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[ "Rad Aweisat\n\nRad Aweisat (; born October 27, 1986) is a Palestinian swimmer, who specialized in butterfly events. ", "Aweisat qualified for the men's 100 m butterfly, as Palestine's youngest athlete (aged 17), at the 2004 Summer Olympics in Athens. ", "He received a Universality place from FINA as part of his Olympic Solidarity program, without meeting an entry time. ", "He participated in heat one against two other swimmers Luis Matias of Angola and Fernando Medrano of Nicaragua. ", "He rounded out a small field of three to last place with a slowest time of 1:01.60, nearly 11 seconds off the world record set by U.S. swimmer Ian Crocker. ", "Aweisat failed to advance into the semifinals, as he placed fifty-ninth overall in the preliminaries.", "\n\nReferences\n\nCategory:1986 births\nCategory:Living people\nCategory:Palestinian male swimmers\nCategory:Olympic swimmers of Palestine\nCategory:Swimmers at the 2004 Summer Olympics\nCategory:Male butterfly swimmers\nCategory:Swimmers at the 2002 Asian Games\nCategory:Asian Games competitors for Palestine" ]

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[ "Cotrimoxazole induced toxic epidermal necrolysis in a suspected case of Pneumocystis carinii pneumonia with human immuno deficiency virus infection.", "\nToxic epidermal necrolysis due to trimethoprim sulphamethoxazole therapy in a subject of HIV with suspected pneumocystis carinii pneumonia, is reported, because of its rarity in Indian conditions. ", "Patient showed excellent recovery on corticosteroid therapy." ]

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[ "Kubernetes 1.14 Enhances Cloud-Native Platform With Windows Nodes\n\nThe first major update of the open-source Kubernetes cloud-native platform in 2019 was released on March 25, with the general availability of Kubernetes 1.14.", "\n\nKubernetes is a broadly deployed container orchestration system project that is hosted by the Cloud Native Computing Foundation (CNCF) and benefits from a diverse set of contributors and vendors that support and develop the project. ", "With Kubernetes 1.14, the project is adding 10 new enhancements as stable features that provide new capabilities for users. ", "Among the biggest enhancements is production-level support for Windows nodes.", "\n\n“I’m proud of just that fact that in Kubernetes 1.14 there are more stable enhancements than any other previous Kubernetes release,” Aaron Crickenberger, Google test engineer and Kubernetes 1.14 release lead, told eWEEK. “", "The continued focus on stability speaks to this community’s commitment.”", "\n\n…One of the biggest changes overall in Kubernetes 1.14 wasn’t any one specific feature, but rather a new process for defining how and when enhancements are accepted and move through the Kubernetes development cycle. ", "The Kubernetes Enhancement Proposal (KEP) approach was first implemented for Kubernetes 1.14 and helped Crickenberger and the broader community manage the enhancements process." ]

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[ "907 F.2d 1227\n285 U.S.App.", "D.C. 221, 12 Employee Benefits Ca 2158\nUnpublished DispositionNOTICE: D.C. Circuit Local Rule 11(c) states that unpublished orders, judgments, and explanatory memoranda may not be cited as precedents, but counsel may refer to unpublished dispositions when the binding or preclusive effect of the disposition, rather than its quality as precedent, is relevant.", "Joseph P. CONNORS, Sr., ", "et al., ", "Appellants,v.INCOAL INCORPORATED a/k/a Incoal Coal Company, et al.", "\nNo. ", "89-7058.", "\nUnited States Court of Appeals, District of Columbia Circuit.", "\nJuly 20, 1990.", "\n\nBefore STEPHEN F. WILLIAMS and Sentelle, Circuit Judges, and SPOTTSWOOD W. ROBINSON, III, Senior Circuit Judge.", "\nJUDGMENT\nPER CURIAM.", "\n\n\n1\nThis case occasions no need for a published opinion. ", " See D.C.Cir.", "Rule 14(c). ", " It is\n\n\n2\nORDERED and ADJUDGED that the decision of the district court is affirmed for the reasons set forth in the attached memorandum.", "\n\n\n3\nThe Clerk is directed to withhold issuance of the mandate herein until seven days after disposition of any timely petition for rehearing. ", " See D.C.Cir.", "Rule 15.", "\n\nMEMORANDUM\n\n4\nThe Trustees of the 1950 and 1974 United Mine Workers of America Pension Plans (pension plans) seek to collect from Adkins Coal Company (Adkins Coal) and its partners a proportionate amount of pension contributions, also known as withdrawal liability,1 that have not been paid since Incoal, Inc., a company with which Adkins Coal had done business, withdrew from the benefit plans. ", " They contend that the District Court erred in dismissing their complaint against Adkins Coal, arguing that the company was a member of Incoal's controlled group, and as such is jointly and severally liable for the unpaid pension contributions. ", " For the reasons set forth below, we affirm the District Court.", "\n\nI.\n\n5\nIn 1974, the Adkins family leased coal reserves from Island Creek Company, formed Adkins Coal Company, a partnership,2 to exploit the lease, and entered into a mining agreement with Incoal, Inc. whereby Incoal would mine the coal reserves. ", " By October 1984, Incoal had completed its operations on the leased property; all available coal reserves had been exhausted, mining operations had ceased, and the site had been abandoned. ", " On December 27 of that year, Adkins Coal received its final payment from Incoal. ", " In March of 1985, a final distribution of $26,703.32 was made to the four individual Adkins partners, and the partnership ceased to have even a shadow of existence.", "\n\n\n6\nAfter the mining operations under the Island Creek lease had expired, Incoal continued to mine elsewhere for other companies. ", " Consequently, it continued to contribute to the pension plans.3 On February 15, 1985, however, Incoal ceased operations and completely withdrew from the pension plans.", "\n\n\n7\nThe Trustees pursued Incoal to recover its withdrawal liability. ", " Incoal failed to pay,4 and the Trustees filed a complaint in the District Court. ", " They alleged that when Incoal withdrew on February 15, 1985, pursuant to section 4203 of the Employment Retirement Income Security Act of 1974, (ERISA),5 it became liable for $810,610.41 plus interest, liquidated damages, attorneys' fees and costs. ", " Upon learning that others, including Adkins Coal and its partners, either had owned an interest of more than 1% in Incoal or had been a member of Incoal's controlled group prior to January 1980, the Trustees amended their complaint to include them as defendants. ", " Although the Trustees conceded that neither Adkins Coal nor its partners were signatory to a UMWA contract or had contributed to or participated in the pension plans,6 they contended that Adkins Coal, as part of a \"brother-sister group\"7 along with Incoal and others, comprised a \"single employer\" of Incoal's employees who were jointly and severally liable for any withdrawal assessment that Incoal owed.8\n\n\n8\nThe partners of Adkins coal moved to dismiss the complaint, principally arguing that the company was not a part of the controlled group because it had dissolved prior to Incoal's alleged withdrawal from the UMWA pension plans. ", " The Trustees countered that Adkins Coal did not dissolve until after it distributed Incoal's final payment among the partners in March of 1985. ", " But even if it had, they asserted, under Kentucky law the company still existed, both factually and legally, during the winding-up period; thus, it remained a \"trade or business\" under ERISA and subject to withdrawal liability.", "\n\n\n9\nThe District Court, rejecting the Trustees' arguments, ruled that as a matter of law Adkins Coal and its partners were improperly made defendants in the suit. ", " It found that although dissolution of the partnership did not terminate its existence, which continued until all affairs were wound up, nothing in the record indicated that operations continued past December 1984.9 Thus, the court concluded, Adkins Coal could not have been a trade or business under common control at the time of Incoal's withdrawal from which any liability could arise. ", " This appeal followed.", "\n\nII.", "\n\n10\nERISA was designed to \"establish[ ] funding and vesting standards for private pension plans.", "\"10 Because of certain defects in that statute, the Multiemployer Pension Plan Amendments Act of 1980 (MPPAA)11 was enacted to protect the retirees and workers who are covered by multiemployer plans12 against the loss of their pensions.13 Under MPPAA, both the employer and trades or businesses with which it is affiliated are held responsible for the withdrawal liability of the departing employer.14 The identity of those liable for the unpaid contributions is determined on the date of the withdrawal.15 No one disputes that Adkins Coal was once a member of the controlled group that included Incoal; at issue here is whether Adkins Coal was still a \"trade or business\" and thus a member at the time of Incoal's withdrawal.", "\n\nIII.", "\n\n11\nAdkins Coal was organized under the partnership laws of Kentucky, which has adopted the Uniform Partnership Act. ", " Under Kentucky law, dissolution is caused without violating the agreement between partners by, among other things, \"the termination of the definite term of particular undertaking specified in the agreement.", "\"16 \"On dissolution the partnership is not terminated, but continues until the winding up of partnership affairs is completed;\"17 however, with some minor exceptions, liability is owed only for commitments made prior to dissolution.18\n\n\n12\nHere, the Trustees contend that Adkins Coal was a \"trade or business\" within the meaning of section 1301 at the time of Incoal's withdrawal, and therefore subject to the withdrawal liability. ", " In support of their proposition, they argue first that the partnership did not dissolve in 1984. ", " They claim that the purpose of the partnership included disbursement of payments to the partners, and that the final distribution did not occur until after the withdrawal in 1985. ", " Appellants' argument is meritless.", "\n\n\n13\nSection 1301(b)(1) states that the regulations governing trades or businesses under common control shall be \"consistent and coextensive\" with section 414(c) of Title 26. ", " ERISA's implementing regulations also direct us to section 414(c).19 The term \" 'trade or business' [however] is not clearly defined in either section 414(c) or the regulations promulgated thereunder.", "\"20 Consequently, federal courts \"consider[ing] this issue have engaged in an essentially factual inquiry.", "\"21 We make this determination, of course, as a matter of federal law, but with some reference to the legal characteristics of the partnership as determined by Kentucky law. ", " We find that competent and credible evidence in the record supports a finding that appellees' actions after 1984 demonstrated a winding-up process and not a continuation of the business. ", " By the start of 1985, Adkins Coal had no further business engagements with Incoal or any other business concern. ", " Rather, it distributed its partnership assets, an administrative task typically associated with winding up of business affairs.22 Since the Trustees point to nothing more, we accept appellees' interpretation that the purpose of the Adkins Coal partnership was to exploit the Island Creek Lease, and concomitantly, embrace their position that once the associated business activity ceased, the partnership was dissolved.23\n\n\n14\nNext, the Trustees argue that even if Adkins Coal was operationally inactive after 1984, it was an existing legal entity during the winding-up period and therefore remained a \"trade or business\" within ERISA. ", " In other words, they ask us to hold a business in its phase-out stages liable for debts incurred by another firm with which it no longer conducted business. ", " This we cannot do.", "\n\n\n15\nA partnership that has arrested all business activity and is in the throes of winding up its affairs is, with some exceptions not relevant here, liable only for pre-dissolution debts.24 In fact, \"[t]he dissolution of a partnership operates only with respect to future new transactions, but as to everything past, including the performance of existing contracts, the partnership continues until all pre-existing matters are terminated.", "\"25 Adkins Coal dissolved in 1984. ", " The withdrawal liability was not incurred until 1985. ", " Thus, under ordinary principles of partnership law, Adkins Coal cannot be held liable.26\n\nIV.", "\n\n16\nAdopting appellants' approach would neither advance the purpose nor the spirit of ERISA. ", " We recognize that \"ERISA (and the MPPAA) are remedial statutes, [and as such] should be liberally construed in favor of protecting the participants in employee benefit plans.", "\"27 And we are mindful that \"[t]he Supreme Court has 'consistently refused to give effect to the corporate form where it is interposed to defeat legislative policies,' \"28 and that \" 'deferring too readily to the corporate identity may run contrary to the explicit purposes of [ERISA].' \"", "29 But we do not perceive Adkins Coal as asserting the dissolution of its partnership to deliberately \"defeat\" the \"legislative policies\" or \"explicit purposes\" of ERISA. ", " Rather, we think it would be grossly inequitable to hold Adkins Coal liable for $810,610.41, as well as wholly incompatible with the statute's objectives, merely because it maintained a residual existence while winding up its partnership affairs some three months after the company had suspended basic operations and discontinued its working relationship with Incoal.30 Since no statute should be so absurdly construed, and partnership law dictates that Adkins Coal and its partners be absolved of any responsibility for post-dissolution debts, we affirm the District Court's dismissal of the Trustees' complaint.31\n\n\n\n1\n The withdrawal liability of an employer is \"the allocable amount of unfunded vested benefits.\" ", " 29 U.S.C. Sec. ", "1381(b)(1) (1985). ", " See also Park South Hotel Corp. v. New York Hotel Trades Council, 851 F.2d 578, 580 (2d Cir.), ", "cert. ", "denied, 109 S.Ct. ", "493 (1988) (withdrawal liability is equal to employer's proportionate share of plan's unfunded vested employee benefits or the difference between the present value of vested benefits and current value of plan's assets)\n\n\n2\n The company had no employees, office space, or telephone number. ", " It also paid no wages or salaries, engaged in no economic activity, and did not participate in or maintain employee benefit plans. ", " It did, however, collect a percentage of the net proceeds from the sale of the coal mined by Incoal\n\n\n3\n Brief for Appellees at 4\n\n\n4\n Incoal informed the Trustees it had depleted its assets and was financially unable to make payments\n\n\n5\n 29 U.S.C. Sec. ", "1383 (1974)\n\n\n6\n Connors v. Incoal, Inc., 699 F.Supp. ", "3, 4 (D.D.C.1988)\n\n\n7\n When the Trustees amended their complaint, they had also added as a defendant Double A Farms which shared the same partners as Adkins Coal. ", " It is those entities which the Trustees term a \"brother-sister group\" under common control that is jointly and severally liable for Incoal's withdrawal liability. ", " According to the regulations, \"brother-sister group\" means \" 'two or more organizations conducting trades or businesses if (i) the same five or fewer persons who are individuals, estates, or trusts own (directly and with the application of [26 CFR] Sec. ", "11.414(c)-4), singly or in combination, a controlling interest of each organization, and (ii) taking into account the ownership of each such person only to the extent such ownership is identical with respect to each such organization, such persons are in effective control of each organization.' \" ", " Board of Trustees v. LaFrenz, 837 F.2d 892, 893 (9th Cir.1988) (quoting 26 CFR Sec. ", "11.414(c)-2(c)(1))\n\n\n8\n \"[A]ll employees of trades or businesses (whether or not incorporated) which are under common control shall be treated as employed by a single employer and all such trades and businesses as a single employer.\" ", " 29 U.S.C. Sec. ", "1301(b)(1) (1985). ", " See also 29 CFR Sec. ", "2612.3 (1989); 26 U.S.C. Sec. ", "414(b), (c), (f)(2) (1988 & 1990 Cum.", "Supp.). ", " Accord Mason and Dixon Tank Lines, Inc. v. Central States, S.E. & S.W. Areas Pension Fund, 852 F.2d 156, 159 n. 2 (6th Cir.1988) (\" 'if a terminating single employer plan is maintained by one or more members of a controlled group, the entire group is the \"employer\" and is responsible for any employer liability' \") quoting 126 Cong.", "Rec. ", "S11672 (daily ed. ", "Aug. 26, 1980) (statement of Sen. Williams)); Pension Benefit Guar. ", "Corp. v. Ouimet Corp., 630 F.2d 4, 11 (1st Cir.1980), cert. ", "denied, 450 U.S. 914 (1981) (same)\n\n\n9\n Connors v. Incoal Inc., supra note 6, 699 F.Supp. ", "at 5\n\n\n10\n H.R. Report No. ", "869, 96th Cong., ", "2d Sess., ", "reprinted in [1980] U.S.Code Cong. & ", "Admin.", "News 2918, 2919\n\n\n11\n Pub.", "L. No. ", "96-364, 94 Stat. ", "1208 (1980) (codified at 29 U.S.C.A. Sec. ", "1001 et seq. ", " (1985))\n\n\n12\n The term \"multiemployer plan\" refers to \"a plan maintained pursuant to one or more collective bargaining agreements which cover the employees of two or more unaffiliated employers.\" ", " H.R.Report No. ", "869, 96th Cong., ", "2d Sess., ", "reprinted in [1980] U.S.Code Cong. & ", "Admin.", "News at 2921\n\n\n13\n Id. at 2919\n\n\n14\n See note 8, supra\n\n\n15\n Connors v. Peles, 724 F.Supp. ", "1538, 1554 n. 12 (W.D.Pa.1989) (citing 29 U.S.C. Sec. ", "1391)\n\n\n16\n Ky.Rev.Stat. ", "Sec. ", "362.300(1)(a), (b) (Michie/Bobb-Merrill 1987)\n\n\n17\n Ky.Rev.Stat.", "Ann. ", "Sec. ", "362.295\n\n\n18\n See Ky.Rev.Stat.", "Ann. ", "Sec. ", "362.325 (\"[t]he dissolution of the partnership does not of itself discharge the existing liability of any partner\") (emphasis added); see also Ky.Rev.Stat.", "Ann. ", "Sec. ", "362.310, Sec. ", "362.320. ", " Cf. ", "Youmans v. Simon, 791 F.2d 341, 346 (5th Cir.1986) (after general partners dissolve the partnership, they become personally liable for pre-existing partnership debts)\n\n\n19\n See 29 CFR Sec. ", "2612.2 (1989) (\"Trades or businesses (whether or not incorporated) which are under common control\" has the same meaning as in section 414(c) of the Internal Revenue Code of 1954 ... and the regulations issued thereunder.\") ", " (emphasis in original)\n\n\n20\n Board of Trustees v. LaFrenz, supra note 7, 837 F.2d at 894 n. 6\n\n\n21\n Id\n\n\n22\n Ky.Rev.Stat.", "Ann. ", "Sec. ", "362.335 states in pertinent part: \"When dissolution is caused[,] ... each partner as against his copartners and all persons claiming through them in respect of their interest in the partnership, ... may have ... the surplus [of the partnership property] applied to pay in cash the net amount owing to the respective partners.\" ", " See also Phillips v. Kaplus, 764 F.2d 807, 814 (11th Cir.1985), cert. ", "denied, 474 U.S. 1059 (1986) (\"distribution of partnership assets ... is the natural consequence of the winding up of partnership affairs\"); Lebanon Trotting Ass'n v. Battista, 306 N.E.2d 769, 772 (Oh.", "App.1972) (\"preservation of the partnership assets ... or ... the[ir] disposal, constitute proper action in connection with winding up the affairs of a partnership after dissolution\")\n\n\n23\n Such inactivity is consistent with the principle that \"[d]issolution brings to an end the ordinary business of the partnership.\" ", " Ford v. Lafayette Life Ins. ", "Co., 362 F.2d 970, 971 (D.C.Cir.1966)\n\n\n24\n See note 18, supra\n\n\n25\n Lebanon Trotting Ass'n v. Battista, supra note 22, 306 N.E.2d at 772\n\n\n26\n Cf. ", "International Bhd. ", "of Painters & Allied Trades Union v. George A. Kracher, Inc., 856 F.2d 1546, 1550 (D.C.Cir.1988) (chief officer and principal shareholder cannot be held liable for corporate debt arising out of delinquent-contribution liability); Connors v. P & M Coal Co., 801 F.2d 1373, 1376 (D.C.Cir.1986) (\"[we find nothing in either the language or purpose of MPPAA ... to suggest that Congress intended to subject owner-operators of a closely held corporation to personal liability merely because they actively participated in running the business.\")", "\n\n\n27\n IUE AFL-CIO Pension Fund v. Barker & Williamson Inc., 788 F.2d 118, 127 (3rd Cir.1986) (citing Rettig v. PBGC, 744 F.2d 133, 155 (D.C.Cir.1984)) (other citation omitted)\n\n\n28\n Lowen v. Tower Asset Management, Inc., 829 F.2d 1209, 1220 (2d Cir.1987) (quoting First Nat'l City Bank v. Banco Para el Comercio Exterior de Cuba, 462 U.S. 611, 630 (1983))\n\n\n29\n Id. at 1220-21 (quoting Alman v. Danin, 801 F.2d 1, 3 (1st Cir.1986))\n\n\n30\n Cf. ", "In re Seatrain Lines, Inc., 46 B.R. 320 (Bankr.", "S.D.N.Y.1985) (bankrupt carrier not \"employer\" under MPPAA where it ceased payment of contributions for longshoremen who had been hired, fired, paid, and subject to direction and control of independent stevedores with which carrier had contracted)\n\n\n31\n In a footnote to its opening brief appellant suggested that it should have been permitted an additional opportunity for discovery. ", " This is insufficient to raise the issue without sandbagging the appellee, and we do not address it\n\n\n" ]

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[ "Chilling Effects: NSA Surveillance Drives U.S. Writers to Self-Censor\n\nIn the human rights and free expression communities, it is a widely shared assumption that the explosive growth and proliferating uses of surveillance technologies must be harmful—to intellectual freedom, to creativity, and to social discourse. ", "But how exactly do we know, and how can we demonstrate, that pervasive surveillance is harming freedom of expression and creative freedom?", "\n\nIn October 2013, PEN partnered with independent researchers at the FDR Group to conduct a survey of over 520 American writers to better understand the specific ways in which awareness of far-reaching surveillance programs influences writers’ thinking, research, and writing. ", "The results of this survey—the beginning of a broader investigation into the harms of surveillance—substantiate PEN’s concerns: writers are not only overwhelmingly worried about government surveillance, but are engaging in self-censorship as a result.", "\n\nExpert Contact\n\nSummer Lopez\n\nSenior Director for Free Expression Programs\n\nContact »" ]

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[ "Your new year's resolution – kickstart your membership with the Appraiser's Association! ", "Join us at our office for a brief information session to learn about different levels of membership, and discuss your pathway forward. ", "Review the entire membership process, from initial application, through to the admissions committee review process, including the timeline and how to navigate the process successfully.", "\n\nIf you are looking for a professional qualification for entry into appraising, the Appraiser's Association is the premiere association of fine and decorative arts appraisers. ", "Attending an information session will give you a deeper understanding of our requirements, and give you a chance to meet our staff and other members of the Association who can guide you through the membership process!" ]

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[ "ALEXANDRIA, VA. — ", "Alexandria prosecutors will take a new approach on marijuana possession cases. ", "Commonwealth's Attorney Bryan Porter announced a new diversion program allowing people charged with possession of marijuana in Alexandria to get their cases dismissed.", "\n\nEffective Sept. 3, 2019, people can complete a diversion program to get their charges dismissed. ", "The program is open to anyone charged with possessing a small amount of marijuana, even those with a previous criminal record.", "\n\n\"My duty is to seek justice for the entire community—including persons charged with offenses—and that duty requires me to implement thoughtful policies with regard to low-level and non-violent crimes,\" said Porter in a statement. \"", "My hope is that the majority of marijuana possession offenses will be diverted from the adjudication process, allowing my staff to focus on more serious crimes.\"" ]

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[ "A conventional electric-heating garment is in the form of an upper garment, and includes an article of clothing, at least one first electric-heating element, a power supply, a pair of gloves, and two second electric-heating elements.", "\nThe at least one first electric-heating element is attached to the article of clothing. ", "The power supply is operable to supply electric power to the at least one first electric-heating element for warming up the article of clothing. ", "The second electric-heating elements are respectively attached to the gloves. ", "The power supply is provided with two male connectors, and each of the second electric-heating elements is provided with a female connector that is operable to be connected to a respective one of the male connectors so as to permit electricity to be transmitted from the power supply to the second electric-heating elements for warming up the gloves.", "\nEach of the male connectors is connected to the power supply via an electric cord. ", "When in use, the electric cords are extended and exposed from the article of clothing for connection between the male and female connectors. ", "When the male and female connectors are disconnected after use, the electric cords have to be manually wrapped and placed into the article of clothing for a neat appearance and for preventing each of the electric cords from tangling. ", "However, such wrapping process is time-consuming and may be troublesome for a wearer." ]

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[ "FLAVOR FOR THE WHOLE FAMILY\n\nTHE SECRET’S IN THE\n\nALL PURPOSE SAUCE\n\nIt took hundreds of batches over countless months. ", "Constant tinkering. ", "A dash more of this, a pinch less of that and it was finally perfected: “The All Purpose Sauce of Country Bob Edson’s dreams. ", "Friends and family raved about it 40 years ago. ", "And now? ", "It’s the featured sauce on our line of flavor." ]

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[ "[Hypersplenism from an aneurysm of the splenic artery. ", "A clinical case].", "\nPresentation of one case. ", "Hypersplenism may be caused by a variety of pathological conditions. ", "Rarely, it may be due to some vascular pathology. ", "The Authors report on a patient with an hypersplenic syndrome, caused by the aneurysm of splenic artery, in whom splenectomy has been curative." ]

{ "pile_set_name": "PubMed Abstracts" }

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[ "I'm new to Alabama just moved here from Michigan. ", "I am trying to find a guide down here were I can try and get a job. ", "I have plenty of hunting experience and want nothing more then to do it for a living. ", "If anyone can point me in the right direction I would greatly appreciate it\n\nWhere in Alabama do u live? ", "I dont know of a single duck guiding service in north alabama where im from. ", "The only place i could think there be one or two would be around Guntersville but not real sure on that. ", "I think there's a few \"hunting plantations\" in central Al but those are usually not fair chase hunts. ", "If you live way down south, there may be a few in the delta but never hunted down there myself so not sure. ", "There just isnt a big demand for duck guides around here cause most people that wanna pay to kill some ducks are gonna go outta state. ", "If all else fails you could start up your own guide service or work in a different state for the season, i've known some people to do that. ", "I know this may not help alot, seeing that im uncertain on most of it but i figure a little help is better than none. ", "Oh and welcome to Alabama, i hope you find it very enjoyable here just dont get your hopes up about killin alot of ducks, now deer are a different story.", "\n\nI live in florence but am willing to move again. ", "I figured I would try and get a good season in down here before heading over to Arkansas because last time i posted something on there page about guiding I basically got ran out of town. ", "I am willling to relocate to do this. ", "I also have my own boat decoys and a 3 yr old black lab" ]

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[ "Background {#Sec1}\n==========\n\nEnsuring good health of migrants is a serious global issue. ", "This is well recognized by the World Health Organization (WHO) which advocated the health promotion of migrants at its 61st World Health Assembly \\[[@CR1]\\]. ", "Access to health care is crucial for ensuring migrants' good health. ", "Unfortunately, illegal status \\[[@CR2]\\], language problems \\[[@CR3]\\], cultural differences \\[[@CR3], [@CR4]\\], lack of basic information \\[[@CR5]\\], inadequate health literacy, \\[[@CR6]\\] and financial difficulty \\[[@CR7], [@CR8]\\] act as barriers to health care access.", "\n\nThere are currently 2,829,416 migrants in Japan, and this number continues to grow \\[[@CR9]\\]. ", "As of 2019, the number of migrants who became permanent residents, referred to as immigrants, in Japan was about 1,160,000 and 64% were women over the age of 40 years \\[[@CR9]\\]. ", "Although immigrants are a diverse group \\[[@CR9]\\], Japan is not a culture that has emerged from an influx of various cultures, as contrasted with Australia, Canada or the United States. ", "Quite the contrary, Japan has a past history of closed borders and tight control of in-migration. ", "Furthermore, the language and customs are thought to be unique and a defining part of the Japanese national identity. ", "This often poses a challenge to immigrants who are attempting to become part of the culture \\[[@CR10], [@CR11]\\]. ", "Many immigrants in Japan reported experiencing similar difficulties as migrants because of the different culture or language and the unfamiliar health services that involve a complicated Japanese insurance system \\[[@CR12]--[@CR15]\\]. ", "Even long-term immigrants had difficulties in communicating with health providers \\[[@CR16]\\].", "\n\nAlthough Japan has a proactive response to its aging population \\[[@CR17]\\], the cultural and language differences may place the middle-age female immigrant population at a disadvantage when facing issues of aging. ", "Middle-aged women have various physiological, physical, cognitive and social changes associated with aging that may increase their risk of non-communicable diseases (NCDs) \\[[@CR18]--[@CR20]\\]. ", "One study reported that there was a risk of obesity in relation to NCDs among Filipina migrants in Japan \\[[@CR21]\\]. ", "Health promotion strategies with a strong focus on disease prevention are needed to empower women to reduce the risks of NCDs \\[[@CR22]\\]. ", "However, there has been little research regarding the risks of NCDs of middle-aged female immigrants in Japan as well as their perception of NCDs and health promotion behaviors. ", "Thus, a major issue that remains to be addressed in Japan is how to promote the health of migrant women. ", "This study aimed to clarify the risks of and perceptions about NCDs as well as the health promotion behavior of middle-aged female immigrants in Japan.", "\n\nDefinition {#Sec2}\n----------\n\nIn this study, the term immigrants refer to persons who were born in a country other than Japan, migrated to Japan, and granted a permanent resident status.", "\n\nTheoretical framework {#Sec3}\n---------------------\n\nThe theoretical framework guiding this study was the health belief model because it predicts people's health-related behavior to prevent, screen for, and control illness conditions \\[[@CR23]\\]. ", "The key constructs of the health belief model are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action and self-efficacy. ", "Diverse demographic, socio-psychological, and structural variables may influence perceptions and indirectly influence health-related behavior.", "\n\nMethods {#Sec4}\n=======\n\nStudy design {#Sec5}\n------------\n\nWe used an exploratory mixed-method design consisting of a quantitative approach to clarify the risks of NCDs and a qualitative approach to identify the perceptions NCDs and health promotion behaviors of middle-aged female immigrant in Japan. ", "There were no previous studies on the perspectives of middle-aged female immigrant regarding their risks and perceptions of NCDs and health promotion behavior. ", "For that reason we used focus group discussions (FGDs), which are suitable for obtaining a wide range of opinions and are therefore helpful tools in assessing group needs. ", "FGDs work particularly well to explore perceptions, feeling, and thinking about issues, ideas, products, services or opportunity \\[[@CR24]\\]. ", "Also, focus groups enable people to ponder, reflect, and listen to experiences and opinions of others\\...this interaction helps participant's compare their own personal realities to those of others \\[[@CR24]\\].", "\n\nStudy setting {#Sec6}\n-------------\n\nThis study was conducted in an urban area (i.e., Chiba prefecture) and a rural area (i.e., Yamagata prefecture) in Japan. ", "For the urban setting, we recruited participants from a church with about 200 immigrants in Chiba which has 200,000 immigrants. ", "We distributed the invitation to 41 eligible immigrant women after church mass. ", "For the rural setting, we conducted the study with an immigrant group in Yamagata prefecture, which has 6000 immigrants. ", "We distributed the invitation to 15 eligible female members. ", "A total of 35 immigrant women agreed to participate in this study.", "\n\nParticipants {#Sec7}\n------------\n\nWe invited a purposive sample of immigrant women living in Japan who were 40 years or older who had attained the legal status of permanent resident either though marriage or their employment. ", "Excluded were women who were unable to communicate in either Japanese or English.", "\n\nData collection {#Sec8}\n---------------\n\nData were collected from October 2016 to November 2016. ", "The data consisted of a questionnaire survey, physical measurements, and FGDs. ", "For the quantitative data, participants completed a self-administered questionnaire documenting their country of origin, age, marital status, years of being an immigrant, experience of having a general check-up, screening for breast cancer and cervical cancer within the year, smoking and drinking history, history of chronic disease and regular medication, and intention of joining a health promotion program. ", "Participants' height, weight, abdominal girth, and blood pressure were also measured. ", "Body Mass Index (BMI) was calculated using weight and height. ", "Based on the WHO standard \\[[@CR25]\\], a person with a BMI of ≥30 or an abdominal girth of ≥380 cm was considered obese. ", "A person with a blood pressure of \\> 140 mmHg over 90 mmHg was identified as having hypertension.", "\n\nFor the focus groups, Krueger \\[[@CR24]\\] suggested conducting 3 to 4 group discussions with 5 to 8 participants. ", "A Japanese-English bilingual researcher (YN) facilitated the discussions. ", "The FGDs were conducted in English and Japanese. ", "Two Japanese research assistants obtained verbal consents to take notes and audiotape the interviews. ", "As Table [1](#Tab1){ref-type=\"table\"} shows, the facilitators used the following questions to guide the semistructured interview \\[[@CR26]\\]: (a) Please described the community in which you live; (b) What are your perceptions of NCDs?; (", "c) How do you prepare for or prevent NCDs? ", "Various probing questions were used to elicit clarification or expansion of the participants' responses. ", "Table 1Focus group discussion questionsa. ", "Please described the community in which you liveb. ", "What are your perceptions of NCDs?c. ", "How do you prepare for or prevent NCDs?", "\n\nThe first question was general and was used as an ice breaker to stimulate further discussion and put the participants at ease while encouraging them to interact normally with the facilitator. ", "The FGDs lasted for approximately 50--60 min. ", "The facilitator transcribed the interviews verbatim. ", "After conducting 3 FGDs with 7 or 8 participants in each group, the full range of ideas was collected and no new information was forthcoming as we had reached data saturation and thus concluded the FGD.", "\n\nData analysis {#Sec9}\n-------------\n\nDescriptive data of the demographic and biomarkers included percents, totals and ranges and were analyzed using SPSS 24. ", "BMI was calculated using the USA Center for Disease Control Adult BMI online calculator. ", "FGD data were analyzed objectively and systematically according to the steps of analysis described by Krueger \\[[@CR24]\\]. ", "We used the classic analysis strategy to identify themes and categorize results \\[[@CR24]\\]. ", "The following steps were taken to analyze the focus group data: (1) printed the transcripts and noted the number of participants who iterated each quote; (2) read each quote and collected the quotes for which \\[a\\] participants answered the question the interviewer asked, or \\[b\\] said something important about the topic; (3) provided explanatory encoding for every sentence or paragraph related to the risks of NCDs or health promotion needs so that similar sentences or paragraphs shared the same code; (4) generated categories and subcategories based on the similarity of each code; (5) discussed the process for generating categories among the authors who were experienced qualitative researchers (YN, YS, YI, YH) to enhance the trustworthiness of data analysis; and (6) revised the naming or classification of categories based on the discussion. ", "Although we had only minor disagreements between authors, we went back to the original quotes and discussed the coding until agreement was reached. ", "The credibility of the results was ensured by triangulating different sources of information, reviewing disconfirming evidence, researcher flexibility, collaborating with participants, and auditing by the academic advisor \\[[@CR27]\\].", "\n\nEthical considerations {#Sec10}\n----------------------\n\nThis study observed all standards for protection of human subjects as set forth by the Declaration of Helsinki. ", "The heads of the local women's immigrant groups granted permission to conduct the study. ", "Research assistants obtained written informed consent from all the participants after they had received oral and written information about the study. ", "The participants were also informed that they could voluntary stop their participation at any time without any questions or repercussions. ", "Verbal consent to audiotape the interviews was obtained. ", "Anonymity of their responses was assured. ", "Each informant confirmed her participation in writing. ", "Ethical approval for the study was obtained from the Research Ethics Committee of St. Luke's International University, Japan (Approval number: 16-A034).", "\n\nResults {#Sec11}\n=======\n\nCharacteristics of participants {#Sec12}\n-------------------------------\n\nTable [2](#Tab2){ref-type=\"table\"} shows the participant characteristics. ", "All the participants were women with a mean age of 50.6 years and a mean residence duration in Japan of 19.5 years. ", "The countries of origin were the Philippines, China, Korea, Thailand, and the United States of America. ", "The majority of the participants were married and from the Philippines. ", "Table 2Characteristics of the participants (*N* = 35)Characteristics**Age** (years)50.6 ± 7.6**Duration of residence** (years)19.5 ± 6.9**Country of origin**Philippines28China3Korea2Thailand1United States of America1**Marital status**Single2Married to Japanese15Married to non-Japanese14Divorced2Widowed2**Chronic disease**With chronic disease11Without chronic disease24**Regular medication**Yes12No23\n\nRisks of NCDs {#Sec13}\n-------------\n\nThere were 29% with hypertension, 29% with a BMI of \\> 30, and 71% with an abdominal girth of \\> 80 cm. ", "Approximately 80% received a regular health check-up, 49% received breast cancer screening, and 34% received cervical cancer screening. ", "About 31% had a history of chronic disease and 34% took prescribed medications.", "\n\nGuided by the health belief model, the qualitative data about the perceptions of NCD risks and health promotion behavior were classified into four categories: (1) Non-communicable diseases as threat; (2) Health promotion behaviors; (3) Barriers related to health promotion behavior; (4) Accelerator of health promotion behavior. ", "Details are shown in Table [3](#Tab3){ref-type=\"table\"}. ", "Table 3Perceptions of NCD risks and health promotion behaviors to prevent NCDsNon-communicable diseases as threatSomething causes serious consequencesUnavoidableNeed effort to preventHealth promotion behaviorsExerciseHealthy dietTaking medicine prescribed by a doctorSleep and restAttend cancer screeningBarriers related to health promotion behaviorBenefits of health promotion behavior not understoodLack of knowledge about methods of health promotion behaviorPassive attitude towards health promotion from country of originMonolingual health service inappropriateAccelerator of health promotion behaviorSuggestion for health promotion by family and friendsPeer supportInvitation of health promotion activity from governmentSupportive health provider\n\nNon-communicable diseases as threat {#Sec14}\n-----------------------------------\n\n### Something causes serious consequences {#Sec15}\n\nAll of the middle-aged female immigrants recognized that NCDs could cause serious consequences because their families or friends experienced NCDs and they had learned about the danger of NCDs in Japan. ", "Even though they were aware that NCDs were dangerous, it remained unclear why they experienced NCDs or how NCDs could be prevented.", "\n\n\"\"*I know that stroke is very dangerous. ", "It killed my brother.* \"\" \"*\"", "My Japanese friends are so concerned about blood pressure, blood sugar and weight. ", "I heard that hypertension is dangerous. ", "I am so nervous. ", "But how can I prevent it? ", "Is there anything we can do to prevent it?\"*\"", "\n\n### Unavoidable {#Sec16}\n\nMany immigrant women felt that NCDs were unavoidable because some NCDs were experienced in the same household and because NCDs were common in their community.", "\n\n\"*\"I am so scared of stroke. ", "My father and brother had stroke. ", "I am afraid that I may have it too. ", "It is a family disease, I guess.\"*\" \"\"*", "You will have them (NCDs) when you get old. ", "It is natural. ", "Many people have them in my country.*\"\"", "\n\n### Need effort to prevent {#Sec17}\n\nSome immigrant women believed that NCDs could be prevented if a person tried to do so even though it was not easy.", "\"\"*We must work hard to keep ourselves healthy. ", "We cannot eat, drink or behave like younger ones if we want keep ourselves healthy. ", "It is hard*.\"\"\"*\"My blood pressure was high. ", "My doctor advised me to lose weight and take medicine. ", "It was not easy to lose weight. ", "But I accomplished it. ", "Now I do not need a medicine for blood pressure. ", "It is controlled.\"*\"", "\n\nHealth promotion behaviors {#Sec18}\n--------------------------\n\nThe participants engaged in some forms of health promotion behaviors such as exercise, healthy diet, taking medication prescribed by a doctor, sleep and rest and attending cancer screening.", "\n\n### Exercise {#Sec19}\n\nA group of immigrants organized an exercise class by themselves because there were no exercise classes for non-Japanese speaking residents, and they also claimed that it is easier to continue exercise if they do it with a friend.", "\"*\"I invite an English speaking instructor to my office every month and have an exercise class with my immigrant friends. ", "It is fun if you have friends to do with.\"*\"", "\n\n### Healthy diet {#Sec20}\n\nSome immigrant women tried to eat in healthy ways. ", "Many immigrant women felt that the Japanese eating styles were healthier than the original eating styles from their countries. ", "However, Filipino participants mentioned that eating Japanese rice made them fat.", "\"*\"Filipinos love eating. ", "It is our culture to eat together ... I rather eat vegetable and fish like Japanese do but I am trying not eat much rice. ", "It makes me fat.", "\"*\"\"*\"I heard that hypertension is dangerous. ", "I am so nervous. ", "But how can I prevent it? ", "Is there anything we can do to prevent it?\"*\"", "\n\n### Taking medicine prescribed by a doctor {#Sec21}\n\nSome immigrant women were taking the prescribed medicine for NCDs. ", "The most common NCD was hypertension and the prescribed hypertensive medication were taken. ", "The physician did not explain how the medication worked, so she was not very motivated to take it.", "\"*\\\"I am taking a medicine because my blood pressure is high. ", "It is Ok to take when my pressure is high but I do not like to keep taking medicine regularly. ", "But my doctor says I must take it everyday. ", "It is hard.\\\"*\"\n\nBarriers related to health promotion behavior {#Sec22}\n---------------------------------------------\n\n### Benefits of cancer screening or health check-ups not understood {#Sec23}\n\nSome participants did not know why people would benefit from cancer screening or health check-ups because receiving a healthy result of health check-up made them feel it is useless.", "\"\"*I always have \"normal\" as a result of my health check-up. ", "Why do I have to go to the hospital for assurance of \"normal\"? ", "It is waste of time and resource*\"\"One participant confessed that she did not attend cancer screening because she was scared to be diagnosed. ", "In her country, cancer is fatal and she believed that there is no point to detect it at an earlier stage.", "\"*\"I am simply scared to be diagnosed with cancer\\...that is why I do not go (to screening).\"*\"", "\n\n### Lack of knowledge about methods of health promotion {#Sec24}\n\nSome immigrant women did not have any idea how to promote their health because they were young and healthy when they departed from their country of origin and did not have an opportunity to learn about health promotion in Japan.", "\"*\"I know I am getting old and want to do something to keep myself healthy. ", "But how? ", "In my country, old people did not care about blood pressure.\"*\"", "\n\n### Passive attitude towards health promotion from country of origin {#Sec25}\n\nSome immigrant women hesitated to visit the hospital because of their cultural background.", "\"*\"Japanese really love to visit the hospital. ", "We visit the hospital only when we have a serious illness. ", "Why do I have to visit a doctor when I have no symptom?\"*\"\"*\"We believe in God. ", "We pray rather than going to the hospital. ", "If I get a cancer, it is my fate.\"*\"", "\n\n### Language barriers obstructing health service {#Sec26}\n\nAll immigrant women demanded the improvement of Japanese health information, which was only written and spoken in Japanese. ", "Monolingualism in the Japanese health service prevented immigrant women from attending the check-up or cancer screening, or if they did they failed to understand the results of the medical examination. ", "Participants wanted know about their health in detail.", "\"*\"I got an invitation form of cancer screening written in Japanese which I do not read. ", "It contained a list of clinics, however, I did not know where I can see the doctor who speaks English.", "\"*\"\"*\"To keep my health, I went to breast cancer screening. ", "The problem was that I did not fully understand the results. ", "I do not read Japanese. ", "My husband said it was OK. ", "What I wanted to know was how it was OK and what to do to keep me away from the breast cancer ... .It is my health, not my husband's.\"*\"", "\n\nAccelerator of health promotion behavior {#Sec27}\n----------------------------------------\n\n### Suggestion for health promotion by family and friends {#Sec28}\n\nSuggestion by the participants' family and friends strongly urging them to attend the health check-up and cancer screening motivated them to attend.", "\"\"*My husband and son asked me to \\[go to the\\] hospital for check-up. ", "That is why I went.\"*\"", "\n\n### Invitation of health promotion activity from government {#Sec29}\n\nInvitation for a free check-up or cancer screening from the government was a strong incentive for immigrant women. ", "This was especially true when it was sent through the employer.", "\"\"*I got an invitation of health check-up. ", "They said it was free. ", "I was sorry to waste it\\...so I went*.\"\"", "\n\n### Peer support {#Sec30}\n\nImmigrant women wanted to attend health promotion events with their friends who shared their language and culture.", "\n\n\"*\"I want to have friends to share the health problem and support each other. ", "I need a community where we are comfortable and empowered.\"*\"", "\n\n### Supportive health provider {#Sec31}\n\nImmigrant women felt empowered to behave in healthy ways when trusted health providers supported them.", "\"\"*I am lucky. ", "My doctor is very nice person. ", "He try to speak English using dictionary. ", "Not good but I know he try to communicate with me ... I feel he really try to help me. ", "That is why I do not skip his medical appointment.\"*\"", "\n\nDiscussion {#Sec32}\n==========\n\nThis exploratory study aimed to clarify the perceived risks of NCDs and the health promotion behaviors of middle-aged female immigrants in Japan.", "\n\nPerceptions of NCD risk and health promotion behaviors {#Sec33}\n------------------------------------------------------\n\nNotably, slightly less than one-third of the female immigrant participants in this study were found to have risks of hypertension, a BMI of \\> 30, and an abdominal girth of \\> 80 cm as NCDs. ", "Chronic disease was also found among one-third of the female immigrant participants, and some took regular medication.", "\n\nInterestingly, 80% of the study participants received a health check-up in the previous year, which is higher than the 53% rate of the Japanese population who received a health check-up \\[[@CR28]\\]. ", "Moreover, 49% of the study participants received breast cancer screening, which is slightly higher than the 36.9% breast cancer screening rate of the Japanese population. ", "Unfortunately, only 34.3% of the study participants received cervical cancer screening, which is nearly the same as the 33.7% cervical cancer screening rate of the Japanese population \\[[@CR29]\\]. ", "Interestingly these screening rates are different from those of studies in other countries, which reported a lower adherence to cancer screening by immigrant women than by non-immigrant women \\[[@CR30]--[@CR32]\\].", "\n\nSeveral reasons may underlie such differences. ", "The first reason may be sample bias. ", "Our sample size was small and many of the participants have been in Japan for a considerable time, which implies that they have become familiar with the health service in Japan. ", "Also, the participants belonged to certain communities such as a church or an immigrant group, which provided them support to engage in health promotion activities. ", "The second reason is the low adherence of the Japanese population to cancer screening. ", "Nevertheless, even though the adherence rates to breast and cervical cancer screenings of the female immigrants were similar to or even higher than those of the Japanese population, the rates are still lower than those of other developed countries \\[[@CR33]\\]. ", "The specific reasons for the low rates of adherence to cancer screening in Japan remain to be elucidated. ", "One possible reason is that the Japanese universal health insurance system has made it possible for all residents including immigrants to have access to reasonable health service any time. ", "Interestingly, even though immigrant women achieved the same rate of adherence to cancer screening, our study showed low satisfaction with health check-ups and cancer screenings, which eventually compounded the negative behavior of complacency in pursuing health promotion activities.", "\n\nPerception of NCDs and health promotion behaviors {#Sec34}\n-------------------------------------------------\n\nAs noted earlier, according to the concepts of the heath belief model, behaviors to prevent disease are related to the following 6 constructs: *perceived susceptibility*, *perceived severity*, *perceived benefits*, *perceived barrier*, *cue to action*, and *self-efficacy* \\[[@CR34]\\]. ", "In this current study, immigrant women recognized the danger of NCDs and may have feared that they could have one which indicated their recognition of susceptibility and severity of NCDs, and potentially increased their motivation for health promotion behaviors \\[[@CR35]\\]. ", "However, some immigrant women failed to understand the benefits of health promotion behaviors such as going to health check-ups or attending cancer screenings. ", "Moreover, barriers such as lack of knowledge about the methods and language difficulties while attending the Japanese health service most likely contributed to their lack of developing effective health promotion behaviors.", "\n\nThe barriers described by the immigrant women were similar to the those of previous studies such as language barrier \\[[@CR35], [@CR36]\\], health care system-related barriers \\[[@CR35], [@CR36]\\], and lack of knowledge \\[[@CR37], [@CR36]\\]. ", "Invitations for health check-ups or cancer screenings, and suggestions by family or friends were effective cues for action. ", "Monolingualism in the Japanese health service was not only a barrier for health promotion but also one that potentially damaged the participants' self-efficacy because immigrant women were incapable of speaking-up, asking questions, understanding health information and making decisions about their own health. ", "According to the health belief model, for immigrant women to engage in health promotion behaviors to prevent NCDs (outcome), they must believe that health promotion behaviors will benefit their health (outcome expectation) and also that they are capable of health promotion behaviors (efficacy expectation) \\[[@CR35]\\]. ", "Furthermore, some immigrant women believed that NCDs can be prevented, which indicates \"internal locus of control\". ", "On the other hand, some immigrant women felt that NCDs are unavoidable and out of control, which indicates \"external locus of control\" \\[[@CR38]\\].", "\n\nTo improve the health promotion of immigrant women, we must start by facilitating their understanding of the benefits of health promotion. ", "The benefits of health promotion should be provided within a context that immigrant women could understand. ", "In terms of effective interventions regarding cancer screening promotion for immigrants, previous studies \\[[@CR39]--[@CR41]\\] found that sociocultural-tailored interventions must be developed. ", "Health care providers should recognize that immigrant women may have different beliefs and values \\[[@CR42]\\]. ", "Because of the deleterious effects of language and knowledge barriers, there is an urgent need to develop multi-language health services in Japan. ", "Interpreters with correct technique and in the right environment to facilitate high-quality communication based on a trustful relationship ensuring confidentiality are needed \\[[@CR43]\\]. ", "Furthermore, community participative communication interventions are recommended for vulnerable populations such as immigrants \\[[@CR44]\\].", "\n\nLimitations {#Sec35}\n-----------\n\nThis exploratory study assessed only 35 female immigrant women from one urban and one rural area of Japan. ", "As the number of the participants was small and the majority of women were Filipino, responses were likely influenced by that culture. ", "Although focus groups provide rich data, they can also make it more difficult for some participants to voice dissenting opinions. ", "In this study, every attempt was made to support all viewpoints. ", "Moreover, immigrant women who are from other countries and who do not speak either English or Japanese may have different health promotion needs. ", "Despite the small sample size and the majority of the participants coming from the Philippines, our findings have some transferability given the similarities of findings from other studies, particularly language barriers within the health care system. ", "Furthermore, because little was known about the risk and perception of NCDs of female immigrants in Japan, the explorative study design was chosen. ", "A study using focus group discussion is not intended to generalize \\[[@CR24]\\] .Although the health promotion needs of the participants in this study may not accurately reflect those of all middle-aged immigrant women in Japan, these reported needs provide a good background for identifying further relevant research areas.", "\n\nConclusions {#Sec36}\n===========\n\nThis study clarified that the participating middle-aged female immigrants in Japan have potential risks of NCDs, and that they have recognized the threat of NCDs. ", "The settled immigrant women received health check-ups and cancer screenings with the support of their family, and consequently attained the same level of adherence as that of Japanese women. ", "However, some of the participants failed to understand the benefits of health promotion. ", "Moreover, the culturally insensitive health service system for immigrants in Japan constrained their health promotion behaviors. ", "Despite the need for additional research, it is recommended that sociocultural multilingual-tailored interventions including interpretation services by care providers with cultural sensitivities must be developed and integrated urgently.", "\n\nNCDs\n\n: Non-Communicable Diseases\n\nWHO\n\n: World Health Organization\n\nBMI\n\n: Body Mass Index\n\n**Publisher's Note**\n\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.", "\n\nWe are grateful to all the immigrant women who participated in the research. ", "We appreciate Ms. Erlyn Regondon and Ms. Judy Chonan for kind advices. ", "Dr. Sarah E. Porter, PhD, RN, MPH, MS, provided editorial assistance.", "\n\nYN conceptualized and designed the study and collected data. ", "YN, YS, YI, and YH substantially contributed to data analysis and interpretation. ", "YN and EB drafted the manuscript, analyzed, cross-checked and interpreted all the results, and made substantial revisions to produce the final manuscript. ", "All authors reviewed the final manuscript and approved it for submission.", "\n\nThis study was supported by JSPS KAKENHI Grant Number 16 K15907.", "\n\nThe datasets used and analyzed in the current study are available from the corresponding author upon reasonable request.", "\n\nEthical approval for the study was obtained from the Research Ethics Committee of St. Luke's International University, Japan (Approval number: 16-A034). ", "Research assistants obtained written informed consent from all the participants after they had received oral and written information about the study. ", "The participants were also informed that they could voluntary stop their participation at any time without any questions or repercussions. ", "Verbal consent to audiotape the interviews was obtained. ", "Anonymity of their responses was assured. ", "Each informant confirmed her participation in writing.", "\n\nThe study was conducted based on the ethical principles of avoiding harm, voluntary participation, anonymity, and protection of privacy and personal information. ", "The purpose, procedures, and confidentiality of the study were explained in written format. ", "The participants were informed that nonparticipation would not disadvantage them.", "\n\nNot applicable.", "\n\nThe authors have no financial or non-financial competing interest associated with this study.", "\n" ]

{ "pile_set_name": "PubMed Central" }

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[ "Q:\n\nRails migration not adding id column\n\nI'm on Rails 4.2 and Postgres 9.5\nI was using the following migration and it is not adding the id column automatically:\nclass AddCharacteristics < ActiveRecord::Migration\n def change\n create_table :characteristics do |t|\n t.string :name\n t.timestamps\n end\n end\nend\n\nThe resulting table as defined in db/schema.rb does not have an id column:\ncreate_table \"characteristics\", force: :cascade do |t|\n t.string \"name\"\n t.datetime \"created_at\"\n t.datetime \"updated_at\"\nend\n\nThe id column not being in the schema.rb is a non-issue as pointed out. ", " However I cannot access the characteristic object from the console:\n2.3.0 :003 > Characteristic.last\n Characteristic Load (0.3ms) SELECT \"characteristics\".* ", "FROM \"characteristics\" ORDER BY \"characteristics\".", "\"id\" DESC LIMIT 1\nActiveRecord::StatementInvalid: PG::UndefinedTable: ERROR: relation \"characteristics\" does not exist\nLINE 1: SELECT \"characteristics\".* ", "FROM \"characteristics\" ORDER BY...\n ^\n: SELECT \"characteristics\".* ", "FROM \"characteristics\" ORDER BY \"characteristics\".", "\"id\" DESC LIMIT 1\n\nIn PSQL console this query works fine:\n# SELECT \"characteristics\".* ", "FROM \"characteristics\" ORDER BY \"characteristics\".", "\"id\" DESC LIMIT 1;\n id | name | created_at | updated_at \n----+------+----------------------------+----------------------------\n 1 | test | 2016-01-29 12:58:24.225279 | 2016-01-29 12:58:24.225279\n\nA:\n\nDon't worry, id columns are not shown in schema.rb but they exist in the DB.", "\nFor example: https://github.com/everydayrails/rails-4-1-rspec-3-0/blob/master/db/schema.rb\n\nThe edited question about my console not working was because my console was in test, but my database query was in development\n\nIf you are using RSpec and want to keep the development and test environments in sync, you might want to add ActiveRecord::Migration.maintain_test_schema! ", "in rails_helper.rb. ", "\nReferences:\n\nhttps://relishapp.com/rspec/rspec-rails/docs/upgrade#pending-migration-checks\nhttps://github.com/everydayrails/rails-4-1-rspec-3-0/blob/master/spec/rails_helper.rb#L16\n\n" ]

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[ "Patreon\n\nLivestream\n\nYoutube\n\nTwitter\n\nA more relaxing little style to get back into the swing. ", "Or just to relax with some Applejack.", "Havn't made a chibi or this visual sketchy style in quite a while. ", "I do still enjoy the charm to it, both in the result and making it.", "Hope y'all enjoy!" ]

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[ "Sunday, September 26, 2010\n\nNostalgic Subcompact: Historic turbocharged hot hatches\n\nI grew up with small hatchbacks. ", "We had a 1979 Plymouth Champ, an '82 Dodge Omni, an '86 Dodge Colt (Mitsubishi Mirage), two Mitsubishi Eclipses ('90 and '94), and a '92 Mitsubishi Expo LRV, which I later inherited. ", "However, we never had the turbocharged \"hot hatch\" version of these vehicles, instead the higher-volume, higher-mileage, lower-cost, normally aspirated variants. ", "I always wished my parents opted for the turbo versions of all of these (sans the Expo, which was available with a turbo overseas).", "\n\nFor example, the Plymouth Champ's twin was the Dodge Colt. ", "The Colt GTS was available with a turbocharged 1.6-liter engine with the Twin-Stick (eight-speed) transmission. ", "It put out 102 hp, but weighed about 1,800 lbs.", "\n\nThe Dodge Omni GLH, with its Shelby-tuned turbocharged 2.2-liter engine put down as much as 146 hp from the factory. ", "And yes, GLH stood for \"Goes Like Hell.\" ", "This is probably the most iconic factory-turbocharged hot hatch of the '80s. ", "There's still a rabid fanbase that tunes the crap out of them, making them crazy fast.", "\n\nThe next-generation Dodge Colt and Mitsubishi Mirage also got a turbo variant, as pictured above. ", "The Colt GTS/Mirage Turbo featured classic angular '80s Japanese styling. ", "It had 120 hp, and like the first Colt GTS I mentioned, is also a rarity to find in good condition. ", "I totally want one.", "\n\nI remember sitting in a 1990 Eclipse at the Minneapolis Auto Show in 1989. ", "My dad, looking for a sporty car with four seats, decided this was going to be our family's next car. ", "We got a GS (non-turbo 4G63) not the turbo GST, but it was a real head turner in Minnesota, and we had one of the first ones. ", "The GS made 135 hp, while the FWD and AWD turbo versions put down 180-195 hp. ", "Of course, these are still incredibly popular with tuners and racers.", "\n\nThe next generation Colt/Mirage also got a turbocharged engine: A 1.6-liter DOHC making 145 turbocharged (non-intercooled) horsepower. ", "Being a DSM household, I remember these, and always thought they were awesome. ", "I'd still rock one.", "\n\nAlthough my family didn't have one of these, I always thought they were cool. ", "The Suzuki-built Chevrolet Sprint turbo had a boosted and intercooled three-cylinder engine that made 70 hp and 79 ft./lbs. ", "of torque. ", "Car and Driver recorded 0-60 times of 8.7 seconds and a quarter mile ET of 16.7 at 79 mpg. ", "Weight? ", "Try 1,633 lbs. ", "Another totally cool, totally wonky '80s hot hatch.", "\n\nPerhaps one of the more elusive models was the Isuzu-built 1987-1988 Chevrolet Spectrum Turbo. ", "I believe the 1.5 SOHC engine made around 110 hp-115 hp, but I haven't been able to confirm that. ", "This car was also sold as the Isuzu I-Mark RS from 1988 to 1989, although in '89, the car offered a DOHC, normally aspirated engine instead of the turbo 1.5. ", "There is a decent site for these vehicles at isuzone.org.", "\n\nFUTURE SUBCOMPACT TURBOSWe've heard the rumors and seen the spy photos. ", "Allegedly, there could be a return of the boosted subcompact market. ", "There have been spy shots of an EcoBoost Ford Fiesta, talks of a turbocharged Chevrolet Aveo RS, and who know what else. ", "I'd love to see a resurrection of this genre. ", "Maybe we'll see a turbo Colt again? ", "Maybe a spooling Suzuki Swift?", "\n\n1 comment:\n\nAnonymous\nsaid...\n\nIt's amazing how modern 4 cylinder engines that are naturally aspirated make more power than these '80s and '90s turbo fours. ", "But one thing those '80s Japanese cars had was a certian fun factor because they were generally crude and weren't \"as polished\" as some of today's models. ", "IMO, the car today that seems to capture some of that lost spirit is the Suzuki SX4.", "\n\nSUBCOMPACT CULTURE DECALS\n\nSubcompact Culture is all about small cars. ", "This includes subcompacts, compacts, micro cars, and more. ", "Heck, even some vehicles that are a bit bigger. ", "From news and reviews to cars shows and project vehicles: Subcompact is the small car blog. ", "Thanks for stopping by, and enjoy your visit.", "\n\nAndy LilienthalEditor\n\nMercedes LilienthalManaging Editor\n\nScott AraujoEditorial Staff\n\nSpencer Whitney Editorial Staff\n\nDo you have a story idea for Subcompact Culture? ", "Want your car featured? ", "Interested in advertising? ", "You can contact us by clicking here." ]

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[ "Jeanine Nicarico murder case\n\nThe Jeanine Nicarico murder case was a complex and influential homicide investigation and prosecution in which two men, Rolando Cruz and Anthony Hernandez, were wrongfully convicted of abduction, rape and murder in 1985 in DuPage County, Illinois. ", "They were both sentenced to death. ", "The case was scrutinized during appeals for being weak in evidence.", "\n\nAfter appeals, one man was acquitted in 1995 at his third trial at which a witness recanted previous testimony and new DNA evidence was introduced; the second man, already serving time after being twice convicted, had his charges dismissed by the Illinois State's Attorney. ", "Because of the notoriety of the case and the possibility at one point that two innocent men would have been executed, it was an influence on Governor George H. Ryan's decision in 2000 to impose a death penalty moratorium in the state. ", "\n\nThe state indicted seven law enforcement officials for wrongful prosecution of the Nicarico case, saying they had illegally conspired against Cruz in an effort to convict him. ", "The three prosecutors and four sheriff's deputies were ultimately acquitted in 1999.", "\n\nIn 2005, Brian Dugan was indicted on charges for the crimes against Nicarico. ", "He entered a plea of guilty in September 2009 to the murder of Nicarico after having previously confessed to the crime. ", "He was already serving a life sentence on two other, unrelated rape and murder charges, one of a 27-year-old woman and one of a seven-year-old girl. (", "Another girl had escaped at the time.) ", "On November 11, 2009, after deliberating about 10 hours over two days, a DuPage County jury sentenced Brian Dugan to death for the rape and murder of Jeanine Nicarico 26 years earlier. ", "Dugan's sentence was commuted to life in prison after Illinois passed a law in 2011 abolishing the death penalty.", "\n\nAbduction, rape and murder\nJeanine Nicarico was born July 7, 1972, in Naperville, Illinois, to Tom and Pat Nicarico. ", "She had two sisters. ", "\n\nOn February 25, 1983, before the family returned home that day, Nicarico was abducted from the house after an intruder entered and burgled it. ", "She is believed to have been raped and murdered the same day.", "\n\nHer body was found two days later along the Illinois Prairie Path near Eola Road. ", "She was determined to have been raped and sodomized before she was killed.", "\n\nProsecution of Cruz, Hernandez, and Buckley\n\nRolando Cruz, Alejandro Hernandez and Stephen Buckley were indicted in March 1984. ", "A joint trial was held; in February 1985, Cruz and Hernandez were convicted, but the jury deadlocked on Buckley. ", "The next month, both Cruz and Hernandez were sentenced to death.", "\n\nIn November 1985, Brian Dugan, who was already in jail and being tried for the rape and murder of a seven-year-old girl and of a 27-year-old woman in separate events, confessed to the crimes against Nicarico through his attorney. ", "Dugan plea-bargained his charges in the two murders for which he had been apprehended to life imprisonment.", "\n\nIn 1987, the charges against Buckley were dismissed by a judge.", "\n\nOn January 19, 1988, the Illinois Supreme Court struck down the convictions of Cruz and Hernandez because the two were not tried separately. ", "Both were retried despite public pressure on the DuPage County State's Attorney's office to investigated the Dugan confession. ", "Cruz was convicted in his second trial in February 1990. ", "The second trial of Hernandez ended in a hung jury in May 1990. ", "He was convicted at his third trial, and was sentenced to 80 years in prison on May 17, 1991.", "\n\nMeanwhile, Cruz had appealed. ", "In December 1992, his second conviction was upheld by the Illinois Supreme Court, but in May 1993 the court agreed to rehear the case. ", "On July 14, 1994, Cruz was granted a third trial.", "\n\nThe Illinois Appellate Court overturned the second conviction of Hernandez on January 30, 1995.", "\n\nDuring Cruz's third trial, a sheriff's lieutenant reversed his testimony, and introduced new information, including that new testing of the DNA of both Cruz and Hernandez had excluded each as matching that in semen evidence at the crime scene. ", "Cruz was acquitted in November 1995. ", "A state investigator was appointed to review the recanted testimony. ", "In December 1995, the State's Attorney dismissed all charges against Hernandez and he was released from jail.", "\n\nAftermath\nIn December 1996 the state indicted seven DuPage County law enforcement officials: three prosecutors and four sheriff's deputies, on charges of \"lying and fabricating evidence against Cruz\"; formally they were charged with conspiracy to convict Cruz despite being aware of exculpatory evidence. ", "After numerous court proceedings, by June 1999 all seven had been acquitted of the charges.", "\n\nCruz, Hernandez and Buckley filed a civil suit for wrongful prosecution against DuPage County. ", "They were awarded a $3.5 million civil settlement on September 26, 2000.", "\n\nIn 2002, Governor George Ryan granted Cruz a pardon. ", "Based in part on the notoriety of this case and Cruz's acquittal, in 2003 Ryan imposed a moratorium on executions in the state, and commuted the sentences to life of 167 persons on death row.", "\n\nIt was not until November 2005 that Dugan was indicted for the Nicarico abduction, rape, and nmurder. ", "Initially he refused to plead in court, and the judge entered a \"Not guilty\" plea for him in 2006 when the trial opened. ", "On July 22, 2009, Dugan pleaded guilty to rape and murder of Nicarico. ", "On November 11, 2009, he was sentenced to death by vote of the jury. ", "On December 16, 2009 the judge set the execution date for February 25, 2010. ", "After the death penalty was abolished in Illinois in 2011 by passage of a new law, Dugan's sentence was commuted to life in prison without possibility of parole (LWOP).", "\n\nSee also\n Kidnapped American children\n Murdered American children\n\nReferences\n\n\t\n\nCategory:1980s missing person cases\nCategory:1983 murders in the United States\nCategory:DuPage County, Illinois\nCategory:Missing person cases in Illinois\nCategory:Murdered American children\nCategory:Kidnapped American children\nCategory:People murdered in Illinois\nCategory:Murder in Illinois\nCategory:1983 in Illinois\nCategory:Rapes in the United States\nCategory:Crimes in Illinois\nCategory:Victims of serial killers\nCategory:Wrongful convictions" ]

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[ "Epithelioid cell Spitz nevus of the eyelid.", "\nTo report a 20-month-old child with a rapidly growing dome-shaped red nodule on the left lower eyelid. ", "The lesion was diagnosed clinically as an hemangioma, but microscopy disclosed an epithelioid Spitz nevus. ", "Case report. ", "Histopathologic examination of the excised lesion disclosed a Spitz nevus (benign juvenile melanoma) of a chiefly epithelioid cell type. ", "The differential diagnosis of eyelid skin nodules in children should include Spitz nevus. ", "This uncommon nevus has many cytologic features in common with nodular malignant melanoma. ", "Histologically, it may be difficult to distinguish between nodular malignant melanoma and Spitz nevus." ]

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[ "Media and internet company Naspers broke through R2,000 a share in morning trade on Monday (13 April), boosted by continued growth in Tencent.", "\n\nBy 10h00 am shares in Naspers traded R75, or nearly 4% higher, at R2020,00, giving the group a market cap exceeding R850 billion.", "\n\nNaspers sits behind only British American Tovbacco, and SAB Miller as the largest companies on the JSE. ", "Both BAT (R1.2 trillion) and SAB Miller’s (R1.04 trillion) market cap exceed a trillion rand.", "\n\nNaspers’ growth has been closely aligned to Tencent, a Chinese media and entertainment company in which it owns 34%.", "\n\nTencent’s share price has outgrown it’s rivals Alibaba and search portal Baidu in China in the first quarter. ", "The group reported better than anticipated results in 2014 and has seen its stock jump more than 30% in 2015, to $21.05 on the Hong Kong Stock Exchange.", "\n\nIn November, Naspers reported a 20% rise in profit for the six months ended September 2014, to R34.4 billion. ", "The group noted that 72% of it’s revenues were earned offshore.", "\n\nNaspers’ local assets include MultiChoice, SuperSport, DStv, OLX, and Media24, while globally, its assets include Russian website Mail.", "Ru, and ndia based e-commerce company Flipkart.", "\n\nMore on Naspers\n\nNaspers revenue soars on Tencent\n\nNaspers wants R3.4 billion for Swiss online retailer\n\nANC doesn’t like free press: Naspers" ]

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[ "La tensión existente en el seno del sindicalismo argentino ya resulta imposible de disimular. ", "La celebración de diferentes actos y las posturas enfrentadas de diversos gremios respecto al apoyo o al rechazo del gobierno nacional alimentaron un clima cada vez más tenso. ", "De tal manera, posiblemente el mejor ejemplo de la confrontación se vio en las inmediaciones del estadio de Obras Sanitarias, minutos antes del acto celebrado por el triunvirato de la CGT: un mensaje con críticas y amenazas hacia Gerónimo \"Momo\" Venegas.", "\n\nEn las calles aledañas al estadio aparecieron decenas de panfletos con el mensaje: \"Momo Venegas traidor. ", "Te va a pasar lo mismo que a Vandor\". ", "El folleto estuvo firmado por la \"Juventud Sindical\".", "\n\nEl mensaje tuvo como único destinatario al actual líder de la UATRE y referente de las 62 organizaciones peronistas aliadas al Gobierno de Cambiemos. ", "Incluso, apareció a la luz pocas horas antes de que el propio Venegas protagonizara un acto por el Día del Trabajador junto al presidente Mauricio Macri en el estadio cubierto de Ferro, en Caballito.", "\n\nLa amenaza de la \"Juventud Sindical\" hace referencia nada menos que a Augusto Timoteo Vandor, apodado \"El Lobo\", quien durante la década del 60 estuvo al frente de la Unión Obrera Metalúrgica (UOM), mantuvo una identidad del sindicalismo participacionista, una confusa relación con la dictadura de Juan Carlos Onganía y fue uno de los principales impulsores del denominado \"Peronismo sin Perón\".", "\n\nAugusto Timoteo “Lobo” Vandor murió asesinado en junio de 1969\n\nEl \"Lobo\" Vandor murió asesinado el 30 de junio de 1969 dentro de su oficina, en lo que se denominó \"Operativo Judas\". ", "La agrupación guerrillera Ejército Nacional Revolucionario se adjudicaría luego la autoría del ataque.", "\n\n\"Siendo las 11.36 hs. ", "del 30 de junio de 1969, el Comando 'Héroe de la Resistencia Domingo Blajaquis' del Ejército Nacional Revolucionario que ocupó el local de la UOM, sito en la calle La Rioja 1945, cumpliendo el 'Operativo Judas', procedió al ajusticiamiento del traidor Augusto Timoteo Vandor, complementando la acción con la voladura parcial del edificio para no afectar fincas vecinas\", rezaba el comunicado del ENR.", "\n\nLEA MÁS:\n\nGerónimo \"Momo\" Venegas explicó por qué Macri eligió su acto para celebrar el Día del Trabajador" ]

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[ "CAAT sites are required for the activation of the H. pulcherrimus Ars gene by Otx.", "\nA product of sea urchin homologues of the Drosophila orthodenticle gene, HpOtxL has been implicated as a transcription activator of the aboral ectoderm-specific arylsulfatase (Ars) gene during early development of the sea urchin embryo. ", "Using an in vivo transactivation system, we present evidence that HpOtxL activates the target gene by interacting with co-factors. ", "Otx binding sites alone have little effect on the activity of an Ars promoter, but when both Otx binding sites and CAAT sequences are present in the enhancer region of Ars, the fragment shows a high enhancer activity. ", "A gel mobility shift assay reveals that a nuclear protein binds to the CAAT sequences present near the Otx binding sites in the enhancer region of Ars. ", "The activation domain of HpOtxL resides in the C terminal region between amino acids 218 and 238. ", "The N-terminal region is responsible for the enhancement of transactivation of the Ars promoter, although the region itself does not function as an activation domain. ", "HpOtxE, which possesses an N-terminal region different from HpOtxL, does not activate the Ars promoter even in the presence of CAAT sequences. ", "Together with previous findings, our results suggest that Otx regulates different genes by interacting with different co-factors in sea urchin development." ]

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[ "Construction and optimization of a Pseudomonas putida whole-cell bioreporter for detection of bioavailable copper.", "\nA Pseudomonas putida whole-cell bioreporter for detecting bioavailable copper was constructed by inserting a CueR-regulated sensor element upstream of a promoterless green fluorescent protein (GFP) reporter gene. ", "The constructed bioreporter cells expressed GFP only in response to Cu and Ag when cultivated in different metal salt solutions. ", "M9 supplemented medium provided higher sensitivity compared with LB medium. ", "The optimal test condition was cell suspension with an OD600 of 0.4-0.5 incubated at 30 °C. ", "The detection range of Cu is 1-70 mg/l under optimal test condition in M9 supplemented medium." ]

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[ "Export/Download Printable Text (.txt) CSV Multiverse id (.txt) Markdown/Reddit MTGO (.dek) MTG Salvation\n\nMTG Arena\n\nCopy to clipboard\n\n1 Algae Gharial (MM2) 137 1 Archangel (MYS1) 5 1 Armed // Dangerous (DGM) 122 1 Asceticism (SOM) 110 1 Basilisk Collar (2XM) 233 1 Behemoth Sledge (C17) 162 1 Borderland Ranger (EO2) 31 1 Boros Garrison (C20) 260 1 Boros Guildgate (C19) 234 1 Caustic Wasps (MMQ) 1 Command Tower (C20) 264 1 Congregate (A25) 8 1 Copperline Gorge (SOM) 14 1 Crocanura (GTC) 1 Cultivate (M21) 177 1 Curse of Predation (IMA) 159 1 Curse of the Forsaken (CM1) 8 1 Deadly Recluse (DDL) 45 1 Death-Hood Cobra (2XM) 163 1 Domri Rade (MM3) 161 1 Dragonlair Spider (CN2) 201 1 Druidic Satchel (C13) 1 Drumhunter (C13) 142 1 Engulfing Slagwurm (SOM) 1 Eternal Dragon (C20) 88 1 Flameblast Dragon (C18) 123 8 Forest (2XM) 381 1 Forgotten Ancient (E01) 65 1 Gaea's Revenge (ORI) 177 1 Giant Adephage (C19) 169 1 Gruul Guildgate (RNA) 249 1 Hoard-Smelter Dragon (C14) 178 1 Huntmaster of the Fells (DKA) 11 1 Hymn of Rebirth (ICE) 1 Inferno Titan (E01) 53 1 Jungle Shrine (C19) 255 1 Kabira Vindicator (DDG) 4 1 Kalonian Behemoth (M10) 1 Koth of the Hammer (DDI) 44 1 Llanowar Reborn (C15) 293 1 Marshal's Anthem (C15) 74 1 Molimo, Maro-Sorcerer (ARC) 74 1 Mosswort Bridge (C20) 291 7 Mountain (2XM) 379 1 Mystic Barrier (C13) 18 1 Naya Charm (MYS1) 195 1 New Benalia (MYS1) 270 1 Odric, Master Tactician (C20) 96 1 Opal Palace (C17) 266 1 Oracle of Mul Daya (JMP) 415 1 Overrun (PCA) 72 1 Overwhelming Stampede (C19) 175 5 Plains (2XM) 373 1 Platinum Angel (CN2) 46 1 Protean Hydra (M11) 1 Rampaging Baloths (C19) 176 1 Rockslide Elemental (HOP) 1 Rubblehulk (C18) 189 1 Rupture Spire (JMP) 495 1 Selesnya Guildgate (GRN) 255 1 Selesnya Sanctuary (C20) 308 1 Shinen of Life's Roar (ARC) 1 Skarrg Goliath (GTC) 133 1 Skarrg Guildmage (GTC) 1 Sol Ring (C20) 252 1 Spawning Grounds (MYS1) 163 1 Stern Judge (TOR) 1 Swiftfoot Boots (C20) 254 1 Sword of Body and Mind (2XM) 295 1 Sword of Feast and Famine (2XM) 296 1 Taurean Mauler (C16) 135 1 Teetering Peaks (PFL) 30 1 Temple of the False God (C20) 319 1 Tempt with Discovery (C19) 183 1 Terra Ravager (C13) 126 1 Thespian's Stage (2XM) 327 1 Tranquil Thicket (MH1) 248 1 Vengevine (2XM) 185 1 Vivid Crag (C17) 289 1 Warstorm Surge (C19) 155 1 Where Ancients Tread (C13) 130 1 Whispersilk Cloak (C16) 280 1 Zhur-Taa Druid (MYS1) 101\n\nCopied to clipboard. ", "You can now import it in the MTG Arena client.", "\n\nIn TappedOut's comments/forums\n\nIn TappedOut's comments/forums with pie-chart\n\nOn your blog\n\nThis will require TappedOut.js included in your blog." ]

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[ "IMSc/2014/12/14\n\n[**Singularity Resolution + Unitary** ]{}\\\n\n[**Evolution + Horizon = Firewall ?**]{}\\", "\n\n[S. Kalyana Rama]{}\n\nInstitute of Mathematical Sciences, C. I. T. Campus,\n\nTharamani, CHENNAI 600 113, India.", "\n\nemail: krama@imsc.res.in\\\n\nABSTRACT\n\n> We assume that a quantum gravity theory exists where evolutions are unitary, no information is lost, singularities are resolved, and horizons form. ", "Thus a massive star will collapse to a black hole having a horizon and an interior singularity–resolved region. ", "Based on unitarity and on a postulated relation, we obtain an evolution equation for the size of this region. ", "As the black hole evolves by evaporation and accretions, this region grows, meets the horizon, and becomes accessible to an outside observer. ", "The required time is typically of the order of black hole evaporation time. ", "If the boundary of the singularity–resolved region can be considered as the firewall of Almheiri et al then this marks the appearance of a firewall.", "\n\n[**(1)**]{} Consider the gravitational collapse of a very massive star. ", "Such a collapse is believed to result in the formation of a black hole, containing a singularity at the center and a horizon surrounding it, with the constituents of the star taken to have disappeared down the singularity, and with the spacetime outside the horizon being given, for example, by the Schwarzschild solution in the static spherically symmetric case. ", "The black hole horizon has Bekenstein–Hawking entropy and emits Hawking radiation until the horizon reaches Planckian size. ", "As Hawking has argued, such an evolution is non unitary and leads to information loss.", "\n\nIn any quantum gravity theory, the evolutions are expected to be unitary, no information is expected to be lost, and the singularities are expected to be resolved. ", "However, whether horizons are present or absent is still debatable. ", "For a sample of works containing similar ideas regarding singularity and/or unitarity and/or horizon, see [@morgan] – [@gp] where horizons are assumed to be present, [@fuzz] for Mathur’s fuzzball proposal which postulates that horizons are absent, [@page] where high entropic objects are considered, and [@k12] where it is argued that horizons are absent.", "\n\nIn this paper, we assume that a quantum gravity theory exists where evolutions are unitary, no information is lost, and singularities are resolved. ", "We further assume that horizons are present, atleast initially, having the same properties as found by standard semi classical analysis. ", "Thus, in such a theory, the gravitational collapse of a very massive star will result in the formation of a black hole which now contains a singularity–resolved region at the center, and a horizon surrounding it which has an entropy given by Bekenstein–Hawking formula and emits Hawking radiation. ", "The spacetime outside the horizon will be given by standard solutions in general relativity. ", "In the following, for the sake of brevity, we refer to the singularity–resolved region at the center as singularity cloud.", "\n\nWe consider a spherically symmetric black hole, and analyse the consequences of the singularity resolutions and unitary evolutions on the singularity cloud and on the horizon as the black hole evolves further by evaporation and any possible accretions. ", "Postulating a simple relation between the size of the singularity cloud and its contents, and based on the unitarity of the evolution, we obtain an equation for the size and analyse its consequences.", "\n\nWe find that, much before its size becomes Planckian, horizon will meet the singularity cloud. ", "The singularity cloud then becomes accessible to an outside observer, thus the horizon ceases to exist. ", "The boundary of this singularity cloud can perhaps be considered as the firewall of Almheiri et al [@amps]. ", "If so then access to the singularity cloud marks the appearance of firewall. ", "The time of this appearance depends on the assumptions made about the size of the singularity cloud, and also on any accretions that may take place in the intervening period, but it is typically of the order of black hole evaporation time.", "\n\nWe conclude with a summary and a few questions for further studies.", "\n\n[**(2)**]{} Consider a spherically symmetric black hole formed in a stellar collapse in $d + 1$ dimensional spacetime. ", "Let $R_h, S, M$, and $T$ denote its horizon radius, entropy, mass, and Hawking temperature respectively. ", "In Planckian units, $S, M$, and $T$ may be written in terms of $R_h$ as $$\\label{smt}\nS = C_S \\; R_h^{d - 1} \\; \\; \\; , \\; \\; \\; \\; \nM = C_M \\; R_h^{d - 2} \\; \\; \\; , \\; \\; \\; \\; \nT = C_T \\; R_h^{- 1}$$ where $C_S$ and $C_M$ are positive numerical constants and $C_T\n= \\frac {d - 2} {d - 1} \\; \\frac{C_M} {C_S} \\;$. Let the initial values of $(R_h, S, M)$ be given by $$\\label{ic0}\n(R_h, S, M) \\vert_{t = 0} \\; = \\; (R_{h 0}, S_0, M_0) \\; \\gg 1$$ where $(R_{h 0}, S_0, M_0)$ obey the relations given in equation (\\[smt\\]) and $t = 0$ is taken as the black hole formation time, namely as the time when the transients of the collapse have died down and the black hole has begun to emit Hawking radiation.", "\n\nThe black hole evaporates by emitting Hawking radiation, therefore its mass will decrease. ", "Also, the black hole may accrete more matter in which case its mass will increase. ", "Thus, $(R_h, S, M, T)$ are all functions of time. ", "The rate of mass loss due to evaporation $\\propto \\; (Area) \\; (temperature)^{d +\n1}$ and, hence, one obtains $\\dot{M}_{evap} = - \\; \\frac\n{C_{evap}} {R_h^2} \\;$ where $C_{evap}$ is a positive numerical constant and an overdot denotes time derivative. ", "Similarly, the rate of mass gain due to accretion may be written as $\\dot{M}_{accr} = g(t) \\; \\ge 0 \\;$. The total rate of mass change is, therefore, given by $$\\label{mdot}\n\\dot{M} \\; = \\; \\dot{M}_{evap} + \\dot{M}_{accr} \\; = \\; \n- \\; \\frac{C_{evap}}{R_h^2} \\; + \\; g(t) \\; \\; .$$ The corresponding changes in the entropy $S$ are obtained by $\\delta S = \\frac {\\delta M} {T} \\;$. The total rate of entropy change is, therefore, given by $$\\label{sdot}\n\\dot{S} \\; = \\; \\dot{S}_{evap} + \\dot{S}_{accr} \\; = \\;\n\\frac{R_h}{C_T} \\; \\left( - \\; \\frac{C_{evap}}{R_h^2} \\;\n+ \\; g(t) \\right) \\; \\; .$$ Equations (\\[smt\\]) and (\\[mdot\\]), or (\\[sdot\\]), lead to an equation for $R_h(t)$ given by $$\\label{rhdot}\n\\dot{R}_h \\; = \\; \\frac{R_h^{3 - d}}{(d - 2) \\; C_M} \\; \n\\left( - \\; \\frac{C_{evap}}{R_h^2} \\; + \\; g(t) \\right) \\; \\; ,$$ which is to be solved with an initial condition $R_h(0) = R_{h\n0} \\;$. Equations (\\[smt\\]) then give the entropy $S(t)$ and the mass $M(t) \\;$.\n\n[**(3)**]{} Consider the interior of the black hole. ", "In the standard semiclassical analysis, there is a singularity of Planckian size at the center and the constituents of the collapsing star are taken to have disappeared down the singularity. ", "Now, we are assuming that a quantum gravity theory exists where the singularities are resolved, evolutions are unitary, and no information is lost. ", "Hence, in the interior of the black hole now, there should be no singularities. ", "Furthermore, whatever is in the interior must be capable of encoding the information about the black hole formation and its further evolution.", "\n\nLet the singularity be resolved, and let the resulting singularity–resolved region be of size $L$ and contain $N$ number of ‘quantum gravity units’ which can encode information of order one bit each. ", "For the sake of brevity, we refer to the singularity–resolved region as singularity cloud, and ‘quantum gravity units’ as simply units. ", "The size $L$ and the number of units $N$ will depend on time $t$ as the black hole evolves further by evaporation and accretions.", "\n\nIt is physically reasonable to expect, and hence we assume, that the initial number of units $N_0$ equals the initial entropy $S_0$ of the black hole formed, so that information about the collapse of the star and the formation of black hole can all be encoded in the singularity cloud. ", "Also, in a theory where the singularities are resolved, the size $L$ should depend on $N \\;$ and be parametrically much larger than Planck length. ", "Otherwise there will be ‘remnant problems’. ", "Thus we write $L \\propto\nN^\\sigma$ and, most conservatively, require only that $\\sigma >\n0 \\;$. Note that: [**(i)**]{} Semiclassically $L = {\\cal O} (1)$, equivalently $\\sigma = 0 \\;$. [**(ii)**]{} The value $\\sigma =\n\\frac{1}{d}$ is natural since it implies a density of order one unit per unit Planck volume. [**(", "iii)**]{} $\\sigma > \\frac{1}{d -\n1}$ implies that the initial size of the singularity cloud $L_0$ is larger than the initial horizon size $R_{h 0}$ which means that there is no horizon. ", "Hence $\\sigma \\le \\frac{1}{d - 1} \\;$ since horizon is assumed to be present atleast initially. ", "Thus, similarly as in equation (\\[smt\\]), we write the relation between the size $L$ of the singularity cloud and the number of units $N$ contained in it as\n\n$$\\label{l}\nN = C_N \\; L^\\alpha \\; \\; \\; , \\; \\; \\; \\;\nd - 1 \\le \\alpha < \\infty$$\n\nwhere $C_N$ is a positive numerical constant and $\\alpha = \\frac\n{1} {\\sigma} \\;$. The ratio $\\frac{L}{R_h}$ is given by $$\\label{lr}\n\\left( \\frac{L}{R_h} \\right)^\\alpha \\; = \\; \n\\frac {C_s^{\\frac{\\alpha}{d - 1}}} {C_N} \\; \\left(\n\\frac {N} {S^{\\frac{\\alpha}{d - 1}}} \\; \\right) \\; \\; .$$ The assumption that horizon is present initially implies that $L_0 < R_{h 0} \\;$. Since $N_0 = S_0 \\gg 1 \\;$, it then follows that $\\alpha \\ge d - 1$ and $C_N > C_S$ if $\\alpha = d - 1 \\;$.\n\nNow consider the evolution of the number $N$ as the black hole evaporates and accretes. ", "The number $N$ encodes the information about evolution. ", "Hence, the rate of change of $N$ due to accretion should be given by $$\\dot{N}_{accr} = \\dot{S}_{accr} =\n\\frac {\\dot{M}_{accr}} {T} \\; \\ge 0$$ so that accretion information can be encoded in the singularity cloud.", "\n\nConsider evaporation, due to which the entropy and mass of the black hole decrease. ", "If $\\dot{N}_{evap} = \\dot{S}_{evap}$ then $\\dot{N}_{evap} < 0$ and, eventually, these decreasing number of units will not be able to encode the information about the formation and the evolution of the black hole. ", "However, if $\\delta N = \\vert \\delta S \\vert$ in any process where the entropy $S$ of the black hole is changed then $\\delta N > 0$ and the information about such a change can continue to be encoded in the singularity cloud by these increasing number of units. ", "We assume that this is the case. ", "Then the rate of change of $N$ due to evaporation should be given by\n\n$$\\dot{N}_{evap} = \\vert \\dot{S}_{evap} \\vert \\; > 0 \\; \\; ,$$ which may also be thought of as the ingoing Hawking photons giving rise to new quantum gravity degrees of freedom upon falling into the singularity cloud. ", "Thus, the total rate of change of the number of units $N$ in the singularity cloud is given by\n\n$$\\label{ndot}\n\\dot{N} \\; = \\; \\dot{N}_{evap} + \\dot{N}_{accr} \\; = \\;\n\\frac{R_h}{C_T} \\; \\left( \\frac{C_{evap}}{R_h^2} \\;\n+ \\; g(t) \\right) \\; > 0 \\; \\; .$$\n\nThe corresponding change in the size $L$ then follows from equation (\\[l\\]).", "\n\nThus, for given initial values and a given accretion rate, one solves equation (\\[rhdot\\]) for $R_h(t) \\;$. One then solves equation (\\[ndot\\]) for $N(t) \\;$. Equations (\\[smt\\]) and (\\[l\\]) then give $S$, $\\; M$, and $L$ as functions of $t\n\\;$. Note that $N$ and $L$ increase with respect to $t \\;$, and that $R_h$ decreases if the accretion rate is sufficiently small. ", "Thus, once the accretion rate has become sufficiently small or vanished for good, there will eventually be a time $t =\nt_{fw}$ when $L = R_h \\;$. This is when the singularity cloud meets horizon and becomes accessible to an outside observer. ", "If the boundary of the singularity cloud can be taken as the firewall of Almheiri et al then $t_{fw}$ is the time when the firewall appears.", "\n\n[**(4)**]{} Consider equation (\\[rhdot\\]) for $R_h(t) \\;$. It is a non autonomous, first order, ordinary differential equation. ", "For a given arbitrary function $g(t)$, it is reasonably easy to understand the behaviour of the solution but, in general, it is not possible to obtain a closed form expression for $R_h(t)\n\\;$. Hence, we first present a few illustrative examples. ", "In the following, let $t_{fw}$ be the time when the singularity cloud meets the horizon. ", "Then $$\\label{lrsfw}\nL_{fw} = R_{h \\; fw} = \\left( \\frac {S_{fw}} {C_s}\n\\right)^{\\frac{1}{d - 1}}$$ where the subscripts $fw$ on the variables denote their values at $t = t_{fw} \\;$.\n\n[**Example (a) :**]{} Let there be no accretion, [*i.e.*]{} $g(t) = 0 \\;$. The solutions are then given by $N = 2 S_0 - S$ and $$\\label{aexample}\nR_h = R_{h 0} \\; \\left( 1 - \\frac{t}{t_e} \\right)^{\\frac{1}{d}}\n\\; \\; , \\; \\; \\; \\;\nL = L_0 \\; \\left( 2 - \\left( 1 - \\frac{t}{t_e}\n\\right)^{\\frac{d - 1}{d}} \\right)^{\\frac{1}{\\alpha}}$$ where the evaporation time $t_e$ is given by $$\\label{tevap}\nt_e = \\frac {d - 2} {d} \\left( \\frac{C_M} {C_{evap}} \\right)\nR_{h 0}^d$$ and $S$ and $M$ can be obtained from equations (\\[smt\\]). ", "Clearly $R_h$ decreases and $L$ increases, becoming equal at $t\n= t_{fw} \\;$. Then, using $N = 2 S_0 - S$, it can be seen from equation (\\[lr\\]) that if $\\alpha = d - 1$ then $$\\label{astfw}\nS_{fw} = \\frac {2 \\; C_S} {C_S + C_N} \\; S_0 \n\\; \\; , \\; \\; \\; \\; \\; \\; \nt_{fw} = \\left(1 - \\frac {2 \\; C_S} {C_S + C_N}\n\\right)^{\\frac {d} {d - 1}} \\; t_e \\; \\;$$ whereas if $\\alpha > d - 1$ then $S_{fw} \\propto S_0^{\\frac {d -\n1} {\\alpha}} \\ll S_0$ and $t_{fw} \\sim t_e \\;$. Also, $$L_{fw} = R_{h \\; fw} = \\left( \\frac {S_{fw}} {C_s}\n\\right)^{\\frac{1}{d - 1}} \\; \\sim \\; \nR_{h 0}^{\\frac {d - 1} {\\alpha}} \\; \\gg 1 \\; \\; .$$\n\n[**Example (b) :**]{} Let the accretion equal the initial evaporation, [*i.e.*]{} $g(t) = \\frac {C_{evap}} {R_{h 0}^2} \\;$. The solutions are then given by $(R_h, S, M) = (R_{h 0}, S_0, M_0)$ and $$\\label{bexample}\nN \\; = \\; S_0 \\; \\left( 1 + \\frac{2 (d - 1)}{d} \\frac{t}{t_e}\n\\right)\n\\; \\; , \\; \\; \\; \\; \nL \\; = \\; L_0 \\; \\left( 1 + \\frac{2 (d - 1)}{d} \\frac{t}{t_e}\n\\right)^{\\frac{1}{\\alpha}}$$ where $t_e$ is defined in equation (\\[tevap\\]). ", "Clearly $L$ increases and becomes equal to $R_h$ at $t = t_{fw} \\;$. Then $L_{fw} = R_{h 0}$ and $t_{fw}$ is given by $$t_{fw} \\; = \\; \\frac {d} {2 (d - 1)} \\; \\left( \\frac {C_N} {C_S}\n\\; R_{h 0}^{\\alpha - (d - 1)} - 1 \\right) \\; {t_e} \n\\; \\; \\sim R_{h 0}^{\\alpha - (d - 1)} \\; t_e \\; \\; .$$ Thus, $t_{fw} \\sim t_e$ if $\\alpha = d - 1$ and $t_{fw}$ is parametrically much larger than $t_e$ if $\\alpha > d - 1 \\;$.\n\n[**Example (c) :**]{} Let there be no evaporation, [*i.e.*]{} $C_{evap} = 0 \\;$. The solutions are then given by $N = S = C_S \\; R_h^{d - 1}$ and $$\\label{cexample}\nR_h = \\left( \\frac {M} {C_M} \\right)^{\\frac{1}{d - 2}}\n\\; \\; , \\; \\; \\; \\; \nM = M_0 + \\int_0^t d t \\; g(t)$$ where $g(t) \\ge 0 \\;$. Hence, $R_h$, $\\; S$, and $M$ are non decreasing. ", "Since $N = S$, we also have $$\\left( \\frac{L}{R_h} \\right)^\\alpha \\; = \\; \n\\left( \\frac{L_0}{R_{h 0}} \\right)^\\alpha \\; \n\\left( \\frac{R_h} {R_{h 0}} \\right)^{d - 1 - \\alpha} \\; \\; .$$ Since $L_0 < R_{h 0}$ by assumption, $R_h \\ge R_{h 0}$, and $d -\n1 \\le \\alpha \\;$, it follows that $L$ remains less than $R_h \\;$ and, hence, the singularity cloud does not meet the horizon.", "\n\n[**General Case :**]{} Consider the general case where $g(t)$ is a non negative arbitrary function. ", "It can be seen from equation (\\[rhdot\\]) that if $g(t)$ is less than the evaporation term $\\frac\n{C_{evap}} {R_h^2}$ then $\\dot{R}_h$ is negative, $R_h$ decreases, $\\frac{C_{evap}} {R_h^2}$ increases, and $g(t)$ becomes even less important. ", "The solution in such a case is of the type given in example [**(a)**]{}: $R_h$ decreases, $L$ increases, and the singularity cloud and the horizon meet at a time $t_{fw}$ which is of the order of evaporation time given in equation (\\[tevap\\]). ", "Similarly, if $g(t)$ is greater than the evaporation term $\\frac{C_{evap}} {R_h^2}$ then $\\dot{R}_h$ is positive, $R_h$ increases, $\\frac{C_{evap}} {R_h^2}$ decreases, and $g(t)$ becomes even more important. ", "The solution in such a case is of the type given in example [**(c)**]{}: Both $R_h$ and $L$ increase, but the singularity cloud and the horizon move apart from each other and do not meet.", "\n\nNote also that for a given value of $R_h$, the values of $S$ and $M$ are uniquely given by equation (\\[smt\\]). ", "However, unless the accretion is always absent as in example [**(a)**]{}, the values of $L$ and $N$ are not unique. ", "This non uniqueness of $L$ and $N$ for a given value $R_h$ can be seen in example [**(b)**]{}. ", "In general, $L$ and $N$ depend on the details of the black hole evolution from the time of its formation.", "\n\nPutting together these properties, one can see the following features of the solutions of equations (\\[rhdot\\]), (\\[l\\]), and (\\[ndot\\]). ", "They can also be proved more rigorously.", "\n\n- The singularity cloud and the horizon do not meet during the accretion phase.", "\n\n- They can meet only during the evaporation phase.", "\n\n- The time required for this meeting is [*generically*]{} of the order of evaporation time given in equation (\\[tevap\\]), but now with $R_{h 0}^d$ replaced by $R_{h \\; max}^d$ where $R_{h \\;\n max}$ is the maximum horizon size reached due to various accretions. ", "However, as can be seen in example [**(b)**]{}, if the model parameter $\\alpha > d - 1$ then it is possible to increase this time arbitrarily by fine tuning the accretion rate.", "\n\n- The black hole quantities, such as its entropy $S$ and mass $M$, are uniquely fixed by its horizon radius $R_h \\;$. However, the singularity cloud quantities, such as its size $L$ and the number of units $N$, are not uniquely fixed by $R_h \\;$ but depend on the details of the black hole evolution.", "\n\n In particular, knowing $R_h$ at a given time $t$ alone is not sufficient to predict when in future the singularity cloud will meet the horizon and become accessible to an outside observer.", "\n\nThe unpredictability of $L$ and $N$, and hence of the time $t_{fw}$ when the singularity cloud meets the horizon, is due to the presence of the horizon and the accretions onto the black hole. ", "This has been referred to as ‘loss of predictability’ in our earlier works [@k12] and has been used to argue that horizons should be absent.", "\n\n[**(5)**]{} In summary: We have assumed that a quantum gravity theory exists where evolutions are unitary, no information is lost, and singularities are resolved. ", "In a gravitational collapse of a very massive star in such a theory, we further assumed that horizons are present, atleast initially, having the same semi classical properties. ", "A black hole in such a theory has a singularity–resolved region at the center, referred to as singularity cloud, which is of size $L$ and which contains $N$ number of ‘quantum gravity units’ so that information about the formation and further evolution of the black hole can be encoded.", "\n\nWe considered a spherically symmetric black hole. ", "Its horizon size $R_h$ decreases due to Hawking radiation and increases due to accretions. ", "An equation for $R_h(t)$ is easy to write. ", "For the singularity cloud, its size $L$ should be parametrically large and should depend on the number of units $N \\;$. Postulating a simple relation between $L$ and $N$, and based on the unitarity of the evolution, we then obtained an equation for $N(t)$ and thus for $L(t)$ also.", "\n\nAnalysing the resulting equations for $R_h$ and $N$, we found that, generically as the black hole evolves, the singularity cloud increases in size, meets the horizon at time $t_{fw}$, and becomes accessible to an outside observer. ", "The horizon thus ceases to exist. ", "If the boundary of the singularity cloud can be considered as the firewall of Almheiri et al then the time $t_{fw} \\;$ marks the appearance of the firewall. ", "The time $t_{fw} \\;$ depends on the details of the evolution but is typically of the order of black hole evaporation time.", "\n\nAlso, knowing $R_h$ at a given time $t$ is sufficient to predict the black hole quantities such as its entropy and mass. ", "However, this alone is not sufficient to predict the singularity cloud quantities, such as its size $L$ or the time of access to an outsider $t_{fw}$, since they depend also on the details of the black hole evolution.", "\n\nWe now conclude by posing a few questions for further studies.", "\n\nCan the boundary of the singularity cloud be taken as the firewall of Almheiri et al? ", "Does its appearance to an outsider at time $t_{fw}$ resolve the issues raised in their paper [@amps]?", "\n\nWhen there are accretions, knowing $R_h$ alone at a given time is not sufficient to predict $t_{fw} \\;$. Since, by assumption, spacetime outside the horizon is described as in standard semiclassical analysis, there seems to be no way at all to predict $t_{fw}$ except by knowing all the past evaporation and accretions onto the black hole since the time of its formation. ", "Is such an unpredictability desireable, or does it point to some inconsistencies? ", "Our own view, see [@k12], is that this unpredictability is undesireable, and implies that horizons do not form.", "\n\nOnce the singularity cloud becomes accessible to an outside observer, namely for $t > t_{fw}$, its further evolution is likely to be that of a standard quantum system with large number of interacting degrees of freedom. ", "What is the nature of these degrees of freedom and the interactions between them? ", "A related question is: how does the singularity cloud form in the gravitational collapse of a very massive star?", "\n\n[**Note added :**]{} J. Pullin informed us that reference [@gp] contains a concrete implementation of the ideas presented here. ", "We thank him for the information.", "\n\n[999]{}\n\nD. Morgan, “Black holes in cutoff gravity,”\\\nPhys.", " Rev. D [**43**]{}, 3144 (1991). ", "S. B. Giddings, “Black holes and massive remnants,”\\\nPhys.", " Rev. D [**46**]{}, 1347 (1992) \\[hep-th/9203059\\]. ", "A. Ashtekar and M. Bojowald, “Black hole evaporation: A Paradigm,”\\\nClass.", " Quant.", " Grav.", "  [**22**]{}, 3349 (2005) \\[gr-qc/0504029\\]. ", "S. A. Hayward, “The Disinformation problem for black holes (conference version),” gr-qc/0504037;\\\nS. A. Hayward, “Formation and evaporation of regular black holes,”\\\nPhys.", " Rev. Lett.", "  [**96**]{}, 031103 (2006) \\[gr-qc/0506126\\]. ", "E. Greenwood and D. Stojkovic,\\\n“Quantum gravitational collapse: Non-singularity and non-locality,”\\\nJHEP [**06**]{}, 042 (2008) \\[arXiv:0802.4087 \\[gr-qc\\]\\];\\\nA. Saini and D. Stojkovic, “Nonlocal (but also nonsingular) physics at the last stages of gravitational collapse,”\\\nPhys.", " Rev. D [**89**]{}, 044003 (2014) \\[arXiv:1401.6182 \\[gr-qc\\]\\]. ", "S. Hossenfelder and L. Smolin,\\\n“Conservative solutions to the black hole information problem,”\\\nPhys.", " Rev. D [**81**]{}, 064009 (2010) \\[arXiv:0901.3156 \\[gr-qc\\]\\]. ", "A. Almheiri, D. Marolf, J. Polchinski and J. Sully,\\\n“Black Holes: Complementarity or Firewalls?,”\\\nJHEP [**02**]{}, 062 (2013) \\[arXiv:1207.3123 \\[hep-th\\]\\].\\\nSee also S. L. Braunstein,\\\n“Black hole entropy as entropy of entanglement, or it’s curtains for the equivalence principle”, arXiv:0907.1190v1 \\[quant-ph\\] published as\\\nS. L. Braunstein, S. Pirandola and K. Zyczkowski,\\\n“Better Late than Never: Information Retrieval from Black Holes,”\\\nPhys.", " Rev. Lett.", "  [**110**]{}, 101301 (2013) \\[arXiv:0907.1190 \\[quant-ph\\]\\]. ", "C. Rovelli and F. Vidotto, “Planck stars,” arXiv:1401.6562 \\[gr-qc\\];\\\nA. Barrau and C. Rovelli, “Planck star phenomenology,”\\\narXiv:1404.5821 \\[gr-qc\\];\\\nH. M. Haggard and C. Rovelli, “Black hole fireworks: quantum-gravity effects outside the horizon spark black to white hole tunneling,” arXiv:1407.0989 \\[gr-qc\\]. ", "R. Gambini and J. Pullin, “A scenario for black hole evaporation on a quantum geometry,” arXiv:1408.3050 \\[gr-qc\\]. ", "O. Lunin and S. D. Mathur, “AdS / CFT duality and the black hole information paradox,” Nucl.", " Phys.", " B [**623**]{}, 342 (2002) \\[hep-th/0109154\\];\\\nS. D. Mathur, “The Fuzzball proposal for black holes: An Elementary review,” Fortsch.", " Phys.", "  [**53**]{}, 793 (2005) \\[hep-th/0502050\\];\\\nV. Balasubramanian, E. G. Gimon and T. S. Levi, “Four Dimensional Black Hole Microstates: From D-branes to Spacetime Foam,”\\\nJHEP [**01**]{}, 056 (2008) \\[hep-th/0606118\\];\\\nI. Bena and N. P. Warner, “Black holes, black rings and their microstates,” Lect.", " Notes Phys.", "  [**755**]{}, 1 (2008) \\[hep-th/0701216\\];\\\nK. Skenderis and M. Taylor, “The fuzzball proposal for black holes,”\\\nPhys.", " Rept.", "  [**467**]{}, 117 (2008) \\[arXiv:0804.0552 \\[hep-th\\]\\];\\\nB. D. Chowdhury and A. Virmani, “Modave Lectures on Fuzzballs and Emission from the D1-D5 System,” arXiv:1001.1444 \\[hep-th\\]. ", "D. N. Page, “Hyper-Entropic Gravitational Fireballs (Grireballs) with Firewalls,” JCAP [**04**]{}, 037 (2013) \\[arXiv:1211.6734 \\[hep-th\\]\\]. ", "S. Kalyana Rama, “Remarks on Black Hole Evolution a la Firewalls and Fuzzballs,” arXiv:1211.5645 \\[hep-th\\];\\\n“Massive Compact Objects in a Quantum Theory of Gravity,”\\\narXiv:1409.3462 \\[gr-qc\\].", "\n" ]

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[ "There is a definite German Shepherd feel to PennySaverUSA.com’s latest Pet of the Week. ", "The pet we are spotlighting that is up for adoption is a German Shepherd, and the pet we are spotlighting that was already adopted, twice, was thought to be a German Shepherd, but was actually something else! ", "Read their stories below.", "\n\nFor our son’s 7th birthday we decided to surprise him with a puppy! ", "After checking the shelters, we fell in love with a little guy labeled to be a “German Shepard” mix.", "\n\nSince we already had a German Shepard Mix that we loved, we thought this would be the perfect fit for our family!", "\n\nThanks the blogger One Bored Mommy for sharing her story of RICO.", "\n\nSure enough, the minute he came into the house, “RICO”, pictured to the right, was an instant hit with the family and even our other dog! ", "Though later, as he aged, we learned that he was actually a pitbull/labrador mix …we loved him so much!", "\n\nHe was great with the kids, quite the landscaper (he chewed all the plants and ate the sprinkler system in our backyard), and even helped me re-decorate (by pulling up an entire room of brand new carpeting in our family room).", "\n\nRICO was very loved & very patient with my kids (since there were four of them)!", "\n\nWe had to adopt him to a family before we moved from California to Connecticut almost 4 years ago, but he adjusted to his new family environment very quickly!", "\n\nFunny enough, they received the finished product of all of our hard work…a perfectly well behaved dog…who has yet to chew up anything he shouldn’t and sleeps with the kids in their beds!", "\n\nI am certain they love him just as much as we did…in fact I know that for a fact!", "\n\nAdopting Rico was a great gift not only for our family, but the family he lives with now too!", "\n\nInstead of having a user-submitted story about pet adoption, along with PennySaverUSA.com‘s regular Pet of the Week currently up for adoption, we’ve decided to spotlight two Pet of the Week pets currently up for adoption in different areas this week.", "\n\nOne cat and one dog. ", "We’ll start with the cat, named Mocha, from Burbank.", "\n\nIn love with Mocha? ", "Adopt her from the Burbank Animal Shelter.", "\n\nMocha, pictured to the right, is a terrific cat with a big attitude.", "\n\nShe has her own ideas about what’s right and wrong, and she will let you know if you’re wrong! ", "She is very independent but does have a soft spot once she gets to know you and will love all the attention you can give her.", "\n\nMocha will likely be the dominant pet in your household, but does get along with dogs and other cats; however young children are probably not the best match for her.", "\n\nHave a cup of coffee, then drop by the shelter to meet Mocha ID #A042692.", "\n\nThis week’s heartwarming tale of a successful pet adoption comes to us from PennySaverUSA Facebook fan Matthew S. Read all about Koda, pictured to the right, in Matthew’s own words:\n\nMy Fiancée and I had been wanting to get a puppy for some time, I have always loved dogs so the idea of having my own was something I was very excited about. ", "I knew I wanted to do a rescue dog so I started my search on www.petfinder.com. ", "Once there I noticed every other dog was a pit bull.", "\n\nKoda gives pit bulls a GOOD name.", "\n\nAfter doing some research and hearing the heartbreaking statistic of how many pit bulls are killed in shelters every day I made the decision that I was going to rescue a pit bull.", "\n\nI found Karma, a 3-month-old female blue nose and submitted my application, and did my phone interview. ", "By the time I was approved to visit, Karma had already been adopted, but they invited me to come see her remaining litter mates.", "\n\nI went in the back yard of the foster family’s home where they had six pit bull puppies waiting for adoption. ", "I sat on the grass in the back yard and Koda ran across the yard to jump in my lap.", "\n\nHe would not leave me alone, so in a way Koda picked me. ", "After a final personal interview at the foster’s house, and a home visit/inspection, Koda was mine.", "\n\nHe has been the most amazing dog and dismisses every myth the media loves to share about pit bulls. ", "Koda frequently is at the dog park in Vista, off Melrose (South Melrose) and is everyone’s favorite dog to play with.", "\n\nHe also enjoys swimming at the lagoon in Carlsbad and going on walks with Mom and Dad. ", "He is very active, but his favorite thing to do is put his front legs on your shoulders and give you kisses until your face is sticky with dog drool.", "\n\nI “rescued” Koda but the truth is he rescued me. ", "He brings me so much self worth and is the best snuggler ever.", "\n\nOur user-submitted story this week actually comes to us from a PennySaverUSA employee, Veronica. ", "She is passionate about rescuing animals and couldn’t help but share this incredible story of her dog Roofus. ", "In Veronica’s own words …\n\nWe adopted Roofus from an Inland Empire shelter. ", "This little guy was used as bait for training fighting dogs and had a rough go of it in his early life.", "\n\nHe’s now living the dream in his forever home with us! ", "He loves people, but does have a hard time adjusting to new animals (probably because of his past), but we work on this.", "\n\nOne animal he does love, however, is his big sister, a Siberian husky.", "\n\nWe have lots of fun with them at night when we have our howling session. ", "You probably think we are crazy, but Roofus loves it (and we aren’t afraid to admit we do, too)!", "\n\nWatch the above video to find out why Ozzie earned the nickname \"The Kissing Bandit\".", "\n\nHe might act a little nervous at first. ", "And he may not look like much of a “smooch pooch.” ", "But when you watch his video above you’ll see why this little bachelor gets more dates than Casanova. ", "Oh, by the way, Ozzie is a 3-year-old, 6 pound, neutered, male, Chihuahua.", "\n\nOzzie was transferred from another shelter to Rancho Coastal Humane Society through the FOCAS program.", "This suave, debonair dog is going to need an adult home with no kids.", "\n\nOzzie the Kissing Bandit is ready to settle down and be a one-family dog. ", "No more bouncing from one place to another.", "\n\nThe $125 adoption fee for Ozzie includes medical exam, neuter, up to date vaccinations, and microchip identification.", "\n\nAdoption Fees: Donation required is $350 and there is also a home check.", "\n\n———————————————————————————————————————————\n\nInstead of a user-submitted pet adoption story today, we wanted to share an amazing story we recently came across on The Stir, a section of the popular site Cafe Mom.", "\n\nPlease read the entire article by clicking here and you can watch the video that inspired the story by clicking the image to the left. ", "We will provide a brief synopsis below.", "\n\nA couple heard about a dog in south Los Angeles that was apparently living in a pile of trash. ", "The couple decided to check it out for themselves and came across Fiona, a filthy dirty flea-infested mass of furry cuteness.", "\n\nThey immediately realized that not only was she in such poor condition, she was also completely blind in both eyes.", "\n\nIn an incredible act of kindness, they cleaned her up, took her to the vet and got her treated.", "\n\nThis week’s user-submitted Pet of the Week comes from PennySaverUSA Facebook fan Shawn. ", "Shawn was gracious enough to share this touching story of how he came to adopt Archie (pictured to the right).", "\n\nClick the image to share your story of pet adoption with us on the PennySaverUSA Facebook wall.", "\n\nRead it in his own words:\n\nA couple years ago, my mom’s dog passed away with cancer. ", "The tumor was the size of a golf ball, and was lodged in his throat. ", "Sad to say he could not eat and each time he tried to eat he would cough it up, so we took him to the hospital, so he could go to the better place.", "\n\nA couple weeks later, we did a Leukemia walk at the Rancho Cucamonga baseball stadium.", "\n\nMy mom had to use the restroom, but while we were standing around, this big beautiful red-haired husky walked past us and then sat down.", "\n\nWhen my mom came out of the restroom I told her I wanted to look at this dog and she was ok with it … unfortunately we didn’t grab any information about this dog, but we knew it was upsetting my mom because she wanted this dog.", "\n\nSo what did we do? ", "We went to the Rancho Cucamonga animal shelter, saw the dog, and she adopted him right there on the spot!", "\n\nAny time a pet has two names, you know it’s special, and our newest Pet of the Week is most certainly in a class of her own.", "\n\nAdopt Lily Banks and you can wake up to that gorgeous face every day.", "\n\nHer name is Lily Binks … but her friends call her “LIL.” ", "She’s the adoptable Pet of the Week at Rancho Coastal Humane Society. ", "She’s a Siamese – Flame Point cat with a white fur coat and bright blue eyes as you can see in the picture to the right.", "\n\nShe weighs 11 pounds and is 4 years old.", "\n\nLily Binks arrived at Rancho Coastal Humane Society when her family moved to a place that doesn’t allow pets. ", "Have other cats? ", "Lil is okay with that. ", "Have no other cats? ", "Lil is fine with that, too. ", "Basically, she’s a pretty agreeable cat.", "\n\nInstead of featuring one Pet of the Week up for adoption and one user-submitted pet that was recently adopted, we decided to spotlight two pets up for adoption this week.", "\n\nRosey had a home, then lost it. ", "It's time for her to get a new one.", "\n\nThe first one is up for adoption in Seal Beach, CA and is named Rosey.", "\n\nRosey and her brother Rocky were adopted from the Seal Beach Animal Care Center as kittens, but returned five years later when their adopter lost her home and had to move where she couldn’t take them along.", "\n\nRosey is sweet and affectionate and will rub her face on yours and give you kisses! ", "However, she is not really happy with her many feline roommates and often prefers to sleep in a cage because it is too stressful for her to be out in the open room. ", "Rosey would love to have her own home and family again. ", "She would like to be the Queen of the Castle, please!", "\n\nRosey’s adoption fee is $50 and that includes her spay, current vaccinations, testing for FIV and FeLV, flea treatment, deworming, permanent microchip identification and a free veterinary exam.", "\n\nIf you’re hungry for real love….treat yourself to SAUSAGE. ", "He’s the adoptable Pet of the Week at Rancho Coastal Humane Society. ", "He’s a 4-year-old, 11-pound, neutered, male, Chihuahua mix. ", "When you meet him face-to-furry-face you’ll see that Sausage could use a few more walks and a few less treats.", "\n\nSausage could use some play time.", "\n\nSausage was transferred to Rancho Coastal Humane Society from another animal shelter through the FOCAS program.", "\n\nAn RCHS foster care volunteer took him home for a sleep-over and said he was a perfect gentleman. ", "He didn’t beg, he napped on the floor next to the couch, and walked well on his leash.", "\n\nThe $125 adoption fee for Sausage includes medical exam, neuter, up to date vaccinations, and microchip identification.", "\n\nPennySaverUSA’s newest Pet of the Week comes to us from the San Diego Humane Society. ", "Her name is Lulu and as you can see in the picture to the right, she’s a real catch. ", "She’s a 3-year-old black terrier and her adoption ID# is 90588.", "\n\nJust look at Lulu. ", "What a hottie!", "\n\nLulu can’t wait to find a special family to cherish! ", "She can be a bit shy at first, but warms up as she becomes more familiar with her environment and gets to know you. ", "Lulu loves relaxing, sleeping and snuggling by the side of a companion or a warm window.", "\n\nThis sweet girl appreciates close, trusting relationships and would do best in a home with no children.", "\n\nLulu’s adoption fee is $75 and that includes her spay, current vaccinations, permanent microchip identification, a certificate for a free veterinary exam, and a license if residing in Oceanside or Vista!", "\n\nDuring the adoption process a San Diego Humane Society Trainer will be present to answer any questions and share how to best care for Lulu and offer tips for continued training in the future.", "\n\nThat lovely little cat to the right you see is named Jellybean and she is (along with pal Sparky) the latest user-submitted Pet of the Week. ", "PennySaverUSA Twitter follower @khealy8834 was the source of this awesome story. ", "Tweet her to find out more about Jellybean and Sparky!", "\n\nPlease tweet us @PennySaverUSA if you want your adopted pet spotlighted like Jellybean.", "\n\nAfter walking around the shelter and seeing all the cats/kittens, there was no way we could narrow it down to one kitten (at least I couldn’t just pick one).", "\n\nWe picked our top 2 kittens and went to speak with the employees figuring we would pick one while doing the paperwork. ", "While talking with the employees, they tugged at my emotions by saying how the one kitten would be lonely when we were both at work all day (I’m a CPA so my hours sometimes are longer).", "\n\nMy partner had also tried to wear me down to get two kittens so I relented. ", "That was how we got 2.", "\n\nJellybean was 8 to 12 weeks old and while they told us Sparky was the same age, we later found out from our vet that Sparky was 3 to 4 weeks younger (and has stomach/intestinal issues).", "\n\nBest decision I ever made.. These two cats are my kids. ", "They know just how to put a smile on our faces. ", "They have total different personalities. ", "Jellybean is very shy around people (she normally runs under a bed when anyone comes into the condo).Sparky is the exact opposite. ", "When someone new first comes into the apartment, she is reserved for 5 to 10 minutes watching what is going on. ", "After 10 minutes, she’ll walk up to the person and start meowing and rubbing against them, it is very cute." ]

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[ "Latest:\n\nIs Obama in Cover-Up on Benghazi? ", "Vote Here\n\nThe Benghazi scandal is not Watergate, says one of the reporters who broke that history-changing story, but he did invoke the name of the president who famously declared, \"I am not a crook.", "\"\"This is not Watergate,\" the Washington Post's Bob Woodward said Sunday on \"Meet the Press,\" \"but there are people in the administration who have acted as if they want to be Nixonian.", "\"In the initial Benghazi talking points, the CIA says explicitly that there were al-Qaida ties to the group that attacked the American diplomatic facilities in Benghazi, Libya, on Sept. 11, 2012, Woodward noted. ", "The final talking points used by U.N. Ambassador Susan Rice on all five Sunday talk shows five days later made no such reference.", "\"This is a business where you have to tell the truth, and that did not happen here,\" Woodward said.", "On CNBC on Friday, however, Woodward seemed more comfortable using the word \"Watergate.", "\"\"If you read through all these emails, you see that everyone in the government is saying, 'Oh, let's not tell the public that terrorists were involved, people connected to al-Qaida. ", "Let's not tell the public that there were warnings,'\" Woodward said on \"Morning Joe.", "\"\"And I have to go back 40 years to Watergate when Nixon put out his edited transcripts to the conversations, and he personally went through them and said, 'Oh, let's not tell this. ", "Let's not show this.' ", "I would not dismiss Benghazi. ", "It's a very serious issue.\"" ]

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[ "Across the country, activists and lawmakers have begun to discuss a radically different approach to making public transit accessible to residents: making it universally free to use. ", "This discussion is also happening in Allegheny County, where public transit advocates hope for fares to be eliminated within 10 years. ", "PublicSource has collected answers to key questions to help area residents understand the pros and cons and how Pittsburgh compares to other cities.", "\n\nWhat sparked this conversation nationally?", "\n\nIn December, Kansas City, Mo., became the first major U.S. city to enact a plan to eliminate public transit fares.", "\n\nThe plan, which the city is still working to fund, prompted discussion of enacting the policy in other parts of the country.", "\n\nRelated stories Develop PGH Bulletins: No 20-story box between Downtown and Strip, commission rules Develop PGH Bulletins will update you on the Pittsburgh region's economy, including close coverage of the Urban Redevelopment Authority, City Planning Commission and other important agencies. ", "Please bookmark, check back frequently, sign up for the Develop PGH newsletter and email rich@publicsource.org with questions, tips or story ideas.", "\n\nEviction Day: Between the state moratorium and the CDC order, landlords file flurry of cases Update (9/4/20): Allegheny County President Judge Kim Berkeley Clark issued an order instructing district judges on the handling of eviction filings in the wake of an order issued by the Centers for Disease Control and Prevention. ", "If a landlord attempts to file an eviction against a tenant who has declared that he or she falls under the income limits and income loss guidelines in the CDC order, the judge may hold an initial status conference to “give the parties an opportunity to also consider available rental assistance,” according to Clark’s order.", "\n\nThis decision prompted discussion of enacting the policy in other parts of the country. ", "But cities like Pittsburgh dwarf Kansas City in ridership, considerably raising the stakes for such a policy. ", "The Port Authority of Allegheny County made more than 64 million public transit trips in 2018, whereas the Kansas City Area Transportation Authority reported about 16 million trips in 2014.", "\n\nKansas City collects about $9 million in fares, according to its 2019 budget. ", "That accounts for about 8% of its total revenue. ", "In Pittsburgh, the Port Authority collected about $77 million in fares during its 2019 fiscal year, which accounts for about 18% of its total revenue.", "\n\nWho’s talking about it in Pittsburgh?", "\n\nShare tips, ideas & your personal stories related to Pittsburgh news.", "\n\n\n\nYour email:\n\nSend\n\nPittsburghers for Public Transit, in conjunction with other groups like Just Harvest and Casa San Jose, put out the #FairFares platform in February. ", "The platform has an extensive list of short- and long-term proposals related to transit fares.", "\n\nA standout part of the platform calls for the long-term goal of eliminating fares systemwide by 2030. ", "The platform has garnered support from some local lawmakers, including Democratic Allegheny County Council members Bethany Hallam and Olivia Bennett. ", "Bennett said the free light rail service between Downtown and the North Shore is an example of this concept working. ", "She said she also believes eliminating fares would reduce harmful emissions by incentivizing residents to use public transit.", "\n\n“Getting people out of their single-use vehicles and onto transit would I think be a very big benefit to the region as a whole,” Bennett said. “", "And if you’re providing free transit, what better motivation is there to use that transit than that?”", "\n\nPort Authority spokesman Adam Brandolph said the authority has an open mind regarding the ideas laid out in the #FairFares platform. ", "But he said any policy that brings a loss in revenue would have to be paired with some change that would increase revenue.", "\n\nWhere else has this been done, and how has it panned out?", "\n\nFew areas have completely eliminated transit fares and, in some cases, it’s been done so recently that it’s tough to measure the impact. ", "Last December, Luxembourg became the first country to eliminate transit fees. ", "Olympia, Wash. — a city of about 52,000 people — made its bus-based transit system free starting Jan. 1, an effort to increase ridership and equity and to reduce car emissions. ", "Austin, Tex. ", "tried the concept from 1989 to 1990, and some smaller cities like Chapel Hill, N.C., have also eliminated fares, according to a December CityLab article.", "\n\nTallinn, the capital city of Estonia, eliminated all of its transit fees in 2013. ", "According to a 2016 article in The Guardian, the city posits that eliminating fares has actually brought in an additional 20 million Euros per year due to an influx in residents. ", "However, Hasselt, a city in Belgium, eliminated all transit fees back in 1997 and ended its policy in 2013 after ridership increased to unsustainable levels, according to Eltis, a transit-focused information resource funded by the European Commission's Directorate General for Mobility and Transport.", "\n\nWhat are the benefits and drawbacks?", "\n\nProponents of eliminating transit fares argue that doing so would increase ridership, simplify the experience of riding and economically benefit low-income riders. ", "They also note that charging fares wastes money due to the subsequent costs of fare enforcement.", "\n\nAccording to Brian Taylor, director of the UCLA Institute of Transportation Studies, these are sound arguments, but he thinks there may be better ways than getting rid of fares to serve the needs of those dependent on transit and increase ridership. ", "Instead of eliminating fares, he suggests fare revenue may be better spent on services and programs targeted at making transit more reliable and accessible. ", "He is also concerned about cost. ", "Taylor noted the risk of eliminating fares during the busiest times, when revenue is typically highest.", "\n\n“By offering free transit service for all trips, you run the risk of actually incurring a very high marginal cost to accommodate where your peak demand is,” Taylor said.", "\n\nWhat do activists want in the short term if this isn’t happening?", "\n\nThe #FairFares platform boasts an exhaustive list of proposed changes to the Pittsburgh transit system. ", "In its short-term goals related to fare costs, the platform proposes capping fare payments, making ConnectCards easier to access and eliminating transfer fees.", "\n\nAccording to Laura Wiens, executive director of Pittsburghers for Public Transit, charging for transfers reflects “a weird assumption that people should pay more for each bus they take, or form of transit that they take, rather than being charged for their whole trip, which airlines do.” ", "Wiens noted that airlines discount airfare if there’s a transfer because it is an inconvenience to travelers. ", "Some transit agencies, such as Metro Transit in Minneapolis and Saint Paul, do not charge extra for transfers.", "\n\nWhat is the Port Authority doing to address concerns about fare costs?", "\n\nPort Authority hired an outside consultant in January 2019 to extensively examine fare collection, according to Brandolph. ", "The Port Authority does not have a timeline for sharing the consultant’s findings with the public, he said.", "\n\nIf fare revenue decreases, Brandolph said one solution to avoid a revenue loss could be to charge fees at more Park and Ride lots used by commuters. ", "Most of these lots in Pittsburgh’s suburbs are free. ", "Some charge, like at the South Hills Village T station, where parking is $2 per day.", "\n\n“If we are lowering our revenue on one hand with something like free transfers, we would want to raise revenue on the other side,” Brandolph said.", "\n\nBrandolph said the Port Authority does not have an opinion about how much of its funding should come from government compared to sources like rider fares.", "\n\n“I think more funding, regardless of how we were to obtain it, is good,” Brandolph said. “", "We did an economic development study last year which found that for every dollar that comes into Port Authority, at least twice as much money goes back out.”", "\n\nWiens said that focusing on only revenue wouldn’t account for the broader value of reducing or eliminating fares.", "\n\n“Increased ridership has benefits that resonate across the region in economic dividends and health benefits and increased equity and all sorts of things,” Wiens said. “", "If we only look at it through a lens of how much revenue they’re taking in, it’s very short-sighted.”", "\n\nClarification (3/12/20): This story was updated to clarify information on the budget and implementation of Kansas City's plan.", "\n\nMatt Petras is a freelance reporter based in the Pittsburgh area as well as a writing and journalism tutor for Point Park University. ", "He can be reached at matt456p@gmail.com or on Twitter @mattApetras.", "\n\nThis story was fact-checked by Sierra Smith.", "\n\nDevelop PGH has been made possible with funding from The Heinz Endowments." ]

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[ "Data from the Japanese Hinode spacecraft have confirmed that a set of long-theorised magnetic waves help power the solar wind that drives charged particles to the frigid boundary of the solar system. ", "Called Alfven waves, they play an important role in accelerating the solar wind to speeds of around 2 million mph, according to results published in the journal Science. \"", "Until now, Alfven waves have been impossible to observe because of limited resolution of available instruments,\" said Alexei Pevtsov, a Hinode scientist in Washington, DC \"With the help of Hinode, we are now able to see direct evidence of Alfven waves.\" ", "Hinode was launched in September 2006, the latest spacecraft trying to unravel long-standing solar mysteries, such as the origin of the sun's huge magnetic field, and the explanation behind the fact that the sun's atmosphere is nearly a million degrees hotter than the surface.", "\n\nEven babies may be good judges of character\n\nIn a study that suggests people may begin evaluating one another for trustworthiness even earlier than believed, researchers showed infants a demonstration in which different shapes played the good guy or the bad guy. ", "Then the infants were allowed to choose one to play with. ", "The good guy won almost every time. ", "In the case of Circle, a small wooden character with big eyes, that would be Triangle, who helped him when he was struggling up the hill—not Square, who gave him a good shove back down. ", "Of course, when the roles were reversed and Triangle was cast as the hinderer, the infants preferred Square. ", "After repeated demonstrations, the infants, 6 and 10 months old, were presented with the helper and the hinderer. ", "They almost always reached for the helper. ", "The study appears in the November 22 issue of Nature; the lead author is J. Kiley Hamlin of Yale. ", "A co-author, Karen Wynn, a psychology professor at Yale, said the study showed that even at an early age, people are assessing those around them. \"", "It's important for them to make a judgment about who might be a friend and who might be a potential foe,\" she said.", "\n\n... contd.", "\n\nALSO READ Fighting the flu\n\nPlease read our terms of use before posting comments" ]

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[ "Scott Westgarth, a British boxer, died after a fight in what was described as a disaster by British Boxing chief Robert Smith on Monday although he said it was impossible to make the sport 100 percent safe.", "\n\nWestgarth, 31, won his fight against Dec Spelman in Doncaster on Saturday but looked uncomfortable as he was interviewed ringside after his points victory.", "\n\nHe was taken to Royal Hallamshire Hospital but his condition deteriorated shortly before arrival and his death was confirmed by his promoter Stefy Bull on Monday.", "\n\nIt was the first death in professional boxing since Canada’s Tim Hague died two days after a fight last June.", "\n\nA year earlier Scotland’s Mike Towell died from a brain injury following a bout.", "\n\nSmith, a former boxer and now the British Boxing Board of Control’s general secretary, reacted with shock to the latest death in a sport often criticized for its brutal nature.", "\n\n“It’s terrible for the sport and terrible for the family and we send our condolences to Scott’s family,” Smith told Reuters.", "\n\nSmith said the sport had made huge advances in safety since the 1980s and that Britain had an enviable record.", "\n\n”We are one of the most forward-thinking commissions in the world regarding medical aspects,“ he said. ”", "Some people don’t like us because they say we are too strict.", "\n\n“This is a tough tough sport and we try to make it as safe as possible but you can’t make it 100 percent safe,” he added.", "\n\n“But that doesn’t take away from the fact that this is a disaster, but more importantly it’s a disaster for his family and that’s the most important thing.”", "\n\nEvents such as Westgarth’s death inevitably lead to soul-searching by those in the sport and fuel the debate about the sport’s ethics.", "\n\n“We all do this for a reason. ", "But that doesn’t take away the feeling I have today of ‘why am I doing this?',” ", "Smith said.", "\n\n“We will continue. ", "If it’s not me it will be someone else. ", "But it makes you question why you are bothering.”" ]

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[ "In many applications in the body involving implants, it is often desirable to create some type of connection between a tissue (a tissue is defined as any part of the body) and the implant (an implant is herein defined as anything which could be implanted into the body, e.g. a breast implant, a intraocular lens or a drug delivery device). ", "The most common way to create such a connection is to use some type of adhesive. ", "The adhesives used in general are cyanoacrylates and fibrin glues. ", "Cyanoacrylates (disclosed in e.g. U.S. Pat. ", "No. ", "6,183,593 and EP 0925795) have the advantage of fast bonding speed and strong bonds. ", "However, they are also known to be toxic to some tissues and their potential degradation products are suspected to be carcinogenic. ", "Further, the strong bonds formed can be a disadvantage in applications where flexible bonds are required. ", "The fibrin glues (disclosed in e.g. U.S. Pat. ", "No. ", "6,699,484 and U.S. Pat. ", "No. ", "6,596,318) have the advantage of being degradable and non-toxic. ", "However, the disadvantage with using fibrin glue is that tissue binding with fibrin glue cannot be subjected to even moderate tensile strength without rupturing the bond. ", "Further, there is a risk of viral infection since fibrin glue is often of animal origin.", "\nAnother type of adhesive composition is provided by WO 02/087642, in which a water-absorbent two-phase adhesive composition containing a hydrophobic phase and a hydrophilic phase is disclosed. ", "The hydrophobic phase is composed of a crosslinked hydrophobic polymer composition and the hydrophilic phase is a water-absorbent blend of a hydrophilic polymer and a complementary oligomer capable of crosslinking the hydrophilic polymer through hydrogen bonding, ionic bonding, and/or covalent bonding. ", "The composition is useful as a bioadhesive, for affixing drug delivery systems, wound dressings, bandages, cushions, or the like to a body surface such as skin or mucosal tissue.", "\nInternational Patent Application WO 03/097759 discloses biomedical adhesives comprising multi-functionally activated groups. ", "The adhesives are used for bonding an implant to a surface, which surface can be either electrophilic or nucleophilic as long as it is opposite to the functional groups of the adhesive. ", "The adhesive is coated on the implant.", "\nThere is, however, still a need for a biocompatible composition comprising compounds that will easily provide a coating on the tissue surface, which will facilitate the connection between said surface and an implant, and that will create a safe and flexible connection between said surface and the implant.", "\nCataract extraction is among the most commonly performed operations in the world. ", "In this operation the natural lens is removed and replaced with an artificial intraocular lens (IOL), which will mimic the transparency and the refractive function of a natural lens. ", "The intraocular lens can either be implanted into the capsular bag or injected as an ophthalmic composition into the capsular bag and then crosslinked (the capsular bag is used as a mold). ", "The removal of the natural lens can be performed by several known techniques, e.g. phacoemulsification, which technique entails the application of ultrasonic energy or other forms of energy to the natural lens, thus breaking the lens into fragments that can be aspirated from the capsular bag.", "\nLens removal with an artificial lens implantation provides significant benefits to most cataract patients (currently lens removal with artificial lens implantation is increasingly carried out in a non-catarcatous eye, so-called refractive lens exchange, often with the purpose to relieve presbyopia). ", "However, it is estimated that up to fifty percent of all patients, who have implants placed within the capsular bag, will develop capsular opacification (CO), also known as secondary cataract or “after cataract”, within five years after surgery. ", "CO is an opacification located on the inner surface of capsular bag, whether located posteriorly (PCO) or anteriorly (ACO) and is caused by deposition (the cell may be deposited on the interior surface of the capsular bag or on the implanted lens) or ingrowths of cells, cell derivatives and/or fibers into the visual axis and/or extracellular matrix production by the lens epithelial cells. ", "The problem with CO is that the optical axis of the eye will be occluded, which will cloud the vision. ", "Ophthalmic surgeons take considerable care in trying to remove as many as possible of the lens epithelial cells prior to implantation or injection of an artificial lens. ", "However, despite these efforts, a significant number of lens epithelial cells are usually left on the interior surface of the capsular bag since these cells are difficult to view and often difficult to reach and virtually impossible to completely remove.", "\nThe most common treatment for postoperative PCO uses laser energy, however, the laser energy applied to the posterior membrane of the capsular bag is ordinarily directed though the implant and might damage the optic of said implant. ", "Accordingly, it is desirable to prevent the occurrence of CO rather than treating CO. ", "Various procedures for the prevention of CO have been suggested in recent years and a lot of those procedures have included the application of chemicals into of the capsular bag in order to destroy residual lens epithelial cells, e.g. WO 02/47728 that discloses a treatment of posterior capsular opacification by using a product comprising death receptor ligand covalently bound to a polymer. ", "However, few if any of these procedures have proven to be particularly successful in the prevention of CO due to the fact that it is extremely difficult to destroy residual lens epithelial cells without simultaneously destroying other cells within the eye.", "\nAnother method for preventing secondary cataract is disclosed in the granted U.S. Pat. ", "No. ", "6,702,853. ", "This granted patent discloses a system and a method for preventing capsular opacification by applying an adhesive to at least one surface of implanted lens.", "\nThus, there is still a need for a method for preventing secondary cataract for system using injectable lenses, which method will affect the tissues and the optical properties of the injectable lens as little as possible." ]

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[ "News\n\nGaga's dark depression\n\nLady Gaga felt like she was 'dying' with depression at the end of last year.", "\n\nThe Applause singer has always been very open about her thoughts and feelings during her career.", "\n\nAnd in an interview with the American edition of Harper's Bazaar, Gaga revealed just how low she felt mere weeks ago.", "\n\n''I became very depressed at the end of 2013,' she confessed. '", "I really felt like I was dying - my light completely out. ", "I was exhausted fighting people off. ", "I couldn't even feel my own heartbeat. ", "I was angry, cynical, and had this deep sadness like an anchor dragging everywhere I go. ", "I just didn't feel like fighting anymore. ", "I didn't feel like standing up for myself one more time-to one more person who lied to me.'", "\n\nThe 27-year-old could be referring to her split from manager Troy Carter, who parted ways with the singer in November just days before her ARTPOP album was released.", "\n\n\"Those who have betrayed me gravely mismanaged my time and health and left me on my own to damage control any problems that ensued as a result,\" she wrote in a blog soon after.", "\n\nGaga, whose real name is Stefani Joanne Angelina Germanotta, admitted she spent most days crying during that dark period.", "\n\nBut the turning point came on New Year's Day when she looked in the mirror as she was crying once more.", "\n\nShe said, 'I said to myself, \"Whatever is left in there, even just one light molecule, you will find it and make it multiply.", "\n\nYou have to for you. ", "You have to for your music. ", "You have to for your fans and your family.'" ]

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[ "Mission Statement\n\nOur mission at Your Health Matters is expressed through a multi-media platform of print, audio and video designed to demonstrate the importance of one’s health. ", "Our mission is to examine the many components and fractals that make up our “Total Health.”" ]

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[ "Exposure to ambient particulate matter (PM) is associated with acute and chronic adverse health outcomes, mediated through pathophysiologic processes including the promotion of inflammation, coagulation, and oxidative stress.^[@R1],[@R2]^ While impacts on the cardiovascular and respiratory systems have been well characterized, associations with many other health conditions are also emerging, including neurologic, immunologic, and perinatal outcomes.^[@R3]--[@R5]^ In particular, associations between outdoor air pollution and metabolic outcomes have also been recently reported.^[@R4],[@R6]^ For example, short-term exposure to ambient PM has been associated with increased blood glucose concentrations,^[@R7]^ hospital admissions for diabetic problems, and admissions for all reasons in people with diabetes.^[@R3],[@R8],[@R9]^ Further, long-term PM exposure has been associated with increased incidence of diabetes.^[@R6]^\n\nMuch of the evidence about the population-level health impacts of PM comes from studies of administrative health data, such as hospital emergency room visits, admissions records, and registered deaths. ", "Air quality estimates for these studies are typically referenced to the usual place of residence. ", "Ambulance records are a source of population-level health information that has been less extensively evaluated with respect to air pollution. ", "They can provide information about common clinical syndromes that are less often managed in hospital settings, such as hypoglycemia (low blood glucose) or fainting (brief loss of consciousness that can have many clinical causes). ", "However, the range of clinical information suitable for evaluation is more limited compared with that available from datasets on hospital admissions or emergency room visits. ", "Unlike other sources of administrative data, ambulance records can also provide the precise geolocation of the health event, rather than place of usual residence, and timing of the call to emergency services. ", "This information is especially helpful for short-term air quality studies because atmospheric pollution can exhibit considerable spatial and temporal variation.^[@R10]^\n\nAmbulance data are typically categorized at two points in time. ", "The first occurs at the time of the initial call to emergency services, when a dispatch category is assigned to indicate the general problem and degree of urgency. ", "The second occurs when an assessment is made by the attending paramedic following a clinical evaluation, including history, examination and, in some cases, investigations such as blood or urine testing. ", "Dispatch categories are assigned according to standardized over-the-phone protocols,^[@R11]^ so the cases included in each category can have considerable clinical heterogeneity and diagnostic uncertainty.^[@R12]^ In comparison, paramedics follow standardized in-person protocols for identifying and managing a range of important medical conditions, which makes their patient records more clinically informative.^[@R13]^ Paramedic assessments have been understudied in the environmental health literature compared with dispatch data, which are more readily available. ", "Paramedic assessments of cardiac arrest have been associated with ambient air quality,^[@R14]^ but studies on assessments for other conditions are limited.^[@R15]^ Here, we aimed to assess the association between PM~2.5~ (PM less than 2.5 μm in aerodynamic diameter) and primary paramedic assessments of selected diabetic, cardiovascular, and respiratory conditions. ", "We hypothesized that by examining data collected in ambulance settings, we would identify new plausible clinical manifestations of reduced air quality.", "\n\nMETHODS\n=======\n\nStudy Population\n----------------\n\nThe study included 394,217 ambulance dispatches with paramedic records in the Southeastern Australian States of Victoria, New South Wales (NSW), and Tasmania for the period 2009--2014 (Figure [1](#F1){ref-type=\"fig\"}). ", "The 2012 combined population of this areas was 13.2 million people, approximately half of the total Australian population. ", "Of the 7.3 million people in NSW, more than half are in the greater Sydney area.^[@R16]^ Similarly, Victoria has a population of 5.6 million, most of which is in the greater Melbourne area. ", "In contrast, Tasmania has a smaller, more dispersed population of 512,000.^[@R16]^\n\n{#F1}\n\nOutcome Data\n------------\n\nA standard clinical information system was used by all jurisdictions participating in this study. ", "Data are entered directly by paramedics at the scene of the incident or after patient hand-over at hospital. ", "We selected primary paramedic assessments of hyperglycemia and hypoglycemia for the diabetes-related outcomes. ", "Cardiovascular outcomes included arrhythmia, heart failure, faint, acute coronary syndrome, angina, stroke, and transient ischemic attack. ", "Heart failure was a combined category that included assessments of both cardiac failure and acute pulmonary edema. ", "Respiratory outcomes included asthma, chronic obstructive pulmonary disease (COPD), lower respiratory infections, and croup, a common upper airway infection in young children. ", "Lower respiratory infections were a combined category that included assessments of chest infection and pneumonia. ", "Later introduction of the electronic information system in NSW meant that only 18 months of paramedic assessment data were available in this state (eFigure 1; <http://links.lww.com/EDE/B415>). ", "The ambulance dispatch date, time, and location were recorded for all cases. ", "We excluded elective (nonurgent) dispatches, which mainly comprised patient transfers for prearranged appointments.", "\n\nExposure Data\n-------------\n\nGridded daily average exposure estimates for PM~2.5~ were produced at a resolution of 5 × 5 km by adapting the general approach of Yao and Henderson^[@R10]^ to the Australian study region using an empirical Random Forest model and more environmental covariates.^[@R17]^ The model domain included the Southeastern states and territories of Australia (Victoria, NSW, Tasmania, and the Australian Capital Territory) from October 2009 to April 2015. ", "Model inputs were remotely sensed aerosol optical depth and fire radiative power from the Moderate Resolution Imaging Spectroradiometer instruments. ", "Aerosol optical depth is a measure of aerosol in the entire atmospheric column that correlates with on-ground particulate concentrations, while fire radiative power measures the intensity of landscape fire points and is proportional to their aerosol emissions.^[@R18]^ We obtained daily PM~2.5~ data from state Environmental Protection Agencies for the nearest available surface monitor, and the atmospheric venting index was interpolated from nearest available weather station.^[@R19]^ In addition, we included the C-Haines index of atmospheric stability, a driver of air pollution dispersion,^[@R20]^ and ozone data from the Aura satellite. ", "Gridded daily average temperature and relative humidity were provided by the Australian Bureau of Meteorology in each state.^[@R19]^\n\nThe PM~2.5~ model was constructed to tolerate missing data. ", "For example, if satellite or monitor data were missing for given day and location, a simpler form of the model was run using the available variables.^[@R17]^ A leave-one-out cross-validation of the model produced a Pearson correlation coefficient of 0.82 with the observed ground-based measurements and a root mean square error (RMSE) of 5.7 µg·m^−3^. Additionally, we cross-validated the model by leaving out individual monitoring stations and predicting those points using remaining stations to assess the spatial stability of the model, which resulted in a mean Pearson correlation coefficient 0.82 mean RMSE of 4.13 µg·m^−3^.\n\nStatistical Analysis\n--------------------\n\nA time-stratified case-crossover design^[@R21]^ was used to estimate the association between exposure to PM~2.5~ and the paramedic assessments. ", "Our design controlled for day of the week, monthly, seasonal, and long-term trends. ", "The daily average of modeled PM~2.5~ on the day of the dispatch and at the location of the dispatch (case exposure) was compared with PM~2.5~ estimates at the same 5 × 5 km grid cell for all other occurrences of the same weekday in the same calendar month and year (control exposures). ", "Control exposure data thus contrast temporal rather than spatial variations in air quality. ", "Because each case is their own control, it accounts for individual factors that do not vary meaningfully within 1 month, such as age, sex, socioeconomic position, residential location, and smoking status. ", "The following conditional logistic model was used to estimate the association between PM~2.5~ and the paramedic assessment as an odds ratio (equation 1):\n\n![](", "ede-30-011-g002.jpg)\n\nwhere the paramedic assessment is 1 for the case day and 0 for control days, conditioned on the unique identifier of the study subject; PM~2.5~ is the daily concentration at the dispatch incident location of each subject; *s* (*T*, 2) is a natural cubic spline of the average temperature with two degrees of freedom (df) and the lag (1--3) is the average for the previous 3 days; and RH is the average relative humidity with the same degrees of freedom and lag structure.", "\n\nWe ran models for the combined dataset and separately for each state. ", "Individual models were run for PM~2.5~ concentrations on the same day (lag 0), the previous day (lag 1), and 2 days (lag 2) before the health outcome to assess temporal relationships. ", "The combined dataset was used to evaluate differences by sex and age group (0--15, 16--50, 51--65, and above 65 years old). ", "The significance of the statistical difference between effect estimates within subgroups (e.g., males versus females) was tested using meta-regression.^[@R22],[@R23]^ All analyses were performed in R statistical software.^[@R24]^ The research was approved by the Health and Medical Research Ethics Committee of the University of Tasmania (Reference H0013521).", "\n\nRESULTS\n=======\n\nAir quality was generally good over the study period, with a mean (standard deviation) daily PM~2.5~ concentration of 8.4 (4.1) µg/m^3^, though there were some highly exposed days (Table [1](#T1){ref-type=\"table\"}). ", "Lower respiratory infections (N = 67,952) and acute coronary syndrome (N = 66,231) were the most common paramedic assessments recorded (Table [1](#T1){ref-type=\"table\"}).", "\n\n###### \n\nTotal Number, Mean, Standard Deviation, Quartiles, and Range of Daily Average PM2.5, Relative Humidity, Temperature, and Health Outcomes for Study Participants, South Eastern Australia 2009--2014\n\n![](", "ede-30-011-g003)\n\nParamedic Assessments and PM~2.5~\n---------------------------------\n\nIn the analysis of diabetic outcomes, we found that increased PM~2.5~ was associated with paramedic assessments of hypoglycemia. ", "In the combined analysis, there was an approximate 7% increase in the odds of this outcome for each 10 µg/m^3^ increase in PM~2.5~ (odds ratio \\[OR\\] = 1.07; 95% confidence interval \\[CI\\] = 1.02, 1.12, lag 0) (Figure [2](#F2){ref-type=\"fig\"}). ", "We also observed positive associations in each individual state (Table [2](#T2){ref-type=\"table\"}). ", "In contrast, there was no association with hyperglycemia in the combined analysis, but results from the state of Tasmania alone showed a strong association (Table [2](#T2){ref-type=\"table\"}).", "\n\n###### \n\nAssociations Between Paramedic Assessments and 10 µg/m−3 Increase in PM2.5 for Same Day (Lag 0) and Lags of 1 and 2 Days\n\n![](", "ede-30-011-g004)\n\n{#F2}\n\nIn the analyses of cardiovascular conditions, paramedic assessments of arrhythmia, heart failure, and faint were all associated with increased PM~2.5.~ For each 10 µg/m^3^ increase in same-day PM~2.5~, the odds of assessments for faint increased by approximately 9% (OR = 1.09; 95% CI = 1.04, 1.13, lag 0) and the odds of arrhythmia increased by 5% (OR = 1.05; 95% CI = 1.02, 1.09, lag 0). ", "In contrast, associations with heart failure increased with increasing lags and were greatest at the maximum lag of 2 days (OR = 1.07; 95% CI = 1.02, 1.12, lag 2). ", "Associations with acute coronary syndrome (OR = 1.02; 95% CI = 0.99, 1.05, lag 0) and angina (OR = 1.04; 95% CI = 0.99, 1.09, lag 0) were imprecisely elevated (Table [2](#T2){ref-type=\"table\"}; Figure [2](#F2){ref-type=\"fig\"}). ", "We did not find any associations with assessments stroke or transient ischemic attack.", "\n\nIn the analyses of respiratory conditions, paramedic assessments of asthma, COPD, and croup were associated with elevated PM~2.5~ (Figure [2](#F2){ref-type=\"fig\"}). ", "The magnitude of the association was greatest for croup, for which the odds were increased by 8%--9% per 10 µg/m^3^ increase in PM~2.5~ at lags of 0 and 1 days (OR = 1.09; 95% CI = 1.02%, 1.17%, lag 1; Table [2](#T2){ref-type=\"table\"}; Figure [2](#F2){ref-type=\"fig\"}). ", "For the other respiratory outcomes, there was some heterogeneity in the results from individual states, especially for the overlapping clinical conditions of asthma, COPD, and lower respiratory infections.", "\n\nDifferences by Age and Sex\n--------------------------\n\nMost outcomes were more frequent in older age groups, apart from the childhood disease of croup, and the number of cases was similar between sexes (Supplemental digital information eTable1; <http://links.lww.com/EDE/B415>). ", "The pattern of association with PM~2.5~ was similar for males and females, with the exception of acute coronary syndrome. ", "The same-day odds of this outcome was increased by 5% per 10 µg/m^3^ increase in PM~2.5~ (OR = 1.05; 95% CI = 1.01, 1.09, lag 0) for males, while no association was observed in females (OR = 0.99; 95% CI = 0.94, 1.03, lag 0). ", "This difference was confirmed by meta-regression comparing results by sex (*P* = 0.03). ", "The pattern of associations by age groups generally reflected the expected population distribution of each outcome with most associations observed in people aged over 65 years (Supplemental digital information eTable 2; <http://links.lww.com/EDE/B415>).", "\n\nDISCUSSION\n==========\n\nWe have identified associations between paramedic assessments and daily ambient PM~2.5~ for a wide range of outcomes. ", "While many of these outcomes have been previously associated with air pollution, our finding of clear associations with hypoglycemia and faint appears to be novel and the association with croup has not been widely reported.", "\n\nDiabetic Outcomes\n-----------------\n\nWhen evaluating diabetic outcomes in association with air pollution, it can be difficult to disentangle direct effects from indirect associations. ", "Poor air quality directly affects diabetic control, but also affects many of the chronic conditions that are more common in people with diabetes, such as heart disease.^[@R3]^ Tasmania was the only state in which an association with paramedic assessments of hyperglycemia was observed. ", "One explanation for this regional difference could be the higher prevalence of self-reported diabetes in Tasmania compared with the national average (9.9% vs. 4.7%)^[@R25],[@R26]^ and the higher rate of diabetes mortality in Tasmania compared with all of Australia (24.7 vs. 15.6 deaths per 100 000 population).^[@R26]^ Another reason for the discrepancy between states could be differences in paramedic coding conventions for determining the primary assessment when more than one condition is present. ", "For example, a person with diabetes who develops a respiratory infection might have raised blood glucose levels in addition to respiratory symptoms, and the primary paramedic assessment could reflect either condition.", "\n\nThe association between hypoglycemia and PM~2.5~ was more consistent in our study. ", "This is, to the best of our knowledge, the first time that a potential association between air pollution and low blood glucose has been reported. ", "While the precise relationship between air pollution and glucose homeostasis is unknown, it has been hypothetically linked with an inflammatory response in the context of insulin resistance.^[@R27]^ Further, positive associations between PM and elevated blood glucose have been observed in people with and without impaired glucose metabolism.^[@R27]^ While the association we observed with hypoglycemia could be a chance finding, the effect was consistent at different lags in all three states. ", "A speculative mechanism might be that increased air pollution leads to decreased glycemic control, such that some individuals increase use of insulin or other medications, which can lead to increased risk of hypoglycemia. ", "However, we could not find any empirical evidence for this association. ", "Previous studies have shown that cases of hypoglycemia attended by ambulance services are often successfully treated at the scene and not transported to hospital,^[@R28],[@R29]^ which might explain why hypoglycemia has not been identified in air quality studies of diabetic outcomes based on ER or hospital admissions datasets. ", "We were unable to explore this observation further because we did not have information about the use of insulin or other medications.", "\n\nCardiovascular Outcomes\n-----------------------\n\nThe pattern of observed associations between PM~2.5~ and paramedic assessments of cardiovascular conditions was partially consistent with the wider evidence.^[@R30]^ This includes the positive associations observed for arrhythmia, heart failure, and acute coronary syndrome in males. ", "In contrast, we did not observe associations with assessments of angina, stroke, or transient ischemic attack, all of which were expected based on the available evidence.^[@R31]^ Although ambulance dispatches for cardiac arrest have been associated with ambient PM in a handful of studies from the United States, Italy, Japan, and Australia,^[@R12],[@R32]--[@R34]^ we were not able to evaluate this outcome because arrest data were not consistently recorded.", "\n\nThere is very little research evaluating the association between air quality and fainting. ", "The only other study we identified also observed associations between ambient PM~2.5~ and assessment of fainting by an emergency responder.^[@R15]^ Fainting can be symptomatic of different medical problems, and the assessment is only made by paramedics after possible alternative causes have been excluded. ", "These typically include seizures, serious cardiac arrhythmias, or low blood glucose, which are excluded by history, examination, electrocardiogram, and blood glucose testing. ", "Fainting can have a number of precipitants including dehydration, prolonged standing, instability of the autonomic nervous system, a neuronal reflex, or transient abnormalities of cardiac rhythm.^[@R35]^ An association with air pollution could be plausible, given that cardiac arrhythmias and alterations in heart rate variability have been associated both with air pollution and with clinical syndromes of fainting.^[@R2],[@R36]^\n\nRespiratory Outcomes\n--------------------\n\nThe literature on air pollution and respiratory outcomes has demonstrated that short-term exposure to PM~2.5~ is associated with exacerbations of respiratory illnesses including asthma, COPD, and infections. ", "Increasing PM~2.5~ is associated with measurable increases in respiratory symptoms, emergency presentations, hospital admissions, and mortality.^[@R1],[@R37]^ However, studies of ambulance dispatches are more limited. ", "In Fukuoka, Japan, a 10-µg/m^3^ increase in PM~2.5~ was associated with ambulance dispatches that were later verified as respiratory diagnoses (odds ratio = 1.03; 95% CI = 1.01, 1.05).^[@R33]^ A study of dispatch codes in Italy found positive associations between increased PM and dispatches for all nontraumatic causes, but not the dispatch categories most associated with respiratory and cardiovascular causes.^[@R38]^ A previous study in Sydney, Australia, found a clear association between increased PM~2.5~ (10 µg/m^3^) and ambulances dispatched for breathing problems (relative risk (RR) = 1.03; 95% CI = 1.02, 1.04), while noting that this could reflect many possible clinical conditions.^[@R12]^\n\nOur findings of associations between air quality and both asthma and COPD are consistent with the wider literature, even though a limited number of studies have analyzed ambulance data. ", "The lagged associations we observed are consistent with the mechanisms of airway inflammation. ", "Croup is a viral infection that typically affects pre-school-aged children and causes inflammation and swelling of the larynx and larger airways to produce a characteristic cough and stridor.^[@R39]^ It has been less extensively studied than asthma and COPD as an outcome related to air pollution. ", "Our finding of an association was consistent with the results of two early studies from Germany.^[@R40],[@R41]^ More recent cohort studies of long-term exposure to air pollution and croup have not found associations.^[@R42]^ This suggests that short-term exposure to air pollution is more important as a risk factor for acute exacerbations of croup, rather than long-term exposure contributing to underlying incidence of the infection.", "\n\nStrengths and Limitations\n-------------------------\n\nMost previous studies of ambulance callouts and air quality have relied on dispatch data, which have limited clinical value because their purpose is to assess urgency and enable allocation of appropriate resources. ", "They are solely based on telephone interviews with the patient, a caregiver, or bystander, who rarely have medical training. ", "However, these data do provide information about ambulance workloads and some dispatch categories have been shown to be sensitive to air quality.^[@R43],[@R44]^ One strength of our study was the use of paramedic assessments, which are conducted according to standard protocols involving clinical history, physical examination, and diagnostic tests. ", "They are much more likely than dispatch data to accurately reflect the clinical problem. ", "Another strength is that ambulance data provide the opportunity to evaluate clinical syndromes such as croup, faint, and hypoglycemia, which are more commonly managed in community than in hospital settings.^[@R29],[@R39],[@R45]^ Further, the data are population based, enabling large, geographically dispersed populations to be included.", "\n\nRelative humidity exhibits temperature-dependent daily and seasonal variation. ", "By including daily temperature and seasonal adjustment in our models, we addressed the potential limitations of using a relative, rather than an absolute measure of atmospheric moisture such as dew point.^[@R46]^ Geospatially resolved PM~2.5~ estimates that integrate surface air quality measurements with remote sensing measurements reduce the likelihood of exposure misclassification when compared with studies that derive exposures by averaging data from fixed-site monitoring stations.^[@R47]^ Our approach of integrating data from multiple sources enabled us to generate exposure surfaces across wide geographic areas, including those places that do not have routine air quality monitoring.^[@R10]^ Another strength was our ability to link air quality data with the timing and location of the clinical event, information that is not readily available from administrative hospital and mortality datasets.", "\n\nLimitations of this study include the potential for both exposure and outcome misclassification. ", "Air pollution can have considerable spatial variation within a 5 × 5 km area, which cannot be captured in our exposure model. ", "Further, when the paramedic attendance occurred in the early morning, a large proportion of the estimated same-day exposure (but not the lagged exposures) followed the health outcome. ", "These limitations are common to population-based studies of acute health outcomes associated with short-term air pollution exposures when individual exposure measurements are not possible.^[@R48]^\n\nExposure misclassification also occurs when the case has a lengthy hospital admission. ", "Such individuals will not be at the same location on control days that follow the case day. ", "However, in situations where individual events do not affect the distribution of future exposure in the overall study population, selecting postevent control windows is acceptable.^[@R49]^ Indeed, postevent control days are essential to minimize the risk of bias by long-term trends and seasonal changes in air quality.^[@R50]^ Both spatial and temporal exposure misclassification introduce nondifferential measurement error, which would bias any true association toward the null.", "\n\nLike other administrative health datasets, records of paramedic assessments rely on documentation of a clinical judgement made by a trained professional based on the patient history, physical examination, and results of diagnostic tests. ", "There is relatively high potential for outcome misclassification, although this varies by outcome. ", "Ambulances carry blood glucose analyzers and electrocardiograms, meaning that paramedics can diagnostically test for hypoglycemia and hyperglycemia, arrhythmia, and acute coronary syndrome.^[@R13]^ Uncertainty is greater for outcomes that rely on clinical identification based on symptoms. ", "For example, COPD and asthma can be especially difficult to distinguish by paramedics and doctors who do not have access to pulmonary function testing.^[@R51],[@R52]^ Inconsistencies can also arise when patients have coexisting conditions, but one must be recorded as the primary assessment.", "\n\nMore than 80% of patients in the Tasmanian data were transferred to hospital for most outcomes we evaluated (Supplemental digital information eTable 3; <http://links.lww.com/EDE/B415>), with the exceptions of hypoglycemia and faint. ", "While we did not have access to linked data, other studies have demonstrated agreement between the paramedic assessment and hospital medical assessments for particular conditions ranging from 45% to 70% for stroke up to 100% for acute anaphylaxis.^[@R53]--[@R55]^ In Australia, where all paramedics hold degree qualifications, a study of outcomes following acute myocardial infarction found that 75% of paramedic assessments of myocardial infarction were later verified in hospital.^[@R56]^ Given the more limited access to specialist clinicians and diagnostic testing in ambulances compared with hospitals, it is probable that paramedic assessments have greater misclassification than hospital admission diagnoses. ", "This means more noise in the outcome data and likely bias of the results toward the null. ", "This could be a factor contributing to our null result for cerebrovascular outcomes, when the weight of existing evidence supports an association between short-term fluctuations in air quality and cerebrovascular outcomes such as stroke.^[@R31]^\n\nOur main results include 13 primary health end points at three different lags (Figure [1](#F1){ref-type=\"fig\"}) to characterize the temporal patterns of any observed associations, for a total of 39 models. ", "We expect that 5% of these models (N = 2) would be statistically significant by chance alone (type 1 error). ", "By presenting the same models for each individual state (Table [2](#T2){ref-type=\"table\"}) in addition to the combined analysis, the expected number of models affected by type 1 error increases (N = 8). ", "However, the information gained by the ability to compare results from three different ambulance services in different geographical settings remains useful. ", "Where we see a consistent pattern of associations across the three states, our confidence in the primary association is strengthened. ", "Such consistency was particularly notable for the outcomes of hypoglycemia and asthma.", "\n\nPeople who use ambulance services for transport to hospital are typically older and of lower socioeconomic status than those who use alternative means of transport to hospital.^[@R57]^ These characteristics are also well-recognized risk factors for increased susceptibility to the adverse impacts of air pollution.^[@R1],[@R58],[@R59]^ Therefore, the effect estimates we report may be higher than if the sample had been completely representative of the population. ", "While this does not affect the internal validity of the study, it limits the generalizability of our results. ", "For example, our results are not generalizable to people who do not seek health care at all for their symptoms, who use other primary health facilities for similar problems or who chose use other means of transport to hospital.", "\n\nCONCLUSIONS\n===========\n\nOur findings generally fit with the known associations of air pollution with metabolic, cardiovascular respiratory systems adding coherence to evidence derived from other sources of administrative health data such as hospital admissions or mortality. ", "We have further identified some health problems that been less conclusively associated with changes in air quality. ", "These included hypoglycemia, fainting, and croup, which are all relatively common health problems in the community. ", "The association with hypoglycemia was unexpected and warrants further investigation.", "\n\nSupplementary Material\n======================\n\n\nThis work was funded by a Discovery Grant (DE130100924) and a Linkage Grant (LP130100146) from the Australian Research Council and the following industry partners: The Victorian Department of Environment, Land, Water and Planning; the Victorian Environment Protection Agency (EPA); the Tasmania Fire Service and Tasmanian EPA; the New South Wales (NSW) EPA; and the British Columbia Centre for Disease Control, Canada. ", "F.S. and G.J.W. acknowledge the financial support of the Centre for Air quality and health Research and evaluation (National Health and Medical Research Council (NHMRC) Centre of Research Excellence).", "\n\nThe authors report no conflicts of interest.", "\n\nData access: Access to data is subject to data custodian requirements.", "\n\nSupplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ([www.epidem.com](www.epidem.com)).", "\n" ]

{ "pile_set_name": "PubMed Central" }

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[ "Q:\n\nAssigning a dynamic array using declaration for static array in C?", "\n\nSo for example, \nint aaa(unsigned int par1, unsigned int par2){\n int array[par1*par2];\n return 0;\n}\n\nI tried compiling the code that contains this, and it compiled well and had no run-time issue - the array was properly created.", "\nBut I know that this is basically declaring a dynamic array in static array declaration fashion. ", "What may go wrong with this declaration? ", "Will there be a compiler issue in a different compiler?", "\n\nA:\n\nThis is correct as per the 1999 C standard. ", " The 2011 standard changed it to be an optional feature, which in practice means that all C11 compilers will support it except for MSVC.", "\nBefore 1999 some compilers offered this as a non-standard extension.", "\nHere is a link to StackOverflow search for other questions on this topic.", "\n\n" ]

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[ "package stun\n\nimport (\n\t\"github.com/pkg/errors\"\n)\n\n// IceControlled struct representated tiebreak\ntype IceControlled struct {\n\tTieBreaker uint64\n}\n\n// Pack with TieBreak\nfunc (i *IceControlled) Pack(message *Message) error {\n\tv := make([]byte, 8)\n\tenc.", "PutUint64(v, i.TieBreaker)\n\tmessage.", "AddAttribute(AttrIceControlled, v)\n\treturn nil\n}\n\n// Unpack with TieBreak\nfunc (i *IceControlled) Unpack(message *Message, rawAttribute *RawAttribute) error {\n\tv := rawAttribute.", "Value\n\n\tif len(v) !", "= 8 {\n\t\treturn errors.", "Errorf(\"invalid TieBreaker length %d !", "= %d (expected)\", len(v), 8)\n\t}\n\n\ti.TieBreaker = enc.", "Uint64(v)\n\n\treturn nil\n}\n" ]

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[ "Betalsätt\n\nBrickArms Boonie Hat Tan\n\nrom the blazing desert to the steamy jungle, the BrickArms Boonie Hat proves its worth.", "\n\nThe BrickArms Boonie Hat is designed to be best the lightweight minifig headgear, providing your minifig with excellent cover and camouflage whether they’re on a top secret mission, or on a trip to the old fishing pond!" ]

{ "pile_set_name": "Pile-CC" }

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[ "Editing Human Genomes\n\nSpeaker\n\nWe’ve made things like viruses and vaccines, and we’re starting to engineer single cells. ", "What happens when we can make a vaccine as easily as we can make a Tweet? ", "What happens when we can engineer plants and animals? ", "Soon we’re going to make synthetic human genomes and edit them. ", "We’re going to end up with reproductive technologies that will make cloning look organic, and the way we make babies today look quaint." ]

{ "pile_set_name": "Pile-CC" }

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[ "Artist: PhoenixSong Title: Consolation Prizes\nIt started all in early September\nWhen my god given little became a lot older\nGoodbyes seal my broken heart\nHold on to your teardrops, You got a long way to go\n\nDid you get older doing nothing today?", "\nDon't you wanna stop complaining?", "\nIf one is easy then hard is two\nNo one knows where you're heading to\nOnce my private collection, always betting on you\n\nNo consolation prizes\nSpit out your lies & chewing gum\nCut off your hair yeah that's it!", "\nIf you look like that I swear I'm gonna love you more\n\nI thought about this for a long time\nNever had the chance to try and make it better\nMy heart is waiting for a new you\nAnd there's no other option on the schedule\n\nLove like ours should never die with years\nOnce you start you can't ever go backwards\nCause if dark is one then bright is two\nNo one knows where we're heading to\nNo matter what it takes, never give up on you\n\nI want you to change it all\nI am gonna make it better\n\nNo consolation prizes\nSpit out your lies & chewing gum\nCut off your hair yeah that's it!", "\nIf you look like that I swear I'm gonna love you more\n\nNo consolation prizes\nSpit out your lies & chewing gum\nCut off your hair yeah that's it!", "\nIf you look like that I swear I'm gonna love you more" ]

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