of drumlins are found in:


title: Drumlin

text: Extensive drumlin fields are found in Patagonia, for example near Punta Arenas Carlos Ibáñez del Campo Airport and on Navarino and Gable Island in the Beagle Channel.


title: Drumlin

text: Discovery of drumlins in Namibia was reported in 2019 though the features described do not appear to be drumlins.


title: Optimization problem

text: In mathematics, computer science and economics, an optimization problem is the problem of finding the "best" solution from all feasible solutions.


title: Optimization problem

text: Optimization problems can be divided into two categories, depending on whether the variables are continuous or discrete:


title: Optimization problem

text: If , the problem is an unconstrained optimization problem. By convention, the standard form defines a minimization problem. A maximization problem can be treated by negating the objective function.


title: Optimization problem

text: For each combinatorial optimization problem, there is a corresponding decision problem that asks whether there is a feasible solution for some particular measure . For example, if there is a graph which contains vertices and , an optimization problem might be "find a path from to that uses the fewest edges". This problem might have an answer of, say, 4. A corresponding decision problem would be "is there a path from to that uses 10 or fewer edges?" This problem can be answered with a simple 'yes' or 'no'.


title: Optimization problem

text: In the field of approximation algorithms, algorithms are designed to find near-optimal solutions to hard problems. The usual decision version is then an inadequate definition of the problem since it only specifies acceptable solutions. Even though we could introduce suitable decision problems, the problem is more naturally characterized as an optimization problem.


title: Drumheller

text: Drumheller is a town on the Red Deer River in the badlands of east-central Alberta, Canada. It is northeast of Calgary and south of Stettler. The Drumheller portion of the Red Deer River valley, often referred to as Dinosaur Valley, has an approximate width of and an approximate length of .


title: Drumheller

text: Drumheller was named after Samuel Drumheller, who, after purchasing the homestead of Thomas Patrick Greentree, had it surveyed into the original Drumheller townsite and put lots on the market in 1911. Also in 1911, Samuel Drumheller started coal mining operations near the townsite.


title: Drumheller

text: Drumheller got a railway station in 1912. It was then incorporated as a village on May 15, 1913, a town on March 2, 1916 and a city on April 3, 1930. Over a 15-year period, Drumheller's population increased from 312 in 1916 to 2,987 in 1931 shortly after becoming a city.


title: Drumheller

text: The City of Drumheller amalgamated with the Municipal District (MD) of Badlands No. 7 on January 1, 1998 to form the current Town of Drumheller. Some of the reasons the two municipalities amalgamated included the MD of Badlands No. 7 having more in common with Drumheller than other surrounding rural municipalities and both were experiencing similar planning and development issues due to their locations within the Red Deer River valley. The amalgamated municipality opted for town status rather than city status so that highways within would remain the responsibility of the Province of Alberta. As a result of the amalgamation, Drumheller became Alberta's largest town in terms of land area at .


title: Drumheller

text: The 1998 amalgamation resulted in Drumheller absorbing six hamlets that were previously under the jurisdiction of the MD of Badlands No. 7 – Cambria, East Coulee, Lehigh, Nacmine, Rosedale and Wayne. Drumheller also previously absorbed the hamlets of Bankview, Midlandvale (Midland), Newcastle and North Drumheller during annexations while under city status. Bankview and Midland were annexed in 1964 and 1972 respectively, while Newcastle and North Drumheller were both annexed in 1967. Other localities within Drumheller, either absorbed through past annexations or its eventual amalgamation with the MD of Badlands No. 7, include Aerial, Eladesor, Kneehill, Rosedale Station, Western Monarch (Atlas) and Willow Creek.


title: Drumheller

text: In total, Drumheller has absorbed at least 13 other communities in its history, some of which are now recognized as neighbourhoods or districts within the town.


title: Drumheller

text: Drumheller experiences a semi-arid climate (BSk) with very cold winters and hot summers. The highest temperature ever recorded in Drumheller was on July 18, 1941. The coldest temperature ever recorded was on January 29, 1996.


title: Drumheller

text: In the 2021 Census of Population conducted by Statistics Canada, the Town of Drumheller had a population of 7,909 living in 3,198 of its 3,557 total private dwellings, a change of from its 2016 population of 7,982. With a land area of , it had a population density of in 2021.


title: Drumheller

text: In the 2016 Census of Population conducted by Statistics Canada, the Town of Drumheller recorded a population of 7,982 living in 3,164 of its 3,471 total private dwellings, a change from its 2011 population of 8,029. With a land area of , it had a population density of in 2016.


title: Drumheller

text: Drumheller was once the largest coal producing city in Western Canada, with the Atlas Coal Mine. Now, coal mining has been replaced by natural gas and oil. Drumheller has Alberta's second largest natural gas field, the West Drumheller Field. However, Drumheller is planning to transition away from fossil fuels and emphasize renewable energy sources, such as wind power, in its economy.


title: Drumheller

text: Currently, tourism is Drumheller's main industry. A federal prison and regional medical complex also contribute to the economy. Agriculture is also quite important.


title: Drumheller

text: South of the traffic bridge over the Red Deer river on Highway 9 is the "World's Largest Dinosaur", a 26.2-metre (86 ft) high fiberglass "Tyrannosaurus rex" that can be entered for a view of the Badlands, including the adjacent 23 metre (75 ft) water fountain, again one of the largest in Canada. Tourist attractions also include the Star Mine Suspension Bridge, Atlas Coal Mine, Canadian Badlands Passion Play, Horseshoe Canyon, Water Spray Park, Aquaplex with indoor and outdoor pools, Horse Thief Canyon, hoodoos, Midland Provincial Park, the Rosedeer Hotel in Wayne, of constructed pathways, Bleriot Ferry, East Coulee School Museum, Homestead Museum, Valley Doll Museum and the Little Church which is capable of seating only six patrons.


title: Drumheller

text: Next to the now closed Drumheller ski hill is the Canadian Badlands Passion Play site, where, for two weeks each July, performances are held. Companies are composed of actors from all over Alberta. The site also offers small plays throughout the summer and an interpretive centre.


title: Drumheller

text: The Royal Tyrrell Museum of Palaeontology is a museum that hosts Canada's largest collection of dinosaur fossils. It boasts 375,000 visitors a year, the largest of all provincial museum attractions. It opened on September 25, 1985. The Royal Tyrrell Museum is located in the northwest quadrant of the Town of Drumheller, in Midland Provincial Park.


title: Drumheller

text: Newspapers covering Drumheller include the weekly "Drumheller Mail", which has been publishing every Wednesday since 1911 and has been owned by the Sheddy family since 1954.


title: Drumheller

text: Drumheller/Ostergard's Airport and Drumheller Municipal Airport are in the vicinity of Drumheller. None have regular passenger flights.


title: Drumheller

text: Passenger rail service ran from 1912 up until 1981 but freight continued on the through lines up until 2014.


title: People v. Murray

text: People v. Murray (The People of the State of California v. Conrad Robert Murray) was the American criminal trial of Michael Jackson's personal physician, Conrad Murray, who was charged with involuntary manslaughter for the pop singer's death on June 25, 2009, from a dose of the general anesthetic propofol. The trial, which started on September 27, 2011, was held in the Los Angeles County Superior Court in Los Angeles, California, before Judge Michael Pastor as a televised proceeding, reaching a guilty verdict on November 7, 2011.


title: People v. Murray

text: The prosecutors in the case, David Walgren and Deborah Brazil, both Los Angeles deputy district attorneys, in their opening statement told jurors, "misplaced trust in the hands of Murray cost Jackson his life." Murray's defense counsel (Edward Chernoff, Matthew Alford, J. Michael Flanagan and Nareg Gourjian) claimed Jackson, who was tired and under pressure from rehearsing, took eight tablets of lorazepam (Ativan), a sedative. "When Dr. Murray left the room, Jackson self-administered a dose of propofol that, with the lorazepam, created a perfect storm in his body that ultimately killed him. The whole thing is tragic, but the evidence is not that Dr. Murray did it", Chernoff said. Testimony during the trial showed Murray stayed with Jackson at least six nights a week and was regularly asked—and sometimes begged—by the insomniac singer to give him drugs powerful enough to put him to sleep.


title: People v. Murray

text: Murray told authorities Jackson was especially eager to be administered propofol, a surgical anesthetic that put him to sleep when other powerful sedatives could not. Testimony indicated that propofol, in conjunction with other drugs in Jackson's system, had played the key role in his death. In 2011, the jury found Murray guilty after about eight hours of deliberation, and he was sentenced to four years in prison, but was released after one year and eleven months on October 28, 2013, owing to prison overcrowding and good behavior.


title: People v. Murray

text: Both sides made opening statements. The jury viewed a photograph of Jackson lying on a gurney, taken minutes after he was declared dead. The jury also heard a tape of Jackson's slurred speech near the end of his life.


title: People v. Murray

text: Murray's attorney told the court that Murray is not to blame for Jackson's death, that Jackson gave himself a dose of drugs that


title: People v. Murray

text: killed him so quickly Jackson "didn't even have time to close his eyes." "What happened during that time frame is that the acts and omissions of Michael Jackson's personal doctor Conrad Murray directly led to his premature death at age 50," prosecutor Walgren said. "That misplaced trust in Conrad Murray's hand is the cause of


title: People v. Murray

text: Two former members of Jackson's staff, bodyguard Alberto Alvarez and Chef Kai Chase, took the stand. Alvarez was the first person into Jackson's bedroom after Murray raised the alarm. He indicated that Murray asked him to place vials from Jackson's bedside cabinet in a bag and remove an IV drip (containing saline solution) from its stand and what appeared to be a propofol bottle, according to Alvarez), before Murray asked him to phone 911.


title: People v. Murray

text: Bob Johnson, owner of a company that manufactures pulse oximeters, testified first. The next witness was a former patient of Murray's, Robert Russel from Las Vegas. The third witness was the first paramedic to enter Jackson's house and bedroom, Richard Senneff. The fourth witness was paramedic Martin Blount. Dr. Richelle Cooper, an emergency room physician at UCLA Medical Center, testified fifth. Although not pronounced dead until sometime after reaching the hospital (2:26 pm), the paramedics never saw any signs of life from the time they first entered Jackson's bedroom (12:26 pm).


title: People v. Murray

text: Cooper continued testifying. According to Cooper, drugs including intravenous sodium bicarbonate, vasopressin, epinephrine, atropine, and dopamine were used during the attempted cardiopulmonary resuscitation of Jackson in the trauma bay of UCLA Medical Center. From the time Jackson was under the care of Cooper until Jackson's death was pronounced, continuous chest compressions and "bagging" were conducted via an endotracheal tube.


title: People v. Murray

text: Cooper testified that Jackson was clinically dead upon arriving at the hospital, and that Murray had told her he had given Jackson 2 mg of lorazepam (a benzodiazepine) sometime earlier that day, then another 2 mg, which caused the cardiac arrest. During cross-examination, Cooper was asked about the effect of propofol as a sedative. She said about a "milligram per kilogram" would be the starting dose on a patient and would be administered into the patient's arm through an injection port. The administration would take place over a period of "a minute to a minute and a half," and personnel would constantly monitor the patient. She further testified that sedation would be expected to last 10 minutes. When asked what effect "25 mg over 3–5 minutes" would have on a patient, she responded that she would not expect that to have any effect. When asked about administering propofol through an IV drip, she said that only occurs if the patient is intubated and the desired effect is deep sedation.


title: People v. Murray

text: Next to the stand were employees from phone companies AT&T and Sprint Nextel, who were asked to guide the jury through the meaning of various data on Murray's phone records from June 25, 2009.


title: People v. Murray

text: Dr. Thao Nguyen, a cardiologist from UCLA Medical Center, testified that she was paged on that day to help with the care of "a V.I.P. patient, named Michael Jackson." She was under the impression the patient was "coding," meaning resuscitation was partially successful. She further testified that when Murray arrived at the hospital, he was "desperate and devastated," and he told the staff: "Do not give up easily, try to save his life."


title: People v. Murray

text: Nguyen's testimony then turned to the effects of Ativan (brand name of lorazepam), the drug that Murray claimed started Jackson's cardiac arrest. According to Nguyen, Ativan acts on the brain to "make you sleep" and can cause respiratory apnea ("not breathing"). She testified that "you do not typically use narcotics (such as Ativan) to treat insomnia, they are used for sedation," but, when cross-examined, she admitted that it is one of its uses.


title: People v. Murray

text: Testimony then turned to the use of flumazenil (a benzodiazepine antagonist) as an antidote to Ativan. Ativan would cause the patient to have slurred speech but propofol would not, it is "quick onset, quick offset." Propofol is only to be used in a hospital, "not just any hospital room, but only in an intensive care unit or procedure room, by specialist personnel" (an anesthesiologist present throughout its use). Constant monitoring is required because [we] "wouldn't be sure of the patient's tolerance threshold" to the drug and there should be a crash cart at hand. Nguyen also testified that Murray never mentioned propofol.


title: People v. Murray

text: Stacey Ruggles, Michelle Bella, and Sade Anding, each of whom was in contact with Murray on June 25, 2009, testified about their relationships with him. Anding, who is thought to be the person Murray was speaking to when he noticed Jackson was not breathing, said she heard coughing and mumbling after Murray stopped speaking on the call, which lasted "three or four minutes."


title: People v. Murray

text: Murray's girlfriend, Nicole Alvarez, was living with Murray in Santa Monica. She is the mother of Murray's son born in March 2009. They met in Las Vegas in 2005, where she was working in a strip club. She testified about visits to Jackson's home and her plans to travel to London with Murray for the concerts. She also told how she was accepting FedEx packages at her home in Murray's name. Prosecution provided FedEx receipts to the court and Alvarez testified that they were accurate and that her signature was on some of them. Alvarez was the person Murray called while he was in the ambulance with Jackson's body. He showed up at her apartment later that evening.


title: People v. Murray

text: Tim Lopez, employed by Applied pharmacy services, liaised with Murray over purchases of propofol and Benoquin. He testified about orders Murray placed for propofol and for Benoquin cream, to use in the treatment of the disease vitiligo, from April to June 2009 (225 vials in total). Murray's propofol orders were being routed through his Las Vegas office and then shipped to Alvarez's apartment in Los Angeles. He was also ordering increasing quantities of propofol as time went on.


title: People v. Murray

text: Sally Hirschberg, a customer service and sales employee of Seacoast Medical, a pharmaceutical distributor in Omaha, Nebraska, was first called to the stand. Testimony included details of Murray's dealing with the firm: he opened an account December 2006; ordered various medical items during April 2009, including "safe site" IV set; and cancelled an order for condom catheters on June 26, 2009. On cross-examination, Hirschberg testified that the items Murray was ordering were not unusual for a medical practice specializing in cardiovascular treatment.


title: People v. Murray

text: Stephen Marx, a computer forensics examiner working for the DEA in Virginia during June 2009, testified next. He performed an analysis of Murray's iPhone and extracted screenshots, emails, and recordings from it. The emails pertained to medical handwritten notes for patients named Omar Arnold and Paul Farance, in which both names were aliases that Jackson utilized under Murray's care. One email asked Murray: "Is that him too?"


title: People v. Murray

text: Emails pertaining to Jackson's insurance while in London were also shown. The insurance company confirmed that Murray was Jackson's only doctor since 2006, and that they wanted very thorough medical reports and records and a review of Jackson during rehearsals before agreeing to cover him. It was heard that Jackson refused authorization to release his medical records.


title: People v. Murray

text: During the testimony, a recording was played of a conversation between Murray and Jackson from May 10, 2009. The recording featured Jackson's talking about healing the world and helping children because he did not have a childhood, in slurred, almost incomprehensible speech. The recording ended with Murray's asking: "Are you OK?" and with Jackson's replying "I am asleep."


title: People v. Murray

text: Next to testify was Elissa Fleak, a Los Angeles County coroner for the past eight years. Her duties include investigating deaths (natural/suicide/homicide) and working with medical examiners to determine causes of death. Fleak went to UCLA Medical Center at 5:20 pm on June 25, 2009, to examine Jackson's body and get information surrounding his death. She examined the body in a private room, as well as notes and photographs, and looked for external wounds/injuries; any sign to signal the cause of death. None were found. She took four vials of Jackson's blood for toxicology testing and went to Jackson's house to perform an onsite investigation. While in Jackson's bedroom, she found an empty 20 ml propofol bottle and an empty 5 ml flumazenil bottle on the floor next to the bedside table. She also recovered other prescription drugs, such as diazepam, lorazepam, and tamsulosin (Flomax), one bottle prescribed to Mick Jackson, and some medicines prescribed by Alan Metzger. Other drugs found were Benoquin, hydroquinone, lidocaine, and an oxygen tank beside the bed. Medical equipment recovered included alcohol prep pads, a 10cc syringe with the needle removed, an IV catheter on the floor under an Ambu bag, an aspirin bottle, a syringe box, catheters, a jug of urine, and an IV pole with a saline bag and tubing draped over it.


title: People v. Murray

text: Three bags were recovered: a black bag containing a Starline blood pressure cuff box and 3 bottles of lidocaine; a blue Costco bag (found in the closet) containing "medical debris" including a pulse oximeter, a lanyard, vials, an empty 20 ml propofol bottle, two bottles of midazolam, an opened IV administration set, a urinary leg bag, a wideband bag, two empty dressing bags, two empty catheter bags, opened alcohol prep pads, dressing backings, an empty syringe packet, four vial tops and a needle cap. Also the saline bag with a cut in it containing the "more or less empty" 100 ml propofol bottle that Alvarez recalls removing from the IV stand; and a light blue "baby essentials" bag, containing an array of bottles that included 100 ml propofol and 20 ml propofol bottles (filled to various levels, some opened, some closed), lorazepam, flumazenil, lidocaine, and Benoquin. Murray's business cards from his Houston practice were also found.


title: People v. Murray

text: Fleak confirmed the presence of an IV stand, a saline infusion set, and a depressed syringe in a y-port connected to the tubing beside Jackson's bed. The court heard that she issued a subpoena to Murray for Jackson's medical records, and only the records pre-2009 were submitted to her. During cross-examination, Chernoff asked Fleak about a number of "mistakes" during her examination, such as picking up a bottle from the floor before photographing it, ignoring the presence of the IV stand, not taking a picture of the propofol bottle inside the cut saline bag (she said she took it out to see what it was then photographed it), and destroying her handwritten notes from June 25, 2009. It was heard that Fleak did not mention the propofol bottle was inside the saline bag in writing until March 2011. The defense suggested that she changed her story to fall into line with other witness' stories regarding the bottle in the bag.


title: People v. Murray

text: Next called to testify was Dan Anderson, chief toxicologist at the coroner's office. He has 21 years' experience in this field. He tested blood and urine taken from Jackson in UCLA and at autopsy on June 26, 2009. Blood taken from a femoral vein showed propofol (2.6 μg/ml), lidocaine (0.84 μg/ml) and lorazepam (0.169 μg/ml). Blood taken from Jackson's heart showed propofol (3.2 μg/ml), lidocaine (0.68 μg/ml), diazepam (<0.1 μg/ml), lorazepam (0.162 μg/ml), midazolam (4.6 μg/ml) and a hemoglobin percentage of 5.1%. Vials of blood taken from Jackson at UCLA were found to contain propofol (4.1 μg/ml). Other results included liver (lidocaine (0.45 μg/ml), propofol (6.2 μg/ml)), stomach (lidocaine (1.6 μg/ml), propofol (0.13 μg/ml)), urine (jug found in bedroom and more than 500 ml collected at autopsy) (lorazepam, lidocaine, midazolam, propofol and ephedrine), vitreous humour (propofol (0.4 μg/ml)). Propofol was found in all eight specimen samples. Also tested were the 10cc syringe and plunger, the syringe barrel, the fluid in the syringe and the IV tubing (propofol and lidocaine found). No alcohol, barbiturates, cocaine, sedative hypnotics, marijuana, methamphetamine, opiates, codeine, morphine, hydrocodone, or Demerol were found in the samples.


title: People v. Murray

text: During cross-examination it was heard that post-mortem redistribution occurs in the blood stream, and hence different concentrations of drugs were found in different parts of the body from which they initially entered. It was also heard that: the jug of urine from the bedroom could be from days before and might not even be Jackson's urine, that the low amount of propofol in the vitreous humour was negligible, and that there was no propofol found on the IV pole. The only place it was found was in the lower portion of the tubing and the syringe; the drug proportions couldn't be ascertained.


title: People v. Murray

text: Dan Anderson continued to answer questions about the levels of drugs in Jackson's system and the substances found in the IV bag (no drugs), tubing, and syringes (in which propofol and lidocaine found) found in Jackson's bedroom. It was heard that the level of lorazepam in Jackson's system (0.162 μg/ml) was within the therapeutic range (0.1–0.2 μg/ml), the level at which it has its desired effect. It was shown that the total amount of lorazepam in Jackson's stomach was 0.046599 mg; about 1/43 of a 2 mg tablet. It was noted that if there were a lot of a certain substance in the blood but not much in the urine then it was recently taken; the same can be said for substances in the stomach.


title: People v. Murray

text: Fleak was recalled to clarify some issues with photographs and the placement of items in the photographs that she testified to on October 6.


title: People v. Murray

text: Next called to testify was Detective Scott Smith of the LAPD. With 24 years experience in the LAPD (20 years as a detective), he was working for the Robbery Homicide division during June 2009. On June 25, 2009, he entered the UCLA emergency room at 4:25 pm and stayed until 7 pm. In that time he did not see Murray, but collected CCTV footage of Murray's leaving the ER at 4:38 pm and appearing in the west lobby at 5:02 pm. Before Smith left, he had brief interviews with Mohammed and Alvarez. Smith then went to the Carolwood residence to assist and support the coroner's investigators. It was heard that everyone left the house at 9:30 pm, and Jackson's security was left in charge of the house. On June 26, Smith attended the autopsy, which was deferred pending toxicology, and then went back to the house to further investigate because the Jackson family had handed some items to the police (some rotten cannabis in a shaving kit, some lotion, paper, an envelope, and other "debris"). Inside the shaving kit was a bottle of temazepam prescribed by Murray to Omar Arnold dated September 26, 2008. While at the house, Smith found some empty pill bottles in the master bathroom.


title: People v. Murray

text: While Smith was on the stand, a two-hour police interview with Murray, taken 48 hours after Jackson's death, was played to the court. It was held in the Ritz Carlton hotel, and Orlando Martinez asked the questions; Chernoff was present. It was heard that Murray first met Jackson in 2006, a security guard (a patient's son) asked Murray to meet him, and Murray first treated Jackson's children for the flu. Amir (Michael Amir Williams) told Murray that Michael Jackson would like Murray to be there for the concerts. Murray understood that he would be an employee of Jackson's, but then discovered his salary would be paid by AEG Live. Murray said Jackson was not a person who ate well, and he was probably seeing doctors for issues he did not disclose to Murray. It was heard that Murray spent six nights a week at Jackson's house, only having Sundays off, and it was usually just Murray, Jackson, and Jacksons' children in the house.


title: People v. Murray

text: The proceedings began with the conclusion of the recording of Murray's interview with the police from 48 hours after Jackson's death. Afterwards, Smith continued his testimony. Smith never mentioned in any notes referencing a propofol bottle being inside a saline bag during searches of Jackson's home in June 2009. He saw the propofol bottle beside a cut saline bag after Fleak had removed them from the Costco bag and it was the only saline bag found. Search warrants were executed of Murray's house in Las Vegas, offices in Las Vegas and Houston, his girlfriend's apartment, his warehouse and his car, and no propofol was found. During brief statements taken from Mohammed and Amir at the hospital on June 25, 2009, neither of them mentioned Murray asking to be brought back to the residence. Alvarez did not mention propofol in an IV bag or Murray asking him to put things in bags until after the cause of death was released on August 27, 2009.


title: People v. Murray

text: Dr. Christopher Rogers, chief of forensic pathology at the coroner's office, testified he had conducted the autopsy of Jackson on June 26, 2009. There was nothing obvious indicating the cause of death, and he was healthier than the average person of his age because there was no atherosclerosis on the walls of his coronary arteries. Jackson did not have heart disease, and there were no irregularities in his heart. There was no evidence of natural disease or trauma, his esophagus was intact with no milky fluid there or in the stomach. The stomach contained no pills or capsules. His mouth, upper airway and trachea were all intact with no foreign material present. Rogers took samples from each organ and sent them to the relevant experts for consults because he was not able to determine the cause of death and wanted a toxicological analysis. Rogers also requested Jackson's medical records from Murray but never received them.


title: People v. Murray

text: After toxicological analysis, Rogers determined the cause of death to be acute propofol intoxication with contributing effects from benzodiazepines exacerbating respiratory and cardiovascular depression. When asked about the manner of death, he testified it was a homicide. Propofol was not necessary, it was outside of a hospital or clinic, and the proper equipment to be used with propofol was not there. Murray administered too much propofol. The "circumstances do not support self-administration" because Jackson would have had to have woken up, self-administer the drugs, circulate to the brain, and then be found not breathing – all in the space of 2 minutes. Rogers said that was a "less likely scenario."


title: People v. Murray

text: The "more likely scenario" was that "Murray was estimating the doses" to give Jackson and that "Murray accidentally gave too much." There was a cut in the rubber stopper in the propofol inconsistent with a needle but a medical device called a spike, which is used to get the liquid to flow out, to "set up constant flow" of the drug.


title: People v. Murray

text: During cross-examination, Rogers testified that the only evidence of propofol in the medical equipment was in the syringe, in the Y-connector and the tubing thereafter. None was found in the upper tubing or the IV saline bag. Defense council Flanagan asked "Would 25 mg propofol pushed over 3-5 minutes make the patient sleep?" Rogers replied yes. Flanagan: "How long would they sleep for?" Rogers: "Approximately 5 minutes." Flanagan: "So a 25 mg dose of propofol at 10:50 am would have no effect after 11.05?" Rogers: "Correct." Flanagan: "After this you would assume the patient sleeping was cause by something else and not propofol, wouldn't you?" Rogers: "Yes." The therapeutic range of propofol required for major surgery was 4 μg/ml, and for lesser operations it was 2 μg/ml. Jackson had 2.6 μg/ml in his femoral blood, which is used for post-mortem examination because as it is not located near any large organs and is less prone to redistribution after death. Rogers stated that a lethal level of propofol has been documented anywhere between 1 and 17 μg/ml. Jackson's stomach level of lorazepam was 0.64 μg/ml, and his femoral blood level was 0.169 μg/ml. It was hypothesized that Jackson must have ingested lorazepam fairly close to the time of death for it not to have been absorbed and distributed yet. Flanagan: "A 2 mg pill of lorazepam gets you to 0.018 μg/ml blood level?" Rogers: "Yes, in Shafer's literature." Flanagan: "If you pushed (all at once) a dose of lorazepam to get you to 0.169 μg/ml blood level, it would stop your heart, wouldn't it?" Rogers: "Yes."


title: People v. Murray

text: On redirect, Walgren asked whether it would still be a homicide if Jackson had self-administered the propofol or lorazepam because of the negligence by Murray, and Rogers said, "Correct." Walgren asked whether the propofol found was the same as in major surgery, and Rogers replied, "Yes." Walgren: "Would 25 mg over 3–5 minutes get you to 2.6 μg/ml blood level?" Rogers: "No."


title: People v. Murray

text: Dr. Alon Steinberg, a cardiologist for 13 years and board-certified in cardiovascular diseases, Cardiac CT and Nuclear Cardiology, testified that he was not an expert in anaesthesia or pharmacology and that Murray was not board-certified in June 2009. Of the three degrees of breaching the standard of care (no deviation, mild deviation, extreme deviation), this case was the first time Steinberg has seen extreme deviations from the standard of care. Steinberg testified that propofol is only used in cases of needing deep sedation when the patient will go through a significantly painful procedure and there are risks that the patient could stop breathing; that is why it is used with constant monitoring and emergency equipment on hand. He testified that he only uses propofol with performing cardioversions and that he is required to have an anaesthetist present. For instances of mild and moderate sedation, Steinberg stated that he would use benzodiazepines and would never prescribe propofol for insomnia. He received Murray's case and was asked to review his acts and omissions against the standard of care. The review was based on Murray's own words from his police interview previously heard by the court. His findings: "Six separate and distinct extreme deviations from the standard of care."


title: People v. Murray

text: Question: "Dr. Murray's deviations in the standard of care contributed to Jackson's untimely death?" Steinberg: "Yes." Question: "If Jackson administered the drugs to himself, was it still gross negligence?" Steinberg: "Yes." All medicines are kept in locked and passworded cabinets. There would have been no opportunity for self-administration in a proper setting.


title: People v. Murray

text: During cross-examination, Steinberg testified that if the patient had a blood pressure (caused by there being a pulse) and a pulse of 122, he was savable. If a patient is not breathing but has a pulse, the course of action is to clear the airways and give breaths.


title: People v. Murray

text: Next to the stand was Dr. Nader Kamanger, board-certified in internal medicine, pulmonary medicine, critical care, and sleep medicine. He uses propofol daily for sedation when placing an endotracheal tube. It is the classic induction agent for deep sedation during painful procedures. It is the most common drug for maintaining sedation on patients on mechanical breathing apparatus. Doctors have to call an anaesthesiologist to administer it, someone who can maintain the airway, and someone who can reverse the effects of the drugs. Kamanger also pointed out Murray's extreme deviation of the standard of care, consistent with Steinberg's testimony.


title: People v. Murray

text: Next to the stand was Steven Shafer, a professor of anesthesiology at Columbia University since 2007 and adjunct professor of anesthesiology at Stanford University since 2000. He is an expert on pharmacokinetics (rate of onset of drug action, duration of action, and elimination of drug action, in sum) and pharmacometrics with 20 years of experience working with the Food and Drug Administration (FDA). His field of interest involves mathematically modeling how a dose of drug translates to concentrations in the body and its effects on a patient. He has published 19 papers about the pharmacokinetics of propofol. Pharmacokinetics involves the study of the dilution of drug in a patient's blood stream. Shafer is the current editor in chief for the Journal of Anesthesia and Analgesia and on the editing board of many other journals.


title: People v. Murray

text: Shafer showed a video of the use of propofol during a procedure. He testified about his review of the Murray case. He found seventeen "separate and distinct egregious violations" of the standard of care, of which four were unconscionable, based on Murray's police interview:


title: People v. Murray

text: Question: "Each one of these seventeen egregious violations is individually likely or expected to result in injury or death to Michael Jackson?" Response: "Yes."


title: People v. Murray

text: He stated that the drugs administered (as described in Murray's interview statement) could not have produced the femoral blood levels at autopsy. He also testified that Jackson repeatedly self-administrating the drugs would not have caused the femoral blood levels found at autopsy.


title: People v. Murray

text: Administration by continued IV infusion would cause the femoral blood levels found at autopsy very quickly after the drip was started. After the patient stops breathing, the heart would still be beating so the IV would continue. This scenario would result in the blood levels at autopsy. According to Shafer: "That's what I think happened, based on all the evidence."