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: What is the water depth in the Greater Ekofisk Area?

Read the following text and answer briefly.

Context 1: Filip Fremo Minge – Ekofisk
Author: Filip Fremo Minge
Posted on 1  October 2019 12  October 2019
— Sunset over Ekofisk  Photo: Husmo Foto/Norwegian Petroleum Museum
The three are operated by ConocoPhillips on behalf of the Ekofisk licensees  The area also embraces former producers Albuskjell, Cod, Edda, Tor, West Ekofisk and Tommeliten G 
These fields all lie within production licence 018 apart from Tommeliten G, which was operated by Statoil from 1976 to 2003 
In all, 31 installations have been positioned in the Greater Ekofisk Area 
First Norwegian offshore field
Ekofisk began production on 15 June 1971, following its discovery in the autumn of 1969  Development of the field has occurred in several phases 
Its central facilities were installed during the early 1970s, with oil initially being buoy-loaded into tankers  From 1975, it has been piped to Teesside in the UK  The gas has been landed by pipeline at Emden in Germany from 1977 
ekofisk i et nøtteskall, engelsk
Jacked up six metres
The water depth in the Greater Ekofisk Area is 70-75 metres  However, declining pressure in the Ekofisk reservoir over the years has caused the seabed to subside 
Efforts began as early as 1985 to safeguard the installations against the effects of this development, and the steel platforms in the Ekofisk Complex were jacked up by six metres in 1987 
In addition, a protective breakwater was installed around the Ekofisk tank in 1989  The rate of seabed subsidence has declined sharply in recent years 
Waterflooding improves recovery
The Ekofisk 2/4 K water injection platform became operational in December 1987 as part of efforts to improve Ekofisk’s recovery factor – the share of petroleum in place actually produced 
Waterflooding capacity on the field to help maintain reservoir pressure was later expanded several times, and had reached just over 500 000 barrels per day by 2019 
Measured in barrels of oil equivalent, the recovery factor on Ekofisk has risen from an original estimate of 17 per cent to over 50 per cent 
Ekofisk I and II plus licence extension
The first phase of development and production on Ekofisk began with initial oil output from the converted Gulftide jack-up rig in 1971 and ended with the start-up of Ekofisk II in 1998 
Large parts of the Greater Ekofisk Area were restructured in the latter year, leading to plans for removing 15 installations – 14 steel platforms and the process facilities on the Ekofisk tank 
plattformer, historie, 2004, driftsenter åpnet,
Embla 2/7 D  Photo: ConocoPhillips/Norwegian Petroleum Museum
Designated Ekofisk I, these redundant structures include Ekofisk 2/4 A, 2/4 B, 2/4 FTP, 2/4 Q, 2/4 H, 2/4 R, 2/4 P and 2/4 T 
In addition come the Edda 2/7 C, Albuskjell 1/6 A, Albuskjell 2/4 F, Cod 7/11 A, West Ekofisk 2/4 D, Norpipe 36/22 A and Norpipe 37/4 A installations 
The concrete part of the tank – Ekofisk 2/4 T – will remain  Gulftide was removed as far back as 1974  Two platforms owned by other companies – Ekofisk 2/4 G and 2/4 S – have also gone 
A new plan for development and operation (PDO) of the field (Ekofisk II) was approved in 1994, at the same time as the Ekofisk licence was extended to 2028 
This creates a new Ekofisk Complex with two structures – the Ekofisk 2/4 X wellhead unit installed in the autumn of 1996 and the Ekofisk 2/4 J processing and transport platform in 1997 
Ekofisk II became operational in August 1998 and is intended to produce until 2028  Ekofisk, Eldfisk and Embla are tied back to the new complex, as was Tor until it shut down in December 2015 
Ekofisk West
historie, forsidebilde, 2003, ekofisk vekst godkjent i statsråd
Ekofisk Growth  Illustration: Ståle Ådland
In December 2002, soon after the Conoco-Phillips merger had been announced, the Ekofisk West project was presented to improve oil and gas recovery  Process capacity and reliability on Ekofisk were also to be enhanced 
This development primarily involved the construction and installation of a new platform, Ekofisk 2/4 M, with processing facilities and 24 new wells drilled over five years 
The latter could contribute to improved recovery both because there were more wells and because they would tap new locations in the reservoir  On stream in 2005, 2/4 M was linked to the Ekofisk Complex with a bridge 
Process capacity for produced water was also to be increased through upgrading on Ekofisk 2/4 J and Eldfisk 2/7 E  A third measure concerned laying a power cable from the Ekofisk Complex to 2/4 K in order to make electricity supplies more efficient 
New developments: Eldfisk II and Ekofisk South
Eldfisk 2/7 S løft
The deck of Eldfisk 2/7 S being mated with the steel jacket  Foto: Øyvind Sætre/ConocoPhillips
The plan for development and operation (PDO) of Eldfisk II, approved by the Storting (parliament) on 9 June 2011, includes a new wellhead, process and accommodation platform – Eldfisk 2/7 S 
In addition come 42 new wells as well as upgrades to existing platforms which extend their commercial life 
The PDO for Ekofisk South involves the construction of a new wellhead platform – Ekofisk 2/4 Z – as well as a new subsea water injection facility and 44 additional wells 
ConocoPhillips Norge, 2004 
Ministry of Petroleum and Energy, press release, “Vekstprosjekt på Ekofisk godkjent”, 6 June 2003 
https://www stortinget no/no/Saker-og-publikasjoner/Saker/Sak/?p=50343
https://www stortinget no/globalassets/pdf/innstillinger/stortinget/2010-2011/inns-201011-398 pdf
https://www regjeringen no/no/aktuelt/klart-for-40-nye-ar-pa-ekofisk-feltet/id642376/)
Published 1  October 2019 • Updated 12  October 2019
— Gassterminalen i Emden  Foto: Husmo Foto/Norsk Oljemuseum
Oil terminal in Teesside
Olje- og gassterminalene, engelsk,
Teesside terminal  Brian Henderson Thynne takes samples of refrigerated propane  Photo: Husmo Foto/Norwegian Petroleum Museum
The terminal at Teesside in north-east England receives oil and natural gas liquids (NGL) by pipeline from the Ekofisk field  It comprises stabilisation, NGL fractionation, storage tanks for crude oil and an export port 
After arriving through the Norpipe Oil line, crude and NGL are separated and the oil goes through a stabilisation process before reaching the 10 storage tanks, which each hold 750 000 barrels 
The NGLs go to the fractionation facility, with a daily capacity of 64 000 barrels, for separation into methane, ethane, propane, and normal and iso butane 
While the methane (natural gas) is used to fuel the plant, the other products (now known as liquefied petroleum gases – LPG) are made liquid by cooling and stored for export by sea 
One reason for the choice of Teesside as the landfall for the Ekofisk pipeline was the opportunity it offered to install deepwater quays 
The terminal has four of these, with those for crude oil able to handle tankers up to 150 000 deadweight tonnes  The LPG quays can accept carriers loading as much as 60 000 cubic metres 
Two of the crude oil quays lie on the main channel of the River Tees, while the others have been installed in dredged docks 
Gas terminal in Emden
Gas arriving at the Emden terminal from the Ekofisk Complex enters nine parallel treatment trains for cleaning, metering and onward distribution to the buyers 
The North Sea gas is very clean, and needs only limited treatment to remove small amounts of sulphur compounds using an absorption process  Impure molecules from the gas accumulate on the surface of small particles, which act as filter spheres 
Each of the nine trains comprises four process columns and a process oven  The gas enters the top of a column and leaves through the base after passing through the filter spheres 
That leaves the gas ready for sale, and it is piped to the fiscal metering station before entering the buyer receiving pipelines and distribution network 
Three separate commercial pipeline systems connect to the terminal, operated by Ruhrgas, BEB and Gastransport Services (previously Gasunie) respectively  They pipe the gas away on behalf of the gas buyers 
The Norsea Gas Terminal in Emden was officially opened in September 1977 by Norwegian industry minister Bjartmar Gjerde and Phillips executive Gordon Goerin 
Ranking as the first gas sales deal for the Norwegian continental shelf, the Ekofisk agreement paved the way for later contracts covering other fields off Norway 
Regularity at the Emden terminal has been very high, with its own equipment never causing shutdowns  Maintenance takes place when other parts of the system are off line 
The terminal has a daily capacity of about 2 1 million cubic feet of gas per day 
Gas transport restructured
Norpipe AS owned the gas pipeline from Ekofisk to Emden until the transport system for the Norwegian offshore sector was restructured at 1 January 2003 
Norsea Gas A/S furthermore served as the formal owner of the Emden facility, with Phillips Petroleum and then ConocoPhillips as operator for both pipeline and terminal 
olje- og gassterminalene,
Teesside gas terminal  Photo: Husmo Foto/Norwegian Petroleum Museum
Since 2007, Norway’s state-owned Gassco company has been responsible for technical operation of the facilities on behalf of their owners 
That included operator responsibility for the H7 and B11 booster platforms along the gas pipeline, which were shut down in 2007 and 2013 respectively and have since been removed 
The Gassled partnership is a project collaboration embracing 10 companies which collective own large parts of the gas infrastructure on the Norwegian continental shelf (NCS) 
A substantial proportion of Norway’s gas deliveries to Germany continues to arrive at the Emden terminal, including the volumes piped from Ekofisk 
Preliminary planning for a new terminal in the German port began in 2011, with Gassled taking the investment decision for this development in the autumn of 2012 
Construction work began in the following year, with the new facility being built on an unused part of the existing terminal site 
The new terminal has not expanded export capacity  But its functionality is well adapted to future processing needs for fields in the Greater Ekofisk Area and other parts of the NCS sending gas through the Norpipe system 
It was officially opened on 24 May 2016 by Elisabeth Aspaker, the Norwegian government minister for the EU and the European Economic Area  That closed a chapter in Ekofisk’s history 
Source: ConocoPhillips Norge
— Gas pipes at Ekofisk  Photo: Husmo Foto/Norwegian Petroleum Museum
In addition to ConocoPhillips’ own production from Ekofisk, these pipelines carry gas and oil from the company’s fields in the UK sector and from other fields on the Norwegian and British continental shelves 
The three fields in the Greater Ekofisk Area are also tied together by pipelines 
Oil pipeline to Teesside
rørledningene, engelsk,
Pipes and oil tanks at the Teesside plant  Photo: ConocoPhillips/Norwegian Petroleum Museum
The pipeline linking Ekofisk with the terminal for oil and natural gas liquids (NGL) at Teesside on the north-east English coast became operational in October 1975 
Pumps raise the pressure of the oil and NGL before they start their journey to land  Two pumping stations – 37/4 A and 36/22 A ­– originally stood along the pipeline to maintain this pressure, but have now been disconnected and removed 
The pipeline was installed with the ability to carry a million barrels per day  However, that much capacity has never been required 
In the UK sector, a 24-inch pipeline has been tied in with a Y connection to receive input from several British fields – including the J block developments operated by ConocoPhillips 
Output from the Greater Ekofisk Area is supplemented by crude from Valhall, Hod, Ula and Gyda heading for Teesside, optimising pipeline utilisation and thereby boosting value creation 
The pipeline is owned by Norpipe Oil AS and operated by ConocoPhillips 
Gas pipeline to Emden
Sandbags and gravel were used to cover Norpipe to Emden  Photo: Unknown/Norwegian Petroleum Museum
This pipeline became operational in September 1977  The starting pressure of around 132 bar is provided by compressors on the Ekofisk Complex 
The 443-kilometre distance to Emden was split into three equal sections, with platforms B11 and H7 located at the intermediate points to provide boosting if required 
However, additional compression was seldom needed on the final stage to Emden  H7 was shut down in 2007 and B11 in 2013, and both have since been removed 
These two booster platforms were located in the German sector of the North Sea, while the pipeline also crosses the Danish sector 
The pipeline has been trenched or covered with sand  Its final section passes the island of Juist before making landfall on the coast of East Friesland to the north of Emden 
Its daily capacity is roughly 59 4 million standard cubic metres (2 1 billion cubic feet)  In addition to gas from the Greater Ekofisk Area, it carries output from Valhall, Hod, Ula, Gyda and the Statpipe system (primarily Statfjord and Gullfaks) 
Posted on 24  June 2017 25  October 2019
Embla 2/7 D
This unmanned wellhead facility is remotely controlled from Eldfisk 2/7 S located 5 2 kilometres to the north, where oil and gas output from the platform is also processed 
Unmanned and remotely operated wellhead platform
On stream 12 May 1993
— Embla 2/7 D  Photo: ConocoPhillips
sokkelkart, illustrasjon, blokker, lisens, forsidebilde, engelsk,
Hand-colored map of the licenses of the first licensing round on the Norwegian continental shelf  Norwegian Continental Shelf Map, 1965 
The Phillips group was awarded block 2/7 as early as 1965, and the Embla reservoir lies in the southern part of this acreage  Drilling began there in 1974 to depths of 4 500-5 000 metres, but pressure and temperature in the wells were too high for testing with the available equipment 
The first production well was not drilled and tested until 1988, followed by a second in 1990  Both yielded very promising results, and the field came on stream in May 1993 
Embla comprises a sandstone reservoir at least 250 million years old  The other fields in the Greater Ekofisk Area comprise fine-grained carbonate rocks deposited about 70 million years ago 
The Embla reservoir has a temperature of 160°C compared with the 125°C normally found in the chalk formations 1 000 metres higher up, and its pressure is almost twice as high 
Fabricated by Heerema in the Netherlands, the Embla 2/7 D jacket (support structure) was installed by the M 7000 crane vessel  It stands 84 metres high and weighs 2 300 tonnes 
A 5 2-kilometre subsea umbilical from Eldfisk comprises three power cables for electricity supply and eight fibreoptic lines handling data transmission and telecommunication 
Eldfisk 2/7 S, embla,
Eldfisk 2/7 S  Photo: ConocoPhillips
The platform has six production wells and an average daily output of roughly 7 000 barrels of oil  All processing and metering took place on Eldfisk 2/7 FTP until 2015, and has now been switched to Eldfisk 2/7 S 
A 14-inch flowline linked 2/7 D with 2/7 FTP and runs today to 2/7 S  Produced at Wick in Scotland, this line was floated out to the field in one piece 
Topside equipment includes the wellhead area, helideck (built by Vindholmen Services in Arendal), crane, control room, workshop, test separator and glycol pump 
Normally unmanned, the platform is maintained as and when required and therefore incorporates a simplified accommodation module with lounge, mess, coffee room, galley, changing room, WC and 12 emergency beds 
More about platforms
Ekofisk 2/4 Z
This installation is a wellhead platform in the Ekofisk Complex 
Gulftide
This four-leg jack-up drilling rig was built in Glasgow during 1967 for Ocean Drilling & Exploration Co 
Posted on 1  September 2019 8  October 2019
— Gulftide with Ekofisk 2/4 A in the background  Photo: Aker Mek  Verksted/Norwegian Petroleum Museum
Gulftide was converted to cope with conditions on Ekofisk in the Åmøy Fjord near Stavanger  This jack-up drilling rig was equipped with process equipment and its derrick, helideck, hangar and legs were reinforced 
To win time, it was decided that the discovery well and three appraisals drilled on Ekofisk by Ocean Viking would be completed for production 
Principles for producing from Gulftide were relatively simple  Output flowed from the subsea wellheads to the platform, where it went through two-stage separation to remove gas and water 
With pressure also reduced, the gas was flared off and the oil sent on by flowlines to two loading buoys where shuttle tankers moored to take on cargo 
utbyggingen,
Tankskipet Donovania laster olje fra lastebøyen på Ekofisk  I bakgrunnen skimtes så vidt Gulftide  Foto: ConocoPhillips/Norsk Oljemuseum
Production could only continue while ships were loading  As soon as one tanker had been filled, the oil stream was diverted to the vessel waiting at the other loading buoy 
The problem with this approach was manifested when weather conditions ­– strong winds and/or high waves – forced the tankers to leave the buoys 
If that happened, production from the wellheads had to be suspended immediately  Given the prevailing weather on Ekofisk, that happened regularly  Output was halted for 20 per cent of the time during the first year 
https://ekofisk industriminne no/wp-content/uploads/sites/2/2019/09/Building-Ekofisk mp4
Gulftide was replaced as the temporary production installation in 1974 by the permanent Ekofisk 2/4 A (Alpha) and 2/4 B (Bravo) platforms for production, drilling and quarters 
In addition came the Ekofisk 2/4 C (Charlie) production, drilling and compression facility, the Ekofisk 2/4 FTP (field terminal platform) for production and risers, and Ekofisk 2/4 Q for accommodation 
Oil and gas were produced by 2/4 A, B and C through their own wells for processing in their separation plants and piping on the 2/4 FTP for a three-stage separation process 
At the same time, the tanker loading buoys were moved further from the platforms and the Ekofisk 2/4 T oil storage tank became operational 
This facility was extremely advantageous, because it allowed production to continue virtually regardless of whether bad weather prevented tankers from connecting to the buoys 
Ekofisktanken ble satt i drift i 1974  Foto: ConocoPhillips/Norsk Oljemuseum
The 2/4 FTP platform, where oil and gas from the three producing facilities was processed, had been planned to handle the level of output estimated for the main field 
Clear restrictions had been imposed by the Norwegian government on the amount of gas Phillips was allowed to flare  That also set a ceiling for oil production, since gas accompanies it up from the reservoir 
The solution was to install two powerful compression packages on 2/4 C in order to inject the gas under pressure back into the producing formation 
Accommodation facilities had to be provided on the two first platforms, 2/4 A and B  Where 2/4 C and FTP were concerned, however, they were tied together with bridges and to 2/4 Q 
Published 1  September 2019 • Updated 8  October 2019
Posted on 9  April 2019 25  October 2019
Jack-up drilling rig
Built 1967 in Glasgow for Ocean Drilling & Exploration Co 
Began test production on Ekofisk 15 June 1971
Produced on Ekofisk until 1974
— Gulftide at theEkofisk field  Photo: Terje Tveit/Norwegian Petroleum Museum
gulftide,
Gulftide  Photo: Unknown/Norwegian Petroleum Museum
A mere 17 months after the Ekofisk discovery was announced in December 1969, Gulftide was ready to come on stream as a temporary production platform 
Its official inauguration took place on 9 June, with initial test output commencing on 15 June  Full production began on 8 July 
The rig was chosen because it was available on the market  Established equipment for processing oil and gas was tailored to the limited space on board  Separate flowlines carried wellstreams from four subsea wells  Oil, gas and water were separated on board, with the gas flared and the oil piped to two buoys for loading into shuttle tankers 
Work on the process equipment was relatively simple  The problem was to tailor it to the rig  The subsea wellheads had to be reinforced to meet the demands posed by the North Sea, and a buoy loading system needed to be developed for waters where this technology had never been used before 
To gain time, it was decided that the three appraisal wells drilled by Ocean Viking to map the extent of the field – in addition to the discovery well – would be completed for production 
Første testflamme tent på Ekofisk  På Gulftide
1973, Teddy Broadhurst, gulftide,
arbeidsliv, hjelpearbeider
Gulftide, separator – på bildet kan man se at det er fire brønner 
arbeidsliv, gulftide, pionerkultur, arbeid, dekk, Norges første havbunnsbrønner, historie, 1971,
The producers would be topped with hydraulically controlled wellheads  Such equipment had been tried out on the seabed earlier, but on a limited scale and not in the deep and rough waters found on Ekofisk  This challenge was overcome by having the wellheads manufactured and then reinforced at the Phillips base in Dusavik outside Stavanger  Flowlines and control cables would also be laid from each well to Gulftide, with production comingled in a single riser to the topsides 
Weather conditions also represented a major problem when designing the loading buoys  Phillips itself had experience with such facilities, but the concept had only been used before in harbour-like conditions and waters no deeper than 27 metres  They were now to stand in 70 metres in the middle of the North Sea 
Gulftide was converted in the Åmøy Fjord outside Stavanger to cope with conditions on Ekofisk  The processing facilities were installed and reinforcements made to the derrick, helideck, hangar and leg structures 
Gulftide, Ekofisk 2/4 A, boretårn, flare, 1971, utbygging,
Gulftide with Ekofisk 2/4 A in the background  Photo: Aker Mek  Verksted/Norwegian Petroleum Museum
Planning began in late 1970, when Phillips received approval to begin laying the flowlines between wellheads and rig  Brown & Root won this contract, with the first oil pipelines on the Norwegian continental shelf laid by the Hugh W Gordon laybarge 
The production principle on Gulftide was relatively simple  Output flowed from the subsea wellheads to the rig, where it passed through two separation levels to be split into oil and gas while the huge pressure was reduced 
Gas was flared off and the oil was piped to one of the loading buoys where a shuttle tanker was moored  Production could only take place when a ship was present 
Offisiell åpning av norsk oljeproduksjon,
The Greek tanker, Theogennitor, unloads crude oil from loading buoys on the Ekofisk field  Gulftide in the background  Photo: ConocoPhillips/Norwegian Petroleum Museum
As soon as one tanker had become fully laden, the oil flow was switched to the other buoy where another ship was waiting to take on cargo 
The problem with this approach arose when weather conditions meant the tankers had to cast off from the buoys because of strong winds or high waves  The rig then had to shut down production from the wellheads immediately 
Given the weather conditions found on Ekofisk, output regularly had to cease  Production was suspended for 20 per cent of the first year for this reason 
Output began cautiously on 8 July 1971 from a single well  The second producer came on stream that September, the third was ready the following month and all four were producing by February 1972  They each flowed 10 000 barrels of oil per day 
Source: Kvendseth, Stig, Giant discovery, 1988 
Published 9  April 2019 • Updated 25  October 2019
Norpipe H-7
This platform served as a pumping/compressor station to maintain pressure in the 443-kilometre Norpipe gas pipeline from Ekofisk to Emden in Germany, which became operational in September 1977 
Kjappe fakta::
Compressor platform on Ekofisk-Emden gas pipeline
Installed 1976
Operational 1977
Shut down 29 October 2007
Removed 2013
— Norpipe GNSC-H7  Photo: Husmo Foto/Norwegian Petroleum Museum
Gas received initial compression to 132 bar at the Ekofisk Complex  The pipeline was divided into three equal lengths, with Norpipe GNSC B11 positioned at the end of the first third to maintain pressure as and when required 
From there, the gas then travelled the next third of the distance to the second and virtually identical compressor platform, H7 
This was also responsible for maintaining pressure, but additional compression was seldom required on this final leg of the journey to Emden 
Both platforms stood on the German continental shelf, but 48 kilometres of the pipeline also ran across the Danish North Sea sector 
The pipeline is trenched or covered with sand  On its final approach to the coast of East Friesland, it passes beneath the island of Juist before making landfall north of Emden 
Capacity in Norpipe is about 60 million standard cubic metres (scm) or 2 1 billion cubic feet per day  In addition to output from the Ekofisk-area fields, it carries gas from Valhall, Ula and the Statpipe system – primarily Statfjord and Gullfaks  Gas was also transported for a time from Hod and Gyda, but that has ceased 
fritid, Norpipe GNSC-H7,
Magnus Refsland and Werner Hein have pulled the crab trap (full of starfish) on the Norpipe H-7 platform  Photo: Husmo Foto/Norwegian Petroleum Museum
Built in 1976, the B11 platform had six decks  Its permanent staffing totalled 14 people, but various service personnel were also often on board  The regular crew included three in catering 
The 11 Phillips employees comprised the offshore installation manager, the nurse/radio operator, eight operators and a roustabout 
In addition to their direct function, the operators covered various other trades which meant the crew was self-sufficient in most circumstances 
Both platforms obtained a satellite antenna in 1986 which allowed them to received Norwegian TV, while the 24-bed accommodation were redecorated in 1981 and upgraded in the summer of 1990 
Work on the upgrading largely comprised converting all cabins to doubles with shower and WC  The galley and changing rooms were renewed and changing facilities for women provided 
A new module with a lounge for non-smokers, a smoking room, gym and pool room was also installed  During this work, the West Gamma accommodation rig was positioned alongside 
Upgrading equipment on the platform was also initiated in 1990  While the pipeline’s original daily capacity had been estimated at 2 100 million standard cubic feet, this was found to have declined after a number of years to 1 975 million 
To return to the original capacity, the compressors needed to be upgraded and power supply from the turbines increased  This was done both on the Ekofisk tank and on the H7 and B11 platforms  Gas coolers on the tank were replaced as well 
Norpipe GNSC-H7, yrker, radiooperatør,
Radio operator Torleif Førland on the platform Norpipe H-7, with his amateur radio  Photo: Husmo Foto/Norwegian Petroleum Museum
The control systems were also upgraded in parallel  Control panels on turbines and compressors were replaced and metering instruments installed to conduct measurements in this equipment 
While the nearest neighbour to B11 was a Danish oil field, H7 stood in the middle of the shipping channel  M/S Hero broke down 15 nautical miles west of the latter platform at around 13 00 on 12 November 1977 
By 21 00, the ship was still adrift and heading directly for H7, and all 14 crew on the platform made ready to evacuate by helicopter – the waves were too high for the lifeboats  The wreck passed at 21 40 with a clearance of 400 metres 
German cargo carrier Reint collided with H7 on 30 September 1995, despite efforts by the standby ship to avert the threat  Production was halted as a safety measure, but the platform luckily suffered only minor damage  The collision was caused by inadequate watchkeeping on the ship’s bridge 
Operator responsibility for B11 and H7 was transferred at the beginning of 2003 to Norway’s state-owned Gassco company, which runs the Norwegian gas transport network 
This change had little significance for operation of the platforms, since the actual work was still carried out by ConocoPhillips as a technical service provider to Gassco 
H7 was shut down in 2007, and removal had been completed in 2013  In connection with preparations to remove the structure, operator responsibility was transferred to Statoil as the company in charge of the project on Gassco’s behalf 
Published 24  August 2016 • Updated 22  October 2019
Phillips inundates Sola with oil revenues
person by Kristin Øye Gjerde
Stavanger and neighbouring Sola were the first Norwegian local authorities to experience fantastic oil-related growth after the award of the first exploration licences in 1965 
— Phillips er i ferd med å etablere seg på Norscobasen nederst til høyre Ca 1972 Foto: Norsk fly og flyfoto/Norsk Oljemuseum
The Shell refinery at Risavika in Sola was completed two years later, while the Norsco base in Tananger became operational as early as 1966 
But things really took off once the Ekofisk field had been discovered in the autumn of 1969 and started trial production on 14 July 1971 
Operator Phillips Petroleum Company moved its offices from the Dusavik base outside Stavanger to Tananger in Sola, and Shell could finally start refining Norwegian rather than imported crude 
Sola’s population now rose steadily from 8 400 in 1965 to 15 000 two decades later, and jobs grew even faster – from about 2 000 in 1970 to almost 8 000 in 1985  That averages 10 per cent annually 
Phillips and Shell became cornerstone companies  A large part of their workforce, particularly in Phillips, worked offshore  In addition came newly established oil supply firms 
More jobs were also created in retail, public administration, education, health and social care, personal services and so forth 
Although traditional agriculture remained important for the local authority, the number of farmers gradually declined as a result of mechanisation [REMOVE]Fotnote: This article is based on the chapter “Elverket i Oljealderen” in I det regionale spenningsfelt  Sola Energi 1913-1999, Kristin Øye Gjerde 
Boreskipet Drillship ligger ved kai på Norscobasen i Tananger (1968)  Foto: NOM/Norsk Fly og Flyfoto
Boreskipet Drillship ligger ved kai på Norscobasen i Tananger (1968)  Foto: Norsk Fly og Flyfoto/Norsk Oljemuseum
The “agio tax”
The sharp rise in Sola’s revenues was attributable entirely to the oil industry, and it found itself in an enviable position during this period  Tax revenues rose even faster than population and jobs 
To give an indication, the local authority’s overall income from wealth and income taxes rose from NOK 9 3 million in 1966 to NOK 198 million in 1990  The biggest growth came in 1978-82, when it averaged 39 per cent a year [REMOVE]Fotnote: Sola local authority, plans 
The secret behind this sharp increase was the tax paid by the oil companies – primarily Phillips – on agio, or the percentage fee charged when exchanging one currency for another 
Under Norwegian law at the time, the companies paid tax on their interest income to the local authority where they had their head office  In making this rule, however, the government had failed to take account of the considerable sums involved 
As operator of the Greater Ekofisk Area, Phillips had placed capital to be used for new investment in banks around the world – particularly the UK 
These deposits yielded substantial interest payments, and tax was payable on converting this income into Norwegian kroner [REMOVE]Fotnote: Toralv Torstenbø, former chief executive officer in Sola local authority, interviewed by Kristin Øye Gjerde, 22 February 2001 
Sola council is said to have almost gone into shock the first time Phillips paid this agio tax  It suddenly had more money than it could spend 
During the 1970s and early 1980s, Sola’s municipal income always exceeded the budgeted amount  Large sums could be transferred every year to a capital fund 
Since the local authority was in a growth phase, additional funding was needed for the big developments it faced  While the rest of Norway experienced a slump in the late 1970s, Sola continued in top gear without a sign of unemployment 
Net income tax revenues came to NOK 55 5 million in 1978, while net spending was NOK 31 9 million  And these fantastic results went on improving 
By 1982, wealth and income taxes yielded NOK 203 4 million – compared with a budget of NOK 146 million, which was upgraded to NOK 190 million during the year 
According to Toralv Torstensbø, the financial controller, agio tax accounted for almost half this amount – in other words, as much as the tax paid by all other enterprises, private individuals and industry in Sola 
Its chief executive officer became a little overweening  In his comments on the 1982 budget, he declared that it would be “natural for Sola local authority to feel a strong regional responsibility and not to be too strict about the traditional division of costs between state, county and local authority ”
In line with this open-handed policy, Sola paid for both road projects and an upper secondary modern school which the county council was supposed to fund [REMOVE]Fotnote: Chief executive officer’s budget proposal for Sola local authority covering 1974-85 
Tightening up petroleum tax
This unexpected prosperity undoubtedly created some jealously in the neighbouring local authorities, and the media began to show an interest in the issue 
Local daily Stavanger Aftenblad interviewed Sola’s chief executive and controller in 1981, when its photographer took a shot which illustrated the boundless wealth – Torstensbø stood showering hundred-krone notes over his colleague 
This story was not only read by the paper’s regular subscribers  The following day, 150 copies were distributed to members of the Storting (parliament) 
That in turn prompted Centre Party representative Lars Velsand to make a passionate speech in which he described the position as a misuse of tax revenues 
He called on the government to intervene so that individual local authorities were unable to benefit in this way  Nor was he alone in finding it unreasonable that a small community like Sola should get so much money 
The result was an amendment to the Petroleum Tax Act on 11 June 1982, which specified that the proceeds from the agio tax should be transferred in future to central government 
Løfteskipet Uglen i aksjon ved Norscobasen i juli 1980  Foto: NOM/Norsk Fly og Flyfoto
Løfteskipet Uglen i aksjon ved Norscobasen i juli 1980  Foto: Norsk Fly og Flyfoto/Norsk Oljemuseum
Unfortunately, however, Sola had got used to consuming these revenues  It is easy to learn expensive habits, but not so straightforward to shrug them off again 
Matters had become a little unusual when the council’s executive board adopted the style of the oil company chiefs and took a helicopter outing during an ordinary budget meeting [REMOVE]Fotnote: Oskar Goa, former chief technical officer in Sola local authority, interviewed by Kristin Øye Gjerde, 23 October 2000 
However, most of the tax money benefitted the general public  Paying for Sola upper secondary school and new national and county highways is an example of this 
The council also invested on local authority school buildings and community facilities such as the big sports complex at Åsen, with an outdoor athletics ground and two modern indoor arenas  Dysjaland and Tananger also acquired new sports arenas 
A new cultural centre built in central Sola has a distinctive architecture in brick and glass, with a grassed roof to blend with the surrounding Jæren landscape  With two stages and a public library, this became the community’s main venue for events and so forth 
The local authority thereby built up a very good infrastructure  Power cables were laid in the same trenches as water and sewage pipes, a network of cycle lanes was built and street lighting installed 
On the downside, virtually all these investments boosted operating expenses  The council’s running costs rose by an annual average of 30 per cent in 1978-84, with the biggest growth in the last three years of the period 
So the calls by Storting representatives to transfer agio tax receipts from councils to central government represented a real threat to local politicians 
Sola joined forces with other local authorities in the same position, including Stavanger, Oslo and Bærum as well as Rogaland county council 
A delegation met the Storting’s standing committee on finance to present their case, and secured a commitment to accept a phased reduction in revenues over four years 
The local authorities would receive 80 per cent of agio tax receipts during the first year, then 60 per cent, 40 per cent and finally 20 per cent [REMOVE]Fotnote: Amendment to the Petroleum Tax Act adopted on 14 May 1982 
In reality, however, the run-down percentages were adjusted to extend over five years in annual steps of 80, 60, 20, 20 and 20 per cent  The total amount going to the local authorities was the same 
The arrangement was controversial to the last, and also uncertain because it had to be approved in each annual government budget 
Living within its means
After the tax change, Sola’s chief executive officer saw the writing on the wall  It seemed “to be unquestionable that [Sola] has seen its best days in purely financial terms and must return to setting tougher priorities for various assignments,” he asserted in connection with the budget process for 1983 [REMOVE]Fotnote: Chief executive officer’s budget proposal for Sola local authority, 1983 
It took the politicians a little longer to accept this reality, but they were forced to reduce investment and operating expenditures in the years which followed 
Cutting back on the new sports arenas and cultural centre was not very desirable  Nor was it pleasant to have to slow down  But savings had to be made, and long-terms spending plans were removed from the budget for possible reintroduction later 
A raft of measures were stripped from the budget in 1985, such as extensions to and modernisation of schools, sports arenas and swimming pools, a new somatic nursing home, housing for the intellectually disabled and sheltered housing  Grants for national and county roads were reduced [REMOVE]Fotnote: Chief executive officer’s budget proposal for Sola local authority, 1985 
Once the government’s compensation scheme had ended, Torstensbø – now chief executive officer – told Stavanger Aftenblad that he did not want to paint too gloomy a picture 
“But it’s clear that we must set much more moderate financial priorities than we’ve been used to  To sum up the position, we were previously flush with cash and poor in facilities  We’re now flush with facilities and poor in cash ”[REMOVE]Fotnote: Stavanger Aftenblad, ”Alt blir dyrere i det rike Sola”, 19 May 1987 
Sola kulturhus fotografert vinteren 2004
Rogaland county council also raised the question of whether it would be possible to establish a permanent arrangement which allowed local authorities and counties to benefit from some of the tax revenues paid by local oil companies 
The council pointed out that it was otherwise normal practice for Norwegian companies to pay taxes to the local communities they were based in 
This request was turned by Labour finance minister Gunnar Berge because the councils concerned still benefitted from bigger tax payments by oil company employees and on property [REMOVE]Fotnote: Stavanger Aftenblad, “Rogaland reiser skattekrav på ny”, 16 January 1988 
According to Torstensbø, this was only partly true  The big oil companies were not so significant for Sola’s income once the agio tax was excluded 
About NOK 2 million was received annually from Phillips, primarily in property tax  The most important taxpayers in the local authority were the roughly 90 companies at Aker Base  These were service providers such as Halliburton, Schlumberger and Baker Hughes 
At the same time, Sola acquired a steadily growing number of affluent residents and a growing share of its revenue came from income tax  Despite the cut-backs, it remained prosperous 
Published 29  July 2019 • Updated 29  July 2019
More about economy
Participants in Ekofisk
The question of who “owns” Ekofisk is not straightforward  In simple terms, however, the field and the rest of Norway’s continental shelf (NCS) belongs to the Norwegian state  This was determined on 14 June 1963, when the Storting (parliament) passed the Act Relating to Exploration for and Exploitation of Submarine Natural Resources  This permits licences to be awarded on certain terms 
Riding out the oil crisis
The greatest-ever oil bonanza, with oil prices hitting USD 130 per barrel, came to an abrupt end in 2014, when the cost of a barrel of crude slumped to less than USD 50 from June to December  And the bottom had still not been reached – this was only the start of a new oil crisis which lasted several years  What effect did this have on ConocoPhillips’ financial position off Norway?
Context 3: My Aspergers Child: COMMENTS & QUESTIONS [for Feb , 2017]
I emailed you a while back and you mentioned that I could email when I needed to  Thank you  I last wrote you in December that my son became involved in a dispute involving the local police  We have had 3 court dates  It keeps delaying due to not being able to come to an agreement  But the attorney, even though he was just vaguely familiar with Aspergers, has been very good with Craig  He has the compassion and excellence that is needed here  What started out very bad is turning into a good thing  It will probably take another 90 days or more 
But Craig is working hard  Too hard sometimes  He goes to therapy 3 times a week  Doing excellent  He's more focused and can calm down easier  He's got a lot on his plate but has support from his family  From his attorney  From therapy  And from his work 
He has been renting a room from a lady who has a son with ADHD  It is good for him  I'm a little worried though because since she smokes he wants to find his own place  With all the costs he has to balance it out financially  That is good  I can't help him more than I am which is good  He is stepping up and taking responsibility  He is listening much better 
He is going to have an evaluation today to get an accurate diagnosis  I understand that is a little difficult since he is an adult  Also the PTSD may cover it over  The attorney stated it would help to have the diagnosis 
Aware this is a long update, but thanks for reading  I am fighting much guilt still but I have a lot of peace now  My daughter and her 4 year old son also have Aspergers symptoms  So my life chapters may not close for a while  :-)
My name is Mac  I'm sure you're quite busy, so I'll get right to it I just wanted to pass on compliments on My Aspergers Child and your post, How to Implement the GFCF Diet: Tips for Parents of Autistic Children 
Me and my wife absolutely loved it!
I got a facebook message from him today begging to be able to come home saying he misses home and he will change  He says he will follow rules now  I stated to him the simple rules he has to follow which were - No weed in my house, or smoked in my house, coming home at curfew, going to school, no skipping, no drugs at school, and to drop the attitude of I am 17 I can do whatever I want 
I have made it very clear that if I see any drugs in my home I will be calling the police, as well as if I see signs of it being sold by him I will report him  (He has never had selling amounts in my house,     I believe it's being kept at his "friends" which of course I have no proof of    I just know it is not here 
I know my battle is not over by a long shot, I am sure we will have more consequences and possibly another being kicked out, but I am going to think positive and hope that he learned some form of a valuable lesson here 
Thank you so much for the guidance, never in a million years did I ever think I'd be on this side, (the one needing the help, as I am the one who helps )
I am going to go back to the start of the program like I said earlier and keep notes close by for reference 
Thanks for all you do, helping us all with ODD children/teens
I have a small company providing educational support services to a few families who have children with various disabilities in Ohio  One of the families has multiple adopted children of whom several have significant attachment disorders including RAD  As an experienced teacher and foster parent I have some experience in working with children who have extensive trauma backgrounds  However, I could use additional training  Also working with these children are two staff members with minimal background in attachment disorders who would also benefit from training primarily in behavior management  The primary caregiver to the children does a wonderful job managing their needs  In order to further develop team cohesion, I'm hoping to include her in any training as well 
Is it possible to schedule such a training session with you? If so, please let us know what will work for you including time, place, and cost  Thank you for your assistance 
I just listed to your tapes on dealing with an out of control, defiant teen  I'd like to ask your advice on a particular situation we have  Our 15 year old daughter is smoking pot almost every day at school  Because we had no way to control the situation, we told her, fine, go ahead and smoke weed  However, you will no longer receive the same support from us  You will not have your phone, lunch money to go off campus (she has an account at the school for the cafeteria she can use), and you will be grounded until you can pass a drug test  We will not be testing you except for when you tell us you are ready to be tested  She is now saying she's suicidal because she feels so isolated, yet she continues to smoke weed  In fact, she tried to sneak out last night but was foiled by our alarm system  For the particular drug test we have, I read it takes about 10 days of not smoking to pass the test  What would you do? Please advise 
I am having a problem with my 18 year old son, Danny, with high functioning autism  We finally had him diagnosed when he was 16 years old  I always knew something was going on with him but the doctors misdiagnosed him as bipolar  It's been 2 years now and he will not accept his diagnosis  He won't talk about it and when I try to bring it up he gets very angry  I've tried telling him that it's not a bad thing, that there's been many, many very successful people with Aspergers  He won't tell anyone and refuses to learn about managing life with it  He once shared with me that the other kids at school use it as an insult, like saying someone is so autistic when they do something they don't approve of  So he doesn't want anyone to know  He's turned down services that could help him  He has a girlfriend, going on 8 months  He won't tell her and they're having problems arguing a lot and I wonder if it would help for her to know 
I'm sad that he thinks it's a life sentence to something horrible instead of accepting, embracing it and learning about it more so he maybe can understand why he's struggling  I told him that he doesn't need to shout it out to the whole world but he won't even accept it himself 
I don't know how to help him with it and because he's almost 19 I have limited control now  It's made my life easier knowing what we're dealing with and I think his life would be easier is he accepted it 
Please help me help him 
I am a clinical psychologist in NYC who now has several (!!) children I see who have RAD  In 20 years of practice, I’d seen only one case  Now, I have at least three children with this  I have no training, per se, in working with this children though I know about setting structure, consistency, etc  I do a lot of work with parents about parenting  I work primarily within the school setting in a charter school whose mission is to educate children on the autism spectrum in a mainstream setting  We use Michelle Garcia Winner’s social thinking program with our ASD kids  I also work with gen ed kids in the school who are at-risk; the school is in the inner city from where the majority of our non-ASD kids live 
It would have been so much easier to mention to my adult son that I think (I know he does, but want to ease into the subject)
he has Asperger's when we were living together two years ago  He has since moved to Tennessee working in his field of interest
which is 3-D printing and software development  I am so happy for him that he has found his way into a job that he truly enjoys
even though he's socially isolated 
He's not diagnosed and does not know he has it  How I know is his classic symptoms being sensory issues (fabric feeling like sandpaper)
communication difficulties, meltdowns and much more  Throughout his childhood I just felt he was a bit different  Nothing major stood out and time
just passes, misdiagnosis of ADHD, low frustration, etc  We've talked about his ADHD numerous times (which I now know he doesn't have) 
It's so much easier to communicate with him now that I know he has Asperger's  I keep it "slow and low" in talking, with long moments
of silence and then we connect  It's really too bad that Asperger's got a diagnostic code back in the 90's, yet all the so called doctors,
physiologist's, etc, didn't know how to diagnose it  Too bad 
There seems to be no one answer to "should I tell my adult son he has Asperger's" from a few specialists I asked  He is typical Asperger,
complicated, highly intelligent (high IQ), anxiety at times, socially isolated, hard to make friends  Not knowing how he will react is the hard part 
How will he be better off knowing he has it? Do I wait to tell him in person, or ease into it with him over Skype? He likes direct, honest, concrete communication 
Why is this so hard for me? Maybe because no one know's if he is going to be better off knowing or not  Do you know if people are better off
knowing? I try to get up the courage to just let him know, then I back down 
I have been searching the web looking for advice and came upon your site  I am trying to read blogs, websites, books, and articles to help guide me  I was so happy when you said that I could ask you a question  My husband and I are struggling with my 27 year old son who lives with us 
Kyle is the youngest of 4 sons  He is a college graduate but never could find the "right" job  He has always been quiet and never had a lot of friends  Two years ago, his girlfriend broke up with him  Kyle had an online gambling addiction and was using pot all the time  After the breakup, Kyle was very depressed and started using heroin and finally told my husband he was using  He is now seeing a psychiatrist who has him on suboxone and antidepressants  He is also seeing a psychologist weekly for counseling but it does not seem to be helping 
Last October,, Kyle lost his job, got drunk, and was agitated and came home , fighting with us, damaging our home and being verbally abusive  My other son , age 32, who also lives with us called the police and Kyle got arrested  He is currently in the family court system  He went through an anger management course and now is in substance abuse classes  Kyle continues to verbally abusive to me and blame me for everything  He says he "hates me "and calls me terrible names  At times, he pushes my husband and intimidates me  My husband and I are so upset  We just hired an attorney for him because since he has been going to these classes, he is getting more depressed and not getting better  Kyle continues to drink while taking his meds prescribed by the psychiatrist and then he has his "moods " My husband and I have met once with the psychiatrist just to give him background information when Kyle started with him 
At this point, we do not know what to do  We never thought at this stage of our life, we would be supporting and spending our retirement money on adult children  I do not know why Kyle hates me, I could not have been a better mom  My husband and I have no life and just do not know what it the right path we should take  Kyle does not want anything to do with us  He spends all his time in his room playing football online We have tried tough love versus caring and love and understanding  Do you have any advice for me?
This whole ODD and ADHD is killing me as a parent  I work in the field of adult psych and addictions so I am well educated  I have been dealing with my teen being like this for almost 3 years and I totally lost my cool today with my 17-year-old son to the point I told him he is out of the house  He can never simple rules, comes and goes as he pleases sometimes doesn't come home, just recently back in school from several suspension for drug related    I am just so exhausted  He has made me hate life, hate being a parent and sometimes I just feel like not even being here  I bought your program in hopes to it would help, I am at week three and I feel things are getting worse    what am I doing wrong??
My partner hasn't been diagnosed yet but I know he has aspergers   day to day is a struggle   I feel I'm going crazy with how he makes me feel Feel let down constantly  He lies alot but I've been told they can't but I know he does I just feel trapped and unloved We have a 4yr old daughter together and my main worry with how he is that it will effect our daughter ; (his skills as a parent are so weak He can't disapline at all Feel so alone  he hides it well too I just wondered if things will get worse? He's angry so quick in arguments Scares me etc I can't leave as he's the main bread winner and our daughter loves him to bits Don't know why I'm writing this  Sorry if I'm going on and not making sense :(
I wanted to let you know about a research opportunity for children, teens, and young adults with autism  I am studying the effects of Brazilian Jiu Jitsu, and psychotherapy on helping people with autism develop subjective awareness of others 
I am writing you to see if this might help someone in your practice, or to see if you might know of someone with autism who may benefit from participating in this study  The requirements of the study will be:
1  A participant should be between 7-21 years of age and have a diagnosis of Autism Spectrum Disorder 
2  The participant should enroll in an approved Jiu Jitsu Academy and attend at least two sessions a week for a period of six months 
3  The participant should enroll in social skills groups, provided by my office or be in a steady psychotherapeutic relationship in your office, at least once a week, or minimally two to three times a month 
4  The participant will be given a SRS (Social Responsiveness Scale) test at the beginning of the study, at three months, and again at six months 
If you know of anyone who might benefit from this novel approach to helping to develop social awareness in autism, please do not hesitate to contact me for further information 
I have a 10 year old daughter who has outbursts with prolonged crying almost like tantrums that 2 year olds have when they cannot express themselves 
I had her in therapy from age 6-8 years old for the same thing but I feel that the sessions didn't really help much 
She has severe sensitivities to light, sound, vibration, frequencies which trigger irritability and crying 
We changed her diet and tried getting her involved with activities but she is anti-social and prefers reading than being social  She is terrified of change even in daily routine (even that will trigger prolonged crying) 
It frustrates me because I don't know what else to do with her behavior 
I've tried acupuncture (she refused at the first session); she refuses massage too 
She is an honor-roll student at school and has very minimal issues at school but if she has had a bad day it does result in a tantrum or crying and defiance 
How can I get her tested for Asperger's Syndrome?
Last night our 24 year old son with Aspergers told his dad and I that he is pulling out of the 4 college classes that he recetnly enrolled in because he has not been attending class or turning in his assignments  He paid $2800 (his own money) for tuition and I reminded him of this when he told us but it did not seem to bother him 
This is the 3rd time he has started college courses and has not completed them  (He also took some concurrent college classes while he was in high school that he failed)  This is a son who basically had a 4 0 grade point average through 10th grade and got a 34 on the ACT the first time he took it 
With the news that he was once again not sticking with college courses I did not sleep well  When I got up this mornning I began looking online for help in how to deal with his situation  I found your "Launching Adult Children With Aspergers" and purchased it  Most of what is included are things we have done or did with our son throughout his life  I was hoping for more help so I am emailing you now in hopes of more specific ideas 
We noticed some things with our son, Taylor, as a yound child but as we had not heard of Aspergers at that time we just did what we thought would help him  As a toddler and a child at pre-school he generally went off on his own to play  When I talked to his pre-school teacher about my concerns (that I was worried he would end up a hermit) she said she did not see him being a loner and that he seemed to interact fine with others in many situations  We worked with him on making eye contact when talking with others  We explained different emotions in people's faces and mannerisms to help him know how to interact with others  We discussed the fact that people would say things that did not mean what they souneded like - such as "I'm so hungry I could eat a horse"  As we did these things he worked hard to better understand communication with others 
During his 4th grade year I had a teacher from the gifted program ask me if I had ever heard of Aspergers  I told her that I had not heard of it  She proceeded to read me some of the charateristics and so many of them described my son  So we had him tested by the school district during the summer between 4th and 5th grade and they did find that he had Aspergers but that he was high functioning  We then set him up with and EIP which stayed with him until his sophomore year  We pulled him from it at that time because we had moved and the new district was requiring him to take one class a day that was a study class  This reduced the number of required classes he could take and he was doing fine with his studies at the time 
It was during the 2nd half of his Junior year that we noticed some of his grades going down  Then during his Senior year is when he started skipping classes and not doing assignments  We had not realized it before then but we soon became aware that he was addicted to gaming  He would go to the library or somewhere else on campus and play games on the computer rather than go to class  It was also at this time that he began lying about his actions (so as not to get in trouble) 
Based on his grades and his ACT score he received offers from colleges for full tuition scholarships  He chose the college where he had taken concurrent classes during his high school years  But he proceeded to skip class and not turn in assignments so he lost his scholarship and quit attending college  During this time he was only able to find employment through an employment agency where he was mostly sent to manuel labor type jobs (which is not something he enjoys but he did it anyway)  It was during this time that at one place had gone to on numerous occasions he was told if he came late one more time they would tell the emplyment agency they did not want him to come there anymore  (This seemed to make an impression on him because he has continued to be reliable and responsbile at his places of employment) 
At 19 1/2 he left to serve a 2 year full-time mission for our church  He completed his mission successfully  (I don't think it was without some struggle, stress and depression, but he was able to pick himself up and move on from those times) 
When he came home he started working for the employment agency again but began looking for employment elsewhere  He got a job at a local Chick Fil-A where he has worked for 3 years  He started college again shortly after he came home but as before it was short lived  He did finish out the semester but failed most of the classes due to his skipping class and not turning in assignments



ground_truth: The water depth in the Greater Ekofisk Area is 70-75 meters.

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: What are the symptoms of vitamin K deficiency?

Read the following text and answer briefly.

Context 2: Vitamin K - Wikipedia
(Redirected from Vitamin k)
This article needs more medical references for verification or relies too heavily on primary sources  Please review the contents of the article and add the appropriate references if you can  Unsourced or poorly sourced material may be challenged and removed  (November 2015)
This article is about the family of vitamers  For vitamin K1 the form usually used as a supplement, see Phytomenadione 
Vitamin K structures  MK-4 and MK-7 are both subtypes of K2 
Vitamin K deficiency, Warfarin overdose
Vitamin K is a group of structurally similar, fat-soluble vitamins the human body requires for complete synthesis of certain proteins that are prerequisites for blood coagulation and which the body also needs for controlling binding of calcium in bones and other tissues  The vitamin K-related modification of the proteins allows them to bind calcium ions, which they cannot do otherwise  Without vitamin K, blood coagulation is seriously impaired, and uncontrolled bleeding occurs  Low levels of vitamin K also weaken bones and promote calcification of arteries and other soft tissues[citation needed] 
Chemically, the vitamin K family comprises 2-methyl-1,4-naphthoquinone (3-) derivatives  Vitamin K includes two natural vitamers: vitamin K1 and vitamin K2 [1] Vitamin K2, in turn, consists of a number of related chemical subtypes, with differing lengths of carbon side chains made of isoprenoid groups of atoms 
Vitamin K1, also known as phylloquinone, is made by plants, and is found in highest amounts in green leafy vegetables because it is directly involved in photosynthesis  It may be thought of as the plant form of vitamin K  It is active as a vitamin in animals and performs the classic functions of vitamin K, including its activity in the production of blood-clotting proteins  Animals may also convert it to vitamin K2 
Bacteria in the gut flora can also convert K1 into vitamin K2  In addition, bacteria typically lengthen the isoprenoid side chain of vitamin K2 to produce a range of vitamin K2 forms, most notably the MK-7 to MK-11 homologues of vitamin K2  All forms of K2 other than MK-4 can only be produced by bacteria, which use these forms in anaerobic respiration  The MK-7 and other bacterially derived forms of vitamin K2 exhibit vitamin K activity in animals, but MK-7's extra utility over MK-4, if any, is unclear and is a matter of investigation 
Three synthetic types of vitamin K are known: vitamins K3, K4, and K5  Although the natural K1 and all K2 homologues and synthetic K4 and K5 have proven nontoxic, the synthetic form K3 (menadione) has shown toxicity [2]
1 2 Cardiovascular health
1 4 Coumarin poisoning
4 1 Conversion of vitamin K1 to vitamin K2
4 2 Vitamin K2
6 Absorption and dietary need
7 Dietary reference intake
10 Biochemistry
10 1 Function in animals
10 2 Gamma-carboxyglutamate proteins
10 3 Methods of assessment
10 4 Function in bacteria
11 Injection in newborns
11 3 Controversy
A review of 2014 concluded that there is positive evidence that monotherapy using MK-4, one of the forms of Vitamin K2, reduces fracture incidence in post-menopausal women with osteoporosis, and suggested further research on the combined use of MK-4 with bisphosphonates  In contrast, an earlier review article of 2013 concluded that there is no good evidence that vitamin K supplementation helps prevent osteoporosis or fractures in postmenopausal women [3]
A Cochrane systematic review of 2006 suggested that supplementation with Vitamin K1 and with MK4 reduces bone loss; in particular, a strong effect of MK-4 on incident fractures among Japanese patients was emphasized [4]
A review article of 2016 suggested to consider, as one of several measures for bone health, increasing the intake of foods rich in vitamins K1 and K2 [5]
Cardiovascular health[edit]
Adequate intake of vitamin K is associated with the inhibition of arterial calcification and stiffening,[6] but there have been few interventional studies and no good evidence that vitamin K supplementation is of any benefit in the primary prevention of cardiovascular disease [7]
One 10-year population study, the Rotterdam Study, did show a clear and significant inverse relationship between the highest intake levels of menaquinone (mainly MK-4 from eggs and meat, and MK-8 and MK-9 from cheese) and cardiovascular disease and all-cause mortality in older men and women [8]
Vitamin K has been promoted in supplement form with claims it can slow tumor growth; there is however no good medical evidence that supports such claims [9]
Coumarin poisoning[edit]
Vitamin K is part of the suggested treatment regime for poisoning by rodenticide (coumarin poisoning) [10]
Although allergic reaction from supplementation is possible, no known toxicity is associated with high doses of the phylloquinone (vitamin K1) or menaquinone (vitamin K2) forms of vitamin K, so no tolerable upper intake level (UL) has been set [11]
Blood clotting (coagulation) studies in humans using 45 mg per day of vitamin K2 (as MK-4)[12] and even up to 135 mg per day (45 mg three times daily) of K2 (as MK-4),[13] showed no increase in blood clot risk  Even doses in rats as high as 250 mg/kg, body weight did not alter the tendency for blood-clot formation to occur [14]
Unlike the safe natural forms of vitamin K1 and vitamin K2 and their various isomers, a synthetic form of vitamin K, vitamin K3 (menadione), is demonstrably toxic at high levels  The U S  FDA has banned this form from over-the-counter sale in the United States because large doses have been shown to cause allergic reactions, hemolytic anemia, and cytotoxicity in liver cells [2]
Phylloquinone (K1)[15][16] or menaquinone (K2) are capable of reversing the anticoagulant activity of the anticoagulant warfarin (tradename Coumadin)  Warfarin works by blocking recycling of vitamin K, so that the body and tissues have lower levels of active vitamin K, and thus a deficiency of vitamin K 
Supplemental vitamin K (for which oral dosing is often more active than injectable dosing in human adults) reverses the vitamin K deficiency caused by warfarin, and therefore reduces the intended anticoagulant action of warfarin and related drugs [17] Sometimes small amounts of vitamin K are given orally to patients taking warfarin so that the action of the drug is more predictable [17] The proper anticoagulant action of the drug is a function of vitamin K intake and drug dose, and due to differing absorption must be individualized for each patient [citation needed] The action of warfarin and vitamin K both require two to five days after dosing to have maximum effect, and neither warfarin or vitamin K shows much effect in the first 24 hours after they are given [18]
The newer anticoagulants dabigatran and rivaroxaban have different mechanisms of action that do not interact with vitamin K, and may be taken with supplemental vitamin K [19][20]
Vitamin K2 (menaquinone)  In menaquinone, the side chain is composed of a varying number of isoprenoid residues  The most common number of these residues is four, since animal enzymes normally produce menaquinone-4 from plant phylloquinone 
A sample of phytomenadione for injection, also called phylloquinone
The three synthetic forms of vitamin K are vitamins K3 (menadione), K4, and K5, which are used in many areas, including the pet food industry (vitamin K3) and to inhibit fungal growth (vitamin K5) [21]
Conversion of vitamin K1 to vitamin K2[edit]
Vitamin K1 (phylloquinone) – both forms of the vitamin contain a functional naphthoquinone ring and an aliphatic side chain  Phylloquinone has a phytyl side chain 
The MK-4 form of vitamin K2 is produced by conversion of vitamin K1 in the testes, pancreas, and arterial walls [22] While major questions still surround the biochemical pathway for this transformation, the conversion is not dependent on gut bacteria, as it occurs in germ-free rats[23][24] and in parenterally-administered K1 in rats [25][26] In fact, tissues that accumulate high amounts of MK-4 have a remarkable capacity to convert up to 90% of the available K1 into MK-4 [27][28] There is evidence that the conversion proceeds by removal of the phytyl tail of K1 to produce menadione as an intermediate, which is then condensed with an activated geranylgeranyl moiety (see also prenylation) to produce vitamin K2 in the MK-4 (menatetrione) form [29]
Vitamin K2[edit]
Main article: Vitamin K2
Vitamin K2 (menaquinone) includes several subtypes  The two subtypes most studied are menaquinone-4 (menatetrenone, MK-4) and menaquinone-7 (MK-7) 
Vitamin K1, the precursor of most vitamin K in nature, is a stereoisomer of phylloquinone, an important chemical in green plants, where it functions as an electron acceptor in photosystem I during photosynthesis  For this reason, vitamin K1 is found in large quantities in the photosynthetic tissues of plants (green leaves, and dark green leafy vegetables such as romaine lettuce, kale and spinach), but it occurs in far smaller quantities in other plant tissues (roots, fruits, etc )  Iceberg lettuce contains relatively little  The function of phylloquinone in plants appears to have no resemblance to its later metabolic and biochemical function (as "vitamin K") in animals, where it performs a completely different biochemical reaction 
Vitamin K (in animals) is involved in the carboxylation of certain glutamate residues in proteins to form gamma-carboxyglutamate (Gla) residues  The modified residues are often (but not always) situated within specific protein domains called Gla domains  Gla residues are usually involved in binding calcium, and are essential for the biological activity of all known Gla proteins [30]
At this time[update], 17 human proteins with Gla domains have been discovered, and they play key roles in the regulation of three physiological processes:
Blood coagulation: prothrombin (factor II), factors VII, IX, and X, and proteins C, S, and Z[31]
Bone metabolism: osteocalcin, also called bone Gla protein (BGP), matrix Gla protein (MGP),[32] periostin,[33] and the recently discovered Gla-rich protein (GRP) [34][35]
Vascular biology: growth arrest-specific protein 6 (Gas6)[36]
Unknown function: proline-rich γ-carboxyglutamyl proteins (PRGPs) 1 and 2, and transmembrane γ-carboxy glutamyl proteins (TMGs) 3 and 4 [37]
Like other lipid-soluble vitamins (A, D and E), vitamin K is stored in the fatty tissue of the human body 
Absorption and dietary need[edit]
Previous theory held that dietary deficiency is extremely rare unless the small intestine was heavily damaged, resulting in malabsorption of the molecule  Another at-risk group for deficiency were those subject to decreased production of K2 by normal intestinal microbiota, as seen in broad spectrum antibiotic use [38] Taking broad-spectrum antibiotics can reduce vitamin K production in the gut by nearly 74% in people compared with those not taking these antibiotics [39] Diets low in vitamin K also decrease the body's vitamin K concentration [40] Those with chronic kidney disease are at risk for vitamin K deficiency, as well as vitamin D deficiency, and particularly those with the apoE4 genotype [41] Additionally, in the elderly there is a reduction in vitamin K2 production [42]
The National Academy of Medicine (NAM) updated an estimate of what constitutes an adequate intake (AI) for vitamin K in 2001  The NAM does not distinguish between K1 and K2 – both are counted as vitamin K  At that time there was not sufficient evidence to set the more rigorous estimated average requirement (EAR) or recommended dietary allowance (RDA) given for most of the essential vitamins and minerals  The current daily AIs for vitamin K for adult women and men are 90 μg and 120 μg respectively  The AI for pregnancy and lactation is 90 μg  For infants up to 12 months the AI is 2–2 5 μg, and for children aged 1 to 18 years the AI increases with age from 30 to 75 μg  As for safety, the FNB also sets tolerable upper intake levels (known as ULs) for vitamins and minerals when evidence is sufficient  In the case of vitamin K no UL is set, as evidence for adverse effects is not sufficient  Collectively EARs, RDAs, AIs and ULs are referred to as dietary reference intakes [43] The European Food Safety Authority reviewed the same safety question and did not set an UL [44]
For U S  food and dietary supplement labeling purposes, the amount in a serving is expressed as a percentage of daily value (%DV)  For vitamin K labeling purposes the daily value was 80 μg, but as of May 2016 it has been revised upwards to 120 μg  A table of the pre-change adult daily values is provided at reference daily intake  Food and supplement companies have until 28 July 2018 to comply with the change 
See also: Vitamin K2 § Dietary sources
K1 (μg)[45]
Kale, cooked
Collards, cooked
Collards, raw
Swiss chard, cooked
Swiss chard, raw
Turnip greens, raw
Romaine lettuce, raw
Table from "Important information to know when you are taking: Warfarin (Coumadin) and Vitamin K", Clinical Center, National Institutes of Health Drug Nutrient Interaction Task Force [46]
Vitamin K1 is found chiefly in leafy green vegetables such as dandelion greens (which contain 778 4 μg per 100 g, or 741% of the recommended daily amount), spinach, swiss chard, lettuce and Brassica vegetables (such as cabbage, kale, cauliflower, broccoli, and brussels sprouts) and often the absorption is greater when accompanied by fats such as butter or oils; some fruits, such as avocados, kiwifruit and grapes, are also high in vitamin K  By way of reference, two tablespoons of parsley contains 153% of the recommended daily amount of vitamin K [47] Some vegetable oils, notably soybean oil, contain vitamin K, but at levels that would require relatively large calorie consumption to meet the USDA-recommended levels [48] colonic bacteria synthesize a significant portion of humans' vitamin K needs; newborns often receive a vitamin K shot at birth to tide them over until their colons become colonized at five to seven days of age from the consumption of breast milk 
The tight binding of vitamin K1 to thylakoid membranes in chloroplasts makes it less bioavailable  For example, cooked spinach has a 5% bioavailability of phylloquinone, however, fat added to it increases bioavailability to 13% due to the increased solubility of vitamin K in fat [49]
Main article: Vitamin K deficiency
Average diets are usually not lacking in vitamin K, and primary deficiency is rare in healthy adults  Newborn infants are at an increased risk of deficiency  Other populations with an increased prevalence of vitamin K deficiency include those who suffer from liver damage or disease (e g  alcoholics), cystic fibrosis, or inflammatory bowel diseases, or have recently had abdominal surgeries  Secondary vitamin K deficiency can occur in people with bulimia, those on stringent diets, and those taking anticoagulants  Other drugs associated with vitamin K deficiency include salicylates, barbiturates, and cefamandole, although the mechanisms are still unknown  Vitamin K1 deficiency can result in coagulopathy, a bleeding disorder [50]Symptoms of K1 deficiency include anemia, bruising, nosebleeds and bleeding of the gums in both sexes, and heavy menstrual bleeding in women 
Osteoporosis[51][52] and coronary heart disease[53][54] are strongly associated with lower levels of K2 (menaquinone)  Vitamin K2 (as menaquinones MK-4 through MK-10) intake level is inversely related to severe aortic calcification and all-cause mortality [8]
Function in animals[edit]
Mechanism of action of vitamin K1 
The function of vitamin K2 in the animal cell is to add a carboxylic acid functional group to a glutamate (Glu) amino acid residue in a protein, to form a gamma-carboxyglutamate (Gla) residue  This is a somewhat uncommon posttranslational modification of the protein, which is then known as a "Gla protein"  The presence of two −COOH (carboxylic acid) groups on the same carbon in the gamma-carboxyglutamate residue allows it to chelate calcium ions  The binding of calcium ions in this way very often triggers the function or binding of Gla-protein enzymes, such as the so-called vitamin K-dependent clotting factors discussed below 
Within the cell, vitamin K undergoes electron reduction to a reduced form called vitamin K hydroquinone, catalyzed by the enzyme vitamin K epoxide reductase (VKOR) [55] Another enzyme then oxidizes vitamin K hydroquinone to allow carboxylation of Glu to Gla; this enzyme is called gamma-glutamyl carboxylase[56][57] or the vitamin K-dependent carboxylase  The carboxylation reaction only proceeds if the carboxylase enzyme is able to oxidize vitamin K hydroquinone to vitamin K epoxide at the same time  The carboxylation and epoxidation reactions are said to be coupled  Vitamin K epoxide is then reconverted to vitamin K by VKOR  The reduction and subsequent reoxidation of vitamin K coupled with carboxylation of Glu is called the vitamin K cycle [58] Humans are rarely deficient in vitamin K1 because, in part, vitamin K1 is continuously recycled in cells [59]
Warfarin and other 4-hydroxycoumarins block the action of VKOR [60] This results in decreased concentrations of vitamin K and vitamin K hydroquinone in tissues, such that the carboxylation reaction catalyzed by the glutamyl carboxylase is inefficient  This results in the production of clotting factors with inadequate Gla  Without Gla on the amino termini of these factors, they no longer bind stably to the blood vessel endothelium and cannot activate clotting to allow formation of a clot during tissue injury  As it is impossible to predict what dose of warfarin will give the desired degree of clotting suppression, warfarin treatment must be carefully monitored to avoid overdose 
Gamma-carboxyglutamate proteins[edit]
Main article: Gla domain
The following human Gla-containing proteins ("Gla proteins") have been characterized to the level of primary structure: blood coagulation factors II (prothrombin), VII, IX, and X, anticoagulant proteins C and S, and the factor X-targeting protein Z  The bone Gla protein osteocalcin, the calcification-inhibiting matrix Gla protein (MGP), the cell growth regulating growth arrest specific gene 6 protein (Gas6), and the four transmembrane Gla proteins (TMGPs), the function of which is at present unknown  Gas6 can function as a growth factor to activate the Axl receptor tyrosine kinase and stimulate cell proliferation or prevent apoptosis in some cells  In all cases in which their function was known, the presence of the Gla residues in these proteins turned out to be essential for functional activity 
Gla proteins are known to occur in a wide variety of vertebrates: mammals, birds, reptiles, and fish  The venom of a number of Australian snakes acts by activating the human blood-clotting system  In some cases, activation is accomplished by snake Gla-containing enzymes that bind to the endothelium of human blood vessels and catalyze the conversion of procoagulant clotting factors into activated ones, leading to unwanted and potentially deadly clotting 
Another interesting class of invertebrate Gla-containing proteins is synthesized by the fish-hunting snail Conus geographus [61] These snails produce a venom containing hundreds of neuroactive peptides, or conotoxins, which is sufficiently toxic to kill an adult human  Several of the conotoxins contain two to five Gla residues [62]
Methods of assessment[edit]
Vitamin K status can be assessed by:
The prothrombin time (PT) test measures the time required for blood to clot  A blood sample is mixed with citric acid and put in a fibrometer; delayed clot formation indicates a deficiency  This test is insensitive to mild deficiency, as the values do not change until the concentration of prothrombin in the blood has declined by at least 50% [63]
Undercarboxylated prothrombin (PIVKA-II); in a study of 53 newborns, found "PT (prothrombin time) is a less sensitive marker than PIVKA II",[64] and as indicated above, PT is unable to detect subclinical deficiencies that can be detected with PIVKA-II testing 
Plasma phylloquinone was found to be positively correlated with phylloquinone intake in elderly British women, but not men,[65] but an article by Schurgers et al  reported no correlation between FFQ[further explanation needed] and plasma phylloquinone [66]
Urinary γ-carboxyglutamic acid responds to changes in dietary vitamin K intake  Several days are required before any change can be observed  In a study by Booth et al , increases of phylloquinone intakes from 100 μg to between 377 and 417 μg for five days did not induce a significant change  Response may be age-specific [67]
Undercarboxylated osteocalcin (UcOc) levels have been inversely correlated with stores of vitamin K[68] and bone strength in developing rat tibiae  Another study following 78 post-menopausal Korean women found a supplement regimen of vitamins K and D, and calcium, but not a regimen of vitamin D and calcium, was inversely correlated with reduced UcOc levels [69]
Function in bacteria[edit]
Many bacteria, such as Escherichia coli found in the large intestine, can synthesize vitamin K2 (menaquinone-7 or MK-7, up to MK-11),[70] but not vitamin K1 (phylloquinone)  In these bacteria, menaquinone transfers two electrons between two different small molecules, during oxygen-independent metabolic energy production processes (anaerobic respiration) [71] For example, a small molecule with an excess of electrons (also called an electron donor) such as lactate, formate, or NADH, with the help of an enzyme, passes two electrons to menaquinone  The menaquinone, with the help of another enzyme, then transfers these two electrons to a suitable oxidant, such fumarate or nitrate (also called an electron acceptor)  Adding two electrons to fumarate or nitrate converts the molecule to succinate or nitrite plus water, respectively 
Some of these reactions generate a cellular energy source, ATP, in a manner similar to eukaryotic cell aerobic respiration, except the final electron acceptor is not molecular oxygen, but fumarate or nitrate  In aerobic respiration, the final oxidant is molecular oxygen (O2), which accepts four electrons from an electron donor such as NADH to be converted to water  E  coli, as facultative anaerobes, can carry out both aerobic respiration and menaquinone-mediated anaerobic respiration 
Injection in newborns[edit]
The blood clotting factors of newborn babies are roughly 30–60% that of adult values; this may be due to the reduced synthesis of precursor proteins and the sterility of their guts  Human milk contains 1–4 μg/L of vitamin K1, while formula-derived milk can contain up to 100 μg/L in supplemented formulas  Vitamin K2 concentrations in human milk appear to be much lower than those of vitamin K1  Occurrence of vitamin K deficiency bleeding in the first week of the infant's life is estimated at 0 25–1 7%, with a prevalence of 2–10 cases per 100,000 births [72] Premature babies have even lower levels of the vitamin, so they are at a higher risk from this deficiency 
Bleeding in infants due to vitamin K deficiency can be severe, leading to hospitalization, blood transfusions, brain damage, and death  Supplementation can prevent most cases of vitamin K deficiency bleeding in the newborn  Intramuscular administration is more effective in preventing late vitamin K deficiency bleeding than oral administration [73][74]
As a result of the occurrences of vitamin K deficiency bleeding, the Committee on Nutrition of the American Academy of Pediatrics has recommended 0 5–1 mg of vitamin K1 be administered to all newborns shortly after birth [74]
In the UK vitamin K supplementation is recommended for all newborns within the first 24 hours [75] This is usually given as a single intramuscular injection of 1 mg shortly after birth but as a second-line option can be given by three oral doses over the first month [76]
Controversy arose in the early 1990s regarding this practice, when two studies suggested a relationship between parenteral administration of vitamin K and childhood cancer,[77] however, poor methods and small sample sizes led to the discrediting of these studies, and a review of the evidence published in 2000 by Ross and Davies found no link between the two [78] Doctors reported emerging concerns in 2013,[79] after treating children for serious bleeding problems  They cited lack-of newborn vitamin K administration, as the reason that the problems occurred, and recommended that breastfed babies could have an increased risk unless they receive a preventative dose 
In the early 1930s, Danish scientist Henrik Dam investigated the role of cholesterol by feeding chickens a cholesterol-depleted diet [80] He initially replicated experiments reported by scientists at the Ontario Agricultural College (OAC) [81] McFarlane, Graham and Richardson, working on the chick feed program at OAC, had used chloroform to remove all fat from chick chow  They noticed that chicks fed only fat-depleted chow developed hemorrhages and started bleeding from tag sites [82] Dam found that these defects could not be restored by adding purified cholesterol to the diet  It appeared that – together with the cholesterol – a second compound had been extracted from the food, and this compound was called the coagulation vitamin  The new vitamin received the letter K because the initial discoveries were reported in a German journal, in which it was designated as Koagulationsvitamin  Edward Adelbert Doisy of Saint Louis University did much of the research that led to the discovery of the structure and chemical nature of vitamin K [83] Dam and Doisy shared the 1943 Nobel Prize for medicine for their work on vitamin K (K1 and K2) published in 1939  Several laboratories synthesized the compound(s) in 1939 [84]
For several decades, the vitamin K-deficient chick model was the only method of quantifying vitamin K in various foods: the chicks were made vitamin K-deficient and subsequently fed with known amounts of vitamin K-containing food  The extent to which blood coagulation was restored by the diet was taken as a measure for its vitamin K content  Three groups of physicians independently found this: Biochemical Institute, University of Copenhagen (Dam and Johannes Glavind), University of Iowa Department of Pathology (Emory Warner, Kenneth Brinkhous, and Harry Pratt Smith), and the Mayo Clinic (Hugh Butt, Albert Snell, and Arnold Osterberg) [85]
The first published report of successful treatment with vitamin K of life-threatening hemorrhage in a jaundiced patient with prothrombin deficiency was made in 1938 by Smith, Warner, and Brinkhous [86]
The precise function of vitamin K was not discovered until 1974, when three laboratories (Stenflo et al ,[87] Nelsestuen et al ,[88] and Magnusson et al [89]) isolated the vitamin K-dependent coagulation factor prothrombin (factor II) from cows that received a high dose of a vitamin K antagonist, warfarin  It was shown that, while warfarin-treated cows had a form of prothrombin that contained 10 glutamate (Glu) amino acid residues near the amino terminus of this protein, the normal (untreated) cows contained 10 unusual residues that were chemically identified as γ-carboxyglutamate (Gla)  The extra carboxyl group in Gla made clear that vitamin K plays a role in a carboxylation reaction during which Glu is converted into Gla 
The biochemistry of how vitamin K is used to convert Glu to Gla has been elucidated over the past thirty years in academic laboratories throughout the world 
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^ "Important information to know when you are taking: Warfarin (Coumadin) and Vitamin K" (PDF)  National Institutes of Health Clinical Center  ^ "Nutrition Facts and Information for Parsley, raw"  Nutritiondata com  Retrieved 21 Apr 2013  ^ "Nutrition facts, calories in food, labels, nutritional information and analysis"  Nutritiondata com  13 Feb 2008  Retrieved 21 Apr 2013  ^ "Vitamin K"  Vivo colostate edu  2 Jul 1999  Retrieved 21 Apr 2013  ^ "Vitamin K"  Micronutrient Data Centre  ^ Ikeda, Y ; Iki, M ; Morita, A ; Kajita, E ; Kagamimori, S ; Kagawa, Y ; Yoneshima, H  (May 2006)  "Intake of fermented soybeans, natto, is associated with reduced bone loss in postmenopausal women: Japanese Population-Based Osteoporosis (JPOS) Study"  Journal of Nutrition  136 (5): 1323–1328  PMID 16614424  ^ Katsuyama, H ; Ideguchi, S ; Fukunaga, M ; Saijoh, K ; Sunami, S  (Jun 2002)  "Usual dietary intake of fermented soybeans (Natto) is associated with bone mineral density in premenopausal women"  Journal of Nutritional Science and Vitaminology  48 (3): 207–215  doi:10 3177/jnsv 48 207  PMID 12350079  ^ Sano, M ; Fujita, H ; Morita, I ; Uematsu, H ; Murota, S  (Dec 1999)  "Vitamin K2 (menatetrenone) induces iNOS in bovine vascular smooth muscle cells: no relationship between nitric oxide production and gamma-carboxylation"  Journal of Nutritional Science and Vitaminology  45 (6): 711–723  doi:10 3177/jnsv 45 711  PMID 10737225  ^ Gast, G  C ; de Roos, N  M ; Sluijs, I ; Bots, M  L ; Beulens, J  W ; Geleijnse, J  M ; Witteman, J  C ; Grobbee, D  E ; Peeters, P  H ; van der Schouw, Y  T  (Sep 2009)  "A high menaquinone intake reduces the incidence of coronary heart disease"  Nutrition, Metabolism, and Cardiovascular Diseases  19 (7): 504–510  doi:10 1016/j numecd 2008 10 004  PMID 19179058  ^ Oldenburg, J ; Bevans, C  G ; Müller, C  R ; Watzka, M  (2006)  "Vitamin K epoxide reductase complex subunit 1 (VKORC1): the key protein of the vitamin K cycle"  Antioxidants & Redox Signaling  8 (3–4): 347–353  doi:10 1089/ars 2006 8 347  PMID 16677080  ^ Suttie, J  W  (1985)  "Vitamin K-dependent carboxylase"  Annual Review of Biochemistry  54: 459–477  doi:10 1146/annurev bi 54 070185 002331  PMID 3896125  ^ Presnell, S  R ; Stafford, D  W  (Jun 2002)  "The vitamin K-dependent carboxylase"  Thrombosis and Haemostasis  87 (6): 937–946  PMID 12083499  ^ Stafford, D  W  (Aug 2005)  "The vitamin K cycle"  Journal of Thrombosis and Haemostasis  3 (8): 1873–1878  doi:10 1111/j 1538-7836 2005 01419 x  PMID 16102054  ^ Rhéaume-Bleue, p  79 
^ Whitlon, D  S ; Sadowski, J  A ; Suttie, J  W  (Apr 1978)  "Mechanism of coumarin action: significance of vitamin K epoxide reductase inhibition"  Biochemistry  17 (8): 1371–1377  doi:10 1021/bi00601a003  PMID 646989  ^ Terlau, H ; Olivera, B  M  (Jan 2004)  "Conus venoms: a rich source of novel ion channel-targeted peptides"  Physiological Reviews  84 (1): 41–68  doi:10 1152/physrev 00020 2003  PMID 14715910  ^ Buczek, O ; Bulaj, G ; Olivera, BM (Dec 2005)  "Conotoxins and the posttranslational modification of secreted gene products"  Cellular and Molecular Life Sciences  62 (24): 3067–3079  doi:10 1007/s00018-005-5283-0  PMID 16314929  ^ "Prothrombin Time"  WebMD  ^ Dituri, F ; Buonocore, G ; Pietravalle, A ; Naddeo, F ; Cortesi, M; Pasqualetti, P; Tataranno M  L ; R , Agostino (Sep 2012)  "PIVKA-II plasma levels as markers of subclinical vitamin K deficiency in term infants"  Journal of Maternal, Fetal & Neonatal Medicine  25 (9): 1660–1663  doi:10 3109/14767058 2012 657273  PMID 22280352  ^ Thane, C  W ; 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Binkley, S  B ; Thayer, S  A ; Doisy, E  A  (1939)  "On the constitution of Vitamin K1"  Journal of the American Chemical Society  61 (7): 1928–1929  doi:10 1021/ja01876a510  ^ Fieser, L  F  (1939)  "Synthesis of Vitamin K1"  Journal of the American Chemical Society  61 (12): 3467–3475  doi:10 1021/ja01267a072  ^ Dam, C  P  H  (12 Dec 1946)  "The discovery of vitamin K, its biological functions and therapeutical application" (PDF)  Nobel Prize lecture  ^ Warner, E  D ; Brinkhous, K  M ; Smith, H  P  (1938)  "Bleeding Tendency of Obstructive Jaundice"  Proceedings of the Society of Experimental Biology and Medicine  37 (4): 628–630  doi:10 3181/00379727-37-9668P  ^ Stenflo, J; Fernlund, P ; Egan, W ; Roepstorff, P  (Jul 1974)  "Vitamin K dependent modifications of glutamic acid residues in prothrombin"  Proceedings of the National Academy of Sciences of the United States of America  71 (7): 2730–2733  doi:10 1073/pnas 71 7 2730  PMC 388542  PMID 4528109  ^ Nelsestuen, G  L ; Zytkovicz, T  H ; Howard, J  B  (Oct 1974)  "The mode of action of vitamin K  Identification of gamma-carboxyglutamic acid as a component of prothrombin" (PDF)  Journal of Biological Chemistry  249 (19): 6347–6350  PMID 4214105  ^ Magnusson, S ; Sottrup-Jensen, L ; Petersen, T  E ; Morris, H  R ; Dell, A  (Aug 1974)  "Primary structure of the vitamin K-dependent part of prothrombin"  FEBS Letters  44 (2): 189–193  doi:10 1016/0014-5793(74)80723-4  PMID 4472513  Bibliography[edit]
Rhéaume-Bleue, Kate (2012)  Vitamin K2 and the Calcium Paradox  John Wiley & Sons, Canada  ISBN 1-118-06572-7  External links[edit]
"Vitamin K: Another Reason to Eat Your Greens"  v
TPP / ThDP (B1)
FMN, FAD (B2)
NAD+, NADH, NADP+, NADPH (B3)
Coenzyme A (B5)
PLP / P5P (B6)
THFA / H4FA, DHFA / H2FA, MTHF (B9)
AdoCbl, MeCbl (B12)
Phylloquinone (K1), Menaquinone (K2)
non-vitamins
Coenzyme B
Heme / Haem (A, B, C, O)
Molybdopterin/Molybdenum cofactor
THMPT / H4MPT
Fe2+, Fe3+
vitamins: see vitamins
Antihemorrhagics (B02)
(coagulation)
Phytomenadione (K1)
Menadione (K3)
intrinsic: IX/Nonacog alfa
VIII/Moroctocog alfa/Turoctocog alfa
extrinsic: VII/Eptacog alfa
common: X
II/Thrombin
I/Fibrinogen
XIII/Catridecacog
combinations: Prothrombin complex concentrate (II, VII, IX, X, protein C and S)
Carbazochrome
thrombopoietin receptor agonist (Romiplostim
Eltrombopag)
Tetragalacturonic acid hydroxymethylester
Epinephrine/Adrenalone
amino acids (Aminocaproic acid
Aminomethylbenzoic acid)
serpins (Aprotinin
Alfa1 antitrypsin
Camostat) 
Context 3:  When he skipped class he would usually sleep in his car 
Taylor's life consists of working (where to the best of our knowledge) he does well, he is reliable and his employer likes him  When he comes home from work he either sleeps or plays video games or other games - such as kakuro  He spendes most of his time in the basement where his bedroom is and this is where he games  Taylor owns his own car, bought his own laptop and very rarely spends money  He pays us $200 /month to still live at home, unloads the dishwasher on a regular basis and does the weekly garbage  However, his room is a mess and he only cleans his bathroom when I tell him he needs to clean it 
Taylor used to read quite a bit and loved to learn  It has just been in his adult years that he has not read as much - I think because of his gaming addiction  Taylor goes to church on a regular basis but sleeps through the main meeting  In Sunday class room settings he stays awake - I think because he is able to particpate in discussions 
Taylor has only had 2 real friends since entering Junior High school  And as of now he only keeps in contact with one of them who still lives in Georgia  We have lived in Utah since the summer of 2007 and he has never had a friend to do things with since we have lived here  He has two younger siblings, a brother 22 and a sister 20  They love Taylor and spend time with him when they are home  They are both at college and doing well 
Throughout Taylor's school years he has seen a counsleor on a fairly regular basis  One summer during junior high he attended a weekly class where he interacted with other kids with Aspergers  We did see a lot of change in him from this group  After he returned from his mission he went to see a counselor for a short period - this counselor tried to help him with some social skills  His dad and I went with him the first 3 or 4 times but we found out that after we quit going with him he only went a few more times and then scheduled appointments but did not show a couple of the times  We only found this out when a bill came for a "no show" appointment 
I don't know if this is too much information but were are in dire need of help for him  In the information that we purchased from you you mentioned that you do coaching for Aspergers adults  I don't know if you can help us but I thought I would check with you just in case 
Alas I think I have found your information too late to save my marriage but I am hoping to save myself 
I am currently going through a very very painful separation after a 27 year relationship with my husband whom I am convinced has aspergers syndrome  It is a long and painful story and I am desperately trying to process it all alongside dealing with a very conflictual separation  My partner is angry non communicative and totally dismissive of me and our long shared history 
He walked out last year after I discovered he had been visiting massage parlours and developed a relationship with an illegal Chinese escourt whom he subsequently moved in with  He had been seeing this woman behind my back for over 18 months  The pain of all this indescribable and his dismissal of my pain and very existence beyond belief 
Leading up to this I had been battling anxiety and depression which my husband found very hard to cope with 
Over the years of our relationship I knew something was off but I just could not put my finger on it  I often felt a complete lack of validation and empathy  Communication was also difficult as my husband was defensive and unwilling to look at issues in our marriage 
Please Mark could you help me validate some of this pain and try and make dense of 27 years of my life without drowning in fear guilt and despair about my future 
Thank you for listening and your site 
I have had problems with drunkenness, being late for school, not handing in school work, buying pot from a dealer etc  I chose to focus on the drinking and did the grounding then (grounding happened 3 times)  I also stopped sleep overs at friends 100%  I have stopped handing out money for no reason or even buying treats like chocolate 
I did lose it one evening (and didn't do the poker face) when I was trying to unplug the internet at midnight on a school night (she’s always late for school so I am trying to get her to sleep at a reasonable hour)  I was physically stopped and pushed around so I slapped my daughter (it was not hard)  This ended up with her saying she didn’t want to come home (the next day after school)  By this stage, I also had enough and didn’t go get her  I thought I am not begging  You will run out of money soon  It was quite a relief to have some peace  Daughter’s Dad was in town (from another country) and called a family meeting with the counsellor  To cut a long story short, daughter and her counsellor put it on the table that daughter wants to go live somewhere else (with her friends family) because of the stress at home with me (we live on our own) (i e  stricter rules and her bucking up against it) 
I didn’t really want this but made a compromise that daughter would go there Tues morning – Friday afternoon as the friend is an A student whereas my daughter is failing  They do the same subjects  I made the decision at the end of the day based on what is good for me – some time away from the daughter  I also thought of your book when the child went to live with the grandparents – daughter will dig her own hole over at the friend’s house  They have a week day no going out policy which made me think it is OK  I went and discussed with them the problems experienced (drinking, pot, late nights, not handing in work)
I am also trying to follow the let go of school thing per your book  I find it really difficult to remain calm when I can see daughter on her phone and watching series (when I have her on the weekends) when I know there are projects due  I hired her a private tutor once a week for help with a subject  The tutor has just fired my daughter for not handing in work and being not committed  It’s not the first time private tutoring has not been appreciated  The school give me a report back on a Friday as to whether everything is handed in  The deal is – if the work is not handed in – no pocket money and no Friday night out)  Her school is a "progressive" school and there are no repercussions for her being late or not handing in work  I would change schools if I could but there are only 8 months left of school (she turns 18 in August) 
We have just completed the first week and beginning week two of your material  We are agreeing with your take and see our son and ourselves in most of what you are saying  Prior to finding your material and starting your program we had been having extreme out of control behaviors and had to call the police because he was breaking things in our house and pushed my husband  This happened three weeks ago  After that incident we took away privileges ie  PS4, phone (which had already been taken for a few days), and friends  So, last week while doing your program he already didn’t have privileges and has continued with poor behavior – name calling, throwing things, slamming doors  We are not sure when to give privileges back  He has been given the privilege of playing with friends on occasion  His 13th birthday is tomorrow  This past weekend, for his birthday my husband and he went boar hunting  Of course we debated about it but decided to go ahead since it was his bday  We are cooking some of the meet on the grill tomorrow night for his bday and inviting a couple of his friends over for a cookout  No more gifts other than cards and balloons  We are wondering if we should go ahead and give him his privileges back and not sure how to do it  Last Friday morning we attempted to talk giving him a date to return privileges and that conversation ended with him getting angry but he gathered from our conversation that he is getting his stuff back on his bday  We are starting week 2 assignments today but not sure how to handle what was already in place  Of course, we aren’t seeing the respect and responsibility we are looking for but realize it has been a long time  We were wanting him to pay for his phone and thought it might be a good time to introduce that idea  Allowing him to earn his phone  We expect that he will be angry with this idea and not sure how to implement 
My son and myself are interested in a inpatient Aspergers program  We line in Calif which is preferable  My son is very high functioning and was diagnosed dry late  He was eight years old  He has never been in or attended a full day of class  Partially due to depression,anxiety, and trouble with his ADHD also his aversion and being bullied and of course his Aspergers  He will not attend his freshmen year due to surgery on both Achilles' tendons from walking on his toes  With physical therapy he should be ready by his sophomore year! We all feel he needs in patient therapy to give him the tools on how to work with his issues in a structured setting and a place that will give him tools for the rest of his life 
In my utter desperation to find a way to get some help for my daughter's increasingly challenging behaviour I trawled the internet to see if I could find some strategies that would provide specific methods on dealing with teenagers with Asperger's syndrome  When I came across your website, I couldn't believe that every statement you made was exactly what I have been going through with my daughter  She has just turned 14 last week, and was diagnosed with Asperger's/ Autism Spectrum Disorder 15 months ago  I have already been seeing a child psychologist for the past five months, however the methods she has been advising have not been very effective 
Our main difficulty with our daughter is her overwhelming obsession to use her cell phone (and to a lesser extent her laptop) constantly  Without any restriction, she will be on it every minute of the day, and will be awake until the early hours every day  We have tried to incorporate her input around rules as to when she has to give in her phone, but she is unwilling to compromise on a time that she should give it to us, believing that she should have unlimited use  I believe she is unable to do any adequate study or homework, as she is constantly having to look at the phone  We have tried to put rules in place that she has to give in her phone and laptop on school nights at 22:15  If she is able to do this then she is given rewards, and if she doesn't then she knows that there will be consequences  The consequence has been restricted use the following day  However, this is usually where we fail, because taking her phone away from her results in tantrums, screaming, and even threatening to harm herself  This behaviour is relentless to the point where the whole family becomes deeply distressed, and inevitably results in her getting the phone back 
This obsession is affecting her schoolwork, and more severely her eyesight  She has become very shortsighted, and her eyesight continues to deteriorate as a result of holding the phone or laptop very close, and mostly in the dark without any lights on  My husband and I have a constant battle on our hands daily, in all areas of discipline with our daughter, but our main concern is that we have been unable to find a way to minimise this obsessive behaviour centred around her phone and laptop  Please can you provide some strategies that can help us specifically with this problem 
First of all, I thank you for developing this program and I am only at the first stage of assignment 1  I have loads of books I have bought, attended psychiatrists for my son and myself, family therapy, occupational therapy, begged and prayed for change but have been dealing with behavioural issues for so long I am definitely exhausted and resentful 
I am a mum to a 15 yr old boy with ASD, dyslexia, OCD and ODD  Sorry to focus on the labels but just to give you an idea of what I am dealing with  I also have a 13 yr old son whom finds his brother’s behaviours difficult, embarassing and challenging  My husband whom is not in great health ( he had a cerebral aneurysm clamped two years ago and has two further aneurysms that are inoperable so endures fatigue, headaches and stress)  We have however a pet cat that is very social and a calming influence in the home! I was fortunate enough to have loving parents but I lost both my mum and dad in 2008 and 2015  My inlaws are elderly and quite directly say they are too old to help us so it feels we are alone in dealing with the issues we have 
I am desperate for change as the household is one of stress and anger and I feel all the control lies in my son Patrick’s hands  I am hopeful your programme can make life better for all of us but I wonder if it is too early to ask you two questions?
The first lies with what to do when Patrick goes into my other son Brendan’s room and will either turn on a light when he is sleeping, yell when he is on his phone or create some disturbance  He will not leave the room when asked to do so and the situation always escalates into yelling and Brendan attempting to physically remove him  This happens regularly and always ends badly with doors slamming, my husband being woken and myself in tears feeling the lack of control and also I admit I seem to think “Why me?” which rationally I know is of no help 
The second problem is leaving the house for school  Patrick refuses personal hygiene (either morning or night) and any request to even brush his teeth is fraught with swearing and abuse  If I can get him to shower, he will watch the water roll down the drain and turn up the water really high temp (mu husband has had to turn down the thermostat on the hot water service) without so much as getting wet  My husband leaves for work at 6am but I leave at 745 to work as a nurse in a busy outpatients department in the Alfred Hospital (Melbourne)  My work is my sanity as it is a paid break from home but most days I am late which is causing considerable stress and anxiety not to mention my responsibility to do my job  Patrick simply refuses to leave the house and as much as I am tempted to just walk out and leave I know the house would be left unlocked and wonder if Patrick would even attend school  The time I need to leave is not negotiable but Patrick uses this to his advantage and seems to delight in stressing me out and subsequently speeding to work in a frazzled mess 
The interesting and frustrating element in all of this is that although he is socially isolated at school (he has no friends) and academically challenged his behaviour at school is not a problem  He is quiet and his teachers report he does his best and is compliant and well mannered  It is like a Jekyll and Hyde situation where another side of him at home is so angry and abusive yet at school this behaviour does not happen 
I’m Jackie, I now work primarily as a freelance tech writer, after starting my career in software development and moving on to teach IT to young adults at a variety of colleges and schools 
My freelance work is pretty varied and looks at many aspects of the computer industry as a whole, and I’ve just recently completed a piece which gives help and advice to anyone wanting to become a game designer, which you can read here: http://www gamedesigning org/become-a-game-designer/  It highlights the hard work and effort it takes to get into such a role, and also how you can further your career and continue to learn and improve as you go  I hope you’ll agree it shows that starting work in the industry takes dedication and skill and that becoming a game designer isn’t just a fly-by-night job!
If you’d be interested in sharing a quick mention of my work on your blog that would be really wonderful and I’d appreciate the chance to get my work out there to a wider audience  Alternatively, I’d be happy to write a short blurb or paragraph or two (or a longer piece - just let me know) highlighting the key points because I think some of your readers might get a lot of value from it 
My son just turned 15 and is a freshman in high school  Although this is his first year in a general ed environment, he is struggling with behaviors in school  He has meltdowns and does not express why he would have them until much later  Once we all know what caused it, the school will accommodate him and try to "change up" things so as not to cause his meltdown  Once that is resolved, another issue comes up and causes him to melt down  He is a high functioning and academically does well, when he wants to do the work  We battle at home over homework  He does not care how it is done, as long as he hands it in  He thinks failing a test is ok, at least he took the test  Homework is never on his mind when he gets home from school  If I never prompt him, he would never open is backpack  He can be aggressive but is never intentionally trying to hurt anyone  He may push over a chair in school, but it is not directed at anyone  We know how that in itself could hurt someone who gets hit by it though  He is defiant in that he only wants to do what interests him  He does not go out by himself (still immature), or abuse alcohol or drugs and never curses  He is a very funny kid and very talented  His main problems are task avoidance and seeking attention  He can be disrespectful to adults in that he is "cheeky" with them, trying to be funny or cute  And he has no "filters" 
I’ve just finished reading your Living with an Aspergers Partner ebook  I found it so informative, thank you 
You offered some personal advise, and i wanted to run a situation past you and seek your input as to a strategy for what to do next 
I’ve been seeing a guy for about 7 months now who I believe has Aspergers  I came to this conclusion months ago and I don’t think he realizes, (or acknowledges) although he is aware he has some traits 
He’s highly intelligent and successful, a pattern seeker, has a tendency to focus on the project to hand to the total exclusion of all else for as long sit takes (work or home) socially awkward (has learned coping strategies), sensitive to loud noise, high anxiety with control strategies, black and white thinking etc  He’s currently not working and I’ve seen a slow withdrawal over the last 6 weeks, including the need to ‘escape’ and leave a situation at least once 
He also has a bipolar ex overseas who has primary custody one daughter where there has been ongoing patterns of drama which has recently increased 
Over the past couple of months (since stopping work and drama increase) I’ve gone from being ‘wonderful’ in his eyes to him now being sorry and not having the ‘urge’ to spend close/intimate time with me and offering friendship  Since he shared that with me in a message he’s stonewalled and has retreated to the safety of minimal messages and talks about not knowing what best to say and not being able to find the right words somehow 
He’s a good kind man who I feel is struggling  I’m concerned about his anxiety and possibly the risk of depression  I’m fairly resilient and whilst i’m disappointed he doesn’t want to pursue a relationship with me, i’m concerned for him and his well being  One of his very few close friends is also just leaving the country to live overseas 
The strategy I’ve used so far is simply to back off and give him space  I’ve asked to take him up on an original offer he made to talk but haven’t pushed it  I also haven’t been aggressive or accusatory in the few messages i’ve sent 
Any advise you could give would be greatly appreciated,
Carli who is 10 years old and has had behavioral issues her whole life  The other night she came home very upset after having a conflict with a friend  She was at her friend's house and her and her friend wanted to get on the computer and the older sister was using it  Carli made up a story that someone was at the door to get the older sister off the computer  Her friend didn't understand that she was making up a story to get the sister off the computer  She got excited that someone was at the door and ran downstairs to answer the door  In the process of getting the door, she fell and yelled at Carli  Carli became extremely upset  She was able to control her feelings at her friend's house, but when she came home, she proceeded to cry extremely loudly for over an hour  Her dad spent most of that time with her, talking to her and trying to calm her down  After an hour, I asked him if he could please tell her to be more quiet because the other members of the household were trying to go to sleep 
My question is    how do I as the girlfriend, handle this? He did not like that I asked her to be quiet  We have a rule that if she is having bad behavior, and can't calm down in 5 minutes, he takes her out of the house because her yelling doesn't stop for a long time and is very upsetting to everyone in the household  I would like to ask him to do this with this kind of situation as well  Is this a reasonable request? His thought was that she shouldn't be made to calm down, because everyone handles being upset in a different way  But, she was literally sobbing and wailing very loudly 
My other question is should she have been told that if she wouldn't have lied, this wouldn't have happened? She has a history of lying and of not accepting responsibility for her actions  My boyfriend became very upset with me when I brought this up  He was being very sympathetic and understanding to her  I feel like he was giving her negative attention, and being an over indulgent parent by not putting his foot gown and saying, "you can't carry on like this, even though you are upset"  Please let me know how we can handle these situations better 
I am contacting you for help with adult AS  I am taking initiative to pre screen potential therapists to help my current boyfriend get therapy and help with Adult AS 
He has seen many therapists, but it seems like they aren’t really helping him with his problems  They don’t seem to understand how his (undiagnosed) AS would affect therapy approaches  For example, he may not share enough in therapy session and I’m assuming an AS therapist would recognize that is part of the AS and employ strategies to get information from him that helps with treatment  Sometime he tunes out when he is processing something heavy or that he doesn’t want to hear necessarily, or he gets distracted and I’m hoping an As therapist would recognize that and get that he may need repeated something for example, if this is happening 
He is currently suffering from depression that appears clinical in nature as well as reoccurring negative thoughts about something specific that has been worrying him about our relationship  Today he told me these reoccurring thoughts happen during all waking hours unless he watches TV, he never gets a break from them and they make him feel like he is going crazy  As his girlfriend, I am extremely concerned that he cannot get relief from these thoughts and that the therapists he is seeing are unable to help him with his problems  Therefore, I am taking initiative to try and help him find better therapy options, because I want to see him someone who can better help him get to the bottom of things and help him with the challenges he is facing  He really needs an advocate that will help him go deep to figure things out and not just assume therapies are working well, without seeing changes or getting supporting feedback from him in that regard 
Here are some questions I am trying to ask in advance to find the right people to help us with this  As you may know, insurance for these therapies are not often available  We don’t have a lot of money to go from therapist to therapist to find the right person and are hoping prescreening will help 
I recently downloaded your e-book and listened to your talks and your information is by far the most helpful I have been able to find to date  It's very accurately describes my situation as an NT wife married to a very probable AS husband  I think you for taking the time to write this and sharing your insights as well as the experiences of many of your clients  It has really helped me understand the last 32 years of our marriage and get a grasp on how to move forward 
One area that is of primary concern to me, that I did not see addressed, is stimming  I believe that is the behavior my husband is showing through constant vocal singing, repetition of words, shouting out, as well as slapping himself in the chest and general nervous activity  It is very loud and disruptive to our household and it is often a relief when he is not at home  I think there may be a level of Tourette's syndrome as well 
I did some searches on the Internet and could not find anything that really describes his behavior  Most of what I found was flapping or children's behavior  I understand that it is a release of nervous tension but I am really trying to find some strategies to help him stop this behavior as it is extremely frustrating and builds my resentment in dealing with it daily  A lot of it is embarrassing as well and sounds childish to me 
He usually does this when close family members are around and will reign himself in if he is around other people besides us  When we are home it is constant  He also has a lot of anger, mostly at himself, and blows up at unimportant things, it is as if he has a ton of negative energy inside him that need to get out and stimming is one outlet 
I will try to build my acceptance of it, but I also would just like him to stop especially the loudest and most annoying portions  Would you have any resources you could point me to?



ground_truth: Symptoms of vitamin K deficiency include anemia, bruising, nosebleeds, bleeding of the gums, and heavy menstrual bleeding in women.

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: Why does Craig want to find his own place?

Read the following text and answer briefly.

Context 4: 
\end{equation}
Assuming $\phi_m\in R_i$, then
\begin{equation}
\label{qqpp} \hat{\phi}^0_m =\frac{(i-1)\pi+i\pi}{4} 
\end{equation}
Table \ref{tab4} shows the structure of the modified PLMS-PPIC
method  It is to be notified that
\begin{itemize}
\item Equation (\ref{qte5}) shows the conventional bit detection
method when the receiver only knows the quarter of channel phase in
$(0,2\pi)$  \item With $L=1$ (i e  only one NLMS algorithm), the
modified PLMS-PPIC can be thought as a modified version of the
LMS-PPIC method 
\end{itemize}

In the following section some examples are given to illustrate the
effectiveness of the proposed method 

\section{Simulations}\label{S5}

In this section we have considered some simulation examples 
Examples \ref{ex2}-\ref{ex4} compare the conventional, the modified
LMS-PPIC and the modified PLMS-PPIC methods in three cases: balanced
channels, unbalanced channels and time varying channels  In all
examples, the receivers have only the quarter of each channel phase 
Example \ref{ex2} is given to compare the modified LMS-PPIC and the
PLMS-PPIC in the case of balanced channels 

\begin{example}{\it Balanced channels}:
\label{ex2}
\begin{table}
\caption{Channel phase estimate of the first user (example
\ref{ex2})} \label{tabex5} \centerline{{
\begin{tabular}{|c|c|c|c|c|}
\hline
\multirow{6}{*}{\rotatebox{90}{$\phi_m=\frac{3\pi}{8},M=15~~$}} & N(Iteration) & Stage Number& NLMS & PNLMS  \\
&&&&\\
\cline{2-5} & \multirow{2}{*}{64}& s = 2 &  $\hat{\phi}^s_m=\frac{3 24\pi}{8}$ & $\hat{\phi}^s_m=\frac{3 18\pi}{8}$ \\
\cline{3-5} & & s = 3 & $\hat{\phi}^s_m=\frac{3 24\pi}{8}$ & $\hat{\phi}^s_m=\frac{3 18\pi}{8}$ \\
\cline{2-5} & \multirow{2}{*}{256}& s = 2 &  $\hat{\phi}^s_m=\frac{2 85\pi}{8}$ & $\hat{\phi}^s_m=\frac{2 88\pi}{8}$ \\
\cline{3-5} & & s = 3 & $\hat{\phi}^s_m=\frac{2 85\pi}{8}$ & $\hat{\phi}^s_m=\frac{2 88\pi}{8}$ \\
\cline{2-5} \hline
\end{tabular} }}
\end{table}
Consider the system model (\ref{e7}) in which $M$ users
synchronously send their bits to the receiver through their
channels  It is assumed that each user's information consists of
codes of length $N$  It is also assumd that the signal to noise
ratio (SNR) is 0dB  In this example there is no power-unbalanced or
channel loss is assumed  The step-size of the NLMS algorithm in
modified LMS-PPIC method is $\mu=0 1(1-\sqrt{\frac{M-1}{M}})$ and
the set of step-sizes of the parallel NLMS algorithms in modified
PLMS-PPIC method are
$\Theta=\{0 01,0 05,0 1,0 2,\cdots,1\}(1-\sqrt{\frac{M-1}{M}})$,
i e  $\mu_1=0 01(1-\sqrt{\frac{M-1}{M}}),\cdots,
\mu_4=0 2(1-\sqrt{\frac{M-1}{M}}),\cdots,
\mu_{12}=(1-\sqrt{\frac{M-1}{M}})$  Figure~\ref{Figexp1NonCoh}
illustrates the bit error rate (BER) for the case of two stages and
for $N=64$ and $N=256$  Simulations also show that there is no
remarkable difference between results in two stage and three stage
scenarios  Table~\ref{tabex5} compares the average channel phase
estimate of the first user in each stage and over $10$ runs of
modified LMS-PPIC and PLMS-PPIC, when the the number of users is
$M=15$ 
\end{example}

Although LMS-PPIC and PLMS-PPIC, as well as their modified versions,
are structured based on the assumption of no near-far problem
(examples \ref{ex3} and \ref{ex4}), these methods and especially the
second one have remarkable performance in the cases of unbalanced
and/or time varying channels 

\begin{example}{\it Unbalanced channels}:
\label{ex3}
\begin{table}
\caption{Channel phase estimate of the first user (example
\ref{ex3})} \label{tabex6} \centerline{{
\begin{tabular}{|c|c|c|c|c|}
\hline
\multirow{6}{*}{\rotatebox{90}{$\phi_m=\frac{3\pi}{8},M=15~~$}} & N(Iteration) & Stage Number& NLMS & PNLMS  \\
&&&&\\
\cline{2-5} & \multirow{2}{*}{64}& s=2 &  $\hat{\phi}^s_m=\frac{2 45\pi}{8}$ & $\hat{\phi}^s_m=\frac{2 36\pi}{8}$ \\
\cline{3-5} & & s=3 & $\hat{\phi}^s_m=\frac{2 71\pi}{8}$ & $\hat{\phi}^s_m=\frac{2 80\pi}{8}$ \\
\cline{2-5} & \multirow{2}{*}{256}& s=2 &  $\hat{\phi}^s_m=\frac{3 09\pi}{8}$ & $\hat{\phi}^s_m=\frac{2 86\pi}{8}$ \\
\cline{3-5} & & s=3 & $\hat{\phi}^s_m=\frac{2 93\pi}{8}$ & $\hat{\phi}^s_m=\frac{3 01\pi}{8}$ \\
\cline{2-5} \hline
\end{tabular} }}
\end{table}
Consider example \ref{ex2} with power unbalanced and/or channel loss
in transmission system, i e  the true model at stage $s$ is
\begin{equation}
\label{ve7} r(n)=\sum\limits_{m=1}^{M}\beta_m
w^s_m\alpha^{(s-1)}_m c_m(n)+v(n),
\end{equation}
where $0<\beta_m\leq 1$ for all $1\leq m \leq M$  Both the LMS-PPIC
and the PLMS-PPIC methods assume the model (\ref{e7}), and their
estimations are based on observations $\{r(n),X^s(n)\}$, instead of
$\{r(n),\mathbf{G}X^s(n)\}$, where the channel gain matrix is
$\mathbf{G}=\mbox{diag}(\beta_1,\beta_2,\cdots,\beta_m)$  In this
case we repeat example \ref{ex2}  We randomly get each element of
$G$ from $[0,0 3]$  Figure~\ref{Figexp2NonCoh} illustrates the BER
versus the number of users  Table~\ref{tabex6} compares the channel
phase estimate of the first user in each stage and over $10$ runs of
modified LMS-PPIC and modified PLMS-PPIC for $M=15$ 
\end{example}

\begin{example}
\label{ex4} {\it Time varying channels}: Consider example \ref{ex2}
with time varying Rayleigh fading channels  In this case we assume
the maximum Doppler shift of $40$HZ, the three-tap
frequency-selective channel with delay vector of $\{2\times
10^{-6},2 5\times 10^{-6},3\times 10^{-6}\}$sec and gain vector of
$\{-5,-3,-10\}$dB  Figure~\ref{Figexp3NonCoh} shows the average BER
over all users versus $M$ and using two stages 
\end{example}


\section{Conclusion}\label{S6}

In this paper, parallel interference cancelation using adaptive
multistage structure and employing a set of NLMS algorithms with
different step-sizes is proposed, when just the quarter of the
channel phase of each user is known  In fact, the algorithm has been
proposed for coherent transmission with full information on channel
phases in \cite{cohpaper}  This paper is a modification on the
previously proposed algorithm  Simulation results show that the new
method has a remarkable performance for different scenarios
including Rayleigh fading channels even if the channel is
unbalanced 





ground_truth: Because his roommate smokes.