With 24 stunning gift ideas you'll find plenty of inspiration for your loved ones, but don't forget about yourself when checking out this great post. The good news is making multiples of these gifts is easy.
So spoil yourself…and I suppose everyone you know too with these fun and chic gifts. With everything from jewelry to a spa in a jar you won't run out of ideas any time soon.
These relaxing bath bombs are perfect for those who enjoy a long soak in the tub or want a soothing spa experience at home. Pack a few together and they'll love it!
These personalized pieces of jewelry can be adapted to suit any style and they cost less than $2.50 to make. They are a great way to give someone you love a beautiful and meaningful gift!
Help ease those aches and pains with these easy to make massage truffles that will totally rejuvenate the receiver! Why not make them a mix of bath bombs and these as an at home spa kit!
Terrariums are fun micro gardens which are designed to take care of themselves. This fun gift is an ingenious alternative to a bunch of flowers or ideal for someone who loves a garden.
This thoughtful gift is a fun way to l,earn more about your own family or your friends roots. It will give them something they'll be able to cherish forever and looks amazing when it's finished!
This delightful idea is a great way to incorporate a trip or an experience you shared with someone into a gift that they'll love. You can easily adapt it to suit your needs or a specific memory you want to share!
This stylish piece of jewelry is a lot easier to make than you'd think and is a fantastic gift. Spoiling someone you love with completely unique and original jewelry has never been so easy!
The fashion conscious will adore this subtle yet elegant necklace. You don't need to be a master jeweler to make it…it really doesn't come much easier or more fashionable than this!
Who wouldn't love a spa trip as a gift…but since that comes with an expensive price tag this is the next best thing…In fact it's better. No need to drive anywhere or even get dressed…relax at home in the lap of luxury with this must have gift!
We all know a die-hard foodie that loves to try new recipes and this is the perfect gift for them. They can enjoy looking at the recipe on their iPad while cooking up a storm.
This fun and simple DIY is an easy gift to make that anyone would love to have. Perfect for dinner parties, casual canapes or nibbles with friends or as a stylish way to enjoy a snack…no homes complete without one!
These easy to make candles will look fantastic in quirky and chic thrift store cups, so you don't have to ruin your china! Why not adapt this simple DIY to include a fun scent too!
Transform an every day diary into a vibrant notebook that can either be a fabulous gift or a quick and easy party favor for something a little bit different.
With full step by step photography and a detailed tutorial there's no need for you to worry about making these…they couldn't be any easier to make. You'll soon be such a pro at sewing them that everyone will get one!
This is such a simple and straightforward ideas but you can adapt it for any event or anyone you know. Whether it's full of messages from loved ones, friends or even teachers this is a gift that will be cherished!
These beautiful luminaries can be made in just a matter or moments and will create such a beautiful ambiance you won't want to give them away. So make spares and keep some for yourself.
Stamp any message you want onto these elegant and trendy homemade necklaces. Why not add a few charms to give it the truly original look!
Whether the person you have in mind is a foodie or a lover of all things garden this is a wonderful gift to give them. It contains everything they need for growing their own herb garden!
Pop them in a cupboard, the car, draws or wherever you need to combat unpleasant smells. The soothing scent of lavender so always popular and will make any space smell delightful!
This simple tutorial will show you how to make a luxurious body scrub that will leave you (ahem the receiver of this gift) with smooth and rejuvenated skin.
Whether you know a baker extraordinaire or a beginner this thoughtful gift will help fan the flame of their passion and maybe even inspire them to make you a bathc of tasty cakes. Plus you'll see 4 other fantastic gifts in Jars too!


"That's How They Getchya"– The Ostensible Subcontractor Rule – The VA honored GCARL by selecting GCARL Contributors Rod Hagen and GCARL President Carl Gebo to reprise their popular presentation on the troublesome affiliation rule that keeps tripping up so many small businesses on set aside procurements. Nothing "kills the thrill" of a Notice of Award like a Notice of a Size Protest. And nothing is worse than losing that award because the Small Business Administration Area Office or the Office of Hearing and Appeals determines that your small business was "unusually reliant" on your subcontractor. By knowing how to see and avoid the traps for the unwary, GCARL will help you steer clear of that "Ostensible" Obstacle. If you are attending the NVSBE 2016, then please come on by our Learning Session in Meeting Room 200-H on Wednesday, Nov. 2nd 10:05am - 10:50am.
And Don't Forget to Visit Us in our Exhibitor Booth # 102.
October, 2016 – ".... They're So Hot Right Now"


Living The Classy Life | LOVE yourself. LOOK your best. LIVE your life!
If procrastination is something that has haunted you for the longest time, like it's done me, then check out the easy way I've found to break that frustrating habit.


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1 - 2 of 2 results for: HISTORY40
HISTORY 40: World History of Science
(Same as HISTORY 140. History majors and others taking 5 units, register for 140.) The earliest developments in science, the prehistoric roots of technology, the scientific revolution, and global voyaging. Theories of human origins and the oldest known tools and symbols. Achievements of the Mayans, Aztecs, and native N. Americans. Science and medicine in ancient Greece, Egypt, China, Africa, and India. Science in medieval and Renaissance Europe and the Islamic world including changing cosmologies and natural histories. Theories of scientific growth and decay; how science engages other factors such as material culture and religions.
Instructors: Proctor, R. (PI)
HISTORY 40 | 3 units | UG Reqs: GER:DB-SocSci, WAY-ED, WAY-SI | Class # 16929 | Section 01 | Grading: Letter (ABCD/NP) | LEC | Students enrolled: 11
01/06/2020 - 03/13/2020 Mon, Wed 9:30 AM - 11:20 AM at 200-002 with Proctor, R. (PI)
HISTORY 40A: The Scientific Revolution
(Same as History 140A. History majors and others taking 5 units, register for History 140A.) What do people know and how do they know it? What counts as scientific knowledge? In the 16th and 17th centuries, understanding the nature of knowledge engaged the attention of individuals and institutions including Copernicus, Galileo, Descartes, Newton, the early Royal Society, and less well-known contemporaries. New meanings of observing, collecting, experimenting, and philosophizing, and political, religious, and cultural ramifications in early modern Europe.
Instructors: Riskin, J. (PI)
HISTORY 40A | 3 units | UG Reqs: WAY-A-II, WAY-SI | Class # 31852 | Section 01 | Grading: Letter (ABCD/NP) | LEC | Students enrolled: 13
01/06/2020 - 03/13/2020 Tue, Thu 3:00 PM - 4:20 PM at 200-002 with Riskin, J. (PI)

redpajama_set_name: RedPajamaCommonCrawl


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La saga de Kristni es una de las  sagas de los obispos escrita a mediados del siglo XIII. Su argumento se concentra en la cristianización de Islandia desde finales del siglo X hasta principios del siglo XII.

La trama se alimenta de diversas fuentes pero tiene todos los indicios de ser un trabajo de autoría individual. Su fuente principal es Íslendingabók pero más breve y mucho más informativa sobre la obra misionera de Þangbrandr, la conversión y los primeros obispos de Skálholt hasta la muerte de Gissur Ísleifsson en 1118. Kristni þættir y la saga de Kristni aportan mucha información adicional de los primeros misioneros, el viaje de Thorvaldur Kodransson y el obispo Friðrekr.

Referencias

Bibliografía
Biskupa Sögur I, Íslenzk fornrit XV, ISBN 9979-893-15-X (sec. Kristni saga)

Enlaces externos
 Íslendingabók; Kristni saga: The Book of Icelanders; The Story of the Conversion, tr. Siân Grønlie, Viking Society for Northern Research Text Series 18, London: Viking Society for Northern Research, 2006, ISBN 9780903521710, pdf

Sagas de obispos
Cristianización de Islandia

redpajama_set_name: RedPajamaWikipedia


This Sunday: Fr Reg Bushau SSC will be our Preacher and Celebrant. Our old friend Alan Littell will substitute for Charles on the organ. Many thanks to them both for their help.
Patronal Festival: this year's Patronal Festival will be on Sunday 24th June. The cost is £15 (children £10): please sign up with Gwen. Please pay immediately for your place to be confirmed. As before, preference is given to members of the congregation so please do not invite more than 2 guests (until 10th June).


This initiative would require outside groups attempting to influence city elections to disclose their donors and ban corporations from directly contributing to candidates. Both of these measures are already in place for state-wide elections.
This initiative would create a small donor matching program, funded by $2 million of the city's budget, for candidates who refuse special interest contributions in order to enable citizens without connections to large financial resources to run for office.
This initiative would decrease the maximum contribution and individual could give to a candidate to $1,000 for a mayoral candidate, $400 for a district council candidate, and $700 for all other positions.
Join the fight for Yes on Democracy for the People: Initiative.


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Close up with NovationWire: a New Type of PR Distribution Service
HONG KONG – NovationWire is an organization that had everything in place to succeed in 2021. They had a 100% remote workforce in place. Their DNA was already in the cloud. The press release distribution industry was already at an inflection point. Overly consolidated. Expensive. The pandemic has resulted in the recalibration of corporate strategies. With that, online is where you have to be. And their market-disrupting price point is really attractive right now.
NovationWire uses its own proprietary distribution channels that combine client press releases with news stories from thousands of newsrooms, globally, into geographic, industry, and subject-grouped newswires. These highly-targeted newswires are a valuable source for anyone interested in breaking news or background material, including reporters, industry leaders, decision-makers, influentials, and even the interested public.
Press releases are further disseminated through NovationWire's social media newsfeeds, the NovationWire news apps (iOS & Android), and made available to thousands of editors and journalists.
NovationWire Chief Executive Officer and Founder, Peter said: "It's very powerful when your newswire service is also a leading publisher of industry news. We've created compelling distribution channels for press releases which we've been able to offer at a fraction of the cost of the traditional newswires because we're using our own proprietary technology to power the distribution network."
"We're offering a real alternative to public relations professionals — at companies and organizations – who are looking for a more affordable option with better results. Our clients also appreciate our DIY upload program. In fact, we're so affordable and easy-to-use, we've branded NovationWire as "Everyone's Internet News Presswire." Peter concluded.
NovationWire launched several years ago as an online news monitoring service and is now a major player in the newswire industry, disrupting the $2 billion-plus press release distribution market. The company entered the press release distribution space a few years ago to provide public relations and marketing professionals at large and small companies, associations, advocacy groups, NGOs, and government agencies with better, more modern options.
Source:https://kjnewswire.com/9262/close-novationwire-new-type-pr-distribution-service


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redpajama_set_name: RedPajamaGithub


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The Critic's Credentials: On "Rotten Reviews Redux"
November 30, 2012 • By William Giraldi
IN 1922, FIVE YEARS before E.M. Forster published his immortal Aspects of the Novel, the English critic and editor Percy Lubbock published The Craft of Fiction, a meticulous autopsy of Tolstoy, Flaubert, and James, among other titans, and probably the first book, according to Mark Schorer, "that tried to treat fiction as an art." Lubbock's treatment was decidedly different from Forster's because its methods derived from a formal critical intelligence and not the lightning of creative acumen. You read Aspects of the Novel and are firmly ensconced within the mind of a supreme creator; you read The Craft of Fiction and are expertly chaperoned through the catacombs of literary creation.
If Lubbock's book has been forgotten as Forster's has not, it might have something to do with the pervasive suspicion that the best literary comment is always penned by those who are masters of the genre they comment on. (Lubbock published a single unsuccessful novel called The Region Cloud in 1925.) That suspicion was helped along in the first half of the twentieth century by the great poet-critics who tweaked the way the world looked at verse: Eliot and Auden, Yvor Winters and R.P. Blackmur, Conrad Aiken and Robert Penn Warren, Allen Tate and John Crowe Ransom, and perhaps, save Emerson, the most distinguished poetical-critical mind in American letters, Randall Jarrell. Their status as eminent poets allotted their criticism the stab of verity. Should you visit a priest for marital counsel? Probably not.
It hasn't quite worked out that smoothly with the novel. There are the exceptions, of course — Forster and James, Trollope and D.H. Lawrence, Orwell and Pritchett, Mary McCarthy and Elizabeth Hardwick, Updike, Vidal, Martin Amis — but by and large our most necessary and sustained analyses of the novel, especially in the twentieth century, came from critics who were not themselves primarily novelists. Edmund Wilson and Lionel Trilling published a novel apiece — and Trilling's racked ambition to be a novelist is well known — but a single novel among alps of the nation's most persuasive criticism does not a novelist make. H.L. Mencken, Malcolm Cowley, Alfred Kazin, Irving Howe, Lewis Mumford, Dwight McDonald, Stanley Edgar Hyman, Wayne Booth, Frank Kermode, Jacques Barzun: no novels. Leslie Fiedler bled out two novels among his nearly forty books but you may without repentance forget them. Harold Bloom, too, might have a novel among his plangent catalog but he wishes you wouldn't mention it. Cynthia Ozick has written beautiful fiction but her prime and indispensable worth is for the literary essay. Denis Donoghue, Andrew Delbanco, Leon Wieseltier, Morris Dickstein: no novels.
This is all to suggest that Lubbock's The Craft of Fiction is every bit as valuable as Forster's Aspects of the Novel and has been unjustly interred in the bone yard of irrelevance. It's especially vital now in our present climate of criticism — a climate in which the Net has spawned a cacophony of gabble impersonating literary comment, palaver and vulgate enough to warp you. Literature has always had its leeches, except now the Net has given every one of them a bog to wiggle around in. This wouldn't be any more of an issue than it is to ignore the wastrel on the corner dispensing pamphlets on anarchy, but as respectable print publications either prune their space for book commentary or else go extinct altogether, more and more criticism — like more and more of everything else — is migrating to blogs and social media sites. Young or new book readers looking for literary analysis are going to have an increasingly arduous chore of dividing the shit from the serious. Worse, the biddable and ovine will gravitate to the shit because that's where all the buzzing is. If you've ever attempted to read a review on Amazon or on someone's personal blog, you know it's identical to seeking relationship advice on the wall of a public restroom.
Which brings us back to Lubbock, and to what Stanley Edgar Hyman once dared to name "the critic's credentials." Henry James's close friend and posthumous editor, Lubbock is his most incisive when holding forth on James's critical capacity. After dismissing the "thinness" and fatuity of a literary evaluation based upon "I like you, I bless you" or "I like you not, I damn you," Lubbock offers this indelible bit:
If you ask Henry James whether he "likes" some book under discussion, the roll and twinkle of his eye at the simplicity of the question is a lesson in itself, and one that a young critic will never forget. Where, he seems to say, on the loose fabric of a mere preference or distaste will be found the marks of the long wear and tear of discrimination that are the true critic's honorable and recognizable warrant? It needs a solider consistency to stand the pressure and take the imprint of the accumulating weight of his scrutiny; and certainly there was no light fondness or hasty petulance in Henry James's praise or blame of a book. A large unhurried mind, solitarily working and never ceasing to work, entirely indifferent to the changes and chances of the popular cry, it was this that gave its sonorous gravity to Henry James's opinion of the thing that he rated.
The long wear and tear of discrimination. The true critic's honorable and recognizable warrant. The accumulating weight of scrutiny. In other words, "James's opinion" was no mere opinion at all, no "mere preference or distaste" swayed like wind chimes by "the popular cry." What a critic likes and feels is immaterial; it's what a critic sees and thinks that matters. But that is precisely what you'll find spattered across the Net and in many a newspaper east to west: unlettered opinions with scarcely more authority than the feral scratching in Cro-Magnon's diary. The critic's credentials — the assertion of an aesthetic and moral sensibility wedded to a deep erudition — haven't changed since James's day; and yet with scant exceptions our culture seems to have misplaced the requirement for those credentials.
Bloggers and other online epigones are the impetus behind editor Bill Henderson's reprisal of his 1987 bestseller Rotten Reviews. (Henderson is the publisher of the long-standing Pushcart Prize series, a labor of love and annual celebration of literary journals for which he deserves to be sainted.) Now called Rotten Reviews Redux, this priceless little compendium boasts a new preface by Henderson in which he castigates the "unfettered, unedited, unfiltered, and ridiculous rage" rampant on the Net. But it's not necessarily the foppish rage that so incenses Henderson — it's the anonymity: "Anonymous online critics ambush unprotected writers in bursts of verbal automatic rifle fire." We now live, according to Henderson, "in an online Wild West." The image is apt, whether or not your business is literature. "All civility gone. Empathy, balance, decency, knowledge, out the window. Everybody a blogger. Everybody an instant critic."
That's a pretty accurate description of the online culture of masked assassins. But as for serious criticism: James and any of the abovementioned critics would have taken issue with "empathy" and perhaps "decency" — the peerless Mary McCarthy would have cringed — since in this case the nouns mean the same thing and in any case have no bearing on the true critic's mission. F.R. Leavis, in his best book of essays, The Common Pursuit, offers memorable attributes for the critic during his discussion of Robert Bridges, the poet responsible for editing and delivering Gerard Manley Hopkins to the world: "What he exhibits is a complete security; a complete incapacity to doubt his competence or to suspect that the criteria by which he condemns, condones, corrects and improves might not be appropriate." Leavis snatched his title from T.S. Eliot's essay "The Function of Criticism" — a nod to Matthew Arnold's seminal essay "The Function of Criticism at the Present Time" — in which Eliot defines criticism as "the common pursuit of true judgment." Empathy is required of us when dealing with children and animals and people in need, but empathy in criticism hinders that Eliotic pursuit of truth. Is it not downright ethically repugnant for a critic to tailor his estimation to the slender emotions of an author?
The vitriolic, lawless picture Henderson draws of the online literary mob is of course only half complete. Because he doesn't pass much time on the Net — bless him — there's another side Henderson might be unaware of: a community of coddlers who approach literature as if it were a Sunday knitting circle. On Twitter and Facebook, on their own websites and blogs, this feel-good community praises one another in pastel colors. (For specifics, see Jacob Silverman's "Against Enthusiasm" in Slate from last summer.) Literature to these online cabals is a social event and not an artistic endeavor; they congregate to swap recipes of cuisine no discerning person would ever care to eat. The idea that a novel can be garbage, and that a critic has the imperative to call it such, is anathema to their aspartame outlook; these vast middle-strata scribes have turned to writing, apparently, because Habitat for Humanity is too demanding. The concept of incessant community in literature is preposterous to begin with. In his Nobel speech Hemingway delivered a truism only a counterfeit could deny: "Writing, at its best, is a lonely life," and of course he means that writing at its best must be a lonely life. All those dysphasic Tweets and Facebook posts and status updates of the status-less? They're an easeful substitute for the hellish emotional and psychological confrontation that genuine literary work requires.
Henderson disapproves of the harsh criticism collected in Rotten Reviews Redux, and in this he might be surprised to find himself aligned with those hoards of online coddlers. It's simple to dismiss jacklegs with no critical cunning, but how do we deal with exalted writers cutting down other exalted writers? As Anthony Brandt remarks in his introduction, "One of the pleasures of this wicked collection is watching the great being terribly wrong about the great." Brandt quotes James twice and Henderson quotes him twice more. On Wuthering Heights: "a crude and morbid story." On Our Mutual Friend: "We are convinced that it is one of the chief conditions of his genius not to see beneath the surface of things . . .We are aware that this definition confines him to an inferior rank." On Middlemarch: "A treasure-house of details, but it is an indifferent whole." On Whitman: "Mr. Whitman's attitude seems monstrous. It is monstrous because it pretends to persuade the soul while it slights the intellect; because it pretends to gratify the feelings while it outrages the taste."
The first two novels aren't difficult to tackle: Wuthering Heights is indeed "a crude and morbid story" next to James and especially the late James. No critic whose name has endured has ever argued that Brontë's gift for storytelling could lie on the same plane as James's leviathan genius. And if Dickens doesn't see deeply enough for James in Our Mutual Friend, well, compared to James every other novelist in English save Saul Bellow has cataracts. It's also true that Our Mutual Friend, with its perplexing characters and wayward narrative, doesn't equal the sublime achievements of Bleak House and Great Expectations.
But about James's views of Middlemarch and Whitman one can only shrug and maybe say that the master was momentarily out of his mind. To claim that George Eliot's masterpiece — for some of us the masterpiece of nineteenth century British fiction — is "an indifferent whole" rather misses the point on purpose. Here one must keep in mind James's aesthetic and formal program: he despised artistic looseness and once described British fiction as "a paradise of loose ends." So when James asserts that Middlemarch is "an indifferent whole" he means that its narrative structure is looser than he himself would have allowed. Read The Ambassadors — for James it was his most finely executed book — right after Middlemarch and you'll register immediately the difference between the loose and the taut. James didn't care that Eliot's grand social and moral vision required that looseness because he wouldn't allow that there was more than one way for artistic genius to be manifest.
As for the divine Whitman — our exuberant homegrown Dionysus, our anointed crooner without whom American character would be neutered — he assailed James's refined sensibilities and so his comments indicate more about James himself than they do about Whitman. Despite Lubbock's insisting that mere taste never factored into a Jamesian appraisal, Whitman "outrages" James's taste. But James was an artist and thinker for whom taste was not subjective, not a simple matter of preference, not susceptible to the climes of human caprice. Taste for James was a dignified outcropping of one's intellectual and moral faculties, so what he really means in his remarks is that Whitman danced like a dervish, which was exactly what our nation needed during that dark night of the soul when he penned his deathless hymns. Henderson touchingly dedicates this volume to Whitman, and Brandt asks us to consider whether or not we "would have had the courage or the insight in 1855, say, to recognize the greatness of the author of Leaves of Grass when the rest of the literary world, almost to a man, was calling him a clown." Well of course we would have.
Henderson scares up some extremely funny barbs, and that's a topic that might deserve finer scrutiny: negative criticism as comedic art form, as living example of Twain's perfect observation, "Against the assault of laughter nothing can stand." In 1912 a French editor named Marc Humblot sent a rejection letter to Proust that contained these lines: "My dear fellow, I may perhaps be dead from the neck up, but rack my brains as I may I can't see why a chap should need thirty pages to describe how he turns over in bed before going to sleep." The hilarity of that derives from its diction and tone, as it must, but it's funny also because you know you've felt the same way about sections of In Search of Lost Time — you've felt the same way while acknowledging that Proust's narrative is a mimesis of the intricate mechanism of memory, and that those thirty pages are at once tedious and glorious. Funnier still is this quick swipe by someone at The Independent writing about Maugham's Of Human Bondage: "Its ethics are frankly pagan."
Henderson could have included some other caustic gems sprinkled throughout letters, interviews, memoirs, and essays: Waugh calling Proust "mentally defective"; Baudelaire insulting Voltaire as "the king of nincompoops"; Vidal's characterization of Updike as "just another boring middle-class white boy"; Noel Coward calling Wilde "a tiresome, affected sod"; James Gould Cozzens declaring, "I can't read ten pages of Steinbeck without throwing up." These verdicts, like most of the verdicts in Rotten Reviews Redux, might supply weight to the erroneous impression that literary comment is a fickle affair, prone to personal weather, but they also have the benefit of being both fun and prodding. If you aren't already inclined to think of Cozzens as a complete ass you might just try to understand where he's coming from.
Anatole France insisted, "We may despair of knowing, we must not despair of judging," and yet it is the charge of responsible critics to know before they judge, to assert erudition in assessment, to bring a lifetime of reading to bear upon any book under review and in that way hold writing to the most rigorous intellectual and aesthetic standards. A world with no deservedly antagonistic reviews would be a literary Disneyland: a wretched uniformity of pleasantness. No dissent, no plurality. A place of whitewash and monotony where happiness is the province of denuded minds. We have a name for an environment of ceaseless sun and no storm: it's called the desert. "Literature always thrives best," wrote Mencken, "in an atmosphere of hearty strife." The moment we stop fighting about books is the moment they cease to matter. Right or wrong, contemptuous or comical, the critics Henderson has collected understood that literature is not a play date for mutually reassuring peddlers but rather the highest possible calling in the arts.
William Giraldi
William Giraldi is author of the novels Busy Monsters and Hold the Dark, the memoir The Hero's Body, and an essay collection, American Audacity. He is an editor for the journal AGNI at Boston University.
The Art of the Critic: On James Wood
IN AXEL'S CASTLE, Edmund Wilson bemoaned Ezra Pound's poetry for being "partially sunk by the cargo of its erudition" — a metaphorical bon mot that expresses Pound's limitations as a poet better than ...
Eden of Clowns
"You've probably heard the news: We Americans are a mob of dipshits."...
Criticism of Criticism of Criticism
Illustration: Fox writing with a quill pen (1852) Courtesy of The New York Public Library THE RENAISSANCE COURTIER and author Philip Sidney described poetry as "that which, in the noblest nations and languages that are known, hath been the first ...
The Room and the Elephant
On internet criticism, Wikipedia, and the waning of expertise....


text:
Yorkvill puede referirse a dos localidades en el estado de Nueva York:

 Yorkville (Manhattan); o
 Yorkville (condado de Oneida, Nueva York)


As an EB-5 investor, how can I get my money back if I no longer wish to obtain a green card?
I have invested $500k in an EB-5 project and have the provisional green card approved. What happens with the $500k if I cannot live in the United States anymore because of personal circumstances? Do I get my money back or is it lost forever? As it took much more than 6-8 months to be approved, my circumstances have changed. What can I do to get my money back?
It will depend on the exit procedures of your project. Some allow for full refunds. Others do not.
Once the provisional green card is approved, chances are the regional center handling the investment might have already invested the funds on the project. While this scenario is unusual, the chance for withdrawing at this point is rather slim. To better address this circumstance, consult the exit strategy or clause in your agreement with the regional center. Advisably, also consult an EB-5 attorney for further examination of possible options, if any exist.
Since you have already invested your funds and obtained your Conditional Green Card, even though you wish to recoup your funds, you may have to wait like all other investors to receive a return of your funds after the stipulated owning period set forth in the documents provided to you. There is no reason why you would lose the opportunity to have your funds refunded along with any other EB-5 investor just because you may relinquish your Conditional Permanent Residency.
You have to study the subscription agreement to see under what circumstances you can cancel the contract. However, generally, even if your circumstances have changed, that is not a valid reason to cancel your contract because the investment is committed. On the other hand, if you can get a replacement investor, maybe by offering a discount, you might be able to substitute that investor if the regional center and project allow it.
If you made an equity investment, the only way to get your money back is to ask the company/sponsor to redeem your shares/units. If there are provisions for this, it will be contained in the offering documents of the investment that hopefully were provided to you. If your money is in the form of a loan, this gets more complicated. However, be aware that there is generally no guarantee that you will get your money back after an EB-5 investment. Your investment was, is, and still may be at-risk, as required by EB-5 criteria. Whatever the case, you are going to need legal counsel to look over your offering documents if you want to back out. At this late stage, it may actually make more sense to stay in.
When, and whether or not, you get your money back depends on the subscription agreement, loan agreement, and partnership agreements you have signed. As most EB-5 cases are set up on loan-based models, once the investment is made and the partnership has made the loan, the investment is locked in until the loan term matures and can be paid back. Please review your offering documents, and consult with your lawyer and regional center.
You need to look to your agreement with the developer/regional center/project to see what your options are at this stage for recovering your funds.
An EB-5 application has two parts: immigration and investment. You have made an investment, and how and when your investment capital will be returned will be contingent on the terms of the agreement you signed.
You can sell whatever saving or assets you have in the business. If you decide not to live in the United States after EB-5 approval and lost money on your investment, then this is a risk you decided to take and those are the consequences.


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International Journal of Clinical Rheumatology
Research Article - International Journal of Clinical Rheumatology (2018) Volume 13, Issue 1
Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data
David J. Kreps1, Florencia Halperin2,3, Sonali P. Desai1,2, Zhi Z. Zhang1, Elena Losina2,4, Amber T. Olson1, Elizabeth W. Karlson1,2, Bonnie L. Bermas5 & Jeffrey A. Sparks1,2*
1Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA
2Harvard Medical School, Boston, MA, USA
3Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, USA
4Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
5University of Texas Southwestern Medical Center, Dallas, TX, USA
Jeffrey A. Sparks
Division of Rheumatology
Brigham and Women's Hospital
Background: Objective: To evaluate the association between weight loss and rheumatoid arthritis (RA) disease activity.
Methods: We conducted a retrospective cohort study of RA patients seen at routine clinic visits at an academic medical center, 2012-2015. We included patients who had ≥2 clinical disease activity index (CDAI) measures. We identified visits during follow-up where the maximum and minimum weights occurred and defined weight change and CDAI change as the differences of these measures at these visits. We defined disease activity improvement as CDAI decrease of ≥5 and clinically relevant weight loss as ≥5 kg. We performed logistic regression analyses to establish the association between improved disease activity and weight loss and baseline BMI category (≥25 kg/m2 or <25 kg/m2). We built linear regression models to investigate the association between continuous weight loss and CDAI change among patients who were overweight/obese at baseline and who lost weight during follow-up.
Results: We analyzed data from 174 RA patients with a median follow-up of 1.9 years (IQR 1.3-2.4); 117 (67%) were overweight/obese at baseline, and 53 (31%) lost ≥5 kg during follow-up. Patients who were overweight/obese and lost ≥5 kg had three-fold increased odds of disease activity improvement compared to those who did not (OR 3.03, 95%CI 1.18-7.83). Among those who were overweight/obese at baseline, each kilogram weight loss was associated with CDAI improvement of 1.15 (95%CI 0.42-1.88). Our study was limited by using clinical data from a single center without fixed intervals for assessments.
Conclusion: Clinically relevant weight loss (≥5 kg) was associated with improved RA disease activity in the routine clinical setting. Further studies are needed for replication and to evaluate the effect of prospective weight loss interventions on RA disease activity.
obesity, rheumatoid arthritis, weight loss, disease activity
Obesity, defined by the World Health Organization as body mass index (BMI) ≥30 kg/m2, is an epidemic that currently affects 34.9% of adults in the U.S. [1,2]. Obesity increases the risk of developing chronic diseases such as hypertension, diabetes mellitus, coronary heart disease, and rheumatoid arthritis (RA) [3,4].
The relationship between obesity, weight loss, and disease control has been investigated among patients already diagnosed with chronic diseases. Health benefits of weight loss (ranging from 1.3-6.4 kg) in chronic diseases include improvements in cholesterol levels, decreased risk of cardiovascular events, and improved quality of life [5-7]. Among patients with hypertension, patients that lost ≥5 kg had improved blood pressure [8]. Weight loss of ≥5% was associated with improved glycemic control in patients with diabetes mellitus [9,10]. In patients with osteoarthritis, weight loss of ≥5% was associated with improvement in joint symptoms [11]. Weight loss of ≥5% was also associated with low/remission disease activity in patients with psoriatic arthritis [12]. However, the effect of weight loss on RA disease activity has been less studied. Most prior studies in RA investigating differences in disease activity compared patients with obesity to patients with normal BMI.
Previous studies performed among patients with RA have associated obesity with increased disease activity scores using 28 joints (DAS28) as well as worsened modified health assessment questionnaire (mHAQ). DAS28 is a validated measure of RA disease activity that combines tender and swollen joint count with laboratory measures of inflammation, either erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) [13]. These serum inflammatory markers are known to be higher in obese individuals [14]. Thus, it is possible that obese patients have increased DAS28 scores on the basis of obesity-related elevations of ESR or CRP independent of RA disease activity [15]. Using an RA disease activity measure that does not include these serum inflammatory markers, such as the clinical disease activity index (CDAI), may therefore be preferred over DAS28 when comparing RA patients with obesity to those without obesity.
The association of obesity with worsened RA outcomes compared to those with normal BMI suggests that weight loss may improve RA disease activity. A prior study reported marked improvements in RA disease activity after bariatric surgery [16]. However, these findings may not apply to other patients with RA in the routine clinical setting, since the magnitude of weight loss after bariatric surgery is greater than would be expected for non-surgical weight loss [16]. Therefore, we aimed to investigate the effect of weight loss on RA disease activity in a routine clinical setting, using the CDAI a disease activity measure that does not rely on serum inflammatory markers. We hypothesized that weight loss would be associated with improved RA disease activity.
We identified patients with RA in the electronic medical record at a single academic medical center, Brigham and Women's Hospital (Boston, Massachusetts), using a previously validated algorithm [17]. Medical record review confirmed RA according to the 2010 ACR/ EULAR classification criteria [18]. All aspects of the study were approved by the Partners HealthCare Institutional Review Board.
We performed a retrospective cohort study of patients with RA that had at least two CDAI measures obtained during routine clinical care with corresponding weight measures at those clinic visits. CDAI is a measure of RA disease activity that quantifies RA disease activity on a scale of 0-76 (higher score indicating higher disease activity), and is calculated by summing the tender joint count and swollen joint counts of 28 joints as well as physician and patient global assessment on a 0-10 scale [19].
Clinic visits for this study were identified as any encounter that had CDAI measured with corresponding weight measures also recorded within one week of that CDAI. Since our goal was to assess both weight and disease activity changes, all patients in this study were required to have at least two clinic visits in order to be included. For patients with more than two clinic visits with CDAI and weight measures, data were collected at each eligible clinic visit. Data on exposures, outcomes, and covariates were collected at each clinic visit using detailed medical record review.
Definitions of weight and CDAI changes
To calculate weight change, we selected the maximum and minimum weights (in kilograms) recorded for each subject among all visit dates that CDAI and weight were measured. We determined which of the maximum and minimum weights occurred first to order them as "initial" or "subsequent". We calculated weight change as: ΔWeight=Subsequent weight–Initial weight. For example, if the maximum weight during the entire follow-up occurred at the second visit and the minimum weight during the entire follow-up occurred at the third clinic visit, then the weight change was calculated between these two visits. Since the maximum weight was at the initial visit, this patient would have ΔWeight<0 and would be treated as having lost weight. Weight at any other clinic visit besides the maximum and minimum weight visits was not included in the calculations. If all weights were identical, the patient was deemed as having no weight change (ΔWeight=0) and we considered the first and last visits to calculate the corresponding CDAI change. If there were multiple visits with the same minimum or maximum weights, we chose the visits which maximized follow-up duration. We similarly defined the CDAI change as the difference between CDAI scores at the same clinic visits used to define weight change. Figure 1 further illustrates the definition of weight and CDAI change that we used in this study.
Figure 1. Example demonstrating how weight change was defined in the study. In this patient, the maximum weight (83 kg) and minimum weight (77 kg) were selected from the four clinic visits (v1-v4) identified with CDAI and weight measured. The change in weight between these maximum and minimum visits was a loss of 6 kg. The change in CDAI was calculated between these same clinic visits. In this example, the CDAI change was an improvement of 10. (CDAI, clinical disease activity index; vn, visit where a weight measure and CDAI measure were available; Wtn, weight in kilograms)
Categorization of weight loss
Our primary exposure was weight loss ≥5 kg as a binary variable among those who were overweight or obese. We chose this threshold of clinically relevant weight loss due to previously reported health benefits of weight loss above this threshold in other chronic diseases [5,8]. We used the WHO classification of BMI categories for underweight (<18.5 kg/m2), normal weight (18.5 to <25.0 kg/m2), overweight (25.0 to <30 kg/m2), and obese (≥30.0 kg/m2) [20]. As previously described, we used the mode of the height of all measures when calculating BMI since patients may have had slightly different heights recorded at different visits [21]. Since weight loss would typically only be recommended for those who were overweight or obese, we included the BMI category at baseline in our analysis.
Disease activity outcomes
The primary dichotomous outcome was a decrease in CDAI by ≥5 points. Since all measures were obtained through routine clinical care, the treating rheumatologist performed all joint counts and physician global assessments in this study. We chose this dichotomous outcome based on the minimal clinically important difference of CDAI improvement reported in prior literature [22].
Covariates
We collected covariate data at the baseline visit, including sociodemographics, lifestyles, comorbidities, RA characteristics, and medication usage. Sociodemographic covariates included age, sex, race (categorized as white or non-white), education (dichotomized as greater than high school education or high school degree or lower), smoking (dichotomized as ever or never), and BMI categories. We considered the three most prevalent comorbidities recorded: osteoarthritis, hypothyroidism, and hypertension. RA disease-specific characteristics included duration of RA, and RA serologic status (seropositive defined as positive rheumatoid factor [RF] and/or anti-cyclic citrullinated protein [anti-CCP]; seronegative as both RF and anti-CCP negative). Laboratory values included CRP. Medication use included biologic and non-biologic disease-modifying antirheumatic drugs (DMARDs), glucocorticoids, non-steroidal anti-inflammatory drugs, and opioids.
We calculated descriptive statistics including frequencies for categorical variables, mean and standard deviation (SD) for continuous variables with normal distributions, and median, range, and interquartile range (IQR) for continuous variables with non-normal distributions. We calculated these statistics for the entire study sample and then stratified by the primary exposure of BMI category and weight loss ≥5 kg. We performed bivariate analyses to examine whether covariates including sex, age, RA duration, smoking status, serologic status, and steroid use were associated with the exposure and outcome. We used t-tests for continuous normally distributed variables, Wilcoxon rank-sum tests for continuous non-normally distributed variables, chi-square tests for categorical variables, and Fisher's exact tests for categorical variables with small cell sizes. We evaluated these covariates as possible confounders due to their associations with RA disease activity in prior literature [23-27].
In the primary analysis investigating a threshold of weight loss, we used logistic regression to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the binary outcome of improved disease activity (ΔCDAI ≤ -5 or not) according to BMI category at baseline and weight loss of ≥5 kg. We also included the BMI categories of overweight/obesity and normal weight in our primary analysis, since weight loss would not be recommended to patients with normal or underweight BMI. While we did not have data on the reason for weight loss, our goal was to identify patients who may have lost weight voluntarily. Therefore, we did not analyze four patients who were normal/underweight and lost ≥5 kg, since weight loss would not be recommended for these patients and may have been indicative of pathologic, rather than voluntary, weight loss. The three categories in the primary exposure variable therefore consisted of: BMI ≥25 kg/m2 and did not lose 5 kg; BMI ≥25 kg/m2 and lost ≥5 kg; and BMI <25 kg/m2 and did not lose 5 kg Figure 2.
Figure 2. Flow diagram illustrating the identification of the final analyzed study sample (ACR, American College of Rheumatology; BMI, body mass index; CDAI, clinical disease activity index; EMR, electronic medical record; EULAR, European League Against Rheumatism; RA, rheumatoid arthritis)
We initially performed logistic regression analysis without adjustment. In the main analysis using a multivariable logistic regression model, we adjusted for age, sex, and baseline CDAI. Since there were only 10 outcomes in the category of BMI ≥25 kg/m2 and lost ≥5 kg, we were limited in the number of covariates that we could include in a multivariable model. Therefore, we performed sensitivity analyses to examine the possible confounding effect of other variables. In these analyses, we substituted the sex variable with the following possible confounders measured at the initial visit in individual models: steroid use, DMARD use, serologic status, smoking status (ever vs. never), follow-up time, and osteoarthritis. The effect size of the BMI ≥25 kg/m2 and lost ≥5 kg category was similar in all models (each of these models affected the OR by <10%), so we reported the model adjusting for age, sex, and baseline CDAI as the final multivariable model.
As a secondary analysis, we analyzed weight loss in kilograms as a continuous variable, among the subset of patients who were overweight or obese at baseline in order to investigate a dosedependent response of weight loss. In this analysis, we used linear regression to estimate the β coefficient and 95% CI for the association between ΔWeight and ΔCDAI among those who were overweight/obese at baseline and lost any weight during follow-up. In the final multivariable model, we adjusted for age, sex, baseline CDAI, RA duration, smoking (ever vs. never), serologic status, steroid use at baseline, and follow-up time.
Two-sided p values <0.05 were considered statistically significant. All statistical analyses were conducted using SAS software, version 9.4.
We analyzed 174 RA patients that had at least two clinic visits with available CDAI and BMI measures. There were a total of 836 clinic visits, with a median of 5 visits per subject (range: 2-11) over 1.9 years (IQR 1.3-2.4) occurring between March 2012 and May 2015. Mean age at baseline was 60.4 years (standard deviation [SD] 13.2), 85% of patients were female, 85% were white, and 55% had ever smoked. The median time between the clinic visits where the minimum and maximum weights were measured and were used to calculate weight and CDAI change was 1.1 years (IQR 0.7-1.5). The most common comorbidities were osteoarthritis (68%) and hypertension (52%) Table 1. Besides CRP which was missing in 14% of patients, there were no missing data.
All patients (n=174)
BMI ≥ 25 kg/m2 and did not lose 5 kg (n=93)
BMI ≥ 25 kg/m2 and lost 5 kg (n=24)
BMI <25 kg/m2 and did not lose 5 kg (n=57)
Sociodemographics and Lifestyle
Mean age, years (SD) 60.4 (13.2) 58.6 (12.9) 60.7 (12.3) 63.2 (13.7)
Female, no. (%) 147 (84.5) 73 (78.5) 19 (79.2) 55 (96.5)
White, no. (%) 148 (85.1) 79 (84.9) 20 (83.3) 49 (85.9)
>High school education, no. (%) 97 (55.8) 49 (52.7) 11 (45.8) 37 (64.9)
Ever smoker, no. (%) 96 (55.2) 52 (55.9) 16 (66.7) 28 (49.1)
Median BMI, kg/m2 (IQR) 28.0 (23.8-31.8) 29.0 (27.2-32.6) 32.4 (29.4-39.5) 23.0 (21.3-23.8)
BMI category
Underweight, no. (%) 1 (0.6) 0 (0.0) 0 (0.0) 1 (1.8)
Normal, no. (%) 56 (32.2) 0 (0.0) 0 (0.0) 56 (98.2)
Overweight no. (%) 59 (33.9) 54 (58.1) 5 (20.8) 0 (0.0)
Obese no. (%) 58 (33.3) 39 (41.9) 19 (79.2) 0 (0.0)
Osteoarthritis, no. (%) 118 (67.8) 59 (63.4) 19 (79.2) 40 (70.2)
Hypertension, no. (%) 90 (51.7) 51 (54.8) 15 (62.5) 24 (42.1)
Hypothyroidism, no. (%) 32 (18.4) 16 (17.2) 4 (16.7) 12 (21.1)
RA characteristics
Median RA duration, years (IQR) 9.8 (4.1-18.6) 8.3 (3.4-18.4) 10.8 (6.3-16.0) 12.2 (5.8-19.4)
Median CDAI (IQR) 10.0 (5.0-18.0) 10.0 (5.0-15.0) 16.5 (7.0-24.5) 11.0 (4.0-22.0)
RA disease activity category
Remission (CDAI 0-2.8), no. (%) 12 (6.9) 4 (4.3) 0 (0.0) 8 (14.0)
Low (CDAI 2.9-10), no. (%) 77 (44.3) 48 (51.6) 9 (37.5) 20 (35.0)
Moderate (CDAI 10.1-22), no. (%) 51 (29.3) 28 (30.1) 8 (33.3) 15 (26.3)
High (CDAI >22), no. (%) 34 (19.5) 13 (14.0) 7 (29.2) 14 (24.6)
Components of CDAI
Mean swollen joint count (SD) 2.9 (3.5) 2.6 (3.1) 3.0 (2.8) 3.4 (4.2)
Mean tender joint count (SD) 4.4 (5.3) 3.6 (4.5) 6.9 (7.5) 4.5 (5.0)
Mean patient global assessment (SD) 3.8 (2.4) 3.5 (2.1) 4.6 (2.7) 3.9 (2.7)
Mean physician global assessment (SD) 2.6 (1.8) 2.5 (1.9) 3.3 (1.8) 2.5 (1.7)
RF positivity, no. (%) 110 (63.2) 55 (59.1) 22 (91.7) 33 (57.9)
Anti-CCP positivity, no. (%) 82 (47.1) 48 (51.6) 12 (50.0) 22 (38.6)
Seropositive (RF or anti-CCP), no. (%) 136 (78.2) 73 (78.5) 22 (91.0) 41 (71.9)
Mean CRP, mg/L (SD)* 7.1 (10.4) 7.1 (10.1) 6.4 (5.8) 7.2 (12.6)
Any DMARD, no. (%) 151 (86.8) 84 (90.3) 20 (80.0) 47 (82.5)
Methotrexate, no. (%) 86 (49.4) 51 (54.8) 13 (54.2) 22 (38.6)
Non-biologic DMARD, no. (%) 103 (59.2) 60 (64.5) 14 (58.3) 29 (50.9)
Biologic DMARD, no. (%) 106 (60.9) 56 (60.2) 17 (70.8) 33 (57.9)
≥ 2 DMARDs, no. (%) 64 (36.8) 37 (39.8) 11 (45.8) 16 (28.1)
Glucocorticoids, no. (%) 55 (31.6) 29 (31.2) 9 (37.5) 17 (29.8)
NSAIDs, no. (%) 82 (47.1) 44 (47.3) 10 (41.7) 28 (49.1)
Opioids, no. (%) 21 (12.1) 14 (15.1) 4 (16.7) 3 (5.3)
*CRP was missing in 25 patients. All other variables had no missing values
Anti-CCP, anti-cyclic citrullinated peptide; BMI, body mass index; CDAI, clinical disease activity index, CRP, C-reactive protein; DMARDs, disease modifying anti-rheumatic drugs; ESR, erythrocyte sedimentation rate; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis; RF, rheumatoid factor.
Table 1. Baseline characteristics of patients according to BMI category and weight loss during follow-up (n=174)
At baseline, the median BMI was 28.0 kg/m2 (IQR 23.8-31.8) and 67% of patients were overweight or obese. The median RA duration was 9.8 years (IQR 4.1-18.6) with 78% being seropositive and 15% having deformities from RA. Seven percent of subjects were in remission, 44% had low disease activity, 29% had moderate activity, and 20% had high disease activity by CDAI at baseline. The median CDAI among those who were normal or underweight (n=53) was 11 (IQR 4-22), while the median CDAI among overweight/obese patients who did not lose 5 kg (n=93) was 10 (IQR 5-15), and 17 (IQR 7-25) for overweight/obese patients who did lose 5 kg (n=24). Within the entire study sample at baseline, 87% were on DMARDs, 59% were on a non-biologic DMARD, 61% were on a biologic DMARD, 47% were on NSAIDs, 12% were on opioids, and 32% were on glucocorticoids.
Ten out of the 24 (42%) of patients who were overweight/obese at baseline and lost above the threshold of ≥5 kg, had a CDAI improvement of ≥5 compared to 18 of the 93 (19%) patients who did not lose ≥5 kg. Overweight/obese patients who lost above the threshold of 5 kg had significantly increased odds of disease activity improvement compared to those who did not lose 5 kg (unadjusted OR 2.74, 95% CI 1.09- 6.91). After adjustment for age, sex, and baseline CDAI, overweight/obese patients that lost ≥5 kg had three-fold increased odds of disease activity improvement (OR 3.03, 95% CI 1.18- 7.83) Table 2 compared to those that did not lose this amount of weight. Results were similar in individual models that adjusted for steroid use, DMARD use, serologic status, smoking, follow-up time, and osteoarthritis instead of sex. Among patients who did not lose 5 kg, those with normal BMI had a trend toward improved CDAI compared to overweight/obese patients (multivariable adjusted OR 1.90, 95% CI 0.88- 4.11).
Baseline BMI and weight loss
Outcomes / Total in category (n)
% with CDAI improvement ≥ 5 points
Unadjusted OR (95% CI)
Adjusted OR (95% CI)*
BMI ≥ 25 kg/m2 and did not lose 5 kg 18 / 93 0.194 1.0 (Ref) 1.0 (Ref)
BMI ≥ 25 kg/m2 and lost 5 kg 45566 0.417 2.74 (1.09-6.91) 3.03 (1.18-7.83)
BMI <25 kg/m2 and did not lose 5 kg 19 / 57 0.333 2.12 (0.99-4.54) 1.90 (0.88-4.11)
Weight loss was defined as the difference between the maximum and minimum weights (kg) at routine clinical visits. ΔCDAI was calculated using measures at these corresponding clinic visits and ΔCDAI <-5 was considered a RA disease activity improvement.
Patients who had baseline BMI of <25 kg/m2 and lost 5 kg (n=4) were not analyzed. None of these patients had CDAI improvement ≥ 5 points.
*Adjusted for age, sex, and baseline CDAI.
BMI, body mass index; CDAI, Clinical Disease Activity Index; CI, confidence interval; OR, odds ratio; RA, rheumatoid arthritis.
Table 2. Odds ratios for RA disease activity improvement (≥5 point improvement in CDAI) according to BMI at baseline and significant weight loss (≥5 kg) (n=174).
Among the subset of patients who were overweight/obese at baseline and lost any weight during follow-up, there was a dose-dependent response of improved CDAI with weight loss. For every 1 kg of weight lost, CDAI improved by 1.15 points (95% CI 0.42-1.88) Figure 3, after adjusting for age, sex, RA duration, smoking, steroid use, serostatus, and follow-up time.
Figure 3. Regression line and 95% confidence bounds of weight loss (continuous, in kilograms) vs. ΔCDAI among patients with rheumatoid arthritis who were overweight or obese at baseline and lost any weight* during follow-up (n=53).
*Weight loss was defined as the difference between the maximum and minimum weight (in kg) measures at routine clinic visits and included all patients with ΔWeight <0. ΔCDAI was calculated using measures at the corresponding clinic visits.
The linear regression model was adjusted for age, sex, baseline CDAI, RA duration, smoking (ever vs. never at baseline), serologic status (seropositive vs. seronegative), steroid use (ever vs. never at baseline), and follow-up time. (CDAI, clinical disease activity index; RA, rheumatoid arthritis).
Among patients with RA seen in routine clinical care, we found that weight loss beyond a threshold of 5 kg was associated with a threefold increased odds of reduced disease activity compared to overweight/obese patients that did not reach this threshold of weight loss. We further observed a dose-dependent response of weight loss and reduced disease activity amongst the subset of patients that were overweight/ obese and lost any weight during follow-up. These results suggest that losing weight may improve RA disease activity. Counseling RA obese patients on the benefits of weight loss on the potential for improving disease activity may provide an additional tool for RA management to clinicians.
Prior studies have associated obesity with worsened RA outcomes compared to patients with either normal or non-obese BMI. A French study found that obese patients were 83% less likely to attain a DAS28 decrease of ≥1.2 after 6 months of follow-up [28]. In the Better Anti-Rheumatic Farmacotherapy (BARFOT) study, obesity was associated with 50% lower odds of sustained remission by DAS28 (OR 0.51, 95% CI 0.32-0.84) and worse mHAQ scores compared to non-obese patients [13]. In a meta-analysis of four previous studies, obese patients had a mean difference in DAS of 0.14 (95% CI 0.01-0.27) compared to patients with normal BMI [29]. In the Epidemiologic Investigation for RA, obese patients were less likely to be in remission by DAS28 compared to RA patients with normal BMI (OR 0.58, 95% CI 0.37-0.92) [30]. Similar results reporting lower odds for remission/low disease activity for obese patients compared to patients with normal weight were found in another study performed in the United Kingdom (OR 0.44, 95% CI 0.22-0.88) [31]. In another meta-analysis of four previous studies, RA patients who were obese were 47% less likely to be in remission/low disease activity by DAS28 (OR 0.53, 95% CI 0.41, 0.69) [32]. Most recently, in a meta-analysis of 10 prior studies, patients with obesity were 42% less likely to achieve minimal disease activity compared to patients with normal BMI (OR 0.58, 95% CI 0.40-0.85) [33]. In a study performed in the Netherlands, continuous BMI was positively correlated with DAS28 (r=0.34, p=0.001) [34]. In another Dutch study, obese/overweight patients had higher tender and swollen joint counts than patients with normal BMI after one year of follow-up [35]. In a meta-analysis of two studies, RA patients with obesity had worse HAQ scores compared to patients with normal BMI (mean difference 0.10, 95% CI 0.01-0.19) [32].
Our results expand upon this prior literature that mostly focused on comparing BMI categories of obese and normal. Similar to this prior literature, we observed a trend towards improved disease activity for patients with normal weight compared to overweight/obese patients who did not lose weight [35-37]. Additionally, we observed that patients who were overweight/ obese at the baseline visit had higher CDAI measures compared to normal weight patients [29]. Unlike prior studies, we aimed to investigate the effect of weight loss on disease activity, rather than static categories of BMI. We found that weight loss beyond a threshold of 5 kg was significantly associated with improved disease activity. We also included the BMI categories of overweight/obesity and normal weight in our primary analysis, since weight loss would not be recommended for patients with normal or underweight BMI. The threshold of 5 kg that we investigated has been described as an obtainable goal through diet and exercise and also improves other chronic disease outcomes [38,39]. In the secondary analysis, we found a dose-dependent response of weight loss with improved disease activity, suggesting that weight loss beyond 5 kg may provide further improvement in RA disease activity.
While the association between obesity and worse RA outcomes is well described, few previous studies have investigated the relationship between weight change and RA disease activity. A prior study by our group investigated the effect of weight loss on RA measures after bariatric surgery [16]. This retrospective cohort identified 53 subjects with RA who underwent bariatric surgery. Twelve months after weight loss surgery, patients lost a mean of 41.0 kg (SD 17.3), and 68% were in remission compared to only 26% at baseline (p<0.01). Another study prospectively followed a cohort of 19 patients with RA who lost a mean of 4.5 kg due to nonsurgical interventions and found a significant improvement in physical function [40]. In BARFOT, there was no association between weight gain during follow-up and RA disease activity, but the association of weight loss with disease activity was not reported [13].
It is possible that the findings of our study may not be generalizable to other populations since the study was performed a single site. However, characteristics of our study sample are similar to other established RA cohorts and the data were collected through routine clinical care [41,42].
Since our study was a retrospective cohort study, we used data already collected and the reason for weight loss was unknown. However, our results suggesting improved outcomes for patients with normal BMI compared to obese patients are consistent with prior literature. More patients with obesity had osteoarthritis in our study than those with normal BMI, also consistent with prior literature [43,44]. However, it is possible that improvements in pain and function from osteoarthritis after weight loss may have contributed to our findings. While we did not utilize DAS28 since this measure includes inflammatory markers that might be higher in patients with obesity, it is possible that subjective components of CDAI, such as joint tenderness, might also be biased. Therefore, even validated disease activity measures such as CDAI may not truly reflect biologic RA disease activity. We designed our study based on when CDAI was measured in the routine clinical setting, as opposed to having a standard interval for CDAI measurement. To standardize follow-up and define weight loss, we identified the maximum and minimum weights during follow-up. However, it is possible that this definition of weight loss may have influenced our results. Glucocorticoid use is associated with weight gain, leflunomide may be associated with weight loss, while other DMARDs had relatively less impact on weight change [45]. However, glucocorticoid use was similar across exposure groups and was adjusted for in the analysis using weight loss as a continuous variable so is likely to influence our results. Few patients started on leflunomide during this study, so this is unlikely to explain our results. Since weight was measured in routine clinical care, it is possible that seasonal factors such as weight of clothes and mood changes might have affected our results. However, median follow-up was 1.1 years, so seasonal differences would be less likely to be important in this length of follow-up. While our goal was to capture voluntary weight loss in the routine clinical testing, we were unable to measure whether patients were actively participating in dietary or physical activity programs to lower weight. Finally, while we aimed to investigate the effect of weight loss on RA disease activity, it is possible that the converse may be responsible for the association we report. Patients with improved RA disease activity may be more likely to lose weight through mechanisms such as improved quality of life, less pain, increased physical activity, and healthier diet. Prospective weight loss intervention studies are needed to definitively establish the causal role of weight loss and disease activity.
In conclusion, we demonstrated that weight loss above a threshold of 5 kg in overweight/ obese patients was associated with a significant improvement in RA disease activity. Additionally, we found a dose-dependent response between weight loss and improved disease activity among RA patients who were overweight or obese suggesting additional benefit in disease activity for weight loss beyond 5 kg. These findings suggest that weight loss may have a role in the non-pharmacologic management to improve RA disease activity specifically for overweight or obese RA patients. Further research is needed to replicate these findings in other populations and to prospectively investigate the effect of weight loss interventions on RA disease outcomes.
This work was supported by the Rheumatology Research Foundation Scientist Development Award (Dr. Sparks) and the Student Achievement Award (Mr. Kreps) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K24 AR052403, K24 AR057827, P60 AR047782, L30 AR066953, R01 AR049880, P30 AR070253, P30 AR072577, and K23 AR069688). The funders had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health.
The authors would like to thank the Section of Clinical Sciences of the Division of Rheumatology, Immunology and Allergy at Brigham and Women's Hospital for helpful guidance.
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Megyn Kelly Claims Double Standard over Robert Downey Jr.'s Tropic Thunder Blackface
The Last Outlaw on Fri Jan 24, 2020 8:36 pm
From Aurelie Corinthios of People Magazine
More than a year after NBC canceled her Today show hour over a controversial segment about blackface, Megyn Kelly is accusing Hollywood of hypocrisy on the matter.
On Wednesday, Kelly, 49, tweeted a link to a recent interview in which Robert Downey Jr. addressed his role in Tropic Thunder as an actor who wears blackface for a part.
The tweet drew criticism that Kelly had missed the point of the 2008 Ben Stiller-directed satire.
"Did you see Tropic Thunder?" The Nation editor Dave Zirin tweeted. "His character was a parody of an idiotic, egomaniacal actor who thought he was making some kind of deep point. In other words, his character was a parody of people like you."
"Are you still f—ing going on about this?" author Dennis DiClaudio tweeted. "Does it really bother you that much that white people can't still smear cork all over their faces for humor?
Others also pointed out that Kelly called out the wrong studio in her tweet: Tropic Thunder was not produced by Universal Pictures, but by DreamWorks/Paramount.
Downey Jr., 54, addressed the controversial role during an episode of The Joe Rogan Experience podcast, admitting his mother was "horrified" by it. In the film, he played a committed Australian method actor who surgically darkened his skin for the role of a black soldier in a war movie.
"I think that it's never an excuse to do something that's out of place and out of its time, but to me, it blasted the cap on [the issue]," he said. "I think having a moral psychology is job one. Sometimes, you just gotta go, 'Yeah I effed up.' In my defense, Tropic Thunder is about how wrong [blackface] is, so I take exception."
NBC pulled Megyn Kelly Today off the air in October 2018 after the host questioned whether wearing blackface as part of a Halloween costume is actually racist. Kelly and an all-white panel were discussing campus attempts to discourage "inappropriate and offensive costumes," when she asked: "But what is racist? Because truly, you do get in trouble if you are a white person who puts on blackface at Halloween or a black person who puts on whiteface for Halloween. Back when I was a kid, that was okay as long as you were dressing up as like a character."
Her NBC colleagues condemned her harshly on-air: Craig Melvin called her remarks "indefensible" as well as "ignorant and racist," and Al Roker insisted she "owes a bigger apology to folks of color around the country."
Kelly apologized for her comments twice — first in an internal email to colleagues, and then on-air the next day.
"I have never been a PC kind of person, but I do understand the value in being sensitive to our history, particularly on race and ethnicity," she said. "This past year has been painful for many people of color. The country feels so divided and I have no wish to add to that pain and offense. I believe this is a time for more understanding, more love, more sensitivity and honor. I want to be part of that. Thank you for listening and for helping me listen too."
Kelly — who had signed a three-year, $23 million-a-year contract with NBC in 2017 — finalized her departure from the network in January 2019, with a source telling PEOPLE at the time, "The contract will be paid out, about $25-$30 million dollars."
The 9 a.m. hour has since been taken over by Melvin, Roker, Dylan Dreyer and Sheinelle Jones. Kelly has been focusing on her family and recently began conducting interviews again, airing the segments on her Instagram Live.


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Vidyanand Choudhary
University of California, Irvine - Information Systems Area
Personalized Pricing and Quality Differentiation
Carnegie Mellon U, GSIA Working Paper No. 2002-E7
Number of pages: 39 Posted: 12 Jun 2002
Anindya Ghose, Vidyanand Choudhary, Uday Rajan and Tridas Mukhopadhyay
New York University (NYU) - Leonard N. Stern School of Business, University of California, Irvine - Information Systems Area, Stephen M. Ross School of Business, University of Michigan and Carnegie Mellon University - David A. Tepper School of Business
Personalized Pricing, Product Differentiation, Price Competition, Electronic Commerce
Pricing and Resource Allocation in Caching Services with Multiple Levels of Qos
Number of pages: 37 Posted: 21 Oct 2004 Last Revised: 02 Aug 2014
Kartik Hosanagar, Ramayya Krishnan, John Chuang and Vidyanand Choudhary
University of Pennsylvania - Operations & Information Management Department, Carnegie Mellon University - H. John Heinz III School of Public Policy and Management, University of California, Berkeley - School of Information and University of California, Irvine - Information Systems Area
Web caching, dontent delivery, pricing, quality of service
Product Recommendation and Consumer Search
Vidyanand Choudhary and Zhe Zhang
University of California, Irvine - Information Systems Area and University of Texas at Dallas - Naveen Jindal School of Management
recommendation systems, product recommendations, bias, analytical modeling, consumer search
Sequential IT Investment: Can the Risk of IT Implementation Failure Be Your Friend?
Vidyanand Choudhary, Mingdi Xin and Zhe Zhang
University of California, Irvine - Information Systems Area, Merage School of Business, University of California, Irvine and University of Texas at Dallas - Naveen Jindal School of Management
Sequential IT Investment, Risk of Implementation Failure
Evaluation Set Size and Purchase: Evidence from a Product Search Engine
Choudhary, Vidyanand, Currim, Imran S., Dewan, Sanjeev, Jeliazkov, Ivan, Mintz, Ofer and Turner, John, Evaluation Set Size and Purchase: Evidence from a Product Search Engine (July 3, 2016), Journal of Interactive Marketing.
Posted: 14 Aug 2016 Last Revised: 09 Dec 2016
Vidyanand Choudhary, Imran S. Currim, Sanjeev Dewan, Ivan Jeliazkov, John Turner and Ofer Mintz
University of California, Irvine - Information Systems Area, Independent, University of California, Irvine - Paul Merage School of Business, Independent, University of California, Irvine - Paul Merage School of Business and Louisiana State University, Baton Rouge - E.J. Ourso College of Business Administration
Evaluation Set Size, Purchase, Product Search Engines, Copula Model, E-Commerce, Bayesian Estimation


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Here Are the Current Job Trends in Direct-To-Consumer Market
By Aakash Sharma
Direct-to-consumer, D2C, is a proliferating segment in the business world and the job opportunities in it are big.
Understanding direct-to-consumer retail or D2C (DTC) is vital for new people entering the workforce and for a beginner corporate entrepreneur. The definition of the direct-to-customer model is the promotion and sale of a product that removes all intermediate channels, such as market middlemen, physical stores and third-party retailers. It directly gives customers the products from the manufacturer.
While D2Cs can be found in every vertical area, from cars and airlines to fertility tests and medication, this model is widely used in the fashion, consumer products, and everyday goods industry.
With less third-party reliance, reduced contract negotiations, and less constrained enforcement and branding methods in the D2C model, it's an attractive option for emerging and traditional brands looking to expand.
D2C is on an Upward Trend
The direct-to-consumer market (D2C) has been multiplying by double digits for many years. It is expected to grow by 19.2% in 2021. Data from the pre-COVID era showed a promising future of the segment. The pandemic further bolstered the demand for direct consumer access due to the digitization boom born out of uncertainties and problems in the supply chain.
New businesses are not the only ones adopting technological advancements in their business models. Businesses operating on traditional channels, including multinational brands such as Heinz and PepsiCo, have also opened new communication channels with their customers where they have activated direct relationships with them.
Direct-To-Consumer (D2C) Segment is the New Hub for Jobseekers in 2021
In the US, Facebook launched a new Facebook Store feature, integrated directly into Shopify. Sports giant Adidas agreed to a joint venture with Storr, Inc. to attract more customers and boost the company's sales channel. It started a new Social Selling App that makes it easy for any user to open their store from their phone and take a 6% commission with each direct sale.
E-commerce and retail are the most critical parts of D2C. The segment grew to more than 1.6 billion app transactions in 2019 and will expand even more in an increasingly digitising market like India. With these emerging markets worldwide and their potential expansion plans in India (the second-largest market globally), D2C companies are looking for new Indian talent to drive their projects in the market.
By eliminating the middleman through D2C, brands can reduce distribution costs and better control profit margins.
Trends that are opening up more opportunities for the New Workforce in D2C
Consumer expectations have reached the highest level
With the help of D2C services, the customer experience has been dramatically improved, and customers now have high expectations from service providers. Brands are proposing products in a highly competitive environment.
According to a survey conducted by D2C organisations, 61% of consumers want to share more information with the brand for a better shopping experience, and 54% of consumers want to receive a personalised cut within 24 hours of the first association with the label.
Direct communication with the consumer in D2C means having an entire relationship with the customer
By using all the data to create a unique, personalised, more efficient and best-performing experience, companies can access big data to deliver the best service. The D2C strategy has enabled the development of new sources of income by:
New versions of the product
Custom strategy
These improve user engagement more effectively than other channels.
Increasing profit margins
By eliminating the middleman, brands can reduce distribution costs and better control profit margins. Inefficient distribution can directly translate into additional revenue for customers, avoiding potential physical channels to hire other partners and conserve business resources.
Digital marketing potential
Brands are entering the digital space and starting to take complete control of all channels, regulating branding and conversion activities across channels and ultimately narrowing the circle to achieve their communication.
To fulfil customer demands, capture new markets and deliver state of the art solutions, companies are hiring left and right. Giant conglomerates in India, including Unilever, Pearson Group, Amazon, Flipkart, and new companies like boAT and Zivame, are onboarding new talent to excel and expand their operations substantially. It is indeed the right time and occasion for you to get on the growth bandwagon of the D2C boom in India.
Aakash Sharma
Aakash writes on Startup Ecosystem, Policies, Legal and Regulatory aspects of business planning. An alumnus of Delhi University, he is assistant editor at Dutch Uncles.
Job Market Trends


We want our students to love learning, do their best and work co-operatively with others.
All Sanson School students to achieve at or above the National Standards in Reading, Writing and Mathematics.
All Sanson School students to be actively involved within the school and the community.
Recognise and honour te Tiriti o Waitangi (the Treaty of Waitangi) and other cultures.
All students to leave Sanson School with the skills required for life-long learning.
The revised school vision reflects The New Zealand Curriculum and its importance in supporting students as 'confident, connected, actively involved, lifelong learners'. Literacy and mathematics continue to be curriculum priorities.
The Positive Behaviour for Learning (PB4L) programme is in its third year at Sanson School. 'STARS' - self control, take responsibility, aroha, respect/resilience and self-belief - are the collaboratively developed values that underpin the school's approach to positive guidance.


Military Tattoo Germany 2018 Magdeburg Was Hess Murdered ?
Bevin Boys were young British men conscripted to work in the coal mines of the United Kingdom, between December 1943 and March 1948. Chosen by lot as ten percent of all male conscripts aged 18–25, plus some volunteering as an alternative to military conscription, nearly 48,000 Bevin Boys performed vital and dangerous, but largely unrecognised service in coal mines. Many of them were not released from service until well over two years after the Second World War ended.
The programme was named after Ernest Bevin, a former trade union official and then British Labour Party politician who was Minister of Labour and National Service in the wartime coalition government. At the beginning of the war the Government, underestimating the value of strong younger coal miners, conscripted them into the armed forces.
By mid-1943 the coal mines had lost 36,000 workers, and they were generally not replaced, because other likely young men were also being conscripted to the armed forces. The government made a plea to men liable to conscription, asking them to volunteer to work in the mines, instead, but few responded, and the manpower shortage continued.
We need 720,000 men continuously employed in this industry. This is where you boys come in. Our fighting men will not be able to achieve their purpose unless we get an adequate supply of coal.
From 1943 to 1945 one in ten of young men called up was sent to work in the mines. This caused a deal of upset, as many young men wanted to join the fighting forces and felt that as miners they would not be valued.
Many Bevin Boys suffered taunts as they wore no uniform, and there accusations by some people that they were deliberately avoiding military conscription.
To make the process random, one of Bevin's secretaries each week, from 14th December 1943, pulled a digit from a hat containing all ten digits, 0–9, and all men liable for call-up that week whose National Service registration number ended in that digit were directed to work in the mines, with the exception of any selected for highly skilled war work such as flying planes and in submarines, and men found physically unfit for mining.
Conscripted miners came from many different trades and professions, from desk work to heavy manual labour, and included some who might otherwise have become commissioned officers.
The Bevin Boys were first given six weeks' training (four off-site, two on). The work was typical coal mining, largely a mile or more down dark, dank tunnels, and conscripts were supplied with helmets and steel-capped safety boots. Bevin Boys did not wear uniforms or badges, but the oldest clothes they could find. Being of military age and without uniform caused many to be stopped by police and questioned about avoiding call-up.
Since a number of conscientious objectors were sent to work down the mines as an alternative to military service (under a system wholly separate from the Bevin Boy programme), there was sometimes an assumption that Bevin Boys were "Conchies".
There are thousands of cases in which conscientious objectors, although they may have refused to take up arms, have shown as much courage as anyone else in Civil Defence.
The Bevin Boy programme was wound up in 1948. At that time the Bevin Boys received neither medals nor the right to return to the jobs they had held previously, unlike armed forces personnel. Bevin Boys were not fully recognised as contributors to the war effort until 1995, 50 years after VE Day, in a speech by Queen Elizabeth II.
On 20th June 2007, Tony Blair informed the House of Commons during Prime Minister's Questions that thousands of conscripts who worked down mines during the Second World War would receive an honour. The prime minister told the Commons the Bevin Boys would be rewarded with a Veterans Badge similar to the HM Armed Forces Badge awarded by the Ministry of Defence.
The first badges were awarded on 25 March 2008 by the then Prime Minister, Gordon Brown, at a reception in 10 Downing Street, marking the 60th anniversary of discharge of the last Bevin Boys.
Historic responsibility within government for the Bevin Boys lies with the Department for Business, Energy and Industrial Strategy. ?
The Bevin Boys Association is trying to trace all 48,000 Bevin Boy conscripts, optants or volunteers who served in Britain's coal mines during and after the war, from 1943 to 1948.
On Tuesday 7th May 2013, a memorial to the Bevin Boys, based on the Bevin Boys Badge, was unveiled by the Countess of Wessex at the National Memorial Arboretum at Alrewas, Staffordshire. The memorial was designed by former Bevin Boy Harry Parkes; it is made of four stone plinths carved from grey Kilkenny stone from the Republic of Ireland.
The stone should turn black like the coal that the miners extracted.