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Sophie and I met Chris at Chuy's at 8 p.m., right after he got off work. They immediately hit it off and were soon making gross jokes. Yes, the talk turned to poop. They seemed to have an obsession with talking about it. I just kept laughing. Then their discussion turned to how they get grossed out about anything to do with the nose. I found it hilarious that they could talk openly about poop, but felt so disgusted by nose stuff. And I loved that they hit it off immediately.
After I got home that night, I started reading a self-help book my counselor had recommended to me. I felt like a dork about reading it but it did make me think. The book talked a lot about how we shouldn't blame our unhappiness on others. It reminded me of how much my ex had annoyed me and how much I had wanted him to change. I had hoped he would change. For awhile I had even tried to be okay with who he was. I shouldn't have thought I could change someone else or tried to force myself to be happy with someone who clearly wasn't right for me. Thinking about that made me feel even better about my relationship with Chris. He had the personality traits I wanted in a relationship.
The next day Chris sent me possibly the longest email I had ever received. It discussed our future and his move. He wrote, "I hope you really think about what is going on with us and can make your decision about us smartly." He said his situation in Washington will be one hundred percent different than it is now, and would make our interactions very different. He said, "In my opinion if I were you I would be thinking less about making the relationship work and more about, 'Do I want to live in the Seattle area any time soon?'" He said he would be following his plans no matter what; that he really likes me but I would have to figure out what I wanted to do with my life. He said it made him sad to think our relationship may be on a time limit. He wrote that he was considering deleting his whole email and just emailing me about Valentine's Day and other happy things. He said he felt better though if he knew I was thinking about us and the scenario we were facing.
"I have never felt so strongly so quickly about someone as I do with you," he wrote. The best case scenario he could think of for us was if I looked into the move and found it if I could transfer there or find a new job. Then I stay here until my apartment lease is up and save up as much money as I can. If I moved up there, we would be living separately and in different towns, him with his best friends there. He said his next year was completely planned out, and if we made it through that year, anything would be possible.
I wasn't sure if my bosses would let me transfer to another office quite yet. I had been with the company for just over a year and a half. I had tried to not think too much about the moving situation because I wanted to enjoy the present. I felt I should stay at my office for at least another year to gain more trust and experience before I asked to transfer. I doubted I would be able to any time this year. I wasn't worried about moving. I wanted to go somewhere new, and the west coast sounded amazing. My only worry was job security. Maybe I worry too much, but I liked my job and wanted to keep it. I didn't want to have to find a new one. I thought about discussing the possibility of moving at my annual review in July. My lease ended in October. My credit card debt and my car would be paid off this year. After that I could start saving for moving. And maybe my bosses would agree to possibly let me move after this year.
Chris added that while he would be in Texas, he was going to enjoy every second he got to spend with me. He wrote, "I know things like this are not at all common. I'm not just 'infatuated' with you." He said he knew we were an amazing match, but to remember that there are other men out there. He didn't want me to end up resenting him for moving. He also said he wasn't sure if people are meant to be with one person their whole lives, since we all change so much. He couldn't believe how much he had changed in the past five or so years. I agreed that we all change a lot over time. My coworker had just pointed out how much I have changed in the past year, and for the better. I felt I got to know myself better all the time.
His email made me feel emotional. Our scenario did kind of suck. But in a way it was awesome because it proved to me that he didn't want to stay in the same place the rest of his life. My exes had been unmotivated people who had no interest in moving out of state. I wanted to see the world, so that had driven me insane. It was refreshing to be dating someone with so much passion for life.


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An Insight Into Cryptocurrency Investment
Investments in cryptocurrencies offer huge returns, but they have huge risks associated with them, so getting trained before investing is vital. The chances of ups and downs in this field are tremendous. The initial coin offerings are being encouraged by significant companies like JP Morgan. Due to their volatility, people are hesitant to invest in cryptocurrencies, but they are worth trying. CryptoSuite Review in the most popular websites that gives us an insight into this innovative field. The Review on the topic whether to invest in cryptocurrencies is the most viewed list these days.
Here are some pros and cons of investing in cryptocurrencies:
1) The returns of crypto currencies are massive. People who invested 1000 dollars in 2013 can receive over 4, 00,000 dollars presently due to the ultimate growth of cryptocurrency market. The initial coin offerings of cryptocurrencies bring out profitable returns in a short span of time.
2) Investing in cryptocurrency is like angel investment and venture capital investing. The risk involved is huge,and one should take care of their initial capital. The crypto currencies are network-based, and the support they are receiving is immense. So, the investors are expecting more returns in short time frames.
3) Unlike equities in startups, the liquidity in cryptocurrencies is high. For example, let us consider the Datum network which is quite successful. One can sell their stakes in the cryptocurrencies at any instant. In startups, the entrepreneur has to wait for the sale of equity or acquisition of his/her stake. The option of immediate sale is not available in the field of investments.
4) In startups, people have to engage themselves in initial investment, and the project needs to be pivoted, and there are many issues to be taken care of for success. In the initial coin offering cryptocurrencies, the working of the network is already established and clear. The right product can be evaluated according to the current market trend.
There are many investment options available in the market, so to sustain in the competitive field, the portfolios must be balanced. The ICO's are better than the venture capital and are worth investing in.
The cons are only a few and let us just have a customary glance through them.
1) Incidents such as hacking are rare, but they might make the investors lose their entire money. The volatility is more in the field of cryptocurrencies rather than in stock markets and real estate.
2) The network of the launch of cryptocurrencies has to attract potential customers and should be stable and user-friendly. Unless the product is strong enough, there will be no significant user base.
3) The cryptocurrency managers are raising pre-initial coin offering funds to build the bar of demand for the currency and to maintain the cost of resources and the network.
4) The team working for the rise of the level of standard from initial coin offerings to large market supply must be sincere and dedicated. They must have the skill set and capability to handle the project efficiently.

subset: commoncrawl


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SOURCE: Egenera
June 20, 2016 08:30 ET
BOXBOROUGH, MA--(Marketwired - Jun 20, 2016) - Egenera, a leading provider of wholesale cloud services and cloud management software to the channel, today announced that its wholesale managed cloud service, Xterity Cloud Services, will be distributed in Canada by Canadian distributor CloudRivo.
CloudRivo will offer Egenera's wholesale managed cloud service, Xterity™ Cloud Services, to service providers in Canada. Xterity delivers a full range of brandable dedicated, managed, private and public cloud services, including Infrastructure as a Service (IaaS), Disaster Recovery as a Service (DRaaS), Backup as a Service (BaaS), and CloudMigrate exclusively through the channel. Xterity's business continuity services deliver on-premise server-to-cloud or cloud-to-cloud backup and disaster recovery.
"At CloudRivo, we are fully committed to marketing Egenera's Xterity Cloud Services in Canada and look forward to working with MSPs who are seeking to offer intuitive, robust and profitable cloud services, " said Nizam Uddin, CEO, CloudRivo.
"Our partnership with CloudRivo marks our entry into the fast growing Canadian market," said Pete Manca, CEO, Egenera. "CloudRivo is ideally positioned to deliver cloud services in Canada and we're excited to bring another distributor on board to fuel our international expansion."
With Xterity, resellers can quickly enter the cloud services market with no up-front capital or ongoing maintenance costs. Unlike reselling cloud services from large, commodity cloud vendors, Xterity delivers the margins resellers need to develop a profitable cloud services business. Xterity is HIPAA compliant and is hosted in Tier 3 and Tier 3+ datacenters worldwide.
Information about Xterity Cloud Services can be found at http://www.egenera.com/xterity-cloud-services/.
About Egenera
Egenera is a leading provider of wholesale cloud services to the channel and data center infrastructure management software. Xterity, the company's white label cloud service, offers revenue generating Infrastructure-as-a-Service (IaaS), Backup as a Service (BaaS) and Disaster Recovery as a Service (DRaaS) to managed service providers (MSPs) and independent software vendors (ISVs) seeking to deliver cloud services with no upfront costs and with higher margins than competing solutions. Headquartered in Boxborough, Mass., Egenera has thousands of production installations globally, including premier enterprise data centers, service providers and government agencies. For more information on the company, please visit egenera.com. Follow Egenera on Twitter, LinkedIn and Facebook.
About CloudRivo
CloudRivo is the Canadian distributor of Xterity Cloud Services. CloudRivo offers Canadian managed service providers (MSPs), value-added resellers (VARs) and ISVs the opportunity to deliver high margin Infrastructure-as-a-Service (IaaS), Backup-as-a-Service (BaaS), Disaster Recovery-as-a-Service (DRaaS), and CloudMigrate migration services to customers with no upfront costs or commitments on a pay-as-you-go basis. CloudRivo, a business unit of GlobalIT / ERP Solutions, was established earlier in 2016 specifically to distribute Egenera's Xterity Cloud Services in Canada.
For more information on CloudRivo visit http://www.cloudrivo.com/why-xterity/.
Contact Information:
Joanne Hogue
Smart Connections PR
+1 (410) 658- 8246Email Contact
Contact Information:
Joanne Hogue
Smart Connections PR
+1 (410) 658- 8246Email Contact
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Relive the Drama - Boys Over Flowers Episode 19 & 20 Recap: Flower Boys Interior Designers
We've finally hit the point in Boys Over Flowers where everyone but Woo Bin is miserable in the romantic department. Thank goodness all the friendships haven't hit rock bottom. But don't worry, another visit from the Wicked Witch of Dramaland is on the agenda just to make sure Jan Di suffers more. Come join in on the discussion with June, Logan, and I, Tiara as we talk about the F3's home improvement skills.
Boys Over Flowers
Starring Gu Hye Sun and Lee Min Ho (Heirs)Add to Queue Remove from Queue Watch Now
Tiara: Yi Jung and Ga Eul's relationship is developing and when I mean developing I mean Yi Jung is being a jerk. On one hand, he's trying to push Ga Eul away because she's an innocent. On the other hand, I think he's pleading for help. He's hurt by his dad's behavior so he's acting out. Good thing Ga Eul is patience, but it has to sting seeing Yi Jung run after your pottery teacher no matter if you know the story.
Logan: Yi Jung is a hot mess. He's obviously still dealing with the hurt that his dad has caused him throughout his life and thinks he's going to turn out to be the same way. It's tragic, but I was so furious when he did that to Ga Eul at the club. He was clearly doing it for his own sake and not for hers, because why would you go out of your way to hurt her if she wasn't even bothering you. The two still have a lot of hurdles to jump before they can really be together.
June: My OTP has such a long way to come until they can get a happily ever after. I think since Yi Jung has had to deal with his dad all his life, it's really hard for him to let go of that mentality. Though being a total jerk to Ga Eul is such a bad look. Like why go that far to hurt her. So sad!
Tiara: Totally they do or else he'll do the same to Ga Eul that he did to Eun Jae. He said she was hiding, but really he pushed her away because he's afraid of being hurt. He sees his mom being hurt everyday by his dad and worries he'll be too if he gives into love. It's a messed up view on love, but I can understand it. However, he'll live a lonely life if he doesn't open his heart for someone. We know he cares for the other F4 so he's capable of love.
Logan: Kudos for Ga Eul for seeing through his messy exterior. She is good and she sees something redeemable in him, so he must not be all bad - if only he could think this way. I also give her props for splashing water in his face when he deserved it. You can be kind, without letting yourself be disrespected and Ga Eul is the perfect role model for this. Jan Di, on the other time sometimes lets herself be disrespected - or at least she's much more prone to stand up for other people than herself. Girl needs to learn to take care of herself just as much as she takes care of others.
June: She's such a good person that Ga Eul is! Ugh this is one of the things I can't stand about Jan Di. I just want her to stand up for herself for once. Like get it together girl, who cares about those other people. But I agree, she needs to take care of herself too!
Tiara: *Groan* You hit the nail on Jan Di's character description. She just allows people to walk all over her, but when she sees other picking on the weak she's wonder woman. She's a very frustrating character to like when she goes back and forth. That isn't a complex character, but an inconsistent writing of a character. It's like the drama doesn't want her to be too strong but not too weak. She can be strong and still get knocked down.
Logan: But I think there are a lot of people out there like Jan Di. Those who take care of and defend their loved ones to the death, but aren't so great at doing the same for themselves. It's sad, but relatable. I was never totally keen on the fact that she had to become Jun Pyo's maid, but the scene where she falls onto his bed is one of my favorites in the drama. One of the scenes that sticks out the most. Sooooo cute!
June: Yeah I was always like of all people to become maid's for of course it was for Jun Pyo!
Tiara: Haha!!! Totally fanservice, but I think the whole forced living together/maid thing is about the same. Jan Di told Jun Pyo her promise about his mom getting in between them was invalid, but let's be honest he broke it first. How else was the drama going to get them back together again … turn her into Jun Pyo's personal maid. I felt it was the drama playing cupid to it's own characters. It's weird, but not harmful. However, Jae Kyung is a problem. I don't hate the character, but she knows about Jun Pyo and Jan Di. I get she's interested in him, but she's still hanging onto him in hopes he'll love her. Not to mention, she still wants Jan Di as her BFF. Is she really that naive to think that will happen?
Logan: Yeah, even I think Jae Kyung is being a little much. If you really want her to be your friend, why would you try to hurt her by bringing her ex around all the time and rubbing it in her face that you're with him now. Pretty uncool. Jun Pyo totally broke the promise first and when he says during the game that he won't let the one he loves go, um...you broke up with Jan Di and you're still broken up. Lol.
June: Ugh Jae Kyung ugh. I can't stand her behavior during this part of the drama. It's all too much and it always hurts Jan Di. I still don't know how Jan Di can stand being around her when she knows she'll get hurt in the process. Maybe it's something in this drama I will never understand no matter how many times I watch it.
Tiara: Right, that never made sense to me or do I need to check off amnesia off my bingo card? Did Jun Pyo forget the hurtful words he told Jan Di in Morocco because I don't and neither did anyone else at that party. By the way, I love Ji Hoo giving a kiss to Yi Jung to not answer his question. I also giggled a lot to the question Jan Di gave to Woo Bin about if F4 were woman whom would he marry. Haha!!!
Logan: I think Woo Bin has the right idea, I wouldn't want to marry any of them either - they have some issues to work out. Haha. Woo Bin's probably the most well-adjusted of the group. But one thing I loved this episode was the fact that he and Ji Hoo and Yi Jung showed up at Jan Di's and helped her spruce it up. We're seeing a return of the Jan Di/F3 friendship scenes and these are the types of things I live for in a Kdrama. It was kind of frustrating to see all their hard work go almost immediately down the drain when our evil witch decided to have the building demolished.
June: F3's return is always welcomed! This friendship is such a highlight for this show. Ugh this Wicked Lady never fails to surprise me in this drama. I remember thinking that this lady has to be the most evil in all of K-Drama moms.
Tiara: I love the support she gets from the F3 and I also love how Ga Eul is included in the remodeling. Must like Jan Di is an honorary member of the F4 so is Ga Eul. In dramaland if it's a good thing, it won't last forever case in point Jan Di's rooftop apartment. It just angers me that the Wicked Witch of Dramaland can't believe her son is at fault for moving into the building next to Jan Di. *Grr* Apparently if he continues to find her when she runs away, it totally means Jan Di is using her womanly ways to seduce him. *facepalm*
Logan: Clearly, Jan Di just cannot keep her wiley ways to herself and managed to seduce all of F4 -that's the only explanation for why they'd want to be around her and help her out. Oh, the logic of evil mother-in-laws in Kdramas. Also, one thing I liked about them decorating Jan Di's rooftop apartment for her, was that what they were giving her wasn't a gift of money. They're filthy rich so giving her money would be nothing to them. Instead, they gave her their time and affection by doing physical labor to make the place she lives prettier. For flower boys, that's a big deal. And it says a lot about how all of F3 feels about her.
June: Ugh all the feels with that friendship. I wish there was more friendships like this in dramas. It's nice to see that every once in a while.
Tiara: I 100% agree. The F3 could have found her a place to live, but instead they just help remodel her apartment. Such a shame their time and effort when to waste. It's the thought that counts at least. Switching topics, I'm not overly fond of Ji Hoo and Grandpa's storyline, but I enjoy seeing Jan Di manipulate both of them into living together. She's the only one who can get away with forcing them to live together and ride together home. It's the one thing Jan Di can do for Ji Hoo to pay him back for being there for her.
Logan: I can never understand how the grandpa, in his head, thought it was okay to abandon his young orphaned grandson to be alone. It's like - I don't care what you're dealing with emotionally, Grandpa, you have to take care of the kid first. The way Jan Di showed up at Ji Hoo's place with luggage cracked me up, especially how he just points her to his guest room before he realizes what's going on. But Ji Hoo and Grandpa need each other - it was the right thing to do.
Tiara: It doesn't make any sense to leave your grandson to grieve on his own, but I'm with you Logan those two need each other now. It's time for them to settle them issues and become a family. One last topic, Granny Head Housekeeper is a hoot. She's totally teaching Jan Di how to run the household. Sure, it was probably Jun hee who asked her to do it, but I don't see Granny saying yes if she didn't think Jan Di would be good from her young master.
Logan: That's for sure, Tiara. I can't see Granny agreeing to anything she didn't want to do. Lol. She knows how to run a household, though. That is for sure.
Tiara: How did everyone do on Bingo? My card is pretty full, but no bingo.
June: My bingo has been so sad ever since my one win! :'(
Logan: I'm pretty sure I'm going to finish out this drama without getting another bingo. Is it because the cliches are more nuanced towards the end of the drama? Either way -oh well...I've gotten a couple dramas, that's enough :)
Tiara: Maybe we need more tropes next time we play bingo. Until next time, watch more dramas.
For more from Chingus in Dramaland or to become a KDrama stalker and follow us:
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Tiara: Aja-Villa.tumblr | Aja-Villa.blog | Twitter: @ajavillablog | Instagram: @ajavillablog | Past Drama Clubs |
Logan:Blog |Tumblr | Instagram|Producer | Cheer Up! | Moorim School | Entertainer |Doctor Crush | Scarlet Heart |
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Catch up on our past Relive Drama Club posts!
Episode 1 & 2 | Episode 3 & 4 | Episode 5 & 6 | Episode 7 & 8 | Episode 9 & 10 |
Episode 11 & 12 | Episode 13 & 14 | Episode 15 & 16 | Episode 17 & 18 |
Episode 19 & 20 | Episode 21 & 22 | Episode 23 & 24 | Episode 25 |


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Words that end in alame
Found 2 words that end in alame. Browse our Scrabble Word Finder, Words With Friends cheat dictionary, and WordHub word solver to find words that end with alame. Or use our Unscramble word solver to find your best possible play! Related: Words that start with alame, Words containing alame
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Sinead O'Connor/Solas
The Emperor's New Clothes
Your Spirit Sings
I Am Stretched on Your Grave
Only one way to be free
John I love you
This is to mother you
Sign to you ??
Thank you for loving me +
Last day of our acquaintance
In this heart (my love)
She's changing ??
I am something ?
He moved through the fair
Labels: Asbury Park, NJ, Paramount Theater, Sinead O'Connor, Solas


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Join us and celebrate the 6th worldwide Rare Disease Day. This year's theme is "Care", with the slogan, "Join Together for Better Care".
Close to 3 million people in MENA suffer from rare disease and/or a genetic and hereditary condition. There is a chance you know someone!
These patients fight their disease and in many cases the social stigma that comes with it. They need your support. To learn which events are close to you, to join and make a difference click here


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DEERFIELD, IL – Walgreens announced it is offering early retirement and severance programs to employees in corporate and field management positions as part of its Rewiring for Growth initiative.
Approximately 1,000 positions (about 9 percent of those currently employed in corporate and field management) will be eliminated by the combination of voluntary and involuntary programs in fiscal 2009. These programs will not impact store personnel.
Rewiring for Growth is one of the company's key strategic initiatives designed to leverage the value of its core businesses — to earn "more from the core" for its shareholders. The project, first announced at Walgreens Analyst Day meeting in October, will align the company's cost, culture and capabilities to enhance customer service and satisfaction levels for shoppers, patients and payors.
To reduce overhead, including the number of people employed in corporate and support roles, Walgreens is enabling eligible employees to voluntarily resign or retire from the company with both severance pay and benefits coverage based on years of service and retirement eligibility. This program is being offered in advance of a supplemental involuntary separation program that will begin in February. The company intends to reduce to the extent possible the number of involuntary separations by offering a more favorable voluntary program first. Under the voluntary program, eligible employees can receive more weeks of severance pay and continuation of retiree medical benefits if they meet certain age and service requirements.
When questioned about how the reductions may affect fleet, Michael Polzin, Walgreens Corporate Communications told Automotive Fleet, "While some corporate management in our transportation area will be eligible for the voluntary program, it won't have an impact on our fleet."
Walgreens expects to incur costs of $300-$400 million over fiscal years 2009 and 2010 as it implements Rewiring for Growth. Fifty percent of the project's benefits are expected to accrue beginning in fiscal 2010, with the full $1 billion in targeted annual savings beginning in fiscal 2011.
Originally posted on Automotive Fleet


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"I have read this to mean if 51% of the population elect a Member of Parliament, genuine democracy means that that person should reflect the will of the people, and not vote according to his will. Assuming my interpretation of your position is correct, then there are indeed areas of difference. The question of whether the electoral system is democratic is divorced from the question of whether that 'democratic system' correctly ensures that the person who is elected reflects the will of the majority." Cho
The way this scenario plays out in Zambia, evokes the most puzzling doubts about whether democracy is really still in play – I may be too simplistic but what would you think if –
You went to dinner in a group and after a discussion between the choices of a steak or seafood restaurant. The group finds that the majority prefers the steak restaurant; they then decide on a menu and choose a representative to make the order. But because the representative feels seafood may be a better diet for his health, he orders seafood for the group and brings the bill along for the group to settle.
Does the order still represent the will of the majority?
During general elections, candidates present themselves under one party and sign a social contract with the electorate to undertake specific development programs. However, after securing the initial votes, some MP's switch parties or deliver programs usually at the bottom of the electorate's priority list.
Results of by-elections show a much lower voter turn out even when the same candidate wins under a different party.
Besides the financial loss suffered by the electorate forced to fund another election, do low turn outs also convey a loss of the majority support or will?


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Do not think about, write about or deal with human behavior without determining the effects of incentives. It's not their money, of course they'll waste it.
I feel their pain. It must be horrible to formulate a hysterical scenario, supported by all those experts from Hollywood and the political arena, and then find it's wrong. Naturally, the theory must be supported by lying and distortion. It's just that important.
National Post – (Latest Edition)
Lawrence Solomon Lawrence Solomon is executive director of Energy Probe, a Toronto-based environmental group. firstname.lastname@example.com
Financial Post
Breaking: 19th Little Ice Age
With a century of cold weather ahead, the public won't buy that cold weather is caused by global warming
The "experts" are already telling us that. Global Warming leads to cooler weather, it's only logical.
Fewer than one-third of Americans lose sleep over global warming
The news was all gloom for globalwarming doomsayers this week — a double whammy of (for them) incomprehensible findings that proves (to them) that the world is either mad or in denial.
The first whammy came via Gallup, in a comprehensive study of American attitudes to the environment in general and global warming in particular. Despite the obvious-as the-nose-on-your-face (to them) environmental calamities that are at this very moment overwhelming the planet, only 9% of the public rate the overall quality of the environment as poor. Inexplicably, 50% rate the environment as excellent or good — the highest degree of satisfaction with the state of the environment that Gallup has recorded since it began asking this question in 2001.
But the gloom for the doomsayers was only beginning. When Americans do worry about the environment, they worry "a great deal" about the quality of their drinking water, followed by pollution of rivers and lakes. They don't worry a great deal about global warming, which ranks dead last on Gallup's list of worries. Fewer than one-third of Americans lose sleep over global warming, fewer than express concern over air pollution, fewer than get stressed over environmental issues that haven't dominated the news in decades, such as the extinction of plants and animals and the loss of tropical rain forests.
Worse, despite everything President Barack Obama has told them about the absolute imperative to stop global warming, despite all the warnings in the mainstream media about how we're running out of time, American are less fussed over global warming today than they were when George Bush was president, when more than 40% were very worried. The urgency has since vanished into the ether. When asked "Do you think that global warming will pose a serious threat to you or your way of life in your lifetime?" Americans now overwhelmingly — 62% — respond "no."
Gallup's research discovered that about half the public associates warmer weather with global warming (the other half sees it as normal variation); fewer associate snow and cold weather with global warming because "the connection [is] less intuitive." With 51% of Americans saying the weather in their area was colder than usual this winter, and only 18% saying it was warmer, it follows that this winter's cold weather has had a chilling effect on potential converts to the cause of global warming.
It likewise follows that the failure of temperatures to rise for almost two decades now has dampened apprehension over global warming, and that the number of future converts will rise or fall with the thermometer.
Enter Habibullo Abdussamatov of the Pulkovo Observatory of the Russian Academy of Sciences, the scientist who heads Russia's space research laboratory and its global-warming research using data collected by the International Space Station. Unlike other scientists in the global warming field who have had to continually backtrack, sidestep and spin erroneous findings when their models proved embarrassingly wrong, Abdussamatov's studies over the last decade have stayed on course, in keeping with the actual temperature readings that ultimately provide a true measure of climate change.
His latest study, published in Thermal Science, delivers this week's second whammy. It continues the analysis he has long pursued, which consistently arrives at the same conclusion: Earth is now entering a new Little Ice Age, Earth's 19th Little Ice Age, to be precise. Abdussamatov has been quite confident of his findings for what might strike some as odd reasons: His science is based on that of the giants in the field — astronomers like Milutin Milankovitch, who a century ago described how tilts in its axis and other changes in the Earth's movements determine its climate, and William Herschel, who two centuries ago noticed an inverse correlation between wheat prices on Earth and the number of sunspots generated by the Sun's cycles. (Hint: the more energy from the sun that Earth gets, the more warmth Earth receives, the more abundant the wheat crops, the lower the price of wheat; the less energy from the sun, the less warmth, the more wheat crop failures, the higher the wheat price.)
Greenhouse gases — CO2 and water vapour — play a role in this drama, but the gases come not from SUVs and other man-made activities but from the oceans, which contain 50 times as much CO2 as the atmosphere. As the oceans warm or cool because of the sun, they release or absorb these gases, whose greenhouse effect is secondary and relatively minor.
Abdussamatov's model incorporates the sun's 200-year cycles and the feedback effects from greenhouse gases released by the oceans, and sees how they acted on Earth's previous 18 Little Ice Ages. "All 18 periods of significant climate changes found during the last 7,500 years were entirely caused by corresponding quasi-bicentennial variations of [total solar irradiance] together with the subsequent feedback effects, which always control and totally determine cyclic mechanism of climatic changes from global warming to Little Ice Age."
If the 19th Little Ice Age follows the pattern of the previous 18, Earth slipped into an ice age in the winter just concluded and will become progressively colder over the next 50 years, reaching its depth around 2060. Another half century, taking us to the 22nd century, and we'll arrive back at today's temperatures.
Through it all, Gallup will be describing the public's opinion of global warming.
Well, if the world doesn't respond to a theory supported by Hollywood, then I don't know what to believe.
Government Job or Respect–Which'll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, "Days of Songs and Mirrors: A Jacobite in the '45."
Cui Bono–Cherchez les Contingencies


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Walking with Dinosaurs
Walking with Dinosaurs features fifteen life-size mechanical dinosaurs in two acts of live theater. Along with the mechanical aspects that allow the animals to walk around, the roaring sounds and dramatic lighting bring these once thriving animals back to life.
ShowTimeTickets.com has been buying & selling the world's most sought after Sports Tickets, Theater Tickets, and Concert Tickets for 25 years. Our unbeatable selection, competitive pricing, and world class service is second to none.
This thrilling production guarantees to captivate audiences of all ages. Don't wait, order your Walking with Dinosaurs tickets from ShowTimeTickets.com online today!


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The body of a south suburban man reported missing New Year's Day was found Monday morning in the Cal-Sag Channel, authorities said.
Police were alerted at 11:08 a.m. to the body on the south bank of the Cal-Sag Channel near Interstate Highway 57 west of Ashland at mile marker 319 in Blue Island.
The man was identified as Phillip Evans, 48, of the 14500 block of South Vail Avenue in Dixmoor, according to the Cook County medical examiner's office.


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Japan is famed for its crowded cities, but much of the country is mountainous territory covered with thick stands of trees. While greenery is always welcome in a landscape, one common type of tree comes in for more hatred than appreciation: Cryptomeria japonica, the cryptomeria (sugi in Japanese, often called "Japanese cedar" in English) responsible for an annual allergy epidemic throughout the country. Each year, from mid-February to the end of April, billions of cryptomeria blanket cities and countryside alike with eye- and nose-watering yellow plumes of pollen. Thanks in large part to these trees, hay fever, known as kafunshō, has in recent decades become the chief springtime bane for hordes of sufferers.
Kafunshō has been on a steady uptick since the early 1980s and by some accounts now affects one in every five Japanese. This boom in sugi allergies is the direct result of government policies implemented following World War II aimed at raising Japan's domestic lumber production.
In the postwar years the country found itself in need of wood for the rebuilding process. Officials turned largely to sugi, cutting down huge swaths of slow-growing deciduous species that produced less lumber and replanting them with uniform stands of the quick-growing and hardy domestic evergreen. For decades these trees provided reliable supplies of straight, long boards with hardly a sneeze. Eventually, though, cheap imported lumber from Southeast Asia and other regions drove down demand for domestic wood. Without a market, huge tracts of sugi were spared the axe and allowed to flourish.
Japan's drug stores do booming business in antipollen masks every spring.
According to Forestry Agency figures, over 4 billion sugi trees were planted in Japan's mountains between 1950 and 1970. Leaving these mature trees unfelled has increased the pollen counts by a factor of five over the last three decades. The number of hay-fever sufferers has trebled during this time, a growth rate that shows no sign of slowing.
In addition to the sheer number of the trees, some experts have pointed to global warming as an allergy culprit for causing sugi and other sneeze-triggering species to mature more rapidly and produce larger quantities of pollen.
Now the promise of relief has appeared in the form of pollen-free trees. In 2007, Toyama Prefecture's Forestry Research Institute made news by registering the first ever non-pollen-producing sugi. Christened Haruyokoi, which means "welcome, spring," the variety was the culmination of a lengthy process that began in 1992—a year when researchers stumbled onto a tree in the city of Toyama that looked exactly like its neighbors except for the fact it didn't produce pollen.
A juvenile Tateyama Mori no Kagayaki tree in Tokyo's Hibiya Park.
In developing Haruyokoi, researchers uncovered the genetic mechanisms for producing pollen-free trees, opening the way to new and different varieties. Following its first success, the institute has since produced a second variety that has caught the attention of both timber growers and allergy sufferers. Named Tateyama Mori no Kagayaki, or "the gem of Tateyama's woods," the tree was created through cross-pollination of hardy regional sugi varieties with ones possessing the all-important quality of not manufacturing pollen.
Production of both varieties of tree is slowly being ramped up, but it is an arduous task. It can take one to two decades for seed trees to begin producing cones and several years to cultivate saplings. However, the institute remains undaunted in its goal of boosting annual plantings of the Tateyama variety from the current level of 30,000 saplings to 300,000 by 2027.
At present, the more than 130 pollen-free and low-pollen varieties that have been developed account for slightly more than 10% of the nearly 16 million trees planted on farms each year. Availability and cost have been major barriers to broader acceptance of new allergy-friendly strains. To address this issue, Japan's Forestry Agency has announced plans to subsidize up to 70% of production and planting costs with an eye to increasing the share of new varieties to 10 million trees a year, more than half of all plantings, by 2017.
This is good news for those with kafunshō. But the factors keeping replacement rates for sugi stands low are not likely to change anytime soon. It will be some time until allergy sufferers can put away the masks and tissues.
(Banner photo: A pollen-laden stamen of a cryptomeria. Courtesy Doug McAbee. Masks photo courtesy Ken Lee.)
Translator and editor, Nippon.com. Graduated from the University of Oregon in 1996 with a degree in Asian Studies. Came to Japan the same year and has lived here ever since, studying Japanese and traveling by train or foot in search of local history, culture, and dialects. Has also spent time as a kindergarten teacher and at-home dad. Began translating in 2008 and has worked both freelance and in-house at a major Japanese food and beverage manufacturer. Joined Nippon.com in 2014.
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Hey, I'm not ashamed of letting the world see what we have going on.
The media's clear implication was that Trump was mocking the way Kovaleski moved his arms. People watching the clip of Trump's impersonation only knew that Kovaleski was disabled. Thus, they naturally assumed Kovaleski's disability must be similar to cerebral palsy where he has limited control of his movements and is prone to have muscle spasms or move his arms in jerky motions as Trump was doing at the rally. This is precisely the image the media wanted in people's minds. They wanted this to be the story: that Donald Trump knowingly and intentionally mocked the flailing arm motions of someone who can't control his muscles. They knew this would naturally trigger a visceral reaction of disgust from viewers and outrage amongst the disabled and all decent Americans, many of whom, to this day, think this is exactly what happened. Is it?
What the media did not choose to show you was video of Serge Kovaleski. Notice how the media only showed and still shows photos of him. This was done for a reason. As it turns out, Kovaleski's disability is a congenital condition called arthrogryposis. Arthrogryposis causes restricted movement in the joints but does not cause spasms or uncontrolled moving of the limbs like cerebral palsy does.To show the depths of the deceit, one CNN reporter explained, while displaying a still photo of him, that Kovaleski, "suffers from a chronic condition that impairs movement of his arms." Again, the implication is that Kovaleski can't control his arms from moving. To the contrary, Kovaleski appears perfectly calm when giving interviews. Thus, if Trump truly wanted to mock Kovaleski's disability, he would have had to stand perfectly still with a flexed right hand and not flail his arms. don't believe me?
In addition, Trump used the same flailing arm movements in a South Carolina rally to impersonate a flustered Ted Cruz being asked about waterboarding. To my knowledge Cruz is not physically disabled:
Thus the true story is as follows: Donald Trump embarrassed the media by finding the 9/11 Washington Post article. The media found the reporter who tried to backtrack. Trump impersonated the reporter backtracking. Media points out the reporter is disabled, but only releases still photos of his flexed hand. Public assumes from Trump's impersonation and being told by the media that he is mocking a disabled man that the reporter must not be able to control his arms and Trump is a dirtbag who hates the disabled. In reality muscle spasms or involuntary arm movements are not part of the reporter's disability. Therefore Trump could not be mocking a disability that doesn't exist. Hear Trump respond to the claim below, which perfectly coincides with the series of events described above:
Thus, Trump's impersonations of a flustered reporter several months ago was turned into a left-wing and Establishment GOP narrative whereby Trump somehow hates the disabled. This despite the fact that Trump has given millions to charities that help the disabled including raising nearly six million dollars for Wounded Warriors just recently, a million of which was his own money.
originally posted by: Mitmein
Just sayin.
a reply to: LesMisanthrope


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|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|aaron morton <aa...@thelastpickle.com>
|Re: Dumping
|Mon, 30 Aug 2010 18:37:51 GMT
sstable2json discussed here http://wiki.apache.org/cassandra/Operations may be what you are after, or the snapshot feature. Not sure what you want to use the dump for. If you do not know the keys in the CF in advance take a look at get_range_slices (http://wiki.apache.org/cassandra/API) it allows you to slice through the keys in a similar way to slicing through the columns. Aaron On 31 Aug 2010, at 05:15, Mark wrote: > Is there an easy way to retrieve all values from a CF.. similar to a dump? > > How about retrieving all columns for a particular key? > > In the second use case a simple iteration would work using a start and finish but how would this be accomplished across all keys for a particular CF when you don't know the keys in advance? > > Thanks
|View raw message


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Savings account - GUARANTEED 2.5% p.a. (Singapore)
Prudential Singapore has just launched a one time savings account, very much like a fixed deposit that gives a guaranteed 2.5% yearly compounded interest. Plus, it's capital guarantee upon 36 months.
Currently, most banks are offering at a rate of just 0.45% yearly.
This is an exclusive product for a limited period only! And based on previous launches, it was sold out within 2 weeks. So hurry! Grab this opportunity today!
Also, spread the good news to your family and close friends.
Check out our website!
Protected content
Simply talk to me to arrange the best time for a short discussion. It will take about 15 minutes.
Best Regards
Financial Consultant
Prudential Assurance Company Singapore


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The club
Deeside Ice Skating Club meets throughout the year and runs sessions on Wednesday evening 6.00pm until 7.30pm and Sunday morning 9am until 10.30pm. Club sessions are open to all skaters who have achieved Skate UK Grade 8 or above. At Deeside Ice Skating Club we take a proactive approach to the skating of all its members adopting a professional, skater focused strategy with the aim to help all skaters achieve their personal goals. The Club hold regular competitions throughout the year for its members and also provide coached sessions. Our highlight of the year and something we are very proud of year in and year out is our annual show – this is an extravaganza of our members skating and performance skills and something we encourage all our full members to participate in. The show proves to be an overwhelming success each year and helps build on the strong bonds our members have. So if you are Skate UK Grade 8 or above and are looking for a progressive but fun club then look no further, you have found it right here! All FULL members receive a FREE Club Fleece! Our club is run by a committee of volunteers along with some very helpful parents, so if you are interested in helping in any way and can spare some time please come and see a committee member at one of the club sessions who will be more than happy to help with any queries you may have.
Jo-Anne Murray
Vice Presidents
Simon Lawton-Hayes & John Haime
Chair Person
Jo Gillmore
Vice Chair Person
Joanne Jones
Sherry Lester
Simon Robinson
Committee Members
Steph Salusbury, Laura St. John Williams, Chloe Lawton Hayes, Dawn Davies, Lorraine Owen, Jayne Ratcliffe, Tracy Carbery, Diane Carbery, Sian Hoole and Jon Brookin.
Welfare Officers
Jo Gillmore, Jo Jones, Fiona Robinson and Lynne Gillmore.
How to Join Deeside Ice Skating ClubJoining couldn't be simpler! Firstly, you are entitled to Two free taster sessions on a club session that suits you (please bring your pass card to show that you are Skate UK Grade 8 or above), once you have skated twice and you are ready to join there are two types of membership you can apply for:
mbFull AssociateApplication forms can be printed off below, please bring your form along with your pass card to show that you are Skate UK Grade 8 or above and hand to a committee member at one of the club sessions. Ice membership form 2017 – 2018 Membership Fees 2016-2017 Membership Fees 2016-2017 5 Standing Order Form 2014-2015 If you have any queries regarding the club or membership please visit our contact us section.
Club Rules and Guidelines
To view a copy of the Club's Constitution, Code of Conduct and Child Protection Policy please see the below documents:Rules and constitution Code of Conduct – 140508
First Aid on the IceThe committee would like to remind all members that when there is a serious fall on the ice and it appears that an individual may be injured, the situation MUST be assessed by a Deeside Leisure Centre designated First Aider. It is vital that immediate contact is made with a member of Deeside Leisure Centre staff when an incident as such occurs. Any intervention of any type prior to the arrival of a designated First Aider must be kept to an absolute minimum to sustain the well-being of the injured person. Intervention in excess of this will result in the Leisure Centre staff deeming that another person has taken control of the situation and they will then NOT take the lead for First Aid purposes at that point. In particular it is important not to lift or move an injured person unless that this is absolutely in their best interest. Remember: You can do more harm than good by moving somebody who is injured. In the vast majority of cases it is best to ensure that the injured person is accompanied at all times whilst waiting for the First Aider to arrive, they will then assess the situation and determine how the injured person is to be treated and moved.


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Here's another find I posted on Digg awhile back -
LOOK AT THIS GUY'S HOME ARCADE!! JUST LOOK AT IT!! (Did ya pee a little? Yea, I did too...)
I found Peter Hirschberg's site years ago and have kept it close ever since. He has got to have the most fantastic, historically accurate portrayal of a classic 80's arcade that I've ever seen! Peter is DEFINATELY a candidate for having on the show. Alot of us out here would love to get into collecting coin-ops and having someone like Peter on would be just the ticket!
Other than the machines he's got, I want to know what he's got powering all of those cabinets!!!
"Death & Dreck You Curse!!!"
- The Bard's Tale II: Destiny Knight


text:
1972 ASP Clubman
$23,990Mileage 4000 Miles Engine 1600 CC 4AG - 20 Valve Rego SOC 199 Originally sold by us we have delighted to list the following car. This genuine ASP built 1972 as track clubman and was later converted to road reg. Historic Logbook S484 Minimal changes despite historic road rego. Ideal vehicle for historic Group P or R racing. Main use to date hill climbing. A reluctant sale that includes enclosed trailer. Contact Ben Finnis for more details . Owner says " Sell" so reduced by $4000 to move it Back


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Article Text
Objectives The objective of this study was to longitudinally describe the history of tonsil surgery in Swedish children and adolescents regarding incidence, indications for surgery, surgical methods and the age and gender distributions.
Setting A retrospective longitudinal population-based cohort study based on register data from the Swedish National Patient Register (NPR) and population data from Statistics Sweden.
Participants All Swedish children 1–<18 years registered in the NPR with a tonsil surgery procedure 1987–2013.
Results 167 894 tonsil surgeries were registered in the NPR 1987–2013. An increase in the total incidence rate was observed, from 22/10 000 person years in 1987 to 47/10 000 in 2013. The most marked increase was noted in children 1–3 years of age, increasing from 17 to 73/10 000 person years over the period. The proportion children with obstructive/sleep disordered breathing (SDB) indications increased from 42.4% in 1987 to 73.6% in 2013. Partial tonsillectomy, tonsillotomy (TT), increased since 1996 and in 2013 55.1% of all tonsil procedures were TTs.
Conclusions There have been considerable changes in clinical practice for tonsil surgery in Swedish children over the past few decades. Overall, a doubling in the total incidence rate was observed. This increase consisted mainly of an increase in surgical procedures due to obstructive/SDB indications, particularly among the youngest age group (1–3 years old). TT has gradually replaced tonsillectomy as the predominant method for tonsil surgery.
- tonsillectomy
- tonsillotomy
- tonsil surgery
- register
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Strengths and limitations of this study
This study describes the epidemiological trends of tonsil surgery in Swedish children over the past few decades.
The major strengths of the study are the large population size and the use of the Swedish National Patient Register (NPR) with unique nationwide data and high coverage.
The study covers a long period of time and can therefore be used to determine actual longitudinal application of clinical practice concerning tonsil surgery in Sweden.
One limitation is the potential inherent weakness of the NPR with the possibilities of missing values and inaccurate data reporting.
Data are limited to a Swedish population and the generalisability from a global perspective might be somewhat limited, but the results can possibly indicate the evolutionary factors affecting tonsil surgery on a more global scale.
Tonsil surgery has an ancient history and was first described in the literature almost 3000 years ago.1 Today, tonsillectomy (TE), with or without adenoidectomy, is one of the most frequently performed surgical procedures in children, with over 530 000 TEs performed on children in the USA each year2 and nearly 9000 tonsil procedures performed on children in Sweden in 2013.3
Over the past 100 years, tonsil surgery has undergone a number of changes, particularly with respect to indications and surgical methods. Prior to 1900, the predominant surgical technique was tonsillotomy (TT) with subtotal intracapsular removal of the tonsils.4 Then, along with advances in anaesthesiology at the beginning of the twentieth century, total extracapsular TE gradually became more common. This paradigm shift from TT to TE was essentially complete by 19504 and during the second half of the twentieth century, TE was the prevailing method. Later, in the 1990s, the previously abandoned method of TT was revived in some countries, including Sweden and Austria.5 Compared with TE, TT is associated with fewer perioperative morbidities, such as postoperative haemorrhage and pain,6 ,7 and it is now primarily used to treat sleep disordered breathing (SDB) caused by upper airway obstruction due to tonsil hypertrophy.8
Along with shifts in surgical methods, the indications for tonsil surgery have also changed considerably. At the beginning of the twentieth century, in the preantibiotic era, infection or recurrent tonsillitis was the main indication for tonsil surgery.9 Following the introduction of antibiotics in the 1950s, the number of TEs decreased dramatically over the following decades.10 ,11 Then, in the 1970s the first cases of paediatric obstructive sleep apnoea (OSA) were identified12 and a successive shift in indications followed. Today, upper airway obstruction/SDB is the most common indication for tonsil surgery in children, having surpassed the second largest indication group, infections related tonsil disease.9
A more detailed analysis of the trends and changes in paediatric tonsil surgery during the twentieth century is difficult to perform due to lack of high-quality data sources.
The National Board of Health and Welfare in Sweden has initiated a national registry, known as the Swedish National Patient Register (NPR), with the aim of collecting data on all healthcare procedures performed in Sweden.13 The NPR provides the possibility of performing detailed analyses of trends and changes in healthcare practices in a nationwide population. Indeed, this database provides a unique source of data with few, if any, equals around the world.
The importance of monitoring historical and current trends in medical practice cannot be overstated. Some of the most important changes in indications and methods for paediatric tonsil surgery over the last century were not the result of evidence-based research; rather they were based on local praxis and traditions. Furthermore, the related consequences of these changes regarding outcome, complications and economic costs are often unstudied.
The objective of this study was to longitudinally describe the history of tonsil surgery in Swedish children and adolescents with respect to incidence, indications for surgery and surgical methods, as well as age and gender distributions. A description of the trends in paediatric tonsil surgery is a prerequisite to identifying critical research areas that will allow us to determine best practices and improve healthcare quality and can also be a guide to future public health planning.
Materials and methods
Study design
A retrospective longitudinal population-based cohort study based on register data from the NPR and population data from Statistics Sweden.
Data sources
Swedish National Patient Register
All medical data were collected from the NPR. Registration in the NPR is mandatory by law for public and private care providers (except primary care) in Sweden. The NPR contains information regarding medical data (diagnoses, surgical procedures), patient-related data (gender, age, personal identity number) and information regarding healthcare providers. The NPR is thought to have complete national coverage for inpatient care starting in 198714; outpatient care was included beginning in 1997 and was mandatory starting in 2001.
Statistics Sweden
A government agency that coordinates the official statistics of Sweden and provides statistical information on the Swedish population.15
Study population
The study population included all patients 1–<18 years registered in the NPR with a tonsil surgery procedure between 1 January 1987 and 31 December 2013. The search was based on surgical codes in the Nordic Medico-Statistical Committees Classification of Surgical Procedures, including TE and TT with or without simultaneous adenoidectomy.
Diagnosis codes from the International Classification of Diseases (ICD) were collected from the NPR. Since 1987, two different ICD classifications have been used (ICD-9 1987–1996 and ICD-10 1997–). For patients registered from 1997 (ICD-10) onward, it was possible to exclude patients with malignant disease (C- or D 0–48 codes).
Population statistics for all individuals in Sweden aged 1–<18 years during the study period were collected from the Sweden Statistics population database.
Indications for surgery were categorised in two main groups: 'obstructive/SDB' and 'infectious' (table 1); all other indications were referred to as 'other'. The indication groups were analysed with respect to age, gender and longitudinal incidence.
Statistical analysis
Mainly descriptive statistics were used. The denominator used for incidence rate calculations was the sum of the end-of-year population estimates for each year and age.
For comparison of the event rate between boys and girls, assuming that the events are Poisson distributed, an exact binomial test was performed.
Gender differences regarding indication for surgery in specific age groups were tested using the Cochran-Mantel-Haenszel test.
Incidence rate trends were tested by using joinpoint regression models (Joinpoint Regression program, V.22.214.171.124, April 2016; Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute) that identified points (joinpoints) where linear trends of tonsil surgery changed significantly in direction or magnitude. The rate of change for each trend was tested to determine whether the change was significantly different from zero. In the final model, each trend is described by an annual percentage change (APC) with a 95% CI. The joinpoint analyses were performed for boys and girls separately.
All significance tests were two-sided and conducted at the 5% significance level. All analyses except the Joinpoint regression were performed with SAS System V.9 (SAS Inst., Cary, North Carolina, USA).
In total, 167 894 tonsil surgeries (82 398 (49%) girls and 85 496 (51%) boys) were registered in the NPR between 1987 and 2013 (table 2).
The overall incidence rate of registered tonsil operations in patients aged 1–<18 years increased from 22/10 000 person years in 1987 to 47/10 000 person years in 2013 (figure 1). This increase was continuous over the study period, with the exception from 1996 to 2001, when a decrease was observed (figure 1).
The most marked increase in incidence was noted in children aged 1–3 years, increasing from 17/10 000 person years in 1987 to 73/10 000 person years in 2013. This 1–3-year-old group increased their share of total tonsil surgeries from 13.5% 1987 to 29.4% in 2013. The trends in incidence rates for boys and girls are shown in figure 2A, B. Trends were similar and significant for both genders (table 3).
Gender and age
For the total time period, the incidence difference between the genders were significant (p=0.0011, exact binomial test), showing a dominance of boys (table 2).
Figure 3A, B shows the age and gender distributions as well as the indication groups. For both genders, the indication 'obstructive/SDB' was most common in the younger age groups, with a peak between ages 2 and 6, and the highest incidence (113/10 000 person years) was in 3-year-old boys with obstruction between 2008 and 2013 (figure 3A, B). Infectious indications were more common in teenagers for both genders, particularly for girls, whose incidence was three to four times greater compared with boys of the same age.
The gender differences were significant in the age group 2–6-year-olds who were operated for obstructive/SDB indications with a male dominance (p<0.001) as well as in the age group 14–17-year-olds operated for infection with a female dominance (p<0.001, Cochran-Mantel-Haenszel test).
Further, figure 3A, B shows that the highest incidence levels for tonsil surgery for boys and girls at all ages were observed over the previous time period, 2008–2013. The major reason for this increase was operations in young children with obstruction.
The indications for surgery between 1987 and 2013 are presented as proportions of the total incidence in figure 1. The incidence of tonsil procedures performed for the indication obstructive/SDB increased nearly fourfold over this period, from 10 to 36/10 000 person years (figure 1). Since 1990, obstruction/SDB constituted the major indication group. In 1987, 42.4% of tonsil procedures were performed for obstructive/SDB, whereas in 2013, this proportion was 73.6%. In the youngest age groups (children 1–<4 years old), the vast majority (>90%) of tonsil procedures were performed for obstructive/SDB indications. The incidence of infectious tonsil disease as an indication remained stable over the study period.
Surgical methods
Figure 4 shows the proportions of TE and TT (± adenoidectomy) between 1987 and 2013. An increase in the number of TT procedures began in 1996 with a gradual annual increasing trend, followed by a sharp increase from 2006 onward. From 1997 to 2005, TT increased from 1.8% to 9.8% of all tonsil procedures, and from 2006 to 2013 it increased from 11.2% to 55.1% of all procedures. From 2011 onwards, TT was more common than TE. The major indication for TT was obstruction, and in 2013 >96% of all TTs were performed for this indication. When TE was used, about half (49%) of the procedures were performed due to infection in 2013, a percentage that was generally stable during the observed period.
In the youngest group (1–3-year-olds), TT was most common, and in 2013, 71% of all tonsil surgeries in this age group were TTs.
This study was based on a national cohort and describes the epidemiological trends during 1987–2013 for tonsil surgeries in Swedish children. Overall, the incidence rate for paediatric tonsil surgery has roughly doubled during the observation period due to an increase in the number of procedures performed for the obstruction/SDB indication. Furthermore, TT has gradually replaced TE as the predominant surgical method. Few previous studies have addressed these topics in large national cohorts over long periods of time.
During the study period, 1987–2013, there was a near doubling of the incidence rate for tonsil operations in Swedish children, with incidence rates reaching 47/10 000 person years in 2013. A similar, albeit weaker, trend was reported in a Danish study based on a national cohort, where the cumulative risk of TE in the first 20 years of life increased nearly 20% between 1980 and 2001.16
Another important observation in the present study was that the incidence for the youngest group of children, 1–3 years of age, increased more than fourfold over the study period. This trend was also seen in a study from the UK in which TE rates among children <4 years of age increased from 13.5 to 21.3/10 000 children during the period from 2001 to 2012.17
The Swedish incidence rate can be viewed as relatively low compared with other nations. Van den Akker et al reported large differences in TE rates between several European countries, the US, Canada and Australia. Incidence rates varied from 19/10 000 person years in Canada to 118/10 000 in Northern Ireland.18 The incidence rates in our study varied from 22/10 000 person years in 1987 to 47/10 000 in 2013. Potential explanations to this variation in incidence rates between different countries include differences in national guidelines for tonsil surgery, differences in the availability of medical service and differences in reimbursement systems.
For instance, in the Netherlands, antibiotics are not recommended for uncomplicated tonsillitis, which could be a reason for the relatively higher incidence of TE in that country.19 In contrast, in the NHS system of the UK, the incidence rate has decreased after evidence regarding outcomes following tonsil surgery for infectious indications were questioned. Concomitant with this decrease in TE rates, there was an increase in admissions and serious complications due to tonsil infections.20
Interestingly, local geographic and sociodemographic factors have been reported to influence tonsil surgery incidence rates.17 ,21 A recent Swedish study reported an increased risk of paediatric SDB in families with low socioeconomic status,22 and this has also been suggested to be a risk factor for group A streptococcal infections.23
Age and gender
We observed a peak in incidence rates during the preschool years, the same age that the prevalence of SDB/OSA peaks.24 This peak was significantly higher for boys than it was for girls, which is likely because childhood SDB is more common in boys.25 Another peak occurred in teenage girls with primarily infectious indications. This significant difference in gender distributions among teenagers could indicate that infectious tonsil diseases are more prevalent in females, although the reasons for this are not fully understood. Overall the observed age and gender distributions were well in line with previous publications showing similar results.21 ,26
Overall, a shift in the prevalence of indications was observed, with obstructive/SDB indications increasing over the study period. Obstruction/SDB now constitutes the primary indication for tonsil surgery in children, which is consistent with other published studies.27 ,28 The incidence for infectious indications remained relatively stable over the study period.
The most common indication in the younger age group by far was obstruction/SDB, which was seen in this study as well as in several previous studies,10 ,28 likely reflecting an increased awareness of upper airway obstruction and SDB as a common disease in the paediatric population. In a single county study from Minnesota, a comparable large-scale shift in indications was observed with an increase in the percentage of SDB/obstructive indications from 12% in 1970 to 77% in 2005.26 Bhattacharyya and Lin29 reported that the rates of paediatric adenotonsillectomy nearly doubled between 1996 and 2006, likely due to increased recognition of SDB and OSA. An increasing use of polysomnography (PSG) could have supported this theory of increased awareness of obstructive/SDB indications, but no such data were available in our database for this cohort. Overall, PSG is very sparsely used in children in Sweden.
Another possible explanation to the increase in obstructive/SDB indications could be increasing prevalence of obesity. However, studies of obesity among Swedish children have observed an increase from 1984 to 2000, but thereafter a stabilisation of the prevalence.30–32 In our database, no information about obesity was available and therefore this could not be further analysed.
Surgical methods
Along with a shift in indications, there has also been a shift in surgical methods, with TT gradually replacing TE as the most common surgical method for children in Sweden. This was also the conclusion of a study based on data from another Swedish registry independent of the NPR, the National Tonsil Register in Sweden.33 Since 2011, TT has become more common than TE in Sweden. That same year, new national guidelines for TT were issued in Sweden.34 One possible explanation for our findings could be that Swedish ENT surgeons consider TT to be safe enough to perform on small children. TT has advantages over TE with respect to postoperative complications such as pain and bleeding6 ,35 with comparable outcomes for symptom relief.36 A known disadvantage of TT is the regrowth of tonsils with recurrence of obstructive/SDB symptoms and need for reoperation. A recent Swedish study based on the NPR found a seven times higher risk for reoperation after TT than after TE, with the highest risk in the youngest age groups.37
However, the clinical practice of TT for treating airway obstructions in children seem to be spreading; for instance, in Austria, several serious complications with post-tonsillectomy haemorrhage has led to a switch to TT.5
Strengths and limitations
In this study, there was a marked decrease in the incidence rate of tonsil surgeries between 1996 and 2001. The reasons for this decrease in the number of recorded surgeries were analysed together with the representatives from the NPR (Personal communication with Quality Manager for the Patient Register, Anders Jacobsson). One reason for this dip could be a failure on the part of the NPR to collect data on performed surgeries, perhaps due to the increased use of day-care surgery between 1997 and 2001. Another reason could be insufficient reporting to the NPR from private hospitals, which became more numerous during this period. However, we believe this decrease was too great to be explained by failed registrations alone and must represent an actual decrease in the number of surgeries, although the true extent of this decrease cannot be precisely determined.
The NPR is generally considered to have high coverage,14 although like all clinical registers, it has potential inherent limitations, including inaccurate data reporting and missing values.
Major strengths include the large population size of the register and its wealth of unique nationwide data over a long time period. It can therefore be used to determine actual longitudinal application of a clinical practice in a specific country over long periods of time.
Our results showed considerable changes in clinical practices for tonsil surgery in Sweden during the period 1987 to 2013. Overall, a doubling in the incidence rates was observed during this period. The reason for this change was an increase in surgical procedures due to upper airway obstruction/SDB, particularly among the youngest age group (1–3 years old) and among boys. Further, TT has gradually replaced TE as the predominant surgical method for obstructive/SDB indications. The incidence rates for infectious indications for tonsil surgery have remained relatively stable during the study period, and the most common patients in the infectious group were teenage girls.
The authors acknowledge Henrik Passmark at the National Board of Health and Welfare for compiling the data from the NPR and statisticians Bengt Bengtsson and Nils-Gunnar Pehrsson from Statistiska Konsultgruppen for statistical analysis.
Contributors AB and JS contributed to the study design. AB, PN, DF, OS and JS contributed to the interpretation and analysis of data. AB wrote the first draft of the manuscript. PN, DF, OS and JS contributed to the final writing and revising of the manuscript and checked for important intellectual content. All authors approved of the final manuscript as submitted.
Funding This study was supported by financial grants from the Acta Otolaryngologica Foundation, the Freemason Child House Foundation in Stockholm and The Health and Medical Care Committee of the Regional Executive Board, Region Västra Götaland.
Competing interests None declared.
Ethics approval This study was approved by the regional ethical review board of Gothenburg, Sweden (Dnr 534-14).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
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Located in Surabaya, 5.5 km from Sharp Bamboo Monument, Yello Hotel Jemursari features free WiFi access and free private parking. Guests can enjoy the on-site restaurant.
Each room includes a flat-screen TV with cable channels. You will find a kettle in the room. All rooms have a private bathroom.
There is a 24-hour front desk at the property.
Submarine Monument is 5.6 km from Yello Hotel Jemursari, and Red Bridge Surabaya is 9.7 km away. Juanda Airport is 8 km from the property.
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Jl. Raya Jemursari 176, 60292 Surabaya, Indonesia


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Just sketchin' around for a short that I might do if I get a break between work, school and my other projects. Enjoy it or get takin' out by the same ninjas that got him...
Wednesday, September 30, 2009
Just sketchin' around for a short that I might do if I get a break between work, school and my other projects. Enjoy it or get takin' out by the same ninjas that got him...
Monday, September 28, 2009
Here it comes! Red Hulk versus Holocaust! My favorite villain in comics today versus my favorite villain from when I was, like, 9. I have no idea why these two would ever fight, and yes Holocaust would get his big orange behind handed to him but, darn it, I wanted to draw it.
Friday, September 25, 2009
Wonder Woman and More!
Howdy folks. With school back, project deadlines breathing down my back and a less than forgiving job, I can't seem to climb out from under what I would assume is an insurmountable pile of paper with a fat midget dancing on top of it. My only tools of escape so far have been a pencil, an eraser and my wife so here is some of what I've created with the first two while gasping for air under what I can only assume is my life(and so far my wife and I haven't created anything... Its a good thing).
I'll be back!
PS: Be sure to Check out the art auction for WONDER WOMAN DAY #4 and show your support!
Friday, September 4, 2009
Snow Ball Fight
Black Knight
I was tooling around online one evening between projects when I saw an Art Challenge on Tentonstudios.com and decided that while I didn't have time to join said contest, I still wanted to try my hand at this lame-ass character. I wasn't a very big fan of the pencilled pic but it does a great job of showing my thought process. The pencilled version had a lot of issues which end up being fixed or enhanced in the inking process. This is how I approach all of my pictures. The pencils are always very rough(or wrong for that matter) and instead of waiting and then coming back and reworking my art again in the pencils' stage I simply address them when I ink my art.
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