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How to Say Amygdala?
This article will cover how to say amygdala. The article will also cover what the amygdala is, what are its functions, and some frequently asked questions about the same.
How to Say Amygdala?
Amygdala is pronounced as ‘uh · mig · duh · luh’.
The term amygdala is derived from the Greek word ‘amygdale’ which means ‘almond’. This is because the amygdala is shaped like an almond. It is located in the medial temporal lobe, right in front of the hippocampus. Amygdala is a paired structure, just like the hippocampus, each pair is located in each hemisphere of the brain.
Amygdala is included in the limbic system. The Limbic system is referred to as a network of nerves that mediate several aspects of emotion and memory. Amygdala is a region of the brain that is majorly involved with emotional processing. In the past, the amygdala was considered to be responsible for primitive fear and other emotions that are a result of aversive or unpleasant situations or stimuli. However, now they are known to be responsible for rewarding emotions, elicited by positive stimuli.
Functions of the Amygdala
The amygdala is known to play a mediating role in emotional learning as well as behaviour. A vast array of human emotions exist, ranging from joy to sadness, disgust to excitement, and regret to satisfaction.
Emotions also possess quality or valence, meaning, they can either be positive or negative. They also vary in intensity, meaning they can either be low or high. This reflects emotional arousal in the person. To study the neural basis of emotions, studies have focused on animal models.
Studies including the ones that focus on the amygdala have used physiological and behavioural measures and have found that valence and intensity are involved in the emotional experience.
Psychologist Heinrich Klüver and neurosurgeon Paul C. Bucy (1939) studied monkeys that had lesions in their temporal lobe including the amygdala. They found that monkeys experienced changes in their emotional, eating, and sexual behaviour. Further studies on this also helped establish the mediating roles of the amygdala in these functions.
The amygdala also mediates several aspects of emotional learning and behaviour. The emotion that the amygdala is especially in control of is fear. With the help of Classical Conditioning (Pavlov, 1897), people can get conditioned to fear responses. This is when a neutral stimulus, which does not emit any kind of response, is paired repetitively with an aversive stimulus.
For instance, if you pair exposing a child to a loud banging noise (here, this is an aversive stimulus as it scares them) with the face of a stranger (neutral stimulus) every time, the child will start fearing the stranger. This is because the neurons in the amygdala will get conditioned to emit fear responses to the face of the stranger.
Existing literature provides support to the view that the amygdala influences cognitive processes of memory-formation, decision-making, social behaviour, and attention.
This may be because the amygdala projects information to the prefrontal and sensory cortices. It also sends information to the hippocampus. Thus, the amygdala can influence emotions in these processes, which are mostly cognitive in nature.
The amygdala is majorly responsible for the formation of emotional memories. Since the amygdala is closer to the hippocampus and is known to have shared connections, the two work together for the formation of memories that are more memorable.
Since the amygdala attributes emotions to cognitive processes, it also includes memories. Thus, the more emotions the memory invokes, the better it is remembered.
For instance, when the mother gives birth to her child, the entire process is remembered in clear detail because it has highly positive emotions attached to the experience. Whereas, everyday mundane tasks that do not invoke emotional attachment are usually forgotten.
The amygdala stores good and bad memories, but is involved especially in storing emotional traumas. This is when the functions of the amygdala in memory formation can be detrimental as emotional traumas are difficult to overcome. The emotions attached to those traumas make it especially difficult for them to get weak.
In fact, people who have been victims of emotional trauma can also find it affecting their cognitive reasoning, this is because the amygdala is also connected to the prefrontal cortex.
Emotional memories are generally stored in the synapses between the neurons in the brain. There is evidence which claims that multiple neuromodulators in the amygdala mediate emotional memory formation (Tang et al., 2020). These neural connections have the emotion of fear embedded in them.
The amygdala, as a part of the limbic system, also controls the emotion of aggression. How reactive is the amygdala is a good indicator of aggression. As reported by Groves and Schlesinger (1982), individuals who have had surgical removal of the amygdala tend to be lower in aggression as compared to before the surgery.
Animal studies also confirm these findings. Removal of the amygdala from monkeys and rats has been linked to lower levels of aggression being observed in them.
Role of Amygdala in Mental Disorders
There has been ample research done to show the involvement of the amygdala in mental health conditions, especially the amygdala on the left side. These mental health conditions include social anxiety, obsessive-compulsive disorder (OCD), generalized anxiety disorder, and posttraumatic stress disorder (Arehart-Treichel, 2014).
Correlations between people suffering from severe social anxiety and increased amygdala activity have been established by research (Phan et al., 2006).
Individuals diagnosed with depression also report over-activity of the left side of the amygdala. This is especially apparent when they interpret emotions from faces, especially fearful ones (Sheline et al., 2001)
These findings are also similar in the case of PTSD. When shown pictures of fearful faces, the participants diagnosed with PTSD showed higher levels of activity in their amygdalas (Kujala et al., 2012).
In the case of bipolar disorder, in one study, it was found that people diagnosed with it tend to have smaller amygdala volumes as compared to those not diagnosed with the disorder (Blumberg et al., 2005).
In cases of amygdala damage, the individual faces difficulties with the formation of emotional memories. They may have an overreactive fear response and may become hypervigilant. This may then lead to wrong interpretation of social cues and threats, and losing control.
They may face emotional sensitivity like anxiety, aggression, irritability, and panic disorder if the damage causes hyperactivity in the amygdala. However, they will not be able to process emotions or recognise them at all if the damage to the amygdala has caused the amygdala to become under-active.
This article covered how to say amygdala. The article also covered what the amygdala is, what are its functions, and some frequently asked questions about the same.
Frequently Asked Questions: How to Say Amygdala?
How do I calm my amygdala?
You can gain control over the emotional reactions that are irrational. This can be done by slowing your pace, deep breaths, and refocusing your thoughts. These techniques allow the brain’s frontal lobes to become active and calm the amygdala.
What can damage the amygdala?
Amygdala can be damaged as a result of temporal lobectomy or amygdalohippocampectomy which is a part of the surgical treatment of intractable epilepsy.
What is the 3-3-3 rule for reducing anxiety?
The 3-3-3 rule is to look around you and name three things that you can see, three things that you can hear, and moving three parts of your body. This helps in reducing anxiety.
Arehart-Treichel, J. (2014). Changes in Children’s Amygdala Seen After Anxiety Treatment.
Blumberg, H. P., Fredericks, C., Wang, F., Kalmar, J. H., Spencer, L., Papademetris, X., … & Krystal, J. H. (2005). Preliminary evidence for persistent abnormalities in amygdala volumes in adolescents and young adults with bipolar disorder. Bipolar disorders, 7(6), 570-576.
Grove, E. A. (1988). Neural associations of the substantia innominata in the rat: afferent connections. Journal of Comparative Neurology, 277(3), 315-346.
Guy-Evans, O. (2021, May 09). Amygdala function and location. Simply Psychology. www.simplypsychology.org/amygdala.html
Kujala, M. V., Carlson, S., & Hari, R. (2012). Engagement of amygdala in third‐person view of face‐to‐face interaction. Human Brain Mapping, 33(8), 1753-1762.
Klüver, H., & Bucy, P. C. (1939). Preliminary analysis of functions of the temporal lobes in monkeys. Archives of Neurology & Psychiatry, 42(6), 979-1000.
Pavlov, I. (1897). Classical conditioning. Wikipedia.[Paper reference 1].
Phan, K. L., Fitzgerald, D. A., Nathan, P. J., & Tancer, M. E. (2006). Association between amygdala hyperactivity to harsh faces and severity of social anxiety in generalized social phobia. Biological psychiatry, 59(5), 424-429.
Sheline, Y. I., Barch, D. M., Donnelly, J. M., Ollinger, J. M., Snyder, A. Z., & Mintun, M. A. (2001). Increased amygdala response to masked emotional faces in depressed subjects resolves with antidepressant treatment: an fMRI study. Biological psychiatry, 50(9), 651-658.
Tang, W., Kochubey, O., Kintscher, M., & Schneggenburger, R. (2020). A VTA to basal amygdala dopamine projection contributes to signal salient somatosensory events during fear learning. Journal of Neuroscience, 40(20), 3969-3980.

domain: medical


Mexico City’s pollution solution: Vía Verde Vertical Gardens3 min read
There is a ring road that crosses several areas of the Federal District of Mexico City for about 60 kilometers. Its name is “El periferico de Ciudad de Mexico”. A fast-moving road of vehicles made of concrete and monotonous gray pylons positioned at regular spatial intervals that support a highway overpass.
But something new is happening in one of the most polluted cities in the world where six out of ten citizens suffer from respiratory problems and where there are only 5.3 square meters of greenery per inhabitant compared to the nine that the World Health Organization (WHO) considers the minimum to achieve an acceptable quality of life.
Architecture and sustainability
Turning Mexico City’s grey to green
The Mexican capital has covered a thousand pylons of highways with shrubs, completing them with an irrigation system that recycles rainwater through an integrated and monitored system, as well as remote-controlled via GSM. The plant species used are high strength, low water consumption, and suitable for the harsh environmental conditions of those places.
The idea for “Vía Verde” emerged in 2016 with a Change.org petition to gauge public support.
The actor Luis Gerardo Méndez and the architect Fernando Ortiz Monasterio of the Studio “Verde vertical” created it together with an interdisciplinary Mexican laboratory that specialized in the design, installation, and maintenance of vertical gardens. They convince the administration of the metropolis, after having collected the support of 80,000 people thanks to the platform specializing in online petitions.
Vía Verde is 100% sustainable project
In addition to the beneficial effects listed so far, there is another very important one. In fact, “Vía Verde” uses recycled plastic. Fernando Ortiz Monasterio and his team have cleverly developed a technological system that allows plants to grow, rather than in the earth, inside a specific felt, composed of recycled plastic bottles. This material allows the development of plant species because it has the same density as the soil.
In addition to sustainability, an enabling factor for Fernando Ortiz Monasterio’s program was the idea of being able to reduce citizens’ stress.
While these plants are able to absorb a significant amount of carbon and particles from the capital’s polluted atmosphere, their purpose is mostly aesthetic. Ortiz Monasterio himself has admitted that 1,000 vertical gardens can only put a mere dent in the megalopolis’s carbon output. The classic “a drop in the bucket”.
Moreover, there is no shortage of (mild) controversies. As a matter of fact, a small group of activists argues that the government’s support indicates a cynical greenwashing and the willingness to double-down on car culture in a city that is already choked with traffic and smog. “Vía Verde” would be simply a more pleasant cityscape for the drivers passing through there every day.


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|»Author||Benjamin Spiegel | Search by Benjamin Spiegel|
|»Description||The Ultimate Head preview of the MaxVent.com EventGuide.In only 80k!!!Chrom 3D Effects plus VoiceTalking and Raytraced...Personal Eventguide Total availible soon|
The flash's horizontal road drive was done in CS4 and was upgraded to CS6. The car responds to right/ left key and flash will auto-generate the movement of roads from left-right or right-left based on random number. Have fun driving in this virtual environment and avoid other cars... :) If you are creative, a road driving game can be created from it.

domain: hobby


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Our stories ... ...
Colombia - 08 July, 2020
Cattle ranchers and indigenous people are often not good neighbours. The municipality of Solano, in the southern Colombian province of Caquetá, was no exception. After the guerrilla movement FARC was disarmed in 2016, a power vacuum developed in the region. Ranchers and indigenous people came to oppose each other. But by establishing a dialogue between the two groups, mutual respect and trust has grown and room has been created to work on joint solutions.
FARC’s solid power base in Caquetá ensured order and a clear balance of power in the region for a long time. The guerrilla group imposed environmental rules that controlled deforestation and promoted the protection of water sources. Small farmers were allowed to grow coca, because it provided income for the FARC through taxation, but large-scale deforestation was out of the question.
This changed after November 2016, when the peace treaty between the Colombian government and FARC was ratified. The FARC fighters left the region for designated transition zones, where they gave up their weapons as part of the agreement. In Solano this caused a power vacuum. Wealthy large-scale ranchers took advantage of the situation by moving unhindered into the region, converting large areas of forest into pastures for their livestock. They hired poor landless people to do the work. Encroachment of the already fragmented reserves (resguardos) of the indigenous people was commonplace. As a result, tensions grew between ranchers and the indigenous population.
Tropenbos Colombia, together with The Nature Conservancy, has been active in the area since 2018. The organizations are working to bring cattle ranchers and indigenous peoples together so that a dialogue can be established to discuss conflicts. Initial talks took place in a tense atmosphere, but since then a great deal of trust and respect has been built up between the two groups.
The two former sworn enemies are now working together on three issues. The first is respecting the boundaries of the reserves of the indigenous people by the farmers. Farmers have never done this before; until now they used indigenous land for cattle ranching and growing coca and cocoa. The second is making agreements about hunting and fishing. The farmers, who acknowledge that the indigenous people manage the area well, take care of wildlife management in the area together with the indigenous people. The third issue is water management. Until now, the farmers did not take good care of the small watercourses in their own areas; in cases of water shortages, they brought their cattle to the reserves. The farmers are now in the process of improving water management in their areas.

domain: news


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Then people went out to see what had happened, and they came to Jesus and found the man from whom the demons had gone, sitting at the feet of Jesus, clothed and in his right mind, and they were afraid.
This response was partly due to the reputation of the wild man of the tombs, and partly due to the power of Jesus. We know the people of the Gerasenes had to deal with this demonized man in the past. They tried guarding him and shackling him with chains, only to have him break the bonds and run madly back to the desert tombs outside the city (see Luke 8:29). They kep their distance from him out of fear, making no more attempts to control his entrapped life by further bondage. They let the demons have him.
But here is this tormented man now clothed, delivered by Jesus, and in a civil frame of mind... and they are still very afraid. This time it is because of the change Jesus brought that saved this man and sent their pork futures plummeting over a cliff to drown in the lake (see Luke 8:33-34). The fear of the wild man has been replaced by the fear of the God man. But this is not righteous respect for the power of Jesus. They do not like what Jesus has done, because it has cost their city to see this man changed.
And so do many people react to the radical changes Jesus brings. They can't accept a new normal that is truly normal and righteous. That is what makes Jesus so controversial.

domain: literature


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Arrow Exploration Corp. begins trading on the AIM market of the London Stock Exchange; completes approximately £ 8.8million fundraiser
Marshall Abbott, CEO of Arrow, said: “We are delighted to have completed our dual listing in London after receiving such support and interest in our story from new and existing shareholders”
(,,). announced the admission of all of its issued and to be issued share capital for trading on the AIM market of the London Stock Exchange PLC and, jointly, a fundraising of approximately £ 8.8 million (15.0 million Canadian dollars).
Admission took place on AIM from today, Monday, October 25, 2021, and trading in its ordinary shares with zero par value has started under TIDM code ‘AXL’ and ISIN CA04274P1053.
In a statement, Marshall Abbott, CEO of Arrow, said: “We are delighted to have completed our dual listing in London after receiving such support and interest in our story from new and existing shareholders. Our offer to the London public is unique. We have multiple short-term value catalysts in an extremely favorable, under-explored jurisdiction that already has existing infrastructure. “
“Our portfolio contains both development wells, offering immediate low-risk cash-generating growth opportunities, but also higher-risk exploration opportunities, which we look forward to drilling shortly. Rio Cravo Este should be fueled in the short term, it is an exciting time for Arrow and its shareholders, ”added Marshall.
READ: Arrow Exploration releases second quarter financial results showing positive cash position of $ 4.6 million as of June 30, 2021
The fundraising saw the placement and subscription of 140,949,545 new ordinary Arrow shares from new and existing investors, as well as the executive management of the company at an issue price of 6.25 pence ( 0.106 $ 125 CAD) each. Arrow’s top management invested around £ 0.83million (C $ 1.41million) in fundraising
Investors in the fundraiser will also receive a warrant for two shares, exercisable at 9p (C $ 0.15282) per new common share for 24 months from admission to AIM. At the fundraising price, the market capitalization of the company will be £ 13.1million (C $ 22.3million)
The company said the net proceeds from the fundraising – along with its existing funds, if needed – are expected to be used to drill two wells at Rio Cravo Este, starting in late 2021, and will also be deployed in the drilling. by Carrizales Norte. -1 exploration well. Additionally, the company will deploy funds to repay approximately US $ 3.15 million from a promissory note the company has with ().
As part of the fundraising, Canacol purchased 36,715,205 shares – representing 17.5% of the issued and outstanding common shares of Arrow – and 18,357,602 warrants. Prior to the acquisition, Canacol held 5,000,000 common shares of Arrow.
Canacol now controls 41,715,205 Arrow common shares, or approximately 19.9% of the total issued and outstanding common shares, and 18,357,602 warrants. Assuming the exercise of the warrants, it would own or control 60,072,807 or approximately 26.6% of the total issued and outstanding Arrow common shares on a partially diluted basis for Canacol only. Canacol stated that it has acquired securities for investment purposes and, currently, does not intend to acquire further securities of Arrow, although it may acquire ownership or control of other securities of Arrow through the future depending on market circumstances.
Canadian private placement without a broker
In addition to the AIM float-related fundraiser, the company said it intends to raise up to an additional C $ 0.5 million through a non-middleman private placement at Canada. The private placement should be carried out at the same price as the fundraising (and in any event at a price not lower than the fundraising price). The private placement is expected to close in late October 2021 or early November.
The net proceeds of the private placement will also be allocated to the work program of the company.
The company’s common shares will continue to trade on the TSX Venture Exchange (TSX-V).
Arden is acting as the company’s appointed advisor, broker and bookrunner in connection with fundraising and admission to AIM. Arden received £ 459,260 (CA $ 779,823) in fees as part of the fundraiser.
Contact the author at firstname.lastname@example.org

domain: economics


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1 The Affordable Care Act: Is Healthcare Becoming More Affordable? Houston Economics Club Federal Reserve Bank of Dallas, Houston Branch November 17, 2014 Vivian Ho, PhD James A. Baker III Institute Chair in Health Economics Director, Health Policy Forum Professor, Department of Economics at Rice University Professor, Department of Medicine at Baylor College of Medicine
2 Outline Changes in health insurance Marketplace plans (Healthcare.gov) Medicaid Large Employer Plans Small businesses Fiscal impact of the ACA The ACA and Medicare
3 Source: Gallop.com Daily News
4 Source: Gallop.com Daily News
5 Source: Congressional Budget Office, Updated Estimates of the Insurance Coverage Provisions of the Affordable Care Act, April 2014.
6 Marketplace Insurance Plans Healthcare.gov April 2014: 5.4 million selected plans through 36 federally facilitated marketplaces (FFMs) 2.6 million enrolled in HI through 14 state based marketplaces. In the FFM, 87% used tax credits to enroll in a plan.
7 Kathleen Sebelius Former US Secretary of Health and Human Services Sylvia Mathews Burwell Current US Secretary of Health and Human Services
8 Marketplace Insurance Plans Average Monthly Premiums before and after Tax Credits, Tax Credit Amount, and Percent Reduction in Premium after Tax Credits for Individuals Who Selected Plans with Tax Credits through the 2014 Federally-facilitated Marketplace Metal Level Percent of Individuals Who Selected Plans with Tax Credits Average Premium before Tax Credits Average Tax Credit Amount Average Premium after Tax Credits Average Percent Reduction in Premium after Tax Credits Bronze 73% $289 $221 $68 76% Silver 94% $345 $276 $69 80% Gold 65% $428 $220 $208 51% Platinum 64% $452 $232 $220 51% All Metal Level 87% $346 $264 $82 76% Source: ASPR Research Brief, June 18, 2014.
10 $263 x 12 = $3156. Source: ASPR Research Brief, June 18, 2014.
11 How do Marketplace premiums compare to premiums purchased by large employers for their workers?
12 Average Annual Premiums for Single and Family Coverage, $2,196 $5,791 $2,471* Single Coverage $6,438* $2,689* Family Coverage $7,061* $3,083* $8,003* $3,383* $9,068* $3,695* $9,950* $4,024* $10,880* $4,242* $11,480* $4,479* $12,106* $4,704* $12,680* $4,824 $13,375* $5,049* $13,770* $5,429* $15,073* $5,615* $15,745* $5,884* $16,351* $0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 $18,000 * Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, Source: KFF.org Employer Health Benefits Survey 2013
15 Source: Health Reform Monitoring Survey Texas, Issue Brief #3, April 14, 2014.
16 Source: Health Reform Monitoring Survey Texas, Issue Brief #3, April 14, 2014.
17 Source: Health Reform Monitoring Survey Texas, Issue Brief #6, July 7, 2014.
18 Employer Provided Health Insurance Source: 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care, 2014
19 Employer Provided Health Insurance Source: 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care
20 Employer Provided Health Insurance Employers face new costs under the ACA Fees that insurers pay to the federal government, which they may pass on to employers. 2015: report whether and what insurance offered to employees. 2015: requirement for large employers to provide affordable coverage to their workers.
21 Employer Provided Health Insurance Excise tax on high-cost coverage ( Cadillac tax ) Plan sponsors must pay a 40% tax on the difference between $10,200 (self-only coverage) or $27,500 (family coverage) and the actual cost of any employer-sponsored insurance Dollar amounts increase, indexed to inflation Includes total cost of coverage (both employer AND employee share of premium) Not in effect until 2018, but many employers starting to think about and prepare plan design changes now
22 How much will insurance coverage and premiums change in 2014? TABLE 3: Changes in Per-capita Employer Spending Due to the ACA, Simulated as if the ACA is Fully Implemented in 2012 All Employers Small firms (100 or fewer employees) Mid-size firms (101-1,000 employees) Large firms (More than 1,000 employees) Total per-capita employer spending Total per-capita employer spending Total per-capita employer spending Total per-capita employer spending Without Reform ACA % Difference $3,653 $3, % $4,126 $3, % $3,509 $3, % $3,683 $3, % Note: Persons reporting ESI coverage in households where no policyholder is identified are included in the total calculations but not the firm size groups. Source: Urban Institute Analysis, HIPSM 2012
23 February 25, 2014
24 Fiscal Impact of the ACA Source: Congressional Budget Office,
25 Fiscal Impact of the ACA The insurance coverage provisions are only one way in which the ACA affects the federal budget. Other provisions are projected to reduce budget deficits. Smaller annual updates to Medicare provider payment rates. Reduced Medicare Advantage payment rates. Lower DSH payments In their most recent comprehensive estimates (July 2012), CBO and JCT predicted that the ACA s overall effect is to reduce federal deficits.
26 Healthcare Spending Source: Congressional Budget Office presentation to Stanford Institute for Economic Policy Research, May 13, 2014.
27 Healthcare Spending
28 Source: Health Affairs, 33, No. 1 (2014):67-77.
29 Medicare Spending Year Calendar Year Expenditures Medicare Trust Funds, Oct-June Source: CMS.gov, National Health Expenditure Data, and Actuarial Studies
30 How is Medicare Bending the Cost Curve? Accountable Care Organizations Bundled Payments for Care Improvement Hospital Readmissions Reduction Program
31 Accountable Care Organizations Reimbursing health care providers using the current fee-for-service system rewards providers for quantity, not quality. No one provider takes responsibility for the overall health of the patient. On the other hand, capitated payment systems provide incentives to deny services. We have a fragmented health care delivery system, leading to waste, which drives up costs.
32 Accountable Care Organizations Section 3022 of the Affordable Care Act established the Medicare Shared Savings Program for Accountable Care Organizations (ACOs) as a potential solution to balance the incentives to overprovide vs. underprovide services. An ACO is a group of health care providers caring for a specific patient population who will share savings with Medicare that are achieved through delivering quality health care.
33 Accountable Care Organizations ACO must agree w/medicare to participate for at least 3 years. Must be legally structured in a manner to receive and distribute payment within that ACO. Include primary care providers sufficient to cover beneficiaries, which must number at least 5,000 Demonstrate that it meets quality criteria related to patient/caregiver satisfaction, care coordination, and patient safety.
34 How are patients assigned to the ACO? Organization and providers decide to participate in an ACO (PCPs must be exclusive to one ACO; Specialists can be part of multiple ACOs) Patients assigned to PCPs providing most primary/preventive care relative to other primary care physicians in other ACOs or non-aco organizations. If unassigned, consider other provider types.
35 Medicare ACO results as of September ACOs caring for 5.6m elderly Americans 64 saved Medicare enough $ to earn bonuses summing to $445m. Overall savings to Medicare of $372m. Quality measures also improved for ACOs.
36 Bundled Payments Traditionally, Medicare makes separate payments to providers for each of the individual services they furnish to beneficiaries for a single illness or course of treatment. e.g., A patient admitted to a hospital with heart failure will generate a payment for the hospital, payment for multiple physician services, and perhaps post-discharge costs (skilled nursing facility or hospital readmission). Medicare is experimenting with offering a provider one bundled payment to cover all services associated with an illness or course of treatment. Hospital admission for heart failure and for the subsequent 30 days, regardless of when the patient is discharged.
37 Bundled Payment Participating Facilities Model Organization Name City State Episodes Model 1 JFK Medical Center Edison NJ All DRGS Model 1 Robert Wood Johnson University New Brunswick NJ All DRGS Model 2 Baptist Medical Center San Antonio TX Congestive Heart Failure Model 2 Model 3 Hospital of the University of Pennsylvania Encompass Home Health of Houston Philadelphia PA UTI, Stroke, Revision of the hip/knee, etc. Houston TX UTI, Stroke, Revision of the hip/knee, etc. Model 4 Valley Baptist Medical Center - Harlingen Harlingen TX Spinal fusion, Major joint replacement of the lower extremity, etc.
38 Hospital Readmissions Reduction Program CMS reduced payments to acute care hospitals with excess readmissions, effective 10/1/12 Initially targets AMI, Heart Failure, and Pneumonia Excess readmission ratio Comparison of hospital s risk-adjusted readmission performance to national average Based on 3 years of discharge data with minimum of 25 cases per condition per hospital Payment reductions applied to all Medicare admissions if riskadjusted readmission rate exceeds average Capped at 1% in FY 2013; 2% in FY 2014; 3% in FY 2015 Source: Reduction-Program.html
39 Hospital Readmissions Reduction Program Analysis of year-1 results 2,189 (66.7%) will receive payment cuts. Percent of Hospitals Highly Penalized Large (400+ beds) 40% Teaching 44% Safety Net 44% Small (<200 beds) 20% Non-Teaching 33% Non-Safety Net 30% Source: K.E. Joynt, A.K. Jhan, JAMA 2013: 309(4):
40 Source: U.S. Department of Health and Human Services, May 7, 2014
41 Is Health Care Becoming More Affordable: For the previously uninsured? Yes. Several million have received subsidies to purchase insurance through the Marketplace, or received Medicaid in expansion states. For workers covered by large employers? On the positive side, premium growth has slowed, which may or may not be related to Obamacare. On the negative side, insurers must now pay fees associated with the ACA.
42 Is Health care Becoming More Affordable: For workers covered by small employers? No. Premiums are expected to rise on average. There is no good estimate of how much premiums will rise, or which small firms will offer coverage. There are likely to be some big winners and losers. For the taxpayer? The ACA is estimated to be deficit reducing in the long run. However, health care is consuming an increasing portion of the federal budget. While ACA measures may reduce Medicare spending somewhat, we must do much more to reduce the federal debt.
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Larynx Anatomy of the larynx, anterolateral view Endoscopic image of larynx
The larynx (plural larynges), commonly called the voice box, is an organ in the neck of amphibians, reptiles (incl. birds) and mammals (including humans) involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume. The larynx houses the vocal folds (commonly but improperly termed the "vocal cords"), which are essential for phonation. The vocal folds are situated just below where the tract of the pharynx splits into the trachea and the esophagus.
Anatomical position and description
In adult humans, the larynx is found in the anterior neck at the level of the C3–C6 vertebrae. It connects the inferior part of the pharynx (hypopharynx) with the trachea. The laryngeal skeleton consists of nine cartilages: three single (epiglottic, thyroid and cricoid) and three paired (arytenoid, corniculate, and cuneiform). The hyoid bone is not part of the larynx, though it is connected to it. The larynx extends vertically from the tip of the epiglottis to the inferior border of the cricoid cartilage. Its interior can be divided in supraglottis, glottis and subglottis.
In newborn infants, the larynx is initially at the level of the C2–C3 vertebrae, and is further forward and higher relative to its position in the adult body. The larynx descends as the child grows.
Fine manipulation of the larynx is used to generate a source sound with a particular fundamental frequency, or pitch. This source sound is altered as it travels through the vocal tract, configured differently based on the position of the tongue, lips, mouth, and pharynx. The process of altering a source sound as it passes through the filter of the vocal tract creates the many different vowel and consonant sounds of the world's languages as well as tone, certain realizations of stress and other types of linguistic prosody. The larynx also has a similar function as the lungs in creating pressure differences required for sound production; a constricted larynx can be raised or lowered affecting the volume of the oral cavity as necessary in glottalic consonants.
The vocal folds can be held close together (by adducting the arytenoid cartilages), so that they vibrate (see phonation). The muscles attached to the arytenoid cartilages control the degree of opening. Vocal fold length and tension can be controlled by rocking the thyroid cartilage forward and backward on the cricoid cartilage (either directly by contracting the cricothyroids or indirectly by changing the vertical position of the larynx), by manipulating the tension of the muscles within the vocal folds, and by moving the arytenoids forward or backward. This causes the pitch produced during phonation to rise or fall. In most males the vocal folds are longer and with a greater mass, producing a deeper pitch.
The vocal apparatus consists of two pairs of mucosal folds. These folds are false vocal folds (vestibular folds) and true vocal folds (folds). The false vocal folds are covered by respiratory epithelium, while the true vocal folds are covered by stratified squamous epithelium. The false vocal folds are not responsible for sound production, but rather for resonance. The exceptions to this are found in Tibetan Chant and Kargyraa, a style of Tuvan throat singing. Both make use of the false vocal folds to create an undertone. These false vocal folds do not contain muscle, while the true vocal folds do have skeletal muscle.
During swallowing, the backward motion of the tongue forces the epiglottis over the glottis' opening to prevent swallowed material from entering the larynx which leads to the lungs; the larynx is also pulled upwards to assist this process. Stimulation of the larynx by ingested matter produces a strong cough reflex to protect the lungs.
The larynx is innervated by branches of the vagus nerve on each side. Sensory innervation to the glottis and laryngeal vestibule is by the internal branch of the superior laryngeal nerve. The external branch of the superior laryngeal nerve innervates the cricothyroid muscle. Motor innervation to all other muscles of the larynx and sensory innervation to the subglottis is by the recurrent laryngeal nerve. While the sensory input described above is (general) visceral sensation (diffuse, poorly localized), the vocal fold also receives general somatic sensory innervation (proprioceptive and touch) by the superior laryngeal nerve.
Injury to the external laryngeal nerve causes weakened phonation because the vocal folds cannot be tightened. Injury to one of the recurrent laryngeal nerves produces hoarseness, if both are damaged the voice may or may not be preserved, but breathing becomes difficult.
Intrinsic muscles associated with the larynx
- Cricothyroid muscles lengthen and stretch the vocal folds.
- Posterior cricoarytenoid muscles abduct and externally rotate the arytenoid cartilages, resulting in abducted vocal folds.
- Lateral cricoarytenoid muscles adduct and internally rotate the arytenoid cartilages, which can result in adducted vocal folds.
- Transverse arytenoid muscle adducts the arytenoid cartilages, resulting in adducted vocal folds.
- Oblique arytenoid muscles narrow the laryngeal inlet by constricting the distance between the arytenoid cartilages.
- Vocalis muscles increase the thickness of the chords changing the tone.
- Thyroarytenoid muscles - sphincter of vestibule, narrowing the laryngeal inlet.
Notably, the only muscle capable of separating the vocal cords for normal breathing is the posterior cricoarytenoid. If this muscle is incapacitated on both sides, the inability to pull the vocal folds apart (abduct) will cause difficulty breathing. Bilateral injury to the recurrent laryngeal nerve would cause this condition. It is also worth noting that all muscles are innervated by the recurrent laryngeal branch of the vagus except the cricothyroid muscle, which is innervated by the external laryngeal branch of the superior laryngeal nerve (a branch of the vagus).
Extrinsic muscles associated with the larynx
- Thyrohyoid muscles
- Sternothyroid muscles
- Omohyoid muscles
- Inferior constrictor muscles
In infant humans and most animals, the larynx is situated very high in the throat—a position that allows it to couple more easily with the nasal passages, so that breathing and eating are not done with the same apparatus. However, some aquatic mammals, large deer, and adult humans have descended larynges. Adult humans, cannot raise the larynx enough to directly couple it to the nasal passage. Despite its presence in deer, proponents of the aquatic ape hypothesis claim that the similarity between the descended larynx in humans and aquatic mammals supports their theory.
Some anthropologists, such as Jeffrey Laitman, have suggested that the descended larynx, by extending the length of the vocal tract and thereby increasing the variety of sounds humans could produce, was a critical element in the development of speech and language, while others cite the presence of descended larynges in non-linguistic animals, as well as the ubiquity of nonverbal communication and language among humans, as counterevidence against this claim.
Disorders of the larynx
There are several things that can cause a larynx to not function properly. Some symptoms are hoarseness, loss of voice, pain in the throat or ears, and breathing difficulties. Larynx transplant is a rare procedure. The world's first successful operation took place in 1998 at the Cleveland Clinic, and the second took place in October 2010 at the University of California Medical Center in Sacramento.
- Acute laryngitis is the sudden inflammation and swelling of the larynx. It is caused by the common cold or by excessive shouting. It is not serious. Chronic laryngitis is caused by smoking, dust, frequent yelling, or prolonged exposure to polluted air. It is much more serious than acute laryngitis.
- Presbylarynx is a condition in which age-related atrophy of the soft tissues of the larynx results in weak voice and restricted vocal range and stamina. Bowing of the anterior portion of the vocal folds is found on laryngoscopy.
- Polyps and nodules are small bumps on the vocal folds caused by prolonged exposure to cigarette smoke and vocal misuse, respectively.
- Two related types of cancer of the larynx, namely squamous cell carcinoma and verrucous carcinoma, are strongly associated with repeated exposure to cigarette smoke and alcohol.
- Vocal cord paresis is weakness of one or both vocal folds that can greatly impact daily life.
- Idiopathic laryngeal spasm.
- Laryngopharyngeal reflux is a condition in which acid from the stomach irritates and burns the larynx. Similar damage can occur with gastroesophageal reflux disease (GERD).
- Laryngomalacia is a very common condition of infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction.
- Laryngeal perichondritis, the inflammation of the perichondrium of laryngeal cartilages, causing airway obstruction.
There are nine cartilages, three unpaired and three paired, that support the mammalian larynx and form its skeleton. The unpaired cartilages of the larynx are the thyroid, cricoid and epiglottis. The paired cartilages of the larynx are the arytenoids, corniculate, and the cuneiforms.
- Thyroid Cartilage: This forms the Adam's apple. It is usually larger in males than in females. The thyrohyoid membrane is a ligament associated with the thyroid cartilage that connects the thyroid cartilage with the hyoid bone.
- Cricoid cartilage: A ring of hyaline cartilage that forms the inferior wall of the larynx. It is attached to the top of trachea.
- Epiglottis: A large, spoon-shaped piece of elastic cartilage. During swallowing, the pharynx and larynx rise. Elevation of the pharynx widens it to receive food and drink; elevation of the larynx causes the epiglottis to move down and form a lid over the glottis, closing it off.
- Paired Arytenoid Cartilage: Of the paired cartilages, the arytenoid cartilages are the most important because they influence the position and tension of the vocal folds. These are triangular pieces of mostly hyaline cartilage located at the posterosuperior border of the cricoid cartilage.
- Paired Corniculate Cartilage: Horn-shaped pieces of elastic cartilage located at the apex of each arytenoid cartilage.
- Paired Cuneiform Cartilage: Club-shaped pieces of elastic cartilage located anterior to the corniculate cartilages.
Most tetrapod species possess a larynx, but its structure is typically simpler than that found in mammals. The cartilages surrounding the larynx are apparently a remnant of the original gill arches in fish, and are a common feature, but not all are always present. For example, the thyroid cartilage is found only in mammals. Similarly, only mammals possess a true epiglottis, although a flap of non-cartilagenous mucosa is found in a similar position in many other groups. In modern amphibians, the laryngeal skeleton is considerably reduced; frogs have only the cricoid and arytenoid cartilages, while salamanders possess only the arytenoids.
Vocal folds are found only in mammals, and a few lizards. As a result, many reptiles and amphibians are essentially voiceless; frogs use ridges in the trachea to modulate sound, while birds have a separate sound-producing organ, the syrinx.
It is tube shaped and is 4.1 inches long.
- Histology of the Vocal Folds
- Jeffrey Laitman
- ^ "GERD and aspiration in the child: diagnosis and treatment". Grand Rounds Presentation. UTMB Dept. of Otolaryngology. February 23, 2005. http://www.utmb.edu/otoref/grnds/Reflux-Aspiration-050223/GERD-pedi-050223.htm. Retrieved June 16, 2010.
- ^ Laitman, J.T. and Reidenberg, J.S. (2009) The evolution of the human larynx: Nature’s great experiment. In: Fried M.P., Ferlito, A. eds. The Larynx, 3rd ed., Plural, San Diego, 19-38.
- ^ Laitman, J.T., Noden, D.M., Van De Water, T.R. (2006) Formation of the larynx: from homeobox genes to critical periods. In: Rubin,J.S.(ed.) Diagnosis & Treatment Voice Disorders Plural, San Diego, pp. 3–20.
- ^ Titze, I.R. (1994). Principles of Voice Production, Prentice Hall, ISBN 978-0137178933.
- ^ Collectively, the transverse and oblique arytenoids are known as the interarytenoids.
- ^ Morgan, Elaine (1997). The Aquatic Ape Hypothesis. Souvenir Press Ltd. ISBN 0 285 63518 2.
- ^ Bower, Bruce (1992). "Neanderthals to investigators: can we talk? - vocal abilities in pre-historic humans". Science News. http://findarticles.com/p/articles/mi_m1200/is_n15_v141/ai_12140517/.
- ^ Laitman, J.T. and Reidenberg, J.S. (1993) Specializations of the human upper respiratory and upper digestive tract as seen through comparative and developmental anatomy. Dysphagia 8:318-325.1993
- ^ Carlson, Ken (January 21, 2011). "Rare transplant gives California woman a voice for the first time in a decade". http://www.vancouversun.com/health/Rare+transplant+gives+California+woman+voice+first+time+decade/4142712/story.html#ixzz1BhfcCFuD.
- ^ Laitman, J.T. and Reidenberg, J.S. (1997) The human aerodigestive tract and gastroesophageal reflux: An evolutionary perspective. Am. J. Med. 103 (Suppl 5A): 3-11
- ^ Lipan, M, Reidenberg, J.S and Laitman, J.T. (2006) The anatomy of reflux: A growing health problem affecting structures of the head and neck. Anat Rec., Part B: New Anatomist: 289B:261-270
- ^ a b Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body. Philadelphia, PA: Holt-Saunders International. pp. 214–215, 336. ISBN 0-03-910284-X.
Human systems and organs TA 2–4:
TA 12–16 Blood
(Non-TA)General anatomy: systems and organs, regional anatomy, planes and lines, superficial axial anatomy, superficial anatomy of limbs
Head and neck anatomy, Upper RT: Larynx (TA A06.2, TH H3.05.01, GA 11.1072) Cartilages Ligaments/folds· lower: Cricothyroid ligament (Median, Lateral/Conus elasticus, Vocal ligament/Vocal folds) Laryngeal cavity Other
Wikimedia Foundation. 2010.


text:
NASHVILLE - Gov. Phil Bredesen says he will veto a bill allowing patrons to carry weapons into Tennessee restaurants and bars.
The bill was to become law June 1. More than 30 states already allow people to carry guns into restaurants that serve alcohol. There are about 218,000 handgun permit holders in Tennessee. The bill would have allowed permit-holders to take guns into bars as long as they didn't drink.
In a letter to House Speaker Kent Williams, Bredesen said while he supports the right to keep and bear arms, he believes allowing a patron "to carry a concealed weapon into a crowded bar at midnight on a Saturday night defies common sense."
Citing a gun safety class he took in high school, sponsored by the National Rifle Association, Bredesen wrote, "A basic tenet taught at that class was this: "Guns and alcohol don't mix."
The bill's lead House sponsor, Rep. Curry Todd, R-Collierville, said he would move promptly to attempt an override next week. The bill passed 66-23 in the House.
"I think they'll stick," he said of the "yes" votes, meaning the veto would be overridden.
Supporters of the measure say those with permits should have the right to carry their weapons, but Walt Baker, CEO of the Tennessee Hospitality Association, which represents hotels, motels and restaurants, says it's not about the Second Amendment.
"This is not a right-to-bear arms issue. It's about creating a problem for businesses when there was not one before," Baker said.
The legislation, he added, shifts the burden from the individual to the business owner. Baker anticipates business insurance will go up as well as the number of lawsuits filed.
While businesses can post a sign prohibiting guns in their establishment, Baker asked, "How welcoming is that?"
Democratic Sen. Doug Jackson of Dickson, the main sponsor of the bill, cited state Safety Department records that show the low number of people who have lost their handgun permits - only 278 permits were revoked last year, Jackson said.
Revocations are issued for felony convictions, while permits can be suspended for pending criminal charges or for court orders of protection.
Since 2005, state records show nearly 1,200 people have lost their permits.
"The bottom line is it's a remarkable record of safety … and responsibility on the part of handgun permit holders in Tennessee," Jackson said.
More details as they develop online and in Friday's News Sentinel.
Nashville bureau chief Tom Humphrey contributed to this report.

domain: politics


Russian investigators have charged a former deputy chief of the YAK Service air company over the air crash outside the city of Yaroslavl where all the members of the local ice hockey team died a year ago.
A spokesman for the Russian Investigative Committee said that Vadim Timogeyev, a former deputy general director at YAK Service, was charged with violation of flight safety regulations.
Russian media reports say Timofeyev faces up to seven years in prison if found guilty of the charges.
The Lokomotiv Yaroslavl ice hockey team, one of the most popular in Russia, lost 36 of its players and coaches in the air crash in the Russian city of Yaroslavl in September 2011.
Based on reporting by ITAR-TASS and RIA-Novosti


The majority of aviation accidents are attributable to human error. Moreover, as machines (or mechanical systems) have become more reliable over the past decades, human error has outpaced machine problems as a major contributing factor in aviation accidents. It is therefore important to address human error for the improvement of aviation safety. Human error typically occurs as a result of poor interactions among operators, machines, and environment, and it is often influenced by group dynamics and organizational factors. This presentation introduces 1) what human error is, 2) the relationship between human error and aviation safety viewed from individual, group, and organizational perspectives, and 3) solutions to reduce human error.


text:
Lima Duarte Tourism
Visit Lima Duarte - Best of Lima Duarte
Lima Duarte is a municipality in the state of Minas Gerais, Brazil. It has a population of 16166 inhabitants (2010) and a total area of 848 square kilometres (327 sq mi) and lies at an elevation of 860 metres (2,822 ft) in the foothills of the Mantiqueira Mountains. It was given city status in 1881. It is 330 kilometres (210 mi) from the state capital, Belo Horizonte, and is part of the Zona da Mata, a region whose economic and cultural center is Juiz de Fora. It is connected with this city by highway BR-267. Ibitipoca state park is situated within the municipality about 25 kilometres (16 mi) from the city center. Average maximum temperature: 28 °C (82 °F);Average minimum temperature: 10 °C (50 °F) Most of the municipality is drained by the Paraíba do Sul River. The most important river is the Rio do Peixe, a tributary of the Paraibuna. The name of the city has no connection to the famous Brazilian actor Lima Duarte, but was in homage to Conselheiro José Rodrigues de Lima Duarte, political leader from Barbacena, who in the nineteenth century was Minister of the Navy and a Senator of the Empire. The city's economy is mainly based on tourism and the dairy industry.Wikipedia
A place in Brazil, Lima Duarte is an interesting place to visit, given its unique culture, history and character. Lima Duarte is located at a short trip away from Rio De Janeiro a major city in Brazil. Rio De Janeiro, is a worth visiting city owing to its prime attractions like Cristo Redentor On Corcovado, Pao De Acucar, Sugarloaf Mountain. Also, to reach Lima Duarte, you'll have to take a flight to Rio De Janeiro; so its not really a detour. And even if it is, the city is worth paying at least a quick visit. Tour packages of Lima Duarte are of 1 to 2 days duration.
Explore the travel itinerary planning tool for your visit to Lima Duarte and create a flawless plan in few simple steps!

domain: travel


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The quality of most commercial jobs is very high. The images have been retouched to perfection and you can select an incredible photo, called a “hero photo”, from an entire day of shooting to be used in an advertisement. Retail photography refers to photography created for the sole purpose of personal use. You'll see these types of photographs filling the walls and frames of people's homes, invitations or personal social media accounts.
These are usually professional photographs of your family, children and pets; portraits. These types of images are authorized for personal use, not for the cover article that appears in a magazine (editorial) or in an advertisement (commercial). commercial photography provides a worthy frame for images. This feature ensures that viewers don't stray from the focused product.
As a result, style, background and lighting have a neutral effect. Advertising photography, on the other hand, uses elegant, bold and ingenious framing techniques. He is a commercial photographer %26 Digital Artist specializing in product photography %26 Architectural Photography, based in the South Bend, Indiana area. This type of commercial photography is based on editorial photographs from restaurants or food magazines to make food look delicious and authentic.
The difference is that an editorial photographer's clients are usually magazines, media and other publications with the ultimate goal of telling a story. I would say that the retail segment arguably has a lower barrier to entry, so the quality of work and experience of a person running a photography business can vary dramatically. Unlike commercial and editorial photography companies that work in B2B, photographers who work in the retail segment work in a B2C (business-to-consumer) way. Whether the photograph is commissioned by a small company or a large global corporation, commercial images are ultimately created with the intention of making the end user of the images earn more money; that is, to obtain a return on investment for the use of photographs.
A commercial photographer cannot use dazzling light in the session because it can overwhelm the product. Commercial photographer clients can range from working with advertising agencies to product manufacturers, architectural firms and companies that sell services such as insurance or food delivery. I would say that the cross between segments is more common between commercial and publishing than between retail trade. But then again, understand that when I photograph people, I do it for commercial, editorial purposes, or simply for my own portfolio.
Commercial and publishing are similar in many ways, while retail is a completely different business model and target audience. As stated above, most photography companies focus only on one of three business segments or models: commercial, publishing or retail. Commercial photography is a type of photography that focuses on the particular product you're selling. Most, if not all, commercial photographers prefer indoor sessions to have more control over lighting settings and backgrounds.
A professional commercial photographer captures photos of models, buildings, artifacts, landscapes, and products. This category of commercial photography focuses on the architectural design or attractiveness of a retail store.


text:
I think we are. Honest. If you take a look at what we do and how we live our lives, it should be more than obvious.
Well, speaking only as an unpublished very-amateur member of the set of writers, here’s some agreement. It’s obvious, really.
I have a universe in my head. Which isn’t this one.
(By most people’s standards, that’s about one step away from institutionizable schizophrenia.)
And it has demands. To be created and explored and documented and obsessed over, and finally, essentially, to get out.
Can you be possessed by a fictional reality? Sure feels that way, sometimes.


text:
Selena gomez is dating who 2014, filmography
Almost Live alongside various other Disney stars. A Sunday well spent brings a week of content! A few hours later, Selena was spotted with Justin in LA. They broke up once again at the end of September Where Justin gives her peak at his cellphone in an adorable new picture of the two posted to Instagram.
To all those who doubted Jelena: They were for Floyd Mayweather vs.
Sources say Jelena is taking time apart Just six days after making their relationship Instagram official, rumours have started circulating that the on-again couple are taking a break. Game Over and the made-for-television film Walker, Texas Ranger: From her field trip experience, Gomez said, "UNICEF is helping Chilean families get out of poverty, prevent violence within the home and promote education.
However, they broke up again in March As her career has been progressing, she has been experimenting with a large number of music genres. Diners and staff saw them holding hands.
Her character Grace is a teenager "mistaken for a socialite while on a trip to Paris. She has released two studio albums, one EPand one compilation album in her solo career.
I'm terrified of what I would have become if I'd stayed [in Texas]. No worries Jelena stans, the couple is going strong. I learned everything from Barney.
Sorority Rising ; she portrayed the president of a Phi Lambda sorority. March - May Dated for the thirteenth time: Life and career — It was also announced that she would partner with the cellphone brand, Case-Mate, as part of its upcoming "Right Case, Right Occasion" marketing campaign.
And judging from the lines, the songs tells the story of two people in a troubled relationship who are fighting to make it work. August - October Dated for the ninth time:

domain: celebrity


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