text:
Epidemiology & Infection
Volume 146 Issue 9
Significant spike in excess mortality in England in...
Significant spike in excess mortality in England in winter 2014/15 – influenza the likely culprit
Published online by Cambridge University Press: 10 May 2018
R. G. Pebody [Opens in a new window] ,
H. K. Green ,
F. Warburton ,
M. Sinnathamby ,
J. Ellis ,
K. Mølbak [Opens in a new window] ,
J. Nielsen ,
S. de Lusignan and
N. Andrews
R. G. Pebody
Public Health England, London, UK
H. K. Green
F. Warburton
M. Sinnathamby
J. Ellis
K. Mølbak
Statens Serum Institut, Copenhagen, Denmark
S. de Lusignan
University of Surrey, Guildford, UK Royal College of General Practitioners, Research and Surveillance Centre, London, UK
richard.pebody@phe.gov.uk
Significant increases in excess all-cause mortality, particularly in the elderly, were observed during the winter of 2014/15 in England. With influenza A(H3N2) the dominant circulating influenza A subtype, this paper determines the contribution of influenza to this excess controlling for weather. A standardised multivariable Poisson regression model was employed with weekly all-cause deaths the dependent variable for the period 2008–2015. Adjusting for extreme temperature, a total of 26 542 (95% CI 25 301–27 804) deaths in 65+ and 1942 (95% CI 1834–2052) in 15–64-year-olds were associated with influenza from week 40, 2014 to week 20, 2015. This is compatible with the circulation of influenza A(H3N2). It is the largest estimated number of influenza-related deaths in England since prior to 2008/09. The findings highlight the potential health impact of influenza and the important role of the annual influenza vaccination programme that is required to protect the population including the elderly, who are vulnerable to a severe outcome.
Influenza A vaccination (immunization)
Epidemiology & Infection , Volume 146 , Issue 9 , July 2018 , pp. 1106 - 1113
DOI: https://doi.org/10.1017/S0950268818001152[Opens in a new window]
Copyright © Cambridge University Press 2018
During the winter of 2014/15, England, as in other European countries [Reference Mølbak1], saw significant increases in excess all-cause mortality predominantly in the elderly [2]. The rise coincided with influenza circulation, which raises important questions as to what contribution influenza made to the observed excess, particularly in the light of the apparent low-intensity activity seen in primary care that season [Reference Hawkes3].
Seasonal cyclical changes in mortality are seen each year in temperate countries, with a higher number of deaths in the winter compared with the summer months. Acute increases in mortality above these seasonally expected levels can occur at any time of the year and are termed 'excess mortality' [Reference Serfling, Sherman and Houseworth4]. In the UK and elsewhere in Europe, all-cause excess mortality is reported on a weekly basis over the entire year through the European network for mortality surveillance, EuroMOMO. Participating countries in EuroMOMO estimate excess mortality using a standard statistical model to make comparable estimates across participating countries [Reference Nielsen5, 6]. EuroMOMO became operational in 2009.
Significantly increased excess mortality in the winter months has typically been linked to factors such as cold snaps and circulation of influenza plus other respiratory viruses; whereas in the summer months, heat-waves have been identified as one of the main temporally associated factors associated with acute increases in excess mortality [Reference Berko7]. Influenza and other respiratory infections are recognised to be considerably under-reported by clinicians as a cause of death at certification, with infection not always diagnosed or recognised as infection resulting in an exacerbation of an underlying condition such as cardiac or respiratory disease. The impact of cold snaps can also result in death [Reference Berko7] as, in addition to hypothermia, low temperature can exacerbate pre-existing chronic, clinical conditions, such as cardio-respiratory disease. As cold weather and acute respiratory infections often temporally coincide, it is challenging to disentangle their respective impact [Reference Brown, Fearn and Wells8]. To determine the relative contribution of various potential explanatory factors to excess mortality, modelling methods with a range of statistical approaches have been employed [Reference Green9–Reference Nielsen14]. As an advance from the EuroMOMO initiative, a standardised European multivariable regression model, FluMOMO, has been developed to estimate the association of influenza to excess mortality while adjusting for the extreme temperature that can be applied across countries and time [Reference Espenhain15]. This paper uses this model to assess the increase in excess mortality seen in England during the 2014/15 winter and to quantify the contribution of influenza, controlling for extreme ambient temperatures, compared with recent past seasons.
The weekly number of death registrations in England was available from the Office for National Statistics. The following age groupings were used: <5 years, 5–14 years, 15–64 years, 65 years or more and all ages.
To incorporate influenza activity as a variable in the FluMOMO model, a measure of influenza incidence was calculated as in previous studies [Reference Green9, Reference Goldstein16]. Weekly age-specific consultation rates for influenza-like illness (ILI) across England through the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network was used. This general practice (GP) sentinel scheme was used as a measure of clinical activity. As a large proportion of these GPs undertook respiratory swabbing of patients who presented with an ILI, virological activity was reported as the proportion of samples tested that were positive for influenza by consultation week. By multiplying clinical activity (i.e. ILI) and virological activity each week, an influenza incidence proxy was determined, hereafter termed influenza activity [Reference Goldstein16].
Daily maximum temperature data from a sample of weather stations in England was selected from the National Oceanic and Atmospheric Administration (NOAA) site [17]. Weekly average, minimum and maximum temperature values were calculated from this daily data and a regression model run to determine expected weekly temperature, as well as expected minimum and maximum temperatures. The extreme temperature was defined according to the following equations (Fig. 1d):
$${\rm Extreme}\,{\rm low}\,{\rm temperature}\!:({\rm temp}\; - {\rm p}{\rm t}_{{\rm low}}) \times ({\rm temp}\; \lt {\rm p}{\rm t}_{{\rm low}})$$
$${\rm Extreme}\,{\rm high}\,{\rm temperature}\!:({\rm temp\;} - {\rm p}{\rm t}_{{\rm high}}) \times ({\rm temp} \gt {\rm p}{\rm t}_{{\rm high}})$$
where temp, weekly mean temperature; ptlow, the minimum predicted weekly-mean temperature across the time series; pthigh, the maximum predicted weekly-mean temperature across the time series.
Fig. 1. FluMOMO influenza (a), positivity (b), activity (c), temperature (d) and mortality (e) variables, 2008/09 week 40 to 2014/15 week 20. 1RCGP ILI consultation rate per 100 000 population multiplied by the proportion of samples positive for influenza through RCGP and PHE-SMN sentinel swabbing schemes. 2Temperature data from National Oceanic and Atmospheric Administration (http://www.noaa.gov/). 3Definitions: temp, weekly mean temperature; ptemp, predicted weekly-mean temperature; ptmin, predicted weekly-mean minimum temperature; ptmax, predicted weekly-mean maximum temperature; ptlow, the minimum predicted mean temperature across the time series; pthigh, the maximum predicted mean temperature across the time series.
The FluMOMO model analyses the time series of all-cause deaths over calendar time (ISO-week as time unit) using a multiplicative Poisson regression model with overdispersion, and a post-estimation 2/3-power correction for skewness in the multiplicative residual variation. The baseline adjusts for seasonal variation by including a sine curve and trend. In addition, we include Influenza Activity (IA) and Extreme Temperature (ET). The model estimates both a baseline and the effect IA and ET simultaneously, controlled for one another i.e. the baseline [Reference Nielsen, Krause and Mølbak18].
The impact of influenza may vary between influenza-seasons depending on the circulating influenza strains. Therefore, we include IA separately for each influenza-season (is). While the effect of influenza is allowed to vary each season, the effect of extreme temperature is assumed constant over time and is included in the model as two variables; a summer effect and a winter effect.
$$\eqalign{E\left[{{\rm log}\,(X_{\rm t})}\right] & = \beta_{0} + \beta_{1}^{\ast}{\rm trend}\,(t)+ \beta_{2}^{\ast}{\rm seasonality}\,(t) \cr & \quad + \Sigma \beta_{\rm is}^{\ast}{\rm IA}_{\rm t,is}+ \beta_{\rm s}^{\ast}{\rm ET}_{\rm s} + \beta_{\rm w}^{\ast}{\rm ET}_{\rm w}}$$
where β 0 + β 1*trend(t) + β 2*seasonality(t) comprise the baseline and the remainder impacts of IA and ET. This is illustrated in Figure 3.
To take into account that there often is a delay between exposure (influenza or extreme temperature) and outcome (death), we also fitted lagged impacts of 2 weeks in the model (not shown in the formula).
The EuroMOMO and FluMOMO models were run in Stata v13 (StataCorp, College Station, TX) with data from week 40, 2008 to week 20, 2015 (using death data available at week 10, 2017, to obtain accurate number of deaths from the 2014/15 season). Winter periods were defined as week 40 to week 20. The number of influenza-associated deaths was estimated and corresponding confidence intervals calculated with a 2/3-power correction for skewness in the residual variation.
The ILI rate, influenza positivity and influenza incidence for the period 2008/9 until 2014/15 are shown in Figure 1a–c. Over this period, GP consultations for influenza-like illness breached the baseline threshold denoting likely community transmission, in all seasons except 2013/14. In the season 2014/15, the threshold was breached from week 50, 2014 to week 13, 2015 (Fig. 1a). Influenza A and B co-circulated in most seasons over this time (Fig. 1b), with A(H3N2) the dominant circulating strain in 2014/15. Influenza activity was highest in 2010/11, the first post-pandemic season when influenza A(H1N1)pdm09 was the dominant circulating strain (Fig. 1c).
No period of extreme cold temperature was observed in the 2014/15 season, unlike the earlier seasons in particular 2009/10 and 2010/11 (Fig. 1d).
The EuroMoMo model showed generally good fit (Fig. 1e). It demonstrated significant excess all-age all-cause mortality in 2014/15, reaching and potentially exceeding the level of excess mortality observed in 2008/09, a season also dominated by circulation of A(H3N2).
Adjusting for extreme weather, the FluMOMO model also demonstrated generally good fit to the observed data (Fig. 2). The model associated significant mortality to influenza over several seasons. This is particularly apparent in 2008/09 and 2014/15, with deaths in both seasons predominantly occurring in 65+ year-olds (Fig. 2). In total, 26 542 (95% CI 25 301–27 804) deaths in those 65+ were associated with influenza from week 40, 2014 to week 20, 2015 (Table 1). This is the highest number of influenza-associated deaths in the elderly over the six winters of the study and significantly higher than what was seen in 2008/09, the last notable influenza A(H3N2) season, where 14 261 (95% CI 13 514–15 023) deaths were attributed to influenza. These patterns remained when mortality cumulative incidence rates were assessed, with the highest mortality rate seen in 2014/15 (Fig. 2).
Fig. 2. Weekly number of deaths and attribution to influenza (red line) and extreme temperature (green line), England, 2008/09 to 2014/15.
Fig. 3. Schema to illustrate defined terms.
Table 1. Number of influenza attributable deaths (95% CI) by age group and season during the winter period, England, 2008/09 to 2014/15 adjusting for extreme temperature
*The model could not attribute deaths for this period.
In children, statistically significant influenza-associated deaths were also seen in under 5 year-olds in 2014/15 (73 (95% CI 61–87) estimated deaths), but also 2008/09 (39 (95% CI 29–50) estimated deaths), 2010/11 (32 (95% CI 20–47) estimated deaths) and 2013/14 (9 (95% CI 1–20)) (Fig. 2 and Table 1). The highest number of influenza-associated deaths in 5–14 years was seen in 2010/11. Influenza-associated deaths in school-age children were also seen in every other season, though the smallest numbers were seen in 2013/14 and 2014/15.
Finally, statistically significant mortality associated with influenza was seen in 15–64-year-olds (1942 (95% CI 1834–2052) estimated deaths) in 2014/15 (Table 1). The number of excess deaths associated with influenza in 15–64-year-olds in 2014/15 was higher than that seen in 2010/11, when the season was dominated by A(H1N1)pdm09 circulation and also 2008/09 (Fig. 2 and Table 1).
We demonstrate the application of a standardised regression modelling approach to estimate the number of deaths associated with influenza before, during and after the 2009 pandemic controlling for cold weather. In England during the 2014/15 winter as in other countries [Reference Mølbak1], significant excess all-cause mortality above expected levels was seen, with the majority of these deaths associated with influenza with levels higher than seen in the previous seven winters, including the A(H3N2) dominated season of 2008/09. Influenza-related deaths were also observed in younger age-groups in 2014/15, as in some earlier seasons, particularly in younger adults in 2010/11, when A(H1N1)pm09 was the dominant circulating strain. No deaths were associated with cold snaps in the 2014/15 winter, unlike some earlier winters, in particular 2010/11, when excess mortality in the elderly was associated mainly with extreme cold, rather than influenza.
The burden of influenza-related mortality described in the elderly in 2014/15 is consistent with the dominant circulating sub-type being A(H3N2), with very little circulation of influenza A(H1N1)pdm09 that season. Influenza A(H3N2) is well recognised to have a more severe impact in the elderly compared with other seasonal influenza viruses. A similar picture to that described here was seen elsewhere in Europe in 2014/15. A pooled EuroMOMO analysis across 14 European countries [Reference Mølbak1] showed significantly higher levels of excess all-cause mortality in the elderly compared with recent years, with influenza hypothesised as the main explanatory factor. Our findings are also consistent with both the timing and intensity of other UK influenza surveillance indicators in 2014/15, despite the lower GP ILI consultation rates. In particular, hospital-based influenza surveillance through the UK Severe Influenza Surveillance System (USISS) showed that the impact of severe influenza was the highest reported since the USISS surveillance system started in 2010/11 and respiratory outbreak surveillance demonstrated a large number of influenza A outbreaks reported in care home settings for the elderly over the same time period [2]. The burden of influenza-associated deaths in the elderly in 2014/15 was significantly higher than that seen in recent A(H3N2) dominated seasons, including 2008/09, the last intense A(H3N2) season. There are a number of potential explanations for large mortality impact of influenza A(H3N2) in particular seasons. These relate to the intensity of virus transmission, the level of which depends upon the dominant circulating A(H3N2) strain and the underlying population immunity, which relates to prior natural infection and recent vaccine uptake and effectiveness. The genetic and antigenic relatedness of the current circulating strain to recent strains and the vaccine virus strain is thus key. The levels of influenza-related mortality in the elderly seen in 2014/15 are of a magnitude similar to that seen in 1999/2000 and 1996/1997 [Reference Goddard19]. Both these seasons were dominated by circulation of A(H3N2) strains antigenically closely related to the vaccine strains (A/Sydney/5/97 and A/Wuhan/359/95 respectively) [Reference Goddard19]. At that time, however, the UK had a risk-group only policy for all age-groups, with uptake amongst elderly at risk only 40–50% [Reference Goddard19]. Due to the health impact of influenza in these seasons, the UK's vaccine policy from autumn 2000 onwards changed to recommend influenza vaccine for all those over 65 years of age, in addition to those of any age in a high-risk group. This led influenza vaccine uptake levels to increase rapidly to approximately 70% in all over 65-year-olds in the early years of the 21st century, a level that has been maintained more recently [2]. Why this might explain the large burden of influenza-related mortality in 2014/15 when vaccine uptake levels in the elderly were high and GP ILI consultation rates apparently low? The 2014/15 season saw the circulation of a drifted A(H3N2) strain resulting in antigenic mismatch to the 2014/15 northern hemisphere A(H3N2) vaccine strain. The end of season all-age influenza vaccine effectiveness estimate for the UK at 34% and specifically 32.6% (95% CI −44.5 to 68.6) for A(H3N2) in the elderly was lower than anticipated [Reference Pebody20], as seasonal influenza vaccines are usually expected to provide overall protection of approximately 50%, though lower VE against A(H3N2) in the elderly is being increasingly recognised, as seen in the recent 2016/17 influenza season in the UK [Reference Pebody21] and as highlighted in a recent meta-analysis from Belongia et al. [Reference Belongia22], who reported a pooled VE against a(H3N2) in >65-yearolds of 24% (95% CI −6 to 45). What contribution did the circulation of a strain with a mismatch to that in the vaccine make to the observed excess mortality? The finding of significant excess mortality in the elderly in 2008/09, when the vaccine strain was moderately well matched to the circulating strain, highlights that increased excess mortality will still occur in the population during intense A(H3N2) seasons when vaccine uptake is high, but without vaccine mismatch [Reference Hardelid23], though the population impact of influenza may be reduced by the programme. Annual influenza vaccination remains the most important intervention to protect the population from the impact of influenza each year, with the selective vaccine programme shown to be a cost-effective intervention [Reference Baguelin24], however, it is hoped that the newer generation of vaccines such as adjuvanted vaccine, which will be available in the forthcoming 2018/19 season or high dose vaccines, some of which will be available in the UK in the near future, can provide better protection to groups such as the elderly, with systematic reviews providing encouraging findings [Reference Wilkinson25, Reference Domnich26]. In addition, the full implementation of the universal paediatric influenza vaccine programme is also predicted to provide both direct, but also indirect benefits to vulnerable members of the community through reduction in influenza transmission.
Influenza is also well recognised to cause severe disease in younger adults and children, particularly those with underlying clinical risk factors. In adults (15–64-year-olds), the number of influenza-associated deaths in 2014/15 exceeded the level seen in 2010/11, a season dominated by A(H1N1)pm09. This observation is also reflected in terms of laboratory-confirmed hospital and ICU/HDU admissions which were higher than the previous three seasons but did not reach the levels seen in 2010/11. Earlier work from the 2009 pandemic and the 2010/11 season highlighted the elevated probability of severe outcome following influenza A(H1N1)pdm09 particularly in younger adults and children with underlying clinical risk factors [Reference Pebody27], but not the elderly who have cross-protective immunity from earlier exposure to A(H1N1) viruses several decades previously [Reference Miller28]. Furthermore, reassuringly the estimates in this paper for the 2009/10 influenza pandemic are in a similar range to those reported in a global burden study [Reference Dawood29]. The findings in this paper reinforce the importance of ensuring clinical at-risk groups <65 years of age receive their annual influenza immunisation. The new universal paediatric influenza vaccination programme will also play an important role in providing both direct protection to the targeted age-groups and ultimately by reducing influenza transmission in the population provide indirect protection to other groups at higher risk of severe disease [Reference Baguelin30].
Cold snaps are an important contributory factor besides influenza to excess mortality during the winter months. Although the extreme temperature was adjusted for in the FluMOMO model, cold snaps are unlikely to have made a large contribution to excess mortality in 2014/15, as mean winter temperatures were near average and climatic conditions were generally mild. No extreme low temperature was seen in either 2014/15 or 2013/14 (Fig. 2) suggesting little impact of cold weather on excess mortality, in contrast with earlier winters, in particular 2010/11, a season also of intense A(H1N1)pdm09 activity, highlighting the importance of the statistical model in disentangling the impact of influenza and extreme temperature.
There are several strengths and potential limitations to note in this paper. Due to underreporting of influenza and complications as a cause of death, statistical modelling is required to measure the mortality burden based on underlying temporal patterns, with the model generally providing a good fit to the observed data. The FluMOMO model presented was developed to provide estimates for influenza-attributable mortality adjusting for trend, seasonality and extreme temperature using a standardised approach and building on earlier work in a large number of countries in Europe [Reference Leon-Gomez10]. One major strength with this approach is the use of a number of deaths from all causes as an independent variable rather than for example respiratory and circulatory deaths. This both enhances the timeliness of the model and overcomes potential comparability issues due to differences in certification practice by time and place. The model, on the other hand, does not stratify by influenza sub-type, with further work needed to allow the relative burden of influenza A and B to be described. In addition, the model is far from exhaustive and does not explain all of the observed peaks in excess mortality across all age-groups and seasons. This highlights the role that other contributory factors might be making to acute increases in mortality such as weather, other circulating respiratory pathogens, like respiratory syncytial virus (RSV) – although RSV peaked considerably earlier than influenza in week 49 2014 [2] and is unlikely to have been an important contributor to the excess seen in the elderly that season. The lack of apparent influenza-associated deaths in some seasons does not suggest that no-one died from influenza, but rather that mortality, in general, was low that season compared with previous years. The model also does not attempt to disentangle the impact of influenza A(H3N2) and A(H1N1)pdm09 as most seasons, such as in 2014/15, one influenza subtype is dominant, with a very little circulation of A(H1N1)pdm09. Finally, the model also fails to take into account other social factors including the quality of housing and adequacy of heating which may also contribute to winter wellness [Reference Gordon31]. Earlier statistical modelling work in the UK has been undertaken to determine attributable mortality to influenza including for overlapping periods [Reference Green9, Reference Hardelid, Pebody and Andrews32]. These earlier regression models differed from the FluMoMo model presented here, in that they included an identity link, incorporated other factors such as RSV and a more general temperature effect and explored lagging. Reassuringly, the derived estimates for influenza, which is the focus of this paper, were similar to those presented. Further work is underway to explore additional refinements and improvements to the FluMoMo model.
In conclusion, determining and quantifying the contributing causes of excess mortality is challenging. We present a standardised tool that can be deployed in a range of geographical settings. Indeed similar approaches have been deployed at global levels to estimate the burden of influenza [Reference Dawood29, Reference Simonsen33]. Assessment of winter 2014/15 mortality in England confirmed the previous hypothesis that influenza was likely to have been the main contributor to the excess mortality seen, notably in the elderly. Routine use of the regression modelling methods, such as FluMoMo can assist in rapidly assessing the impact of influenza, which varies considerably by age group and season, and allow standardised assessment across Europe at country level and over time. Ongoing work is underway to further improve the model. The impact of influenza demonstrated in this paper highlights again the important role that annual influenza vaccination needs to provide in protecting the population each year.
PHE is part of the EuroMoMo network. The EuroMOMO network, hosted by the Statens Serum Institut, has received financial support from DG Sanco (Directorate-General for Health and Consumer Protection) through an operating grant 2013 31 02 SSI_FY2014. We would like to acknowledge all the EuroMOMO partners for their contributions to the development of the FluMoMo model. We would also like to thank the patients, who consented to virology swabs being taken and allow their data to be used and RCGP Research and Surveillance Centre practices for sharing pseudonymised clinical data.
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Thomas, Spencer A. Smith, Nadia A. Livina, Valerie Yonova, Ivelina Webb, Rebecca and de Lusignan, Simon 2019. Analysis of Primary Care Computerized Medical Records (CMR) Data With Deep Autoencoders (DAE). Frontiers in Applied Mathematics and Statistics, Vol. 5, Issue. ,
Rosano, Aldo Bella, Antonino Gesualdo, Francesco Acampora, Anna Pezzotti, Patrizio Marchetti, Stefano Ricciardi, Walter and Rizzo, Caterina 2019. Investigating the impact of influenza on excess mortality in all ages in Italy during recent seasons (2013/14–2016/17 seasons). International Journal of Infectious Diseases, Vol. 88, Issue. , p. 127.
Saulnier, Dell D. Green, Helen K. Ismail, Rohaida Chhorvann, Chhea Bin Mohamed, Norlen Waite, Thomas D. and Murray, Virginia 2019. Disaster risk reduction. Disaster Prevention and Management: An International Journal, Vol. 28, Issue. 6, p. 846.
Fenton, Lynda Minton, Jon Ramsay, Julie Kaye-Bardgett, Maria Fischbacher, Colin Wyper, Grant M A and McCartney, Gerry 2019. Recent adverse mortality trends in Scotland: comparison with other high-income countries. BMJ Open, Vol. 9, Issue. 10, p. e029936.
Joy, Mark Hobbs, FD Richard Bernal, Jamie Lopez Sherlock, Julian Amirthalingam, Gayatri McGagh, Dylan Akinyemi, Oluwafunmi Byford, Rachel Dabrera, Gavin Dorward, Jienchi Ellis, Joanna Ferreira, Filipa Jones, Nicholas Oke, Jason Okusi, Cecilia Nicholson, Brian D Ramsay, Mary Sheppard, James P Sinnathamby, Mary Zambon, Maria Howsam, Gary Williams, John and de Lusignan, Simon 2020. Excess mortality in the first COVID pandemic peak: cross-sectional analyses of the impact of age, sex, ethnicity, household size, and long-term conditions in people of known SARS-CoV-2 status in England. British Journal of General Practice, Vol. 70, Issue. 701, p. e890.
Ramsay, Julie Minton, Jon Fischbacher, Colin Fenton, Lynda Kaye-Bardgett, Maria Wyper, Grant M A Richardson, Elizabeth and McCartney, Gerry 2020. How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017. BMJ Open, Vol. 10, Issue. 10, p. e036529.
Sinnathamby, Mary A Whitaker, Heather Coughlan, Laura Lopez Bernal, Jamie Ramsay, Mary and Andrews, Nick 2020. All-cause excess mortality observed by age group and regions in the first wave of the COVID-19 pandemic in England. Eurosurveillance, Vol. 25, Issue. 28,
de Lusignan, Simon Sherlock, Julian Akinyemi, Oluwafunmi Pebody, Richard Elliot, Alex Byford, Rachel Yonova, Ivelina Zambon, Maria and Joy, Mark 2020. Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013–2018). BMC Public Health, Vol. 20, Issue. 1,
Rajaram, Sankarasubramanian Boikos, Constantina Gelone, Daniele K. and Gandhi, Ashesh 2020. Influenza vaccines: the potential benefits of cell-culture isolation and manufacturing. Therapeutic Advances in Vaccines and Immunotherapy, Vol. 8, Issue. , p. 251513552090812.
Boulieri, Areti and Blangiardo, Marta 2020. Spatio-temporal model to estimate life expectancy and to detect unusual trends at the local authority level in England. BMJ Open, Vol. 10, Issue. 11, p. e036855.
Smith, Sue Morbey, Roger de Lusignan, Simon Pebody, Richard G Smith, Gillian E and Elliot, Alex J 2020. Investigating regional variation of respiratory infections in a general practice syndromic surveillance system. Journal of Public Health,
R. G. Pebody (a1), H. K. Green (a1), F. Warburton (a1), M. Sinnathamby (a1), J. Ellis (a1), K. Mølbak (a2), J. Nielsen (a2), S. de Lusignan (a3) (a4) and N. Andrews (a1)
DOI: https://doi.org/10.1017/S0950268818001152


It has just been announced that a new director of Sweden's second largest airport has been appointed. Once confirmed by the Swedish Transport Agency, Anna Strömwall will assume the position of heading Gothenburg's Landvetter airport in February.
Currently working as head of Swedavia Consult, the consultancy unit of the Swedish airport operator Swedavia, Strömwall "has many years of management experience in the transport and logistics sector", Swedavia says.
She has previously been employed as planning manager at Scandinavia's biggest network of container ports, APM Terminals, and as head of security screening at Stockholm Arlanda Airport.
Anna Strömwall is 42 years old and has a Master's degree in industrial economics from the Institute of Technology at Linköping University.
She succeeds Charlotte Ljunggren, who has been Landvetter's airport director since 2012. Ljunggren will assume a new position as director for markets and commercial development for Swedavia's ten airports, also staying on as a member of Swedavia's group management team.
Sweden's second-biggest airport after Stockholm Arlanda saw more than 6.7 million passengers in 2017, of whom about 5.3 million were international and 1.5 million domestic.
"[Anna Strömwall's] extensive experience in the sector and her leadership will be a useful addition to the development of Göteborg Landvetter Airport as western Sweden's international airport and as one of the world's most climate-smart airports," commented Jonas Abrahamsson, president and chief executive of Swedavia.


JacquesBarack, I am amazed by the way in which you have attempted to walk back your caricature of me as "Fetal Freddy." Now, I am suddenly "Lamar" or the "City blogger," and you're quick to let all of us know that Von Jennings has nothing to do with what you've been blogging– even though you support her 100% and remain outspoken on her behalf.
I know, I know. You even asked me to contribute to your website. I should be honored, but please, let me spare you the bandwidth.
Here's what I think: You are nothing more than an immature hate-monger, a bigot who got caught, a single blogger who is now attempting to create multiple personalities in order to win back our collective acceptance.
You are in way over your head, and on top of that, you are a publicly-known coward.
You are afraid of telling people who you are.
You are ashamed of putting your own name behind your words.
Anonymous speech is commendable whenever it proves a point and achieves a purpose, but when it is only intended as a thinly-veiled masquerade for a group of people who would otherwise be easily discredited- when anonymity is used as a platform for unaccountable bigotry-then it is not commendable; it's repulsive.
And that is what JacquesBarack is: Repulsive.
The name of the blog- JacquesBarack- is rather ridiculous: Marrying the name of the first African-American President with the white Mayor of Alexandria, and all in an apparent attempt to promote an African-American candidate. Beware white people: Jacques and Barack, they kind of rhyme!
I know you, and I know exactly- precisely- what you're up to. No matter who wins, JacquesBarack will be exposed, laid bare for all of us to see.
Sorry to break the news– but when you are an outspoken bigot, people are less inclined to protect your anonymity. Though, as I said in a previous post, there is a time and a place for everything. I don't need to bury your blog; I have a feeling you'll bury yourself.
But either way, I remain on standby.
(Really, honestly, I'm a nice person, but this has all gone way too far. I have to stand up for myself; this has become absurd).
Lol..> I just got a good chuckle…JB is excited to get 397 blog hits….I get 300 every time I post something new…just from old house folks. Is 300 blog hits really something to brag about?
"…because Jacques Barack is for citizen journalists." Amusing. Not even good satire.
You have to admit..he is a beacon of stupidity.
jacquesbarack, marilynmanson, what kind of twisted mind comes up with garbage like that. Very creepy.


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On Thursday, after completing my volunteering gig, I hopped into an Uber to partake in my Thanksgiving meal. There was a small accident. Spent the night in emergency. MRIs and x-rays show no damage. Just very sore.
I will be slow answering comments. And I am trying to catch up on blog reading. Hope all are well.


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Up to two 5448 PKM modules may be connected to a single 5220 IP phone.


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text:
Sustainable Elements
Defending Gio Ponti
The Modern revisited
Chameleon Interiors
A wood to live in
Vertigo in the Danish forest
Abitare Design Best Before
Redazione Abitare
Are we witnessing the reinvention of the lightbulb – or has design's use-by date expired? On young designers' latest experimentations with light.
Text by Annina Koivu
Did you know that light can be generated from blood, sea algae, soil and, in a pinch, hamster cells? No? Well, then, you must not be a graduate of one of the many International "conceptual" design academies. If you were, you'd know that it's the most unexpected ingredients that are currently de rigueur for the making of design. It might be curiosity – a yearning for the new – or simply boredom with the established. But an increasing number of designers have begun revamping the world as we knew it. They're setting out to discover brand new materials to work with. And provocation is one of their favourite tools. The goal: play with the audience's expectations while seeking out new concepts in contemporary design. Interestingly, these projects are often centered around the creation of light. When Mike Thompson discovered that the iron contained in red blood cells was a potential carrier for electricity, he created the "Blood Lamp". A few drops of blood are poured into a drop-shaped flacon filled with luminol (typically used in forensic crime scene investigation) and the liquid starts to glow blue. This year he moved on to cultivating algae. The "Latro" prototype (Latin for thief) is a funnel-shaped tank filled with nanotechnologically- enhanced algae, which will, at least in theory, charge a battery through photosynthesis. The battery, in turn, will light up a simple bulb. Marieke Staps, inspired by the possibilities presented by new energy sources, created the "Soil lamp."
If watered frequently, the zinc and copper in the dirt generate enough power to illuminate a small bulb on top of the lamp's belly. Bioluminescence was also the starting concept for designer Joris Laarman. For his recent in vitro project, he experimented with hamster cells and the enzymes that make fireflies glow in order to come up with a "living" lamp. Unfortunately, the organisms that he presented last spring in New York died before arriving at the Friedman Benda Gallery, where he had a show. As a result, the "Half Life Lamp" could only be shown as lightless prototypes and on grainy film evidence. Which brings us to what is currently bugging me most about biological design. Because its "best-before" date expires so quickly, we are presented with lighting design that is – literally – dead and lightless. Too often, these would-be provocations end up as gallery installations composed of scientific tools in a well-staged amateur laboratory. They are pretty to look at, but are too abstract to be taken seriously. The teaming of designers with scientists became mainstream in 2008, with the "Design and the Elastic Mind" exhibition at the MoMA. Then, Paola Antonelli wrote that the figure of the designer "is changing from form-giver to fundamental interpreter of an extraordinarily dynamic reality" (see A478). These ranged from portable solar panels weaved into textiles, which bring light to the most remote places (MATx of Kennedy & Violich Architecture, see A476) to lasers tailored into the seams of high-fashion outfits (Moritz Waldmeyer, see A475). Graffiti Research Lab turned light into a tool for freedom of speech with their long-distance lasers capable of tagging any surface at distances that are literally kilometres away. These examples show how designer-scientist teams, at their best, open up breath-taking views into a possible future. They raise controversy and truly fuel the design discussion. But when prototypes – preferably going by Latin names – are as sought after as limited edition pieces, the faintest glimmer of an idea is enough to arouse the interest of galleries, followed by the press and, consequently, buyers. Biological design raises questions about wasteful consumption, planetary eco-conscience and new implications of design, yes.
But we also have to ask ourselves: Is provocation enough, when the project itself simply does not work? Design schools are to blame, at least in part, for this dilemma. In a best-case scenario, "independent thinkers" have at their disposal all necessary creative tools for the design discipline. But the mission – to prepare future designers as visionaries who are "undaunted by the potential failure in their quest for dreams that precede invention" (Eindhoven Design Academy) – can also be misinterpreted. "Undaunted by failure" does not necessarily equal the tedious but fundamental process of "trial and error". A work that is limited to prototypes – which are, after all, supposed to precede, not take the place of, inventions – doesn't cut it. What we are left with is a wholly conceptual design. What is being sold are dreams. If we look at history's true inventors, we see that they lived dangerously in the quest for fulfilment of their beliefs (the Wright brothers), had to struggle to prove their ideas (Buckminster Fuller), created industrial research labs to test new applications (Thomas Edison) and always focused on realization (Gino Sarfatti). Success followed only if they proved their utopian projects feasible. The London-based collective rAndom International is a particularly successful explorer of new boundaries. Their "Light Roller" creates temporary light-based graffiti on a light reactive surface. The interactive "You Fade To Light" project plays with the fractured reflection of a person's movements in OLED-spiked mirrors mounted on a wall. Little mirrored baby-robots mutate into an "Audience" of friendly pets that follow your every step. These designs engage in a playful interaction with latest technology. They are conceptual, yet they work. Worthy of being called "Designers of the Future" (at the last June's DesignMiami in Basel), rAndom International is among a select few creating projects that manage to shed light on the future of design without resorting to science fiction.
Foto in copertina 'self-portrait'
www.mariekestaps.nl
www.miket.co.uk
www.jorislaarman.com
www.random-international.com
www.graffitiresearchlab.com
Mathery 01 & 02
STUDIO GORM
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50 years of architecture in Tokyo 11 Oct 2019 – 26 Jan 2020
Vienna celebrates Thonet 18 December 2019 – 13 April 2020
Millennial design from 17 to 21 January
Architecture is reaction Through 17 January
And after Sol, there is Eva LeWitt 6 October 2019 – 5 April 2020
Reality meets the virtual
More and more companies are using virtual reality to streamline the design...
Founded in 1961 by Piera Peroni Abitare magazine has crossed the history of costume, architecture and design, international, following in its pages the evolution of our ways of life and how we inhabit places

redpajama_set_name: RedPajamaCommonCrawl


text:
Michigan Planning to Allow Football Fans in the Fall
Wolverine fans might see some light at the end of the tunnel.
On Tuesday, the University of Michigan Athletic Director announced that the school is planning for fans this fall. As things begin to open back up in Michigan, hopes are high that we will see fans return to the stadiums for games.
For one year now, the public has been barred from most events throughout the state. However, as things begin to reopen, many are itching to get back to life, including going to live sporting events. Even if some of the restrictions for capacity are still active when the games start, the University of Michigan has the largest college football stadium in the United States. Michigan Stadium, a.k.a. "The Big House," has a seating capacity of 107,601.
We are planning for fans, (for there) to be attendance in the fall...Although there's nothing finalized in terms of capacity in our facility...We're trying to look at different models there, to be prepared if fans are allowed at our competitions...said University of Michigan Athletic Director Warde Manuel.
As of right now, restrictions on the capacity for outdoor entertainment venues are in place in the state of Michigan. Venues that have under 10,000 seats of capacity are allowed up to 375 fans and venues over 10,000 seats are allowed up to 750. Hopefully, those restrictions will be eased as time goes one and more fans will be allowed to attend.
The Big House will see the return of fans on September 4th as the Wolverines take on Western Michigan.
Source: MLive
UP NEXT: The Top Ten Athletes Who Played for The University of Michigan
Famous Michigan Athletes and Their Jersey Numbers
Filed Under: michigan, michigan stadium, The Big House, University of Michigan, UofM, Wolverines
Categories: Michigan News, Sports
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I was looking for something for my younger son that is getting married next month for the first time; and found this cross. I am hopeing that i can aford it in time for the wedding. Because it was a sad day four the whole family as we lost or oldest son to murder on Sept 7th 2008, it was his one and only, older Brother. And it was his wish that one day he could stand with him in the wedding.When i seen this cross it came to me that what not a better way to honer his older brother by having him, with him close next to his heart after death. What a great thing that i could give him for that wonderful day. I will now just hope i can get it in time for the wedding, as i looked so many others ,yet none like your's. Thank you B.G.


text:
https://celticswire.usatoday.com/lists/nba-boston-celtics-brown-dunk-fortson-trade-history-2/
On this day: No-look Dee Brown dunk; doomed Fortson trade made
Jed Jacobsohn/Getty Images
February 9, 2022 12:25 pm ET
On this day in Boston Celtics history in 1991, guard DeCovan Kadell (better known to fans of the Celtics by his nickname as "Dee") Brown threw down one of the most famous dunks of all time in that year's All-Star Game Slam Dunk Competition.
Brown, a rookie recently picked up by the Celtics out of north Florida's Jacksonville University with the 19th overall pick of the 1990 NBA draft, made a lasting impression to NBA fans around the world with the flush, which was (and still is) among the flashiest dunks ever completed at the All-Star Week's annual dunk contest.
The event also featured Shawn Kemp of the Seattle Supersonics, Rex Chapman of the Charlotte Hornets, Kenny Smith of the Houston Rockets, Kenny Williams of the Indiana Pacers, Blue Edwards of the Utah Jazz, Otis Smith of the Orlando Magic, and Kendall Gill of the Atlanta Hawks.
Allsport/Getty Images photo
In the end, it came down to Kemp and Brown, which the latter managed to steal through pumping up his Reeboks (remember those?) and covering his eyes.
The dunk, which has become iconic for not just Brown and the Boston Celtics, but also the contest itself.
The first four-team trade in NBA history was built around Howard Eisley, Danny Fortson and Donyell Marshall: https://t.co/slUVOGbHG2
— NBA Trades (@nba_trades) October 22, 2016
It is also the date of the trade of that would have sent Danny Fortson to the Toronto Raptors.
In return, the Celts were to receive Alvin Williams and Sean Marks, but the trade was voided after Williams failed his physical.
(TONY RANZE/AFP via Getty Images)
Fortson would return to the team for the remainder of the season, only to be included in the league's first four-team deal that offseason that sent him to the Golden State Warriors the following offseason.
The deal also saw the Celtics trade Dana Barros to the Dallas Mavericks, the Mavs trading Robert Pack, Hot Rod Williams, and cash to Boston, and the Jazz trade a 2001 first-round draft pick which would eventually become Joseph Forte.
Celtics Lab 88: Making sense of the early deadline moves, rumors - and what it could mean in the East with Nick Fay
WATCH: Boston's two way forward Sam Hauser gets 30 points, 5 boards, 6 assists on 7-of-13 shooting from 3 vs. Grand Rapids
WATCH: Would it make sense to try and trade Robert Williams III for Indiana's Domantas Sabonis?
Celtics team president Brad Stevens called 'fair' in trade discussions by other execs (report)
Reports: Boston's Josh Richardson a Los Angeles Lakers, Minnesota Timberwolves trade target
Celtics at Nets: Boston beats up on a dinged-up Brooklyn, win 126 - 91 in blowout


text:
New Business Blueprint
Fourscore News
Often Present, Rarely Applicable
While most contracts contain various clauses that clearly specify when the obligations of each party cease to be enforceable, there is one particular boilerplate paragraph present in almost every contract that is less than clear. Parties to a contract usually agree that if certain unforeseen events take place, such as "Acts of God", that literally make performance impossible, it would be unreasonable for one party to enforce a contract against the other. An excuse of performance under these types of provisions typically requires notice from the party that is unable to perform because of whatever circumstances that are outside of their control. Those circumstances that trigger the application of this provision could be a hurricane or an earthquake, or it could be human action, such as armed conflict. If you haven't guessed already, we're talking about the "force majeure" clause.
The force majeure clause is one of those boilerplate paragraphs present in most contracts which is oftentimes glossed over by the parties. Because a "true" force majeure is rather rare, very few parties spend a significant amount of time or effort negotiating the language. Notwithstanding the rarity of its applicability, the language does actually matter (as does every provision of a contract). But, frankly, it is more likely to face a situation where a party claims the force majeure provision excuses their failure to perform than to face a situation where the force majeure provision actually does so. For that reason, it is important to make sure the triggers in the language are appropriately narrow to avoid potential arguments down the road. For example, in most cases, the fact that a party's email service went down for 6 hours should not trigger a force majeure, while a coordinated and nationwide cyber-terrorist attack that affected all corporate email services might. The specific context is crucial to determine the appropriate triggers of a force majeure clause. For example, if you are entering into a financial trading document, where significant damage can result from failure of one party's performance within minutes, you may want to include force majeure events when major markets or exchanges are down. Ultimately, however, you will want to ensure that the language in the contract sufficiently covers the underlying risk you may assume under the contract.
Recently, many communities and businesses in the southeastern United States battled through a major storm and are currently in clean-up mode thanks to Hurricane Florence. A major hurricane such as this has the potential to be a legitimate force majeure event under certain contract language, but again, the language matters.
The next time you enter into a contract, take a few minutes to read the force majeure provision. Apply the facts of Hurricane Florence and see if it would trigger the force majeure provision. Is it too broad, leaving wiggle room for a later argument? Do the notice requirements provide the necessary protection? At what point, if any, does the event cease to be a force majeure?
If you have any questions on force majeure or other legal principles that may apply to your contracts, please feel free to contact the lawyers at Fourscore Business Law.
Based in the Research Triangle region of North Carolina, Fourscore Business Law serves entrepreneurs and businesses in Raleigh, Durham, Chapel Hill, Wilmington, Charlotte and throughout the Southeast. We also represent venture capital funds and other investors who invest in companies located in New York, Silicon Valley and everywhere between.The idea of delivering maximum impact in a simple and succinct manner is what we're calling the Fourscore Principle. And that is what Fourscore Business Law is based on. Our clients operate in a broad range of industries including tech, IoT, consumer products, B2B services and more. Questions? Shoot us an email or give us a call at (919) 307-5356. Your first call is on us.
September 27, 2018 /by Jesse Jones
https://fourscorelaw.com/wp-content/uploads/2018/09/tulen-travel-143274-unsplash.jpg 3333 5000 Jesse Jones https://fourscorelaw.com/wp-content/uploads/2020/06/Fourscore-Logo_color-horizontal-logo.png Jesse Jones2018-09-27 02:44:272019-01-02 21:58:12Often Present, Rarely Applicable
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Some changes the Ontario government is making to its COVID-19 response
TORONTO — Here are some of the changes the Ontario government announced Thursday to its response to the COVID-19 pandemic:
_ On Dec. 31, publicly funded PCR testing will only be available for high-risk individuals who are symptomatic or are at risk of severe illness from COVID-19, as well as vulnerable populations.
_Those with symptoms should assume they have COVID-19 and isolate at home.
_ Most individuals with a positive rapid antigen test will no longer be able to get a PCR test to confirm the results.
_ Isolation period for those with COVID-19 will drop to five days from 10 for those who are vaccinated and children under 12 years old. Household contacts must also isolate.
_ Isolation ends after five days if symptoms have improved for at least 24 hours.
_ Individuals who are unvaccinated, partially vaccinated or immunocompromised will be required to isolate for 10 days.
_ School will resume on Jan. 5, two days later than originally scheduled.
_ School staff will have access to N95 masks and the province is rolling out 3,000 more HEPA filter units.
_ Only low-contact indoor sports and safe extracurricular activities will be temporarily permitted beginning in January.
_ Large indoor venues such as arenas, concert venues, and theatres are limited to 1,000 spectators.
_ Smaller venues remain limited to half capacity.
_ Fourth doses of an mRNA vaccine will be available to residents of long-term care homes, retirement homes, Elder Care Lodges and other congregate care settings if at least three months, or 84 days, have passed since the third dose.
_ The province is mandating third doses for all staff, students, volunteers, caregivers and support workers by Jan. 28, 2022.
_ Long-term care visitors will be required to show proof of a booster once the pause on visitation is lifted.
Dog trying to escape the cold gets a rude wake up call
Moe the dog is used to the door being open when he goes outside, but today it was closed. What happens next is a hilarious epic fail!
Why is it better to wear an N95 than a cloth mask right now?
NEW YORK (AP) — Why is it better to wear an N95 than a cloth mask right now? Health experts suggest stepping up protection against the highly contagious omicron variant with stronger masks such as N95s or KN95s. It's especially important now with health care systems under strain, and with people in higher-risk situations such as crowded, indoor settings for extended periods, says Linsey Marr, who studies viruses at Virginia Tech. The U.S. Centers for Disease Control and Prevention recently updat
Spike in deaths causes Yukon to declare overdose emergency
WHITEHORSE — The Yukon government has declared a substance-use health emergency after toxic drugs pushed overdose deaths to new peaks. Health Minister Tracy-Anne McPhee said Thursday the drugs are killing people and creating a mental health crisis in every community in Yukon. While the declaration doesn't provide the government with more powers, she said it does express a commitment to make the problem a priority and indicates the need for a co-ordinated response. "And it is a call to all Yukone
The U.S. Department of Homeland Security (DHS) is announcing Thursday it is requiring that non-U.S. essential workers such as truck drivers and nurses who are crossing land borders be fully vaccinated against COVID-19, effective Saturday. The Biden administration first announced in October that effective Nov. 8 it would again allow non-essential foreign visitors to travel from Canada and Mexico into the U.S. across land borders if they were vaccinated. The U.S. land borders with Canada and Mexico had been closed to non-essential travel for 20 months because of COVID-19 concerns.


LONGCASE GRANDFATHER CLOCK CHAIN 418cm - 29 links per 12"
6 BRASS LONGCASE CLOCK "S" HOOKS - SEALED AND STILL IN BAB UNUSED.
30 HOUR BIRDCAGE LONGCASE/GRANDFATHER CLOCK MOVEMENT & BRASS DIAL.
GENUINE VINTAGE LONGCASE GRANDFATHER CLOCK FACE.


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What the pro's are saying about Henrik Stenson's first major win
Erica Bloom
Henrik Stenson just won The 145th Open Championship and has been receiving high praise from countless Tour players. This is Stenson's first major win and you can see just how popular he is by what all of the pros are saying about him.
Rory McIlroy, who won The Open in 2014, said:
"It was such a popular win because we know how hard he works and some of the battles that he has had to go through in his career. So to come out the other end and get that major is really well deserved."
Justin Rose who is another extremely well liked player on Tour, said:
"It's so great to see him win. We have obviously given him plenty of banter over the last couple of years for not being a major champion…. so Henrik couldn't be more deserving.
"He works hard, he's a great professional, he's disciplined, he's got a great sense of humor and no one can begrudge him of that major title."
A lake Nona affair………Young boys whatching the old boys!!! Mabye the other way around in 20 years……..:-)
A photo posted by Henrik Stenson (@henrikstenson) on Oct 25, 2013 at 11:27pm PDT
What's so great about golf right now is that there aren't that many sore losers. If a player didn't come in the place they thought they would then they are hard on themselves, not on the player who won.
They are a tight knit group of guys who appreciate when one of their friends gets a chance to shine. They even add to the glimmer by lifting them up with the praise they think they deserve.
Clearly Stenson deserved this win and not only that but he earned it. He went 68, 65, 68, 63 to win The Open. He became the first ever male Swede to win a major and he has moved to 5th place in the world ranking.
Source: Matthew Lewis/Getty Images
Jack Nicklaus had a ton to say about the match between Mickelson and Stenson calling it one of the greatest rounds he's ever seen.
"I was fortunate to watch every second of today's final round of the Open Championship, and I thought it was fantastic," Nicklaus wrote.
"Phil Mickelson played one of the best rounds I have ever seen played in The Open and Henrik Stenson just played better — he played one of the greatest rounds I have ever seen."
Even Phil had praise for Stenson, even though he wanted to win just as badly.
"I played close to flawless golf and was beat," Mickelson said. "It's probably the best I've played and not won. But Henrik made 10 birdies, so what are you going to do? I like and respect him. It was impressive and he'll be a great champion."
Source: PA
It's always nice to see the pro's acknowledge one another but it seems that no one has gotten more praise than Stenson.
Erica	Bloom
You can find me in a golf cart discussing Game of Thrones over a beer (or two).


As China seeks to position itself as a reasonable power on the world stage, it must recognize the needs and aspirations of the multitude of "minority nationalities" within its territories. In this talk, Dr. Leo Shin will examine some of the "minority problems" China is encountering and situate them within a broader historical context. As a cultural historian of later imperial China, Professor Shin offers courses on Chinese and world history. Visitors are encouraged to learn more about his research and teaching as well as to explore the wider world of history and China resources.
Leo K. Shin is a cultural historian specializing in later imperial China. His research interest lies in the relationship between culture, identity, and historical memory. In his reading and writing, he seeks to understand in particular how the sociology of culture—the production, transmission, and consumption of beliefs and practices—has shaped not only how the boundaries of China have been drawn but also how China itself has been historicized. His current book project, The Uses of a Chinese Martyr, is a study of the memories of Yue Fei (1103–1142), the famous Song-dynasty general who was ordered to death by the emperor but who has since been transformed into the premier symbol of loyalism and patriotism in Chinese societies. The study examines the history of this transformation and explores what it may reveal about the relationship between culture, identity, and memory in later imperial China.


how to make the Footprints on My Heart bracelet.
and tools we'll need to make it.
the expandable charm bangle bracelet.
and then a 17 by five sterling silver vertical Mom charm.
that I'll use to attach the charms to my bangle bracelet.
so it'll be easy for you to customize your bracelet.
For my tools, I will just be using two chain nose pliers.
and I'm going to pick up a five millimeter jump ring.
with my two chain nose pliers.
Then I'm going to slide on my little amethyst charm.
but you could also put 'em back here too.
However you would like to do your bracelet.
and then gently close your jump ring.
Got the first charm on there.
Now I'm gonna go ahead and I'm gonna add the Mom charm.
it already has a little jump ring on there.
so I'm just gonna go ahead and remove this jump ring.
and then I'm going to attach it to the bangle bracelet.
And then the same thing with the footprint charm here.
to attach it to the bangle.
when you put it on there.
but your footprint's only on one side there.
Attach it to the bangle.
with the guide in the way.
or add charms that would fit your Mom.
for this inspiration design at FusionBeads.com.


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The Scorch Trails... what did I just watch? (Spoilers)
No seriously, what did I just watch?
Watching The Maze Runner last year as an enjoyably stupid experience, not on the level of Divergent which we saw with a cocktail in hand, but still fun. Although through out the entire movie there is this awareness at the back of you head that no answer will be satisfactory to setting, a nagging voice that is made worse by the fact it's a known trilogy.
Sure enough the visceral excitement of the group of teens trying to escape and survive this maze is met with an ending that... is so stupid. Unbelievably so.
Cult Classic - The Army of Darkness
I was first shown the 3rd in the Evil Dead series during a drama class, and I would be lying if I didn't say that I hated it, however my opinion was deeply shaded by the fact that I wasn't enjoying drama at the time and that the HSC was in the process of putting my brain though a blender. A couple of years later I caught Army of Darkness on television and was laughing my head off within a few minutes, seeing the first two movies isn't at all vital to enjoying the third.
The star of this series, Bruce Campbell enjoys a status in a similar fashion to Chuck Norris. Granted he doesn't have a third fist under his beard or have Jesus following him on twitter but he is recognised as the coolest hero of B-movies. The main character Ash, who chopped off his hand with a chain saw after it became infected with evil and since replaced it with the chain saw, has been sent back in time... Don't ask why... it's not important. Mistaken as a solider of Henry the Red he is taken to the castle in chains. He is sentenced to be executed by being thrown into a pit with unspeakable Eldritch horrors... just roll with it. After defeating the evils with his chain saw and double barrel Remington shot gun he frees Henry the Red's men and forces the people of the castle to find a way to send him home. This is also the scene where we get some of the best quotes from this movie, including 'all right you primitive screw heads, this. is. my. BOOM STICK'.
Embeth Davidtz plays the love interest Shelia, yes, that's really her name. I know this because I looked it up... thank you IMDB, and found out she is in fact cast as Mary Parker in the upcoming Spiderman reboot as well as having serious roles in movies such as Schindler's List. Where as Bruce Campbell appears to be able to survive simply off making cameos. The wise man tells Ash that he can return him home if he journeys to fetch the Necronomicon, a book the people also need to vanquish the evil in the land. After a brief montage of getting ready, in which we see an almost fetishistic love from director Sam Raimi of sudden zooms in, Ash leaves on his quest. Chased by a unseen evil he hides in a windmill and we enter one of the tripiest scenes... I don't really want to spoil what happens here as I don't think I could do it justice but the end result is an evil Ash appears. Ask buries his evil counterpart and continues on to the cemetery, he grabs the Necronomicon but fails to say the correct magic words and raises the army of darkness. Shelia is captured and thus Ash must rally the castle to fight against the forces of evil led by the again risen evil Ash.
This movie is great fun... it's pure retro silliness with a few really good lines. The special effects are bad even for the time but that adds to the enjoyment of it all. This is a fun movie to see but again one of those that is even better in a group, it has a decent re-watch value as well. Especially considering the first time you see it you'll spend a lot of time hitting your head and going 'WHAT?'.
Mega Shark Vs Giant Octopus
I debated where I should follow up on the bad movie trend after The Room and in my quest to find the worst of the worst movies one name keeps popping back up, one company that made a name for itself trying to cash in with cheap rip-offs of Blockbusters. The Asylum.
Whilst they normally limit their activity to confusing fans by releasing movies such as Transmorphers, Alien VS Hunter or classics like Bram Stokers Dracula's Curse. The Asylum has since moved into making original productions, whether this is for better or worse is really up for debate. Mega Shark Vs Giant Octopus has reached a large amount of popularity based on it's simple silliness, following a very set monster movie plot line the silliness is unfortunately seriously hampered. This movie is not as enjoyable as the Room, the acting is not by any measure good but for the most part tolerable and I can't really criticize the writing too much, the dialogue is cliched but never to an amusing level and even competent at times. That said it is difficult to imagine that the screenwriter had to sit down and write 'then the mega shark leapt thirty thousand feet into the air and ate a 747 jet'.
This movie really doesn't have a great re-watch value, The Room I was able to watch many times over, this however I struggled to get through once. Not because it was too bad such as Birdemic or anything but rather because it was just bad. It is worth a watch and certainly would be better seeing along in a group... preferably with alcohol.
Well, I thought that I've been reviewing so many things I love and praise as good it's time for me to take a quick walk down some of the doggier streets of the entertainment city, keeping my hand closely around my bag and my eyes to the ground. And I decided to start this walk with a movie that is unquestionably, undeniably bad, but also just so enjoyable!
Released in 2003 and proclaimed by the director/producer/writer/actor Tommy Wiseau to be 'the next street car named desire', The Room has reached a level of notoriety as a cult classic to rival that of something like the Evil Dead series. People go and see it with props and catch phrases ready just as they do for Rocky Horror Picture Show. But what is it that makes it so bad, why is this movie so monumentally made of fail and yet enjoyable. Let us take it in three parts, the writing, the cinematography and finally the acting.
The writing needs to be taken in 2 parts, the story and the dialogue. The story can be summarised as girl cheats on boy with his best friend. By no means a revolutionary concept, but it is in the finner more unique details that makes the story really stand out, important contemporary issues that carry important weight such as breast cancer, gang violence and drugs are picked up and then dropped faster than this script would have been by any studio in their right mind. A perfect example of this would be the main girl, Lisa's, mother. One of their incredibly brief conversations goes as such.
Mother: Everything always goes wrong at once, no-one wants to help me, and I'm dying.
Lisa: Your not dying mum.
Mother: I got the results of the test, I definitely have breast cancer.
Lisa: Don't worry mum every things going to be fine, they're curing lots of people every day.
And that's it. It is never mentioned again. But back to the plot, or what we are meant to assume is the plot. It starts with Johhny (Tommy Wiseau) and Lisa (Juliette Danielle) being a happy and prosperous couple. Well at least Johhny is prosperous at his job at the bank doing... something unspecified as compared to Lisa's job which apparently makes far less and in very competitive and has something to do with computers. Then, for no reason Lisa announces that she is unhappy and after her mother tries to draw in her 'rebelious attitud' which just causes her to run into the confused arms of Mark. And I mean confused, no matter how many times they have sex he always seems completely dumbfounded by what is happening. Character development takes a back seat too... well I'm not really sure what it is that Tommy Wiseau has replaced it with. He certainly writes in opportunity for character development, there is an incident where Mark is confronted by another friend about his affair with Lisa and then goes off and shaves his beard. I had originally thought that this was meant to represent him getting his life in order and he was going to start being a good friend but then he just sleeps with Lisa and goes back to being a bit of a confused dick. So, there is no character development at all.
Does the writing improve with the dialogue, short answer no, long answer... noooooooooo. Well, to be fair the dialogue is only bad, not as horrible as the characters or plot. The only reason some lines are so memorable is in their delivery, this brings us right into the acting. It is spectacularly strange to watch, like seeing a children's play but you don't have the excuse of politeness to stop yourself from laughing. The worst of the worst is our star, Tommy Wiseau, who you could spend the entire movie attempting to guess just what accent he has. Hi acting is bland to periods where he tries to emote and just painfully inflicts on the wrong words. But we can thank him for the Internet meme of...
'YOUR TEARING ME PART LISA'
That isn't to say that the other actors are much better. Juliette Danielle's main acting talent seems to lie in her ability to pout, and pout, and pout... and... pout. She is also able to make every one of the sex scenes she is in awkward as she struggles to remove clothing in fluid movements. The other special actor to mention is Phillip Haldiman as Denny. This character... confuses most, and understandably so. He is said to be the 'ward' of Johnny, as Johnny wanted to adopt him and is now paying for his apartment in the same building. Ummm... and the first scene we have with Denny is him wanting to go up to the bed room with the 2 main characters and then follows them up saying 'I just like to watch you guys'. I believe the actor was going for charmingly innocent, but he just comes across as perverted and creepy.
The cinematography of this is, special. Most of the shots are well done if a little boring and pretty standard. Its the endless shots of San Fransisco that causes with stock music over it that gets painful, especially if you set a drinking game to it. The editing is often confusing and I am positive they got the order of certain shots wrong at one point.
All these things considered, you really do need to see this. Three weeks after it came out and was canned as a drama and praised as an accidental comedy Tommy Wiseauamusing but just comes of as tired. This is really Tommy Wiseau's magnus opum.


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20 Finding Aids.
Virginia Agricultural and Mechanical College and Polytechnic Institute in subject [X]
• Virginia Agricultural and Mechanical College and Polytechnic Institute [X]
• Virginia Polytechnic Institute (19)
• University Archives (15)
• University History (11)
• Faculty (10)
• Local/Regional History and Appalachian South (5)
• Montgomery County (Va.) (5)
• Blacksburg (Va.) (4)
• Virginia Polytechnic Institute and State University. Corps of Cadets (3)
• Medal of Honor (2)
• Virginia Agricultural and Mechanical College (2)
• Food Technology and Production (1)
• Forests and forestry (1)
• Heraldry (1)
• History of Food and Drink (1)
• Horticulture (1)
• New Yorker (New York, N.Y.: 1925) (1)
• Women--History (1)
A Guide to the Harold C. Cox Memorabilia Collection, 1923-1984 #Ms2014-014
Local/Regional History and Appalachian South | Montgomery County (Va.) | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute and State University | Virginia Polytechnic Institute and State University. Corps of Cadets
A Guide to the Dayton M. Kohler Papers, 1889-1972 #Ms1971-002
Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University | Faculty | University Archives
A Guide to the Stanley A. Huffman, Jr., Papers, 1917-1991 #Ms1991-056
A Guide to the Henry B. "Puss" Redd Collection, 1930-1984 #Ms2013-017
Faculty | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Leon Dalmain Simmons Memorabilia, 1933-1987 #Ms1998-030
University Archives | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Virginia Polytechnic Institute and State University Dance Cards, 1909-2002 #Ms2002-023
A Guide to the Harry Downing Temple. Jr., Papers, 1872-2004 #Ms1988-039
Special Collections and University Archives, Virginia Tech, Blacksburg, Va.
Heraldry | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University | Virginia Polytechnic Institute and State University. Corps of Cadets
A Guide to the William A. Duerr Papers, 1934-1987 #Ms1975-006
Faculty | Forests and forestry | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Carol M. Newman, Jr. Papers, 1930-1987 #Ms1978-004
Faculty | New Yorker (New York, N.Y.: 1925) | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
10Title:
A Guide to the G. Burke Johnston Papers, 1900-1992 #Ms1983-005
Faculty | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Frank Horsfall, Jr. Papers, 1917-1973 #Ms1992-040
Faculty | Horticulture | Science and Technology | University Archives | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Henry M. Morris Papers, 1937-1999 #Ms1994-028
Faculty | Science and Technology | University Archives | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Biographical Vertical Files, 1960s-present #VerticalFile.004
Blacksburg (Va.) | Local/Regional History and Appalachian South | Montgomery County (Va.) | Virginia Agricultural and Mechanical College | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University | Women--History
A Guide to the Robert E. Femoyer Papers, 1938-1996 #Ms2000-091
Medal of Honor | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Virginia Polytechnic Institute and State University Postal Card Collection, 1906-1995, undated #Ms2002-025
Blacksburg (Va.) | Local/Regional History and Appalachian South | Montgomery County (Va.) | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Antoine Gaujot and Julien E. Gaujot Papers, 1840-1999 #Ms1992-046
A Guide to the Virginia Congress on Hunger 1988 Report Collection, 1985-1988 #Ms2015-050
Agricultural extension work | Agriculture | Food Technology and Production | History of Food and Drink | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Rudolph Dixon Michael Papers , 1925-1984 #Ms1960-005
Special Collections, Virginia Polytechnic Institute and State University
Blacksburg (Va.) | Faculty | Local/Regional History and Appalachian South | Montgomery County (Va.) | University Archives | University History | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University
A Guide to the Historical Photograph Collection (List of Subjects), 1890s-present #Photographs.001
Agricultural extension work | Blacksburg (Va.) | Local/Regional History and Appalachian South | Montgomery County (Va.) | University History | Virginia Agricultural and Mechanical College | Virginia Agricultural and Mechanical College and Polytechnic Institute | Virginia Polytechnic Institute | Virginia Polytechnic Institute and State University | Virginia Polytechnic Institute and State University. Corps of Cadets