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Association between outdoor air pollution and chronic rhinosinusitis patient reported outcomes
S. Peeters1,
C. Wang2,
E. M. Bijnens2,
D. M. A. Bullens1,3,
W. J. Fokkens4,
C. Bachert5,6,
P. W. Hellings1,4,5,7,
T. S. Nawrot2,8 &
S. F. Seys1
The aetiology of chronic rhinosinusitis (CRS) is multifactorial with a complex interplay between environmental, microbial endogenous and genetic factors. The impact of outdoor air pollution on prevalence or severity of CRS remains largely unknown.
Real-life geolocation data (2017–2018, Belgium) from 278 CRS patients (2576 health records) using the mySinusitisCoach mobile application were analysed to calculate the patients' individual exposure to outdoor air pollutants (ozone (O3), black carbon (BC), nitrogen dioxide (NO2) and particulate matter with diameter < 2.5 μm (PM2.5)) and to associate these pollutants with the patients' sinus related symptoms measured at multiple occasions by visual analogue scale (VAS).
The adjusted seasonal model for the spring–summer (n = 1000 health entries, N = 83 patients) population revealed an increase of 6.07 (p < 0.0001) in overall CRS symptom scoring for an interquartile range (IQR) increase in exposure to O3 (26.9 μg/m3). An increase of 1.69 (p = 0.05) in total CRS symptom scoring was observed for an IQR increase of PM2.5 (7.1 µg/m3) exposure. Sex-stratified analysis in the spring–summer population showed significant interaction between air pollution and sex with male patients having higher total CRS symptom scores for an IQR increase in exposure to PM2.5 (3.52, p = 0.001), and O3 (8.33, p < 0.0001), while no significant association with symptom severity was seen in the female patients. In the analysis stratified by comorbid asthma, CRS patients with comorbid asthma had higher total CRS symptoms for an IQR increase in exposure to PM2.5 (2.58, p = 0.04) and O3 (7.72, p < 0.0001) while the patients without comorbid asthma had no significant symptom increases.
Exposure to outdoor air pollution is associated with increased symptom severity in CRS patients. The extent to which CRS patients are sensitive to outdoor air pollution exposure varies per season and depends on their sex and comorbid asthma status. mHealth technology has the potential to reveal novel insights on the patients' exposome and disease severity in the real-life situation.
Chronic rhinosinusitis (CRS) in adults is defined as an inflammation of the paranasal sinuses and nose with symptoms being present consecutively for more than 12 weeks [1, 2]. It is a common disease, with an overall prevalence of 10.9% in Europe [2, 3]. Two major phenotypes are characterized within CRS, namely CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) [1, 4]. Depending on the type of inflammation present in the sino-nasal cavities, different endotypes can be distinguished of which type 2 and non-type 2 impact the treatment decisions [5, 6]. The aetiology of CRS is multifactorial, which makes it challenging to identify the exact causal elements of the disease [7]. Genetic factors, environmental factors and the host microbiome have been most commonly reported [1]. Among environmental factors, airway infections, history of smoking, allergies and air pollution have been associated with CRS but their relative contribution to disease severity and progression remains unclear [1].
Outdoor air pollutants are a mixture of harmful components such as ozone (O3) and nitrogen dioxide (NO2) and particulate matter (PM) with diameter < 2.5 µm (PM2.5) and < 10 μm (PM10). The association between outdoor air pollution and certain diseases like cardiovascular disease, asthma and chronic obstructive pulmonary disease (COPD) has been extensively studied. Asthma is one of the most prevalent comorbidities in CRSwNP patients with 30%—47% of the CRSwNP patients reporting comorbid asthma [8, 9]. Exposure to outdoor air pollution can cause exacerbations and new-onset of asthma [10,11,12]. The airway epithelial lining protects our body from pollutants or other environmental intruders [11]. Outdoor air pollution may among others, including occupational agents, negatively affect epithelial barrier function thereby contributing to increased CRS severity [13, 14]. Only a limited number of studies have been performed investigating the relationship between CRS and outdoor air pollution. It has been demonstrated that a positive association exists between outdoor air pollution exposure and the prevalence of CRS [15, 16]. Mady et al. demonstrated that for each unit increase in PM2.5 there was a 1.89 fold increased risk in the proportion of CRSsNP patients who needed sinus surgery, and that exposure to black carbon (BC) was associated with a more pronounced disease presentation in CRSsNP patients [17]. Although scientific evidence on the association between CRS and outdoor air pollution is limited, it appears that long-term exposure to ambient pollutants is related to a higher prevalence of CRS and more severe CRS symptoms. On the other hand, when looking at studies investigating acute effects of highly concentrated pollutants, studies in the context of the World Trade Centre disaster are of particular interest. One 10 year follow up study in firefighters showed a 2-times increased risk of CRS in high compared to low exposed individuals [18].
In this study the association between short-term exposure to outdoor air pollution and CRS symptom severity is investigated using mixed models with real-life data generated by a mobile application used by CRS patients. The availability of longitudinal data and geolocation records enabled us to perform an analysis of CRS symptom severity associated with air pollution exposure. We hypothesized that increased exposure to outdoor air pollution may be associated with an increase in total symptoms that CRS patients experience. This relationship may be modified by sex, age, smoking status, surgery status, presence of nasal polyps and comorbid diseases like COPD, asthma and allergic rhinitis (AR).
Real-life data from patients with CRS were collected through a mobile health application called mySinusitisCoach [19]. Patients were considered for use of mySinusitisCoach when they have filled out that they have two or more sino-nasal symptoms and/or have a doctor-based diagnosis of CRS [20]. Patients using the application were asked to fill out a health diary in which they were asked to mark their total CRS symptom severity based on a visual analogue scale (VAS) from 0 (no symptoms) to 100 (maximum symptoms). In addition to the symptom record, the timestamp and geolocation of each entry was recorded. Patients were advised to complete the health diary on a weekly basis. For this study, only entries made in 2017–2018 by patients located in Belgium at time of registration were included. Minors were excluded. The study was approved by the institutional review board of UZ Leuven, Belgium.
The database consisted of 10,719 days of unique health records that are available from 714 different CRS patients from the UK, Belgium and the Netherlands. All health records were created between 09/11/2017 and 14/07/2019. After applying exclusion criteria, the final study population consisted of 278 different CRS patients residing in Belgium above the age of 18, with 2,576 corresponding days of health records coupled to a geolocation made in Belgium between 10/11/2017 and 31/12/2018 (Fig. 1). In order to take into account the consistence of the actual exposure and outdoor pollutant concentrations, the population was split up into two seasonal populations: a spring–summer population consisting of health entries made during the months April—September of 2018 (n = 1144, patients = 116) and a fall-winter population that consisted of health entries made during the months November and December of 2017 and January – March and October—December of 2018 (n = 1432, patients = 222).
Flowchart of the visual analogue scale (VAS) health record selection process. The final study population consisted of 278 CRS patients above the age of 18 that made 2576 days of VAS health records in Belgium
Calculation of individual exposure data and descriptive analysis
The geolocation information was used to estimate the average daily concentrations of O3 by taking the 8-h average, and PM2.5, BC and NO2 by taking the 24-h average. For every health entry, the daily average concentrations were calculated for the day of the entry (lag 0), as well as 1–7 days prior to the entry (lag 1–7) in order to study the lagged effect of the exposures on the recorded symptoms. Daily air pollution levels were modelled by the RIO detrended kriging interpolation model (4 by 4 km) that uses land cover data obtained from satellite images [21]. The RIO model outperforms standard interpolation techniques such as the Ordinary Kriging model as the bias, root mean square error and mean absolute error improve for each O3, NO2 and PM10 [21]. The validation statistics of this interpolation model give an explained spatiotemporal variance of more than 0.74 for BC, 0.78 for NO2 and 0.80 for PM2.5 [22]. Average daily temperatures and relative humidity recorded in Uccle, Belgium for the respective period were requested at the Royal Meteorological Institute. Distance between individuals' location and monitors of temperature and humidity was 46.1 (27.9 – 71.5) km (median with interquartile range). Average exposures of each pollutant and relative humidity and temperature were calculated for seven different lag intervals: lag 0–1 (AVG 1), lag 0–2 (AVG 2), lag 0–3 (AVG 3), lag 0–4 (AVG 4), lag 0–5 (AVG 5), lag 0–6 (AVG 6) and lag 0–7 (AVG 7). The production of O3 is catalyzed by sunlight and O3 concentration displays a strong seasonal pattern which is highest during the spring and summer in Belgium [23]. Therefore, O3 exposure was only studied for the spring–summer population, which had relevant UV-levels and O3 concentrations. Descriptive statistics of the exposure data were analyzed using Prism Graphpad 6 and R 3.6.3. Spearman's rank correlations were calculated between the different pollutants on the same day as well as between adjacent days for the same pollutant. Comparisons were made between both seasonal sub-populations for the pollutants and total symptom scoring using the Mann–Whitney U test.
The statistical workflow can be observed in supplementary Figure S1. To evaluate the association between the symptoms and the exposures, linear mixed models were fitted to account for the intercorrelation between each patient's multiple health entries. Whether to include random intercepts or random slopes was decided based on the intraclass correlation coefficients, which were calculated for the models to assess for the necessary random effects. This was followed by regressing the symptoms on the mean exposure of each pollutant of each of the seven exposure intervals, separately. The Akaike Information Criterion (AIC) was calculated for each model to select the models with the best fitting exposure interval [24]. Possible confounding was considered by creating adjusted models, with the following covariates: outdoor temperature, humidity, sex, age, smoking history, sinus surgery history, nasal polyps and comorbidities such as COPD, AR and asthma, which were selected a priori based on previous literature studying the potential association between air pollution exposure and CRS. The non-numerical covariates were coded as follows; sex: male or female; smoking status: smoker or never smoker; nasal polyp status: CRSsNP or CRSwNP; sinus surgery history, COPD, AR: yes or no; and asthma: asthma since adulthood or asthma since childhood or no. Effect modification of the association between the exposures and the overall CRS symptoms was assessed for these covariates by testing the interaction terms between the exposure and the covariates. Stratified analyses were performed based on the significant effect modifications in the spring–summer population for lag exposure interval AVG 7. For the stratification of asthma, no distinction between 'asthma since adulthood' and 'asthma since childhood' was made. It was considered that pollution exposure, temperature and relative humidity might have a non-linear effect by fitting models with high-order terms. To avoid multicollinearity temperature and relative humidity were scaled. The AIC was calculated for each model to determine the best fitting order [24]. In the adjusted models the variance inflation factor (VIF) was calculated for each selected adjusted model to check for multicollinearity among the covariates. A VIF of 5 was taken as the cut-off value for the presence of a multicollinearity problem. All mixed models were fitted using the lme4 package in R 3.6.3 [25].
The characteristics of the study population are shown in Table 1. The average age of the total study population was 44 (± 13.56) years. Man (51.43%) and women (48.56%) were equally represented. 53.02% of the population had nasal polyps and 54.68% of the population had a history of sinus surgery. 49.05% of the population had AR, 6.77% had COPD and 23.02% had asthma (Table 1). The patients had significantly higher total CRS symptoms in the fall and winter compared to the spring and summer (p < 0.001) (Fig. 2A, S2). Months with known birch (April) and grass (June-July) pollen season peaks for Belgium did not show increased total CRS symptoms (Figure S2 and consulted at: https://airallergy.sciensano.be).
Table 1 Information collected on the study population (N = 278)
VAS total CRS symptom data and exposure data from both seasonal populations. VAS total CRS symptom data and exposure data presented as boxplots. A Distribution of the VAS total CRS symptoms of the spring–summer (red) population (patients = 116, health records = 1144) and the fall-winter (blue) population (patients = 222, health records = 1432). B Exposure data generated for the spring–summer (red) population (patients = 116, health records = 1144, exposure days = 9152) and for the fall-winter (blue) population (patients = 222, health records = 1432, exposure days = 11,456) for O3, PM2.5, BC and NO2. *** = p-value < 0.001
Outdoor air pollution exposure
As expected, significant pairwise correlations were found for all of the pollutants (Supplementary Table S1, S2).
When comparing the exposures of the spring–summer and the fall-winter population with each other, the O3 concentration appeared to be significantly higher in the spring–summer months than in the fall-winter months (p < 0.001). BC, PM2.5, and NO2 concentrations were significantly higher in the fall-winter months compared to the spring–summer months (p < 0.001) (Fig. 2B).
Effect-modification
Sex, age, nasal polyp status, COPD, adulthood onset asthma and history of sinus surgery were found to be effect-modifiers in the spring–summer population (Table 2). Sex was found to be an effect-modifier of the association between the total CRS symptom score and BC, PM2.5, and NO2 exposure, as male patients had a greater change in the total CRS symptom scoring per 1-unit increment in the pollutants, compared with female patients. Comorbid COPD and adulthood onset asthma were found to be effect-modifiers of the association between O3 exposure and the total CRS symptom scoring, with a greater change in the symptom scoring of COPD or adulthood onset asthma patients per 1-unit increment in the pollutants. Patients with a history of sinus surgery showed a smaller change in the total CRS symptom score per 1-unit increment in BC, PM2.5, and NO2 exposure compared to patients without a history of sinus surgery. Comorbid AR, smoking status and childhood onset asthma did not modify any of the associations.
Table 2 Effect-modification observed for the spring–summer CRS population
Associations between symptom severity and exposure to pollutants using repeated measures
In the adjusted models for the spring–summer population (n = 1000 health entries, N = 83 patients), each patient made an average of 12 health entries in mySinusitisCoach. The largest lag interval (AVG 7) was selected for all pollutants as the best fitting exposure term. The models with temperature, humidity, and pollution exposure as first order terms were selected as best fitting models (Table S3). A significant increase of 6.07 (p < 0.0001) in total CRS symptom score was found for an IQR increase in the average O3 (26.9 µg/m3) exposure the week before the entry (Fig. 3). A significant decrease of 2.24 (p = 0.03) in total CRS symptom score was found for an IQR increase in NO2 (9.1 µg/m3) exposure. An increase of 1.69 (p = 0.05) in total CRS symptom scoring was observed for an IQR increase of PM2.5 (7.1 µg/m3) exposure. No significant changes in symptoms were observed for BC (Fig. 3). In the adjusted models for the fall-winter population (n = 1149 health entries, N = 153 patients) no significant changes in total CRS symptom scores were observed (Supplementary Figure S4B).
Relationship between CRS symptom severity and outdoor air pollution for the spring–summer population. Change in total CRS symptom scoring for the total spring–summer population (n = 1000 health entries, N = 83 patients) as perceived by the patients after being exposed to an interquartile range (IQR) increase of the pollutant the week before the entry (lag 0 – lag 7). IQR BC = 0.5 µg/m3, IQR NO2 = 9.1 µg/m3, IQR O3 = 26.9 µg/m3, IQR PM2.5 = 7.1 µg/m3. The population was adjusted for outdoor temperature, humidity, sex, age, past smoking status, sinus surgery history, nasal polyp status and comorbidities: COPD, AR and asthma. A Stratification based on sex. B Stratification based on comorbid asthma status. C Stratification based on sinus surgery history. D Stratification based on nasal polyp status
Exposure to O3 and PM2.5 caused a significant increase in total CRS symptom scoring in males, with the observed changes for an IQR increase being 3.52 (p = 0.0153) for PM2.5, and 8.33 (p < 0.0001) for O3 (Fig. 3A) In females, significant change was only detected with NO2 where an IQR increase in NO2 was associated with 4.27 (p = 0.03) decrease in symptom score (Fig. 3A).
CRS patients with comorbid asthma showed increased total CRS symptom scores with increased exposures, where the association with an IQR increase in PM2.5 was 2.58 (p = 0.04) and in O3 was 7.72 (p < 0.0001) and had less symptoms for an IQR increase in NO2 (-3.17, p = 0.03) (Fig. 3B). No significant estimates of symptom scores were seen in CRS patients without asthma.
Prior sinus surgery status
Prior sinus surgery status did affect the association between the pollutants and the total CRS symptoms. A significant change in CRS total symptom score was observed after exposure to NO2 (-4.12 per IQR increase, p = 0.0300) and O3 (5.97 per IQR increase, p = 1.96E-04) in the CRS population that had prior sinus surgery. For the CRS patients without history of sinus surgery an IQR increase of exposure of PM2.5 and O3 was associated with an increase of 3.56 (p = 0.0104), and 5.15 (p = 0.00965) respectively (Fig. 3C).
CRS phenotype
A significant association was found for NO2 as well as O3 exposure and the total CRS symptom scoring of the CRSwNP patients. A change of -3.61 per IQR increase (p = 0.002) for NO2 and of 6.25 per IQR increase (p < 0.0001) for O3 was observed, whereas the CRSsNP population did not show significant total CRS symptom associations to any of the pollutants (Fig. 3D).
Although exposure to environmental and occupational factors such as tobacco smoke, fire smoke and dust exposure have been linked with the prevalence of CRS, the association between the prevalence and severity of CRS and outdoor air pollution is far less understood [1, 4, 26]. According to a recent systematic review, 10 relevant manuscripts have been published before demonstrating higher odds of CRS particularly with PM exposure [27]. To our knowledge this is the first study using mixed models to describe symptom severity data of CRS patients in relation to outdoor air pollution exposure. We here demonstrated that exposure to O3 and PM2.5 leads to an increased CRS symptom scoring in CRS patients during the spring–summer period. Sensitivity of CRS patients to outdoor air pollution exposure depends on their sex, presence of comorbid asthma and history of sinus surgery.
In our study, we speculated that the models created for the spring–summer population were better in reflecting personal exposure to outdoor air pollution than the models fitted for the fall-winter population. It has been previously demonstrated that during colder months people spend more time inside and aerate their households less [28]. Therefore, a stronger association has been observed between indoor exposure and outdoor exposure during warmer months compared to the colder months [28]. It was observed that in the fall-winter population CRS symptom scores were higher than those of the spring–summer population, while the association between outdoor air pollution and increased CRS symptoms were more present in the spring–summer population. This is likely due to the fact that during the winter viral infections are more prevalent among the population which often exacerbate CRS symptoms [29]. This may thus overshadow the effects of the pollutants on the symptoms, which together with the fact that the fall-winter population models contain less accurate estimates of the exposure, explain the observation of nonsignificant changes in the total CRS symptoms after exposure in this population.
The unstratified adjusted spring–summer population showed a significant increase and decrease in symptom score for O3 and NO2 exposure respectively. The increase of symptoms associated with O3 exposure is approximately three times bigger than the decrease of symptoms associated with NO2 exposure when comparing their IQR estimates. O3 exposure has previously been shown to cause damage to the nasal epithelium and to cause increased nose and sinus symptoms, such as rhinorrhea, nasal dryness, nasal obstruction, epistaxis and olfactory impairment, in non-CRS patients [30,31,32]. The observed decrease in symptoms associated with NO2 exposure could be explained by the interaction between O3 and NO2. O3 is formed by a photochemical reaction requiring NOx and volatile organic compounds and an inverse relationship exists between O3 and NO2 [33, 34].
No significant effects were observed for black carbon. Mady et al. observed more pronounced disease progression in CRS patients after BC exposure [17]. The relative low sample size may have been the reason why we failed to detect the association between BC and the symptoms in the adjusted spring–summer population.
In our population, male patients are more sensitive to O3 and PM2.5 exposure compared to female patients. In literature, evidence of effect modification by sex on respiratory health remains uncertain as studies most often find stronger effects of pollution exposure among women, however certain studies have also suggested stronger effects among men [35]. Confounding may exist because of unmeasured characteristics, including biological factors related to deposition, reactivity, and hormonal influences on chemical transport and systemic regulation as well as gender-related explanations such as exposures to indoor allergens and cleaning agents, job-related chemical exposures, and differing exposure and response to psychosocial stressors [35].
A remarkable finding of this study is that CRS patients with comorbid asthma are sensitive to outdoor air pollution while non-asthmatic CRS patients are not. This could be explained by the fact that asthma exacerbations are known to be associated with outdoor air pollution and that poor asthma control has a negative effect on CRS patient outcomes [11, 36, 37]. Self-reported AR did not affect the relationship between air pollutants and symptoms in CRS patients. Increased total CRS symptoms over the year also did not track with tree or grass pollen seasons. This is not surprising since the prevalence of AR is not higher in CRS compared to the general population except for specific phenotypes like allergic fungal rhinosinusitis or central compartment atopic disease [38]. Also, local polyclonal IgE is produced in the upper airways of CRS patients irrespective of their allergy status [39]. It has been shown that superantigens such as Staphylococcus Enterotoxin B are drivers of this polyclonal IgE response [40].
Sinus surgery significantly changes the airflow and increases the deposition of particles in the sinuses, possibly making patients more sensitive after surgery [41]. However, we observed significant symptom increases after exposure to PM2.5 in the group that did not have prior sinus surgery and no significant symptom changes in the prior surgery group. This may be due to the fact that the time between the last sinus surgery and symptom reporting varies between patients and no information was available on patient's date of last sinus surgery. For O3 we did not observe an impact of prior sinus surgery.
A previous study demonstrated that CRSsNP patients are more sensitive to PM and BC compared to CRSwNP patients [17]. In our population the observed increases for the CRSsNP patients for BC and PM2.5 were not significant, however changes in symptom severity were higher for these pollutants in CRSsNP compared to CRSwNP patients.
Lastly, smoking status did not affect the relationship between air pollutants and symptoms in CRS patients in this study. Exposure to cigarette smoke on itself, either active or passive, though contributes to chronic rhinosinusitis according to a review by Reh et al. [42].
Certain limitations of this study should be noted. A first limitation of the study relates to the fact that we calculated exposure data for the coordinates recorded on the day of entry and assumed the same location for up to the prior seven days. Besides, outdoor pollutant concentration does not necessarily reflect the actual personal exposure of the patients to pollutant since indoor pollutant concentrations have been shown to impact patients' health variables as well [28]. Secondly, patients' self-reported outcome measures were based on total sinusitis symptoms in this analysis. In future studies with larger numbers of patients reporting on specific symptoms of CRS, it would be interesting to study how specific symptoms such as impaired smell, facial pain and nasal blockage are affected in CRS patients by air pollution. This type of analysis featuring longitudinal real-life data can have many significant implications in further understanding the real-world impacts of pollution on CRS symptom outcomes. Therefore, we suggest a follow-up study to be performed with a larger dataset on a larger geographical scale.
In conclusion, several novel findings have been observed in the present study for CRS patient symptomatology in relationship to air pollution exposure. During the spring and summer period in Belgium, an association between the total CRS symptoms and O3 as well as PM2.5 exposure was demonstrated in CRS patients. Additionally, male patients and patients with comorbid asthma appeared to be more sensitive to the exposure of several of the pollutants compared to the female CRS patients and patients without comorbid asthma.
Akaike Information Criterion
AR:
COPD:
CRS:
Chronic Rhinosinustis
CRSsNP:
Chronic Rhinosinustis without Nasal Polyps
CRSwNP:
Chronic Rhinosinustis with Nasal Polyps
Particulate Matter < 10 µm
Particulate Matter < 2.5 µm
Visual Analoge Scale
VIF:
Variance Inflation Factor
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Sillman S, Logan JA, Wofsy SC. The sensitivity of ozone to nitrogen oxides and hydrocarbons in regional ozone episodes. J Geophys Res. 1990;95(D2):1837.
Clougherty JE. A growing role for gender analysis in air pollution epidemiology. Environ Health Perspect. 2010;118(2):167–76.
Phillips KM, Talat R, Caradonna DS, Gray ST, Sedaghat AR. Quality of life impairment due to chronic rhinosinusitis in asthmatics is mediated by asthma control. Rhinology. 2019;57(6):430–5.
Phillips KM, Hoehle LP, Caradonna DS, Gray ST, Sedaghat AR. Association of severity of chronic rhinosinusitis with degree of comorbid asthma control. Ann Allergy Asthma Immunol Off Publ Am Coll Allergy Asthma Immunol. 2016;117(6):651–4.
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinol J. 2020;58(Suppl S29):1–464.
Bachert C, Maurer M, Palomares O, Busse WW. What is the contribution of IgE to nasal polyposis? J Allergy Clin Immunol. 2021;147(6):1997–2008.
Zhang N, Holtappels G, Gevaert P, Patou J, Dhaliwal B, Gould H, et al. Mucosal tissue polyclonal IgE is functional in response to allergen and SEB. Allergy. 2011;66(1):141–8.
Abouali O, Keshavarzian E, Farhadi Ghalati P, Faramarzi A, Ahmadi G, Bagheri MH. Micro and nanoparticle deposition in human nasal passage pre and post virtual maxillary sinus endoscopic surgery. Respir Physiol Neurobiol. 2012;181(3):335–45.
Reh DD, Higgins TS, Smith TL. Impact of tobacco smoke on chronic rhinosinusitis: a review of the literature. Int Forum Allergy Rhinol. 2012;2(5):362–9.
We thank EUFOREA for providing access to the historic database of CRS patients.
Department of Microbiology, Allergy and Clinical Immunology Research Group, Immunology & Transplantation, Herestraat 49/811, 3000, Louvain, KU, Belgium
S. Peeters, D. M. A. Bullens, P. W. Hellings & S. F. Seys
Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
C. Wang, E. M. Bijnens & T. S. Nawrot
Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
D. M. A. Bullens
Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands
W. J. Fokkens & P. W. Hellings
Department of Otorhinolaryngology, Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
C. Bachert & P. W. Hellings
Department of Clinical Science, Intervention and Technology, Division of ENT Diseases, Karolinska Institutet, Stockholm, Sweden
C. Bachert
Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Leuven, Belgium
P. W. Hellings
Department of Public Health and Primary Care, Environment and Health Unit, KU Leuven, Leuven, Belgium
T. S. Nawrot
S. Peeters
C. Wang
E. M. Bijnens
W. J. Fokkens
S. F. Seys
SFS, PH, NTS conceptualized and designed the study. PS, WC, BEM, SFS, NTS analyzed and interpreted the data. PS and SFS drafted the article and WC, BEM, BDMA, FWJ, BC, HPW, NTS critically revised and edited the manuscript. All authors read and approved the final manuscript.
Correspondence to S. F. Seys.
The authors have no competing interests to declare related to this manuscript.
Additional file 1:
Figure S1. Workflow depicting hierarchical model build-up and selection process. Figure S2. Variation in VAS of the total CRS symptoms per month. Figure S3. Relationship between CRS symptom severity and outdoor air pollution for the spring-summer population. Figure S4. Relationship between CRS symptom severity and outdoor air pollution for the fall - winter population. Table S1. Spearman's rank correlation for same pollutants on adjacent lag days. Table S2. Spearman's rank correlation for different pollutants on lag day 0. Table S3. AIC for model selection of the adjusted spring-summer population.
Peeters, S., Wang, C., Bijnens, E.M. et al. Association between outdoor air pollution and chronic rhinosinusitis patient reported outcomes. Environ Health 21, 134 (2022). https://doi.org/10.1186/s12940-022-00948-7
Chronic rhinosinusitis
Patient reported outcome measures


text:
Mostly clear. Low around 75F. Winds light and variable..
Mostly clear. Low around 75F. Winds light and variable.
Walker High coach Hannah Jones calls out instructions to her team during the Class 5A state semifinals in Alexandria.
Morgan Prewitt | 4-5alockerroom.com
Walker High coach Hannah Jones helped guide the Lady Cats to the District 4-5A championship and berth in the Class 5A state tournament.
Patrick Dennis | 4-5alockerroom.com
Walker coach Hannah Jones: "I love teaching and coaching kids."
Ralph Melancon | 4-5alockerroom.com
GIRLS BASKETBALL | Family Matters! Hannah Jones bids hometown farewell after guiding Walker girls to 5A state semifinals
By: William Weathers | 4-5ALockerRoom.com
4 min to read
WALKER – She tried to prepare herself as much in advance as possible with one goal in mind.
Don't cry.
Hannah Jones wasn't successful.
After first informing the parents of Walker High's girls basketball team that she wasn't returning to her alma mater to serve on the Lady Cats' coaching staff, Jones was set to face the players themselves and deliver the news.
"I thought I had this, that I'd hold it together," Jones said.
Turns out Jones didn't stand a chance.
Jones' announcement near the end the school year that she was leaving Walker High, where she coached the girls basketball team to the Class 5A state semifinals and track team for three years, turned into a task she was unable to perform without a box of Kleenex nearby.
Once Jones explained she was making a family-related move to the Lake Charles area with her husband Timothy, a member of the U.S Coast Guard, her heart then got in the way of her intentions, and the tears began flowing.
"I couldn't look at all of them," she said. "I was trying to focus on what I was saying and not let tears stream down. They all jumped up and hugged me."
It was quite different from the times they shared after Walker captured the District 4-5A championship and later advanced to the state tournament after an overtime victory at home against Natchitoches Central.
This was more about a finality between athletes and their beloved coach parting ways and trying to squeeze out every second of their time together.
"It's sad because our team's like a family and I have my own family outside of basketball here," said Jones, who taught at Walker's Freshman High the past four years. "It's a new adventure and that's how we're looking at it. This is opening the door for us to do new things as a married couple. It's exciting."
It came after a tumultuous six-month span.
Jones, a former Walker High standout player who played collegiately at the University of Arkansas-Little Rock, found herself in a much different role this season than she could have ever imagined.
When head coach Korey Arnold was suspended by the LHSAA on Nov. 16 for recruiting violations, the 27-year-old Jones was elevated to head coach – a position she had never previously never held at the varsity level before.
"It was a form of adversity," Jones said. "It happened in November, right where you're almost in that true season grind. I'm thankful and honored that Walker let me be the one to be the head coach. We had an amazing support system and an amazing group of coaches that whenever something needed to be done, we worked together.
"I think it showed because we had a great season," Jones said. "To be able to coach those girls made me better. A lot of times you think the coach makes them better, but they made me better."
Walker was off to a 4-0 start at the time of the LHSAA's announcement, and the Lady Cats went on to win their first 11 games of the season until a 54-38 loss to Denham Springs in the final of the parish championship.
Led by eventual Class 5A state MVP and Miss Basketball Tiara Young, an LSU signee, Walker later gained the services of Tarondia and Trinity Harold in December and the Lady Cats began to truly hit their stride.
Walker finished the regular season on a 10-game win streak, capped by a come-from-behind 58-50 victory at Denham Springs, to capture the District 4-5A title.
The Lady Cats, the second-seeded team in the Class 5A state playoffs, extended their win streak to 13 games with three consecutive home playoff wins over Destrehan, Sulphur and Natchitoches Central, the latter turning into another example of the team's resolve after Young spent much of the first half on the bench in foul trouble.
Walker finished the season with a 32-5 record and Jones was selected the District 4-5A Coach of the Year.
"I remember being a nervous wreck for my first college game," Jones said. "I'm good at not showing emotion. I was like that for the Sulphur game. I was very nervous because in the playoffs you never know -- wanted to prepare them and make sure they were mentally ready for every little thing."
Walker was in position to reach the Class 5A state championship game, facing Denham Springs for a third time this season, when the Lady Cats lost the services of Young for the remainder of the game with 6:22 to play and fell 48-33.
Jones, along with assistant Vance Law, guided Walker to a runner-up finish in the District 4-5A track meet and a fifth place showing in the Region II-5A meet.
The Lady Cats qualified five athletes for the Class 5A meet with Kaitlyn Hayes leading the way in three events – the long jump along with the 4x100 and 4x200 relays.
"The transition of moving is hard because you're so used to things," Jones said. "I've grown up here and know a lot of people in the community. They've watched me grow up and play. Those things are hard when you look at the investment I put in teaching at the school and coaching basketball and track."
While moving away from family and life-long friends will prove difficult in the short term Jones, who celebrated her one-year wedding anniversary in May, would like to maintain her career as an educator and secure a coaching position where she proved adept at serving as a calming force for a unit during turbulent times.
"I love teaching and coaching kids," she said. "It can be a demanding job in certain aspects, but the reward is greater. You never know what hand you'll be dealt. You take what you get and try and mold them into great young ladies.
"I did it on the fly for one year," she said. "That's something I want to carry. It's more than the Xs and Os. It's teaching, it's guiding. Now I'll have some more confidence under my belt. I think that experience is going to help in the long run."
Walker High School
Walker High School Girls Basketball

redpajama_set_name: RedPajamaCommonCrawl


Nature sounds and the soft accompaniment of acoustic guitar provide musical overlays to the native american flute. Beautiful blend of a wooden flute and chorus of nature's inspiring sounds to soothe and comfort. Meditative. Simple elegance. Tranquil. Floating vibrations.
Visit our web site at: http://www.jchigheagle.com/1webmus.html and hear samples.


Home Recherche Projets de recherche en cours URBAN-REV POLITICS, The Urban Revolution and the Political.
Urban-rev politics is on the political implications of speculation-driven urbanism in the current context. Adopting an urban political economy approach we examine the global dimensions of accumulation practices based on rent extraction and the extent to which our 'urban age' corresponds to a new kind of 'urban politics'.
The research is organized around three themes: 1. uneven globalization of real estate markets, 2. exploitation of urban space through rent extraction, 3. the ways in which these are negotiated and contested at different scales. Through a multi-sited ethnography approach the work is based on case studies in Hong Kong, Istanbul, London, and São Paulo. These cities feature broadly similar processes of property-led (re)developments, and a variety of activist and advocacy networks that challenge these. Additionally all four cities have experienced largely spontaneous mobilizations and/or popular occupations in the recent past.
Comparative analysis, transnational ethnography, commodity chain analysis, participant observation, interviews, cartography, discourse analysis, filming.


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With a team ERA in interleague of 1.02, the Hawks have been nothing short of dominant with their pitching. Yesterday was another ho-hum day against the Chunichi Dragons, with another combined effort shutout.
Despite Hawks starter Tsuyoshi Wada getting knocked out in the 6th due to injury (he took a batted ball off his right ankle), the bullpen was able to pick up the slack and keep the game out of reach.
The win extended Chunichi's winless streak at Yahoo! Dome. Today marks the last time the Dragons won in Fukuoka, four years ago. It was also the Hawks 8th shutout win of the season.
Against Taiwanese lefty Wei-yin Chen, SoftBank got the only run they would need in the 2nd inning. Tamura singled and came around to score on backup catcher Katsuki Yamazaki's RBI single after the former got to second on a groundout.
SoftBank added another run two innings later when Fukuda singled and stole second, and he got to third on a sacrifice fly. The super-utility man came in on Hasegawa's infield single. Fukuda was inserted on defense after Tamura fouled a ball off his left ankle and couldn't continue.
Chunichi managed to keep it close as Chen was able to wiggle out of the trouble he did get himself into. However, the home team broke the game open in the 7th and 8th with two runs in each inning. Enyelbert Soto was undone by two walks and a booted ball by the normally sure-handed Masahiro Araki.
Yoshihiro Suzuki was called on to clean up Soto's mess. With the bases loaded and nobody out, SoftBank got one run without even putting bat on ball. Uchikawa was plunked with a pitch to force one run home, and Kokubo lifted a sacrifice fly to put the game out of reach at 4-0.
SoftBank would add two more in the 8th on a sacrifice fly by Kawasaki and an RBI single from Honda. The relief corps of Morifuku, Falkenborg and Kanazawa kept Chunichi off the board and maintained the Hawks undefeated mark in interleague.
SoftBank continues their interleague campaign by taking on the Hanshin Tigers at Koshien Stadium tomorrow. DJ Houlton (6-1, 1.60) will face Minoru Iwata (1-5, 2.70).


Campus was the best time I had in my youth years.
I'm a budget vegan -- can't afford animal products, but peanut butter and beans are cheap!
I don't get who would want to go on the show "Naked and Afraid"?!
I time it to pass by the big trucks asap - better not to be in its driving path, makes sense!
Politicians always are the same .


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Tag Archives: Matt Schaub
I've Been Away Too Long
Posted by gee4213 in Gee's Thoughts, Pre-Season
AJ Green, All or Nothing, Altanta Falcons, Cam Newton, Carolina Panthers, Cincinnati Bengals, Denver Broncos, Drew Lock, Green Bay Packers, Greg Olson, Khalfani Muhammad, Kurt Benkert, Marvin Lewis, Matt Schaub, NFL, Oakland Raiders, Pre-Season
I'm a day late thanks to work, but with our first pre-season game in the books, Hard Knocks airing in the States and a full set of games incoming it's time to get into pre-season mode.
I watched the Hall of Fame game between the Atlanta Falcons and the Denver Broncos with interest rather than being enthralled. I got my first looks at Drew Lock who looked every bit a rookie who needed time to develop both missing throws and holding onto the ball and so giving up sacks. It can be hard for a lot of positions to catch the eye when watching the broadcast version of pre-season games. It tends to be offensive skill players, pass rushers or a flashy linebacker play that gets your attention and for the Broncos this was running back Khalfani Muhammad who picked up fifty yards on seven carries and got a touchdown whilst looking like he had an extra burst of pace. That said, I have seen plenty of running backs catch my eye in pre-season over the years and not have it translate to the regular season. I wouldn't place too much emphasis on pre-season for predicting the coming year, in fact I don't tend to place too much stock in predictions full stop but it is still an important time of year for the players involved.
Even at this early stage Matt Schaub struggled to move the ball effectively and it looked for all the world that Kurt Benkert was making a good start to win the backup quarterback job when a toe injury took him out the game and he has now been placed on injured reserve. On such fates entire careers can turn so fingers crossed he at least gets another shot at some point.
I'm currently catching up with last of Amazon's All or Nothing series that followed the Carolina Panthers, but so far I've only seen the first episode where we get introduced to Cam Newton who is pretty peak Cam smoking a cigar in the barber's chair. We've already seen Greg Olson re-injure his foot and it will be interesting to see the rest of the season play out and what we get to see of Cam's shoulder problems later in the year.
What I Heard
The NFL media had something of a lull post the draft and OTAs but is now in full swing. The Eagles have a daily podcast following training camp and obviously the news starts to churn as we get the endless hopeful updates out of camp and the injuries start to mount.
There's been quite a lot of talk about the various running back holdouts and whether Ezekiel Elliot is worth the money he's asking for or not. The prices of a player is going to be set by the market, but the current CBA is not working for running backs, particularly those selected in the first round. If you have a first round running back like Elliott then you can pick up their option for a fifth season, franchise them for two more and by that time the player is likely coming to the end of their career given how hard it is to play the position. For a quarterback the money is so high and the career is so long that you can manipulate your way out of a bad situation eventually, but the running back has so little leverage thanks to the their shorter careers. You can speculate all you want about the fairness of this and putting in an exemption for the running back to take into account the wear on their bodies, but the owners are going to want to be given something to negotiate for that and I can't see that it will be a priority come the CBA negotiations as what do the players have to give other than playing more games?
I'm going to allow myself a little worry here as what I think is that the Bengals have overhauled a lot in the off-season having moved on from Marvin Lewis. I think a lot of fans forget just how bad the team was before Lewis was hired and improved things dramatically. This is all up in the air right now and losing your first round draft pick to injury, a second offensive lineman to a medical retirement, and AJ Green to torn ligaments on a college field the team were playing on as part of the centenary celebrations is not exactly a great start. I was worried already, and whilst I'm not sure that the Bengals are as non-competitive in the division as most seem to think (there is still a lot of talent on the roster) – I'm not at all confident of a good record, in fact I'm gearing up for a tough season of watching. I just hope the rest of games are good.
What I Know
This pre-season I will be watching the Bengals as usual, the Oakland Raiders as they are on Hard Knocks, which could be very interesting given the roster moves and Antonio Brown's sore feet that was apparently caused by a Cryotherapy mishap, and the Green Bay Packers as I'm intrigued to see how they look under a new coach.
What I Hope
I'm hoping that the Bengals manage to put a season together than can be built upon even if it doesn't result in wins, that we get good entertaining games, and that more teams play good football. The higher the quality the better for all.
And that's it for my first weekly column of the 2019 season. I'm not going to count how many weeks to go as it will likely give me a certain degree of panic but in no time at all the picks competition will be in full swing, and Dan's Dad will likely be stumping us again with more NFL trivia.
This is not a drill, football is coming!
Rams, Broncos, and Special Preseason Week 3 Guests the Miami Dolphins
Posted by gee4213 in Uncategorized
Adam Gase, Alec Ogletree, Arian Foster, Atlanta Falcons, Buffalo Bills, Case Keenum, CJ Anderson, Dak Prescott, Dallas Cowboys, Damien Williams, Denver Broncos, Jared Goff, Jay Ajayi, Los Angeles Rams, Mark Sanchez, Matt Schaub, Miami Dolphins, NFL, Paxton Lynch, Reshad Jones, Rex Ryan, Ryan Tannehill, San Francisco 49ers, Todd Gurley, Tony Romo, Trevor Siemian
We are twelve days away from the start of the 2016 season, and the preseason week three games where the starters will see the most game time have already started. I will take you through the remaining week two games I have watched, as well as the visit of the Atlanta Falcons to Dan's Miami Dolphins taking in my quarterback curse and general thoughts.
There is always a ton of news at this time of year, each team still has ninety players on its roster until the Tuesday deadline for cuts down to seventy-five. There are injuries, worries about the team, and a lot of fan angst as the positivity of the offseason hits the stark reality of playing games in the NFL. Already the Buffalo Bills are struggling with injury to numerous players as Rex Ryan's team seem to beset by difficulty as they approach the season.
Meanwhile, Tony Romo has a fractured vertebrae in his back, meaning that Cowboys fans will be getting an extend look at whether Dak Prescott can be a starter in the NFL as Romo is not expected back until mid-season. Prescott's play so far would give some confidence, but it is always best to treat play in the preseason with a healthy amount of scepticism. You will hear people talk about vanilla plans in preseason, but that's overstating things somewhat. However, coaches have teams work on what they want to work on, so blitz heavy teams will blitz as they will be getting ready for the season. What is not happening, is the detailed team specific game planning that goes into every regular season game, and so whilst flashing in preseason is definitely an encouraging sign, the test, and particularly for quarterbacks, is whether you can adjust and counter what your opposition put in place to specifically stop you. Any player that demonstrates a weakness in their game can expect to see a heavy dose of whatever counters or exposes it until said player can show that they have cleared it up.
So on to the games as I get myself into season shape with game watching, and hopefully step up the number of articles next week.
The LA Rams managed to get a second win hosting the Kansas City Chiefs despite going in down at half time again. In fact, things got off to a bad start for them as they gave up a touchdown on the opening drive of the game for a second game in a row. For those watching Hard Knocks, you will have seen Alec Ogletree's frustration as well as him fighting to get the first team defence lined up correctly. That said, the Rams had a good response with Case Keenum leading the Rams' offence straight back up the field to score a touchdown, although the plaudits ought to go to Todd Gurley who ran the ball effectively and scored the equalising touchdown. The coaches had seen enough and pulled Gurley from the game before he could get hurt.
The Rams defence then stiffened to get the ball immediately on a three and out, giving the offence the ball. The Rams moved the ball well again, with Case Keenum passing to Pharoh Cooper for a go ahead touchdown and so Keenum was finished for the game.
The big question for Rams quarterback Jared Goff is when will he be ready, but whilst the coaching staff are seeing progress, they also are stating that you can see rookie mistakes, and given that on his first two plays Goff threw an incomplete pass, then was sacked and fumbled the ball, you can see what they mean. That said, he did finish the game completing eight of his twelve attempts for eighty-two yards and threw his first touchdown as a professional to running back Malcolm Brown.
We will have to see how this team fare on the road, and how much momentum the Rams can carry into the regular season, but if nothing else, their attendance has been huge so far and they will want to make the most of the interest by winning games if they are to make the transition to LA successful.
Following a week one win, the Broncos lost their second game of preseason as they welcomed the San Francisco 49ers to Denver.
It feels like there is only one question hanging over the Broncos this offseason, despite the loss of some players on defence, and all the usual roster skirmishes, the big question for this team is who is going to start at quarterback.
For the second week in a row, I sat watching a Broncos starting quarterback thinking that this might work out and they threw an interception. This week it was Trevor Siemian that I managed to retroactively curse, but it is a big step that he got the start and looks to be making a strong case to be the opening night starter. Certainly Mark Sanchez didn't help his cause by losing two fumbles. In fact, it may even be possible that he is being pressurised by rookie project Paxton Lynch who threw two touchdowns and an interception, although he does still look like a rookie and held onto the ball a bit too long for my liking at times. There was even some talk on commentary about giving Lynch the start next week to see if has the goods, but I would suggest it is a little early for such a move, yet I do feel that Trevor Siemian could well be the starter come week one.
The Broncos starting defence looks good, and even if the team did lose this game, I do think the Broncos are going to have another strong based on another good year on defence, and a run game that looks better than last year with CJ Anderson looking in good shape already and strong players behind him that could make for a good rotation to support an inexperienced quarterback.
The Broncos played the Rams last night, and I look forward to seeing how they went over the next couple of days. As a result of this fixture I had an extra game that I could watch, and Dan asked me to take a look at the Dolphins, who conveniently hosted the Atlanta Falcons on Thursday night.
I still have questions about the way the Miami Dolphins have approached their offseason, and in particular how they are building their offensive line given that of the three interior linemen that started the game, all of them are inexperienced and/or changing permission. However, new Dolphins head coach Adam Gase is a quality offensive coordinator who got the Dolphins job off the back of good work with Jay Cutler and Peyton Manning.
The Dolphins started the game playing no huddle offense, and did look to be making good use of Ryan Tannehill skills, moving him with roll outs, running the ball, and passing. However, he again fell to the, I think this going to be good Gee curse, and as soon as I thought how good he looked, Tannehill immediately threw an interception.
However, the Dolphins ran out pretty convincing winners in this game, thanks to an ability to move the ball and a defence that restricted the Falcons all game and didn't allow a touchdown.
There are questions at running back with Jay Ajayi battling health problems, Arian Foster looking good but at age thirty and a recent history of injuries you probably can't rely on him all season. I do however like Damien Williams who has caught my eye before, but who has never broken out, yet in this game he had a couple of nice runs and scored a touchdown.
My worry for the Dolphins is the depth, and whilst I like what I saw, the defence still seems to be thin past the starters, and I'm not sure about the secondary barring Reshad Jones who is a really good safety.
I did like the look of second year defensive end Julius Warmsley who got a sack and showed good penetration on a couple of other plays, but whether this will be enough to get him off the practice squad and onto the roster only time will tell. Fellow second year end Cleyon Leign also got a quarterback hit from a lovely spin move playing inside at tackle in the fourth quarter. However, even if the line play is better this season for the defence, the back seven is where the questions are and without access coaching tape in preseason, it is hard to know for sure how they will fare given how much you can see them play. Certainly, whilst unable to score touchdowns, Falcons backup Matt Schaub looked pretty good completing ten of eleven passes against the backup secondary.
Overall, I expect the Dolphins to be better than last season as they will have a more coherent plan on offence, after the muddle that was last year's experience with two head coaches, but I think they will continue to be hampered by how the roster is constructed. I do wish them well if only to cheer Dan up next season, I still remember how much it hurts for your team to miss the playoffs for a number of year even if the Bengals have had a better run of it recently.
Time is running out for players to make the roster, and with the regular season just around the corner, it's nearly time for the games that count, although you try telling a player who is fighting to get on a roster that the remaining preseason games are meaningless.
The season is nearly here, and football already is.


text:
date: 2020-05-03T13:05:57-0600
updated: 2020-05-03T13:13:00-0600
feedId: /notes/1305/
tags:
    - Zettelkasten
    - note-taking

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I got curious, and (after some [command-line shenanigans]) figured out that I've written/collected about 22,000 words of notes in my [Zettelkasten] so far in 2020. That's… a lot of notes. 😅

[command-line shenanigans]: https://v5.chriskrycho.com/journal/find-grep-xargs-newlines-null/
[Zettelkasten]: https://v5.chriskrycho.com/topics/zettelkasten/

redpajama_set_name: RedPajamaGithub


Olena Jennings has published poetry in Poems by Sunday. Her translations of poetry can be found in Chelsea, Poetry International, and Wolf. She has published fiction in Joyland, Pioneertown, and Projecttile. She completed her MFA in writing at Columbia and her MA in Ukrainian Literature at the University of Alberta.
She has deftly translated 2 fan loved volumes of poetry for UB, and has published her fine collection of poems "Songs from an Apartment" this 2017! Look forward to 2018's Shut Mouth!
Links, Poems, Stories, and Reviews!
Olena Jennings - The Short Affair — pioneertown.


CassieFairy . LindaPerry. Lakomkkaa. AdorableKitten.
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CarolyneAnnaAngelDaisy1995SamiHazeQuietAurora .LoongJohnEasyrichAddalyneWild19Nicol .TRANNYVSGIRLSEXOceanEyesJullyLovelyBoyNormanEmiliaCox .AddalynejessimillerAdryanGoldAarerCute .KevinWicksAddalyneAlisterSmithTRANNYVSGIRLSEX .RossiRoDevonJayAddalyneRebecaDivine .ErikaHopelatinabigcockxxUrLovelyBriAngelDayx .MonikaLove6PregnantXLoveLoveIrenenaadin .BrentDeckerMonikaLove6MariahJensenLouise3 .AdryanGoldEasyrichDavidAndTonyajessimiller .AnnabellSkyXQuietAuroraTheSexAMBASSADORLovelybkk .


Whose brand does Google want to build?
Why give priority to mobile and social marketing?
Which Google do your customers use? Which Facebook? Which Twitter?
What's the big question for online marketing success?
What's the most important marketing skill for 2011?


text:
Rempex Raises $67.5M, Vertex Shares Tumble, & More San Diego Life Sciences News
Xconomy San Diego —
The price of shares at San Diego's Gen-Probe, Amylin Pharmaceuticals, and Optimer were clipped for various reasons over the past week, but several local startups successfully raised capital. Our good news, bad news briefing begins here.
—Rempex Pharmaceuticals, a San Diego biopharmaceutical startup developing a new approach to antibiotics resistance, said it raised $67.5 million in Series B venture funding—bringing total funding for the company to $76 million since its founding less than five months ago. The startup is on a fast track, and plans to use the capital to accelerate the commercialization of its therapies for treating gram-negative bacterial infections. Rempex said it plans to file a new drug application for its first drug candidate in the second half of 2012. New investors Frazier Healthcare Ventures and Vivo Ventures joined existing investors SV Life Sciences, OrbiMed Advisors, and Adams Street Partners in the latest round.
—Cambridge, MA-based Vertex (NASDAQ: VRTX) has held the high ground in hepatitis C therapies since the FDA approved its protease inhibitor drug telaprevir (Incivek) last year. But two rivals are gaining ground. The price of Vertex shares have fallen with the rise of Alpharetta, GA-based Inhibitex (NASDAQ: INHX) and Princeton, NJ-based Pharmasset (NASDAQ: VRUS). Vertex, which has operations in San Diego, hit a 52-week high of $58.87 on May 12, but it has been trading around $31 in recent days.
—Adding to the competition in hepatitis C drugs, San Diego-based iTherX Pharmaceuticals raised almost $3.2 million to advance its development of a prophylactic treatment for Hepatitis C, according to a regulatory filing earlier this week. The startup said in March that its drug candidate TX-5061 appears to prevent the hepatitis C virus from entering liver cells, and has shown "potent preclinical antiviral activity against all HCV genotypes." Former UCSD virologist Flossie Wong-Staal is a co-founder and chief scientific officer. The company raised $2.8M in 2010.
—San Diego-based Amylin Pharmaceuticals (NASDAQ: AMLN) agreed to pay Eli Lilly more than $1.5 billion as it gradually reassumes responsibility for global commercialization of its best-selling diabetes drug in a deal that ends its 10-year partnership with Lilly. Under their agreement, which also ends litigation with Lilly, Amylin will take over sales of exenatide (Byetta) in the U.S. by the end of this month—and global sales of both Byetta and an experimental, extended release version (Bydureon) over the next two years. Amylin shares, which hit a 52-week high of $16.65 on Jan. 27, have been trading around $10 a share over the past few weeks.
—Xconomy east coast biotechnology editor Arlene Weintraub profiled PharmaSecure, a four-year-old startup in Lebanon, NH, with operations in San Diego, Michigan, and India. The company provides machines to drug-makers that print unique bar codes and serial numbers on drug packaging. PharmaSecure raised $3.9 million last month from Innovation Endeavors, Gray Ghost Ventures, Healthtech Capital, and angel investors. The Tech Coast Angels (TCA) participated in an earlier $2 million round with Life Science Angels, according to San Diego TCA member Jay Kunin, who told me in an e-mail, "which is how I ended up on the board." Kunin says he also is PharmaSecure's acting CTO, but he won't be moving to India, where the company's technology team and data centers are based.
—San Diego-based Gen-Probe (NASDAQ: GPRO) wrote off $39.5 million of its $50 million investment in Pacific Biosciences, the DNA sequencing company based in Menlo Park, CA. "Even though we have both the ability and the intent to hold this investment for the long-term, we wrote it down because the trading price of Pacific Biosciences' stock may remain below our cost basis for an extended period of time," Gen-Probe CEO Carl Hull told analysts in a third-quarter earnings call. Gen-Probe said the write-down contributed to its net loss of $15.4 million, which contrasts with the $27.4 million profit posted in the same quarter last year. Revenue rose 5 percent to $139 million.
—Perminova, a San Diego startup developing Web-based software to manage the workflow at cardiac centers, raised $3 million in equity and secured a $4 million loan in a Series A financing. Perminova's technology began as a database for tracking cardiac patient care but has evolved into a more comprehensive system for everything from patient scheduling to post-procedural documentation and billing.
—San Diego-based Optimer (NASDAQ: OPTR) generated almost $11 million in new revenue during the quarter that ended Sept. 30 from its sale of fidaxomicin (Dificid), its drug for treating intestinal bacterial infections caused by the C. difficile bacteria. Optimer reported a net loss of $26.8 million in the quarter, which prompted a sell-off in Optimer shares. The company's stock price, which hit a 52-week peak of $17.95 on Sept. 23, has been trading above $11 a share in recent days.
—The Sanford-Burnham Medical Research Institute has joined the global network New York-based Pfizer has been building to foster collaborations between basic research and new clinical applications. The institute will be working closely with UC San Diego at Pfizer's Centers for Therapeutic Innovation, which UCSD joined in August.
Decentralized Clinical Trials: The Call for a New Paradigm
Virtual/hybrid trials and decentralized research can better integrate healthcare into patients' lives and accelerate approval of new medications
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Manoel de Oliveira: A Poetics of Dissent
VI CECC Conference in Culture and Conflict | Universidade Católica Portuguesa | Lisbon, April 7-8 2016
VI CECC Conference in Culture & Conflict
Research Centre for Communication and Culture – Universidade Católica Portuguesa
7-8 April 2016
Programme for download: Draft Programme_Oliveira_30mar
Manoel de Oliveira's life and work merged with the history of cinema from 1931 when Douro, Faina Fluvial [Labour on the Douro River] was first exhibited until April 2, 2015, when he died. Considered for many years as the oldest filmmaker in activity (Oliveira's last film O Velho do Restelo [The Old Man of Belém] dates from 2014 when he was 105), Oliveira's filmography is definitely marked by novelty and esthetic dissent.
Internationally acclaimed, Oliveira's filmography is unique and distinctive, since, both within the frameworks of international and Portuguese film, it cannot be considered as belonging to a specific cinematic movement/trend and to a particular category. By excelling both in the domain of documentary and fiction or by subtly and skillfully merging both, by making film enter in dialogue with the literary text, Oliveira's production from the very beginning interrogates what cinema is and what the cinematic language searches for as if his whole work were an attempt to provide an answer to this concern. Besides this crucial ontological interrogation, his filmography reveals a particular ethos that can be analyzed from a universal and a national perspective, since his compromise with unveiling and dissecting the ambiguities and contradictions of the human soul inevitably leads spectators to question individual and collective identities.
Wishing to pay tribute to the filmmaker when the first year of his death is celebrated, this international conference seeks to analyze the various cycles of Oliveira's work by examining how and to what extent his cinematography can be considered adversarial, and how it configures a poetics of dissent by addressing, among others, the following issues:
. Oliveira and film criticism
. Oliveira's work or the cinema of non-illusion
. Oliveira and the word as an esthetic object
. Oliveira and the use of irony
. The role of music in Oliveira's cinema
. Faith and reason or the religious dimension of Oliveira's filmography
. Death as a leitmotif in Oliveira
. Oliveira, cinema and theatre
. The mystery of time in Oliveira
. Oliveira and the narratives of frustrated passion
. Oliveira between film and literature
. Oliveira's films and gender roles
. Oliveira and the construction of Portugal on the screen
. Oliveira's role in Portuguese and international filmmaking
The Conference's working languages are Portuguese and English.
Paper proposals
Please send the Organizing Committee 300-word abstracts for 20-minute papers, as well as a brief biographical note (circa 100 words), to oliveirapoetics@gmail.com by November 30, 2015. Proposals should list paper title, name, institutional affiliation, and contact details.
Notification of acceptance will be given by December 17, 2015. All candidates will be notified.
Should you have any queries feel free to write us to oliveirapoetics@gmail.com.
Adriana Martins
Maria do Rosário Lupi Bello
Daniela Agostinho
Miguel-Pedro Quadrio
Tiago Baptista


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Bezdružice () jsou město v severovýchodní části okresu Tachov. Jsou nejmenším sídlem pověřeného obecního úřadu, které má status města (viz seznam) a členem Mikroregionu Konstantinolázeňsko. Leží v Tepelské vrchovině 33 kilometrů severovýchodně od Tachova a 41 kilometrů severozápadně od Plzně, mimo důležité silniční tahy. Žije zde  obyvatel.

Historie

První písemná zmínka o Bezdružicích pochází z roku 1227, kdy vesnice patřila Hrabišicům. Později se připomíná v letech 1360–1379 Bušek z Bezdružic, který byl pravděpodobně předkem rodu Harantů z Polžic a Bezdružic. Od roku 1390 byly Bezdružice majetkem Kolovratů, jejichž rodová větev nesla jméno Bezdružičtí z Kolovrat. Jan II. Bezdružický z Kolovrat († 1467) patřil k vlivným osobnostem v západních Čechách a na jeho žádost byly Bezdružice Jiřím z Poděbrad 31. října 1459 povýšeny na městečko. Po Janovi II. drželi Bezdružice postupně jeho tři synové, z nich Jiří († 1526) udělil bezdružickým česky psané městské privilegium.

Od Jetřicha Bezdružického z Kolovrat koupil Bezdružice v roce 1542 Hanuš Elpognar z Dolního Šenfeldu, který pocházel z bohaté měšťanské rodiny z Lokte a v roce 1548 byl přijat do panského stavu. Byl úspěšným hospodářem a přikoupením nedalekého hradu Gutštejna (1549) vytvořil z Bezdružic centrum rozsáhlo panství s 21 vesnicemi. Bezdružicím potvrdil Hanuš Elpognar městská privilegia (1559), jeho synové však majetek v krátké době zadlužili a již v roce 1569 bylo panství prodáno Švamberkům, kteří měli hlavní sídlo na nedalekém hradu Švamberk. Bohatí Švamberkové měli k dispozici řadu jiných sídel, takže bezdružický zámek za jejich éry neprošel žádnou výraznou stavební úpravou.

Po smrti posledního ze Švamberků, Jana Bedřicha († 1659), zdědila Bezdružice jeho manželka Marie Magdalena († 1661), která se vzápětí podruhé provdala a dědicem panství se stal její druhý manžel hrabě Jan Kryštof z Heissensteinu († 1693). Jeho vláda je spojena s účastí poddaných na selském povstání v roce 1680, kdy bylo povražděno padesát sedláků na Ovčím vrchu, což připomíná kaple a památník selských bouří z roku 1936. Po Heissensteinově smrti přešel majetek na jeho dcery, poté se ve vlastnictví rychle vystřídalo několik rodů (Stadionové, Berlepschové), až v roce 1712 koupil v dražbě zadlužené panství za 120 tisíc zlatých kníže Maxmilián Karel Löwenstein-Wertheim.

Löwensteinové krátce po získání Bezdružic přikoupili i sousední statky Švamberk a Gutštejn, oddělené od bezdružického panství za předchozích majitelů, v roce 1720 koupili i nedaleké panství Bor. Löwensteinové pobývali především na svých sídlech v Německu nebo ve Vídni a Bezdružice pro ně byly podružné. Přesto se jejich rozvoji věnovali a založili zde textilní manufakturu nebo sklárnu. V roce 1730 Bezdružice z velké části vyhořely a měšťané pak na náměstí nechali postavit sloup svatého Floriána, který měl město ochránit před dalšími požáry.

V polovině 18. století byly Bezdružice centrem rozsáhlého panství, k němuž patřilo 49 vesnic, 16 hospodářských dvorů, 24 mlýnů a panský pivovar pod hradem Švamberk. Kníže Karel Tomáš Löwenstein (1714–1789) nechal v letech 1772–1776 přestavět bezdružický zámek do dnešní podoby, inicioval také výstavbu zámku v Cebivi, těmito aktivitami ale panství zadlužil a musel je předat do vnucené správy. Jeho nástupce Dominik Konstantin (1762–1814) přivedl Bezdružice opět k prosperitě a založil nedaleké Konstantinovy Lázně, které nesou jeho jméno. Od 18. století se v Bezdružicích začala usazovat židovská komunita, která zde měla od roku 1812 i vlastní synagogu.

V roce 1850 se Bezdružice staly sídlem soudního okresu, v témže roce zde byla zřízena pošta a četnická stanice. Kostel Nanebevzetí Panny Marie, přestavěný po požáru v roce 1838, se stal farním (1857), poté došlo i na výstavbu školy (1860). Löwensteinové v té době realizovali rozsáhlou novogotickou přestavbu zámku v Boru, který se stal jejich sídlem i centrem správy všech knížecích statků v Čechách. O bezdružický zámek proto ztratili zájem a ten byl v roce 1868 uvolněn pro státní úřady, samotný objekt ale zůstal nadále jejich majetkem. Bezdružice v té době měly přibližně tisíc obyvatel.

Počátkem 20. století podpořily rozvoj Bezdružic železniční spojení (1901) a výstavba vodovodu (1907–1909). V době první republiky byla postavena nová měšťanská škola (1925) a město jako sídlo soudního okresu a četných spolků bylo centrem rozsáhlého regionu. Za druhé světové války byly převážně německojazyčné Bezdružice součástí Velkoněmecké říše, americká armáda vstoupila do města 4. května 1945. Následovalo vysídlení německého obyvatelstva, ale i přes příchod nových osídlenců z různých částí Československa klesl počet obyvatel na polovinu. Bezdružický velkostatek se zámkem, jehož majitelem byl kníže Alois Löwenstein–Wertheim (1871–1952), byl jako německý majetek zestátněn v roce 1945. Do okolních vesnic Bezdružicka byli po druhé světové válce repatriováni potomci českých exulantů z doby pobělohorské z polského Čermína a Malého i Velkého Tábora.

Krátce po druhé světové válce došlo k demolici domů na náměstí západně od radnice, později byly v různých částech města zbořeny i další domy, ale přísun dalších obyvatel vyvolal potřebu výstavby nových bytů. V roce 1970 byly dokončeny tři panelové domy u školy, další domy zde vznikly během sedmdesátých a osmdesátých let 20. století, svépomocí občanů byl již předtím postaven kulturní dům (1958–1960).

K 10. říjnu 2006 byl obci vrácen status města.

Obyvatelstvo
Při sčítání lidu v roce 1921 zde žilo 1 025 obyvatel (z toho 483 mužů), z nichž bylo čtrnáct Čechoslováků, 992 Němců a devatenáct cizinců. Většina se jich hlásili k římskokatolické církvi, ale pět lidí bylo evangelíky, tři patřili k církvi československé, 24 k církvi izraelské a jeden člověk k jiným nezjišťovaným církvím. Podle sčítání lidu z roku 1930 mělo město 1 066 obyvatel: 79 Čechoslováků, 971 Němců a šestnáct cizinců. Kromě římskokatolické většiny zde žilo také třináct evangelíků, tři členové církve československé, 21 židů, dva členové jiných církví a třináct lidí bez vyznání.

Části města
Město Bezdružice má devět částí ležících na šesti katastrálních územích:
 k. ú. Bezdružice – část Bezdružice
 k. ú. Polžice u Bezdružic – části Dolní Polžice a Horní Polžice
 k. ú. Zhořec u Bezdružic – části Zhořec, Kamýk a Pačín
 k. ú. Kohoutov u Bezdružic – část Kohoutov
 k. ú. Křivce – část Křivce
 k. ú. Řešín – část Řešín

Služby

Bezdružice jsou přirozeným menším centrem pro okolní menší sídla. Ve městě funguje mateřská škola, základní škola, základní umělecká škola, pošta a zdravotní středisko. Město je plynofikováno a je v něm zavedena kanalizace.

Doprava
Bezdružice leží mimo hlavní silniční tahy. Prochází jimi jenom větší počet silnic III. třídy. Ve městě končí ve stanici Bezdružice železniční trať Pňovany–Bezdružice. Hlavními linkami autobusové dopravy jsou Úterý–Bezdružice–Stříbro, Bezdružice–Planá a Bezdružice–Plzeň. Autobusová doprava také sváží občany z místních částí do obce.

Pamětihodnosti

Bezdružický zámek stojí na návrší nad náměstím. Původní gotický hrad vznikl před rokem 1330. Za Kolovratů byl renesančně přestavěn. Zchátralé zdivo starého hradu bylo v osmnáctém století částečně zbouráno a zámek upraven v barokním slohu (1772–1776). Až do roku 1945 patřil Löwensteinům, kteří ho v polovině devatenáctého století přenechali městu ke zřízení kanceláří soudu a berního úřadu. Od roku 1953 zámek fungoval jako rekreační středisko.

Kostel Nanebevzetí Panny Marie je poprvé zmiňován roku 1515, v roce 1710 byl původně gotický kostel zbourán a na jeho místě vystavěn kostel barokní. Od roku 1995 prošel kostel rekonstrukcí.

Galerie

Rodáci
 Louis Weinert-Wilton, spisovatel
 Erik Worscheh, hoteliér
 MUDr. Anton Friedrich Hässler, lékař
 Johannes Nepomuk Alois Zeschick, římskokatolický duchovní, opat broumovského kláštera svatého Václava v Rohru

Reference

Literatura

Související články
 Synagoga v Bezdružicích
 Židovský hřbitov v Bezdružicích

Externí odkazy

Města v Čechách
Obce s pověřeným obecním úřadem
Obce v okrese Tachov
Mikroregion Konstantinolázeňsko
Místní akční skupina Český západ
SOČ Černošín
Šance pro jihozápad
Regionální sdružení obcí a měst Euregio Egrensis
Vodohospodářské sdružení obcí západních Čech
Města v okrese Tachov
Sídla v Tepelské vrchovině

redpajama_set_name: RedPajamaWikipedia


Congratulations! Your child's braces are finally off and they've moved on to retainers.
Retainers are the final phase of orthodontic treatment. They prevent your child's teeth from shifting back into their original, pre-braces position.
This unwanted shifting is because teeth are not set into the jawbone like concrete pillars. Instead, teeth are attached to the jawbone by periodontal ligaments. These elastic ligaments allow the teeth to shift back to their previous position if your child doesn't wear their retainer.
Retainers help ensure all of the work achieved by braces isn't lost.
Some retainers are fixed and are worn all the time. They can only be removed by a dentist or orthodontist. Some retainers are removable by the patient. Both types are used to keep teeth from shifting away from the position achieved by using braces. Retainers can be just metal, plastic or plastic with metal wire.
Your child's orthodontist will recommend the best type of retainer for their smile. They'll also instruct you on how often and how long your child needs to wear it. Retainers are usually worn for at least as long as your child wore braces.
Also, be sure to keep retainers clean. They can be a breeding ground for bacteria if not cleaned properly. And bacteria leads to cavities.
Make sure your child follows the retainer wear and care instructions provided by their orthodontist.


Way back in the depths of last week. Last Thursday to be precise. A band of adventurers came from Wimborne in a bid to derail our hopes of waltzing to a Dorset League Div championship without a single loss.
Dragi, myself, Richie and Adam lined up against them.
Adam managed a fairly quick win against Phil Holden with a good smattering of Pawns in a Rook and Bishop end game.
The other boards were all looking reasonable at this point. I had a strong King side attack after a Rook lift glaring down at his King. Richie had a Knight outpost deep in enemy territory.
Things started going downhill, Dragi lost an exchange, my attack had petered out with the Rook trying to back track to lend support to its vacated post, and Richie managed to lose a Queen side's worth of Pawns.
I was short on time having pondered too many sacrifices but done none so fell into a Knight fork, there was a Pawn covering that square but then I moved my King so the Pawn was then pinned. And that was that.
Richie managed to battle well with two King side Pawns threatening to Queen, one of them eventually did Queen, as did an opponent's Pawn. A draw was eventually agreed with 2 Rooks apiece fighting over a single Pawn. There were opportunities for both sides to win it so perhaps the draw was the fairest result in this odd game.
Dragi was bravely battling on trying to make a Pawn advantage make up for being an exchange down. His Bishop was eventually sacked to take care of the last Pawn opponent, but this meant it was a Rook against two Pawns. They were nicely advanced but unfortunately the position didn't allow much hope from that position and the game was lost.
Well done to Adam for the win and Richie for the draw, well battled Dragi. We're still at the top of the league but missed the opportunity to seal the title with two games to go. It will now go down to the wire!


I dread people asking my opinion on stuff. Whether it be the presidential elections. Or what kind of music I listen to.
Cos the truth is I'm not sure anymore.
I can't remember the last time I sat down and read the papers. Or watched something other than X Factor on the telly. My cultural references are determined by what Gary Barlow says.
I've become an expert at the knowledgeable nod. Combining the authoritative 'ummm', when I find myself, sometimes for the fourth or fifth time that day, totally out of my depth.
The best line of defence, I've found, is just don't say anything, otherwise you get your self into a complete conversational cul de sac.
I'm sure I used to have opinions about stuff other than whether Tyrone should leave Kirsty if she doesn't go to a counsellor on Corrie.
For the meantime, maybe what Nancy and I need is a bit of variety. A greater wealth of collective experience to draw from when I try and cover up the vacuum if someone attempts to engage me in conversation about something current.
My dad gave Nancy some money for her birthday and suggested we do something nice for her instead of putting it in her bank account.
So I thought I'd get her posh swimming lessons.
That way she gets to go in a pool that isn't sub zero temperatures. And I get to take her to somewhere once a week that isn't Card Factory, Boots, or Aldi.
So I rang up to book her in.
And the woman asked how experienced Nancy was at swimming.
And I asked her what she meant.
And she said, what's her ability.
I said she'd been to loads more lessons than she actually has.
And now she has a trial. She's one and she has a trial to see how good she is at something.
She's one, and she's being tested against other one year olds.
I thought the main hurdle with posh swimming lessons was finding the money to pay 12 quid for half an hour every week.
Not testing her to see if she's the next Michael Phelps.
Have I inadvertently become a pushy mum? I genuinely only wanted Nancy and I to have a nice time for thirty minutes every Thursday morning.
Now I'm nervous for her that she won't remember how to cling onto the side of the pool. Or might freak out if they try to dunk her underwater.
To be frank, it's sometimes a complete ball bag trying to work out what kind of person you are after having a child, let alone, what kind of a parent you want to be.
I know I don't want to be shouty mum. Or a mum who tries too hard to be down with the kids. I want to be able to cook. Not just hummus on toast, but stuff that looks good, smells nice, and takes longer than 2 minutes to make.
I want to know enough about politics that I don't embarrass myself if Nancy asks a question.
I want to feel driven by work, committed to my family and know more about what's going on in the world than who Nicole Scherzinger's mentoring this year.
But for the meantime, I want Nancy to be a one year old who doesn't have to meet anyone's expectations, other than to be happy and healthy.
And especially not when it's costing twelve quid every half hour for the privilege.
But, in the words of Gary Barlow, 'I don't think you'll ever be happy about anything unless you've done it.' Wise words Gaz.
I guess it's difficult to know who to take advice from these days.


Presidents are expected to keep quiet about whatever the Federal Reserve does. But Donald Trump has become famous for upending supposedly sacrosanct protocols.
In the first nine months of the present fiscal year, total federal revenues were $2.54 trillion, while total federal spending was $3.15 trillion, leaving a deficit of $607 billion. That's 16-percent higher than it was at the same time a year ago.
Schumer says it's a plot. Portman says it's understated. Lots of things will change in 30 years.
Federal Reserve Chairman Jerome Powell suffers from the same disease infecting all those on the board: the hubris that they really know what's best for the economy.
Is the Fed Risking a Recession by Raising Interest Rates?
With the Fed likely to raise overnight bank lending rates by one quarter of one percent on Wednesday, observers are increasingly concerned that those increases may throttle Trump's roaring economy just as it's beginning to hit its stride.
Recession in Trump's First Term?
Even the hardiest skeptic cannot find clouds in the economy's sky.
This year's Tax Freedom Day, which "represents how long Americans as a whole have to work in order to pay the nation's tax burden," falls on April 19 according to the Tax Foundation.
VIDEO - A growing number of American states are taking action to restore sound money, reports correspondent Alex Newman for The New American. Among the recent victories in the ongoing battle was Alabama, where a new law removed taxes on gold and silver. Before that, Texas passed a law creating a state depository for gold bullion and other precious metals to help sideline the Federal Reserve in commerce. Utah kicked off the trend in 2011, when it declared gold and silver to be legal tender in the state. With the central bank's fiat currency constantly depreciating, and the monetary system becoming increasingly unstable, Newman argues that it's time for states to take the lead in restoring honest money.
To judge from the impassioned cries of his opponents, one might think President Donald Trump's tariff announcement on March 1 was the opening shot of a calamitous "trade war" that will end in apocalypse and ashes.
The Fed will make eight quarter-point rate hikes between now and the end of the year 2020 in order to stave off predicted inflation.
Under President Trump's proposed budget, the governemnt admits it can't end deficit spending, but will merely attempt to make those deficits smaller by increasing tax receipts owing to economic growth.


Hi all just joined as I've acquired a 1998 XSI in black, love the car. I'm sure I'll be posting plenty in the wanted section!
Welcome to the club Oliver. Glad to hear you're enjoying the car.
When it comes finding spares you occasionally find members on here breaking a 306. Also check out the FB page as I think more advertise there than on here.


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News Local Turkish TV channel red-tagged after reports on municipal corruption
Local Turkish TV channel red-tagged after reports on municipal corruption
The headquarters of TV 52, situated in Turkey's Ordu province, was red-tagged on March 12 over alleged violation of fire safety regulations.
Police from Ordu's central Altinordu district raided TV 52 and red-tagged its offices on the grounds that the company had failed to meet zoning and fire safety regulations on the building's top two floors within a designated period of time.
The reason behind the move has nothing to do with safety regulations, TV 52 Chairman İsa Akçay said, but rather the station's broadcasts on corruption in municipal tenders and construction permits.
"TV 52 has been around for 25 years. However, some people became disturbed after the channel reported on Ordu Metropolitan Municipality corruption in tenders and zoning, in accordance with the people's right to know," Atilla Sertel, a deputy for Turkey's main opposition Republican Peoples's Party (CHP), said in a written statement.
"We have just witnessed in Ordu an example of the pressure, intimidation and jailing that have become normal for journalists during the time in power of the Justice and Development Party (AKP). The purpose is not to inspect but to silence TV 52," added Sertel.
The mayors of both the Ordu Metropolitan Municipality and the Altınordu Municipality were elected on the ticket of the ruling AKP, led by Turkey's autocratic President Recep Tayyip Erdoğan.
Turkey is the biggest jailer of journalists in the world. The most recent figures documented by SCF show that 248 journalists and media workers were in jail as of March 9, 2018, most in pretrial detention. Of those in prison 193 were under arrest pending trial while only 55 journalists have been convicted and are serving their time. Detention warrants are outstanding for 139 journalists who are living in exile or remain at large in Turkey.
Detaining tens of thousands of people over alleged links to the Gülen movement, the government also closed down more than 180 media outlets after the controversial coup attempt. (SCF with turkeypurge.com)
[VIDEO] Local TV channel red-tagged after reports on municipal corruption || https://t.co/E7TFcuTPbG pic.twitter.com/KfqDIZyHwo
— Turkey Purge (@TurkeyPurge) March 15, 2018