text:
The quest to dismantle race-based medicine
by Joy Howard
Joy Howard
In July 2012, Audrey* logged into her patient portal following her annual physical, as she had done for years.
A middle-aged white woman in good health, Audrey was pleased by the array of test results confirming her well-being. But then, in small print under one result, she noticed something strange related to an eGFR test: "If patient is black, multiply by 1.21."
Audrey wondered, "What is eGFR? Why would it be different only for Black people? Who decides who's Black?"
*Patient's name has been changed to protect privacy.
Separate and unequal kidney medicine
"Every system is perfectly designed to get the results it gets."
– Paul Batalden, MD, senior fellow, Institute for Healthcare Improvement
The eGFR is a blood test result estimating the glomerular filtration rate (GFR), which shows how well kidneys are filtering our blood. Because kidney function is difficult to evaluate with precision, accuracy, and speed, eGFR is a fast, inexpensive way for doctors to assess the health of these vital organs and determine if additional testing is needed.
The first method for estimating GFR through a blood test was developed in the 1970s but created from a study of 249 white men. In 1999, a new method for estimating GFR was introduced from a study of 1,628 participants, 12% of whom were Black. This method included a race adjustment, partly justified by a theory that Black people have more muscle mass than white people. This new approach to estimating GFR became a widely used standard of care in the U.S, even though it increased Black people's GFR values by 21% (higher values indicate better kidney function).
"It's interesting because these two studies introducing race adjustments in estimates of kidney function [the first in 1999 and a revision in 2009] were considered landmark, gold-standard studies at the time," says Mallika Mendu, MD, MBA, nephrologist and executive medical director of clinical operations at Brigham and Women's Hospital. "Both attempted to be inclusive of patients from different racial backgrounds, which was a huge improvement over prior studies that had been more homogeneous."
Mendu adds, "I was taught the race adjustment in medical school in 2004, and then as a resident, and then as a fellow. And, to be frank, I didn't question it."
But Mendu's perspective changed when she began practicing.
"I thought I needed to be transparent with my patients about the race adjustment," she says. "And when I met with my patients and said it out loud, I found it confusing and hard to explain. So I stopped using it for my patients."
Mallika Mendu, MD, MBA (Photo by Stu Rosner)
Questions can change patient care
"If you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else."
– Toni Morrison, author
A decade after Mendu began medical school, racial justice and health equity movements began to take hold in academic medical centers across the U.S.
Across the country, Black patients are three times more likely to progress from chronic kidney disease to kidney failure.
Mallika Mendu, MD, MBA
In 2016, Cameron Nutt, MD, was in his first year at Harvard Medical School (HMS) when he learned about the race adjustment for eGFR from his professor, Melanie Hoenig, MD, a nephrologist at Beth Israel Deaconess Medical Center (BI). Nutt and other students in the HMS Racial Justice Coalition asked Hoenig why the formula inflates Black people's kidney function when they are at the greatest risk for kidney disease of any racial group.
"Even though racialized eGFR reporting was standard practice in nephrology, Dr. Hoenig never got defensive with students asking questions," says Nutt. "She listened thoughtfully to our concerns. Then she set up meetings for us with other nephrologists at the BI and with pathologists who ran their lab. And after a long process and many conversations led by Dr. Hoenig, the BI changed their policy in March 2017 to stop reporting inflated eGFR values for Black patients."
When Nutt joined the Brigham as an internal medicine resident in 2019, he wanted to learn more about the possible contribution of racialized eGFR reporting to racial disparities in the treatment of chronic kidney disease (CKD). Nutt joined a research team led by Mendu and her colleague, Salman Ahmed, MD, MPH, to analyze the records of more than 56,000 patients with CKD across Partners HealthCare (now Mass General Brigham).
When the researchers removed the race adjustment and reclassified the severity of CKD for the 2,225 who self-identified as Black or African American, 743 people (33%) met the criteria for a more severe stage of CKD. Of those, 64 met the criteria to be referred for kidney transplant—but because their scores had been adjusted for race, none of them had been waitlisted, evaluated, or even referred for a kidney transplant.
KIDNEYS 101
Breaking down kidney function from creatinine levels to glomerular filtration rate.
"Our research countered current practice by putting the facts out there, and this was only for our system," says Mendu. "Across the country, Black patients are three times more likely to progress from chronic kidney disease to kidney failure. And they are less likely to be seen by a nephrologist, receive home dialysis, or receive a transplant, which makes the upward adjustment in kidney function more concerning as it can delay delivery of care. So when you think about this race adjustment happening for two decades in the U.S., the number of people potentially affected is huge. What happens to all these patients and their care?"
Based on the study's preliminary findings, the MGB hospital system eliminated the use of race adjusted eGFR in June 2020. At the time, only a few other health systems in the U.S. had taken this action.
The unscientific use of race in medicine
"The concept of race has no genetic or scientific basis."
– J. Craig Venter, the Human Genome Project, June 2000
More than 20 years after the completion of the first draft of the human genome, race-biased algorithms such as eGFR persist in healthcare across many disciplines.
"We have 10 more race adjustments I'm trying to address across our system," says Tom Sequist, MD, MPH, Brigham internist and chief patient experience and equity officer for Mass General Brigham. "The challenges for dealing with them are all different. But they all face two common barriers: inertia and resistance to change."
Sequist adds that race adjustments stretch beyond the realm of the hospital or the electronic medical record.
"An outside testing lab might have a racial algorithm built in," he says. "Or equipment for a cardiac test may require the clinician enter the patient's race, and the patient might never know."
Another flaw is that many race adjustments classify patients using an inappropriate binary distinction of Black or not Black, as in the eGFR. And none of these calculators account for the multiracial diversity of our population.
"The American College of Cardiology has an online risk estimator for ASCVD [atherosclerotic cardiovascular disease] with required race categories of white, African American, and Other," says Sequist. "But the results for Other are identical to the results for white, so you have an illusion of a nonbinary race choice between Black and not Black. On top of which, what do you enter if a patient self-identifies as both Black and white?"
One of these is not like the others
Age, height, weight, sex, and race are common clinical variables collected by physicians and researchers. They drive everything from prescribing decisions to diagnostic decision trees to treatment plans to research and trial protocols. Yet, among those, race is the only variable with neither a biological component nor universal criteria to describe it.
"We know race isn't biological," Sequist says, shaking his head. "But we've been treating it that way for years! And even more problematic is that we don't have a consistent way for collecting race data. When we see race data in Epic (the Brigham's electronic medical record system), we don't know whether the patient self-identified, if a clinician or registration staff made an assumption, what the choices were when it was entered, or whether the patient even knows what was entered."
How Bias Persists: A Case Study
Racially biased findings have permeated clinical research, even in recent decades.
Another complication with race as a standalone medical demographic is that, unlike ancestry or ethnicity, it is often dependent on geography, history, or who is making the assessment. A person considered white in the Bahamas or Brazil may be considered Black in the U.S. A person who has identified as Black their entire life may, after death, be described as white by a physician or medical examiner filling out a death certificate.
Throughout U.S. history, states had different rules for defining racial groups, and the rules varied depending on the race. Native Americans could be white if they had one white parent. In one state, a person was Black if they had a Black parent. In another state, they were Black if they had a Black grandparent. By the 20th century, Jim Crow laws cemented the infamous "one-drop rule," where anyone with one drop of African ancestry was defined as Black.
"We are the only country in the world that applies the one-drop rule, and the only group that the one-drop rule applies to is people of African descent," says G. Reginald Daniel, professor of sociology at the University of California, Santa Barbara.1
Zara Cooper, MD, MSc (Photo by Stu Rosner)
Health—and healthcare—mirror society
"Race is not a biological category that naturally produces health disparities because of genetic differences. Race is a political category that has staggering biological consequences because of the impact of social inequality on people's health."
– Dorothy Roberts, "Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century," p. 129
For centuries, structural racism in the U.S. has created and perpetuated racial and ethnic disparities in health, housing, employment, access to healthy food, and proximity to environmental hazards (often referred to as social determinants of health). This same racism then blames disadvantaged groups for those disparities, due to imagined genetic, biological, character, or behavioral defects.
Our goal is to infuse equity in everything we do. When we can better understand the experience of our patients and our employees, we can better align our intentions and performance with our values.
Zara Cooper, MD, MSc
"We've had a decade of genome-wide association studies now, we've spent billions and billions of dollars…it looks like 97% of the mortality disparity between blacks and whites in the United States has nothing to do with genes," says McGill University epidemiologist Jay Kaufman in Angela Saini's 2019 book, "Superior: The Return of Race Science."
If racial health disparities are a reflection, even a measure, of structural racism, what is a new way forward?
As widely documented, the COVID-19 pandemic disproportionately devastated minority communities. The Brigham's multifaceted response to the crisis hinged on gathering richer demographic information related to social determinants of health: race, ethnicity, language, sex, insurance status, and geographic location.
In July 2020, a group of Brigham faculty discussed the benefits of expanded demographic data gathering in a Harvard Business Review article, "A Data-Driven Approach to Addressing Racial Disparities in Healthcare Outcomes":
This powerful and underused approach revealed inequities that otherwise would have remained hidden. For example, we found that Hispanic non-English speaking patients were dying at higher rates than Hispanic English-speaking patients. Further risk-adjustment analyses then confirmed the finding and led to quality-improvement efforts to improve patient access to language interpreters.2
Structural racism:
Racial bias across society over time, it's the cumulative and compounded effects of an array of factors such as public policies, institutional practices, cultural representations, and other norms that work in various, often reinforcing, ways to perpetuate racial inequity.
While gathering more expansive demographic data helps reveal disparities across many aspects of healthcare, data is not the only answer, especially when it is easily misinterpreted.
"Interpreting data with a health equity lens is essential," says Zara Cooper, MD, MSc, an acute care surgeon and co-chair of the Brigham Health Board of Trustees Committee for Diversity, Equity, Inclusion and Community Health. "Our goal is to infuse equity in everything we do. When we can better understand the experience of our patients and our employees, we can better align our intentions and performance with our values."
Key to this effort at the Brigham has been looking at health equity as a quality and safety issue, not just in outcomes of care but in access to care itself.
Better data, better care
"If medicine is to fulfill her great task, then she must enter the political and social life. Do we not always find the diseases of the populace traceable to defects in society?"
– Rudolf Virchow, German physician and pathologist, 1848
"Our goal is to think about equity up front, as integral to safety," says Andrew Resnick, former senior vice president and chief quality and safety officer at the Brigham. "And our approach is based on the evidence that when we can make care better for people facing the biggest barriers, we make it better for everyone."
This involves evaluating and considering richer demographic data across the spectrum and reporting it on dashboards in every clinical area.
"In the old days, we avoided demographics," says Resnick. "Now, we know demographics can help us understand how equity contributes to problems. We ask a lot of what-if questions in every case review."
Resnick cites two scenarios to demonstrate how collecting more robust demographic data reveals inequities that might otherwise go undetected.
• Scenario 1: "60-year-old woman has trouble getting her medication at the pharmacy."
• Scenario 2: "60-year-old non-English-speaking woman from the Dominican Republic with low vision has trouble getting her medication at the pharmacy."
"Assessing equity up front for all cases enables us to identify corrective actions that promote equity and safety in everything we do," says Resnick. "We can't correct problems we don't know about. And the bottom line is that we know there is no quality or safety without equity."
From data to empathy
"It is not your duty to finish the work of perfecting the world, but neither are you at liberty to neglect it."
– Rabbi Tarfon, "The Mishnah," first century CE
"COVID-19 shattered the compartments of our lives," says Cooper. "The crisis showed us how much this organization needs data to persuade people to act. We can't turn everyone into an empathy expert, but we can drive home a core value and a recognition that we're all interconnected."
As medicine and science grapple with the long legacy of racism, the challenge of embracing more varied aspects of humanity beyond skin color is akin to the challenges of learning multiple languages.
Bad Ideas from Great Minds
Historically revered thinkers spread false claims that racial differences reflect different biology, genetics, and even character.
"The story is that it's going to take a long time," says Cooper. "Many of us were raised to think that a racist is a person, without recognizing that society is set up to be racist. We each have a personal responsibility for dismantling it. This is a fundamental structural change that should be forcing each one of us to rethink our society, our medicine, and our healthcare."
On September 23, 2021, the National Kidney Foundation and the American Society of Nephrology Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease published "Unifying Approach for GFR Estimation," including three high-priority recommendations to remove race from calculations, adopt other race-free markers such as Cystatin-C, and conduct research interventions "that promote health equity and do not generate disparate care."3
As a member of the task force that included nephrologists, primary care providers, researchers, and most important, patients, Mendu is grateful for the progress. "Getting rid of the race multiplier is not enough, but it's progress," she says. "I hope we can keep cultivating an environment that empowers people who are focused on equity. There's so much more work to be done."
On September 16, 2020, Audrey repeated her annual task of logging into her patient portal to see the test results from her annual physical. The race adjustment for eGFR was gone.
She was relieved. In the years since 2012, she did extensive research and reading to understand more about the history of racism in science and medicine, and what the Brigham is doing to identify and eradicate it. She used what she learned to write this story.
1 Wright L, "One Drop of Blood," The New Yorker. July 24, 1994.
2 Sivashanker K, Duong T, Ford S, Clark C, Eappen S. "A Data-Driven Approach to Addressing Racial Disparities in Health Care Outcomes," Harvard Business Review. July 21, 2020.
3Delgado C, Baweja M, Crews D C, et al. "A Unifying Approach for GFR Estimation: Recommendations of the NKFASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease," American Journal of Kidney Diseases, 2021.
transplant medicinehealth equityhealthcare deliverykidney diseasepatient carechronic disease
Crossing the Digital Divide
Uniting for Justice and Health Equity
Skincare Across the Spectrum
How Bias Persists
Research Spurs Action for Equitable Heart Failure Care
The Quest for Knowledge
Making Connections in the Community


text:
PTI feed
Tailoring systems for Trai's pesky call rules to cost Rs 200-400 cr: COAI
UPDATED: August 3, 2018 15:31 IST
New Delhi, Aug 3 (PTI) Mobile industry body COAI today raised red flag over Trai's new rules on curbing pesky calls and messages saying tailoring of systems, and use of blockchain technology will involve Rs 200-400 crore investment and 18 months for the roll out, at a time when the sector is financially-stressed.
The Cellular Operators' Association of India (COAI) represents the voice of a large telecom operators in the country, all of who would be required to comply with these rules by December.
"As this system has not been implemented elsewhere in the world, it is difficult to quantify the exact investment or the time involved. But roughly, it will be in excess of Rs 200-400 crore investments for tailoring of the system," COAI Director General Rajan S Mathews told reporters.
Even the December timeline is "extremely unfeasible" for customising the system to comply the new rules, Mathews said adding that at least 1-1.5 years would be needed to put the full system architecture in place.
On whether the increased cost of compliance will be passed on by operators to the consumers in form of higher tariffs, Mathews said that generally costs tend to get passed on but in this case it would depend entirely on market dynamics.
Telecom Regulatory Authority of India (Trai) last month came out with stringent unsolicited commercial communication rules under which an individual can revoke permission that they have granted to any commercial entity for a service.
The mandated granularity in customer preferences also permit subscribers to set preference about days and time bands on which they would like to receive commercial communications as well as indicate preferred modes of communication - call or SMS.
The rules lay down obligations for operators including evolving Code of Practices, maintaining records, and registering customers preferences, and mandate the adoption of blockchain or the Distributed Ledger Technology.
Blockchain provides a decentralised database or digital ledger of transactions that everyone on the network can see.
"This is complex, time-consuming and a new territory. No cost-benefit analysis has been done to quantify the material impact that the changes will bring in. No other market has requirements this stringent," he said.
The overhauled rules put the onus of compliance on telecom operators but do not effectively fix the overhanging issue of unregistered telemarketers, Mathews said.
"Access providers are on the hook...but how do we cast a net on the outsiders and unregistered telemarketers," Mathews said, adding that the rules also do not tackle the issue of pesky calls and messages being pushed through the Over-The-Top channels like WhatsApp.
Terming the regulations as "practically unenforcable", COAI has also opposed financial disincentive on the operators for peksy calls made by the users.
COAI said it plans to meet Trai to highlight these outstanding issues.
Mathews said that the industry has had one round of discussions with players like IBM to understand the new system architecture that the regulations mandate.
Under the new norms, Trai has asked telecom operators to allow customers to set their preference using mobile app developed by them or the regulator, by sending SMS to 1909, website etc without paying any money for these services. This facility comes in addition to existing choice of subscribers to partially or fully block telemarketers from calling them.
Trai has raised the penalty cap on telecom operators by 10 folds to Rs 50 lakh in a month from Rs 5 lakh in previous regulations for violations of the norms. PTI MBI SA SA
This is unedited, unformatted feed from the Press Trust of India wire.
Posted byPTI

redpajama_set_name: RedPajamaCommonCrawl


Let's talk about brand specific hashtags. What are they? You probably noticed the # sign aka hashtag on social media used by many brands, celebrities, business owners and regular people.
A brand will use it in daily communication on their social media posts, but have you ever asked yourself how to use it properly? What is a good hashtag? How much is too much?
Hashtag is not just a thing that "looks fancy" but an inevitable "tool" in communication on social media. People use it to attract followers and to make their brand more popular.
#UsersOftenDoNotKnowHowToUseHashtags. (See what I did there?) A hashtag is a powerful tool, but keep in mind that it only has power when used correctly and logically.
What do you think is the right way people search keywords: #TheTV or #TV? Does it make sense to use the hashtag #like4like on Instagram or Pinterest if you sell TVs?
Yes, you will get more brand followers, but does your target group search such words?
For Twitter you already that you are limited to 140 characters. The optimum is to tweet using 1-2 hashtags associated with the topic. Although they might not have great popularity, hashtags are used on Facebook too, but not more than 4.
Do not "use more than 10 hashtags on Instagram and Pinterest. You do not want to be one of those who #UseHastagsOnEverything.
Facebook, Twitter, Instagram, Pinterest, Vine, G +, all of these networks support hashtags. But do not try to play and put hashtags on LinkedIn because this social network does not support that option.
Note that hashtags do not support spaces, so you will need to connect words. For better visibility, it is recommended to write the initial letter of each word capitalized in order to facilitate reading the text, for example, #FridayFun.
Create a hashtag of your brand name and use it on your posts. You can easily see what others write about you just by using the hashtag. Make sure you come up with a unique hashtag that can have more than one word, and use it with your posts.
Encourage your fans and followers to use the hashtag in communication or in reference to your brand. Not only will increase the visibility of your brand, but you can connect with fans and keep track of everything related to it.
Could You be Getting More Traffic From Social Media? Learn to To Use The Power Of Hashtags With 'Hashtag Straffic Secrets' – a FREE DOWNLOAD!
Thanks for visiting our website. I'm glad you found this article helpful. Helping small business owners is our passion. I agree with your thoughts, customer feedback is very important. I took a look at your website and it looks great! If you'd ever like a more in-depth website audit please don't hesitate to reach out to us.


Latitude and longitude coordinates are: 25.161301, 55.408623.
International City, Persia O 01, is one of the modern compounds in Dubai, United Arab Emirates. It is a closed area provided with all necessary European-type services, starting from schools and small markets and ending up with swimming pools and bars. Those who came to UAE and want to carry on their usual lifestyle are invited to stay in this and other kinds of compounds.
The latitude of Persia O02 - Dubai - United Arab Emirates is 25.161301, and the longitude is 55.408623. Persia O02 - Dubai - United Arab Emirates is located at United Arab Emirates country in the Companies place category with the gps coordinates of 25° 9' 40.6836'' N and 55° 24' 31.0428'' E.
Persia O02 - Dubai - United Arab Emirates elevation is 16 meters height, that is equal to 52 feet.
Coordinates of Persia O02 - Dubai - United Arab Emirates is given above in both decimal degrees and DMS (degrees, minutes and seconds) format. The country code given is in the ISO2 format.


Many of us have heard about the wonderful benefits of meditation but aren't sure how to get started. Join our casual group in a friendly and inspiring atmosphere to learn simple techniques to connect with a deeper level of mind.
There is a suggested donation of $10 for Drop-in or $7 for Concession.


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. . . a white knit camisole top, edged in plaid ....optional plaid belt.
. . . Tillie's beautifully colored plaid pleated skirt falls above the knee and features a torn fringed hem with a back snap closures. Tiny sprays of flowers are embroidered here and there amidst the pleats, adding a bit of additional interest.
. . . Tillie's jacket is made of a beautiful high quality100% imported felt in a sunny day yellow. It features a halter neckline and gored construction which gives it a bit of a flare. It is trimmed with white wool felt to provide an accent, and is embellished with sprays of 3 dimensional appliqued flowers, embroidered flowers and a pocket.
The back features yet another appliqued flower and an accent belt. The jacket has a front snap closure, hidden behind tiny beads.


Then for you it works.
And i understand how youd have to change the rest black because thats what id be doing if i had black badges.
Black rings would be too much of a modded look. Looks nice and OEM now.
Lol. Why did you think I would have gotten rid of it??
Just looked at the date you bought it. Honestly thought it was longer!


New Delhi: Former chairman of the All-Parties Hurriyat Conference Mirwaiz Umer Farooq on Sunday met with Foreign Minister Khurshid M. Kasuri to urge the greater involvement of Kashmiris in the ongoing India- Pakistan peace dialogue. Mr Farooq, a moderate Kashmiri leader, told Mr Kasuri that discussion on the Kashmir dispute could only make headway if Kashmiris were involved. 'It is a positive development that Pakistan-India dialogue is going on,' he said. 'But we feel nothing is having an impact on the ground situation on Kashmir.' 'We told him (Mr Kasuri) we feel that the governments of Pakistan and India need to adapt a step-by-step approach in the Kashmir issue,' Mr Farooq said. 'You (Pakistan) and India have been talking since 1947, but all your agreements have failed because the main party has never been taken into confidence,' Mr Farooq told Mr Kasuri during a two-and-a-half hour meeting, he said. Mr Farooq said Mr Kasuri had assured him the 'time has come that the people of Kashmir should be involved.' Indian Foreign Minister Natwar Singh and Kasuri held their first ministerial meeting in three years in New Delhi on Sunday. Mr Farooq also urged the governments of India and Pakistan to allow people living in the divided Kashmir to have a dialogue among themselves about the peace process.


Stephen Lee set up a camera to watch his dogs and might just have captured something altogether different. Take a look and let us know what you think? Of course, the video has been picked up by several mainstream media outlets as well in recent days. Apparently, the room overlooks a back garden and so there are no car lights or anything to cause these anomalies and, just to make things creepier, his home was once used as a hospital!
I had travelled to the United States to meet with some members of my family who had lived there for many years. It so happened that as part of my first stop I ended up staying at a relative's house, which unknown to me at the time, was believed to be haunted, at least by some members of the household. Among other things, they would see things like fresh meat falling out of clothes in an unexplained manner as well as blood stains appearing in various places of the house, in an equally unexplained manner. They lived on the fifth floor, where it would make it very unlikely for any animal to climb up from the outside. Now this is a detail that will be important in the coming paragraphs.


Spawn in mesa with a large Bryce canyon around part of its edge. Mesa is close to extreme hills, forest, and swamp biomes. Very pretty mesa colors.
Largest part of the Bryce canyon, next to extreme hills and swamp.


text:
Erik Gustaf Holger Almqvist, född 30 juni 1907 i Gällersta, Närke, död 1978, var en svensk konstnär.

Han var son till smidesmästaren Axel Almqvist och Alma Pettersson och från 1936 gift med  Anna-Margareta Palmer.

Almqvist studerade vid Harald Erikssons målarskola i Örebro, Konstakademin i Stockholm 1933-1936 och under studieresor till Frankrike och Spanien. Han har haft separatutställningar i Stockholm och ett flertal gånger i Örebro samt medverkat i samlingsutställningarna Unga tecknare på Nationalmuseum, Vårsalongen på Liljevalchs konsthall och i Örebro, Malmö och Karlskoga.

Han tilldelades Ester Lindahls stipendiet 1936.

Almqvist konst består av modellstudier, porträtt, stilleben och landskapsmotiv från Närke, Skåne, Stockholm, Paris och Mallorca i olja eller tempera.

Almqvist är representerad vid Örebro läns museum, Örebro läns landsting och Moderna museet.

Tryckta källor
Svenskt konstnärslexikon del I sid 52 Allhems Förlag, Malmö
Svenska konstnärer, Biografiskt handbok, Väbo förlag, 1987, sid 20,
Vem är Vem?, Stor-Stockholm, 1962, sid 34

Noter

Svenska målare under 1900-talet
Födda 1907
Avlidna 1978
Män
Personer från Gällersta socken
Representerade vid Moderna museet

redpajama_set_name: RedPajamaWikipedia


text:
Q: How to use Vue directive in external file and import into components? I'm using Vuelidate in a project and when the user types something I set a timeout to wait for validation.  I tried to use mixins and it was successful, but for good habits I need to create a Vue directive without registering it globally, and use that in some components.
I created an external file directives/delayTouch.js (I tried to export only const with export const but Vue forces me to use export default)
const delayTouch = {
  inserted ($v) {
    const touchMap = new WeakMap()

    $v.$reset()
    if (touchMap.has($v)) {
      clearTimeout(touchMap.get($v))
    }

    touchMap.set($v, setTimeout($v.$touch, 1000))
  }
}

export default delayTouch

And I imported into my component:
<template>
  <TextField
    v-delay-touch="$v.data.name"
    :v="$v.data.name"
    v-model.trim="$v.data.name.$model"
    id="name"
    label="Nome da campanha"
  />
</template>
<script>
import delayTouch from '@/directives/delayTouch'

export default {
  directives: { delayTouch }
}
</script>

In param ($v) I receive the HTML correctly but I'm still receiving the error $v.reset is not a function. Why?

A: Directive hooks receive 4 arguments:

*

*el, binding, vnode, and oldVnode
So the first argument to the inserted hook is the HTML element, not the $v object.  To bring a component property into the directive, use the directive's vnode argument, getting the component's context through it:
inserted(el, binding, vnode) {
  const $v = vnode.context.$v;
  ...
}

Wherever you want to access the element in the directive, use el.

redpajama_set_name: RedPajamaStackExchange


text:
Dr. Russell D. Moore (photo via Wikimedia Commons, CC BY-SA 3.0)
Russell Moore to GOP: God Talk Is No Longer Enough
The threats to Christian freedom and inclusion in this country are multiplying but the GOP has yet to rise to the defense, preferring to flee anything that offends the Human Rights Campaign's powerful network. Russell Moore, president of the Southern Baptists' Ethics and Religious Liberty Commission, lays down a new call to action:
"In recent years candidates have assumed that they can win over evangelicals by learning Christian slogans, by masking political rallies as prayer meetings, and by basically producing a long-form new birth certificate to prove they've been born again. This sort of identity politics is a luxury of a past era when evangelicals were part of a silent majority in the U.S., with our First Amendment freedoms assumed and guaranteed. That is not the present situation. . .
In 2016, it doesn't matter whether a candidate knows the words to hymns. What will matter to evangelicals is how the candidate, if elected president, will articulate and defend religious-liberty rights. This is about more than whether the candidate will repeat clichés about appointing Supreme Court justices who will "interpret the law, not make the law." We want to know how this potential president will rein in an administrative apparatus that has plunged the country into ongoing culture wars over, for instance, compelling virgin nuns to pay for birth control.
This also will mean a vision of religious liberty that is about more than pandering to an interest group. Some of today's most pressing religious-liberty questions concern groups who, unlike evangelicals, have no large voting blocs. That is why evangelicals care about whether Muslim prisoners are forced to shave their beards without a compelling government interest, at issue in a Supreme Court decision last month that a man jailed in Arkansas could not be forced to shave."
Giving Thanks for Religious Liberty — America's First Freedom
Trump Admin Supports Catholic School in Indiana Religious Freedom Case
At UN, Trump Ignores Climate Panic, Promotes Religious Freedom


TBI added five new vendors to its provider portfolio during the third quarter, including Equinix, Nextiva, Office Depot, Sierra Wireless and Towerstream.
The addition of these vendors not only presents partners with a new set of products and services, but also offers additional resources for end-user engagement, according to TBI. Its solution engineers also are accessible to help all selling partners position, design and implement the new portfolio additions.
Equinix is the world's largest retail colocation provider, and offers data-center services such as colocation; hybrid, private and multicloud solutions; cross-connects and an exchange fabric between Equinix data-center assets.
Nextiva's portfolio includes UCaaS (including interactive voice response and application integration), Nextiva Clarity, Nextivia Drive, and CCaaS.
Office Depot's ITaaS managed service is focused toward small businesses across many verticals. Some of the services include proactive monitoring, antivirus updates, Microsoft Windows patch management, 24/7 tech support, email protection, server/server OS monitoring, and user identify and access management.
Sierra Wireless' cellular cradlepoint services allow end-users to diversify their networks and allow for dual SIM cards, which enables redundancy in their cradlepoint to failover.
Spanning 12 major U.S. markets, Towerstream's fixed wireless internet network is 800 feet above the city. Terrestrial diversity allows Towerstream to provide independent and redundant Internet connections.
TBI maintains a portfolio of voice, internet, data, mobility, cloud and managed services accompanied by back-office sales and support resources designed to allow reseller partners to conduct more effective sales and customer engagement.


There was a comment on the previous mention of Melaleuca nesophila which sent me to the books again and Australian Plant Society informatiom.
This very hardy plant reads almost like the perfect plant to grow. Apart from not liking severe frost, it will grow practically anywhere. The information says that it will tolerate salt spray, acid to very alkaline soil and lime. Many Melaleucas will grow in quite damp soils and this is one of them, as well as growing in very dry conditions. It also takes hard cutting and trimming which makes it ideal for wind breaks and hedges. Apart from that it is also a very pretty plant.
Melaleuca nesophila is a large shrub from Western Australia which I have seen trimmed to be tree-like. The lower branches can be removed to leave a trunk. The plant can grow to 4 metres tall by 4 metres wide. Mauve flowers are in large clusters and appear in late spring through the summer.
This plant is spectacular when in flower and a very attractive plant all year round. It is very hardy in most soils and aspects. It is frost hardy to about -7C. There must have been a severe frost in my daughter's neighbourhood last winter as all the Melaleuca nesophila bushes in the neighbours' yards were burnt. It is a fast growing screen or feature plant.
I arrived home today from a few weeks enforced convalescence at daughter's home in the mid north of the state. On many of my gentle walks with her dog I was able to observe the frost damaged plants in the district.
I thought one could not kill old fashioned marguerite daisies, or geraniums, but both have been severely burnt in daughter's yard. Both plants have sap in the stems we discovered when tidying some plants so we are hopeful that there will be regrowth. Left the geranium untouched until the frosts have finished as some new growth appeared at the base of the plant and the burnt bits appear to be giving some protection.
I hate to think what the situation is further north where the temperatures dropped even lower.
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Many of us can barely make it through the morning without first downing a cup of hot coffee. It's become such a big part of our daily rituals that few actually give much thought to what it is that we're putting in our bodies.
To help us break down the little-known things about caffeine, NPR's David Greene spoke with Murray Carpenter, author of Caffeinated: How Our Daily Habit Helps, Hurts and Hooks Us. These are the things you probably aren't thinking about as you wait in line at your local coffee shop.
Caffeine is a drug. Treat it as such.
In its essential form, caffeine is a bitter white powder derived from a natural insecticide found in some plants. Over the years, it became acknowledged as a drug after people independently discovered its stimulating effect.
But, Carpenter says, people often underestimate just how powerful that drug is. "A tablespoon — about 10 grams — will kill you," he says, recounting the unfortunate story of a college student who went into a seizure and died after chasing down spoonfuls of caffeine with an energy drink.
Most of the caffeine in soft drinks comes from factories in China.
And our favorite caffeinated beverage? Not coffee, but soft drinks.
"Despite the Starbucks on every corner [and] this sort of conspicuous coffee culture that we have today, we're not drinking as much coffee as our grandparents did," Carpenter says.
As coffee consumption has declined, our love of soft drinks has taken over. Today, eight of the 10 top-selling soft drinks are caffeinated. "If you look at, say, Coke, Diet Coke, Pepsi, Mountain Dew, Dr. Pepper, the only common denominator, besides carbonated water, is caffeine," he says.
Sometimes, he says, caffeine can lurk in unexpected places — like orange soda.
Which brings us to the case of the supercharged Sunkist soda.
In 2010, a batch of Sunkist orange soda was bottled with a botched caffeine content. "These were sodas that should've had 41 milligrams of caffeine per 12-ounce serving, but they were blended with six times the labeled amount of caffeine," Carpenter says. "So [there were actually] 240 milligrams per bottle." That's as much as three Red Bulls or 16 ounces of strong coffee, Carpenter notes in the book.
After Sunkist started getting complaints from consumers, it finally agreed with the Food and Drug Administration to voluntarily recall the 40,000 cases of supercaffeinated orange soda it had sent out.
"But my impression is that a lot of the people who consumed this and had some funny experiences with caffeine probably didn't know what was going on," he adds.
So what's the takeaway? Drink in moderation.
Carpenter says three to four cups of coffee a day isn't dangerous over the long term. That's in line with what we've previously reported. Of course, if you're experiencing symptoms like jitters or sleeplessness related to too much caffeine, cut back.
42-year-old Ibrahim Yucel has smoked for more than two-and-a-half decades, but he's trying to give up the habit for his family's sake. It hasn't proven an easy task, though, so Yucel has developed a rather extreme way to help him kick the habit — every day, he dons a wire helmet that makes it impossible for him to smoke a cigarette. The Saw-style head cage doesn't prevent Yucel from wanting a cigarette at work, but since the Turkish father of three leaves the keys to the locked helmet with his wife and kids every day, it does prevent him from following through on the craving.
Think of drug lords in America, and it's likely that you'll think of emotionally erratic men with harems of coked-up megababes on big yachts in Miami. Or, if you watch a lot of DVD box sets, terminally ill chemistry teachers or Idris Elba. One cliche that probably won't spring to mind is a polite, educated ex-stockbroker from the UK's industrial Cheshire.
Shaun "English Shaun" Attwood is an incredibly unlikely ecstasy kingpin. Growing up in Widnes, just outside of Liverpool, Shaun invested in the US stock market when he was young, made his millions, moved to Phoenix, Arizona, started throwing raves, and became a major drug supplier. While he wasn't planning parties in the deserts of Arizona, he was working in direct competition with the Italian Mafia and alongside the New Mexican Mafia to supply millions of dollars' worth of ecstasy to the ravers of mid-90s Phoenix.
His motivation for doing all this, besides the fact that partying for a living is a lot more fun than selling shares? He wanted to introduce Americans to the British rave culture he'd grown up with. Unfortunately, as is often the way when you're handling millions of dollars of narcotics, Shaun was caught and ended up being sent to Maricopa County Jail, widely regarded as America's toughest prison. Shaun's been out of jail for a few years, so I called him to see if he's still so keen to spread the love to the Yanks.
VICE: So you went from being a millionaire stockbroker to becoming a major drug dealer in Arizona. How did that happen?
Shaun Attwood: The Manchester rave scene made such a big impression on me that I decided to transfer that scene to Phoenix, Arizona, after moving over there. After becoming a millionaire as a young person, I had more money than common sense, so I didn't see the law as an obstacle to my partying or a barrier to bringing tens of thousands of hits of ecstasy into America from Holland.
That was for the Mafia, right? Yeah, I was supplying ecstasy to the New Mexican Mafia. In the beginning, I didn't know who they were, but it came about because I was a friend of a gang member's brother. Years later, they were all arrested and the news headlines reported that they were the most powerful and violent Mafia in Arizona at that time, committing murder-for-hire and executing witnesses.
And you were in direct competition with the Italian Mafia member Sammy "The Bull" Gravano—what's the story with that? Yeah. Years later in prison, his son, Gerard Gravano, told me that he'd been dispatched as the head of an armed crew to kidnap me from a nightclub and take me out to the desert. I'd avoided him that night because my best friend, Wild Man, had got in a fight, and we'd had to leave the club in a hurry.
Talking of clubs, how did the rave scene in America compare with the raves in England at the time? Oh, it was small at first. It took years to catch up. Ecstasy was very expensive—it was $30 a hit in the mid-90s.
Where did you put on your parties? The first one was in a warehouse in west Phoenix owned by the Mexican Mafia, but they were at various different locations after that.
Did selling drugs come after you started putting on raves? It seems like throwing raves is the perfect way of creating a solid customer base. Well, I was selling ecstasy before I started the raves, but they obviously provided more of a market.
How did you find it going from a high-pressure, high-income job to dealing and partying all the time? I enjoyed it at first. There was one rave where I booked Chris Liberator and Dave the Drummer. I remember hearing Chris Liberator's beats and being mesmerized by the sight of thousands of people dancing to English DJs with the same blissful expressions that I had on my face when I first got into raving. I thought, This is it, I've realized my dream. But I started taking too many drugs and got incredibly paranoid because of all the risks I was taking.
That sounds like a familiar story. Did the police get on to you? It was inevitable. Dealing drugs leads to police trouble, prison, or death. I sowed the seeds of my downfall and take full responsibility for landing myself behind bars. Informant statements led to a wiretap, and 10,000 calls were recorded. I rarely spoke on the phone, but they caught me talking about personal use and many of my employees were referencing my name on the phone, which resulted in a conspiracy charge.
What did you make of the media dubbing your organization the "Evil Empire" when you were caught? Did you think it was a bit over the top? My heart went "badum, badum, badum" when I saw the cover of the Phoenix New Times with a portrait of me as Nosferatu on it, which was where they called it the "Evil Empire." And the cover also had four of my co-defendants, including Wild Man and my head of security, Cody, in the foreground, with my arms encircling them like some evil puppeteer. I couldn't believe it.
Was this when you were locked up already? It was before I'd been sentenced, and I was worried that there was going to be something in there that might damage my case. I read in there that the prosecutor had classified me as a serious drug offender likely to receive a life sentence, and I went into shock. I'd thought I was getting out, but I was now facing 25 years. If I'd got a life sentence I would have been 58 when I got out, basically at retirement age. But yeah, when I read the article, I felt like some arch-villain from the Marvel comics I collected as a child.
What was your time inside like? Early on, I was with lots of people who were arrested with me, including my large and fearless best friend and raving partner from my hometown of Widnes, Wild Man, who the gangs respected for his fighting skills. He looked out for me. I was split up from my co-defendants after the first year, so then I had to rely on my people skills, Englishness, education, etc., etc.
You wrote blogs inside as well, right? Yeah, that enabled me to make some powerful alliances with characters like T-Bone and Two Tonys, who was a Mafia mass murderer and was serving multiple life sentences. T-Bone was a deeply spiritual, massively built African American who towered over most inmates. He was a prison gladiator and covered in stab wounds. He was a good man to have on your side.
You've told me before about the trouble you had with the Aryan Brotherhood as well. Yeah, all the way through my incarceration, I was trying to dodge Aryan Brotherhood predators. They run the white race in the prison system. You have to do what they say or else you get smashed or murdered.
So I take it racism featured quite heavily in the prison that you were in? Yeah, it was completely racially segregated. The way it works there is that, as soon as you walk in, a soldier from your racial gang tells you the rules that are enforced by the head of each race. Disobedience means that you get smashed, shanked or murdered. The rules include stuff like not being able to sit with the other races at the dinner tables or exercise with the other races. But when it comes to drugs, the gangs all deal with each other regardless of race.
I bet there were some pretty nice characters in that environment. God, it was full of scary people. In super maximum security, I lived next door to a serial killer and my first cell mate was a satanic priest with a pentagram tattooed on his head. He was in for murder and was part of a cult that was drinking blood and eating human body parts. Fortunately, he was quite nice to me.
That's good. So what are you doing with your life now? Are you a reformed character? Yeah, and I credit incarceration with sending my life in a whole new positive direction. I tell my story to schools across the UK and Europe to educate young people about the consequences of choosing the drugs lifestyle in the hope that they don't make the same mistakes I did. The endless feedback that I get from students makes me feel that the talks are a better way of repaying my debt to society than the sentence I served.
Shaun has written two memoirs, Hard Time and Party Time.
Thanks to SRW for bringing this to the attention of the It's Interesting community.
What's more, people who used diet mixers scored more poorly on a test of reaction time that people who used regular mixers, although both groups reported feeling similar levels of intoxication.
People "think they're saving some calories by drinking their alcohol with a diet drink, [but] it's much more harmful to the body to have a high blood alcohol concentration," Marczinski said.
During the study, the 16 participants came into the laboratory three times, and received either vodka mixed with Squirt, vodka mixed with diet Squirt, or a placebo (Squirt containing a very small dose of alcohol to mimic the appearance and smell of an alcoholic beverage.) Besides the placebo, each drink contained equal amounts of alcohol and mixer. The dose of alcohol in each individual drink was based on the participant's body weight.
Regular mixers may slow down the time it takes a person to become intoxicated from drinking, the researchers said. Alcohol is absorbed by the body when it reaches the small intestine. But the stomach may treat the sugar in regular mixers as if it were food. As a result, the alcohol doesn't reach the small intestine as quickly, Marczinski said. The artificial sweeteners in diet soda, on the other hand, may not delay stomach emptying, so the alcohol travels straight through to the small intestine, Marczinski added. An earlier study found that men who drank vodka mixed with a diet beverage had higher blood alcohol levels than men who drank vodka mixed with a regular beverage. Using an ultrasound, the researchers showed that the regular drink delayed stomach emptying, but the diet drink did not.
The new finding "helps people to make an informed decision" about the mixer they chose for their alcohol, said Emma Childs, an assistant professor in the University of Chicago's Department of Psychiatry, who has researched the effects of alcohol on physiology and behavior, and was not involved in the study.
Cigarettes leave you with more than a smoky scent on your clothes and fingernails. A new study has found strong evidence that tobacco use can chemically modify and affect the activity of genes known to increase the risk of developing cancer. The finding may give researchers a new tool to assess cancer risk among people who smoke.
DNA isn't destiny. Chemical compounds that affect the functioning of genes can bind to our genetic material, turning certain genes on or off. These so-called epigenetic modifications can influence a variety of traits, such as obesity and sexual preference. Scientists have even identified specific epigenetic patterns on the genes of people who smoke. None of the modified genes has a direct link to cancer, however, making it unclear whether these chemical alterations increase the risk of developing the disease.
In the new study, published in Human Molecular Genetics, researchers analyzed epigenetic signatures in blood cells from 374 individuals enrolled in the European Prospective Investigation into Cancer and Nutrition. EPIC, as it's known, is a massive study aimed at linking diet, lifestyle, and environmental factors to the incidence of cancer and other chronic diseases. Half of the group consisted of people who went on to develop colon or breast cancer 5 to 7 years after first joining the study, whereas the other half remained healthy.
The team, led by James Flanagan, a human geneticist at Imperial College London, discovered a distinct "epigenetic footprint" in study subjects who were smokers. Compared with people who had never smoked, these individuals had fewer chemical tags known as methyl groups—a common type of epigenetic change—on 20 different regions of their DNA. When the researchers extended the analysis to a separate group of patients and mice that had been exposed to tobacco smoke, they narrowed down the epigenetic modifications to several sites located in four genes that have been weakly linked to cancer before. All of these changes should increase the activity of these genes, Flanagan says. It's unclear why increasing the activity of the genes would cause cancer, he says, but individuals who don't have cancer tend not to have these modifications.
The study is the first to establish a close link between epigenetic modifications on a cancer gene and the risk of developing the disease, says Robert Philibert, a behavioral geneticist at the University of Iowa in Iowa City. "To the best of my knowledge, no previous genome-wide epigenetics study has taken such efforts from initial discovery to replication to experimental validation," adds Lutz Breitling, an epidemiologist at the German Cancer Research Center in Heidelberg, Germany.
The work may lead to new ways to asses cancer risks from smoking. "Previous research into smoking has often asked people to fill out questionnaires, … which have their obvious drawbacks and inaccuracies," Flanagan says. The new study, he says, may make it possible for doctors to quantify a person's cancer risk simply through an epigenetic analysis of their DNA.


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A Diocese of the Orthodox Church in America
From the Archbishop
Diocesan Council
Diocesan Seminarians
Personal Assistance Program
Parish Development
ST PAUL DAYTON CELEBRATES TWENTY-FIVE YEARS OF WITNESS
DAYTON, OH [MW Communications] – On May 23, the Feast of Pentecost, St. Paul the Apostle Orthodox Church celebrated 25 years as a parish community with prayer, food, music, dancing, and fellowship.
A quarter-century ago, a small group of Orthodox Christians began meeting for prayer at Wright-Patterson Air Force Base, and then in private homes, community centers, and similar available venues, until it found a permanent home on Wagner Road in Sugarcreek Township in 2000. Granted mission status by the late Bishop Boris of Chicago and the Midwest, and parish status by the late Archbishop Job of Chicago and the Midwest, the community now ministers to almost 200 people in the greater Dayton region.
"Twenty five years ago when we were discussing how to begin a new Church, we didn't know what should come first: a building or a priest," remarked Steve Brown, a founding member of the parish. "Twenty five years later we know the answer: it's the people-they come first; who when led by a wonderful priest, create a beautiful building. May this Church be a blessing to those who now follow us."
That "wonderful priest" is the Very Rev. Archpriest Ted Bobosh, who was the first permanent priest assigned to the parish, and has been there ever since. Unfortunately, Fr. Ted fell ill during the celebrations, and underwent a successful emergency appendectomy that evening. Fr. Ted is now resting comfortably at home.
In conjunction with the 25th anniversary festivities, the parish has embarked on an extensive iconography project, commissioning renowned iconographer Dmitry Shkolnik to create a series of 20 large icons celebrating the Kenosis of Christ and the life and influence of Saint Paul. An open house to share the new icons with the Dayton community, as well as an exhibition of 350 years of Orthodox iconography from local private collections entitled Transfigured Life and Lives, is planned for the public in late August.
May God grant the community of St. Paul's many years!
Chancery Blessed at Administration Meeting
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PRADO 12 CHARACTERS. Exhibition from the PRADO Museum (2017)
From 25th March until 16th July 2017, the "PRADO 12 Characters" Exhibition – twelve masterpieces by world famous artists, which have brought joy to millions of viewers over the centuries at Spain's largest museum, the PRADO, were on view for the first time in the Baltic region at Art Museum RIGA BOURSE. It became the most visited exhibition in a history of RIGA BOURSE and the most visited exhibition in Latvia in 2017.
The people of Rīga and visitors to the city had the opportunity to see portraits of females created by Paolo Veronese (1528-1588), Anthony van Dyck (1599–1641), Peter Paul Rubens (1577-1640), Bartolomé Esteban Murillo (1617-1682), Francisco de Goya (1746–1828) and other artists.
The exhibition from the PRADO collection was the special gift for Latvia's centenary from philanthropists Boris and Ināra Teterev. The patroness for the exhibition - the former President of Latvia and President of the Club de Madrid, Vaira Vīķe- Freiberga.
Frans Pourbus the younger (1569–1622). Isabelle of France. The Queen of Spain (1615). From the collection of PRADO.
The "PRADO 12 Characters" Exhibition of masterpieces from the 16th to 19th centuries revealed the history and the character of the collection in a concentrated form, where Spanish art undoubtedly dominated with its expressive colour and forms, enriched by the presence of the French, Italian, and Flemish cultural space. At the same time these twelve characters were revealed in a very feminine form, as the exhibition is made up of twelve portraits of females or genre paintings with a religious and allegorical character. The portraits revealed the broad opportunities for the theme's interpretation, the social position of the portrayed person, or show the female as a symbol of power, elegance, beauty, motherliness, piety or frivolity. These contrasts and similarities weaved through the centuries, each coming with a different ideal of beauty or fashion and an understanding of attitudes to the enjoyment of life as opposed to morality. At the same time, the opportunity was available in the "PRADO 12 Characters" Exhibition, to see the diversity of the styles of art in the collection, starting from high renaissance, colourfully revealing the Spanish and Flemish baroque period and rococo, and then moving on right up to examples of 19th century realism.
VIDEO: Exhibition "PRADO 12 Characters"
The "PRADO 12 Characters" became the most extensive joint project between the Boris and Ināra Teterev Foundation and the Art Museum RIGA BOURSE, which continued their fruitful collaboration in the creation of "Riga's Gondola" (2012), the "Magnetism of Provence" Exhibition dedicated to French culture (2015) and events in various forms within Boris and Ināra Teterev's TÊTE-À-TÊTE Art Programme.
Spain's largest museum, the PRADO, which celebrates its Bicentenary in 2019, is one of Europe's richest and most famous repositories of art, which was developed on the basis of the Royal Household Collection. Initially, the PRADO was created as a national art museum on the initiative of King Ferdinand VII, but over time, some outstanding works from other Western European schools were added to this collection of Spanish art.
Exhibition "PRADO 12 Characters". 24.03.2017.


As Delhi chief minister Arvind Kejriwal walked along the urbanised banks of the Cheonggyecheon in Seoul on Wednesday, a string of thoughts must have been triggered by the sight of a once-dirty drain now revived and converted into a crystal-clear stream running through the heart of the South Korean capital. He may have unconsciously drawn a parallel with his own city's Barapullah drain.
NEW DELHI: As Delhi chief minister Arvind Kejriwal walked along the urbanised banks of the Cheonggyecheon in Seoul on Wednesday, a string of thoughts must have been triggered by the sight of a once-dirty drain now revived and converted into a crystal-clear stream running through the heart of the South Korean capital. He may have unconsciously drawn a parallel with his own city's Barapullah drain.
Cheonggyecheon, a rivulet reduced to a sewage drain in the 1940s, was an urban eyesore and the local government took the ostrich-like measure of hiding it beneath concrete slabs. Three decades later, an elevated 12-lane highway was built atop it to further obscure it from public view. Delhi's Barapullah drain has undergone much the same treatment, with the odiousness of the sewage-strewn water reduced by the construction of the Barapullah elevated road over it.
However, Kejriwal, who is in South Korea on his first official bilateral trip as CM, must have pondered at how Cheonggyecheon actually showcases how a fetid channel can be transformed into a beautiful recreational space with simple interventions. Between 2002 and 2005, the government dismantled the elevated highway and developed landscaped banks on either side of Cheonggyecheon, and supplemented the river's intermittent flow with treated water from the Han river.
Pathways were then erected parallel to the 11-km river with seating at intervals to encourage the public to use the space. There are recreation areas along the banks, and signage and maps embedded into the embankment walls provide information about the different 'theme' zones there. The final is a 'natural' zone, designed to let nature take its own course.
Experts who studied the Seoul urban revival project say it has had a considerable impact on the area, including a reduction in the urban heat island effect, air pollution levels and an improvement in quality of life nearby.
Delhi government could similarly utilise the drain space below the Barapullah elevated road for an active public space. However, Manoj Mishra, convener of Yamuna Jiye Abhiyan, feels the Najafgarh drain is more appropriate if Delhi were to emulate such an achievement.
If Kejriwal is inspired, then it would be a welcome fallout of Delhi's twin city agreement signed with Seoul in November 2017 to provide cooperation in areas like waste water, environment and public health.


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Reading: Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video ...
Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room
Michel Lavaerts ,
UZLeuven, BE
Hilde Vandenhout,
Raymond Oyen,
Chantal Van Ongeval
OBJECTIVES: Patients often confuse the role of the radiologist with that of the technician. The aim of this study is to explore patients' current perceptions about the radiology department and to evaluate how it's possible to get rid of misconceptions using informative animated video in the waiting room.
MATERIALS AND METHODS: In this multi-centric study (UZ Leuven, ZNA Middelheim), 278 patients of all ages and education levels were surveyed in the radiology waiting room. 107 patients filled out the survey after watching an informative animated video (www.makeradiologyvisible.com). The remaining patients did not watch the video.
RESULTS: Half of the patients (86/171) in the non-video group believe the radiologist "performs the scanning", compared to 19% (20/107) in the video group (p < 0.001). Patients who think their own physician will interpret the images is 36% (61/171) in the non-video group and 10% (11/107) in the video group (p < 0.001). In the non-video group, 32% (55/171) believe the technician performs the exam compared to 59% (63/107) in the video group (p < 0.001). After the video, 67% (72/107) of patients have more respect for the work of the radiologist, 52% (56/107) experience less anxiety and 65% (70/107) think the video is of added value to their visit. All items showed a better impact in high-educational subgroups.
CONCLUSION: Animated informative videos help to increase patient knowledge about the radiology department. It moderates expectations, reduces anxiety, and ameliorates the overall experience. Although, the learning curve is steeper in highly educated patients, all educational levels benefit.
Keywords: Radiology, Learning-curve, Animated Video, Waiting Room, Misconception, Education
How to Cite: Lavaerts M, Vandenhout H, Oyen R, Van Ongeval C. Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room. Journal of the Belgian Society of Radiology. 2021;105(1):41. DOI: http://doi.org/10.5334/jbsr.2405
Accepted on 12 Jul 2021 Submitted on 21 Dec 2020
Throughout history, the diagnostic radiologist has developed an increasing distance from the patient [1]. Because of modern imaging techniques and higher workloads, radiologists today seldom get to meet their patients. Besides, there are numerous popular medical TV shows in which a radiologist rarely is involved, which does not improve the overall perception of their role [2]. In 2012, a study in the British Journal of Radiology reported that 76% of patients surveyed in a breast radiology waiting room think the radiologist "takes the x-rays", 86% say radiologists are "not doctors" and 40% believe radiologists "play no role in patient care" [3]. A study by Grant et al. found that up to 38% of patients do not consider radiologists as part of the medical team [4]. Hence, there is a significant lack of awareness amongst patients regarding the role and responsibilities of the modern diagnostic radiologist.
One can expect that patients will better comply to medical advice if the medical qualifications of the radiologist are well understood. Likewise, patient care (or the perception of care) could be impacted because the radiologist's medical qualifications are misunderstood [5]. Besides, the public's perception of physicians in general (at least in the industrial world) has changed from profound respect, towards physicians being seen more as business minded. Newspaper publications of average incomes for specialists do not soften that image [6]. It is thus imperative for radiologists to educate the public and increase awareness of the radiology profession so that future changes in the health service will reflect the scope and importance of radiology.
We hypothesized that an informational animated video could help educate patients in the radiology waiting room about the specific role of the radiologist in their care. We created a two-minute animated video in which we walk the patient through the radiology process. In this study, we investigated the impact of such a video on patient knowledge about the job of radiologist/technician. We examined whether the learning curve depended on patient educational levels.
A total of 278 patients (122 men, 156 women) were surveyed in our study conducted in two different hospitals in Belgium (UZ Leuven, ZNA Middelheim). Every patient who presented to the Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and X-ray waiting rooms, willing and able to fill out the survey was included. The inclusion criterion was an average knowledge of the Dutch language in order to understand all questions. The survey was filled out on portable tablets to reach every age group. In our experience, all ages feel more comfortable with this technology compared to computers (Figure 1). The survey was not conducted in ultrasound waiting rooms as these exams are performed by the radiologist in Belgium. The goal of the study is to teach patients a basic understanding of who performs medical exams (the technician) and who interprets the images (the radiologist).
Survey was taken on tablets in the waiting room. Snapshot of the informative animated video that was playing in the radiology waiting rooms.
First, patients were surveyed without a video playing. On a different day, a non-intrusive, muted, animated, informative video was shown on a wall-mounted TV in loop, in the radiology waiting room. In the video, are explained the consecutive steps patients go through when having an imaging exam. We explain that the patient will be called out by a technician to the exam room. Afterwards, technicians will position and guide the patient during the exam and produce all the images in close contact with the supervising radiologist. Patients are told they would ask the technician to meet the supervising radiologist if necessary since, they will not likely need to meet him otherwise. After the exam, all data are sent to the diagnostic radiologist who will interpret the images, make a diagnosis, and issue a report. The video explains that a radiologist is a certified medical doctor with an additional five-year specialization in medical imaging interpretation after the master's degree in medicine. Lastly, a short fragment of the video teaches patients about the work behind the scenes as the diagnostic radiologist interacts with other medical specialists that are also interventional radiologists. (See the video here or on www.makeradiologyvisible.com.)
Every patient was asked at the beginning of the survey "did you see the video play?", which allows us to divide those surveyed in two groups: A baseline "non-video group" which totalled 171 patients (61.5%) and a "video group" of 107 patients (38.5%). Why some patients did not see the video when it was playing was beyond the scope and the intent of this study. Plausible reasons are smartphone usage and short radiology waiting times. Nobody was actively asked to look at the video. The video group was additionally questioned on their appreciation of the video and what influence it had on their visit.
The data collection was anonymous and only non-specific demographic data were obtained (sex, age-group, highest educational level, nationality). Multiple-choice questionnaire in the survey included the following:
– Did you see the animated video play?
– Who performs the exam?
– What is the qualification of the radiologist?
– What are the core tasks of the radiologist?
– How long (after high school) does it take to become a radiologist?
– What education does a radiologist have?
– What is the role of the radiologist in your care?
– Do you expect to meet the radiologist?
Patients who watched the video received those additional questions:
– Were you more at ease prior to the exam, because of the video?
– Was the video of added value for your visit?
– Do you feel more respect for the job of the radiologist after watching the video?
Ethical evaluation and approval were obtained from the OBC of the Catholic University of Leuven, Belgium (File number: MP015121). To measure the changes in patient understanding about the role of the diagnostic radiologist, results were computed and analysed using Qualtrics. Proportions are given in percentages and compared using chi-squared tests.
In the non-video group, 43% (73/171) of patients select "taking X-rays" and 50% (86/171) select "performing scans" as core tasks for the radiologist. In the video group, that number lowers respectively to 14% (15/107) and 19% (20/107) (all p-values < 0.05). Only half of the patients (50%, 86/171) in the non-video group know that radiologists have a "full medical degree", whereas the video group patients realise radiologists are doctors in a higher frequency (72%, 77/107, p < 0.001).
Further, in the non-video group, 66% (113/171) patients know that part of the radiologist's job is to interpret the images and report the findings, whereas in the video group that number rises up to 94% (101/107, p < 0.001). Only 32% (55/171) know that the exam will be conducted by technicians, and in the video group this number almost doubles to 59% (63/107, p < 0.001). 36% (61/171) of patients in the non-video group believe the referring physician does the imaging interpretation and in the video group this frequency drops to a mere 10% (11/107, p < 0.001). In the non-video group, 47% (81/171) expect to meet the radiologist compared to 30% (32/107, p < 0.01) in the video group (Table 1).
Better patient perception of the role of the radiologist, non-video (blue) versus video-group (orange).
IMPACT of Patient Educational Level
Out of 278 patients, 243 provided information about their educational level; 53% (142) of patients had a maximum educational level of a high school diploma ("the less-schooled group"); 38% (101) had a higher degree of education ("the well-schooled group"). Both educational groups show a similar percentage of patients in the video-group (Table 2).
Patients who provided their educational level were split in two groups to evaluate learning curves based on the information shown in the video. A cut-off was made at the high school degree: the "less-schooled" (max high-school degree) and the "well-schooled" (higher education).
TOTAL (N = 243, 100%)
GROWTH LESS-SCHOOLED
GROWTH WELL-SCHOOLED
LESS-SCHOOLED (N = 142, 58%)
WELL-SCHOOLED (101, 42%)
NON-VIDEO GROUP (N = 87, 61%)
VIDEO GROUP (N = 55, 39%)
1. Correct answer to: Radiologist qualification 30 (34.5%) 24 (43.6%) 24 (39.3%) 28 (70.0%) +9.1% +30.7%
2. Correct answer to: Radiologist degree 30 (34.5%) 32 (58.2%) 37 (60.6%) 37 (92.5%) +23.7% +31.9%
3. Correct answer: Technician makes the images 22 (25.3%) 31 (56.4%) 21 (34.4%) 26 (65.0%) +31.1% +30.6%
4. Correct answer to: Duration radiology education 5 (5.7%) 14 (25.5%) 6 (9.8%) 25 (62.5%) +19.8% +52.7%
5. Correct answer to: what's the radiologist's role? 46 (52.9%) 45 (81.8%) 37 (60.7%) 38 (95.0%) +28.9% +34.3%
Total growth in both groups: +22.5% +36.0%
In the non-video group, 35% (30/87) of the less-schooled patients are correctly informed about the medical qualifications of the radiologist, compared to 39% (24/61) in the well-schooled group. After watching the video, 43% (24/55) of the less-schooled (+9%; p = 0.34) and 70% (28/40) of the well-schooled (+31%; p = 0.0024) patients answered correct (Figure 2).
Learning curves in table 2 visualized (cut-off at between "less-" and "well-schooled" is possession of a high-school diploma).
When the non-video group is questioned on how long their radiologist has studied after high school, only 6% (5/87) of the less-schooled check the ">10 years" box, compared to 10% (6/61) in the well-schooled group. After seeing the video, 26% (14/55, p < 0.001) of the less-schooled group answers correctly, a moderate increase. The well-schooled group now answers correctly in 63% (25/40, p < 0.001) of cases. Again a steeper increase (+53% compared to +16% in the less-schooled group).
When asked if the radiologist has a master's degree in medicine, 45% (67/148) in the non-video group answers correctly, in the video group 73% (69/95) answers correctly (p < 0.001), this equals +32% in the well-schooled group compared to +18% in the less-schooled group.
The Video Group In-Depth
The video group is further evaluated on the use of method for information transfer (animated video). Almost all 94% (100/107) perceives a better understanding of what a radiologist is and does. Nearly half of patients 52% (56/107) have less pre-exam anxiety and feel more at ease in the waiting room. Most patients 65% (70/107) reacted fondly on the extra information and the format in which it was presented, for them it was of added value for their visit. Most strikingly, 67% (72/107) of the patients feel more respect towards the radiologist solely due to the video/obtained knowledge, without having to meet a radiologist (Figure 3).
Extra questions for the "video group".
In the past, several communication methods have been used to educate patients on the role of the radiologist. For example, Madden et al. started to inform breast patients pre-exam through booklets, which greatly improved the levels of knowledge [7]. In 2019, several web-based platforms were studied for patient-centred communication in our current digital age. This study emphasized once again why communication is paramount to the patient-centred imaging experience of today [8].
However, as radiologists we must feel obliged to search for an alternative-modern way of communicating to maintain a connection with our patients without increasing workload and without risking changing the patient-doctor relationship. Short, fun-to-watch, animated videos are ubiquitous and represent a superb tool to capture the attention of all ages. They have the advantage of being easy, cost effective, environmentally- friendly tools to transfer information to masses without being intrusive. Animated videos are known for a better short and long-term retention of information compared to non-animated graphical information [9, 10, 11, 12]. However, the advantage over well-designed static materials in patients with low health literacy shows no objective significance [13]. This communication method has proven to be easy to understand, practical, and leads to a better patient waiting experience while decreasing anxiety. The 52% decrease in pre-exam anxiety in our study is in line with results found in literature [14, 15, 16, 17]. Even though the perceived waiting room time is not significantly shortened when using animated video, waiting satisfaction scores are significantly higher [18].
For the above reasons we opted to produce a modern animated video to educate patients on how the radiology department works and what they can expect from their visit while waiting in the radiology waiting room (www.makeradiologyvisible.com). When compared the study of O'Mahony et al. [3], Belgian patients seem more aware of what a radiologist and a technician are, although the knowledge of the job content is still somehow low. Overall, well-schooled patients have a better perception of the jobs of the radiologist and technician compared to the less-schooled group, prior to seeing the video. Even though baseline knowledge already is better in the well-schooled group, the gain in knowledge in the video group is significantly higher in the well-schooled group (average +36%) compared to the less-schooled group (average +22%). However, the improvement of patient perception of radiology jobs, after seeing the video, was high on all educational levels. Thus, all patient educational levels benefit from informational animated video although the learning curve is steeper when patients have a higher degree of education.
DUTCH.
Caution is needed when comparing our results with the study of O'Mahony et al. [3] because that was held in the breast radiology waiting room while our study was held in MRI/CT and X-ray waiting rooms. Importantly, the breast radiologist does often meet the patient, contrary to the modality waiting rooms we have chosen to perform our study.
It is also plausible that our patients have a better understanding of the role of the radiologist compared to those in the UK where the technician is named "radiographer" which could be confusing given this term similarities with the word "radiologist". The Dutch word for a technician meanwhile is a literal translation of "image-maker" that quite obviously explains the job content and therefore causes less confusion.
Different patients were surveyed in the non-video versus the video group (all were surveyed prior to their exam). Therefore, we cannot objectify a person-based learning curve. Population-wide interpretation of the results can be justified given the consistent outcomes in both institutions (that also showed similar demographics).
According to this study, animated informative video in the radiology waiting room helps getting rid of misconceptions about the role of the radiologist and the technician in all educational levels, although well-schooled patients benefit more. Animated informative video is of added value for a radiology department visit as it decreases pre-exam anxiety and increases overall patient respect for the radiology profession, without having to meet a radiologist in person.
The video itself is copyrighted however the concept of the video ("the story") is free to copy, and is even encouraged by the author. The author sold personalized/branded variants of this video to hospitals. upon their request. No third-party competing interests.
Otoni JC, Cohen MP, Bitencourt AGV. Physician-patient communication in diagnostic examinations: What is the role of the radiologist? Radiol Bras. 2018; 51(2): 109–11. DOI: https://doi.org/10.1590/0100-3984.2017.0084
Thrall JH. The radiologist in the 1990s: New practice expectations and management responsibilities. Am J Roentgenol. 1994; 163(1): 11–5. DOI: https://doi.org/10.2214/ajr.163.1.8010194
O'Mahony N, McCarthy E, McDermott R, O'Keeffe S. Who's the doctor? Patients' perceptions of the role of the breast radiologist: A lesson for all radiologists. Br J Radiol. 2012; 85(1020). DOI: https://doi.org/10.1259/bjr/74006772
Grant L, Griffin N, McDonald S, Vargas H, Hampson F, Sinnatamby R, et al. The role of a consultant radiologist – Are patients still in the dark? Eur Radiol. 2009; 19(10): 2326–32. DOI: https://doi.org/10.1007/s00330-009-1436-0
Edwards M. Mythbusters: Radiology Edition; 2014.
Margulis AR, Sunshine JH. Radiology at the turn of the millennium. Radiology. 2000; 214(1): 15–23. DOI: https://doi.org/10.1148/radiology.214.1.r00ja4515
Madden S, Johnston M, Parbhoo S. Evaluation of women's worries and the effects of a preparatory booklet for patients attending a breast clinic. The Breast. 1994; 3(3): 169–72. DOI: https://doi.org/10.1016/0960-9776(94)90070-1
Vijayasarathi A, Kharkar R, Salamon N. Strategies for Patient-Centered Communication in the Digital Age. Internet Curr Probl Diagn Radiol. 2019; 48(3): 210–5. DOI: https://doi.org/10.1067/j.cpradiol.2018.05.004
Kakinuma A, Nagatani H, Otake H, Mizuno J, Nakata Y. The effects of short interactive animation video information on preanesthetic anxiety, knowledge, and interview time: A randomized controlled trial. Anesth Analg. 2011; 112(6): 1314–8. DOI: https://doi.org/10.1213/ANE.0b013e31820f8c18
Jeppson PC, Clark MA, Hampton BS, Raker CA, Sung VW. Improving patient knowledge about sacral nerve stimulation using a patient based educational video. J Urol [Internet]. 2013; 190(4): 1300–5. DOI: https://doi.org/10.1016/j.juro.2013.04.074
O'Day DH. The Value of Animations in Biology Teaching: A Study of Long-Term Memory Retention. CBE-Life Sci Educ. 2007; 6: 217–23. DOI: https://doi.org/10.1187/cbe.07-01-0002
Al Owaifeer AM, Alrefaie SM, Alsawah ZM, Al Taisan AA, Mousa A, Ahmad SI. The effect of a short animated educational video on knowledge among glaucoma patients. Clin Ophthalmol. 2018; 12: 805–10. DOI: https://doi.org/10.2147/OPTH.S160684
Housten AJ, Kamath GR, Bevers TB, et al. Does Animation Improve Comprehension of Risk Information in Patients with Low Health Literacy? A Randomized Trial. Med Decis Mak. 2020; 40(1): 17–28. DOI: https://doi.org/10.1177/0272989X19890296
Nathoo D. Video Material as an Effective Educational Tool to Address Informational and Educational Needs of Cancer Patients Undergoing Radiation Therapy. J Cancer Educ. 2017; 32(2): 219–27. DOI: https://doi.org/10.1007/s13187-015-0933-x
Newsom E, Lee E, Rossi A, Dusza S, Nehal K. Modernizing the Mohs Surgery Consultation: Instituting a Video Module for Improved Patient Education and Satisfaction. Dermatol Surg. 2018; 44(6): 778–84. DOI: https://doi.org/10.1097/DSS.0000000000001473
McNab M, Skapetis T. Why video health education messages should be considered for all dental waiting rooms. PLoS One. 2019; 14(7): 1–11. DOI: https://doi.org/10.1371/journal.pone.0219506
McGlashan HL, Dineen RA, Szeszak S, et al. Evaluation of an internet-based animated preparatory video for children undergoing non-sedated MRI. Br J Radiol. 2018; 91(1087). DOI: https://doi.org/10.1259/bjr.20170719
Papa L, Seaberg DC, Rees E, et al. Does a waiting room video about what to expect during an emergency department visit improve patient satisfaction? Can J Emerg Med. 2008; 10(4): 347–54. DOI: https://doi.org/10.1017/S1481803500010356
Lavaerts, M., Vandenhout, H., Oyen, R. and Van Ongeval, C., 2021. Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room. Journal of the Belgian Society of Radiology, 105(1), p.41. DOI: http://doi.org/10.5334/jbsr.2405
Lavaerts M, Vandenhout H, Oyen R, Van Ongeval C. Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room. Journal of the Belgian Society of Radiology. 2021;105(1):41. DOI: http://doi.org/10.5334/jbsr.2405
Lavaerts, M., Vandenhout, H., Oyen, R., & Van Ongeval, C. (2021). Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room. Journal of the Belgian Society of Radiology, 105(1), 41. DOI: http://doi.org/10.5334/jbsr.2405
1. Lavaerts M, Vandenhout H, Oyen R, Van Ongeval C. Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room. Journal of the Belgian Society of Radiology. 2021;105(1):41. DOI: http://doi.org/10.5334/jbsr.2405
Lavaerts M and others, 'Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room' (2021) 105 Journal of the Belgian Society of Radiology 41 DOI: http://doi.org/10.5334/jbsr.2405
Lavaerts, Michel, Hilde Vandenhout, Raymond Oyen, and Chantal Van Ongeval. 2021. "Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room". Journal of the Belgian Society of Radiology 105 (1): 41. DOI: http://doi.org/10.5334/jbsr.2405
Lavaerts, Michel, Hilde Vandenhout, Raymond Oyen, and Chantal Van Ongeval. "Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room". Journal of the Belgian Society of Radiology 105, no. 1 (2021): 41. DOI: http://doi.org/10.5334/jbsr.2405
Lavaerts, M, et al.. "Getting Rid of Patient's Misconceptions About the Radiology Department Using Animated Video in the Waiting Room". Journal of the Belgian Society of Radiology, vol. 105, no. 1, 2021, p. 41. DOI: http://doi.org/10.5334/jbsr.2405
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text:
using System;
using System.Collections.Generic;
using System.ComponentModel;
using System.Data;
using System.Drawing;
using System.Text;
using System.Windows.Forms;

namespace TemcoStandardBacnetTool
{
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    {
        public int Minimum { get { return m_progessbar.Minimum; } set { m_progessbar.Minimum = value; } }
        public int Maximum { get { return m_progessbar.Maximum; } set { m_progessbar.Maximum = value; } }

        public event EventHandler Cancel;

        public ProgressDialog()
        {
            InitializeComponent();
        }

        public int Value
        {
            get
            {
                return m_progessbar.Value;
            }
            set
            {
                m_progessbar.Value = value;
                Application.DoEvents();
            }
        }

        public void Increment(int value)
        {
            m_progessbar.Increment(value);
            Application.DoEvents();
        }

        public string Label
        {
            get
            {
                return m_Label.Text;
            }
            set
            {
                m_Label.Text = value;
                Application.DoEvents();
            }
        }

        public bool IsCancelled
        {
            get
            {
                if (this.IsDisposed || this.DialogResult == System.Windows.Forms.DialogResult.Cancel) return true;
                else return false;
            }
        }

        private void m_CancelButton_Click(object sender, EventArgs e)
        {
            this.Close();
        }

        private void ProgressDialog_FormClosing(object sender, FormClosingEventArgs e)
        {
            if (Cancel != null) Cancel(this, null);
        }
    }
}

redpajama_set_name: RedPajamaGithub