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Special Report: Scientists describe problems in Philip Morris e-cigarette experiments
By Tom Lasseter, Paritosh Bansal, Thomas Wilson, Ami Miyazaki Duff Wilson, Aditya Kalra
TOKYO/NEUCHATEL, Switzerland (Reuters) - The U.S. Food and Drug Administration is weighing whether to approve a potentially path-breaking smoking device by Philip Morris International Inc PM.N. With a decision expected next year, former employees and contractors have described to Reuters a number of irregularities involving clinical trials that underpin the tobacco giant's application to the agency.
A man smokes iQOS at a restaurant in Tokyo, Japan November 2, 2017. Picture taken November 2, 2017. REUTERS/Kim Kyung-Hoon
By heating tobacco instead of burning it, the company says the device, known as iQOS, avoids subjecting smokers to the same levels of carcinogens and other toxic substances found in a regular cigarette. The company has spent more than $3 billion developing new smoking platforms like iQOS. As part of that initiative, Philip Morris has published extensive scientific findings, based in part on clinical studies.
Tamara Koval, who worked at the company from 2012 to 2014 and helped coordinate clinical trials for the device, questioned the quality of some of the researchers and sites contracted to carry out those experiments. Koval was a co-author of the company's protocol used to run the studies globally. When she highlighted an irregularity in one of the studies, Koval said, Philip Morris excluded her from meetings.
Reuters also found irregularities during interviews with some of the principal investigators contracted to conduct the trials for the company. One principal investigator said he knew nothing about tobacco. Philip Morris had to jettison the experiment that investigator performed after it emerged he hadn't followed a basic procedure for obtaining informed consent from participants during clinical trials.
A second investigator submitted urine samples that exceeded what a human being is capable of, according to two former company employees, and then initially refused to acknowledge there was a problem. A third said he doesn't hold such company-sponsored clinical trials in high regard, describing them as "dirty" because their purpose is more commercial than scientific.
After reviewing Reuters' findings, Philip Morris said in a statement that "all studies were conducted by suitably qualified and trained Principal Investigators." The company said it understands that "FDA inspectors have already audited some facilities" involved in the trials. Philip Morris also said it had taken steps to address "any reported irregularity in our studies."
"Our policies encourage speaking up about suspected violations of law or our policies and we do not tolerate retaliation against those who speak up," the company said.
In addition to former Philip Morris employees involved with the iQOS program, Reuters interviewed six of the 11 principal investigators who were responsible for five of eight clinical trials the company submitted to the FDA. Reuters also reviewed hundreds of pages of publicly available Philip Morris study reports and FDA filings.
That reporting identified shortcomings in the training and professionalism of some of the lead investigators, as well as their knowledge of the study results.
A group of tobacco research and policy experts reviewed detailed summaries of Reuters' reporting and Philip Morris' response. The experts, including a former head of the FDA and two former scientific advisers for the agency, said those findings raise concerns about Philip Morris' clinical trial program.
"Taken as a whole, it's clear they do not have the sophistication to carry out adequate and well-controlled clinical trials," said David Kessler, the FDA's commissioner from 1990 to 1997, referring to the company. "I am not inferring any malicious intent here, just that they lack sophistication, because this is not their bread and butter."
If the FDA has already audited some of the trial sites used by Philip Morris, the agency "should carefully review its audits and possibly expand them," said Kessler, a former dean of the medical school at Yale University.
'THE FDA SHOULD AUDIT'
Tom Eissenberg, who served on the FDA's tobacco products scientific advisory committee until earlier this year, said: "The FDA should audit."
Reuters did not find any evidence that the outcome of the experiments presented by the company to the FDA was manipulated or falsified.
The new insights into the company's clinical trial program for iQOS come at a crucial time for Philip Morris. The world's largest publicly traded tobacco company by market value and maker of Marlboro cigarettes has applied to the U.S. FDA to be able to sell iQOS in America, and also for permission to market it as a modified-risk tobacco product. That designation could mean that Philip Morris is allowed to market iQOS as presenting less harm or risk of disease to users than traditional tobacco.
For now, the FDA is evaluating the company's studies. Reuters outlined its findings about the iQOS trials to the agency. The FDA said it cannot comment on a pending application.
Philip Morris says the device, which heats small tobacco inserts, is meant for smokers who would not otherwise quit. Its chief executive officer, Andre Calantzopoulos, has told investors and media alike that he intends to one day replace cigarettes with products like iQOS. So far, iQOS makes up a fraction of the company's $75 billion revenues and Philip Morris continues to market conventional cigarettes across the globe.
Internal Philip Morris documents reviewed by Reuters show the significance of iQOS goes beyond its profit potential. The device is now sold in more than two dozen nations after it was first launched in Japan and Italy during late 2014.
The company has a 10-year plan for what it calls "normalization" of the tobacco industry, according to a 2014 strategy document. The industry has been shunned over the past two decades for producing and marketing products that kill people and previously lying about it. Under a section on "strategies and actions" to achieve that goal, the document lists, among other things, new smoking devices such as iQOS and the scientific research involved in developing them.
Told about that document, Philip Morris said: "The suggestion that the purpose of our development of IQOS and our scientific research program is to 'normalize' the tobacco industry is false."
That previously undisclosed document and others can be found in a searchable repository published by Reuters, The Philip Morris Files. (reut.rs/2sT51xF)
'I JUST DON'T READ THEM'
Philip Morris' search for a cigarette no more harmful than a cup of coffee
As part of its submission to the U.S. FDA, the company said the results of its research showed the device significantly reduced the level of certain harmful substances that users were exposed to compared with cigarettes, and satisfied their nicotine cravings. "In fact the level of reduction is so considerable, it approaches 95% of the levels measured in smokers who quit altogether," the company said in a statement to Reuters.
Taken along with the company's laboratory studies, Philip Morris said, the research program "in its entirety demonstrates that IQOS is likely to reduce the risk of smoking related diseases."
Philip Morris is responsible for the majority of the science that has been published about iQOS. "Those who criticize us should probably look at our science," said Tommaso Di Giovanni, a company spokesman, during a tour of Philip Morris' research and development headquarters in March.
The eight clinical experiments that Philip Morris submitted to the FDA were conducted between 2013 and 2015. For one study, scientists in Texas and Florida did not respond to messages left by Reuters. Other scientists, in Belfast and Tokyo, declined to talk. Half of the eight studies were done in Japan.
FDA guidelines for conducting clinical studies say a trial should adhere to standards such as Good Clinical Practice. That best-practices document says investigators "should be qualified by training and experience and should have adequate resources" to properly conduct a trial.
Masayuki Sugimoto, the principal investigator who oversaw testing at one facility used by Philip Morris to conduct a trial, said his Tokyo clinic is "heavily in the red."
Sugimoto said he generally has little confidence that all the participants in experiments like the one he ran for Philip Morris on nicotine tell the truth about their smoking history – that is, whether they smoke.
Speaking about the final study report from the Philip Morris trial, Sugimoto said in an interview that he generally doesn't have time to read such things in detail. He said he probably signed a document indicating he had received the final report. Sugimoto gestured with his thumb and forefinger to indicate a thick document: "I just don't read them."
Philip Morris said that it "did not receive any such comments or statements from the PI," or principal investigator. Sugimoto's study, it said, was completed "without any issues." The company said the study data was reviewed and discussed with the investigator throughout the trial.
The Japanese company hired to monitor studies in the country, CMIC Holdings Co Ltd 2309.T, said in a statement that researchers confirmed that trial participants were smokers by using urine tests.
Asked about the tests, Sugimoto said he thought they would prevent non-smokers from joining the trial but added, "I don't know whether they were done that rigorously."
Told of Sugimoto's doubts about the honesty of study participants, Eissenberg, who served on the FDA's tobacco products scientific advisory committee from 2011 to 2017, said "it raises a great deal of concern."
A principal investigator "is required to make sure that the participants meet the inclusion-exclusion criteria that are in the protocol," said Eissenberg. He was referring to the fact that clinical trial subjects' backgrounds – such as whether they are smokers – should meet the parameters of the experiment for the data to be valid. "And a PI should have confidence in that," he said.
DATA DISCARDED
At another laboratory in Japan, issues with how the study was carried out were so acute that data from 56 participants was thrown out, raising questions about the competence of the principal investigator. Philip Morris halted the study at that location.
In the company's study documentation released by the FDA, Philip Morris recorded the reason for discarding the data as non-compliance with good clinical practices, specifically "failure of the site to meet sample collection procedures and data recording procedures."
Kishor Lad, who was Philip Morris' data manager on the study, said the site crossed a line of what's allowed during such trials: It collected samples before getting informed consent forms signed by the volunteers. "Completely a no-no in the GCP world," Lad said, using the acronym for good clinical practice.
Philip Morris confirmed to Reuters that "informed consent was not obtained prior to execution of a study procedure" – specifically, the collection of urine samples. The problem was identified by CMIC, the contract research group, during a routine monitoring visit, Philip Morris said. A subsequent round of audits, it added, "led to prompt discontinuation of the study at the Seishukai Clinic." The incident, the company said, was properly logged in the study report and the submission to the FDA.
"It suggests the investigator had no idea, did not understand or just didn't care what his responsibilities were in conducting the study," said Greg Koski, a former director of the U.S. federal Office for Human Research Protections, which advocates for research subjects. "This is such a flagrant violation, that investigator shouldn't be doing clinical studies."
Mamoru Oki was the principal investigator at the time at the facility, the Seishukai Clinic in Tokyo. Reached by phone, Oki said: "My specialty is urology and I don't know anything about tobacco, so I cannot talk."
Told of that remark, Philip Morris said: "Dr. Oki was qualified and trained specifically on the product."
Dorothy Hatsukami, a member of the FDA's tobacco products scientific advisory committee from 2010 to 2013, said a principal investigator's professed lack of knowledge about tobacco is not ideal.
Slideshow ( 8 images )
"For any tobacco-related clinical trial, an investigator with a background in tobacco product research would have better qualifications to evaluate the study results than a novice," she said.
The study continued at a parallel site, the Tokyo Heart Center.
During an interview at the center, principal investigator Masahiro Endo said repeatedly that he had no idea what the results were from his study.
"We did medically safe and accurate blood samples, but were not told the results. So even if we are asked questions, we won't be able to answer," he said. "We were paid, it ended there."
But in a statement signed last year and submitted by Philip Morris to the FDA, Endo said he had read the clinical study report from the company and confirmed "that to the best of my knowledge it accurately describes the conduct and results of the study." Principal investigators in all of the Philip Morris clinical trials signed the same statement.
A day after speaking with Reuters, Endo sent an email clarifying that after checking his records he saw that he'd signed a receipt saying he received a report on the results and acknowledging that he'd be listed as the principal investigator. He had spoken during the interview "with a fuzzy memory," Endo said.
'LESSER OF TWO EVILS'
Clinical trial experts interviewed by Reuters said it's not uncommon for principal investigators to be unaware of test results sent to a third party specialty laboratory for analysis. But they also emphasized that if companies want better science, they need the investigators to be more involved with all aspects of a study.
"It seems like the investigator here is in the role of a technician, not as a principal investigator," said Kessler, the former FDA commissioner.
Kessler said it's hard to understand how such investigators could have signed off on the clinical study report "when they clearly were not versed in the study results."
Other principal investigators described their work differently.
Fumimasa Nobuoka, a principal investigator on one of the trials in Japan, said he read the Philip Morris study report: "I thought it was well done, well written."
James Borders, who was the principal investigator for a study held in Lexington, Kentucky, said the experiments in his trial were done ethically and followed sound scientific practice.
Borders, who became chief medical officer at the Baptist Health Lexington hospital, said such studies help consumers make an informed decision. His decision to be involved with the study, he said, hinged on the proposition that a device like iQOS could be the "lesser of two evils."
Philip Morris said that while it sponsored the clinical trials, the experiments were "performed by reputable research facilities" and monitored by contract research organizations – companies used to oversee such studies. It hired U.S.-based Covance Inc to serve as its global contract research organization, according to an internal Philip Morris 2013 assessment plan. Covance, a unit of Laboratory Corporation of America Holdings LH.N, declined to comment.
CMIC, the company hired to monitor the Japan studies, said in a statement: "All the clinical trials you referred to were conducted in accordance with GCP guidelines" – good clinical practices – "and we believe that the results of the trials are scientifically trustworthy."
As part of her job coordinating between Philip Morris and those contracted to run its clinical trials, Koval, the former company scientist, conducted medical safety training across the world for principal investigators and others involved with the iQOS studies.
During one study training session in Tokyo, Koval said, she realized some of the researchers could not speak English well and she was unable to communicate with them. Koval said she does not speak Japanese and there was no interpreter present.
"I was like, Jesus, what are we doing here?" she said. At dinner later, Koval said, she saw two of the men, and they were unable to describe in English what their jobs were.
When asked about Koval's session, Philip Morris said it was a meeting with its contract research organization and others. It added that "all PIs and team members with active roles in the study were fluent in English."
But Sugimoto, one of the Japanese principal investigators, told Reuters in an interview, "I can't speak English."
And Endo, another of the lead researchers, said that when Philip Morris executives visited his site someone was present who helped translate "questions like whether to cut the crusts off bread" when giving food to study subjects.
CMIC said, "All the principal investigators received adequate training in Japanese before the trial began."
URINE SAMPLES
In Poland, some urine samples collected as part of one Philip Morris clinical study exceeded the limits of what a human being is capable of producing in a single day, according to Koval and Lad, the former clinical data manager.
Lad, who worked at Philip Morris from 2012 to 2015, said he didn't think anything "malicious" had happened. Maybe urine samples were swapped or there was a mistake with the containers used to collect the urine, he said.
But when the principal investigator for the Polish site was asked about the results, she would not admit there was a problem, Lad and Koval said. Instead, they said, the scientist explained that the test subjects were large Polish men.
Philip Morris said that "a few participants" in an early stage of the trial "produced unusually large volumes of urine." Because medical tests showed no problems with the subjects, the company said, the investigator did not initially consider the samples to be "adverse events."
After discussion with the medical monitors of the study as well as Philip Morris, the investigator "ultimately decided to mark these incidences as adverse events," the company said. An investigation at the site confirmed that researchers had followed study protocol and good clinical practices, the company said.
The principal investigator running the study in Poland for Philip Morris, Katarzyna Jarus-Dziedzic, declined to discuss what happened with the urine case at her site, citing confidentiality.
Koval said that after she raised concerns about the Polish study with Philip Morris executives in Switzerland she was excluded from meetings.
Philip Morris said in a statement that Koval was "part of the team" that followed up on the urine samples. In fact, the company said, she was "an active member" of the group that finalized the data set from the studies for further analysis.
Koval confirmed that she was part of the team and involved with the data set. But she stood by her account that she was shut out of conversations and meetings about the urine samples.
In 2014, Philip Morris terminated her contract, Koval said. She said she returned to the pharmaceutical industry a few months later and now works for Swiss drugs giant Novartis AG NOVN.S.
After leaving Philip Morris, Koval was given a certificate of service that said, "Tamara drove clinical program development activities." It said she had demonstrated "professionalism" and "unwavering commitment" in her work.
Additional reporting by Ari Rabinovitch in Jerusalem, Joe Brock in Johannesburg, Anna Koper in Warsaw, Amanda Ferguson in Belfast, Hyunjoo Jin in Seoul and Kate Kelland in London; Editing by Peter Hirschberg


It has been quite a while.
And here is my explanation.
Book Blogging used to be my hobby. I would enjoy reading books and reviewing them, interacting with other book bloggers and sharing my love for literature.
For some reason I cared about the numbers too much and reading as many books as possible. I became envious of people who had more books than me. Even if I had bought books or had access to books in the library, I would continue to buy more and more not because I wanted the book but because everybody else had that book on their shelf. It became a toxic cycle and it reached a point where I stopped reading completely.
Yes. Me who used to read every single day of their life went to reading a book once every 3 months. I would pick up books read a bit of them and then chuck them somewhere. I was in a slump in a way. With exams and wanting to have a great social life it meant that I felt the need to drop my love for reading.
It has taken me a while to have a 'positive' relationship with reading. I would associate reading with pressure and it reached a point where it became lackluster. It has definitely taken a long time for me to pick up a book and read because I want to read and when I picked up one special book it made me realise how exciting reading was for me. I missed that thrill and I am so glad to have it back.
Nothing makes my heart pump harder than a thrilling part of the book. Nothing makes my imagination run wilder and nothing makes me feel more relaxed than reading. I spent a good 2 years glued to my phone and watching movies and tv shows but they just aren't as exciting to me. As much as I do love the shows and movies, my attention span cannot last for more than 30 minutes when it comes to watching shows.
Also one weird reason I left book blogging was because in a way I felt excluded from the community. Everybody else had their cute online friendships, interacted with eachother on twitter and being friends with book publishers. To be completely honest I was intimidated. I was a teen (still am) blogging in an adult world in a sense. Adults read and reviewed YA majorly and I felt kind of left out as I didn't know how to communicate with them very well. Feeling like a little bug in the corner is hard especially if you want to put out a young adult perspective on young adult literature.
I feel like I'm going off on a tangent but I just wanted to explain to the few who cared why book blogging became less of a hobby and more of a burden and I hope whoever decides to read this post understands.
This year I promise to blog again even if it just one more post.
Today I want to write about a) my favourite musical at the moment b) how it has impacted me as a teen of colour and c) why Lin Manuel Miranda is the best person on this earth. (I recently found out that he is in London meaning that I am breathing the same air as him and the prospect of ever bumping into him makes me squeal). Enough of the fangirling, let's begin.
Firstly, I will talk about my history with musicals. Before I joined secondary school, I didn't know what musicals were until I started having singing lessons in year 7. My teacher introduced me to the wonderful world of musics and of course WICKED. Musicals have always helped me get through things. For example, when I was bullied in year seven to stop myself from going down a dark path I would repeat to myself every morning "Think like Elphaba" because I admired her as a character. She was different, smart, green and ambitious but was bullied as well but go through it and it so weird how a musical soundtrack helped me get through that part of my life.
Being bullied for being different is something I struggled with for a while and sometimes I remember it and cry and this is why musicals are so important to me. This was when I knew I wanted my life to lead in that direction.
This is now the part you are waiting for: How Hamilton affected me and why it is important to me.
This all started when I told my siblings in my high pitched voice "I want to be the black Elphaba and I will be" which was responded with laughs from my siblings. They told me that the west end and Broadway don't hire black people especially dark skinned girls into theater roles. I am so angry with myself that I listened to them, so angry that I didn't pick GCSEs which meant that I would be able to do Musical Theater, so angry that I let myself believe that I couldn't do it.
I am everything the musical world doesn't want to hire into roles. I am extremely dark skinned with an afrocentric nose, east african and really skinny with braids in my hair. When I found out about Hamilton I was shocked. A successful musical about old white men but played by people of colour? And it has hip hop in it? AND it's successful? AND it involves my two favourite things history and MUSIC? Whaaaattt?(hamilton reference if you 'know' you know) I thought it was a dream.
Representation matters guys. If me 5 years ago could hear about Hamilton, I wouldn't have been discouraged, I would've said "Yes this is possible" and I would probably listen to the soundtrack throughout over and over again for a good 3 years.
Now that Hamilton is coming to the west end, I have never been more excited. I hope the tickets are affordable though but I would love to thank Lin Manuel Miranda because he has taken a step forward into making musicals more diverse.
I hope to one day see an Elizabeth Schuyler with dark skin and non-western features with braids or twists in her hair because that it something I would look up to.
P.S. I WOULD LOVE IT IF YOU CHECKED OUT MY COVER OF 'TAKE A BREAK' FROM HAMILTON AND SHARED IT!
I am back for a while now. I feel awkward typing this as I haven't blogged in a while so I apologize in advance for an utter crapness I splurge out, As you can see, I have actually removed all my previous posts hence why this post is called 'A New Beginning'. I want my blog to be mine again and I want to be passionate about blogging again so I decided to erase the past and begin this new era of The Perks of Being A Bookworm. If you read my blog before it was usually gushing over love triangles and writing random posts about random things and I enjoyed it for quite a while, blogging was my happy space, I found myself drifting away from blogging and I felt as though my posts were getting quite repetitive and there wasn't really much for me to say. Doing the same posts over and over again felt like such a long task and I felt myself sighing whenever I remembered to write a blog post.
That old feeling is over. Looking at the books I have read this year, the movements I have explored this year I have found a new and better me. Taking a step bakc and looking at what is in front of you and around you is a great experience. I used to believe that getting the most views possible was the only way I would be able to be proud of my blog, Now this blog is about me, not views, me.
I hope you guys can join me on my journey to discovery.
I was inspired by my favourite youtuber Savannah Brown to write poetry and start my writing journey. Here is one a made at the end of March called Bibliophile when I was sitting in bed and I couldn't sleep.
Wrung in the hands of those who once cared, taking a piece and passing it on as though at a party of sadistic teens and instead of passing parcels, we pass feelings.
Illustrated by a psychedelic paw, each page a burst of melancholy colours, scribbles in permanent link embedding itself into the rough paper and ending unfinished sentences.
Your eyes skim past the meanings written in italic comic sans, screaming to be looked at but you sit in your clear specs feigning the intelligence you claim to have.
Coffee stains, heart pains, messed up lies and constant tears.
You say you like literature and hidden meanings, you're addicted to words spun to create images. Why can't you see the message I'm clearly sending to you? You say you're a bibliophile, why can't you be addicted to me?
Thank you for reading this poem. It has nothing to do with me but I like to create characters and I wanted to act heart broken for one night.
into this Southern United States idea on religion and how it effects people's opinions on others completely. In this community called Forrestville we meet three characters, Dill, Travis and Lydia wjo don't fit into the category of cool to other people. Travis is a fantasy book loving, lumber working and overlooking boy who just wants to be understood. Lydia is the girl with the blog, she looks out for her friends, is quick witted and a believer in imperfection. Then there is Dill who is basically the main focus of the story, his dad is in prison, his mother has to work hours to make ends meet and all he has is his songwriting. This follows their journey through senior year and the pressure they take to try and make futures for themselves even though they're from a small town.
I tried to explain the book without giving to much away as it is better to be kept on the dark side with this one. This book really captured the essence of being a teenager and I really did enjoy Zentner's writing style as it was easy to follow yet kept you pulled into the story.
My only criticism for this book would be the fact that the pacing varied throughout the book. In other words, sometimes it was a bit too fast and sometime it was a bit too slow but by the end there was a balance. I found myself having to flip back sometimes to pick up parts I didn't really catch on to.
My favourite character by far would have to be Travis. The way that he was fearless and selfless and really valued the small things in life. He was admirable and really came through a lot. He didn't let petty arguments between his friends wreck his day and I just wanted to be his friend so we could discuss fantasy books together.
I'm not going to lie. I did shed a big tear at the end if this book and I don't cry much when I read books! It was a full on 1am sob and the way these characters overcame their issues and pushed forward even if they felt like their thread had snapped.
Overall, I do recommend this book as it is a gripping read which I think you would enjoy!
Sorry if this review is messy, I'm a bit rusty as I haven't written a proper review in months!
In the frozen north, Kestrel is a prisoner in a brutal work camp. As she searches desperately for a way to escape, she wishes Arin could know what she sacrificed for him. She wishes she could make the empire pay for what they've done to her.But no one gets what they want just by wishing.
Why Am I Waiting This Wednesday?
After marathoning the first two books at the start of the year, The Winners series has quickly become one of the favourite trilogies of all time. I'm extremely invested into this world and the publication date is so close yet so far! I really can't wait for this book to be released.
What are you waiting on this Wednesday??
Last year one of my personal goals was to step out of my comfort zone a tiny bit more. This included my reading. I used to only read books like "Angus, Thongs and Full Frontal Snoggimg" which are cutesy tween reads. I started to read more fantasy which I have now become obsessed with and different genres like steampunk and historical fiction. One genre I hadn't dived into completely was horror because I get scared so easily but I enjoy being scared. Today I will be reviewing two horror books which I enjoyed that I would recommend if you feel like being scared a bit!
I personally loved this book! It gave me the right kind of chills and really had me on the edge off seat. I liked how modern elements were added to make the story more relatable for a younger audience and it gave of an eery feel to the book. This was a gripping, action packed and fun read which I would definitely recommend to anyone who is looking for a horror book to send a shiver down their spine! I overall gave this book a 4.5/5 stars.
People say that all Cornish inns are haunted, but the Waterwitch's history is particularly chilling. Built from the salvaged timber of a cursed ship, the guest house's dark secrets go further back than anyone can remember.
A chilling new title in the Red Eye horror series from the author of Frozen Charlotte.
Although this book was a fun read, I didn't enjoy it as much as I wanted to. I had high hopes for the book but it took me so long to get through it as it didn't pull me in as much as The Dark Room. Nonetheless, it was a fun read and I did like the diversity in this book by having one of the main protagonists in a wheel chair who is strong minded and thoughtful. It still held the creep factor and I would recommend this book if you're into historical horror! I gave this book a 3/5 stars.
My name is Naomi and I am a book lover, musical fanatic and history geek. Thank you for visiting my blog!


Why Is The Harley Davidson So Popular?
The 2017 Harley Davidson Road Glide – A Return To Form?
Ford has officially presented new F-150 Harley Davidson Edition, an interesting pickup with a powerful engine. The F-150 truck has a 6.2 V8 powerful engine and many improvements to its interior and exterior look.


CANIDAE All Life Stages Bakery Snacks for Dogs with Turkey, Quinoa & Butternut Squash are made with 7 nutritious main ingredients for healthy dog treats with irresistible taste. They're designed to break in half easily—making treating or training a snap for dogs of all life stages, breeds, and sizes. Their crunchy texture also helps clean your dog's teeth. Go ahead, enjoy some well-deserved time with your dog knowing that you're giving them a great-tasting oven-baked snack. With 40+ treats in every bag, there are plenty to go around!


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Dear Hollywood, here are 5 female founders to showcase instead of Elizabeth Holmes
Posted by Buzzrb — May 5, 2019 in Tech — Leave a reply
Joseph Flaherty Contributor
Why the 'end of the startup era' could be great for entrepreneurs
Invisible unicorns: 35 big companies that started with little or no money
There's a seemingly insatiable demand for Theranos content. John Carreyrou's best-selling book, "Bad Blood," has already inspired an HBO documentary, The Inventor; an ABC podcast called The Dropout, a prestige limited series starring SNL's Kate McKinnon, was just announced; and Jennifer Lawrence is reportedly going to star in the feature film version of this tawdry "true crime meets tech" tale. That's before getting started on the various and sundry cover stories and think pieces about her fraud.
I think it's fair to say the Theranos story has been sufficiently well-documented, and I'm worried that this negative perception may be reinforced now that uBiome founder Jessica Richman has been placed on administrative leave. While it's hard to pass on a chance to stoke startup schadenfreude, perhaps we could focus less on these rare, unrepresentative and dispiriting examples? Instead, Hollywood could put the spotlight on women who pioneered the bleeding edge of tech and actually produced billion-dollar successes. Here are a few candidates ready for their close-ups:
Judith Faulkner, founder and chief executive officer, Epic Systems
Judith Faulkner – Founder/CEO, Epic Systems
In the late 1970s, the picture of a working woman in Wisconsin was likely Laverne or Shirley. Little did anyone know that in the basement of a Victorian manse in Madison, the future of healthcare was being coded by Judith Faulkner, the founder and CEO of what would become Epic Systems. Epic is arguably the most impactful startup in the history of health software, and Faulkner was building medical scheduling software before most people could even picture a PC. Her efforts established the Electronic Medical Records market as we know it and today. Her company manages records for more than 200 million people, employs nearly 10,000 and generates around $2.7 billion per year in revenue — not bad for a math graduate who never raised any venture capital.
One might argue that the origins of medical software are too tepid to make for exciting TV, but something tells me the kind of CEO who hires Disney alums to design her corporate campus and dresses up like a wizard to address her employees might make for a compelling subject.
SANTA BARBARA, CA – FEBRUARY 09: Lynda Weinman speaks onstage (Photo by Rebecca Sapp/Getty Images for SBIFF)
Lynda Weinman – Founder/CEO, Lynda.com
Lynda Weinman might have the most esoteric path to becoming a billion-dollar entrepreneur in history. After getting a humanities degree from Evergreen College, where she was classmates with "Simpsons" creator Matt Groenig, Lynda opened a pair of punk rock fashion boutiques on LA's Sunset Strip.
After those folded in the early 1980s, she taught herself enough computer graphics to become a freelance animator on movies like "Bill & Ted's Excellent Adventure," which in turn led to her becoming a teacher at the prestigious Art Center College of Design. Her academic pedigree provided the launching pad to write an influential textbook; that, in turn, gave her the star power to strike out on her own as one of the first web celebrities.
Keep in mind; this dramatic arc only covers the time before she started the eponymous Lynda.com, and bootstrapped it to a $1.5 billion exit in edtech — an industry most VCs and entrepreneurs fear to tread. In terms of material for a memoir, Hannah Horvath has nothing on Lynda Weinman.
FRAMINGHAM, MA – MAY 30: Shira Goodman, former chief executive at Staples, poses for a portrait in Framingham, MA on May 30, 2017 (Photo by Suzanne Kreiter/The Boston Globe via Getty Images)
Shira Goodman – CEO, Staples.com
Shira Goodman has arguably done more for online shopping in the U.S. than anyone not named Bezos. She didn't found Staples, but she did start and scale its "delivery business," as she humbly calls it, to the point where it became the fourth largest e-commerce company in the U.S.
At a time when more nimble startups were disrupting big-box retailers, Shira did what few of her contemporaries could do — rapidly shifted a multi-billion-dollar legacy company in an ancient industry into the future, and eventually became CEO of the entire enterprise. She did this while also raising three children and supporting her husband when he decided to change careers and go to Rabbinical school. Sitcoms have been premised on less, and since two versions of "The Office" have captivated audiences, perhaps it's time to provide the perspective from the CEO of Dunder-Mifflin HQ?
Helen Greiner, co-founder, iRobot
Helen Greiner – Co-founder, iRobot
From C. A. Rotwang in "Metropolis" to Tony Stark in the Marvel movies, there have been plenty of cinematic explorations of robot builders, but the story of iRobot co-founder Helen Greiner might be more interesting than anything yet committed to celluloid. As a recent grad from MIT, Greiner spent a substantial chunk of the 1990s applying her mechanical genius to everything from a mechatronic dinosaur for Disney to a store cleaning robot with the potential for mass destruction for SC Johnson.
Far from an ivory-tower academic, Grenier helped the government deploy search and rescue efforts at Ground Zero after 9/11 and cave-clearing 'bots in Afghanistan, and the bomb-disposing Packbot she developed has saved the lives of thousands of service members. Grenier, at age 38, took her company public and made the Jetson's vision of a robot housekeeper a reality in the form of the Roomba.
CAMBRIDGE, MA – MARCH 15: Kelsey Wirth, who has a grassroots organization called Mothers Out Front: Mobilizing For A Livable Climate (Photo by Essdras M Suarez/The Boston Globe via Getty Images)
Kelsey Wirth – Co-founder, Align Technologies
While the original startup bros were inflating the tech bubble in the late 1990s, Kelsey Wirth was pioneering 3D printing, which at the time was as fantastical as anything Theranos promised. Wirth's story as the co-founder of Align Technology is especially compelling in the way it shares some surface similarities with Holmes' narrative. Prominent skeptics of Invisalign cast doubts on the company in its early days, noting that the startup's PR had outstripped its clinical validation. Wirth had to solve seemingly intractable technical challenges, including scanning misaligned incisors, developing algorithms to overcome underbites, pioneering new manufacturing process, convincing the FDA to clear the product and then selling it across the country — armed only with an English lit degree and an MBA. Despite the long odds of curing crossbites with software, Wirth started what has become a publicly traded business that is currently worth more than 20 billion dollars.
Most of these founders faced setbacks, including external obstacles and those of their own making. There were layoffs, bad deals and few of these stories had perfectly happy endings. Still, while a contemporary startup can earn plaudits for simply repackaging CBD and pushing it on Facebook, these entrepreneurs demonstrated a level of ambition rarely seen among modern upstarts.
The sensational focus on Elizabeth Holmes' misdeeds steal focus from a group of landmark female entrepreneurs and waste a tremendous opportunity to inspire the next generation with heroic tales instead of fables of fabrication. None of these accounts have the black and white morality of the Theranos debacle, but these founders cleared hurdles both scientific and social. They flipped the script and made history; surely Hollywood can find some drama in that.
Thanks to Parul Singh, Elizabeth Condon and Alyssa Rosenzweig for reviewing drafts of this post.
Original Post: https://techcrunch.com/2019/05/03/dear-hollywood-here-are-five-female-founders-to-showcase-instead-of-elizabeth-holmes/
afghanistan cambridge Column Disney Diversity eCommerce elizabeth holmes Entrepreneur fda HBO healthcare helen greiner iRobot Jennifer Lawrence linkedin learning Lynda.com massachusetts MIT online shopping printing Startup company Startups TC teacher The Inventor Theranos ubiome United States venture capital wisconsin

redpajama_set_name: RedPajamaCommonCrawl


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Incident 21/2017 – Ankle Injury, Rivington
At 14:33 one of the team's 'Callout Contacts' (who operate a shift system to ensure there is always someone to receive any call we get from the emergency services) received a call on the team's direct phone number. Please note that we always advise against attempts to call us directly; those requiring mountain rescue should always call 999 and ask for police, then mountain rescue. The call from the person requiring rescue was unfortunately cut off and could not at first be re-established. We knew our team were being requested, but not by whom, why, or where. The team member who took the call, Steven Fletcher, kept trying to re-connect while the team's deputy leader, Chris Greenhalgh, contacted the North West Ambulance Service (NWAS) control room to see if they were aware of an incident that might require our services. Shortly after this Steven managed to re-establish contact. He determined that a woman had become injured on the steep track down from the Pigeon Tower, Rivington, down towards Lower House Car Park, the very rough track being known locally as 'Old Kate's Dingle'. BMRT members were alerted to standby for a possible call out to Rivington.
Team member Mark Scott had been hillwalking and was returning from White Coppice when the standby was received. He decided to make a detour in order to ascend the track to see if he could locate the incident and to see if any help was needed. About two thirds of the way up the track he met up with the injured woman and three NWAS crew who were attending, as well as the woman's friend and others who had helped.
The woman had a suspected fracture of the right ankle and could not stand. Mark asked the NWAS crew whether our assistance was required and the crew confirmed they would like help to transport the woman to their ambulance. The incident then became a full team call out and within twenty minutes team members and equipment started to arrive, especially the mountain rescue stretcher and heavyweight casualty bag (a very warm fleece sleeping-type bag) because the woman was very cold. The short stretcher carry commenced at about 15:30. The woman was carried to Lower House Car Park and was then taken to hospital in the awaiting ambulance. The incident was complete at 15:55.
The team would like to thank the two walkers who came across the injured casualty and stayed with her while help arrived; also two members of United Utilities staff who offered help and helped relocate the ambulance from the Pigeon Tower to Lower House Car Park, and the owners of a Land Rover Defender vehicle who also offered help but found the track too steep.
We wish the casualty a speedy recovery from her injury.
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By Paul Brain • 2017, Incident	• Tags: WalkerRambler
Bolton MRT announced as Enriched Events Charity of the year.Support from Darwen Dashers Running Club


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Арисба () — имя ряда персонажей греческой мифологии:

 Арисба — жена Приама;
 Арисба — дочь Тевкра или Макарея, жена Дардана.

Примечания

Герои древнегреческих мифов

redpajama_set_name: RedPajamaWikipedia


OCR Group BhD operates in the Operative builders sector. In addition to historical fundamental analyses, the complete report available to purchase compares OCR Group BhD with three other companies in this sector in Malaysia: JKG Land Bhd (2018 sales of 78.38 million Malaysian Ringgits [US$18.95 million] ), Ken Holdings Berhad (64.28 million Malaysian Ringgits [US$15.55 million] ), and Talam Transform Bhd (56.69 million Malaysian Ringgits [US$13.71 million] ).
Sales Analysis. OCR Group BhD reported sales of 67.93 million Malaysian Ringgits (US$16.43 million) for the fiscal year ending July of 2018. This represents a sharp decrease of 23.5% versus 2017, when the company's sales were 88.77 million Malaysian Ringgits.


Hey dear.. Good of you to take a step in solving the problem.
Life is tough and difficult moments come. Many a times what we want is not what we get and that doesn't mean life is any less beautiful. You need to try and take your mind into things which interest you. You had a beautiful life before this guy comes into your life and you still can have the same.
1. List things and times when you were not thinking about him.
2. List activities which you still enjoy and feel good.
3. Pick up any of these activities and try to spend some time into it.
5. Surround yourself with friends as much as you can.


Home » Home Subdivision Perth: Are you Eligible?
Home subdivision Perth can be a lucrative way to supplement your income.
Home subdivision Perth and WA have an actual government website dedicated to the subdivision process. See www.planning.wa.gov.au once you're done here. This is a good site, compiled by the Department of Planning and the WAPC (Western Australian Planning Commission). Check the site for some general knowledge, plans, policies and applications.
If you want to work on this yourself, start by checking with your local council, licensed surveyor or town planner to information on permits, certifications and compliance issues in your area. Talk with them about what you are planning and let them figure out if it's possible for the size of your property. They will take into consideration the zoning laws and how close you are to the neighbors.
You can do this part yourself if you think you can handle it or you can hire a professional. Given the choice, I'm leaving all this up to the professionals! Unique Residence can create a plan, and do all the applications for you. This way they can plan the most optimal layout for your property and interface with the WAPC on your behalf for your home subdivision Perth project.
Next your application makes stops at various local government offices, the Water Corporation and last but not least, Western Power.
Then the subdivision is conditionally subject to a lot of requirements. They are providing services, demolition and removal if required, covenants, easements and possibly notifications. Are you seeing why I'm going to a professional?
In order to subdivide, you're going to need new land titles. This requires a survey done by a Registered Licensed Surveyor and allows you to have separate land titles created.
Clearance requests are determined for the many WAPC conditions. Clearances are collected and then filed with the WAPC.
Unique Residence offers Project Management services for this type of project or better yet you could just put the whole project in their hands from start to finish. Let them get the approvals, manage the subdivision process, save you a ton of money and oh did I mention, you get to keep your sanity!
Still we look for the answer to do I qualify to subdivide? It all depends; and you can find the answers at the WAPC site or by talking to your local planning board. Even if you call in a contractor or consultant, they will need to answer the following questions before proceeding.
What are the area R codes or Residential Design Codes…this is the density of housing allowed in that specific area?
What are the minimum and average lot sizes?
Do you know your block size?
What is the Town Planning Scheme? This varies, so you must check.
Where on your block are the existing dwellings positioned?
What are the minimum lot sizes and frontage requirements?
Are there any existing easements on your Certificate of Title?
Are there any environmental constraints?
Ok, that's a lot to think about and digest. Really for the average person, it's too much! You can research this yourself, but it requires a lot of time and extreme attention to detail.
When I first started the process, I visited a few home subdivisions near me to see for myself what the process looked like. They were all in various stages of completion. It's a lot to familiarize yourself with in a short period of time. That's why I suggest hiring a firm specialising in new homes Perth like Unique Residence to deal with everything. This way you can live your life, watch the process and not be stressed!
Finally, in the end you can save money by hiring experts in subdivisions Perth. They know the ins and outs. Mistakes in a project of this magnitude are expensive. Projects like a home subdivision Perth are worth looking into and can be a money-making venture for you and your family, so do yourself and them a favor and hire the right firm from the start. Unique Residence is here to serve.