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Question: What are the symptoms of alpha thalassemia major?

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Context 1: Thalassaemia minor | definition of Thalassaemia minor by Medical dictionary
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Thalassemia describes a group of inherited disorders characterized by reduced or absent amounts of hemoglobin, the oxygen-carrying protein inside the red blood cells  There are two basic groups of thalassemia disorders: alpha thalassemia and beta thalassemia  These conditions cause varying degrees of anemia, which can range from insignificant to life threatening 
All types of thalassemias are considered quantitative diseases of hemoglobin, because the quantity of hemoglobin produced is reduced or absent  Usual adult hemoglobin is made up of three components: alpha globin, beta globin, and heme  Thalassemias are classified according to the globin that is affected, hence the names alpha and beta thalassemia  Although both classes of thalassemia affect the same protein, the alpha and beta thalassemias are distinct diseases that affect the body in different ways 
Beta thalassemia may be the most best-known type of thalassemia and is also called Cooley's anemia  It is caused by a change in the gene for the beta globin component of hemoglobin  Beta thalassemia causes variable anemia that can range from moderate to severe, depending in part on the exact genetic change underlying the disease  Beta thalassemia can be classified based on clinical symptoms  Beta thalassemia major usually causes severe anemia that can occur within months after birth  If left untreated, severe anemia can result in insufficient growth and development, as well as other common physical complications that can lead to a dramatically decreased life-expectancy  Fortunately, in developed countries beta thalassemia is usually identified by screening in the newborn period, before symptoms have developed  Children who are identified early can be started on ongoing blood transfusion therapy as needed  Although transfusion therapy prevents many of the complications of severe anemia, the body is unable to eliminate the excess iron contained in the transfused blood  Over time, the excess iron deposits in tissues and organs, resulting in damage and organ failure  Another medication must be administered to help the body eliminate the excess iron and prevent iron-over-load complications  Beta thalassemia intermedia describes the disease in individuals who have moderate anemia that only requires blood transfusions intermittently, if at all 
Alpha thalassemia is the result of changes in the genes for the alpha globin component of hemoglobin  There are two main types of alpha thalassemia disease: hemoglobin H disease and alpha thalassemia major  The two diseases are quite different from beta thalassemia as well as from one another  Individuals with hemoglobin H disease can experience events of hemolytic anemia—anemia caused by the rapid breakdown of the red blood cells  These events are thought to be triggered by various environmental causes, such as infection and/or exposure to certain chemicals  Hemoglobin H disease is in most cases milder than beta thalassemia  It does not generally require transfusion therapy  Alpha thalassemia major is a very serious disease that results in severe anemia that begins even before birth  Most affected babies do not survive to be born or die shortly after birth 
The thalassemias are among the most common genetic diseases worldwide  Both alpha and beta thalassemia have been described in individuals of almost every ancestry, but the conditions are more common among certain ethnic groups  Unaffected carriers of all types of thalassemia traits do not experience health problems  In fact, the thalassemia trait is protective against malaria, a disease caused by blood-borne parasites transmitted through mosquito bites  According to a widely accepted theory, most genetic changes—mutations—that cause thalassemia occurred multiple generations ago  Coincidentally, these mutations increased the likelihood that carriers would survive malaria infection  Survivors passed the mutation onto their offspring, and the trait became established throughout areas where malaria is common  As populations migrated, so did the thalassemia traits 
Beta thalassemia trait is seen most commonly in people with the following ancestry: Mediterranean (including North African, and particularly Italian and Greek), Middle Eastern, Indian, African, Chinese, and Southeast Asian (including Vietnamese, Laotian, Thai, Singaporean, Filipino, Cambodian, Malaysian, Burmese, and Indonesian)  Alpha-thalassemia trait is seen with increased frequency in the same ethnic groups  However, there are different types of alpha thalassemia traits within these populations  The frequency of hemoglobin H disease and alpha thalassemia major depends on the type of alpha thalassemia trait  The populations in which alpha thalassemia diseases are most common include Southeast Asians and Chinese (particularly Southern Chinese) 
It is difficult to obtain accurate prevalence figures for various types of thalassemia within different populations  This difficulty arises due to testing limitations in determining exact genetic diagnoses, as well as the fact that many studies have focused on small, biased hospital populations 
Two studies reflect prevalence figures that can be helpful counseling families and determining who to screen for beta thalassemia  Between the years of 1990 and 1996, the State of California screened more than 3 1 million infants born in the state for beta thalassemia  Approximately 1 in 114,000 infants had beta thalassemia major, with prevalence rates being highest among Asian Indians (about one in 4,000), Southeast Asians (about one in 10,000), and Middle Easterners (about one in 7,000)  Another type of beta thalassemia disease, E/beta thalassemia, was represented in approximately one in 110,000 births, all of which occurred in families of Southeast Asian ancestry  Among Southeast Asians, the prevalence of E/beta thalassemia was approximately one in 2,600 births  This is in keeping with the observation that hemoglobin E trait carrier rates are relatively high within the Southeast Asian population: 16% in a study of 768 immigrants to California, and up to 25% in some specific Southeast Asian populations such as Cambodians  While these California studies address some of the limitations of earlier population studies, the pattern observed in California is expected to be different in other areas of the United States and the world  For example, Italians are underrepresented in this population when compared to the population of the East Coast of the United States 
Determining prevalence figures for alpha thalassemia is even more difficult due to increased limitations in diagnostic testing  All types of alpha thalassemia disease are most common among people of Southeast Asian and Chinese descent, for reasons that become clearer with an understanding of the underlying genetics of alpha thalassemia  One study of 500 pregnant women in Northern Thailand estimated a frequency of one in 500 pregnancies affected by alpha thalassemia major, for example  Prevalence of alpha thalassemia disease is significantly lower in the United States primarily because of immigration patterns; although at least one state, California, has observed growing hemoglobin H disease incidence rates that are high enough to justify universal newborn screening for the condition 
Humans normally make several types of the oxygen-carrying protein hemoglobin  An individual's stage in development determines whether he or she makes primarily embryonic, fetal, or adult hemoglobins  All types of hemoglobin are made of three components: heme, alpha (or alpha-like) globin, and beta (or beta-like) globin  All types of thalassemia are caused by changes in either the alpha- or beta-globin gene  These changes cause little or no globin to be produced  The thalassemias are, therefore, considered quantitative hemoglobin diseases  All types of thalassemias are recessively inherited, meaning that a genetic change must be inherited from both the mother and the father  The severity of the disease is influenced by the exact thalassemia mutations inherited, as well as other genetic and environmental factors  There are rare exceptions, notably with beta thalassemia, where globin gene mutations exhibit a dominant pattern of inheritance in which only one gene needs to be altered in order to see disease expression  Scientists continue to study the causes  For instance, a new mutation for alpha-thalassemia was discovered for the first time among Iranian patients in 2004 
BETA-THALASSEMIA  Most individuals have two normal copies of the beta globin gene, which is located on chromosome 11 and makes the beta globin component of normal adult hemoglobin, hemoglobin A  There are approximately 100 genetic mutations that have been described that cause beta thalassemia, designated as either beta0 or beta + mutations  No beta globin is produced with a beta0 mutation, and only a small fraction of the normal amount of beta globin is produced with a beta + mutation 
When an individual has one normal beta globin gene and one with a beta thalassemia mutation, he or she is said to carry the beta thalassemia trait  Beta thalassemia trait, like other hemoglobin traits, is protective against malaria infection  Trait status is generally thought not to cause health problems, although some women with beta thalassemia trait may have an increased tendency toward anemia during pregnancy 
When two members of a couple carry the beta thalassemia trait, there is a 25% chance that each of their children will inherit beta thalassemia disease by inheriting two beta thalassemia mutations, one from each parent  The clinical severity of the beta thalassemia disease—whether an individual has beta thalassemia intermedia or beta thalassemia major—will depend largely on whether the mutations inherited are beta0 thalassemia or beta + thalassemia mutations  Two beta0 mutations generally lead to beta thalassemia major, and two beta+ thalassemia mutations generally lead to beta thalassemia intermedia  Inheritance of one beta0 and one beta + thalassemia mutation tends to be less predictable 
Although relatively uncommon, there are other thalassemia-like mutations that can affect the beta globin gene  Hemoglobin E is the result of a substitution of a single nucleotide  This change results in a structurally altered hemoglobin that is produced in decreased amounts  Therefore, hemoglobin E is unique in that it is both a quantitative (i e  thalassemia-like) and qualitative trait  When co-inherited with a beta thalassemia trait, it causes a disease that is almost indistinguishable from beta thalassemia disease  Large deletions around and including the beta globin gene can lead to delta/beta thalassemia or hereditary persistence of fetal hemoglobin (HPFH)  Interestingly, delta/beta thalassemia trait behaves very similarly to beta thalassemia trait in its clinical manifestations  However, HPFH trait does not tend to cause hemoglobin disease when co-inherited with a second thalassemia or other beta globin mutation 
ALPHA-THALASSEMIA  Most individuals have four normal copies of the alpha globin gene, two copies on each chromosome 16  These genes make the alpha globin component of normal adult hemoglobin, which is called hemoglobin A  Alpha globin is also a component of fetal hemoglobin and the other major adult hemoglobin called hemoglobin A2  Mutations of the alpha globin genes are usually deletions of the gene, resulting in absent production of alpha globin  Since there are four genes (instead of the usual two) to consider when looking at alpha globin gene inheritance, there are several alpha globin types that are possible 
Absence of one alpha globin gene leads to a condition known as silent alpha thalassemia trait  This condition causes no health problems and can be detected only by special genetic testing  Alpha thalassemia trait occurs when two alpha globin genes are missing  This can occur in two ways  The genes may be deleted from the same chromosome, causing the 'cis' type of alpha thalassemia trait  Alternately, they may be deleted from different chromosomes, causing the 'trans' type of alpha thalassemia trait  In both instances, there are no associated health problems, although the trait status may be detected by more routine blood screening 
Hemoglobin H disease results from the deletion of three alpha globin genes, such that there is only one functioning gene  Typically, this can occur when one parent carries the silent alpha thalassemia trait, and the other parent carries the 'cis' type of the alpha thalassemia trait  In this situation, there is a 25% chance for hemoglobin H disease in each of such a couple's children 
Hemoglobin H disease-like symptoms can also be a part of a unique condition called alpha thalassemia mental retardation syndrome  Alpha thalassemia mental retardation syndrome can be caused by a deletion of a significant amount of chromosome 16, affecting the alpha globin genes  This is usually not inherited, but rather occurs sporadically in the affected individual  Affected individuals have mild hemoglobin H disease, mild-to-moderate mental retardation, and characteristic facial features  This syndrome can also occur as a sex-linked form in which a mutation is inherited in a particular gene on the X-chromosome  This gene influences alpha globin production, as well as various other developmental processes  Individuals affected with this form of the syndrome tend to have more severe mental retardation, delayed development, nearly absent speech, characteristic facial features, and genital-urinary abnormalities  The remaining discussion will focus only on aspects of hemoglobin H disease 
Alpha thalassemia major results from the deletion of all four alpha globin genes, such that there are no functioning alpha globin genes  This can occur when both parents carry the 'cis' type of the alpha thalassemia trait  In this situation, there is a 25% chance for alpha thalassemia major in each of such a couple's children 
Beta thalassemia major is characterized by severe anemia that can begin months after birth  In the United States and other developed countries beta thalassemia is identified and treated early and effectively  Therefore, the following discussion of symptoms applies primarily to affected individuals in the past and unfortunately in some underdeveloped countries now  If untreated, beta thalassemia major can lead to severe lethargy, paleness, and delays in growth and development  The body attempts to compensate by producing more blood, which is made inside the bones in the marrow  However, this is ineffective without the needed genetic instructions to make enough functioning hemoglobin  Instead, obvious bone expansion and changes occur that cause characteristic facial and other changes in appearance, as well as increased risk of fractures  Severe anemia taxes other organs in the body—such as the heart, spleen, and liver—which must work harder than usual  This can lead to heart failure, as well as enlargement and other problems of the liver and spleen  When untreated, beta thalassemia major generally results in childhood death, usually due to heart failure  In 2004, the first known heart attack associated with beta thalassemia major was reported  Fortunately, in developed countries diagnosis is usually made early, often before symptoms have begun  This allows for treatment with blood transfusion therapy, which can prevent most of the complications of the severe anemia caused by beta thalassemia major  Individuals with beta thalassemia intermedia have a more moderate anemia that may only require treatment with transfusion intermittently, such as when infections occur and stress the body  As a person with beta thalassemia intermedia gets older, however, the need for blood transfusions may increase to the point that they are required on a regular basis  When this occurs their disease becomes more similar to beta thalassemia major  Other genetic and environmental factors can influence the course of the disease as well  For example, co-inheritance of one or two alpha thalassemia mutations can tend to ameliorate some of the symptoms of beta thalassemia disease, which result in part from an imbalance in the amount of alpha- and beta-globin present in the red blood cells 
Hemoglobin h disease
Absence of three alpha globin genes causes an imbalance of alpha and beta globin proteins in the red blood cells  The excess beta globin proteins tend to come together to form hemoglobin H, which is unable to release oxygen to the tissues  In addition, hemoglobin H tends to precipitate out in the cells, causing damage to the red blood cell membrane  When affected individuals are exposed to certain drugs and chemicals known to make the membrane more fragile, the cells are thought to become vulnerable to breakdown in large numbers, a complication called hemolytic anemia  Fever and infection are also considered to be triggers of hemolytic anemia in hemoglobin H disease  This can result in fatigue, paleness, and a yellow discoloration of the skin and whites of eyes called jaundice  Usually, the anemia is mild enough not to require treatment  Severe anemia events may require blood transfusion, however, and are usually accompanied by such other symptoms as dark feces or urine and abdominal or back pain  These events are uncommon in hemoglobin H disease, although they occur more frequently in a more serious type of hemoglobin H disease called hemoglobin H/Constant Spring disease  Individuals effected with this type of hemoglobin H disease are also more likely to have enlargement of and other problems with the spleen 
Alpha thalassemia major
Because alpha globin is a necessary component of all major hemoglobins and some minor hemoglobins, absence of all functioning alpha globin genes leads to serious medical consequences that begin even before birth  Affected fetuses develop severe anemia as early as the first trimester of pregnancy  The placenta, heart, liver, spleen, and adrenal glands may all become enlarged  Fluid can begin collecting throughout the body as early as the start of the second trimester, causing damage to developing tissues and organs  Growth retardation is also common  Affected fetuses usually miscarry or die shortly after birth  In addition, women carrying affected fetuses are at increased risk of developing complications of pregnancy and delivery  Up to 80% of such women develop toxemia, a disturbance of metabolism that can potentially lead to convulsions and coma  Other maternal complications include premature delivery and increased rates of delivery by cesarean section, as well as hemorrhage after delivery 
Thalassemia may be suspected if an individual shows signs that are suggestive of the disease  In all cases, however, laboratory diagnosis is essential to confirm the exact diagnosis and to allow for the provision of accurate genetic counseling about recurrence risks and testing options for parents and affected individuals  Screening is likewise recommended to determine trait status for individuals of high-risk ethnic groups 
The following tests are used to screen for thalassemia disease and/or trait:
hemoglobin electrophoresis with quantitative hemoglobin A2 and hemoglobin F
free erythrocyte-protoporphyrin (or ferritin or other studies of serum iron levels)
A complete blood count will identify low levels of hemoglobin, small red blood cells, and other red blood cell abnormalities that are characteristic of a thalassemia diagnosis  Since thalassemia trait can sometimes be difficult to distinguish from iron deficiency, tests to evaluate iron levels are important  A hemoglobin electrophoresis is a test that can help identify the types and quantities of hemoglobin made by an individual  This test uses an electric field applied across a slab of gel-like material  Hemoglobins migrate through this gel at various rates and to specific locations, depending on their size, shape, and electrical charge  Isoelectric focusing and high-performance liquid chromatography (HPLC) use similar principles to separate hemoglobins and can be used instead of or in various combinations with hemoglobin electrophoresis to determine the types and quantities of hemoglobin present  Hemoglobin electrophoresis results are usually within the normal range for all types of alpha thalassemia  However, hemoglobin A2 levels and sometimes hemoglobin F levels are elevated when beta thalassemia disease or trait is present  Hemoglobin electrophoresis can also detect structurally abnormal hemoglobins that may be co-inherited with a thalassemia trait to cause thalassemia disease (i e , hemoglobin E) or other types of hemoglobin disease (i e , sickle hemoglobin)  Sometimes DNA testing is needed in addition to the above screening tests  This can be performed to help confirm the diagnosis and establish the exact genetic type of thalassemia 
Diagnosis of thalassemia can occur under various circumstances and at various ages  Several states offer thalassemia screening as part of the usual battery of blood tests done for newborns  This allows for early identification and treatment  Thalassemia can be identified before birth through the use of prenatal diagnosis  Chorionic villus sampling (CVS) can be offered as early as 10 weeks of pregnancy and involves removing a sample of the placenta made by the baby and testing the cells  CVS carries a risk of causing a miscarriage that is between 0 5%-1%  Amniocentesis is generally offered between 15 and 22 weeks of pregnancy, but can sometimes be offered earlier  Two to three tablespoons of the fluid surrounding the baby is removed  This fluid contains fetal cells that can be tested  The risk of miscarriage associated with amniocentesis ranges from 0 33-0 5%  Pregnant woman and couples may choose prenatal testing in order to prepare for the birth of a baby that may have thalassemia  Alternately, knowing the diagnosis during pregnancy allows for the option of pregnancy termination  Preimplantation genetic diagnosis (PGD) is a relatively new technique that involves in-vitro fertilization followed by genetic testing of one cell from each developing embryo  Only the embryos unaffected by sickle cell disease are transferred back into the uterus  PGD is currently available on a research basis only and is relatively expensive 
Individuals with beta thalassemia major receive regular blood transfusions, usually on a monthly basis  This helps prevent severe anemia and allows for more normal growth and development  Transfusion therapy does have limitations, however  Individuals can develop reactions to certain proteins in the blood—called a transfusion reaction  This can make locating appropriately matched donor blood more difficult  Although blood supplies in the United States are very safe, particularly relative to the past and to other areas of the world, there remains an increased risk of exposure to such blood-borne infections as hepatitis  Additionally, the body is not able to get rid of the excess iron that accompanies each transfusion  An additional medication called desferoxamine is administered, usually five nights per week over a period of several hours, using an automatic pump that can be used during sleep or taken anywhere the person goes  This medication is able to bind to the excess iron, which can then be eliminated through urine  If desferoxamine is not used regularly or is unavailable, iron overload can develop and cause tissue damage and organ damage and failure  The heart, liver, and endocrine organs are particularly vulnerable  Desferoxamine itself may rarely produce allergic or toxic side effects, including hearing damage  Signs of desferoxamine toxicity are screened for and generally develop in individuals who overuse the medication when body iron levels are sufficiently low  Overall, however, transfusion and desferoxamine therapy have increased the life expectancy of individuals with the most severe types of beta thalassemia major to the 4th or 5th decade  This can be expected to improve with time and increased developments in treatment, as well as for those with more mild forms of the disease 
New treatments offer additional options for some individuals with beta thalassemia major  There are various medications that target the production of red blood cells (i e  erythropoeitin) or fetal hemoglobin (i e  hydroxyurea and butyrate)  Their effectiveness in ameliorating the severity of beta thalassemia is currently being investigated  Another promising new treatment is bone marrow transplantation, in which the bone marrow of an affected individual is replaced with the bone marrow of an unaffected donor  If successful, this treatment can provide a cure  However, there is an approximately 10-15% chance the procedure could be unsuccessful (i e  the thalassemia returns); result in complications (i e  graft-versus-host disease); or result in death  The risk for specific individuals depends on current health status, age, and other factors  Because of the risks involved and the fact that beta thalassemia is a treatable condition, transplant physicians require a brother or sister donor who has an identically matched tissue type, called HLA type  HLA type refers to the unique set of proteins present on each individual's cells, which allows the immune system to recognize "self" from "foreign " HLA type is genetically determined, so there is a 25% chance for two siblings to be a match  Transplant physicians and researchers are also investigating ways to improve the safety and effectiveness of bone marrow transplantation  Using newborn sibling umbilical cord blood—the blood from the placenta that is otherwise discarded after birth but contains cells that can go on to make bone marrow—seems to provide a safer and perhaps more effective source of donor cells  Donors and recipients may not have to be perfect HLA matches for a successful transplant using cord blood cells  Trials are also underway to determine the effectiveness of "partial transplants," in which a safer transplant procedure is used to replace only a percentage of the affected individual's bone marrow  Other possible treatments on the horizon may include gene therapy techniques aimed at increasing the amount of normal hemoglobin the body is able to make 
Hemoglobin H disease is a relatively mild form of thalassemia that may go unrecognized  It is not generally considered a condition that will reduce one's life expectancy  Education is an important part of managing the health of an individual with hemoglobin H disease  It is important to be able to recognize the signs of severe anemia that require medical attention  It is also important to be aware of the medications, chemicals, and other exposures to avoid due to the theoretical risk they pose of causing a severe anemia event  When severe anemia occurs, it is treated with blood transfusion therapy  For individuals with hemoglobin H disease, this is rarely required  For those with the hemoglobin H/Constant Spring form of the disease, the need for transfusions may be intermittent or ongoing, perhaps on a monthly basis and requiring desferoxamine treatment  Individuals with this more severe form of the disease may also have an increased chance of requiring removal of an enlarged and/or overactive spleen 
Anemia — A blood condition in which the level of hemoglobin or the number of red blood cells falls below normal values  Common symptoms include paleness, fatigue, and shortness of breath 
Bilirubin — A yellow pigment that is the end result of hemoglobin breakdown  This pigment is metabolized in the liver and excreted from the body through the bile  Bloodstream levels are normally low; however, extensive red cell destruction leads to excessive bilirubin formation and jaundice 
Bone marrow — A spongy tissue located in the hollow centers of certain bones, such as the skull and hip bones  Bone marrow is the site of blood cell generation 
Bone marrow transplantation — A medical procedure used to treat some diseases that arise from defective blood cell formation in the bone marrow  Healthy bone marrow is extracted from a donor to replace the marrow in an ailing individual  Proteins on the surface of bone marrow cells must be identical or very closely matched between a donor and the recipient 
Desferoxamine — The primary drug used in iron chelation therapy  It aids in counteracting the life-threatening buildup of iron in the body associated with long-term blood transfusions 
Globin — One of the component protein molecules found in hemoglobin  Normal adult hemoglobin has a pair each of alpha-globin and beta-globin molecules 
Heme — The iron-containing molecule in hemoglobin that serves as the site for oxygen binding 
Hemoglobin — Protein-iron compound in the blood that carries oxygen to the cells and carries carbon dioxide away from the cells 
Hemoglobin A — Normal adult hemoglobin that contains a heme molecule, two alpha-globin molecules, and two beta-globin molecules 
Hemoglobin electrophoresis — A laboratory test that separates molecules based on their size, shape, or electrical charge 
Hepatomegaly — An abnormally large liver 
HLA type — Refers to the unique set of proteins called human leukocyte antigens  These proteins are present on each individual's cell and allow the immune system to recognize 'self' from 'foreign'  HLA type is particularly important in organ and tissue transplantation 
Hydroxyurea — A drug that has been shown to induce production of fetal hemoglobin  Fetal hemoglobin has a pair of gamma-globin molecules in place of the typical beta-globins of adult hemoglobin  Higher-than-normal levels of fetal hemoglobin can ameliorate some of the symptoms of thalassemia 
Iron overload — A side effect of frequent blood transfusions in which the body accumulates abnormally high levels of iron  Iron deposits can form in organs, particularly the heart, and cause life-threatening damage 
Jaundice — Yellowing of the skin or eyes due to excess of bilirubin in the blood 
Mutation — A permanent change in the genetic material that may alter a trait or characteristic of an individual, or manifest as disease, and can be transmitted to offspring 
Placenta — The organ responsible for oxygen and nutrition exchange between a pregnant mother and her developing baby 
Red blood cell — Hemoglobin-containing blood cells that transport oxygen from the lungs to tissues  In the tissues, the red blood cells exchange their oxygen for carbon dioxide, which is brought back to the lungs to be exhaled 
Screening — Process through which carriers of a trait may be identified within a population 
Splenomegaly — Enlargement of the spleen 
Because alpha thalassemia major is most often a condition that is fatal in the prenatal or newborn period, treatment has previously been focused on identifying affected pregnancies in order to provide appropriate management to reduce potential maternal complications  Pregnancy termination provides one form of management  Increased prenatal surveillance and early treatment of maternal complications is an approach that is appropriate for mothers who wish to continue their pregnancy with the knowledge that the baby will most likely not survive  In recent years, there have been a handful of infants with this condition who have survived long-term  Most of these infants received experimental treatment including transfusions before birth, early delivery, and even bone marrow transplantation before birth, although the latter procedure has not yet been successful  For those infants that survive to delivery, there seems to be an increased risk of developmental problems and physical effects, particularly heart and genital malformations  Otherwise, their medical outlook is similar to a child with beta thalassemia major, with the important exception that ongoing, life-long blood transfusions begin right at birth 
As discussed above, the prognosis for individuals with the most serious types of thalassemia has improved drastically in the last several years following recent medical advances in transfusion, chemo-, and transplantation therapy  Advances continue and promise to improve the life expectancy and quality of life further for affected individuals 
"First Known Heart Attack Associated With Beta-thalassemia Major Reported " Heart Disease Weekly February 22, 2004: 10 
"Novel Alpha-thalassemia Mutations Identified " Hematology Week January 26, 2004: 19 
Children's Blood Foundation  333 East 38th St , Room 830, New York, NY 10016-2745  (212) 297-4336  cfg@nyh med cornell edu 
Cooley's Anemia Foundation, Inc  129-09 26th Ave  #203, Flushing, NY 11354  (800) 522-7222 or (718) 321-2873  http://www thalassemia org 
March of Dimes Birth Defects Foundation  1275 Mamaroneck Ave , White Plains, NY 10605  (888) 663-4637  resourcecenter@modimes org  http://www modimes org 
National Heart, Lung, and Blood Institute  PO Box 30105, Bethseda, MD 20824-0105  (301) 592-8573  nhlbiinfo@rover nhlbi nih gov  http://www nhlbi nih gov 
National Organization for Rare Disorders (NORD)  PO Box 8923, New Fairfield, CT 06812-8923  (203) 746-6518 or (800) 999-6673  Fax: (203) 746-6481  http://www rarediseases org 
Bojanowski J  "Alpha Thalassemia Major: The Possibility of Long-Term Survival " Pamphlet from the Northern California Comprehensive Thalassemia Center  (1999) 
Children's Hospital Oakland, Northern California Comprehensive Thalassemia Center website  http://www thalassemia com 
Cooley's Anemia Foundation, Inc  website  http://www thalassemia org/gohome html 
Joint Center for Sickle Cell and Thalassemic Disorders website  http://cancer mgh harvard edu/medOnc/sickle htm 
[thal″ah-se´me-ah]
a heterogeneous group of hereditary hemolytic anemias marked by a decreased rate of synthesis of one or more hemoglobin polypeptide chains, classified according to the chain involved (α, β, δ); the two major categories are α- and β-thalassemia 
α-thalassemia (alpha-thalassemia) that caused by diminished synthesis of alpha chains of hemoglobin  The homozygous form is incompatible with life, the stillborn infant displaying severe hydrops fetalis  The heterozygous form may be asymptomatic or marked by mild anemia 
β-thalassemia (beta-thalassemia) that caused by diminished synthesis of beta chains of hemoglobin  The homozygous form is called t  major and the heterozygous form is called t  minor 
thalassemia ma´jor the homozygous form of β-thalassemia, in which hemoglobin A is completely absent; it appears in the newborn period and is marked by hemolytic, hypochromic, microcytic anemia; hepatosplenomegaly; skeletal deformation; mongoloid facies; and cardiac enlargement 
thalassemia mi´nor the heterozygous form of β-thalassemia; it is usually asymptomatic, but there may be mild anemia 
sickle cell–thalassemia a hereditary anemia involving simultaneous heterozygosity for hemoglobin S and thalassemia 
thal·as·se·mi·a
, thalassanemia (thal'ă-sē'mē-ă, thă-las-ă-nē'mē-ă),
Any of a group of inherited disorders of hemoglobin metabolism in which there is impaired synthesis of one or more of the polypeptide chains of globin; several genetic types exist, and the corresponding clinical picture may vary from barely detectable hematologic abnormality to severe and fatal anemia 
[G  thalassa, the sea, + haima, blood]
/thal·as·se·mia/ (thal″ah-se´me-ah) a heterogeneous group of hereditary hemolytic anemias marked by a decreased rate of synthesis of one or more hemoglobin polypeptide chains, classified according to the chain involved (α, β, δ); the two major categories are α- and β-thalassemia 
α-thalassemia that caused by diminished synthesis of alpha chains of hemoglobin  The homozygous form is incompatible with life, the stillborn infant displaying severe hydrops fetalis  The heterozygous form may be asymptomatic or marked by mild anemia 
β-thalassemia that caused by diminished synthesis of beta chains of hemoglobin  The homozygous form is called t  major and the heterozygous form is called t  minor 
thalassemia ma´jor the homozygous form of &#x03B2;, in which hemoglobin A is completely absent; it appears in the newborn period and is marked by hemolytic, hypochromic, microcytic anemia, hepatosplenomegaly, skeletal deformation, mongoloid facies, and cardiac enlargement 
thalassemia mi´nor the heterozygous form of &#x03B2;, usually asymptomatic, although there is sometimes mild anemia 
(thăl′ə-sē′mē-ə)
An inherited form of anemia occurring chiefly among people of Mediterranean descent, caused by faulty synthesis of part of the hemoglobin molecule  Also called Mediterranean anemia 
thal′as·se′mic adj 
[thal′əsē′mē·ə]
Etymology: Gk, thalassa, sea, a + haima, without blood
production and hemolytic anemia characterized by microcytic, hypochromic red blood cells  Thalassemia is caused by inherited deficiency of alpha- or beta-globin synthesis  See also hemochromatosis, hemosiderosis 
Beta thalassemia, clinical thalassemia, Cooley's anemia, Mediterranean anemia, thalassemia major Hematology A group of genetic diseases by underproduction of hemoglobin due to mutations in the beta globin gene, which is more common in Mediterraneans Heredity Parents are carriers–heterozygotes; one in 4 children is homozygous for the mutation and thus has full-blown disease Clinical See Anemia  Cf Sickle cell anemia 
α-thalassemia
Hemoglobin Barts Hematology An inherited condition caused by a defect in the synthesis of the Hb α chain; Hb Barts hemoglobinopathy is characterized by the presence of 4 gamma chains; it is more common in southeast Asians; the most severe form of alpha thalassemia causes stillbirth due to hydrops fetalis Heredity Parents are carriers–heterozygotes; one in 4 children is homozygous for the mutation and thus has full-blown disease Clinical Pallor, fatiguability, FTT, fever, infections, diarrhea Management Transfusions
Thalassemia major Hematology A hemoglobinopathy caused by a defect in the synthesis of Hb β chain Clinical Pallor, fatigability, FTT, fever due to infections, diarrhea, bone deformities, hepatosplenomegaly Management Transfusions, but iron overload can damage the heart, liver, and endocrine systems, ergo iron chelation–early use of deferiprone, deferoxamine ↓ transfusion-related iron overload and may protect against DM, cardiac disease, early death
δ-thalassemia
Hematology A condition characterized by a defect of Hb A2–α2δ2; because Hb A2 comprises only 3% of the circulating Hb, even its complete absence; δ-thalassemia has little clinical or hematologic impact
γ-thalassemia
Hematology A condition characterized by a defect of gamma–γ Hb chains found in Hb F–α2γ2; because Hb F is present primarily in the fetus and newborns, it is rarely seen outside of the neonatal period, but may cause transient neonatal hemolytic anemia 
, thalassanemia (thal'ă-sē'mē-ă, -ă-să-nē'mē-ă)
Any of a group of inherited disorders of hemoglobin metabolism in which there is impaired synthesis of one or more of the polypeptide chains of globin; several genetic types exist, and the corresponding clinical picture may vary from barely detectable hematologic abnormality to severe and fatal anemia  People of Mediterranean, extraction are more often affected than others by this type of anemia 
Synonym(s): thalassaemia, thalassanaemia 
Any of a group of inherited disorders of hemoglobin metabolism with impaired synthesis of one or more polypeptide chains of globin; several genetic types exist 
<a href="https://medical-dictionary thefreedictionary com/Thalassaemia+minor">thalassemia</a>
Barts hemoglobin
beta hemoglobinopathy
beta-delta thalassemia
beta-thalassaemia
Bite Cell
black gallstone
I know of a couple, totally unrelated and unbeknownst to them, who are silent carriers of Thalassaemia minor 
Pakistan: Genetic factor: All in the genes
But, unfortunately, when one person with thalassaemia minor carrier happens to marry another with the same diagnosis, there is a strong possibility that their child would be thalassaemia major, as happened in the case of Taneja 
' My life depends upon a monthly blood transfusion '
0] thalassaemia demonstrates variable severity, ranging from a condition similar to [beta] thalassaemia minor to something approaching thalassaemia major 
A retrospective review of homozygous haemoglobin E patients
Thal, Alan P 
thalame
thalamencephalic
thalamencephalon
thalamic
thalamic fasciculus
thalamic nucleus
thalamic pain syndrome
thalamic peduncle
thalamic radiation
thalamo-
thalamocoele
thalamocortical
thalamocortical fibers
thalamogeniculate artery
thalamolenticular
thalamoperforating artery
thalamostriate radiation
thalamotuberal artery
Thalassaemia minor
thalassaemiaor Cooley's disease
thalassemic facies
thalasso-
Thalassobacter
Thalassobacter utilis
thalassoplankton
thalassoposia
thalidomide neuropathy
Thalidomider
thallium poisoning
Thalarctos
THALAS
Thalasaemia
Thalassaemia Association of Malaysia
thalassaemia major
Thalassaemias
thalassaemic
thalassanaemia
Thalassemia Action Group
Thalassemia Clinical Research Network
thalassemia syndrome
Context 2: McPherson County (standard abbreviation: MP) is a county located in the U S  state of Kansas   As of the 2020 census, the county population was 30,223  The largest city and county seat is McPherson  The county is named for Civil War General James B  McPherson 

History

Early history

For many millennia, the Great Plains of North America was inhabited by nomadic Native Americans  From the 16th century to 18th century, the Kingdom of France claimed ownership of large parts of North America  In 1762, after the French and Indian War, France secretly ceded New France to Spain, per the Treaty of Fontainebleau  In 1802, Spain returned most of the land to France, but keeping title to about 7,500 square miles 

In 1803, most of the land for modern day Kansas was acquired by the United States from France as part of the 828,000 square mile Louisiana Purchase for 2 83 cents per acre  In 1848, after the Mexican–American War, the Treaty of Guadalupe Hidalgo with Spain brought into the United States all or part of land for ten future states, including southwest Kansas  In 1854, the Kansas Territory was organized, then in 1861 Kansas became the 34th U S  state 

19th century

From the 1820s to 1870s, the Santa Fe Trail passed through, what is now McPherson County  The trail entered the county, east of Canton, then south of Galva, then north of Inman, and west towards Lyons  In 1855, Charles O  Fuller established a ranch adjacent to the Running Turkey Creek Crossing about two miles south and one mile east of Galva  Fuller's Ranch provided accommodations for travelers on the Santa Fe Trail and was probably the first white settlement in McPherson County 

Peketon County was established in 1860, by the passage of a bill by S  N  Wood:  An act to establish Peketon County  Section 1  - That all that territory west of the sixth principal meridian and south of Township 16, in Kansas Territory, be and the same is hereby erected into a county, to be known by the name of Peketon County  On February 17, 1865, Peketon County was abolished, and McPherson County was made a part of Marion County, which extended from the west line of Chase County to the present western boundary of Kansas 

In 1868, Solomon Stephens and L  N  Holmberg were appointed Justices of the Peace—the first officers in what is now McPherson County  The next year (1869) occurred the first election for the township, now the county of McPherson  McPherson was regularly organized as a county in the spring of 1870, a mass meeting being held at Sweadal  Sweadal, the county seat thus selected, was located about one mile and a half southwest of the present site of Lindsborg  In September, however, the County Commissioners resolved to meet at the latter place, McPherson which had already been located some two years 

In April, 1873, a petition was filed for the county seat re-location  It was signed by 483 voters, and a special election was accordingly ordered for June 10  Upon that day, McPherson received 605 votes, New Gottland 325, King City 3 and Lindsborg 1; McPherson's majority over all, 276  In May the McPherson Town Company had offered, as an inducement for the location of the county seat at this point, the free use of rooms for ten years, and the donation of two squares of land on the town site  The offer was accepted the next month, the County Commissioners selecting blocks 56 and 65  Thus the county seat was established at McPherson and has remained since 

As early as 1875, city leaders of Marion held a meeting to consider a branch railroad from Florence  In 1878, Atchison, Topeka and Santa Fe Railway and parties from Marion County and McPherson County chartered the Marion and McPherson Railway Company   In 1879, a branch line was built from Florence to McPherson, in 1880 it was extended to Lyons, in 1881 it was extended to Ellinwood  The line was leased and operated by the Atchison, Topeka and Santa Fe Railway  The line from Florence to Marion, was abandoned in 1968  In 1992, the line from Marion to McPherson was sold to Central Kansas Railway  In 1993, after heavy flood damage, the line from Marion to McPherson was abandoned  The original branch line connected Florence, Marion, Canada, Hillsboro, Lehigh, Canton, Galva, McPherson, Conway, Windom, Little River, Mitchell, Lyons, Chase, then connected with the original AT&SF main line at Ellinwood 

In 1887, the Chicago, Kansas and Nebraska Railway extended its main line from Herington to Pratt   This main line connected Herington, Ramona, Tampa, Durham, Waldeck, Canton, Galva, McPherson, Groveland, Inman, Medora, Hutchinson, Whiteside, Partridge, Arlington,  Langdon, Turon, Preston, Natrona, Pratt   In 1888, this main line was extended to Liberal   Later, this line was extended to Tucumcari, New Mexico and Santa Rosa, New Mexico, where it made a connection with the Southern Pacific from El Paso, Texas   The Chicago, Kansas and Nebraska Railway was absorbed by the Chicago, Rock Island and Pacific Railway  This line is also called the "Golden State Route" 

20th century
The National Old Trails Road, also known as the Ocean-to-Ocean Highway, was established in 1912, and was routed through Windom, Conway, McPherson 

Geography

According to the U S  Census Bureau, the county has a total area of , of which  is land and  (0 3%) is water 

Adjacent counties
 Saline County (north)
 Dickinson County (northeast)
 Marion County (east)
 Harvey County (southeast)
 Reno County (southwest)
 Rice County (west)
 Ellsworth County (northwest)

Major highways
  Interstate 135
  U S  Route 56
  U S  Route 81
  K-4
  K-61
  K-153

Demographics

The McPherson Micropolitan Statistical Area includes all of McPherson County 

2000 census
As of the census of 2000, there were 29,554 people, 11,205 households, and 7,966 families residing in the county   The population density was 33 people per square mile (13/km2)   There were 11,830 housing units at an average density of 13 per square mile (5/km2)   The racial makeup of the county was 96 53% White, 0 81% Black or African American, 0 34% Native American, 0
Context 3: Transport Aircraft for IAF - Page 67 - Bharat Rakshak
Transport Aircraft for IAF
Re: Transport Aircraft for IAF
Postby abhik » 17 Nov 2014 05:55
+1, Air India recently sold their entire fleet of Boeing 777s 
afaik the A330 MRTT does not make any structural mods or add anything internally in cargo or passenger cabin  it just relies on the intrinsic 110 tons of fuel  external refueling pods are added and internally the control station and cameras for the operator i guess 
so its a easy conversion from a passenger layout to the AAR mode - mostly ripping out the passenger cabin of all extra stuff and retuning the FCS for any changes in COG 
this should have been pursued years ago
the IL78 adds a palletized drum tank system inside its cargo bay due to paucity of intrinsic fuel but it can be removed and a/c converted back to cargo hauling or send off to russia for Phalcon structural mods if we want it that way  they will however need to change engines to PS90 as they have the old engines
http://www airplane-pictures net/images     7/5616 jpg
the RAF is already gone that route in 2011
http://www defensenews com/article/2011     -Refuelers
LONDON - Airbus Military has delivered the first of 12 A330-200 airliners due to be converted into in-flight refueling planes for the British Royal Air Force by Cobham Aviation Services 
The aircraft, part of an order of 14 jets, will be modified with aerial refueling pods and other equipment at Cobham's newly refurbished facility in Bournemouth, England  The first two aircraft have already been converted by Airbus in Spain 
The multirole tanker aircraft are being provided to the RAF under a private finance initiative service deal led by Airbus parent EADS 
Seven of the planes will be operated full time by the RAF  The remainder will be available for lease in the third-party market, with the proviso that they can be returned to British military service to meet any surge in demand 
All of the aircraft, to be known as the Voyager in RAF service, will be fitted with two wing-mounted refueling pods, while half the fleet will also be fitted for, but not necessarily with, a center-line mounted unit  The refueling units are being supplied by Cobham 
The first aircraft will become operational in a passenger and freight transport role by the end of this year to start relieving pressure on the RAF's hard-pressed assets 
Despite the increasing fragility of current RAF in-flight refueling operations, the new capability is not contracted to start being used in this role until 2015 
All 14 Voyagers are scheduled to be available for RAF operations by the middle of the decade  The A330 will replace the increasingly ancient Tristar and VC-10 refuelers now in service 
Push the 6 Il-476 from refueler to AEW duty  Phalcon them up
Not sure if that is a good path to follow  For one they all should be sent to pasture in about 8 years  Then if the are to be phalconed up - the requires major structural changes  Not worth that cost 
Whatever happened ot the two new ones that were supposed ot be ordered?
the IL78 can be easily converted back to IL76 cargo hauling  only the fuel tank inside cargo bay needs removal   infact that was even mentioned in initial days as swing role fuel/cargo 
Postby Cybaru » 17 Nov 2014 07:55
I am talking about the new il78 that we ordered recently in refueling role  Sorry for the mix up  They are the same platform, that I why i used 476 or 76 to identify it 
777 carries more internal fuel than the A330  We suck!
From the KC-777 program 
http://www globalsecurity org/military/     kc-777 htm
"the KC-777 would be 209 feet long with a wingspan of 212 feet, 7 inches  That's the same size as the 777-200LR commercial jet  The KC-777 would be able to carry far more fuel, cargo and passengers than either the KC-767 or the Airbus A330 tanker  The KC-767 offers more operational flexibility, while the KC-777 would be better suited for long-range strategic missions in which more cargo needs to be delivered  The KC-777 would be able to carry more than 350,000 pounds (160,000 kilograms) of fuel and offload more than 220,000 pounds (100,000 kg) of it on a mission of 500 nautical miles (900 kilometers)  On the other hand, the KC-767 can lift off with more than 200,000 pounds (90,000 kg) of fuel and offload more than 130,000 pounds (60,000 kg) in a similar mission  The KC-777 would be able to deliver 200 percent more fuel after flying 1,000 nautical miles than older Air Force KC-135s  The KC-777 could carry up to 37 pallets of cargo, compared to the 19 pallets for the KC-767 "
Postby Cosmo_R » 18 Nov 2014 04:31
Viv S wrote: From Ajai Shukla's article -
HAL points out that, since each Avro flies barely 350 hours every year, most of them have a residual life of about 80,000 hours  In a request for information (RFI) released on August 15, HAL has proposed replacing the aircraft’s engines (Rolls Royce Dart) with “modern fuel efficient engines” 
So, the IAF's Avros have a residual life of 228 years at the current rate of usage  Ain't life grand?
At zero up time, it could reach infinity 
Relax Cy  Kc777 has no client  Usaf is going with kc767 and almost everyone else with a330 
We don't have the number of heavies and long missions of usaf else I would say convert an124 
KC777 will be extremely expensive given the demand/backlog for the 777 and the 777x  Any buyer would have to virtually pay for the increase in capacity 
I think the 767 production line is closed  so the proposed KC767 Boeing is supposed to deliver 18 by 2017  that can be managed from mothballed and cargo hauler airframes on the market 
but to meet the final order of around 180 will they not have to open the production line unless such a huge number were available on the market?
I do get the spider feel this program again will be cancelled in favour of a in-production plane like the 777X ?
I wasn't suggesting we get the KC777  All I was doing was comparing what possibly the 777 could offload compared to A330  It carries 171000 liters of fuel versus 130000 liters that the A330 carries  If we had older 777s in stock, we could have quite easily converted them to this config  The cost to us would be miniscule just the refurbishing cost vs acquiring a new type 
Singha wrote: I think the 767 production line is closed  so the proposed KC767 Boeing is supposed to deliver 18 by 2017  that can be managed from mothballed and cargo hauler airframes on the market 
The Line is open, they have a backlog of around 50 (All Fed ex), with Fed Ex placing a small order this year  The Pegasus order is for all new builds, and so will the follow on order  The only reason for any nation to buy the 767 tanker is going to be because of the ability to hard bargain with Boeing given that the commercial future of the 767 is dead  This also allows a potential buyer to purchase cheap spares from the open market, or club its logistical and inventory purchase with that of the USAF  Other than that and perhaps availability (which would be doubtful once USAF pushes through a larger order) there is really no technical reason to purchase the this tanker over the A330 which by all accounts is a superior tanker in addition to being a much much better airliner in general 
IAI is doing conversations for the 767 and its called the 767 MMTT
http://www iai co il/sip_storage/FILES/1/38471 pdf
Cybaru wrote: I wasn't suggesting we get the KC777  All I was doing was comparing what possibly the 777 could offload compared to A330  It carries 171000 liters of fuel versus 130000 liters that the A330 carries  If we had older 777s in stock, we could have quite easily converted them to this config  The cost to us would be miniscule just the refurbishing cost vs acquiring a new type 
The cost of converting a commercial airliner to a tanker, certifying it and running a full fledged test program is by no means small  There is absolutely no justification for that sort of cost over and above the capability that that A330 provides  If it were a certified and tested conversion, that would be a different matter 
Postby Kartik » 21 Nov 2014 12:27
Cybaru wrote:
Why? If the airframe can handle more flight hours, why not?
because it is a very very old airframe as is  Maintenance spares won't be available easily even as of now, then imagine how it'll be 20-30 years from now   and as things stood anyway, the HS-748 offered very little in terms of payload and range versus a C-295 class aircraft  The C-295 offers a very credible light transport, whereas the HS-748's role in the IAF was more akin to a transport trainer and for communication duties with little operational use  Having seen a dozen or so HS-748s parked at Vadodara airport all through my childhood, I never once saw one in the air  They just seemed to be stored out in the open  Upon asking an IAF transport pilot who was my friend's father, he remarked "zyaada kaam ke nahi hain yeh" 
Why would you expend more capital on what is essentially an obsolete airframe, even if theoretically it had not yet reached its service life? You'd have to re-engine it, put new avionics on board and even that wouldn't suffice for para dropping requirements  it was operationally never suitable for para dropping, which is an important mission for transport aircraft and had deficiencies in hot and high climes as well 
Unfortunately, the 748 was never meant to be a military transport  At the request of IAF, its door was enlarged to enable larger cargo items to be loaded and to allow para dropping without hitting the tail plane  However, to load a jeep in it, a 30-ft long ramp was required  The jeep would drive in and insert its front wheels into the aircraft  Then it had to be manually lifted and turned to get it in  Unloading it was just as difficult  Para dropping of troops or cargo even from the aircraft with the enlarged door was considered too dangerous with the risk of hitting the tail plane  The aircraft's performance at hot and high airfields was hopelessly inadequate  Eventually IAF acquired the tail-loading An-32s which were powered specifically for IAF's need for operating in the Himalayas 
BRF article -Avro in IAF service
Now unless you want to overcome all these through a costly, time consuming engineering re-design program, that too without access to original documents since this airplane was designed in the 1960s, there is no question of keeping them going for another 40 years  By which time the original design would be over 80 years old and with no one on earth but the IAF as an operator and HAL as the agency supporting it  Hardly a situation anyone would want 
abhik wrote: +1, Air India recently sold their entire fleet of Boeing 777s 
Only 5 of the Boeing 777-200LR, to Etihad Airways, which IMO was a bad decision  they could have reconfigured the airplanes with just 2 classes and continued to fly them to the US, non-stop 
The remaining 3 777-200LR were offered for lease but are still a part of AI's fleet since they didn't find any takers  This particular model hardly sold much and was developed for ultra-long range flights  it was the least successful 777 model and clearly AI goofed up on the configuration by going for these in place of the 300ER  The economics however didn't make too much sense for AI eventually 
there are 13 777-300ER as a part of their fleet ahd their economics is much better 
Govt  to decide tomorrow on whether to go ahead and allow the IAF to verify the technical details of the C-295 bid by Tata-Airbus instead of scrapping the tender due to single vendor situation 
The government will decide on Saturday whether to press ahead with the Rs 13,000 crore mega project for the private sector to supply 56 medium transport aircraft to the IAF despite only a single bidder, the Tata-Airbus consortium, being in the fray 
Though the defence acquisitions council (DAC) chaired by Manohar Parrikar will take the final decision, MoD sources on Tuesday said the "emerging dominant view" is that green signal should be given to the crucial project designed to promote Indian private sector's entry into the domestic aerospace arena with foreign collaboration 
"The Tata-Airbus technical and commercial bid is a credible offer submitted in a competitive environment  The other seven contenders backed out for one reason or the other," said a source 
IAF has now sought the clearance of the DAC -- the first such meeting to be chaired by Parrikar after becoming defence minister on November 10 -- to begin technical evaluation of the C-295 aircraft offered by Airbus Defence & Space and Tata Advanced Systems 
Though it has become a single-vendor situation, the DAC can approve it if it wants as per existing procurement procedures  Of the eight foreign aviation majors that got the global tender, American Boeing and Lockheed-Martin as well as Brazilian Embraer said they did not manufacture the class of aircraft being sought by IAF 
Refusing to take part in the tender, Russian Rosoboronexport said it wanted a fresh design and development project  Antonov of Ukraine wanted yet another extension of the bid submission deadline due to the ongoing conflict in Crimea  Swedish Saab said it had shut down its assembly line for such aircraft 
Then, Alenia Aermacchi was linked to Italian conglomerate Finmeccanica, which has been slapped with "a partial ban" after the infamous VVIP helicopter scandal  "All this left only the European consortium Airbus  The DAC will have to take a call since re-tendering may lead to the same situation," said the source 
Incidentally, it was the Modi government's first DAC in July -- then headed by Arun Jaitley - which revived the Avro replacement project after it was put on hold by the UPA-2 regime last year due to strong opposition from the powerful PSU lobby and ministers like Praful Patel, as reported by TOI earlier 
Apart from the critical need to encourage the private sector to enter defence production in a big way, especially in the aerospace arena where Hindustan Aeronautics enjoys a monopoly, its felt the defence PSU's order books are already overflowing with projects 
Fingers crossed  Hopefully sense will prevail 
Why was lr got? Er is capable of Dubai to sfo nonstop 
Lr is overkill unless we want Delhi to Peru  
Singha wrote: Why was lr got? Er is capable of Dubai to sfo nonstop 
they wanted it for non-stop routes from India to the west coast of the US  But with fuel prices going higher and with the lower seat count on the 777-200LR, the seat mile costs grew too high  A 3 class configuration only made matters worse  A higher density configuration with more economy class seats and just 12-15 Business class seats would have been better perhaps, especially if they didn't have very high First Class load factors 
LR and ER is better if you want to have a better payload down below for long haul  Ultimately, the best bet is going to come form the 787's that take a fewer people (so you can do the longer routes) with still a competitive CASM, and the B and F class folks will pay good money for newer aircraft 
Postby Kartik » 04 Dec 2014 12:55
Lets see if there is any forward movement on the stalled MTA project once Putin arrives in New Delhi
Major defence deals to be signed during Putin-Modi summit
In this connection, it is expected that during the summit, Russia and India may ultimately resolve several long-delayed agreements on military-technical cooperation projects between the two countries and sign them finally for their implementation  These agreements, above all, include joint Fifth Generation Fighter Aircraft (FGFA) project and joint development of Multi-role Transport Aircraft (MTA) 
A final deal on FGFA for production has been delayed because the Indian Air Force (IAF) did not approve the design and work-share  Now Russia has reportedly agreed that the jet would be a two-seat design, not a one-seater  India’s work-share would also be increased from18 percent to 25 percent, and even up to 40-50 percent in the near future, in view of the steady development of the Indian aviation industry 
Defence and SecurityAccording to the agreement, India’s stealth air-to-air missile “Astra” along with Indo-Russian BrahMos supersonic cruise missile will be mounted on the FGFA 
The preliminary design agreement on FGFA had been signed in 2010 between Indian HAL and Russian Sukhoi Design Bureau to build the jet for the use by both countries



ground_truth: Severe anemia that begins even before birth.

prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: Who is the county seat of McPherson County?

Read the following text and answer briefly.

Context 2: 32% Asian, 0 06% Pacific Islander, 0 79% from other races, and 1 16% from two or more races   1 94% of the population were Hispanic or Latino of any race  37 1% were of German, 12 9% Swedish, 12 1% American, 6 7% English and 6 3% Irish ancestry according to Census 2000 

There were 11,205 households, out of which 33 00% had children under the age of 18 living with them, 62 50% were married couples living together, 6 00% had a female householder with no husband present, and 28 90% were non-families  25 50% of all households were made up of individuals, and 11 80% had someone living alone who was 65 years of age or older   The average household size was 2 49 and the average family size was 2 99 

In the county, the population was spread out, with 25 40% under the age of 18, 10 30% from 18 to 24, 25 20% from 25 to 44, 21 80% from 45 to 64, and 17 30% who were 65 years of age or older   The median age was 38 years  For every 100 females there were 95 90 males   For every 100 females age 18 and over, there were 92 90 males 

The median income for a household in the county was $41,138, and the median income for a family was $48,243  Males had a median income of $33,530 versus $21,175 for females  The per capita income for the county was $18,921   About 4 20% of families and 6 60% of the population were below the poverty line, including 5 20% of those under age 18 and 8 10% of those age 65 or over 

Government

Presidential elections
McPherson county is often carried by Republican candidates  The last time a Democratic candidate has carried this county was in 1964 by Lyndon B  Johnson 

Laws
Following amendment to the Kansas Constitution in 1986, the county remained a prohibition, or "dry", county until 1996, when voters approved the sale of alcoholic liquor by the individual drink with a 30 percent food sales requirement 

Education

Colleges
 McPherson College in McPherson
 Bethany College in Lindsborg
 Central Christian College in McPherson

Unified school districts
 Smoky Valley USD 400
 McPherson USD 418
 Canton-Galva USD 419
 Moundridge USD 423
 Inman USD 448

School district office in neighboring county
 Goessel USD 411
 Little River-Windom USD 444

Museums
 Birger Sandzén Memorial Gallery in Lindsborg
 McCormick-Deering Days Museum in Inman
 McPherson Museum in McPherson
 Lindsborg Old Mill & Swedish Heritage Museum in Lindsborg
 Kansas Motorcycle Museum in Marquette

Communities

Cities

 Canton
 Galva
 Inman
 Lindsborg
 Marquette
 McPherson (county seat) 
 Moundridge
 Windom

Unincorporated communities
† means a Census-Designated Place (CDP) by the United States Census Bureau 
 Conway
 Elyria†
 Groveland
 Johnstown
 New Gottland
 Roxbury†

Ghost towns
 Alta Mills
 Battle Hill
 Christian
 Doles Park
 Elivon
 King City
 Sweadal

Townships
McPherson County is divided into twenty-five townships   The cities of Lindsborg and McPherson are considered governmentally independent and are excluded from the census figures for the townships   In the following table, the population center is the largest city (or cities) included in that township's population total, if it is of a significant size 

See also
 List of people from McPherson County, Kansas
 National Register of Historic Places listings in McPherson County, Kansas
 McPherson Valley Wetlands
 Maxwell Wildlife Refuge

References

Notes

Further reading

 Wheeler, Wayne Leland  "An Analysis of Social Change in a Swedish-Immigrant Community: The Case of Lindsborg, Kansas " (PhD dissertation, University of Missouri-Columbia; ProQuest Dissertations Publishing, 1959  5905657) 

County
 Through the Years: A Pictorial History of McPherson County; McPherson Sentinel' Heritage House Publishing Co; 1992 
 McPherson County First Courthouse Built About 1869 or 1870; Lindsborg News-Record; March 30, 1959 
 Pioneer Life and Lore of McPherson County, Kansas; Edna Nyquist; Democratic-Opinion Press; 1932 
 A History of the Church of the Brethren in Kansas (includes McPherson College history); Elmer LeRoy Craik; McPherson Daily; Republican Press; 397 pages; 1922 
 Portrait and Biographical Record of Dickinson, Saline, McPherson, and Marion Counties, Kansas; Chapman Bros; 614 pages; 1893 
 Standard Atlas of McPherson County, Kansas; Geo  A  Ogle & Co; 82 pages; 1921 
 Plat Book of McPherson County, Kansas; North West Publishing Co; 50 pages; 1903 
 Edwards' Atlas of McPherson County, Kansas; John P  Edwards; 51 pages; 1884 

Trails
 The Story of the Marking of the Santa Fe Trail by the Daughters of the American Revolution in Kansas and the State of Kansas; Almira Cordry; Crane Co; 164 pages; 1915  (Download 4MB PDF eBook)
 The National Old Trails Road To Southern California, Part 1 (LA to KC); Automobile Club Of Southern California; 64 pages; 1916  (Download 6 8MB PDF eBook)

Mennonite Settlements
 Impact of Mennonite settlement on the cultural landscape of Kansas; Brenda Martin; Kansas State University; 1985/1988  
 Mennonite settlement : the relationship between the physical and cultural environment; Susan Movle; University of Utah; 1975/1886 
 Status of Mennonite women in Kansas in their church and home relationships; Eva Harshbarger; Bluffton College; 1925/1945 

External links

County
 
 McPherson County - Directory of Public Officials
Historical
 , from Hatteberg's People'' on KAKE TV news
Maps
 McPherson County Maps: Current, Historic, KDOT
 Kansas Highway Maps: Current, Historic, KDOT
 Kansas Railroad Maps: Current, 1996, 1915, KDOT and Kansas Historical Society

 
Kansas counties
1867 establishments in Kansas
Populated places established in 1867
Context 3:  The final design contract was to be signed in July-August 2012  But the deadline has already passed  According to the Indian media reports, under the programme, India is expected to build 200 fighter jets at the cost of $30 billion 
FGFA is not the only Indo-Russia joint project  The two countries also signed an agreement on the joint development of MTA in 2007, based on Il-214 Russian plane  The cost of the $600 million project is being equally shared by the two countries  The MTA, when developed, will have ready market for 205 aircraft - 45 for the Indian Air Force, 100 for the Russian Air Force, and 60 more for exporting to friendly countries  The international market for MTA is estimated at 390 planes  Under the agreement, thirty percent of the annual production of planes could be exported to third countries 
The MTA was expected to go in service with the Russian and Indian Air Forces in 2015  But the project faced a number of problems, delaying the development of the MTA  The project got into rough weather after India felt there was nothing much for Indian engineers and scientists to do in the design and development of the MTA 
However, all the issues related to the project were resolved with the Russians when the HAL undertook to carry out design and development of its work-share of MTA at Aircraft R&D Centre at Bangalore  Russian Ilyushin Design Bureau and the Irkut Corporation and HAL are participating in the project  The first flight is expected to take place in 2017-18 
The MTA would replace the AN- 32 aircraft being used by the IAF  It will be used for both cargo and troop transportation, para-drop and air drop of supplies, including low-altitude parachute extraction system 
BrahMos missile exports a challenging proposition
Another key deal expected to be signed during the summit, is for the development of “BrahMos mini missile” by the Indo-Russian joint venture BrahMos Aerospace which manufactures supersonic cruise missile  BrahMos’ new CEO Sudhir Mishra recently said he was hopeful that a deal to develop the mini version of the missile will be signed during Putin’s summit with Modi 
“We are hoping to sign a tripartite agreement between DRDO, NPOM lab and BrahMos Aerospace during the planned visit of Russian President in December,” Mishra said 
He said that the new missile will have a speed of 3 5 mach and carry a payload of 300 km up to a range of 290 km  In size, it will be about half of the present missile, which is around 10 metres long  The missile can be integrated with different platforms, including submarines and FGFA  It is planned to be inducted into service by 2017 
Modi-Abbott to upgrade defence ties
A new dimension:
In a first, India and Australia will also set up a mechanism to discuss “synergies in integrating defence system”, including research and development cooperation on integrating defence equipment that both countries currently purchase, for example, U S’s C-17 Globemaster III, according to officials 
^^That report about MTA is fishy  First it says that India has nothing to learn from an existing design (duh) and then says the issue has been resolved  How? Next it says India's need is 45 planes to replace over 100 An-32s  It also speculates about the export potential which may be nonexistent unless we sell it for peanuts 
This is a scam which only aims to create screwdriver jobs at HAL, stall any attempt to introduce private players into the aviation market and continue the Russian gravy train  My fear is the Russkies have our testiments in a firm grip with key components of Brahmos, nuke subs, Su30mki etc and we may be jerked around 
(They need to be more definitive about "MTA" - Multirole vs  Medium)
The Indians had not selected an engine (among other things) for the MTA with the Russians  Perhaps that has been resolved now 
On export numbers, IIRC, it was the responsibility of Rosoboronexport  ?????
Kartik wrote: The MTA would replace the AN- 32 aircraft being used by the IAF  It will be used for both cargo and troop transportation, para-drop and air drop of supplies, including low-altitude parachute extraction system 
Pardon my ignorance  The Avro and An-32 have different upgrade paths  How are the replacements for these venerable aircraft different in terms of use cases in IAF  Cannot one platform replace both these types? (Either MTA or C-295)
In this case, I feel they should have just gone with screwdrivergiri (production tech) and got to market first  There is no jet-powered transporter in this range! Just license produce the IL-214 with the PD-14M, glass cockpit and a state-of-the-art COTS avionics computer 
In my view, it was a low hanging fruit, which they completely messed up! They could have learnt on how to adopt the plane for the 160-200 seater 
indranilroy wrote: They could have learnt on how to adopt the plane for the 160-200 seater 
Yes, the MTA project should fold the Avro, An-32 and the regional transport role and become a conversion project rather a development one  The driving numbers will come from the regional transport (thousands in India itself) rather than the Avro or medium transport roles (max 300 between them)  This changes the ball game and introduces all kinds of possibilities  But I'm pretty sure that the Il-214/MTA is not the way to go because it will take a decade or more to arrive  A good possibility was another Antonov, the An-148 but it has some mechanical glitches apparently besides being bogged down in the Ukraine mess  Maybe the Russians can "relocate" the aircraft to Russia? The other possibility is the BAe-146 which is ironically another Avro  We should remember that both the HS-748 "Avro" and An-32 were regional airliners that were converted to military use, not the other way around  HAL or a private firm will pick up a lot of experience in the conversion process itself 
The Sukhoi Superjet is already in production/orders,with over 100+ for Russian and intl  customers  It is ideal for regional transport,perfect for flights to smaller Tier-2/3 cities from metros  If we really want a regional jet this is the fastest way toi go,we can set up a manufacturing unti here for the same at an HAL unit 
Postby shaun » 05 Dec 2014 15:24
Its an international projects, with components outsourced from different international vendors   Over 30 foreign partnership companies are involved in the project and partly financed by Italy 
Sukhoi is good for passenger use but wont be suitable for military, rough field use  The shoulder wing jets like the An-148 have slower speeds and better ground clearance  The Bae-146 was usedby Druk Air in Bhutan so it should do OK in the ALGs  If we don't fold our requirements then we should go with something like the Superjet which we will at least be able to make in India and also modify to stretched versions  Unless we have a clear path to operational clearance within 10 yrs for the RTA project vetted by our top industrial houses, it is pie-in-the-sky and should be dropped  The RTA will be big enough to keep 2-3 factories humming and leapfrog our capabilities  If we don't get our act together almost immediately, we will miss the boat, just like our trainer fiascos 
I don't think Superjet fits into our scheme of things  We should think as a country and see to it that our programs don't trample on each other 
First, the more certain ones:
1  Mahindras NM5 and Airvans can care of the low-cost but sturdy 5,8,10 and 18-seater section 
2  Saras had such great potential for being the high performance 14-18 seater  But I have almost given up on it  This section will most probably be taken up by the Tata-built Do-228 NG 
3  We should standardize the C-295 as the Avro/An-32 replacement and create a 70-80 seater variant out of it 
And then the more wishful ones:
1  If the RTA is going to be a jet, then make it a 100-130 seater  I don't expect the first prototype to take the sky before 2025  I feel it is too big of a jump where we don't even have a base  With LCA, at least we were at least license producing other fighters 
4  Building on the IL-214, the MTA was on a more sure footing  But, I can't see how the first prototype can to take to the sky before 2019(more than 10 years since MTAL was formed)! If the transport plane materializes, then one can imagine making a civilian 150-200 seater version of the same  But this program needs a push  Will Putin's visit be able to galvanize this into the next symbol of Indo-Russian cooperation  Probably not!
Postby GeorgeWelch » 12 Dec 2014 23:39
http://www ctvnews ca/canada/defence-de     -1 2144472
The Defence Department intends to purchase a Boeing C-17 Globemaster III, a large military transport plane that comes with a price tag of just under $200 million, CTV News has learned
It's difficult to get a good count, but by some sources, if this and the 4 Australia planes go through, there will only be 5 left 
X-Posting from FGFA thread 
Despite Putin’s visit, two pacts on military aircraft still in doldrums
President Vladimir Putin may have come and gone but stalemate largely persists over two key long-pending India-Russian defence projects, the fifth-generation fighter aircraft (FGFA) and military multirole transport aircraft (MTA) 
The deadlock over the MTA, which were initially envisaged to gradually replace IAF's ageing fleet of the medium-lift AN-32 aircraft, seems to be much more serious  India now wants to ascertain the cost viability of the twin-engine transport aircraft in comparison to similar planes available in the market 
There are also questions about the MTA's "predicted timelines for delivery" as well as its failure to meet the high-altitude requirements, which need to be answered before India even thinks of inking the full-scale contract for the project, said sources 
Postby Gyan » 13 Dec 2014 12:29
indranilroy wrote: I don't think Superjet fits into our scheme of things  We should think as a country and see to it that our programs don't trample on each other 
1  Mahindras NM5 and Airvans can care of the low-cost but sturdy 5,8,10 and 18-seater section  Righto
2  Saras had such great potential for being the high performance 14-18 seater  But I have almost given up on it  This section will most probably be taken up by the Tata-built Do-228 NG  We need future extended variants of presurrized aircraft like 30 seater Saras and say 30 seater unpressurized Do-328 NG 
3  We should standardize the C-295 as the Avro/An-32 replacement and create a Civilian turboprop pressurized cabin 70-80 seater variant out of it 
1  If the RTA is going to be a jet, then make it a 100-130 seater  Agreeeeeed I don't expect the first prototype to take the sky before 2025  I feel it is too big of a jump where we don't even have a base  With LCA, at least we were at least license producing other fighters  Though I think that we should participate in Russian MS-21 and also the wide body follow on 
4  Building on the IL-214, the MTA was on a more sure footing  But, I can't see how the first prototype can to take to the sky before 2019(more than 10 years since MTAL was formed)! If the transport plane materializes, then one can imagine making a civilian 150-200 seater version of the same  Though I think that we should participate in Russian MS-21 and also the wide body follow on  But this program needs a push  Will Putin's visit be able to galvanize this into the next symbol of Indo-Russian cooperation  Probably not!
Absence of any specifics on Sukhoi Superjet, MS-21, Wide body aircraft, Mi-38, MRTA, FGFA, even after Putin visit is very disappointing 
FlightGlobal- Boeing sitting on 8 unsold C-17s
By: Dan ParsonsWashington DCSource: Flightglobal com
This story is sourced from Flightglobal com 12 hours agoBoeing has sold two more C-17 transports to an undisclosed customer, but it will likely end the year with eight unsold white tails 
There are 10 Boeing C-17 airlifters in various stages of assembly at the company’s Long Beach, California, production facility 
Two of the aircraft are spoken for by an unnamed customer, Boeing says  Boeing is trying to sell off the other eight white tails, which will be the last produced before the factory is shuttered sometime in the summer of 2015 
The 279th – and final – C-17 fuselage will be mated to its wings in January or February, programme spokeswoman Tiffany Pitts tells Flightglobal  The operation is California’s last remaining aircraft production line and the lone widebody military aircraft production line in the USA, according to Boeing 
At least two countries – Australia and Canada – have publicly announced an intention to purchase a C-17, though neither factor into Boeing’s future planning, Pitts says  Until contracts are finalised, the number available remains eight, she says  The Royal Canadian Air Force already has four C-17As, according to Flightglobal’s World Air Forces 2014 directory 
Canadian news outlets reported earlier in December that the air force would buy one C-17 with money left over at the end of 2015 
Australia is further along with its bid to purchase C-17s  The US Defense Security Cooperation Agency in November announced Australia was approved to buy up to four C-17s and support equipment for $1 6 billion 
Boeing has plans to store any unsold C-17s following closure of its production line, Pitts says 
“I’m hoping they all will be sold before then, but we’ve had plans in place for a very long time to store and maintain the aircraft if that doesn’t happen,” she says 
the IAF will need to factor in the demand vs availability of C-17s and stock up with a follow-on order quickly  The initial plan to have 16 C-17s may not fructify, considering that there are just 8 left now, with Australia having announced plans to buy 4 more 
why are they closing the line if it has demands ???
Real estate sales tactics probably  Buy now last 8 3bhk flats Saar 
krishnan wrote: why are they closing the line if it has demands ???
It requires 3 years lead time to order raw materials/parts from all of its sub-vendors  All current firm orders have been fulfilled, and no new orders have come  Anticipating a need for a few more aircrafts, they produced 10 extra (self-funded) units before production winded down  Bottom line is they don't make money keeping an idle plant around with all its employees and infrastructure  At most what they will likely do is keep a limited infrastructure around for a few more years in case a bunch of new orders come  They can then see if it makes business sense to re-open the plant 
Postby Aditya_V » 17 Dec 2014 12:19
Wish this can be brought to the notice of Journos/ Poster when slamming LCA/ Arjun and other indigenous projects  If there are no orders there will be no efficiency 
Dec 10, 2014 :: Russia launches Il-76MDM upgrade programme
Russia's Ilyushin has started to upgrade a first Russian Air Force (VVS) Ilyushin Il-76MD 'Candid' military transport aircraft to Il-76MDM standard, company officials have told IHS Jane's   The main features of the upgrade include refurbished engines and upgraded avionics 
The modernisation is being conducted at the VVS's Military Transport Aviation (MTA) maintenance facility based at the Ilyushin division in Zhukovsky city near Moscow 
A senior Ilyushin official told IHS Jane's that the upgrade of the first aircraft will be finished in 18 months  Subsequent aircraft will take less time to complete the process, however  When the modernisation is finished the initial Il-76MDM will undergo state trials  The upgrade process for subsequent aircraft will begin when the trials programme is completed 
IHS Jane's was previously told by a VVS senior official that the modernisation of 41 MTA Il-76MDs is planned by 2020  While the Il-76MDM upgrade retains the old D-30KP engine (compared with the PS-90A engine equipping the new Il-76MD-90A/Il-476), the modernisation effort should match the aircraft's onboard electronics with those of the newbuild Il-76MD-90A  This and other efforts mean the cost of modernising the Il-76MD to Il-76MDM is only a third of that of a newbuild Il-76MD-90A 
The existing D-30KP engines are to be enhanced to increase their service life  The overall aircraft's service life will be extended by 15 years 
The upgrade works are planned to be conducted in an aviation repair factory or in the MTA's aircraft maintenance facility  As a result, the Ulyanovsk-based Aviastar-SP plant, which is building the Il-76MD-90A, is not involved in the Il-76MD to Il-76MDM modernisation programme 
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ground_truth: McPherson.

prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: Besides the Boeing C-17, what other transport aircraft is the IAF considering for acquisition?

Read the following text and answer briefly.

Context 4: 
So, so far, caution seems to be winning out over urgency -- Wolf 
Jill is at the State Department 
The House speaker, John Boehner, may be doing double duty if the government shuts down this weekend  You're going to find out why he could be cleaning up a lot of trash in his own backyard 
And a former U S  Congressman now on a mission to meet with Moammar Gadhafi in Tripoli in person  Curt Weldon, he's here  He'll join us in THE SITUATION ROOM from Tripoli  You're going to find out who he says would be a good replacement for the embattled Libyan leader 
BLITZER: Military leaders have a message for Congress about "don't ask/don't tell "
Well, military leaders say preparations for repealing "don't ask/don't tell" are going better than they expected  They testified before a House committee today about getting rid of the policy that bars openly gay service members  They caution, though, that it will take time and training to implement the repeal  And it must still be certified by President Obama, the Defense secretary and the chairman of the Joint Chiefs of Staff 
Well, your Smartphone just got a little smarter  The FCC is requiring that wireless carriers provide access to the mobile Internet anywhere it's available, even when it's offered by a competing provider  And that could be a huge -- make a huge difference to smaller carriers, who told the FCC they just can't compete otherwise against industry heavyweights like Verizon and AT&T 
New York City school chancellor, Cathie Black, is stepping down after only three months on the job  Mayor Michael Bloomberg says her short stint just didn't work out as either of them had expected or hoped  Her approval rating has plunged to 17 percent 
Black chaired "First" magazine before overseeing the nation's largest school system  Deputy Mayor Dennis Walcott will replace her 
And a war of words is erupting between an emerging Republican star, New Jersey Governor Chris Christie, and his state's largest teachers' union  In a network TV interview, Christie called the union leaders, quote, "political thugs " He blames them for teacher lay-offs that he says could have been avoided if they had not opposed salary freezes  The New Jersey Education Association is firing back, accusing Christie of name-calling -- Wolf 
BLITZER: Sticks and stones will break many bones 
SYLVESTER: Sticks and stones may break my bones --
SYLVESTER: But words never hurt me 
A former U S  Congressman is in Tripoli, Libya right now  His goal -- to talk to Moammar Gadhafi  His message -- we'll talk about that  My interview with Curt Weldon coming up next 
Plus, we showed it to you earlier -- a member of Congress telling colleagues to, quote, "go to hell "
Now she's is joining us live here in THE SITUATION ROOM to explain 
HOLMES NORTON: -- of Columbia  It's another thing to drop a bomb on a city  And that's what this --
BLITZER: Former Congressman Curt Weldon is in a -- Weldon is on a mission to Libya right now to try to meet with the embattled leader, Moammar Gadhafi  But that may be easier said than done 
Joining us now from Tripoli, former Republican Congressman Curt Weldon of Pennsylvania  Congressman, thanks very much for coming in 
And joining us now from Tripoli, former Republican Congressman Curt Weldon of Pennsylvania 
CURT WELDON, FORMER U S  CONGRESSMAN: My pleasure, Wolf 
BLITZER: Let's talk about your meeting with Moammar Gadhafi  I take it it has not yet happened 
Do you expect to meet with the Libyan leader? WELDON: Absolutely  The invitation that was sent to me was from his chief of staff, Bashir Salah, who I've met on all three of my official visits here in 2004 and 2005  And the letter specifically says we want you to come over and meet with the leader and our senior leadership 
And I said it's worth me coming over to support the administration and to try to let the leader know face to face that this is facing -- it's very grave timing in the situation and they have to have some movement fairly quickly or they're not going to be happy with the -- with the alternatives 
BLITZER: What's taking so long?
Why haven't you been able to meet with Gadhafi yet?
WELDON: Well, it -- that's not unusual  I mean all three of the delegation trips that I led here in 2003 and 2004 -- or, actually, 2004 and 2005 -- they always make you wait until 30 minutes before the meeting and then you go  And some of those meetings were at 10:00 at night, some were at 5:00 in the afternoon 
As you know from the excellent reporting being done by your folks here, there's a lot of security concerns, and they are very concerned where Gadhafi is at any given moment  That's one of the issues, but we have been making ourselves available 
We have been doing a lot of back-channel meetings with friends and associates that I have here, and we have met with the chief of staff and one of the sons, and today with the prime minister, a very lengthy meeting for two hours  So, we're going to give them until tomorrow  We're not going to stay beyond that  And we have given them some suggestions, and we expect a response by midday tomorrow  And if we don't, we will done exit conversation with your people and let you know our feelings 
BLITZER: What's the major headline that you got out of these meetings with other leaders? I take it you met with Saif Al-Islam Gadhafi, one of the sons of Moammar Gadhafi  What are they saying to you?
WELDON: Well, we actually didn't meet with Saif  I have met with Saif probably 10 times over the past seven years, both in America and here in Libya  I have not yet met with Saif  I have offered, if he is available 
I have met with Saadi  And the general thrust is obviously that they want peace and they want to find a way out of this  But as I have explained to them, there's certain things that have to be done according to our president and our secretary of state, who I'm here to support 
We don't have a different agenda  There's no compromise on our part  Our only mission here is to talk face to face with them and say this is reality and this is a grave situation, and you need to do certain things that we suggest that we think will get our administration to respond to your actions  And again, we're not doing any negotiating 
They know me, they have seen my efforts  I have not taken anything from their country in the way of financial benefits, and I'm here only because I want to avoid war  I don't want to see American soldiers killed, and I don't want to see more innocence Libyans killed 
BLITZER: You wrote an op-ed in "The New York Times" this week saying that once you meet face to face with Moammar Gadhafi, you will tell him to step down  Is that still your intention?
WELDON: Absolutely, Wolf  I wrote the op-ed before the trip was planned  And I wrote it, Wolf, because back in 2004, when I led the first delegation of Americans to sit down with him in the tent in Tripoli, he said to me, "Congressman, why did it take 30 years for someone from your country to come and sit with me and tell me to my face that you believe that I'm a criminal and a terrorist  And then if you didn't believe me, bomb me?"
And I said, "Leader, I can't explain that " So I said now it's time for someone to sit in a tent face to face with Colonel Gadhafi and let him know how grave this situation is 
And I'm willing to do that  And I think I'm probably the best person because I have met with him three times, and because I sat in that tent in 2004 and listened to him tell me that  So, in effect, that's why I'm here 
BLITZER: You wrote also in "The New York Times" this -- you wrote, "Colonel Gadhafi's son, Saif, a powerful businessman, a politician, could play a constructive role as a member of the committee to devise a new government structure or constitution "
You know, a lot of people, including the opposition, the rebels, as they're called, they think Saif Al-Islam Gadhafi is just as much a killer or thug as his father is, and they say they have no interest in dealing with him either 
What do you say to that criticism?
WELDON: Well, what I said, I'm not endorsing anything anyone for any office here  What I am hoping for is what the president wants, which is a free and fair election to take place, hopefully sooner rather than later 
But having been involved with Libya for seven years, I was a witness to the work that Saif did in the Lockerbie case, the La Bella nightclub bombing  I personally witnessed through the Gadhafi Foundation the work that Saif did to free up the Bulgarian nurses who were sentenced to death twice, along with a Palestinian doctor 
I have seen the work that Saif and Dr  Salani (ph) at the foundation have done in dealing with chemical weapons destruction and with the elimination of landmines and humanitarian efforts worldwide  I have been out to (INAUDIBLE), the chemical weapons plant, and I have actually seen visibly how they have removed the chemical weapons production materials  He was behind all of that 
Believe me, Wolf, I'm not happy with some of the statements and the actions that he's made over the past month, and he knows I'm not happy  But I think in a fair election, up until now, he should be given the opportunity to seek office where he can run against other candidates, perhaps, for the presidency  And so I would at this time think that he should be allowed that opportunity 
That's not to say I condone anything that he said or his actions  He will have to be accountable for those on his own 
BLITZER: Because you make him sound like he's a decent guy when so many people think he is a killer, a murderer, especially given the statements that he recently made, that if he goes into Benghazi, if he finds these rebels, he will go and kill them all  You make it sound like he's a decent guy 
WELDON: Well, I -- you know, I haven't been with him on a continual basis  I have met with him a number of times, both in the U S  and here, under some very stressful situations, especially when it came to resolving the Lockerbie case and the La Bella nightclub  And despite what Sarkozy said about resolving the issues of the Bulgarian nurses when they were sentenced to death twice, it was Saif who played a very critical role against some very powerful forces in this country that wanted to kill those people 
You know, I don't know of any incidences where I, first hand, have seen evidence of him committing human rights violations, and if he did, he has to be held accountable like everyone else  And I have said that publicly and I will say that privately 
So my judgment is just based upon my experience with him, the fact that he is a knowledgeable person, he understands the need to interact and interface with the West  I think he could be a viable candidate  But ultimately, my opinion is hopefully going to be the opinion of the Libyan people 
BLITZER: Because you probably have seen all of the articles, the reports over the past month, month and a half, of mass murder, of killings, not only by Saif Al-Islam, but some of his brothers that have gone on, the atrocities that have been so widely reported  I hear what you're saying about his role over the recent years when the Bush administration, and later the Obama administration, was trying to improve relations with Libya, but over the past several weeks, based on all of the international reporting we have seen, it's been a brutal record that he has accomplished 
WELDON: Well, again, I don't have firsthand evidence of that  I just got here two days ago  And I fully support an international tribunal to look at human rights violations on everyone in this country  That's necessary  And if they find evidence that he has been involved in that, then he should suffer the consequences of his actions 
(END VIDEOTAPE) BLITZER: In our next hour, part two of the interview with former congressman Curt Weldon  There have been some questions raised about his motive  Is he in all of this for the money? You're going to find out his answer to that and more  Stand by 
Also, Washington, D C 's congressional delegate is telling colleagues -- and I'm quoting her now -- "Go to hell " She is joining us live in THE SITUATION ROOM to tell us why 
Plus, no budget deal, no food -- the extreme tens of thousands of people are going to as a government shutdown looms 
BLITZER: Let's get back to the outrage boiling over on Capitol Hill, only hours before a potential government shutdown 
Joining us now, the Democratic delegate representing the city of Washington, D C , Eleanor Holmes Norton 
ELEANOR HOLMES NORTON (D), D C  DELEGATE: Of course, Wolf 
BLITZER: I think it's fair to say that Washington, D C , a city of a population of about 600,000 people, the only major metropolitan -- the only major city in the United States that's going to foal the direct impact of a federal government shutdown so dramatically, so powerfully, because it is a federal district 
Give me an example of what's going to happen if there's a government shutdown 
NORTON: Absolutely, although your viewers will be shocked by what they are about to hear 
They know a little bit about taxation without representation -- we pay our taxes, then we have full representation in the House and the Senate  But I bet they didn't know that our local budget, without a dime of federal money in it -- and we support ourselves almost entirely -- has to be sent to the masters in the Congress to sign off on it before we can spend our own local money 
Well, listen to this, Wolf  We passed our budget in -- last spring  The appropriators signed off on it last summer 
So, why are we in a federal budget fight over their money when it is our money I am talking about? I have put forward amendments that said the district can spend its own local funds 
BLITZER: What's going to happen in the District of Columbia Saturday, Sunday, Monday, if there is a government shutdown? Give me an example or two 
NORTON: I will give you some dramatic ones  How about the shutdown of the D C  government itself? Because since the final gavel hasn't fallen on all the federal appropriations, then the district government has now prepared to shut down on Saturday morning just because the federal government is shutting down 
We are at the height of the tourist season, the Cherry Blossom Festival  That has been severely curtailed because of the federal shutdown  That's going to -- three million people come here just in one month for the cherry blossoms  Our mayor has had to put out a list of agencies that will be open and a list of agencies that won't be open 
BLITZER: Trash collection -- will there be any trash collection in the District of Columbia?
NORTON: No trash collection, and some residents have started up a Facebook page that says if they close down the District of Columbia, we're carrying our trash to Speaker Boehner's House 
BLITZER: You don't support that do you?
NORTON: I do not 
NORTON: And let me just say right here, I do not  But let me tell you, I am only expressing a little of the rage that the taxpaying residents of the District of Columbia are feeling 
BLITZER: But let me ask you this, Congresswoman, because the Democrats were in control, they had a large majority in the House all of last year; in the Senate, a significant majority  They failed to pass a budget  Don't the Democrats deserve a lot of the blame for this current impasse?
NORTON: Absolutely not, because the Democrats would never have held our budget up here 
LISA BLOOM, CNN LEGAL ANALYST: Why didn't they pass the budget?
NORTON: Well, that doesn't have anything to do with us  This is our local money 
All it would take is -- the Democrats in the Senate are ready to agree  The president is ready to sign an amendment --
BLITZER: But they could have done this any time last year 
NORTON: Wait a minute, Wolf  Wait a minute -- an amendment that said while we're fighting it out on the federal budget, we will let the district spend its own local funds 
So that's all I'm asking  I'm not in this fight, so don't ask me why the Democrats didn't pass the Democratic budget 
I passed -- we passed our budget  Our budget is balanced  The only issue before the Senate and the House is, can we spend our local money? It doesn't have anything to do with their budget 
They can go on from now until Timbuktu  Let us spend our money and don't close down our city because the federal government can't get its act together 
BLITZER: I'm with you there  This is an outrage, the fact that there is -- if there is going to be shutdown  I'm still hoping there won't be a shutdown, but it's --
NORTON: I think there may not be 
BLITZER: -- ridiculous when you think about it, when you think about how close they are  It would be a horrible, horrible tragedy, because 800,000 people directly are going to start losing their paychecks  And the District of Columbia, which is, as you point out correctly, taxation without representation, is going to suffer a great deal more than any other city in the United States 
Good luck, Congresswoman  Thanks very much 
NORTON: Thank you, Wolf 
BLITZER: I feel your pain 
Concerns within military families over a government shutdown  Also, why they are downright scared they won't be able to put food on the table 
And tens of thousands of people on a hunger strike, including some members of Congress  We'll explain why 
CAFFERTY: The question this hour is: Do you believe you're being told the truth about the nuclear accident in January?
Fred writes, "You want the truth? You can't handle the truth "
"Just how should a government balance our right to know the truth with the perceived need to not create a panic and thus a larger problem? Can you really evacuate a million people? To where? Yes, without the truth, how can anyone try to act reasonably?"
"In the end, we do have a right to know the truth  Honesty is the best policy "
Paul in Ohio writes, "Jack, I believe they're telling what they think they know with certainty  It is most certain that they don't know everything "
Jeremy in California, "So I'm confused  Is the current California radiation level 'harmless to human health,' 'not immediately harmful to human health,' not permanently harmful to people outside the region,' or no more than an apples-to-oranges transcontinental flight?"
Craig writes, "Perspective  In Japan, they have had yet another earthquake and have lived in fear and chaos for over a month  And yet, their government hasn't shut down  Nuclear disaster, natural disaster, absolute destruction hasn't kept their elected officials from doing their duty to the people 
"Yet, in America, we get Harry Reid, John Boehner and a White House who are more concerned with the 2012 election campaign  It's times like these when we see just how far off the mark we really are "
Louis writes, "No  Just too many things going wrong  They say that the seafood will be safe  I ask this: Do fish migrate or do they set up housekeeping in one spot and then stay there? And if so, why don't I catch fish in the same place every day?"
And Jim in Colorado, "The nuclear industry telling the truth? The unicorn, garden gnome and I were talking this over just the other day, and we all agreed it could happen  Why not?"
If you want to read more about the unicorn and the garden gnome, go to CNN com/CaffertyFile 
BLITZER: We will, for sure, Jack  Thank you  See you in a few moments 
Several sticking points in the ongoing budget negotiations, but will the government shutdown come down to money or social issues?
Plus, Donald Trump, he's making allegations about President Obama's birthplace  Does Donald Trump have any grounds for any of that? We're digging deeper for answers 
BLITZER: The growing outrage over the budget crisis isn't just about Congress' failure to reach a deal, it's also about some of the cuts that are being proposed 
Lets bring in our own Lisa Sylvester once again  She has the details -- Lisa 
Well, as congressional leaders hammer away on a budget compromise, a group of religious leaders have been fasting and praying to raise awareness of cuts in the budget that they say will harm the poor 
JIM WALLIS, PRESIDENT, SOJOURNERS: Orange juice never tasted so good 
SYLVESTER (voice-over): It's been 10 days since Jim Wallis last had solid food  The president of Sojourners, a Christian group that advocates for the underprivileged, is leading the charge among faith groups on a hunger fast to protest proposed cuts in the federal budget for the poor 
WALLIS: We're saying a budget is a moral document  And whether at your kitchen table, as a family, or a church or a nation, you make choices  What's important, what's not?
SYLVESTER: Wallis said in the last 10 days, more than 30,000 people around the country have joined in the fast in their own way  He says they have become a bit like God's lobbyists for the poor, putting a theological and moral spin on the cuts  Wallis said he is all for deficit reduction but --
WALLIS: I don't think doing this at the expense of the poorest people is a good choice, or hurting those who are already hurting the most is moral or even is smart 
SYLVESTER: Fiscal conservatives have suggested cuts in food stamps, foreign aid, and preschool programs for low-income families, that private groups can and should provide for the needy  But David Beckman of Bread for the World, who used to work at the World Bank, says the private sector can't fill the gap 
DAVID BECKMAN, PRESIDENT, BREAD FOR THE WORLD: All the private charitable feeding in the country amounts to about six percent of the food that poor people get from the national programs  So if you slash food stamps, as the House Republicans are proposing to do, there is no way that churches and charities and charitable people can make up for that 
SYLVESTER: Tony Hall was a member of Congress for years  As part of the fast, he is urging his former colleagues to reconsider cuts 
TONY HALL, ALLIANCE TO END HUNGER: When you make decisions about people's lives, be careful  You don't cut the poorest of the poor, because they didn't get you here  They didn't cause this mess 
SYLVESTER: On Wednesday, members of Congress began signing up for the fast 
REP  BARBARA LEE (D), CALIFORNIA: Several members of Congress today will be joining you in this fast 
SYLVESTER: Now, Sheila Jackson Lee, Keith Ellison and Jim McGovern are among 28 congressional Democrats who have signed on so far to join the hunger fast, and they will be doing a relay, with each taking one day to fast and then passing on the fast to their colleagues 
Wallis and Hall, they're doing it a little differently  They're fasting all the way through Easter Sunday  But they say for them, this fight for the poor is larger than just the specific budget battle -- Wolf 
BLITZER: These are committed, committed people to try to help 
We're going back to Libya in just a few moments  Rebel forces, furious with NATO right now, the R-rated message they are sending through our own Ben Wedeman 



ground_truth: The IAF is considering the acquisition of the Airbus A330 MRTT (Multi-Role Tanker Transport) besides the Boeing C-17.