Saturday, October 23, 2004
Baseball is the most probabilistic of sports. A game centered on smacking together two round fast-moving objects (ball and bat) can hardly be anything else. That's why it is so loved by statisticians and the statistically minded.
One of the consequences of this is that any team really will beat any other team a certain percentage of the time, even if the difference in quality between them is great (as long as it is not too absurdly great). It's not like football or basketball, where physically superior players can overwhelm weaker opposition by force.
In baseball even a short, slight platoon infielder with a .219 lifetime batting average and all of seven career home runs may be remembered decades later as a "Series Hero" for taking the opposition's All-Star pitcher downtown at a critical moment. And a good thirty-five years later he'll be enshrined on the list of those who hit the 100 Greatest Home Runs of All Time.
Things like that happen in baseball, a certain percentage of the time. They're part of what makes the game so rewarding to watch. The fact that it's the only sport where the team with the ball plays defense isn't the only thing that's unique about it.
Another consequence is that despite what all the fans and sportswriters say -- especially during second-guessing time, which Joe Torre is enjoying in New York right now -- the outcome of every individual game is mostly the result of luck, chance, contingency. The difference in quality between major league teams is not so great as to be visible in results on a game-by-game basis, no matter what fans and sportswriters think they see. It takes a 162-game season for the luck to even out and the difference in quality to assert itself in the won-lost record. In shorter stretches bad teams will frequently outperform good ones.
How likely are they to do so? The statisticians have worked it out, of course. In a given game the probability of the stronger team beating the other is pretty close to the difference in their winning percentage plus .500. So a team with a .550 record will beat a team with a .470 record 58% of the time. To figure out the odds of each team winning a series of given length, just apply the standard rules of probablility.
What does this mean to post-season playoff series, and to the World Series, where both teams are good and are pretty evenly matched? In the memorable words of Oakland general manager Billy Bean -- quoted in Moneyball, the book about him bringing statistical analysis to team building -- they're "a crapshoot".
Take the Red Sox and Yankee teams that just completed their historic series. During the regular season the Yankees won three more games than the Sox out of 162. So the difference between those two teams was just one win every 54 games. But the contest between them was only seven games, and over the season any seven-game stretch accounted on average for only about 1/8th of a win difference between them -- with the other 7/8ths (or more) of a win resulting from chance.
Or, using the formula mentioned above, on the basis of full regular season records that gave the Yankees a winning percentage 1.8% higher than that of the Sox, the Yankees had a 51.8% chance of winning each game on average, and (if my binomial calculator is working correctly) a 54% chance of winning that series. Even if you adjust for things like home-field advantage on the odd game, those odds are pretty even. (Although after the Sox lost the first three games, their coming back by winning four in a row was about a 17.5-to-1 shot.)
This "playoff crapshoot" notion isn't appreciated by many baseball purists who think games should be won by the players' fighting character and their manager's cunning and force of will in directing them to victory, but it's hard to argue against it when you look at the numbers.
One of the common pre-Series media stories has been about how the Cardinals' star manager Tony LaRussa has taken teams to the post-season playoffs 10 times yet won the Series only once. But with a team having to win three playoff series for its manager to win a ring, if the odds in each are near 50/50 he'd be expected to win through in just one of eight chances -- so Tony's about par for the course.
The Times today reports some other post-season numbers...
Not that any of this should in any way diminish a fan's admiration for the fighting character shown by his baseball heroes. Curt Schilling having his tendons sewn to his leg -- in a procedure that had never been done before and was only tested on a cadaver -- so he could pitch the do-or-die sixth game against the Yankees with blood seeping through his pants, was a performance that deserves to put him in any sports heroes' hall of fame for courage alone. But both teams' players are playing as hard as they can, and their managers are leading as well as they can, and that's what makes them evenly matched and the outcome a near toss-up.
Before 1969, when there was only one annual best-of-seven-game postseason series, the team with the better regular-season record won 34 of 65 series, just a tick more than 50 percent.
From 1969 through 1993, when baseball played one additional preliminary series, a league championship series (first best of five games, later best of seven), the team with the best regular-season record ended up wearing rings 7 of 25 times, or 28 percent. That is very close to the 25 percent of the time a flipped coin will come up heads twice in a row.
Since 1995, when the postseason expanded to eight teams and three rounds, the best team in the regular-season has won one of nine World Series, just what a coin's theoretical probability (1 in 8, or 12.5 percent) would prescribe.
Everything is older than we think, and the Times notes that the modern statistical analysis of baseball fathered by Bill James has a grandfather in Frederick Mosteller -- a Red Sox fan born in Boston four years before Babe Ruth left for New York, who's still rooting for them -- who published along these lines in the Journal of the American Statistical Association a generation earlier, starting in 1952.
What are the odds that Professor Mosteller and his intellectual heirs put on his seeing his Red Sox escape the Curse of the Babe to finally bring the championship home this year?
Boston carried in a winning percentage of .610 (including postseason), St. Louis .647. This suggests that the Cardinals have a 53.7 percent chance of winning the average game between them. And after applying Mosteller's binomial theory, the Cardinals have a 58 percent chance of beating the Red Sox to four victories.So there you have it, in real numbers.
But ... the Sox could play four games at home, and home games typically add 42 points to a team's winning percentage. Making that adjustment, the Cardinals decline to a 57 percent favorite.
Even more significantly, the two teams' rosters have changed, specifically Boston's addition of shortstop Orlando Cabrera. Using only the teams' winning percentages since the July 31 trade deadline, Boston, which has played .700 ball since then, becomes the favorite, at 61 percent.
After more than 50 years of the development of the statistical analysis of baseball into its modern state of the art, we can say definitively: The Red Sox are either the underdog or the favorite.
My advice: Enjoy the play of the game for its own sake. Don't get too drawn into the issue of whether or not the best team is winning.


Month: March 2013
Nanogram | PUC Collaboration wins Phoenix Grant
Friends, Join us in congratulating Nanogram + PUC (Phoenix Urban CoLab) in their award winning project “Civic Operations in Roosevelt Row: PUC Manifesto”. Greg Esser, Board of… Read more “Nanogram | PUC Collaboration wins Phoenix Grant”
Nanogram Competition Entry: Flatlot 2013
Welcome to Park|Park, an undulating landscape of mounds forged from construction debris and re-purposed materials. Day and night, weekdays and weekends, Park|Park is host to a series of events from the quotidian to the spectacle. The parking lot is not displaced but enhanced, offering the amenity infrastructure and outdoor open-space for the community to value. Sustainability is at the core of Park|Park, from the wood pallet structures to their synthetic grass skins discarded from sports arenas. During the day visitors run, climb, and lay upon the mounds shaded by inset box trees. At night, lights from the tire formed portals self-illuminate the transient parkscape. The parking lot maintains its function for the temporary storage of vehicles, but pockets of park are inserted upon its bays. Dimensionally, each mound is inextricably driven by the size of a parking space at 9’-0” x 18’-0“. The gridded park of alternating 18’-0” and 36’-0” mounds re-inserts the human element to a cold and mundane flat-lot. Wedged between machines, the public park themselves between parked cars. Park|Park stands as Flint’s face to the world, a reminder of a past born from the automobile industry and of a future rooted in sustainability and its human drivers.


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Homer runs Sunnyside Farm, a pasture based farm in south central PA. This is the farm blog, written by the farmer's wife, Dru.
Saturday, June 16, 2012
We are having the most beautiful weather. Clear, sunny, warm with little humidity. It is a true joy to be in the farm. Everything is growing, producing and looking good. Much of the garden area is walk able, as the pathways have been cleared by human, pig and chicken power. The cattle herd are doing what they are supposed to do, the big pigs are installing their own ponds, the turkeys look great, the chickens are getting closer to the size needed, we are getting clean and gorgeous eggs. The temperature and humidity will climb soon, so we are loving this weather while we have it. Life is good.
I am the lucky woman who gets to be the farmer's wife to Homer Walden, the hardworking, creative and innovative force behind Sunnyside Farm. The farm is a pasture based intensive grazed farm in Dover, PA. We grow heirloom, open pollinated vegetables, chicken, eggs from heritage breed chickens, beef, heirloom breed turkeys for Thanksgiving and pork with no commercial feed, honey, eggs, Buff ducks. And the occasional flower or 2.

domain: agronomy


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Ahead of the release of his upcoming film ‘Jawan’, superstar Shah Rukh Khan paid a visit to Vaishno Devi shrine in the Himalayas.
According to reports, the actors offered prayers at the revered shrine atop Trikuta hills in Reasi district of Jammu and Kashmir. He reached the shrine late Tuesday night to pay his obeisance.
A video has been doing the rounds on social media, where the actor is seen at Vaishno Devi, dressed in a blue jacket and his face fully covered. In the clip, police officials of the Vaishno Devi shrine are seen, some policemen and personal staff of the star could also be seen in the clip.
This is not the first time he visited the shrine. He visited Vaishno Devi nine months ago in December last year, over a month before the release of his blockbuster hit ‘Pathaan’.
‘Jawan’ is a Red Chillies Entertainment presentation directed by Atlee, produced by Gauri Khan, and co-produced by Gaurav Verma. The film will release worldwide in theatres on September 7, 2023, in Hindi, Tamil, and Telugu languages.

domain: news


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At the N end of the Xanthus valley. Nothing is recorded of its foundation, no Lycian inscriptions have been found on the site, and its Lycian name is not known. An inscription at Sidyma (TAM II. 1.174) mentions a local legend that Leto bore Apollo and Artemis at Araxa. All that is known of the city's history is contained in an inscription found at Oren in 1946 (JHS  46, no. 11 = SEG XVIII 570): At an uncertain date in the 2d c. B.C., hostilities broke out between Araxa and Bubon and again later between Araxa and Cibyra; in both cases Araxa appealed to the Lycian League, of which she was a member, whereas Bubon and Cibyra at that time were not. Some time afterwards Araxa was instrumental in securing the admission of her neighbor Orloanda (otherwise unknown) to the Lycian League. In general the inscription shows Araxa functioning as a full and active member of the League. No coinage is known; the former attribution of a single specimen of the time of Hadrian is now discredited. In Byzantine times the bishop of Araxa ranked fourth under the metropolitan of Myra.
The ruins are not extensive. The acropolis hill is immediately above the village; it is precipitous on the SE, but is quite low. A little below the summit are remains of a 'cyclopean'; wall of very large blocks with a superficial area up to 3 sq. m, in some cases drafted at the edges; most conspicuous is a massive tower over 9 m wide. In the village is a stretch of polygonal wall 9 m long and still 3 m high.
A kilometer or so to the W of the village is a group of a dozen rock-cut tombs at the base of a rocky hillock; most of these are of Lycian house type, but they are not inscribed. One, evidently later, has two antae decorated with rosettes and nondescript capitals, an architrave, a row of dentils, and a curiously naked pediment lacking the usual raking cornices. By the river, close to the village, are a number of gable-shaped sarcophagus lids with inscribed panels.
A little to the N of Oren is an exceedingly abundant spring which, though not the actual source of the Xanthos river, supplies the greater part of its stream. (G. E. BEAN) Wikipedia: https://en.wikipedia.org/wiki/AraxaWikidata ID: Q626773Trismegistos Geo: 34342
Info: Princeton Encyclopedia
(Princeton Encyclopedia of Classical Sites, from Perseus Project)

domain: geography


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The Motley Fool Discussion Boards
Investment Analysis Clubs / Macro Economic Trends and Risks
|Subject: Re: Portfolio Strategy in a Global Down Draft||Date: 9/15/2008 11:53 AM|
|Author: WendyBG||Number: 252009 of 514465|
An excellent anaylsis, as usual.
One important factor that you left out:
Many of the large institutional investors are leveraged. Some of them are heavily leveraged. The "shadow banking system" involves trillions of dollars of borrowed money.
As the price of assets (bonds, stocks, commodities) drop, leveraged players may get margin calls. They may be forced to sell good assets to cover bad. The shadow money evaporates.
Less money = less bids on assets. This will cause the price of all leveraged assets to fall.
What is the only asset that isn't leveraged?
Real money, not borrowed money.
That is why the majority of my holdings are in cash or cash equivalents (FDIC insured CDs), and in TIPS and I-Bonds.
|Copyright 1996-2017 trademark and the "Fool" logo is a trademark of The Motley Fool, Inc. Contact Us|

domain: economics


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Galveston \ League City, TX DWI Attorneys
DUI and DWI Defense: Houston, Galveston and League City, Texas
For many residents of the Houston area, their first (and hopefully only) contact with law enforcement comes in the form of a DWI arrest. Drunk driving is a criminal offense in Texas, so you need to take any such charge seriously. Even a first-time offender faces significant consequences to their life and liberty, which is why you need to work with an experienced Houston DWI defense attorney who understands the Texas criminal justice system.
The Law Offices of Tad Nelson & Associates focuses on DWI defense. Attorney Tad Nelson is a former prosecutor who is intimately familiar with how these cases work. He and his team know that you are likely overwhelmed by your arrest and may not even fully comprehend your constitutional and legal rights. Indeed, we find that in many criminal DWI cases the police or prosecution make mistakes that undermine their case. We will seek to expose such weaknesses and aggressively defend your interests.
What Does It Mean to Be “Intoxicated” in Texas?
Section 49.04 of the Texas Penal Code defines the basic offense of DWI. The prosecution needs to prove that you were “intoxicated while operating a motor vehicle in a public place.” A first-time DWI offense is normally treated as a Class B misdemeanor with a minimum jail term of three days (72 hours). Your driver’s license can also be suspended in a separate administrative proceeding.
You probably know that a person is “intoxicated” if they have a blood-alcohol concentration of at least 0.08 percent, which is the DWI limit in all states. But this is just one standard for legal intoxication. In fact, you can be convicted of DWI if the prosecution can prove–beyond a reasonable doubt–that you did not have the “normal use of mental or physical faculties” due to the use of any alcohol or drug. For example, you may be convicted of DWI even if you just took prescription medication that impaired your ability to safely operate a vehicle.
Dealing With Special Circumstances in Drunk Driving Cases
While a first DWI offense is normally a Class B misdemeanor, second and subsequent offenses are treated more severely and in some cases are felonies. At the Law Offices of Tad Nelson & Associates we can assist you with many types of “enhanced” DWI cases involving issues like the following:
- Commercial Driver DWI (CDL license)
- Driving Under the Influence of Drugs (DUID
- DWI With a Child in Car
- Intoxication Assault
- Intoxication Manslaughter
- Third DWI Offense
- Underage Drinking and Driving (DUI)
We Can Help You Fight Your DWI Charge
Whatever the charge you face, the important thing to remember is that you have a constitutional right to the assistance of qualified legal counsel to prepare your defense. The Law Offices of Tad Nelson & Associates has been helping Harris and Galveston County residents like you fight DWI charges for nearly two decades. Contact us today at (281) 280-0100 if you have been charged with drunk driving and need to speak with an attorney right away.

domain: law


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The 2013-14 edition of the Annual Parliamentary Report on Assistive Technology Research and Development was laid before parliament in July 2013 and is freely available to download. Drawn from our database of information about AT research and development, FAST has produced this report for the past fifteen years.
The Department of Health have a statutory requirement to produce such a report (pursuant to Section 22 of the 1970 Chronically Sick and Disabled Persons Act) and the FAST report documents the projects funded by the UK government and by the EU and gives active links through to the project information that is regularly updated on the FAST database.
Only work funded (directly or indirectly) by the UK government is featured in the report but FAST's database incorporates work funded from a wide range of sources.
Editions of the report can be downloaded using the links below:

domain: politics


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Ten mini libraries are available throughout Emerald Isle, due to a project through the Friends of the Carteret County Public Library that serves Western Carteret.
These mini libraries are stationed in public areas, where anyone can take a book to read, then return it or donate one of your own. According to a press release from the Friends, each box was individually created and donated by a local resident. In addition, each box has a personal steward who will keep it clean and stocked on a regular basis.
The Town approved the various locations, and helped by installing the posts for the mini libraries. A dedication was held just prior to Memorial Day Weekend, and Mayor Jason Holland and Parks and Recreation Director Candace Dooley were on hand.
The libraries can be found at the following locations:

domain: library


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Archive for the ‘Recession’ Category
Posted by vmsalama on December 15, 2011
Thanks to TIME Magazine for recognizing the revolutionaries all over the world… I’ve been meaning to write this for quite some time but only finding the chance to do it now.
A year ago when Mohammed Bouazizi, a fruit vendor in Tunisia, burned himself out of frustration from a political system that neglected him, I was en route to Beirut ahead of the Christmas holiday and writing, mainly, about the credit crunch in the Arab Gulf states and mounting concerns that the banking system would not soon recover from the blow. Days after I returned from Beirut, my host, Rania Abouzeid, came to stay with me in Dubai in a desperate attempt to fly to Tunisia, where flights were almost entirely grounded amid an uprising across the country. It was hard to imagine then that the desperate act of this young man not only set in motion a revolution in his country, but around across the region.
On January 14, 2011, following a month of violent protests against his rule, Zine El Abidine Ben Ali – Tunisia’s president since 1987 — was forced to flee to Saudi Arabia along with his wife and their three children. A week later, Rania and I were on a flight to Cairo where calls for a revolution had begun to circulate on social media websites. They were days I will never forget, and with TIME Magazine’s 2011 Person of the Year issue being dedicated this year to The Protester, I want to share with you all a few memories and photos of the protesters I met in Cairo this year. (Click here to read some of my stories on the Arab Spring)
On January 27, two days after the protests officially begun, Internet and mobile phone service was completely cut off in Egypt and we were left guessing where crowds were gathering. After trying a few spots around town, Rania and I decided to go toward the Mohendiseen neighborhood near the Moustafa Mahmoud mosque. It was a good guess! About 500 protesters had gathered after Friday prayers where they came face to face with riot police chanting slogans like “The people want the end of the regime” and “Hosni Mubarak: illegitimate.”
Sure enough, we were quickly confronted by tanks and soldiers firing tear gas at the crowd. I’ve never seen so much camaraderie in my life. Soldiers at a nearby military hospital threw medical masks at the protesters and pharmacists handed them out to the crowds. At one point I felt quite ill from the tear gas. A man approached from behind me and pressed a vinegar-covered mask against my mouth and nose. A nearby vendor (who probably struggles to feed his own family with the pennies he earns) emptied his refrigerator, handing out water bottles and cans of soda to the fatigued protesters.
Every where I looked, people were helping each other, helping strangers tie their masks, sharing water bottles, aiding those who were most affected by the gas.
There was one point, marching with the crowd from Mohendiseen, when we approached a major intersection and I heard roaring cheers. I jumped up on a car to see what had happened and was personally overcome by emotion. From three different directions, massive groups of protesters were approaching the intersection – the other groups coming from as far as Giza and the Nasr City. They did this without Internet or mobile phones.
Groups of young men pushed to the front of the crowd and began to battle riot police, taking over their vehicles and chasing them away. Our group, now numbered in the hundreds of thousands, pushed slowly across the historic Qasr El Nil bridge in an attempt to move into Tahrir. There were moments when I worried that an attack by the military would trigger a stampede – we were stuffed tightly onto the bridge. But every time protesters began to push back, the young men in the crowd would grab the women in the crowd and push them against the bridge railing so to protect them from being knocked down.
It was a long night with protesters burning the ruling National Democratic Party headquarters and battling with soldiers in Tahrir. Riot police trucks were set on fire (and the Semiramis Hotel, where many journalists took refuge) was partially on fire for part of the evening. I was trapped in Tahrir for the night and forced to take a last minute room at the Semiramis. I woke up early the next morning to a different Cairo, where charred military tanks stood in the middle of Tahrir Square and smoke billowed from the NDP headquarters and, sadly, from the adjacent National Museum. It would take another two weeks (only!) to overthrow Hosni Mubarak but that first Friday was by far the most memorable. There is an Arabic expression that often refers to the Egyptian people as being “light blooded” (light hearted/good senses of humor). They definitely showed their spirit throughout the frustrating 19 days (and 30 years) it took to shake up their political system.
I visited Bahrain in the weeks that followed and I spent a lot of time covering the uprisings in Yemen and, less so, the ongoing crisis in Syria. After years of battling misguided stereotypes of terrorism and violence, these protesters have showed the world that they desire freedom and a decent standard of living and they have the right to demand it just as those in Europe and the US demand of their governments.
The Tunisians, Egyptians and all the other citizens around the world fighting for democracy have a very long and bumpy road ahead. The TIME Magazine Person of the Year issue questions whether there is a global tipping point for frustration. I believe what happened this year is, in large part, because of overpopulation and because of the global economic slowdown touched societies rich and poor – but toppled those that were already on the brink before markets crash. The world is smaller than ever thanks to the Internet and various technologies that allow us to share experiences with people on opposite corners of the world. As we continue to get closer, and the world, smaller, it will become impossible to distance ourselves from even the most seemingly remote events.
Posted in American, Arab, Arab League, Arab Spring, Arabic, Bloggers, Cairo University, Censorship, Coptic, Culture, dictatorship, discrimination, Economy, Education, Egypt, Elections, Employment, Environment, Foreign Policy, Hosni Mubarak, Internet, Journalism, Libya, Media, Middle East, military, Mubarak, Muslim Brotherhood, Negotiation, Obama, Politics, Qaddafi, Qatar, Recession, Refugees, Religion, State of Emergency, Succession, Syria, Terrorism, Tunisia, United Nations, United States, Yemen | Leave a Comment »
Posted by vmsalama on December 2, 2011
As some of you may know I just moved back to New York last week after living in the Middle East for much of the last 10 years, most recently in the United Arab Emirates, which is today celebrating its 40th anniversary. There is no doubt that the UAE has accomplished pretty spectacular things in 40 years, fueled greatly by the abundant oil wealth of Abu Dhabi, which holds more than 90 percent of the crude in the country, and about 7 percent of the world’s proven oil reserves, according to BP data.
The country is home to the world’s tallest building, the Burj Khalifa in Dubai, one of the world’s biggest malls, the world’s largest dancing fountains (I must confess, the fountain is rather amazing), the only manmade island visible from space and one of two gold vending machines in the world!
It is, undeniably, a remarkable accomplishment given that just 40 years ago the emirates, prior to unification and the discovery of oil, earned much of their income from pearl diving and exporting dates.
The pride of its citizens is something to be admired, and for weeks (even before I departed for the US), skycrapers were covered from top to bottom in lights of white, green, red and black, the colors of the UAE flag. Emiratis, the citizens of the UAE, wore scarves and jewelry with the colors of the flag, and cars were covered, literally, in photos of leaders past and present.
But a challenging road lies ahead for the UAE, particularly after this year’s events in the Middle East, where longtime dictators were forced out by popular uprisings. There is one clear advantage the UAE has over countries like Egypt, Syria, Libya and Yemen: it’s citizens are not poor. There are parts of the country that are in great need for updated infrastructure – roads, power lines, etc – but citizens are, at worst, comfortable thanks to lifetime handouts by the government. (Click here for my story Abu Dhabi’s Spending on Soccer and Skyscrapers Masks Slower Times at Home)
But citizens of the UAE are hungry for one thing: opportunities. Currently, foreigners make up about 85 percent of the country’s population – the majority hailing from countries on the Indian subcontinent. British/Western European, Canadian, Australian and South African expats hold many of the high paying white-collar positions, in SOME cases because they are better trained to do so, leaving few high profile jobs for the locals.
Emiratization, a policy now enforced by the government in many workplaces, seeks to boost Emirati employment whether by providing training and education for Emiratis, or setting quotas in certain sectors for Emirati employment. Ultimately the government is trying to prevent their own talented citizens from being lured to the West. But many critics believe that the UAE cannot afford to lose its foreign workers as they may have been the driving force for the country’s speedy success in the first place. In the meantime there is growing resentment among foreigners who, despite making up the majority of the population, have few rights. There is no legal protection on property rights, and police, in practice, do not need a reason to stop, question or even detain people.
Another challenge is maintaining the “vision” set by the country’s founders some 40 years ago. Seldom was there a day in the UAE that I did not hear someone refer to the “vision.” Abu Dhabi and Dubai have set urban planning roadmaps for diversifying their economies away from oil and expanding certain sectors (services, real estate, alternative energy, etc). However, the global economic crisis dealt a massive blow to the once seemingly invincible UAE and its seemingly invincible real estate market. Slowly we’ve seen the country scale back, but its officials still maintain that the overall “vision” is intact and on track. We shall see.
Finally, a problem facing many of the Gulf sheikhdoms: succession. The country’s founder Sheikh Zayed bin Sultan Al Nahyan has been dead for 7 years now but his legacy undeniably lives on. The question is whether his sons, the current President Sheikh Khalifa and Abu Dhabi’s Crown Prince Sheikh Mohammed, can continue the vision he laid out for the country 40 years ago. Many experts I’ve spoken with believe that the vision of the two brothers has grown less cohesive, and the two have developed mini “kingdoms” – investing money in projects that are too different, both from each other and from that envisioned by their father.
The government is so private in nature (painfully so) that it’s always hard to know exactly what is going on behind the scenes. But given Dubai’s economic disaster and, more recently, Abu Dhabi’s problems, it raises a lot of questions as to who is calling the shots. The country enjoys making a splash, and it’s served them well, but if it genuinely wants to keep out of the spotlight during tougher times, it may want to adopt a more humbled approach over the next 40 years. (ie, no more $20 million hotel debut parties, ok?)
Good luck UAE. I am excited and eager to see what you have up your sleeve for the next 40 years!!
Posted in Abu Dhabi, Aldar, Arab, Arab Spring, dictatorship, Dubai, Economy, Egypt, Elections, Employment, Foreign Policy, Libya, Media, Middle East, Mubarak, Politics, Recession, Succession, Syria, Tunisia, United Arab Emirates, Yemen | 1 Comment »
Posted by vmsalama on October 22, 2011
A short one from the World Economic Forum at the Dead Sea, Jordan (Click here for original link):
By Vivian Salama
Oct 22, 201
Bloomberg — Qatar is concerned about the effects of European legislation on sovereign wealth funds and is willing to cooperate with Europe on its economic crisis, Prime Minister Sheikh Hamad bin Jassim Al Thani said.
“We have some agreements, but not with everyone, not as we want,” Sheikh Hamad, who is also the country’s foreign minister, told reporters today at the World Economic Forum in Jordan. “Discussions are under way with some European countries to resolve certain regulatory hurdles, such as taxation. We are worried that there will be new regulations that can make obstacles for our sovereign wealth fund.”
Qatar has already agreed several investments in Greece, including a 1 billion-euro ($1.3 billion) commitment to invest in Greek mining companies. The Persian Gulf emirate will also acquire a 10 percent stake from Ellaktor SA and will have an option to buy another 5 percent from the Greek construction company, Ahmad al-Sayed, the chief executive officer of Qatar Holdings, said on Oct. 1.
Qatar may buy a 7.5 percent stake in European Aeronautic, Defence & Space Co. from Daimler AG with the voting rights remaining at Daimler, Handelsblatt reported Sept. 28, without saying how it got the information.
Sheikh Hamad said he is ‘‘worried’’ that European politicians have done ‘‘too little too late’’ to solve the ongoing economic crisis.
Posted by vmsalama on September 11, 2011
By Vivian Salama – Sep 21, 2011
“Everyone got really excited about the plans to build up Abu Dhabi, then out of nowhere everything came to a stop,” said Kaddourah, 31, who runs a local private hospital and invests in property to rent. “If this can happen here, I don’t want to imagine what’s happening in the rest of the world.”
Abu Dhabi internationally is the oil-rich emirate spending billions of petrodollars on English soccer team Manchester City, the iconic Chrysler Building in New York and London’s Gatwick Airport. Yet that image is masking pressure at home as the government supports its six neighboring emirates while financing a $500 billion development plan.
In a year that saw uprisings in almost a dozen Arab countries, citizens in the U.A.E. will head to the polls for only the second time in the country’s 40-year history on Sept. 24 to choose members of a council that will advise the sheikhs in control. In the background are deteriorating infrastructure and rising unemployment in the northern emirates and an end to the breakneck investment in Dubai and Abu Dhabi.
“We’re starting to see chinks in the armor,” Christopher Davidson, author of “Power and Politics in the Persian Gulf Monarchies.” “The bottom line is they can’t keep distributing the wealth to an ever-growing, ever-developing population.” (click here to read more…)
Posted by vmsalama on February 15, 2011
By Vivian Salama and Mariam Fam
Click here for original story
Feb. 15 (Bloomberg) — Egyptian Foreign Minister Ahmed Aboul Gheit called on the international community to offer support for the economy, saying it “has been greatly affected by the political crisis that has rocked the country.”
The protests that culminated in the Feb. 11 ouster of the former president, Hosni Mubarak, have led businesses to shut down, scared off tourists and pushed up Egypt’s borrowing costs. The Mubarak-appointed government, now running the country under military oversight pending elections, is forecasting slower growth. It has promised a stimulus plan to address the economic complaints of the demonstrators, such as high unemployment.
Egypt’s finance minister, Samir Radwan, said yesterday the country’s budget deficit will widen to about 8.4 percent — less than some analysts forecast — as spending increases and economic growth slows after Mubarak’s fall. The Institute of International Finance in Washington predicts the budget gap will be 9.5 percent of gross domestic product, rather than the 7.9 percent previously forecast by the government.
The turmoil has cost the nation about $1.5 billion of tourism revenue, according to Central Bank Governor Farouk El- Okdah. It has also forced companies to close and sent the currency skidding to a six-year low. Before Mubarak’s resignation, the benchmark EGX30 Index tumbled 16 percent in one week. The bourse has been closed since Jan. 27.
Aboul Gheit said U.S. Secretary of State Hillary Clinton, as well as British Foreign Secretary William Hague and Saudi Foreign Minister Faisal bin Abdulaziz bin Faisal al-Saud were among the officials who have called him to discuss support and developments in the country, according to a statement posted on the ministry’s website late yesterday. (click here to read more…)
Posted in Arab, Arab Spring, Arabic, dictatorship, Economy, Education, Egypt, Elections, Employment, Inflation, Middle East, Mubarak, Persian Gulf, Politics, Qatar, Recession, Saudi Arabia, State of Emergency, United Arab Emirates, United Kingdom, United Nations, United States | Leave a Comment »
Posted by vmsalama on February 2, 2011
By Vivian Salama, Dahlia Kholaif and Caroline Alexander
Bloomberg (Click here for original story)
Egypt’s Muslim Brotherhood didn’t immediately join the spontaneous street demonstrations against President Hosni Mubarak. Now the Islamist group, the country’s largest opposition faction, is positioning itself to help shape the country’s political future.
The Brotherhood waited a few days after the uprising began and then publicly supported the protesters, saying it shared their goals: an end to Mubarak’s 30-year rule, a new constitution, open elections and a new all-party government. Mubarak’s Feb. 1 announcement that he won’t seek another presidential term may allow the Brotherhood, brimming with grassroots skills, to take advantage.
“They are the most organized and most popular, with a hierarchy in Egypt in terms of membership and leadership,” said Omar Ashour, an Egyptian lecturer on Arab politics at the University of Exeter in England. “In the post-Mubarak period, they may have a role,” even though “their involvement right now isn’t major.”
Founded in 1928, the same year Mubarak was born, the Muslim Brotherhood has influenced Islamist movements across the globe, including Hamas in the Palestinian territories, which the U.S., European Union and Israel consider a terrorist organization. As conditions change in the Arab world’s most populous country, the group may have to allay concerns about the role it will play. The Brotherhood is banned from politics in Egypt, and members have had to run for office as independents.
Essam al-Erian, a senior Brotherhood leader who was arrested several times under Mubarak, says the opposition is united. The Brotherhood is working with “liberals, secularists, communists and every section” to ensure “the transition from a tyrannical corrupt regime to a civil democracy that guarantees equal rights to all,” he said in a telephone interview from Cairo.
“The Muslim Brotherhood is part of Egypt’s people, and we acquiesce in the verdict of the people, whatever it may be,” al-Erian said, adding that the group seeks “a democratic regime with the Islamic Sharia as a reference,” which he said already is enshrined in Egypt’s constitution. Sharia is based principally on laws from the Koran, sayings by the Prophet Mohammed and the opinions of Muslim scholars, and it’s the basis of some areas of Egyptian law though not the penal code.
That stance may conflict with other vested interests. Egypt’s military leadership is committed to the foreign policy pursued by Mubarak, who has helped Israel blockade the Hamas- ruled Gaza Strip and sought to rally Arab support against Islamic extremism.
While President Barack Obama’s administration has reached out to a range of Egyptian contacts since the uprising began, it isn’t talking to the Brotherhood, State Department spokesman Philip J. Crowley said Jan. 31 when asked at a press briefing how America would view its involvement in a future government. Any group that wants to play a role must be “committed to nonviolence” and “respect a democratic process,” he said.
U.S. foreign-policy experts and former diplomats are evaluating America’s position as they gauge how the strife in Egypt might spread across the Arab world. Protests continued early this morning in Cairo, as demonstrators who demand Mubarak’s ouster clashed with supporters of the president’s regime, hurling rocks at each other in Tahrir Square.
Anti-government turmoil already has spilled over into neighboring Jordan, where King Abdullahon Feb. 1 sacked his prime minister. Yemen President Ali Abdullah Saleh said yesterday he’ll step down when his term ends in 2013, and protesters in Algeria have been killed in clashes with security forces.
‘Calamitous’ for Security
The Brotherhood “would be calamitous for U.S. security,” Leslie Gelb, president emeritus of the Council of Foreign Relations in New York and a former U.S. assistant secretary of state, wrote Jan. 29 on the Daily Beast website. The group opposes the Egyptian-Israeli peace treaty of 1979 and “would endanger counterterrorism efforts in the region and worldwide,” he said. “That is a very big deal.”
It “supports Hamas and other terrorist groups, makes friendly noises to Iranian dictators and torturers,” and would be “uncertain landlords of the critical Suez Canal,” he added.
The canal carries about 8 percent of global maritime trade. Crude-oil prices have risen more than 5 percent since the protests began Jan. 25 on concern that the turmoil in Egypt may disrupt supply.
The Brotherhood is “committed to all international agreements and treaties at this phase,” Mohamed al-Beltagy, a senior leader of the group, said in a phone interview. “Later, it should be left to the people to decide.”
The idea that the Brotherhood could hijack the anti-Mubarak rebellion has been dismissed byMohamed ElBaradei, the former United Nations atomic agency chief and one of the opposition movement’s leaders. Mubarak stoked such fears to perpetuate U.S. support, ElBaradei told ABC News on Jan. 31.
“This is what the regime sold to the U.S. and the West: It’s either us and repression, or al-Qaeda type extremist groups,” ElBaradei said of the Brotherhood, describing the group as religiously conservative and nonviolent. “You have to include them.”
International companies including Amsterdam-based brewer Heineken NV, which bought Egypt’s Al Ahram Beverages Co. for $287 million in 2002, have halted operations in the country or pulled expatriate staff since the protests began. As the turmoil continued yesterday, businesses were trying to forecast the future and the likelihood of a government with Islamist influence.
Such a government may pursue “economic policies which cater more to social welfare but are less friendly to foreign investment from the West and business in general,” London-based risk consultant Maplecroft said in report this week.
The Brotherhood’s history fuels the concern. While its radical wing was accused of trying to assassinate Gamal Abdel Nasser, a former president, in 1954, the group has been a persistent critic of the Mubarak regime for decades without pursuing violence.
It has survived widespread jailings of its leadership over the years to emerge as the main opposition in parliament after 2005, when it won about one-fifth of parliamentary seats by running candidates as independents. It lost ground last year when the government disqualified a quarter of its candidates from the November elections.
The Brotherhood has sought to avoid being identified as a religious movement and to broaden its appeal. Its former Supreme Guide, Mahdi Akef, instructed members in 2005 not to brandish the Koran at anti-government protests, saying that would undermine their politicking. Still the Brotherhood raised objections from other opposition groups, and dissent within its own ranks, when it proposed in 2007 that women and non-Muslims shouldn’t be eligible for the presidency.
It has fostered social and health programs for Egypt’s poor that, in turn, have helped its political prospects. The social- service model has been followed by other Islamist groups in the region with varying success.
“One could quite easily see the Muslim Brotherhood picking up 20 to 25 percent of the vote” in a free election, said Paul Rogers, a specialist in international security at Bradford University inEngland.
While the group is conservative, its brand of Islam isn’t “puritanical,” and “the idea that we are going to get an Islamic revolution in Egypt like in Iran is very unlikely, just nuts,” Rogers said.
Michele Dunne, who tracks the evolving political situation in Egypt for the Carnegie Endowmentin Washington, said differences between Hamas and the Brotherhood, and their political impulses, have to be explored.
“They founded Hamas. There is a relationship,” she said of the Brotherhood. “The big difference is Hamas has used violence and arms to pursue its goals. And the Brotherhood hasn’t used violence in 40 years.”
Dunne said the U.S. likely will have to reconcile itself with whatever transpires.
“At this point, it’s irrelevant what we think about the Brotherhood. Things are moving very fast in Egypt,” she said. “If the political leadership opens up, the Brotherhood will be there.”
RELATED STORIES WRITTEN BY ME:
Egypt’s Muslim Brotherhood Plans to Establish Official Party — by Mariam Fam and Vivian Salama
Mubarak Orders Egyptian Army to Aid Police as Protests Against Rule Widen — by Vivian Salama, Ola Galal and Caroline Alexander
Posted in Arab, Arab Spring, Economy, Education, Egypt, Elections, Employment, Foreign Policy, Freedom of Speech, Hosni Mubarak, Human Rights, Inflation, Internet, Middle East, military, Mubarak, Muslim Brotherhood, Politics, Recession, State of Emergency, United States | Leave a Comment »


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text:
*editing in progress*
Lol I love how she say "oh no he didn't" and then she like "oh someone please save me" lol 😂
@Wolfie_Girl_Collins thanks! You see... I wrote this last year .. And I was very new to this .. And now I look back... And I think... 6 k reads .. Ok I do write ok
No one's ever terrible at writing. There's always someone who will enjoy it.
@beautifulfairytale15 sure thing!!i would love to check out your book!!
this is awsome i would appreciate it if you looked at my new Thranduil fanfic its calked welcome to my world Thranduil fan fic i would love your input
Aww thank you so much!!ik the chapter could have been longer...but when I write it in my notebook..it was two pages...but I think I could have made indentations in my paragraphs...but anyways...the next chapter should be out tommorow or so

domain: literature


text:
Revista da Sociedade Brasileira de Medicina Tropical 48(6):724-730, Nov-Dec, 2015
Corresponding autor: Dra. Thaís Furtado Ferreira. Avenida 06, Quadra 10,
Casa 51, Turu, 65066-730 São Luis, Maranhão, Brasil.
Phone: 55 98 98125-0200
Received 3 August 2015
Accepted 10 November 2015
Diagnosis of latent Mycobacterium tuberculosis infection:
tuberculin test versus interferon-gamma release
Thaís Furtado Ferreira,
, Pollyanna da Fonseca Silva Matsuoka,
Alcione Miranda dos Santos,
and Arlene de Jesus Mendes Caldas,
. Programa de Pós-Graduação Stricto Sensu em Saúde Coletiva, Universidade Federal do Maranhão, São Luis, Maranhão, Brasil. . Secretaria Municipal de
Saúde, São Luis, Maranhão, Brasil. . Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luis, Maranhão, Brasil. . Departamento de
Enfermagem, Universidade Federal do Maranhão, São Luis, Maranhão, Brasil.
Introduction:The treatment of individuals with active tuberculosis (TB) and the identiﬁcation and treatment of latent tuberculosis
infection (LTBI) contacts are the two most important strategies for the control of TB. The objective of this study was compare
the performance of tuberculin skin testing (TST) with QuantiFERON-TB Gold In TUBE® in the diagnosis of LTBI in contacts
of patients with active TB. Methods: Cross-sectional analytical study with 60 contacts of patients with active pulmonary TB.
A blood sample of each contact was taken for interferon-gamma release assay (IGRA) and subsequently performed the TST.
A receiver operating characteristic curve was generated to assess the cutoff points and the sensitivity, predictive values, and
accuracy were calculated. The agreement between IGRA and TST results was evaluated by Kappa coefﬁcient. Results: Here,
67.9% sensitivity, 84.4% speciﬁcity, 79.1% PPV, 75% NPV, and 76.7% accuracy were observed for the 5mm cutoff point. The
prevalence of LTBI determined by TST and IGRA was 40% and 46.7%, respectively. Conclusions: Both QuantiFERON-TB
Gold In TUBE® and TST showed good performance in LTBI diagnosis. The creation of speciﬁc diagnostic methods is necessary
for the diagnosis of LTBI with higher sensitivity and speciﬁcity, preferably with low cost and not require a return visit for reading
because with early treatment of latent forms can prevent active TB.
Keywords: Tuberculosis. Diagnosis. Latent tuberculosis. Interferon-gamma.
Latent tuberculosis infection (LTBI) is deﬁned as the period
between infection with Mycobacterium tuberculosis (MBT) and
the onset of tuberculosis (TB) disease. LTBI detection is a well
established TB control strategy recommended by the World
Health Organization (WHO)(1)
; it enables infected individuals
who are at greater risk of progression to active disease to
commence with drug treatment.
It is estimated that one third of the world’s population is
infected with MTB, mostly in its latent form, constituting an
important reservoir for disease reactivation(2)
. This pool is
sufﬁcient for the long-term generation of new TB cases, even
if the transmission chain is interrupted(3)
Identiﬁcation and treatment of LTBI can reduce the risk of
active disease development by 90%(4) (5)
. Contact with patients
with active pulmonary TB increases the risk of infection,
especially when the diagnosis is delayed. Approximately 30%
of those who come in contact with pulmonary TB patients are
infected; of these, 5% develop active TB within two years and
another 5% develop the disease 2 years post infection(6) (7)
In most situations of contact with MTB, the host immune
response is sufﬁcient to prevent disease; the bacteria may be
completely destroyed or a state of latency could be established.
Individuals who remain infected exhibit positive tuberculin skin
testing (TST) but are asymptomatic. In addition, microbiological
tests for MBT are negative and chest X-rays show no changes.
Occasionally, the immune response is not effective, resulting in
active TB due to a primary infection or the reactivation of a state
. Bacilliferous patients who come in close or casual
contact with active TB are considered to have an increased risk
of developing LTBI and therefore must be tested(5)
In Brazil, LTBI individuals are diagnosed mainly by means
of a positive TST associated with the exclusion of TB disease.
Previous studies have demonstrated the advantages of TST
including the technical ease of the method and its low cost.
However, its speciﬁcity can be affected by false-positive results
due to previous vaccination with Bacille Calmette-Guerin (BCG)
or non-tuberculous mycobacteria infection(9) (10)
. Moreover, the
sensitivity of TST may be reduced in various situations such
as pregnancy, malnutrition, sarcoidosis, malignant neoplasms,
and immunosuppression related to infection by the human
immunodeﬁciency virus (HIV)(11)
Ferreira TF et al. - Diagnosis of latent tuberculosis
Because of the limitations of TST, interferon-gamma release
assays (IGRAs), which measure the production of interferon-
gamma (IFN-γ) in response to stimulation by speciﬁc MTB
antigens (ESAT-6, CFP-10, and TB7.7), have been developed.
Of these, QuantiFERON-TB Gold In TUBE® has been shown
as the most effective in the diagnosis of LTBI compared with
TST. In addition, since the BCG vaccine does not inﬂuence
assay outcome, IGRAs are very useful in countries where BCG
is administered post infancy or in cases of repeated boosters.
Moreover, this method requires only a single visit to perform
the examination(5) (12) (13) (14) (15)
Studies comparing the two tests (IGRAs and TST) have
demonstrated that IGRAs exhibit higher speciﬁcity and limited
sensitivity, but cannot distinguish between active TB and
LTBI, especially in populations subject to BCG vaccination,
and therefore are more recommended for the diagnosis of
LTBI(12) (13) (14) (15) (16)
. Thus, in this study, we compared the
performance ofTSTwith QuantiFERON-TB Gold InTUBE® in
the diagnosis of LTBI in contacts of bacilliferous pulmonary TB
patients. It is hoped that this study to analyze the performance
of the TST in the diagnosis of LTBI as the incorporation of
IGRAs in clinical practice seem unfeasible due to its high cost.
A cross-sectional analytical study was conducted with
contacts of bacilliferous pulmonary TB-positive patients treated
at a referral hospital in São Luis, State of Maranhão, Brazil.
Samples were obtained from the contacts of 48 active
tuberculosis index cases identiﬁed through the laboratory log
book fromApril 2012 to May 2013 (Figure 1).All patients with
active pulmonary TB and positive sputum smear microscopy
were considered as index cases(11)
During consultation with the specialist doctor
(pulmonologist), the index cases were instructed on the
importance of evaluating their household contacts and meetings
were scheduled with these contacts. A household contact was
deﬁned as anyone living in the same domicile with the index
case for more than 6 hours/day for a period ≥ 3 months at the
time of TB diagnosis(11)
The study included all asymptomatic household contacts
aged over 18 years of both sexes with no history of TB or prior
treatment with isoniazid. Pregnant or lactating women and
respiratory symptoms, positive HIV serology, changes in their
chest X-rays, and any immunosuppressive disease were excluded.
During the meeting the contacts were offered information
regarding active and latent TB and presented with the study
proposal. All contacts who agreed to participate in the study
signed an Informed Consent form and subsequently underwent
a chest X-ray and a rapid HIV test (Rapid Check® HIV ½).
Contacts with an abnormal chest X-ray and/or positive rapid
HIV test were excluded from the study. It should be emphasized
that only one contact showed changes in the chest X-ray and
was excluded from the study.
Up to two contacts were selected per index case to avoid
selection bias. When the index case had more than two eligible
contacts, which happened in only ﬁve cases, a random selection
was performed by a simple draw. In total, the study sample
consisted of 60 household contacts.
Participants who met the inclusion criteria completed a
structured questionnaire that was administered individually by
a previously trained interviewer and consisted of the following
variables: gender (male, female); age (in years); type of kinship
with the index case [mother, father, spouse (a), brother (sister),
cousin (a), uncle (a)]; time between symptom onset and TB
diagnosis in the index case; presence of BCG scar; time of
completion of BCG vaccination; nature of contact with the
index case (intradomiciliary, extradomiciliary); and whether the
participant slept in the same room with the index case (Yes, No).
Following completion of the questionnaire, 3ml of peripheral
blood was collected from each participant, then packaged
and stored for performing the IGRA (QuantiFERON-TB Gold
In TUBE®) according to the manufacturer's instructions
(Cellestis Ltd., Carnegie, Victoria, Australia)(17)
. Next, TST
was conducted using the antigen and technique recommended
by the Ministry of Health of Brazil(11)
The TST reading was performed 48 hours post application
using a speciﬁc millimeter ruler and measuring the largest
transverse diameter of induration perpendicular to the forearm;
the results were recorded in millimeters, even in the absence of
. Contacts with a result ≥ 5mm were considered as
LTBI carriers by TST. The TST reading was performed by two
trained raters and the Kappa coefﬁcient was used to estimate
the inter-rater agreement. The TST readings were conducted for
all contacts on a previously scheduled day.
The amount of INF-γ was measured by enzyme-linked
immunosorbent assay (ELISA). The results were analyzed using
the QuantiFERON-TB Gold In TUBE® software provided by
the manufacturer and expressed as UI/ml IFN-γ. Contacts with
positive results were referred for consultation with a medical
specialist at the referral hospital.
The TST and QuantiFERON-TB Gold In TUBE® assays
were performed independently by different professionals
without any knowledge of the other test results.
Data were collated and analyzed using the STATA program
version 11.0. A descriptive analysis was performed based on
the calculation of means and standard deviation (numerical)
and frequencies (categorical). A signiﬁcance level of 5% was
The cutoff points for TST were determined using a
Receiver Operating Characteristic (ROC) curve (Figure 2).
Although there is no gold standard detection method for LTBI,
QuantiFERON-TB Gold In TUBE® was used in this study
to elucidate the operational characteristics of IGRA and TST.
The sensitivity, speciﬁcity, positive predictive value (PPV),
negative predictive value (NPV), and accuracy were calculated
for the identiﬁed cutoff points. Sensitivity was deﬁned as the
ratio between TST positive results and positive IGRA results;
speciﬁcity was deﬁned as the ratio of negative TST and negative
Rev Soc Bras Med Trop 48(6):724-730, Nov-Dec, 2015
FIGURE 1 - Flowchart of study design. BCG: Bacillus Calmette-Guérin; TST: tuberculin skin testing.
IGRA results; PPV was calculated as the proportion of TST
positive participants who were also IGRA positive; NPV was
calculated as the proportion of TST negative participants who
were also IGRA negative; and accuracy was calculated as the
ratio between the total number of correct results (sum of true
positive and true negative) and the total number of participants.
The prevalence of LTBI determined using QuantiFERON-
TB Gold InTUBE® was calculated as the number of participants
with positive results, divided by the total number of participants,
multiplied by one hundred [(number of positive participants/
total number of participants) x 100]. The prevalence of LTBI
determined by TST was calculated as the number of participants
with TST ≥ 5mm divided by the total number of participants,
multiplied by one hundred [(number of positive participants
with TST ≥ 5mm/total number of participants) x 100]. The
agreement between the QuantiFERON-TB Gold In TUBE®
and TST results was evaluated using the Kappa coefﬁcient. The
Kappa test was interpreted according to Landis and Koch(18)
< 0.40, weak agreement; 0.40 to 0.75, moderate agreement;
> 0.75, good agreement.
FIGURE 2 - ROC curve for determination of TST cut-off point (in millimeters). São Luis, State of Maranhão, Brazil, in 2013. ROC: Receiver Operating
Characteristic; TST: tuberculin skin testing.
The study was evaluated and approved by the Ethics
Committee in Research of the University Hospital of the Federal
University of Maranhão (CEP/UFMA) under embodied opinion
n. 240/11, in accordance with Resolutions 196/96 and 466/12.
The procedures followed were in keeping with the Helsinki
Declaration of 1964, as revised in 1975, 1983, 1989, 1996,
Most of the 60 evaluated contacts were female (75%) with a
mean age of 37 years (±12.18); 35% were partners of the index
case; 88.3% had household contact with the index case; 58.3%
slept in the same room with the index case; 86.7% had only one
BCG vaccination scar while the rest (13.3%) had none. The
average time between symptom onset and the diagnosis of TB
in the index case was 87.63 days (± 88.97).
Table 1 details the sensitivity, speciﬁcity PPV, NPV, and
accuracy for the different TST cutoff points. The best cutoff
point was 5mm, with 67.9% sensitivity, 84.4% speciﬁcity, 79.1%
PPV, 75% NPV, and 76.7% accuracy. Of the 60 contacts, 46.7%
were positive for LTBI based on the QuantiFERON-TB Gold
In TUBE® test and 40% were TST positive. The agreement
between the TST and QuantiFERON-TB Gold In TUBE®
results was 76.7% (Kappa coefﬁcient = 0.5270; p value ≤ 0.001;
The results of this study indicate that the 5mm cutoff
exhibited enhanced sensitivity, predictive values, and accuracy.
Previous studies suggest that reducing the TST cutoff point
leads to increased sensitivity and decreased test speciﬁcity.
Although using a more sensitive cutoff point increases the risk
of mistakenly diagnosing an individual as an LTBI carrier, the
beneﬁts of treatment appear to outweigh the risks; adverse
reactions to isoniazid are rare and the risk of selection for
resistant strains during the treatment of index case contacts is
minimal since the bacillary population is low(6)
Takenami et al.(19)
demonstrated that 70.3% of contacts were
identified as positive using QuantiFERON-TB Gold In TUBE®
while only 52.5% were detected by TST. Machado et al.(20)
Ferreira TF et al. - Diagnosis of latent tuberculosis
TABLE 2 - Kappa Index for tuberculin skin testing (TST)
and QuantiFERON-TB Gold In TUBE®. São Luis, State of
Maranhão, Brazil, in 2013.
positive negative total
Positive 19 5 24
Negative 9 27 36
Total 28 32 60
Kappa= 0.5270 p<0.001CI: 95%.
TABLE 1 - Sensitivity, speciﬁcity, positive predictive value, negative predictive value, and accuracy of tuberculin skin testing in
predicting latent tuberculosis in pulmonary tuberculosis contacts. São Luis, State of Maranhão, Brazil, 2013.
TST (mm) Sensitivity e (%) Speciﬁcity (%) PPV (%) NPV (%) Accuracy (%)
≥5 67.9 84.4 79.1 75.0 76.7
≥9 57.1 84.4 76.1 69.2 71.7
≥10 50.0 87.5 77.7 66.6 70.0
≥11 32.1 93.7 81.8 61.2 65.0
TST: tuberculin skin testing; PPV: positive predictive value; NPV: negative predictive value.
found an agreement of 76% (k=0.53) between the TST
and QuantiFERON-TB Gold In TUBE® results among the
household contacts of patients with active TB; these ﬁndings
conﬁrm the results of this study.
In countries with a high TB burden, treatment of active
TB is the top priority for disease control. The second priority
is the identiﬁcation and treatment of individuals with LTBI,
since this practice can reduce the risk of progression to active
TB by 90%(4)
. The goal of TST and IGRAs tests is to identify
individuals who are at increased risk of reactivation or of a new
infection by MBT, such as the contacts examined in this study.
The guidelines of the Center for Disease Control and
Prevention (CDC) in Europe do not recommend the use of IGRAs
in countries with a high incidence of TB(21)
. In addition, TST
appears to be the most viable option in low-and middle-income
countries because of its low cost(22) (23) (24) (25)
. However, although
TST has been extensively studied, there is still some discrepancy
between the optimal TST cutoff point for LTBI diagnosis and
subsequent isoniazid treatment recommended by the Ministry
of Health (≥ 5mm)(11)
and the professional practice (≥ 10mm).
Previous studies have shown that the sensitivity of
QuantiFERON-TB Gold In TUBE® and TST is approximately
. However, IGRAs has a specificity > 95% in the
diagnosis of LTBI(22) (26)
. The speciﬁcity of TST is affected by
previous BCG vaccination; speciﬁcity values reach 97% in
unvaccinated populations, while in populations extensively
vaccinated with BCG, it is approximately 60%(22)
BCG vaccination administered up to the age of one does not
interfere with TST results after 10 years(26) (27)
According to the World Atlas of BCG Policies and
, BCG vaccination was introduced in Brazil in 1976
as a single dose vaccine administered at birth. Subsequently,
changes in procedure were introduced such as the institution of
booster doses in 1994, a practice that was then banned in 2006.
Notwithstanding, in this study, over 80% of the participants had
a history of BCG vaccination at birth.
PPV denotes the probability of a true infection; the higher
the risk of exposure, as in cases of close contact with patients
with active TB, the greater the PPV(29)
False-negative TST results can be explained by exposure
time; a period of 6-8 weeks post exposure to MBT is necessary
for LTBI screening. The longer the time period between
exposure and testing, the greater the agreement between the
TST and the QuantiFERON-TB Gold In TUBE® results(30) (31)
Our results indicate that the average period of incubation in the
index cases was 87.63 days (±88.97), which might explain the
statistical difference between the PPV and NPV observed for
participants with an induration ≥ 9mm.
Our study sample consisted mainly of household contacts,
mostly index case partners, with a high risk of infection due to
the increased degree of exposure.This ﬁnding corroborates with
the results of previous studies; Gazzetta et al.(32)
that 69.3% of contacts had a very close degree of kinship to the
index case (father, mother, children, siblings, and partner) and
that because of their proximity to the focus they were at high
risk of becoming infected. Kipfer et al.(33)
, identiﬁed a correlation
between proximity/exposure time and LTBI following the
detection of pulmonary TB in a Swiss army training camp. The
QuantiFERON-TB Gold In TUBE® (IGRA) diagnosis was
positive in 93% of the individuals who shared the same dorm
with the index case.
The limitation of this study is that TST was not repeated
eight weeks later in contacts that had an induration ≤5mm;
initially negative contacts could present an increase of 10mm
compared to their ﬁrst results, which could explain the positive
results obtained using QuantiFERON-TB Gold In TUBE®
(IGRA) and the negative TST results.An additional limitation
is the possible small sample size. A strong point of the study
is the involvement of index case contacts from the State of
Maranhão, Northeastern Brazil, which has high rates of TB
and abandonment (9.1%)(34)
Rev Soc Bras Med Trop 48(6):724-730, Nov-Dec, 2015
In summary, both QuantiFERON-TB Gold In TUBE®
and TST have proven effective for the diagnosis of LTBI in
household contacts of patients with active TB; both exhibit
excellent sensitivity, speciﬁcity, predictive values, and accuracy.
The concordance between these tests was moderate; the
simplicity and low cost of TST indicate it is a good option for
LTBI screening in sites with high TB prevalence and a history
of childhood BCG vaccination. Thus, the diagnosis of LTBI by
TST is proved to be effective and the initiation of treatment for
latent forms of TB can prevent the active forms of the disease
resulting impact on reducing morbidity and mortality from TB.
The authors declare that there is no conﬂict of interest.
CONFLICT OF INTEREST
We wish to thank the Graduate Program in Public Health
at the Federal University of Maranhão and the Epidemiology
of Communicable Diseases Research Group of the Federal
University of Maranhão for study design and support.
Foundation for Research and Scientiﬁc and Technological
Development of Maranhão.
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surveillance, planning, ﬁnancing. WHO Report; 2008.
2. Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC. Global
burden of tuberculosis. Estimated incidence, prevalence, and
mortality by country. JAMA 1999; 282:677-686.
3. Sociedade Brasileira de Pneumologia e Tisiologia. Sociedade
Brasileira de Infectologia. Sociedade Brasileira de Reumatologia.
Participantes: Conde MB, Mello F, Lima MA, Guerra RL,
Miranda SS, Galvão TS, Pinheiro VG, Laurindo IM, Carvalho
NB. Tuberculose infecção latente: diagnóstico (Elaboração Final:
31 de janeiro de 2011). Diretrizes Clínicas na Saúde Suplementar.
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4. Comstock GW. How much isoniazid is needed for prevention
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5. Pai M, Menzies D. Diagnosis of latente tuberculosis infection
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et al. Delayed tuberculosis diagnosis and tuberculosis transmission.
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7. Rose CE Jr, Zerbe GO, Lantz SO, Bailey WC. Establishing priority
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M, et al. Comparison of tuberculin skin testing and QuantiFERON-
TB gold-In Tube test in health care workers. Tuberk Toraks 2011;
Manual de recomendações para o controle da tuberculose no
Brasil. Brasília: MS; 2011.
12. Aagaard C, Brok I, Olsen A, Ottenhoff TH, Weldingh K, Andersen P.
Mapping immune reactivity towards Rv2653 and Rv2654: two novel
low-molecular-mass antigens found speciﬁcally in the Mycobacterium
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13. Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N,
et al. A systematic review of rapid diagnostic tests for the detection
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Vernon A. Guidelines for using the Quantiferon-TB Gold test for
detecting Mycobacterium tuberculosis infection, United States.
MMWR Recomm Rep 2005; 54:49-55.
15. Pai M, Riley LW, Colford JM Jr. Interfero-gama assays in the
immunodiagnosis of tuberculosis: a systematic review. Lancet
Inf Dis 2004; 4:761-776.
16. Pai M, Menzies D. Interferon-gama release assays for diagnosis of
latente tuberculosis infection: Systematic review. Uptodate 2014.
(Accessed 2015 March 12). Available at www.uptodate.com
17. Cellestis Limited, Australia e Cellestis GmbH. QuantiFERON-TB
Gold: Método in tubo, Teste de interferon-gama para sangue total,
para medição de respostas aos péptidos antigénicos ESAT-6, CFP-10
& TB7.7, Folheto informativo para diagnóstico in vitro. Hannover,
Germany: ellestis Limited, Australia e Cellestis GmbH; 2009.
18. Landis JR, Koch GG. An application of hierarchical kappa-type
statistics in the assessment of majority agreement among multiple
observers. Biometrics 1977; 33:363-374.
19. Takenami I, Loureiro C, Machado A Jr, Emodi K, Riley LW,
Arruda S. Blood cells and interferon-gamma levels correlation in
latent tuberculosis infection. ISRN Pulmonology 2013; 2013:1-8.
20. Machado A Jr, Emodi K, Takenami I, Finkmoore BC, Barbosa T,
Carvalho J, et al. Analysis of discordance between the tuberculin
skin test and the interferon-gamma release assay. Int J Tuberc
Lung Dis 2009; 13:446-453.
21. European Centre for Disease Prevention and Control (ECDC). Use
of interferon-gamma release assays in support of TB diagnosis.
Stockholm: ECDC; 2011.
22. Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang
L, Hopewell PC, et al. Interferon-γ release assays for active
pulmonary tuberculosis diagnosis in adults in low- and middle-
income countries: systematic review and meta-analysis. J Infect
Dis 2011; 204:1-10.
23. Sester M, Sotgiu G, Lange C, Giehl C, Girardi E, Migliori GB, et al.
Interferon-γ release assays for the diagnosis of active tuberculosis:
a systematic review and meta-analysis. Eur Respir J 2011; 37:
24. Rangaka MX, Wilkinson KA, Glynn JR, Ling D, Menzies D,
Mwansa-Kambafwile J, et al. Predictive value of interferon-γ
release assays for incident active tuberculosis: a systematic review
and meta-analysis. Lancet Infect Dis 2012; 12:45-55.
Ferreira TF et al. - Diagnosis of latent tuberculosis
25. Machado PC, Valim ARM, Maciel ELN, Prado TN, Borges TS,
Daronco A, et al. Comparação do teste tuberculínico e do ensaio
de liberação de interferon-gama para diagnóstico de tuberculose
latente em agentes comunitários de saúde do Sul do Brasil,
Rio Grande do Sul, 2012. Epidemiol Serv Saude 2014; 23:675-681.
26. Menzies D, Pai M, Comstock G. Meta-analysis: new tests for the
diagnosis of latent tuberculosis infection: areas of uncertainty and
recommendations for research. Ann Intern Med 2007; 146:340-354.
27. Rosemberg J. Mecanismo imunitário da tuberculose: síntese e
atualização. Boletim de Pneumologia Sanitária 2001; 9:35-59.
28. Zwerling A, Behr M, Verma A, Brewer T, Menzies D, Pai M. World
Atlas of BCG Vaccination Policies and Practices. 2015 (Accessed
2012 March 15). Available at: http://www.bcgatlas.org.
29. Menzies D, Gardiner G, Farhat M, Greenaway C, Pai M. Thinking in
three dimensions: a web-based algorithm to aid the interpretation of
tuberculin skin test results Int J Tuberc Lung Dis 2008; 12:498-505.
30. Lee SW, Oh DK, Lee S, Kang HY, Lee CT, Yim JJ. Time interval
to conversion of interferon-gamma release assay after exposure to
tuberculosis. Eur Respir J 2011; 37:1447-1452.
31. Adetifa IM, Ota MO, Walther B, Hammond AS, Lugos MD, Jeffries
DJ, et al. Decay kinetics of an interferon gamma release assay with
anti-tuberculosis therapy in newly diagnosed tuberculosis cases.
PLoS One 2010; 5:e12502.
32. Gazetta EC, Rufﬁno-Netto A, Pinto Neto JM, Santos MLSG,
Cury MRCO, Vendramini SHF, et al. O controle de comunicantes
de tuberculose no programa de controle da tuberculose em um
município de médio porte da Região Sudeste do Brasil, em 2002.
J Bras Pneumol 2006; 32:559-565.
33. Kipfer B, Reichmuth M, Büchler M, Meisels C, Bodmer T.
Tuberculosis in a Swiss army training camp: contact investigation
using an Interferon gamma release assay. Swiss Med Wkly 2008;
34. Silva PF, Moura GS, Caldas AJM. Fatores associados ao abandono
do tratamento da tuberculose pulmonar no Maranhão, Brasil, no
período de 2001 a 2010. Cad Saude Publica 2014; 30:1745-1754.
Rev Soc Bras Med Trop 48(6):724-730, Nov-Dec, 2015

domain: medical


People power utilised to help keep track of coastal erosion
By Michael Edwards on AM
Scientists are harnessing the power of 'citizen science' to prevent the erosion of some of Sydney's best known beaches.
It's a project called CoastSnap and it involves getting members of the public to take photos of particular beaches to help monitor changes to the shoreline and it's an initiative that's spreading across Australia and around the world.
Dr Mitchell Harley, University of New South Wales
Frances Whitfield, Manly Beach regular
Byron Horell, North Narrabeen Beach regular
KIM LANDERS: The power of "citizen science" is being harnessed to help prevent the erosion of some of Sydney's best known beaches.
It's a project called CoastSnap and it involves getting members of the public to take photos of particular beaches to help monitor changes to the shoreline.
It's an initiative that's spreading across Australia and around the world as Michael Edwards reports.
(Sounds of the surf)
MICHAEL EDWARDS: It's a beautiful day at Manly Beach - gentle waves are rolling in, children are playing in the shallows, others are swimming out beyond the buoys, some are sun baking.
It is like a postcard but this natural beauty is under constant threat.
MITCHELL HARLEY: The real threat comes when we get extreme storms.
MICHAEL EDWARDS: Dr Mitchell Harley is a coastal erosion expert from the University of New South Wales.
He's tracking the changes to some of the our most well-known beaches on the east coast like Manly.
MITCHELL HARLEY: In south-east Australia storms like east coast lows where you can see waves of up to 15 metres breaking off the coast and that can move a lot of sand and subsequently undermine beachside infrastructure, houses, anything that is in its way.
MICHAEL EDWARDS: Monitoring coastal erosion is a big job. It takes a lot of time and money or the co-operation of many people.
FRANCES WHITFIELD: I've got my camera in my mobile phone here and I'm just going to stick it in the cradle, is that right? Have I got it in the right way?
MICHAEL EDWARDS: And that's exactly what Dr Harley is harnessing in a project known as CoastSnap. It's simple - people use their smartphones to keep watch over a beach.
MITCHELL HARLEY: Just a stainless steel camera cradle and what it means is that people go along and place their smartphone into this camera cradle and that camera cradle basically controls the position and the angle of where the photo is taken.
All they have to do is take the photo and upload it to social media or if people don't have social media, they can send it via email and basically we crowd source all of these images and over time, because it is always at the same location, we can actually track the changes to that particular coastline.
MICHAEL EDWARDS: Frances Whitfield is a regular at Manly Beach. She's incorporated CoastSnap into her daily routine.
FRANCES WHITFIELD: Basically whether I'm swimming or diving, I will always park the car whenever you can find a parking spot in Manly. If I've got someone with me, whether it's the kids or my dive buddy, get them to jump out, come down and take the photo. Get back in the car, upload it because I think the more people that get involved in these things the better.
MICHAEL EDWARDS: The photo stands have also been installed at North Narrabeen, Byron Bay and Blacksmiths Beach in New South Wales and at Maroochydore in Queensland.
The danger of coastal erosion was driven home to Sydneysiders in the winter of 2016 when a massive storm caused huge tides, destroying homes and eroding large parts of the beaches in the area.
Seeing this prompted Byron Horell, a regular at North Narrabeen to get involved with CoastSnap.
BYRON HORELL: Seeing what happened, especially at Collaroy, was quite frightening. That was a wake-up call to everyone.
MICHAEL EDWARDS: CoastSnap is already attracting overseas interest with a number of countries including Spain, Portugal and Brazil developing their own programs.
Here in Australia, a considerable database has already been built-up and Dr Mitchell Harley says it's already making a difference.
MITCHELL HARLEY: With all these photos we're building up a database of how our coastlines are changing. You can actually then identify hotspots of erosion, where our coastlines are changing, how much are they changing and so forth.
So it is really powerful information.
MICHAEL EDWARDS: There are plans to expand the project into Western Australia, South Australia and Tasmania.
KIM LANDERS: That report by Michael Edwards.


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Do you eat rice? Drink rice milk? Eat energy bars? Then, you'll want to read this guest post by a mom of 4 boys from "Green Talk", Anna Hackman. She is an attorney and a LEED accredited professional who built an eco-friendly Energy Star house. She is always in the "front lines", protecting her family, from all kinds of environmental assaults. So imagine how she felt when she found out that there is arsenic in rice and rice products? What she found out in her research was alarming. Read on.
- - - - -
Get Arsenic Out Of Rice! Now!
Recently the use of organic brown rice syrup in health food came under scrutiny when a 2012 Dartmouth study revealed disturbing levels of arsenic in tested toddler formulas, cereal bars, and energy products. In the case of toddler formula, the total arsenic level was six times the amount allowed by the EPA for arsenic in water. This standard is based on adults, not children.
Sadly, this news was not a new revelation. It was just another disturbing study pointing to the rice and arsenic connection in which US and EU guidelines have not been established. As I started to prepare an article for my website regarding the Dartmouth study, something just didn’t seem right. Call it mother’s intuition.
With the help of Professors Duxbury of Cornell University and Merharg, of Scotland University, I was able to put the pieces together.
How does arsenic get into the rice?
Arsenic is naturally occurring in the soil. However, we have increased the amount of inorganic arsenic in our soil due to pesticides use, water contamination, CCA wood preservatives, sewage sludge, and air pollution from burning fossil fuels and metal smelting. The EPA has labeled inorganic arsenic as a known carcinogen.
Since rice is grown in water, it sucks up arsenic in the soil. Eighty percent of rice grown in the United States comes from the South where arsenic pesticides were used. Arsenic remains in the soil. The balance of rice grown in the United States comes from California, where arsenic is more prevalent due to its geochemical profile
Since organic brown rice syrup is a concentrated form of rice, it will naturally contain more arsenic. Now I understood the puzzle.
But I was outraged.
Five years ago, a study done in 2007 by Dr. Meharg’s team revealed that infants due to their low body weight, people who are on a gluten free diet and ethnic groups who ate rice as a staple could be at risk. And here is when I cringed. The November 2001 issue of Pediatrics reports that an estimated 15% of autistic children are on gluten free diets.
In 2009, the UK Food Safety Standards warned parent as a precaution to stop giving children ages 1 to 4.5 years old rice drinks due to an arsenic/rice milk study. Two years later, another Dartmouth study revealed that arsenic in pregnant women’s urine increased with rice consumption. And now, another Dartmouth study tells us that arsenic is in brown rice syrup in products that we consume daily, like energy bars, cereal bars, and infant formula.
The effects of arsenic in humans
For five years or possibly more, there hasn’t been any US or European Union guidelines on the amount of arsenic allowable in rice. Short term health consequences for children exposed to low levels of arsenic are unknown. Long term exposure to arsenic in drinking water includes high risk of lung and bladder cancer and increase risk to skin, liver, and kidney cancer. In addition, developmental defects, stillbirth, and spontaneous abortion as well as heart attacks, strokes, diabetes mellitus, and high blood pressure have been associated with long term arsenic exposure.
How can we avoid arsenic in rice?
Both Professors told me that this issue was solvable. The rice farmers could let their fields dry out more and flood them less. This change in farming method would decrease the arsenic uptake. Alternatively, Dr. Meharg suggested “selectively breeding arsenic-poor rice varieties.” He further explained this is not to be confused with creating genetically modified seeds.
For more detailed information, read this article on the Dartmouth and other studies on Green Talk.
Food Safety News recently reported that Reps. Frank Pallone (D-NJ) and Rosa DeLauro (D-CT) are urging the U.S. Food and Drug Administration to respond to reports of arsenic in juices and other foods. Pallone held a press conference at a preschool in New Brunswick, NJ to gain support for his bill, "Arsenic Prevention and Protection from Lead Exposure in Juice Act of 2012'' otherwise known as the "APPLE Juice Act of 2012." The legislation, which DeLauro has cosponsored, would require that FDA establish lead and arsenic standards for fruit juices within two years.
"There are no regulations for this toxin in other food products, including juices or infant formula, though China has a standard for arsenic in food," in its letter to FDA Commissioner Margaret Hamburg.
In their letter, Pallone and DeLauro tout their bill, which targets apple juice, and ask FDA to move on a wider variety of FDA-regulated products, including juices and infant formula, in a timely manner."
UPDATE** [September 19, 2012] - ABC News reported today that Consumer Reports finds Arsenic levels in rice "worrisome" and that daily consumption of rice can raise arsenic level in your body 44 percent! Read the full article here.


text:
This post is gonna be a downer. Sorry. But it has to be said. And I promise that if you stick with me, I’ll end on a happier note.
In the past month or so, it seems like everyone online has spent at least some time remembering Robin Williams. And although I do not tend to get especially upset by celebrities passing (not in the same way as when I lose someone I know, at least), this particular tragedy has affected me more than others involving people I’ve never met.
Here’s why: I’ve known more than one person who has attempted suicide. I can count at least five friends, family members, and acquaintances who have done so. None of them have succeeded, thank goodness. But I have known people who have lost loved ones to suicide.
And there are many more whose stories I don’t even know.
(This is part of the reason why I included attempted suicide in Cinnamin’s story. It’s a reality of too many people’s lives – it cannot be ignored.)
The thing is… you never know who your actions are affecting. For better or worse, everything you do ripples.
Like I said, for better or worse. Meaning, if you were to attempt suicide, your actions would affect people for the worse. But the other side of the coin is, the good you do affects people for the better. And I guarantee you, you have already affected people for the better. Maybe some people you don’t even know.
Look at the above story about Robin Williams. He might never have known that Redditor’s name. We know they never saw each other again after that day. But he made his life a little better. He made his burdens a little easier to bear.
Believe it or not, you have done the same thing for someone you may never meet again. Someone whose name you will never know. (This happens to be the idea behind my novel in progress about hair donation.)
When I was in high school, a classmate of mine drove drunk and ended up killing his best friend, who was in the passenger seat when they got into an accident. I did not know either kid. I’d never known their names before. But the Monday after it happened, I heard other kids talking about it. I saw how it affected them. And it affected me. I cried. I mourned. Not for someone I’d lost, but because I saw others who had lost someone.
I called my friend in Maryland after school and told her. We cried together. She was with another friend when I called, someone I’d never met or spoken to. But she cried too.
Do you see the ripples? Three thousand miles away, death can affect a friend of a friend of an aquaintance of a friend.
The good news is that the possitive impact you have on a person’s life can do the same thing.
Whoever you are, you are the Robin Williams to the above Redditor for someone out there. Some small act of kindness you’ve done has affected someone’s life for the better. True, there’s no way of proving this, of tracking down that person and finding out what kind act you don’t remember that changed everything for them. But every action ripples. If you have ever done anything good, chances are it helped someone in some way.

domain: sociology


Safeguarding our heritage for future generations
Din l-Art Ħelwa, National Trust of Malta, is a non-governmental, not-for-profit, voluntary organisation founded in 1965 to safeguard the historic, artistic and natural heritage of Malta. Since its foundation, Din l-Art Ħelwa has restored and managed numerous cultural sites of immense historic and environmental importance.
We promote the preservation and protection of historic buildings and monuments, the character of our towns and villages, and places of natural beauty and importance and the flora and fauna of such places, especially in relation to the problems arising from modern urban development. We stimulate the enforcement of existing laws and the enactment of new ones for the protection of our natural and built heritage.
Din l-Art Helwa supports protest outside Planning Authority
The Planning Authority has failed to provide a sound and timely policy review on the relocation of fuel stations to outside development areas.
DLH slams MDA proposal to ‘reassign’ floor area to further boost construction
Din l-Art Helwa asks the government to immediately and unequivocally reject this proposal by the Malta Developers Association
Alex Torpiano is Din l-Art Helwa’s new Executive President
Professor Alex Torpiano has been appointed Executive President of Din l-Art Ħelwa
Press Conference : An informed discussion on the Malta-Gozo tunnel has yet to start
Press Conference 09/03/2019 Whilst fully acknowledging the need to address mobility challenges experienced by Gozitan workers and students, we express … Read More


text:
Clinical and angiographic assessment of complex mammary artery bypass grafting.
The internal mammary artery has become the coronary bypass graft of choice in recent years because of enhanced long-term patency. Along with this trend, sequential, bilateral, and free mammary grafts have been employed more frequently in an effort to maximize the number of distal internal mammary anastomoses. This approach of maximally using the internal mammary artery (complex mammary grafting) seems logical, but at present little information about patency of the newer types of internal mammary artery grafts is available to justify the more complicated procedures. Over a 15 month period, 207 patients underwent bypass graft angiography from 1 to 32 weeks after operation. This is an 85% restudy rate for a consecutive series of coronary bypass procedures. Patency was defined as complete filling of the graft and distal vessel bypassed. A total of 841 distal vessels were grafted, or 4.1 per patient. The overall patency rate was 91% for 503 distal vein graft anastomoses and 99% for 338 internal mammary artery grafts. Individual patency rates of distal anastomoses, expressed as number patent/total (percent patent), were as follows: simple vein grafts, 262/285 (92%); sequential vein grafts, 196/218 (90%); left internal mammary artery to left anterior descending coronary artery, 109/110 (99%); left internal mammary to circumflex marginal artery, 14/14 (100%); right internal mammary to right coronary artery, 19/20 (95%); right internal mammary to left anterior descending coronary artery, 10/10 (100%); right internal mammary to circumflex marginal artery via transverse sinus, 18/20 (90%); sequential left internal mammary artery to left anterior descending system, 133/134 (99%); sequential left internal mammary to circumflex marginal system, 15/15 (100%); free internal mammary artery, 9/9 (100%); free sequential internal mammary artery, 6/6 (100%). Of the 18 patent transverse sinus right internal mammary grafts to the circumflex marginal artery, three exhibited very slow flow and probably were not functional. The hospital mortality associated with internal mammary revascularizations was 0.4% for nonemergency cases and 3.1% for emergency procedures. On the basis of clinical and postoperative graft patency data, expanded use of more complicated types of mammary grafts seems justified. Function of the right internal mammary graft to the circumflex marginal artery was suboptimal, and this method has been discontinued. All other complex mammary techniques had excellent patency rates as compared to vein grafts, and these differences may become even more significant in the late postoperative period.(ABSTRACT TRUNCATED AT 400 WORDS)
Rankin, JS; Newman, GE; Bashore, TM; Muhlbaier, LH; Tyson, GS; Ferguson, TB; Reves, JG; Sabiston, DC
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text:
Some bands from the industrial scene do get noticed outside the scene as well. English electronic music DJ, producer and radio presenter Dave Clarke has picked the newest single by Implant, “Phone call”, to be featured on his latest White Noise radio show.
The track used is the Radical G remix of Implant’s “Phone call”. It doesn’t come as a surprise as “Phone call” is a pure old school electronic track with a very attractive beat, which gets emphasised in the remix Radical G made of the track. You can find “The Phone Call” on the band’s newest single with the same title and of course on their upcoming album “Oxynoxe-X” which will be out later in November – check here to order the 2CD boxset)
Here’s the track below:
The original version, in a video edit, can be viewed below.

domain: artistic


text:
Gear Up for Idaho Gives 2017
Are you ready to commit to building a stronger Idaho? The time to gather as a community and celebrate giving has rolled around again. May 4th, 2017 kicks off the statewide, 24 hour giving day known as Idaho Gives.
Idaho Gives is an inspiring event that truly illustrates how generous and giving our great state can be. Last year, Idaho banded together to raise an astounding 1.1 million dollars, from 13,000 donations and 7,515 individuals. This helped 632 nonprofits make a staggering difference within our beloved community. 2017 marks the 5th year of this awesome event, and everyone is excited to see if we can beat last year's record of giving.
Idaho Gives is hosted by the Idaho Nonprofit Center, a pillar of the community, Idaho Nonprofit Center acts as a bridge between Idaho’s nonprofit, for-profit, and government sectors. They seek to share knowledge, solve problems, and serve the public good.
What’s changed for 2017?
This year the donation platform has been changed from Razoo to the new online giving program GiveGab. This change results in reduced credit card fees, a quicker turn around for funds received by the nonprofit of your choice, and an easier to use search feature (by county).
What hasn’t changed for 2017?
All donations will still take place online. That means you can give anytime and anywhere on May 4th by visiting the homepage. It's not too early to check and see if your favorite nonprofit is registered, or to find a new inspiring mission…and with over 500 nonprofits to choose from, you’ll want to investigate early.
The day will also still be filled with fun live events all over the state. To find an exciting way to participate, visit https://www.idahononprofits.org/day-of-events-statewide. You can also sport your support with a t-shirt.