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Drug companies repeatedly wrestled with suspicious orders and large shipments, documents show.
In 2008, a congressional panel summoned executives of the nation’s largest drug distribution companies to explain why they were saturating the country with opioid pills. Here's what they said.
Court filings unsealed in a landmark case contend the drug industry failed to control the diversion of opioids into the black market.
Analysis of previously undisclosed DEA data reveals corresponding spikes in deaths and pill shipments at the height of the epidemic.
Six companies distributed and three companies manufactured the bulk of the pills that saturated the nation with opioids from 2006 to 2012.
Though no one questions the bravery of the Army Rangers who scaled Pointe du Hoc, the discovery of a massive German artillery installation three miles away threatens to alter the narrative.
The president has called tackling the opioid epidemic a priority, but fentanyl overdose deaths continue to soar as federal resources fail to keep pace.
Justice Department alleges that health professionals, mostly in Appalachia, illegally dispensed 32 million pills.
Despite mounting deaths and warnings, the administration did not take extraordinary measures to confront an extraordinary crisis, experts say.
Rep. Tom Marino (R-Pa.) was under fire in the wake of revelations in a Washington Post/“60 Minutes” investigation that the lawmaker helped steer legislation in Congress making it harder for the DEA to act against giant drug companies.

domain: law


What is the history of the band – how did it come into being, members, its journey (in brief) and what does the name of your band signify? “The band was formed by the manager o..
India has a history of vibrant culture. And music, Music Instruments being an integral part of our culture has had really strong roots in India. Same is true with Music Instruments..


Slide Fire Partners with Colt Competition Creating the CRZ-16 Slide Fire Equipped Rifle
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Slide Fire Solutions, a veteran-owned, US designer and manufacturer of patented bump fire technology, is expanding their product portfolio to include some of the hottest brands in the firearms industry. One of the newest offerings is the Colt Competition CRZ-16 Marksman which has been integrated with the Slide Fire SSAR-15 MOD Adjustable Stock for the remarkable suggested retail price of just $1,199.95.
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Additionally, the Colt Competition CRZ-16 Bump Fire Rifle features a blackened 16-inch HBAR-contour, mid-weight 4150 chromoly steel 5.56 barrel. The barrel comes with a twin chamber steel muzzle brake and a low-profile fixed gas block. The rifle also features a crisp 6-lb. target trigger with an enlarged Magpul trigger guard and a Magpul 30-round PMAG.
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Many of you will have been aware over several months of rumours about a radical shake-up in vaccination protocols for dogs. At GVH we have been closely examining the claims and counter-claims of the various vaccine manufacturers, and also the objective scientific evidence for these claims. Until now we have not felt that the evidence has justified any change to our previously-recommended protocols.
Recently, however, a new vaccine has become available which has changed our minds, and we are switching over completely to this new vaccine. There are some quite significant implications for you, our clients, so we’d like to take the time to explain the changes to you.
The first thing to say is that this new protocol applies to dogs only.
Our vaccination recommendations for cats remain unchanged.
In the past, adult dogs have had a C5 vaccination once every year; this is because the immunity to the diseases we vaccinate against has not reliably lasted for longer than that period. C5 can be thought of as comprising C3 (Distemper, Adenovirus and Parvovirus) and KC (the two kennel cough organisms).
Up until now puppies have had a C3 vaccination at 6 to 8 weeks (this has often already been done by the breeder by the time you get your puppy), then a C5 vaccination at 12 weeks of age, then another C5 at 16 weeks. The reason for this is that they get some maternal immunity from their mother’s milk which interferes with the immune response to the vaccine. This immunity runs out by the time they are 16 weeks, and therefore it is not until the final (16 week) injection that the immunity will last a full year.
The new vaccine has some major advantages.
The first is that it overcomes the maternal immunity, so that the pup can respond fully to the vaccine as early as 10 weeks of age. So now a vaccination given at 10 to 12 weeks of age does not have to be repeated at 16 weeks. The pup just needs to come back after a year for its first annual booster.
The second advantage is that after the first annual booster vaccination (at 12 to 15 months of age), the C3 component of the vaccine lasts for 3 years. The KC component still only lasts one year. So your dog still needs to come in once a year, but the vaccination he receives will vary each year (one year C5, the following two years just KC, then C5 again). You don’t need to try to remember which one is due- our vet will know from your dog’s records.
We recommend that your dog comes in once a year for an annual health check in any case- this is equivalent to a person seeing their GP just once every seven years. If your dog has no health issues that you’re aware of, the annual health check can be combined with whatever vaccination is due.
We are aware that most vet practices have not yet switched over to the new vaccine. There are a number of reasons for this. The GVH vets have examined all the scientific evidence about the new vaccine and we believe that it is a superior product. We are therefore instituting it because we believe it provides a better standard of health care for your dog.
The new vaccine is substantially more expensive than the old one, and consequently we have had to increase the cost of vaccinations. However, in the case of puppies, the additional cost is still substantially less than the previous cost of two visits.
In the case of adults, the cost of the annual vaccination will be higher than it used to be once every 3 years, but in the other 2 years it will be less- so over a three year period the costs to you are substantially less.
One aspect that has concerned us as a potential problem is that there will now be some puppies that we will only be seeing for one visit early in life, whereas previously we would have seen them for at least two consultations. There are usually some very important issues that we discuss with owners at these consultations, especially when the client is a first-time dog owner or hasn’t owned a pup for some years.
We have therefore increased the time we allow for these puppy vaccination consultations, so that we have plenty of time to discuss with you all the general health aspects that we need to, such as worming, heartworm prevention, diet, training and behaviour problems.
We also strongly encourage you to consider bringing your pup along to our Puppy Pre-School classes; we have found these to be of great benefit, not only in getting the pups to socialise with others, but also for the owners to clear up any areas of concern they might have.
We also emphasise that if ever you have any queries one of our vets will be available to discuss any issues with you, either over the phone or in person.
Another aspect of the new vaccination you should be aware of is that the KC component is administered by dripping a very small volume of fluid into the nose. Rest assured that this is not distressing for the dogs- in fact, they don’t seem to mind it at all, and seem to prefer it to having another needle!
So…. To sum up:
If your pup has not had a temporary C3 vaccination at the breeder at 6 to 8 weeks of age, we still recommend that they have this. Then they can have full adult protection at any age from 10 weeks on, and will need one less needle than previously. A week after this vaccination, they may then go to the park and socialise with other dogs quite safely. They will need to come back after a year for their first booster C5. Thereafter, their annual health check visits will include a C5 vaccination every third year, and a KC vaccination in the other two years.
This new vaccine represents a huge innovation in the vaccination options we have for dogs, and we believe is a quantum leap forward for the health and well-being of your pet.
If you have any queries about our new vaccination protocols, please discuss them with any of our staff.

domain: biology


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StartUp Europe Awards Special Edition SES19 is looking for the best European startups
StartUp Europe Awards (SEUA), an initiative supported by the European Commission in collaboration with Startup Europe and organized by the Finnova Foundation, is holding a Special Edition for European startups that will be recognized during the Startup Europe Summit 2019 (SES19), to be celebrated in Cluj-Napoca, Romani, on 21 and 22 March 2019.
This SEUA Special Edition SES19 will recognize five startups, one for each one of the following prizes: Female-led startup; Young-led startup (founder under 30); United Nations Sustainable Development Goals startup; Social Inclusion startup and Job Growth startup.
It is possible to apply to the awards for every startup created 5 or less years ago in Europe. To apply, startups must fill in with detail the form found in the website of the SEUA Special Edition, and the deadline to apply ends on 23:59 hours (CET) of 17 February 2019. The startups should choose the prize most suitable for them (just one option).
A multidisciplinary jury, composed by professionals from different countries and fields, will make the selection of the best EU startups taking into account existing startups in the EU that meet these criteria and the applications received. Some of the jury members are part of the High Level group of experts from Startup Europe (European Commission).
Benefits for the selected startups
Winning startups will be invited to participate in the Startup Europe Summit SES19 that will take place between 21 and 22 March in Cluj-Napoca, Romania. The expenses during both days for 1 member of the startup will be reimbursed (transport from country of origin to Cluj-Napoca, accommodation and daily allowance).
The startups will be recognized in a ceremony that will be held on March 21 in the frame of the Startup Europe Summit 2019 and will count with the presence of authorities from the European Commission, key influencers, investors, tech leaders, tech journalists, policy makers and entrepreneurs.
In SES19, the selected startups will be able to showcase their innovation in the networking area of the conference and will gain exposure and visibility through the StartUp Europe Awards Media Alliance composed by more than 30 media outlets and social networking sites.
The selected startups will pass to the European level of the next StartUp Europe Awards edition, regardless of any other startup competing or awarded in their country or category.
StartUp Europe Awards (SEUA) is an open innovation initiative promoted by the European Commission and the Finnova Foundation in collaboration with StartUp Europe; it is supported by the President of the European Parliament, the President of the Committee of the Regions, the Vice-President of the Economic and Social Committee and several members from the European Parliament. StartUp Europe Awards is sponsored by StartUp Europe Accelerator.
SEUA has celebrated two European finals (one in Brussels and the other one in Sofia), and is going to launch the third edition during the first quarter of 2019.
The winning startups will have access to information on opportunities offered by the European Union to boost and internationalize their projects through the StartUp Europe Accelerator program of the Finnova Foundation.
For more information about the StartUp Europe Awards Special Edition SES19 please visit https://bit.ly/2RMIL42
Startup Europe Summit 2019
Known as an evolving tech hub in Romania, the city of Cluj-Napoca will host the fourth edition of Startup Europe Summit in 2019, the perfect occasion to recognize the best European startups.
In the previous edition of the Startup Europe Summit, startups found information about new funding opportunities; meetings with investors, corporates and leading enterprises and public administration representatives as well as networking with a vivid community of key decision makers and tech leaders within EU, notably Central Eastern Europe and Western Balkans regions.
Calling MedTech European startups to join our Deep Dive Week in Dublin – Applications until 15 February
Startup Lighthouse is opening up applications for its next mini acceleration programmes with Dublin being the first. Do you have a #MedTech #startup and you are looking to scale abroad? Have you been considering Ireland? Join us at our Deep Dive Week Dublin (7-10 April). (more…)
MY-GATEWAY EMBRACES THE NEW YEAR WITH A GOLDEN TICKET TO STARTUP OLÉ.
What did you write in your New Year’s resolutions list?
Did you wish for happiness, travelling to a Western European country, attending startup events, meeting new investors..? If this is the case, I’m thrilled to announce that Startup Olé is looking for 15 CEE startups to join the event! Yes, you read it well: 15 startups!
MY-GATEWAY will help detect those Central and Eastern European startups that will benefit the most from attending the Spanish event, making sure startups are well aware of the opportunities they can be catered for. The target of our contest are startups based either in Romania, Czech Republic and Slovenia.
Those startups will need to really convince and tell us why they think Startup Olé can help them out boost their business growth, and, of course, send us a pitch deck. Attending Startup Olé can be a truly enriching experience… as you long as you prepare well for it! By using the Startup Olé app, you can gain access to investors, corporates, mentors and set up meetings with our fellow attendees.
To make sure you stand out as you deserve, you’ll be provided with a whole stand to show your product and sell it to your target, so do come prepared with merchandising and flyers that can help you achieve your objectives! And…did I already say that travel and accommodation costs are included for one representative of your team? We really don’t want the distance, and its costs, to be a problem. That’s why travel and subsistence expenses are entirely covered by us.
Last but not least, some of the startups which will go through our selection process will also gain the possibility to join the PITCHING competition.
What do YOU need to do?
In order to be eligible for this contest you’ll have to do the following:
send your pitch deck to firstname.lastname@example.org
in the body of the email, tell us:
why you’d like us to attend,
what your expectations are,
contact details of the person who would be attending the event (name, surname, email, telephone);
on social media, share/retweet a message in which you saw the open call promoted (in your email, we’d like to see the link to your publication or a screenshot)
Deadline for applications: 4th of February 2019
What is Startup Olé?
Startup Olé 2019 will take place in Salamanca (Spain) from 26-29 of March and it will gather +30.000 attendees from 120 countries; +850 startups, scaleups and spin-offs; +500 speakers; +250 corporates and investors with an investment portfolio of over €50k M. Our fifth edition will be the biggest so far and we are working hard to make this an event that you will never forget, so do not wait any longer and join the family!
What is MY-GATEWAY?
MY-GATEWAY is an initiative of Startup Europe that aims to strengthen the capacities of high-tech start-ups and innovative SMEs in the CEE region to become better connected, gain higher market exposure, and have improved, streamlined access to funding opportunities and talents.
Startup Europe Summit 2018
- Mariya Gabriel, Commissioner for the Digital Economy and Society, European Commission
- Simon Schaefer, Founder & CEO of Factory, President of Startup Portugal and Angel Investor in Europe.
- Anja Monrad, Senior Vice President & General Manager at Dell EMC, CEE and chair of the Digital Skills and Jobs Coalition Governing Board.
Previous editions have featured key influencers such as Commissioners Kroes, Oettinger, and Moedas, President of the European Committee of the Regions Markku Markkula or executives such as former Uber CEO, Travis Kalanick.
What you will find within the Summit?
Breaking news from EU & Tech Leaders
Get inspired from leading tech stars and EU policymakers. Discover new funding opportunities, including programs to support startups (Startup Europe, European Innovation Council). Learn how you can change the tech game.
It’s about doing business deals. Meeting with investors, corporates and leading enterprises. Discovering how public administration from across the region and Europe can help. This is the place to be.
Ecosystem building – Networking
Startup Europe Summit attendees are driven and focused. Whether you’re looking for funding, a new job, your new co-founder or investment, the summit offers several ways to help you connect with the right people efficiently and effectively.
Three reasons to attend:
- Learn about European funding opportunities directly from Brussels. With more than €10 Billions in the pipeline, EU is becoming the main investor in Europe!
- Network with the key decision makers and tech leaders within EU, notably Central Eastern Europe and Western Balkans regions
- Have access to business deals with corporates- investors – and public administrations for startups and scaleups.
Register now to join 400 key European startup ecosystem enablers – accelerators, investors, entrepreneurs, academia, policy makers and media representatives.
You can find more details about the programme below:
Registration concludes on 12 November 2018, 12:00 CET. On-site registration is not possible.
Networking marketplace: If you want to get the most out of your participation to the event, take a few minutes to see who else is attending the Summit and arrange bilateral meetings with the participants that are of your interest. Participants can look each other up on the participants directory of the event page, and use the personal messaging feature to arrange a bilateral meeting during the event.
MY-GATEWAY project wants 22 CEE and Western Balkan startups to attend Startup Europe Summit!
In total twenty-two startups, twelve from Central and Eastern Europe and ten from the Western Balkans, will be selected to attend this year’s edition of ‘The European Startup Event’. A committee comprised of leading startup support organizations from the CEE and Western Balkan countries will select the startups through specific criteria.
Selected startups will be given the possibility to meet high-profile people such as Prime Ministers and European Commission policymakers to discuss European entrepreneurship and new opportunities. The one-day Summit will be filled with workshops on how to access venture capital, business angel funding, EU funding and panel talks on how to scale-up. Travel and accommodation expenses of one representative per selected startup selected will be reimbursed by the European Commission.
Take a look at the Summit’s agenda here.
Would you like to apply? Click here.
‘We need to create programs and policies to connect ecosystems, founders and startups at European level.’
Mariya Gabriel, European Commissioner for Digital Economy and Society, and also key-note speaker at the Summit, said at her speech on Masters of Digital.
‘This is with a view to accelerate growth, cooperation and diversity.’
In order to be considered for the application process and be eventually selected to attend Startup Europe Summit, startups need to have a high growth potential, a prototype or viable business plan and a unique business idea.
What is Startup Europe Summit?
Startup Europe Summit is a European Commission event which aims to bring together startup founders and policy makers. More than 400 people will attend this year’s Bulgarian edition to learn about new funding opportunities, meet entrepreneurs and ecosystem builders and benefit from the possibility of closing a business deal.
Check out the agenda here.
What is MY-GATEWAY?
MY-GATEWAY is an initiative of Startup Europe that aims to strengthen the capacities of high-tech start-ups and innovative SMEs in the CEE region to become better connected, gain higher market exposure, and have improved streamlined access to funding opportunities and talents.
Innovation Fund awards grant to MY-GATEWAY advisor to promote young ideas!
4th September 2018 – MY-GATEWAY project is very pleased to announce that Seavus Incubator, together with Business-Technological Accelerator “UKIM” DOO Skopje and the Company for Business, Technical Support and Education “ICS Factor” received a total of 1.5 million Euros from the Innovation Fund to establish business accelerators for young people.
Seavus Educational and Development Center is one of MY-GATEWAY’s advisors, prividing counsel on how MY-GATEWAY activities can be adapted to the Balkan region.
The aim of those business accelerators is to provide young, creative people with the tools needed to start and develop specific businesses that will profit and participate in the progress of the Macedonian economy.
After signing the agreement, Vesna Ivanovska, general manager of Seavus Educational and Development Center, one of the three companies that received help to form a business accelerator, said she expects this project to have a big social impact.
“This project will encourage young businesses in Macedonia when they need it the most”
said Vesna.It is thanks to those initiatives and projects that the efforts made by the Government of the Republic of Macedonia to catch up with the European standars of work are undeniable. Young people represent the country’s future and potential to grow. It makes a lot of sense to invest in them.
To read the full article in Macedonian, click here.
Original article by: Maja Илиевска-Пачемска
Startup Lighthouse congratulates 14 winning startups for DDW Lisbon
European Commissioner Miguel Arias Cañete to keynote at #SEC2SV 2018
San Francisco, September 10th, 2018 – Miguel Arias Cañete, European Union’s Commissioner for Climate Action & Energy, confirmed to attend the 4th edition of “Startup Europe Comes to Silicon Valley”, the premier program for future European Unicorns (Silicon Valley, 9-15 September) organized by Mind the Bridge with the support of the European Commission, the European Parliament, and EIT Digital.
Mr. Canete leads the EU initiatives to increase European energy security, energy infrastructure projects, rules and laws to implement the 2030 climate and energy framework, policy for renewable energy and the promotion of the “Emissions Trading System”, the flagship of European climate policy.
“It’s an honour for us to host this year Commissioner Cañete at our annual SEC2SV program in Silicon Valley – commented Alberto Onetti, Chairman of Mind the Bridge and Coordinator of Startup Europe Partnership – According to our last research ‘European Innovation Economy in Silicon Valley’, Energy&Power is the second most represented vertical among the European Corporate Outposts in Silicon Valley, with 7 outposts, right after the Automotive industry. Innovation and regulation should go hand by hand. On that regard, the ‘transatlantic’ dialogue is key.”
On Wednesday, September 12th (6.30PM-7.30PM), the 2018 SEC2SV delegation will attend the invitation-only meeting with the Commissioner which will include a presentation from Ivan Contreras, CEO and founder of Muving Ecosystem, a European startup active in e-mobility, currently expanding into the US. Muving is one of the 14 European companies invited to attend the week-long SEC2SV program.
After the introduction by Marco Marinucci, CEO and founder of Mind the Bridge, Alberto Onetti, Chairman Mind the Bridge and Coordinator Startup Europe Partnership will present some highlights from their new research on “European Innovation Economy in Silicon Valley” and moderate the debate.
The meeting between the EU Commissioner Cañete and the European innovation ecosystem in Silicon Valley is organized by Mind the Bridge.
Scaleup Finland: A key scaleup ecosystem for Europe with a (still) unexploited potential
Brussels, September 5th, 2018 – Finland is a key scaleup ecosystem for Europe, but still shows an unexploited potential, according to the last “Tech Scaleup Finland” Report presented today by Mind the Bridge and Startup Europe Partnership with the support of Business Finland.
219 scaleups have been in fact identified in Finland (equivalent to about 4% of the total amount tracked in Europe), totally raising $1.9B in funding since inception (2.3% of the total capital raised by European scaleups to date).
In addition, Finland ranks 9th in the Scaleup Country Index 2017*, between The Netherlands and Denmark, with only Sweden, among the five Nordic countries, outperforming it both in capital raised and scaleup population. In these terms, the gap with larger ecosystems such as the UK, Germany or France is likely far too wide to be bridged: UK scaleups raised, alone, 15 times more capital, the German about 8 times more, the French 5 times more.
“Though absolute numbers suggest that Finland is really far from UK, Germany, France, and Sweden, the conversation changes in relative terms – commented Alberto Onetti, Mind the Bridge Chairman and Startup Europe Partnership Coordinator – Starting this year we introduced two indicators to better understand the efficiency of a scaleup economy as it relates to the size of the country in question. Finland outperforms the rest of the continent for what we labeled the ‘Scaleup Density Ratio’ by producing an average of 4 scaleups per 100,000 people, compared to 2.5 in UK, 0.6 in Germany and 1.0 in France. And it scores well also against the ‘Scaleup Investing Ratio’, with 0.75% of GDP dedicated to scaleup innovation, 1.7x more than the European average, doubling the European powerhouses Germany (0.40%) and France (0.34%), being substantially aligned with the Nordics average of 0.82%.”
“Finland is definitively a key scaleup ecosystem for Europe with a still unexploited potential.” added Isidro Laso Ballesteros, Head of Startup Europe European Commission.
“The startup ecosystem is already now effective and flourishing in Finland. One can see an upward trend in the share of foreign VC investments and the growth in exit valuation levels.There is always room to improve. We are constantly building the Finnish startup community to the next level together startups, accelerators and investors. High-growth, scaleup companies create jobs and exports and thus are crucial for our national economy.” commented Marjo Ilmari, Executive Director, Startup & Fast Growth Business Finland.
Growth – Scaleup Population and Capital
The Finnish scaleup ecosystem increased its size in 2017 with 16% growth in scaleup population (+34 new scaleups) and raised $0.3B more capital, with a YoY increase of 17%. These numbers place it behind Sweden in the growth charts (35% increase in population, 30% in capital), but Finland still runs faster than its other Nordic siblings Denmark (13% increase in population, 6% in capital), and Norway (11% growth in population, 15% in capital).
Since 2013 the scaleup population of Finland has been growing a consistent 15-17% without any fluctuation, up to 10 point less behind the European average of 28% for the years 2016-2017. 2018 will be not different with a 18% YoY growth figure. Also on the capital raised side, despite the fact that in 2017 the country had a YoY loss of 20%, the $318M that the scaleups raised was good enough to add another 34 scaleups to the count. A constant growing trend is expected this year.
Capital Raised: 96% comes from VC, a few IPOs, no ICOs.
When it comes to capital raised, 96% comes from Venture Capital, while only 4% (about $0.1B) comes from the IPO channel. In 2017, 2 more companies joined the IPO club: Next Games and Rovio, not surprisingly reinforcing the impression that Finland remains the “land of gaming”. Both IPOs were around $40M, below the European average ($120M). Surprisingly Finnish scaleups have not jumped on the ICO train yet, as we didn’t track a single company which has launched a crypto offering the previous few years.
Scaleup Migration to the US
There are 33 (15% of total) companies in Finland that moved their headquarters abroad (typically to have access to capital) and we can classify as “Dual Companies”. These 33 raised $552M altogether, amounting to 29% of the total capital raised by Finnish scaleups. They mostly moved to the US (19 of them, 11 to Silicon Valley) and outperform in terms of capital raised, having attracted an average of $16.7M, compared to the $7.3M average of companies that choose a domestic growth path.
Founding vs Funding
Despite a recent story of the scaleup ecosystem in Finland, only 25% of the scaleups have been founded in the last 3 years. Finnish scaleups are very active in raising capital constantly: 52% had a funding event in the past 2 years. In 2017 56 scaleups registered a funding event.
Sizes don’t matter
The scaleup scene in Finland is dominated by “small” scaleups: the ones that raised between $1 and $10M, represent in fact the large majority (79%) of the population. Only the 3% raised above $50M (tech giants). However, in Finland size doesn’t seem to be that relevant in the Finnish ecosystem: the Scalers (companies attracting over $100M in financing) account only for the 13% of the total funding, while the “middle class” segment ($20-$50M) attract the most funding among the cohorts. The smaller ones raised 27% of the total.
Geography of fundings
Of all capital poured into Finnish scaleups, one third (34%) comes from Finnish funds, while US funds account for slightly less than one third of investments (27%) and British for a little minority (6%). Investments coming from the rest of the world are relevant as well, accounting for a consistent 10% of capital (coming mostly from Chinese and Singaporean investors).
“Startups ecosystems in Europe start to be connected among themselves. But we need to do still more – added Isidro Laso Ballesteros, Head of Startup Europe European Commission– Our competitive advantage is to be united in diversity. Advantage that can only be realised by working at ecosystems level to be a Startup Europe: a startup continent.”
To Game or not to Game?
Finnish companies operating in the Gaming industry are only 13% of the population and have attracted almost $400M, 21% of all capital made available to scaleups to date. But if we remove the 2 IPOs by Rovio and Next Games, investments in Gaming are actually slightly declining over that period. YoY growth (2017/2016) is anyway the highest, 3.7x.
Medtech (11% of the population) attracted 8% of the total capital ($142M) with a YoY of 1.5, Cleantech the 10% ($190M) with a YoY of 2.0, while traditional industries such Hardware and Software collected respectively 8% ($153M) and 9% ($161M), covering the 9% of the population each.
The capital city of Helsinki hosts 131 scaleups, which raised altogether almost $1.2B. This concentration is 60% of the total population, and contains 63% of the capital raised. If we add Espoo, home of other 33 scaleups, concentration rates go up to 75% and 82%. Outside of the capital, Oulu is the largest scaleup hotspot, followed by Tampere and Turku.
The Finnish ecosystem is definitely seeing momentum in M&A activity. With a total of 112 acquisitions of Finnish startups and scaleups since 2010, after a relatively stale M&A activity, each year since 2013, 2017 signed a turning point with 45 M&A transactions, 3.5x compared to 2016. Nevertheless, they are still a domestic business, since the 38% of Finnish startups are acquired by Finnish companies. 28% belongs to US, 16% other countries, 13% to other Nordics and 5% to other countries (mostly Chinese and Japanese companies).
Not surprisingly, the Gaming startups get the third spot in the industry ranking of Finnish startup M&As with 11 deals (the 10% of all), right behind Software Solutions (first at 18 deals, the 16%) and Enterprise Software (14 deals, the 13%).
* Notes on Methodology
Scaleup Density Ratio: number of scaleups per 100K inhabitants. A measure of density of scaleups in a given ecosystem.
Scaleup Investing Ratio: capital raised by Scaleups as a percentage of GDP. A measure meant to measure the capital invested in scaleups in a given ecosystem, compared to the size of the overall economy of that country.
Scaleup Country Index: country ranking built upon Scaleup Density Ratio and Scaleup Investing Ratio. A measure of the overall innovation commitment of a given ecosystem and its ability to produce significant tech players.
The indicators above are produced and monitored by Mind the Bridge.
CONGRATULATIONS TO THE 11 LUCKY WINNERS!
Congratulations to: Spendee from Czech Republic, GewdTime from Slovenia, bFertile from Slovenia, SettleMint from Belgium, Smart Optometry from Slovenia, Axensor from Belgium, FeliCity LTD from Hungary, CargoPlanning from Romania, Silent Call from Czech Republic and FINQware from Romania, Finbot platform from Denmark!
MY-GATEWAY cannot wait to formally meet all of these amazing startups and help them grow through Web Summit and beyond. MY-GATEWAY was astounded by the variety and creativity of the many applications submitted to the ticket giveaway. In the end, we believe we have a great group of entrepreneurs and innovators we believe will be the future of disrupting the startup industry. Stay tuned to keep up with our road to Web Summit!
What is Web Summit?
Web Summit is the largest tech conference in the world and is always a complete success. Like every year, we expect to gather in Lisbon over 70.000 attendees, 1.200 speakers and 170 countries for 3 full days of networking and business. Web Summit also gathers the entire investor ecosystem, from big fishes to the most relevant angels and venture investors, as well as over 2,500 international media outlets. Here, startups have lots of opportunities to gain exposure, such us networking, presenting their business and participating in panels, among others. MGW just cover the entry ticket, not the travel cost or any financial support.

domain: geography


text:
In today’s world, agreements and contracts play a vital role in various aspects of our lives. From business transactions to legal obligations, these documents ensure that parties involved are bound by specific terms and conditions. Let’s explore some interesting agreements and their significance.
1. Articles of Agreement IMF PDF
The International Monetary Fund (IMF) is an organization that works towards promoting global economic stability. The Articles of Agreement IMF PDF outline the principles and responsibilities of member countries within the IMF. It serves as a significant document for understanding international financial cooperation.
2. Leasing Agreement WA
Whether it’s a car, property, or equipment, leasing agreements are prevalent in many industries. In Washington (WA), the leasing agreement WA governs the terms and conditions of leasing transactions within the state. This agreement protects the rights and interests of both lessors and lessees.
3. Entire Agreement Section
When entering into a contract, it’s crucial to have clarity on what is included and what is not. The entire agreement section within a contract explicitly defines the scope of the agreement. This section ensures that the contract represents the entirety of the parties’ understanding and avoids any ambiguity.
4. CEBA Loan Agreement CIBC
The Canada Emergency Business Account (CEBA) provides financial assistance to small businesses affected by the COVID-19 pandemic. The CEBA loan agreement CIBC outlines the terms and conditions for obtaining this financial support. It enables businesses to understand their obligations and repayment requirements.
5. Definition of Contractor California Business and Professions Code
In California, the Business and Professions Code defines the roles and responsibilities of contractors. The definition of contractor California Business and Professions Code helps ensure that contractors operate within the legal framework. It protects both contractors and consumers from any potential disputes.
6. EE Exempt by Totalization Agreement
When it comes to international social security coverage, totalization agreements play a significant role. The concept of EE (exceptionally exempt) by totalization agreement allows individuals to be exempt from certain social security contributions. Learn more about EE exempt by totalization agreement and how it impacts international workers’ benefits.
7. DFID Framework Agreements
The Department for International Development (DFID) works towards achieving sustainable development around the world. DFID establishes framework agreements to streamline their procurement processes. These agreements ensure efficient and transparent collaboration with suppliers and service providers.
8. Horizon 2020 Collaboration Agreement
Horizon 2020 is a European Union (EU) research and innovation program. The Horizon 2020 collaboration agreement establishes partnerships between entities participating in research projects. It facilitates international cooperation and contributes to scientific advancements.
9. How to Detect Side Agreements
While negotiating contracts, it’s essential to ensure there are no undisclosed side agreements. These hidden agreements can significantly impact the overall contract and parties involved. Discover how to detect side agreements and protect yourself from potential legal complications.
10. Non-Disclosure Agreement NGO
Non-Disclosure Agreements (NDAs) are commonly used to protect confidential information. In the context of non-governmental organizations (NGOs), an NDA specifically designed for NGOs safeguards sensitive data, trade secrets, and intellectual property. It ensures that NGOs can carry out their operations without the risk of information leakage.


text:
What's with the supercharged scene at the volleyball final four?
The static electricity at the Target Center in Minneapolis is a hair-raising and laughing matter for Stanford and Nebraska.
Stanford and Nebraska set for dream final
The Cardinal have won seven NCAA championships; the Cornhuskers have won five. One royal will get a new title on Saturday.
Stanford set to face Nebraska
Stanford and Nebraska will face off on Saturday with the volleyball championship on the line.
Vote: Will Stanford or Nebraska win the title
Volleyball titans Stanford and Nebraska will play for the 2018 title. Pick the winner.
Nebraska outlasts Illinois to reach championship
Mikaela Foecke comes up with the kill for the win against Illinois to send Nebraska to its ninth championship match.
Nebraska survives with Sun kill to force 5th set
Nebraska's offense dials it up and takes the fourth set against Illinois as Lexi Sun gets a big-time kill.
Nebraska takes 3rd set to stay alive vs. Illinois
After a rocky start, Nebraska rallies in the 3rd set to stay alive against Illinois.
Illinois scrambles to keep ball alive, Quade with the kill
Jacqueline Quade comes up with the big-time kill after Illinois scrambles to keep the ball alive at the net.
Poulter sneaks one past the defense
Jordyn Poulter uses some deception to catch Nebraska off-guard for the Illinois score.
Quade comes up with big-time dig
Nebraska can't come up with the save as Jacqueline Quade digs deep for her 3rd dig of the match.
Huskers' rally sets up volleyball final vs. Stanford
Defending champion Nebraska will face 2016 winner Stanford for the NCAA volleyball crown after the Cornhuskers stunned Illinois and the Cardinal swept past BYU.
Stanford throws block party in win over BYU
The Cardinal avenged their lone loss of the season to advance to the NCAA volleyball championship game.
The Stanford block party continues against BYU
Tami Alade comes up with another huge block and the Cardinal's 15th of the match against BYU.
Stanford defense makes strong defensive stand
Stanford's Tami Alade and the Cardinal defense make a strong stand against BYU.
Lexi Sun lifts Nebraska out of 0-2 hole, into title game
Texas transfer Lexi Sun stars in a furious Nebraska rally over Illinois. It's Nebraska-Stanford in the final.
Four potential breakout stars at volleyball's final four
Roni Jones-Perry, Meghan McClure, Lauren Stivrins and Jacqueline Quade could be the difference-makers at the final four.
Powerful and precise, Plummer repeats as player of year
Stanford outside hitter Kathryn Plummer knows teams divert defenders to stop her, so she breaks out creativity to complement her crush.
Final four setters dispel notions of a sixth sense
Setters admit to using sight, sound and touch to elevate their teams. But how do they explain knowing exactly whom to feed the ball to and when?
New-look Nebraska back in same old spot
Seniors Mikaela Foecke and Kenzie Maloney provided stability and leadership to help put the young Huskers in the NCAA volleyball final four for the fourth consecutive year.
History and outside hitters galore at final four
Nebraska and Illinois will meet for the third time this season, and Stanford will try to avenge its lone loss of the season against BYU.
Maryland beats Akron to win men's soccer title
Amar Sejdic scored on a penalty kick in the 57th minute and Maryland held off Akron 1-0 on Sunday night to win its fourth NCAA men's soccer title.
Vote: Who will win the NCAA volleyball national title?
Stanford, Illinois, BYU and Nebraska advanced to the final four. Who will be the last team standing?
BYU scores 5 straight points to defeat Texas
BYU moves on to the final four after scoring five straight points to defeat Texas in straight sets.
Stanford-BYU and Illinois-Nebraska in final four
It will be a pair of rematches in the national semifinals in Minneapolis on Thursday.
Nebraska advances to the final four
Lexi Sun gets the huge kill to win the set 25-17 and the match 3-0. Nebraska advances to the final four for the fourth straight season.
Check out which teams won every men's and women's fall championship and where they stand in the current Capital One Cup standings.

domain: news


text:
Stay ahead of the curve as a political insider with deep policy analysis, daily briefings and policy-shaping tools.Request a Demo
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Howey Daily Wire Nov. 14, 2022
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PENCE BOOK PUBLISHED TUESDAY; CALLS TRUMP ‘RECKLESS’: Former Vice President Mike Pence’s book “So Help Me God” will be published on Tuesday, the same day Donald Trump kicks off his presidential campaign. Pence will be featured in an ABC News interview tonight and will then do a CNN Town Hall on Wednesday (Howey Politics Indiana). Pence gave his ...

domain: politics


Gorakhpur: With nine more children succumbing to encephalitis at the BRD Medical College here, the death toll due to the disease has climbed to 304 in eastern Uttar Pradesh this year.
The dead include one child each from Deoria, Gorakhpur, and Kushinagar districts of eastern UP, health officials said, adding 18 persons suffering from encephalitis have been admitted to the hospital since yesterday.
This year as many as 1504 persons suffering from encephalitis, mostly children, were admitted to BRD Medical College Hospital, of which 304 died, they said.
Meanwhile, local BJP MP Yogi Adityanath undertook a foot march along with around 500 supporters from different organisations to protest the increasing Encephalitis toll and poor civic amenities.
The procession began from BRD Medical College and reached the Commissioner`s office after covering important places of the town.
The march culminated into a public meeting at the commissioner`s office where Yogi demanded immediate action to check Encephalitis deaths. He handed over a memorandum to the commissioner in this regard.
Yogi had launched a campaign on September 16 against Encephalitis deaths and poor civic amenities in the town.


High efficiency perovskite light-emitting diodes (PeLEDs) using PEDOT:PSS/MoO-ammonia composite hole transport layers (HTLs) with different MoO-ammonia ratios were prepared and characterized. For PeLEDs with one-step spin-coated CHNHPbBr emitter, an optimal MoO-ammonia volume ratio (0.02) in PEDOT:PSS/MoO-ammonia composite HTL presented a maximum luminance of 1082 cd/m and maximum current efficiency of 0.7 cd/A, which are 82% and 94% higher than those of the control device using pure PEDOT:PSS HTL respectively. It can be explained by that the optimized amount of MoO-ammonia in the composite HTLs cannot only facilitate hole injection into CHNHPbBr through reducing the contact barrier, but also suppress the exciton quenching at the HTL/CHNHPbBr interface. Three-step spin coating method was further used to obtain uniform and dense CHNHPbBr films, which lead to a maximum luminance of 5044 cd/m and maximum current efficiency of 3.12 cd/A, showing enhancement of 750% and 767% compared with the control device respectively. The significantly improved efficiency of PeLEDs using three-step spin-coated CHNHPbBr film and an optimum PEDOT:PSS/MoO-ammonia composite HTL can be explained by the enhanced carrier recombination through better hole injection and film morphology optimization, as well as the reduced exciton quenching at HTL/CHNHPbBr interface. These results present a promising strategy for the device engineering of high efficiency PeLEDs.
PMID: 31284675 [PubMed]


text: Two scientists from Dalhousie University in Halifax will have an anxious years wait as their laser probe lifted off today from Cape Canaveral in Florida aboard a Delta II rocket destined for Mars. The Phoenix Mars Lander is expected to reach Mars next spring and is equipped to study the climate of the red planet's northern pole. Odds are not in their favor however, as only 1 in 3 missions to Mars is, historically, successful. Good luck gentlemen, I'm sure that the weather here in Atlantic Canada has prepared your equipment well for its destination! CBC News Story.


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text:
A fairly trivial matter compared to all of the other posts on here, but do any of you fellow runners wear glasses?
I wear glasses nearly all the time, and I can just about see well enough to read large print without them if I squint. So I can read Mr Garmin without them, pretty much because I already know what his menu items say, so can guess what he's telling me.
Anyway, I've become increasingly irritated by having to keep pushing them back up my nose while running. They are pretty much as light as they can be with my prescription, I've paid for the lightest frames and lenses that my prescription will allow.
Soooo, yesterday evening I decided to run without them. I'm not quite Mr McGoo, I can see generally what is around me, but not much in detail. In the end I felt it to be a great success, once I got used to not being able to see too well, I kind of got used to it.
I seem to be running more and more naked No mp3 player for the last two weeks, and now no glasses.

domain: hobby


Things are heating up in the UK for Apple thanks to a recent ruling made by Judge Colin Birss. In an unexpected decision, Judge Birss ordered Apple to publish an official statement on their website that Samsung did not copy the iPad design with their Galaxy Tab devices. Apple’s law team did their best to fight the decision by stating that this would directly promote Samsung, but the Judge would have none of it and respectfully threw out Apple’s argument.
The ruling requires Apple to keep the statement on their website a total of six months in addition to publishing it in various newspapers and magazines. This decision should help dramatically improve Samsung’s image in the UK. Now if only we could get that kind of support here in the U.S.


text:
stone and heart necklace
Rose-gold tone chain necklace from Stella McCartney featuring topaz and yellow coloured stones, star and heart charms and a designer embossed disc and clasp for closure.
Item ID: 10320924
- circumference: 102 centimetres
- Brass 100%
- Brand Style ID
Your order will be shipped directly from the boutique to you.

domain: design


Though he hasn’t flat out announced it, Bruce Boudreau in practices hasn’t hidden the fact that his top line, at least at the start of this season, will likely feature Zach Parise, Eric Staal and Charlie Coyle.
That trio was together again at practice Saturday and will finally get a taste of preseason action Sunday against the Carolina Hurricanes.
“I just want them to get to know each other,” Boudreau said. “I want to see some continuity. … Like every team in the NHL there’s a top six. And they’re part of our top six. And we expect them to score. And I expect them to be able to defend. It’s not a one-way street.”
Those players aren’t the only roster locks that will see action in the preseason game.
Boudreau said the plan is to play many players because “we have to get everybody acclimated to each other.”
“The best way to do that is in games,” he said.
That means World Cup of Hockey returners such as Ryan Suter, Mikko Koivu and Mikael Granlund should also see their initial preseason game Sunday. Erik Haula, who also competed in the World Cup of Hockey, played in the preseason game against the Winnipeg Jets on Thursday.
At practice on Saturday, Koivu centered the second line between Granlund and Chris Stewart. Haula, meanwhile, centered the third line between Jason Zucker and Jason Pominville. The fourth line featured a smattering of veteran roster hopefuls like Zac Dalpe, Ryan Carter and Jordan Schroeder.
Boudreau opted to work prospects Alex Tuch and Joel Eriksson-Ek with the second line and third line, respectively, because he said they are “big prospects” and he wants “to see how they play with the better players.”
“I’m pretty sure that both of them will play (against the Hurricanes),” Boudreau said, though he noted that Tuch was ill after practice. “We will find out tonight how he is.”
As for the blue line, those pairings are also slowly starting to fall into place. Suter worked with Jared Spurgeon, Marco Scandella with Nate Prosser, Jonas Brodin with Christian Folin, and Matt Dumba with Mike Reilly. Reilly and Folin are presumably fighting for roster spots.
Boudreau said while he’s excited to see some of the top players in action, he knows they’ll have to be wary of whomever the Hurricanes bring.
“You’ve got to watch out. Sometimes those representative lineups get beat pretty good by a lot of young guys,” Boudreau said. “Because this is their Stanley Cup.”
Boudreau expects Nino Niederreiter to practice with the team Monday.
Niederreiter hasn’t practiced under Boudreau after only recently returning from the World Cup of Hockey. Team Europe lost to Team Canada in the finals Thursday.
Boudreau said earlier in camp that Niederreiter’s absence won’t impact his playing time moving forward.
There are many ways Boudreau could use Niederreiter this season, though it’d make sense to pair him with Haula and Pominville on the third line after the success that trio had toward the end of last season.


text:
Dr. Barbara Jones, MD is accepting new patients on Healthline FindCare. You can check to see if Dr. Jones is offering online scheduling or call the provider’s office for more information.
Dr. Barbara Jones, MD
Overview of Dr. Barbara Jones, MD
Dr. Barbara Jones, MD is an Obstetrics Specialist in Chicopee, MA. They specialize in Obstetrics, has 36 years of experience, and is board certified in Obstetrics & Gynecology. They graduated from Virginia Commonwealth University School of Medicine and is affiliated with Cooley Dickinson Hospital and Mercy Medical Center. Dr. Jones, completed a residency at Baystate Medical Center. Patients rated Dr. Jones an average 4.0 star rating.
Dr. Jones works at
Dr. Jones' Office Locations
- Cooley Dickinson Hospital
- Mercy Medical Center
Experience & Treatment Frequency
View All Accepted Carriers
- Aspirus Network, Inc.
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* Please verify this information when scheduling an appointment.
Ratings & Reviews
How was your appointment with Dr. Jones?
About Dr. Barbara Jones, MD
- 36 years of experience
Education & Certifications
- Baystate Medical Center
- Virginia Commonwealth University School of Medicine
- Mount Holyoke College
- Obstetrics & Gynecology
Frequently Asked Questions
Dr. Jones has indicated that they do offer telehealth services. Please call the provider’s office at for more information.
Dr. Jones works at
5 patients have reviewed Dr. Jones. The overall rating for this provider is 4.0. You can read verified reviews and ratings and leave your own review based on your experience with Dr. Jones.
Whether a person prefers to schedule an appointment online or over the phone with Dr. Jones, there are benefits to both methods. A person calling to schedule an with Dr. Jones appointment can ask questions about the practice, provider availability, conditions treated, procedures performed, and if their insurance carrier is accepted. While online scheduling is quicker, easier, allows one to view a wide range of appointment times, and may provide the ability to sync with a personal calendar.

domain: medical


New garage decks are obviously developed to fill a perceived need for additional parking in a given area. The bet is that, as in the movie “Field of Dreams”, if you build it, they will come. Mixed-use structures hedge that bet by combining supply and much of the demand in one package.
Located in the fashionable Southtown area of Minneapolis, the MoZaic mixed-use project stacks six floors of structured parking on top of ground floor retail and restaurant space, and tops it off with three floors of offices. The 10-story structure contains 13,000 square feet of restaurant space on the ground floor, 556 parking stalls on the second through seventh floors, and 65,000 square feet of Class A office space on the top three floors. The parking levels are disguised by a six-story, vertical grow wall that’s billed as the largest green wall in Minnesota.
They Will Come
The synergy created by mixed uses is the formula for success. It’s cyclical: Having retail and parking handy attracts office tenants and restaurant customers who, in turn, provide much of the clientele for the parking spaces. Placing the offices on the top floors of the structure provides fabulous views of downtown Minneapolis and the lakes and was a major factor in attracting office tenants; this jumpstarted the synergy process. To make the whole package architecturally appealing, an art park with connections to nearby green trails was constructed in front of the building, and the giant green wall was added to the building’s front to mask the parking deck.
“The mixed-use design was conceived with the understanding that the building would be displacing parking by infilling an existing parking lot,” says Mark Harris, managing architect with the BKV Group. “There also was an obvious need for parking in the area. In addition to parking for the offices, the deck also services the parking needs of the [ground floor] restaurants and the neighborhood.” While there is no physical separation, the upper levels of the deck are designed for the office clientele with separate key card control in the elevator lobby. Public parking, operated by Loop Parking Company, Minneapolis, features automated ticket and pay stations.
“Our design vision for MoZaic was centered on three goals,” explains Joanna Hicks, senior vice president of project owner The Ackerberg Group of Minneapolis. “First, we wanted to solve the parking shortage in the area that was a concern to nearby residents by providing sufficient parking to handle peak load times. Second, we wanted to create retail to bring energy to our plaza. And third, we wanted to add daytime population to the area, create a more balanced local economy, and provide demand for the goods and services of the retail and restaurant establishments beyond just nighttime and weekend traffic.”
The Green Wall
The 60- by 90-foot-long green wall is flanked by a decorative custom-perforated metal screen and faces a 20,000 square-foot, ground-level plaza and art park at the building entrance.
Construction of the mixed-use building consisted of precast concrete spandrel panels and precast architectural cladding from Hanson Structural Precast. These are set on a post-tensioned, cast-in-place structural system and reinforced concrete foundation. Shear forces are transferred to vertical elements in the structure, including the heated elevator core and stair tower constructed with Hanson precast insulated wall panels.
Office floors feature floor-to-ceiling glass with floors separated by four-foot-high horizontal, precast spandrels. In the garage, the spandrels are only at even numbered floors and are slimmed down to two feet, eight inches high. The other garage floors are set back. Floor height at the first level of parking is nine feet, nine inches to accommodate accessible parking. On the other parking levels, the floor height is eight feet, nine inches.
“To accommodate the green wall, the post-tensioned floor slabs at levels two, four, and six cantilever out above the plaza below,” explains Harris. “Planter beds are located in these areas. Pre-manufactured four-inch-deep gridded mesh grow screens are clipped to the structure directly above the planter beds. Various species of vines are planted in these beds, extending vertically onto the grow screens. To accommodate drainage, the cantilevered slabs are insulated and waterproofed. The planter beds are filled with lightweight soil with an irrigation drip. Drainage for the planter beds is accommodated through weeps back into the parking garage.”
The large public plaza in front of the building contains benches, plantings, statues, a sculptured-art water fountain, and such fun objects as an 11-foot-tall clay human head, a giant blue arrow, and a reproduction of an old streetcar. Adjacent to the building and accessed from the art park plaza is the historic Midtown Greenway, which is an abandoned railway converted to a bike and pedestrian trail. To capitalize on this feature, the MoZaic plaza features both a ramp down to the greenway and a pedestrian bridge over it, connecting the building with neighborhoods to the north that had been cut off from the site.
Placing an unheated parking garage between two enclosed heated spaces (office and restaurant) presented obvious challenges to the design of the thermal envelope, says architect Harris. “The challenge was how to best address the atypical situation of an unheated second floor parking deck located directly above the tempered restaurant spaces. The last thing we wanted with the wild fluctuations in temperature in Minneapolis was to have the slab above the restaurants sweat with condensation. The question was how to best insulate the restaurant ceilings. This was handled with a closed cell, foam insulation product that contains an inherent vapor barrier. Use of the foam insulation product required prior review and approval from the City of Minneapolis. Concerns related to fire and flame spread were addressed with a fire-resistant intumescent coating.”
The interface with the office space was handled differently. There is a suspended, exterior-grade acoustic ceiling above the upper deck of the parking garage. The space above that—between the ceiling and the first floor of offices—is mechanically tempered. This approach addressed the concerns related to thermal performance while also providing a warm floor for the office tenants.
Another challenge, adds Harris, was meeting building code and zoning requirements that seemed somewhat at odds. The code has strict exterior envelope openness requirements to ensure ventilation of open parking garages “At the garage, there are both the horizontal spandrel panels and vertical infill panels which had to be taken into account,” Harris explains. “Additionally, we had to assume a certain percentage of openness for the green wall and review that with the city. Finally, there were strict requirements as part of the planned unit development (PUD) because the surrounding neighbors were concerned about the impact of headlights in the evening. To solve this issue, perforated metal panels were installed between the precast panels designed to obscure vehicle headlights as people pull into parking stalls.”
The Ackerberg Group, which specializes in urban, infill, mixed-use projects, is currently working on plans for a second building to be built on the site’s remaining 116-stall, surface parking lot. The plan calls for a 150,000 square foot building with offices and retail that would include two-levels of parking with 720 stalls underneath the building. Construction is scheduled for 2014.
Roy Diez is executive vice president of JOA, Inc. He can be reached at firstname.lastname@example.org.


text:
Friday, November 20, 2009
Wednesday, November 18, 2009
Tuesday, November 17, 2009
Abstract painting: Poppies is a free flow of orange color slowly blending into the lights. This is one of my experiments interpreting the nature and its various forms.
14" x 11" canvas
Sunday, November 15, 2009
Textures. Textured painting on yupo.
Love these textural paintings. I painted this with AUBURN colors blue and orange. Games season in Auburn. We see Blue and orange every where.
Abstract design with Yellow ocher, black and whites. Limited colors but I liked the texture developed within the variations. Just amazes me...


text:
About this item
- PEVA textile material
- Urbane & trendy design
- Wipe clean
Give your dining themed decor a colorful addition with this Red Rainbow Tablecloth. It features smart multi-colored striped designs that is both attractive and stylish. Have your cheerful outdoor dishware blend in effortlessly with this tablecloth. Made from durable PEVA makes cleaning and caring for this tablecloth an absolute breeze.
Features: Rectangle (shape)
Number of Pieces: 1
Dimensions (Overall): 84 inches (L) x 60 inches (W)
Textile Material: 100% PEVA
Backing Material: 100% Polyester
Textile construction: Non-woven fabric
Fits Table: 36" x 60" to 48" x 72" Rectangular
Care and Cleaning: Spot or wipe clean
Item Number (DPCI): 067-00-1039
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The aim of this study was to evaluate the association between changes in the type of Modic change (MC) and newly developed MCs and low back symptoms.
This retrospective study includes all the patients suffering from low back pain who has at least two magnetic resonance studies between 2013 and 2016. Patients with MC in at least one vertebra in magnetic resonance imaging (MRI) images were included in the study. The patients who have periods of two MRIs less than six months were excluded.
A total of 129 patients were included in the study and 774 vertebrae were evaluated. At the time of the first admission, MC was observed in 283 out of the 774 vertebrae (37%), whereas in the second admission, MC was observed in 343 of 774 (43%) vertebrae. New MCs were observed in 59 vertebrae. Two patients showed complete resolution of MC in the second admission. It was observed that patients with type 1 change were more associated with pain than other types (p=0.001).
In our retrospective case-control study, we have found that MCs can transform into different types or disappear completely over time. A significant positive correlation was found between the presence of MC type 1 changes in the visual analog scale (VAS).
It has been suggested that Modic changes (MCs) are a specific reason for low back pain (LBP) [1-3]. In recent years, it has started to be a subject that attracts attention. MCs have been determined by magnetic resonance imaging (MRI) since 1988 (Modic et al).; based on histological studies, they are divided into three types . A type I MC shows a signal reduction in T1-weighted (T1w) MRI and a signal increase in T2-weighted (T2w) MRI, and, histologically, reflects inflammatory changes in the vertebral endplates . A type II MC T1w and T2w show both signal increase and represent a more stable phase of degenerative disc disease but has the potential to transform into another type. A type III MC shows decreased signal intensity in both T1w and T2w and is associated with large subchondral bone sclerosis in plain radiography scans [4-5]. However, when an MC type is transformed into another, mixed MC types can develop [1,4,6-7].
The relationship between MC and LBP has been studied many times, and the presence of MC has been reported to increase pain levels [8-10]. MC type II may depict a more stable phase of degenerative disc disease but has the potential to transform into another type [11-14]. However, type 1 MC has been shown to be more correlated with LBP symptoms than other varieties in both the general population and the clinical patient group [3,15-18]. MCs are quite common in patients with LBP, but the long-term clinical effects have not yielded sufficient results. The aim of this study was to evaluate the association between changes in the type of MC, newly developed MCs, and low back symptoms.
Materials & Methods
This retrospective study includes all the patients suffering from low back pain who have had at least two magnetic resonance studies between 2013 and 2016 in Ağrı state hospital. Patients with MC in at least one vertebra in MRI images were included in the study. The patients who have had at least two MRIs at less than six months were excluded. Patients who had vertebral fractures, spondylolisthesis (≥4 mm), spinal stenosis, disc extrusion, neoplasia, inflammatory vertebrae, lumbar disc herniation or lumbar stabilization were not included in the study. Annular tears, disc bulging, and facet joint degeneration were excluded. Because they are often associated with pain and creates biases about the source of low back pain.
The VAS pain score of the 129 patients in the hospital data system was examined. The VAS scores were defined as 0 indicating no pain and 10 indicating the worst pain. This study was approved by the local ethics committee and informed consent was obtained from each participant.
MR imaging method and image analysis
All MR images were obtained using a 1.5T scanner (Siemens, Munich, Germany, or Philips, Best, The Netherlands). For the present study, L1-S1, T1- and T2-weighted sagittal, and T1-weighted axial MRI images were acquired using the following protocol: slice thickness, 5 mm; slice gap, 1 mm; field of view, 280 × 240mm2; and matrix,448 × 336.
All MR images were analyzed by a radiologist who was not informed about the clinical characteristics of patients. The initial and second admission MR images of the patients were evaluated from the L1 corpus to the S1 corpus according to the criteria determined in previous studies . T1 and T2 weighted sagittal images were evaluated, and the modular changes were reported as previously described in the literature (MC type I, MC type II, MC type III, MC type I / II, MC type II / III MC type I/II/III) .
Descriptive statistics were used for continuous variables (mean, standard deviation, minimum, maximum, median). The student's t-test was used to compare VAS scores among the Modic group. Significance was set at the 5 % level and all analyses were performed using IBM SPSS Statistics version 22 (IBM Corp., Armonk, NY).
A total of 129 patients (774 vertebrae) (n = 91 (67%) females and n = 38 (33%) males) were included in the study. The mean age of the patients was 42 (min. 18 - max. 77) and the mean time between the first and second admissions was 13.3 months (6-24 months). At the time of the first admission, MC was observed in 283 of the 774 (37%) vertebrae, whereas in the second admission, MC was observed in 341 of 774 (43%) vertebrae. The first and second admissions' scanning results are shown in Table 1. New MCs were observed in 60 vertebrae (Figure 1). Twelve of these cases had type I, 41 had type II, five had type I / II, and two had type II / III. MCs were observed to be transformed in 35 vertebrae (Figure 2). MCs disappeared completely in two patients (Figure 2).
The mean VAS score was 5.44 (SD 1.26, range 3-9) at the time of the first admission and the mean VAS score was 5.56 (SD 1.2, range 3-9) at the second admission. In the second admission, the mean VAS score of 12 patients with the new MC type 1 was 6.71 (SD 1.32, range 4-9) while the mean VAS score was 5.14 (SD 1.09, range 4-9) at the first admission (p = 0.003). The mean VAS score of patients with MC type I and M type I / II changes at the time of the first and second admission was 6.62 (SD 1.24, range 4-9) and 6.65 (SD 1.12, range 4-9) and the mean VAS score of patients without MC type I changes at the time of the first and second admissions was 5.12 (SD 1.07, range 3-7) and 5.29 (SD 1.06, range 3-8, respectively; (p = 0.001, p = 0.001, respectively).
In the present study, we found that the transformation rate in the 13 months' mean period MCs was 12.3%. A significant positive relation was found between the development of new MC type I and transformation to MC type I from other types and the severity of pain. The transformation from MC type I to MC type II was related to a decrease in pain, but it is not statistically significant.
The present study shows that all evaluated MCs can be converted into almost any type and that they can completely disappear and not persist in follow-up (Figure 2). In our study, it was seen that 33% of vertebrae from type I / II to type II and 17% from type I to type II. However, 17% of the vertebrae were seen from MC type I / II to MC type I and 3% from MC type II to MC type I. In one patient, MC type I at L4 level in one patient, and MC type II changes at L5 level at one patient disappeared during the follow-up period. This situation does not comply with the assertion that MCs can be transformed from type I to type I / II or type II [1,4,6-7]. However, in the 14-month follow-up study conducted by Jensen et al. in 2012, they have found conflicting results with the developmental path hypothesis, as in our results .
The present study shows a statistically significant relationship between MC type I and the level of LBP. The VAS score of patients with MC type I at the time of first admission and second admission was significantly higher than the other types. In the recent two cohort follow-up studies, patients with MC type I at both first admission and follow-up were found to have a worse prognosis as compared to other types, which was consistent with that in our study [17,19]. The control VAS score was found to be statistically significantly higher than the first admission VAS score of patients with new MC type I (20%) and type I / II (8%) in the second control. Therefore, our findings highlight that MC type I has a stronger relationship with LBP than other MC types [4,10-11,13,20-22]. It is not clearly known how MCs cause pain. However, in human and animal studies, vertebral endplates are known to have immune reactive nerves [23-24]. When the endplate histology of patients with discogenic LBP was evaluated, more inflammation and axon growth were detected in the endplate with MC than the normal endplate cases . In addition, in a one-year follow-up study of chronic LBP patients, the development of MC type I and the increase in the vertebral involvement of the current MC type I showed that adjacent disc degeneration accelerated and disc degeneration was slowed down in patients without MC type I, which suggests that MC type I may be more related to LBP symptoms .
There are some limitations to this study. This study did not evaluate other degenerative imaging findings (i.e., disc degeneration, disc bulging, and Schmorl’s nodes). It is based on the assumption that the only source of pain in LBP patients may be MCs. The potential effect of other degenerative MRI scan analyses of LBP symptoms, pain medication, somatic and psychological comorbidities, educational level, and other psychosocial factors have not been evaluated.
In our retrospective study, we have found that MCs can transform into different types or disappear completely over time. MC type I has a stronger relationship with LBP than other MC types.
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Evaluation of the Relationship Between Clinical Symptoms and Modic Changes
Ethics Statement and Conflict of Interest Disclosures
Human subjects: Consent was obtained by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
Cite this article as:
Çevik S, Yılmaz H (February 12, 2020) Evaluation of the Relationship Between Clinical Symptoms and Modic Changes. Cureus 12(2): e6970. doi:10.7759/cureus.6970
Received by Cureus: January 22, 2020
Peer review began: January 31, 2020
Peer review concluded: February 03, 2020
Published: February 12, 2020
© Copyright 2020
Çevik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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