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Minding Your Business Reporter Tad Sooter keeps tabs on the West Sound economy, nonprofits and health care.
Tag Archives: restaurants
ChocMo, High Spirits plan move to new Poulsbo building
Tad Sooter
Poulsbo's ChocMo restaurant and High Spirits liquor store plan to move to a new building and expand next year.
The businesses will set up shop in a 28,000-square-foot commercial facility planned by the Crabtree and Ryan families on Eighth Avenue.
The building is expected to open in the fall of 2017, according to a news release.
ChocMo and High Spirits will be joined in the facility by a 180-seat restaurant called Crabtree kitchen + bar and a shared workspace center called Vibe Coworks.
The move will allow High Spirits to grow from 4,000 to 10,000 square feet.The store will add a growler-filling station, "beer cave," and wine cellar, and plans to host classes and tastings.
A delivery service is being considered, according to the release.
ChocMo, which began as a chocolate shop in 2005, will offer breakfast, lunch, espresso and chocolate drinks. With added space to work in, ChocMo staff will start making chocolate from raw cocao beans.
Upstairs, Crabtree kitchen + bar will focus on connecting diners with locally-grown food, including fruits and vegetables cultivated onsite. Beef for the restaurant will be raised at the family's Silver Creek Angus farm in Kingston, which currently supplies ChocMo.
November 18, 2016 Agriculture, Business, Construction & Development, Eating and Drinking, Retailcandy, chocmo, chocolate, construction, crabtree kitchen + bar, development, dining, high spirits, liquor, local food, north kitsap, poulsbo, restaurants, silver creek angus, vibe coworks
Jimmy John's opens in Port Orchard
A Jimmy John's sandwich shop is now open at 1800 SE Mile Hill Dr. in Port Orchard, according to a Tuesday news release.
The 1,400-square-foot store features a drive-thru window, as well as indoor seating. Delivery and catering are available.
The Port Orchard franchise is owned by Angela Daniels and Mary Jo Smallman, who also own the Jimmy John's in Bremerton.
They plan to open a Silverdale location in 2017.
November 15, 2016 Business, Eating and Drinking, Openings & Closingsdining, fast food, jimmy john's, mile hill, openings, port orchard, restaurants, sandwiches, south kitsap
Developer shares plans for Rolling Bay project
A Bainbridge developer plans to seek approval this fall for a project that will bring new homes, shops and a restaurant to the island's Rolling Bay center.
Sunrise Square, which came before the city's Design Review Board in 2015, will be located on Sunrise Drive, just north of the intersection with Valley Road.
Rolling Bay Land Co. owner Lisa Martin said she expects construction to begin by next summer, if permitting goes smoothly. The development could be ready for tenants in by early 2018.
Plans for Sunrise Square include 6,700 square feet of residential space (both detached homes and apartments), 4,100 square feet of commercial space and a 2,300-square-foot freestanding restaurant.
Martin and architect Russ Hamlet, who've teamed up on several eco-friendly projects, emphasized energy and water efficiency in the design of Sunrise Square.
Geothermal and solar systems will help offset the development's energy needs, Martin said.
Buildings in Sunrise Square will feature vacuum toilets that use far less water than even low-flow toilets. Waste will be composted before it's discharged into the development's septic drain field.
The western portion of the 2-acre parcel will be left undeveloped as an open space meadow.
Rolling Bay Land Co. is seeking tenants for the future development. Leasing information and more designs are posted below.
Renderings courtesy Rolling Bay Land Co. and Studio Hamlet
October 19, 2016 Business, Construction & Development, Eating and Drinking, Real Estate, Retailapartments, bainbridge island, construction, development, housing, restaurants, rolling bay, rolling bay land company, russ hamlet, studio hamlet, sunrise square
Hitchcock's pizzeria spinoff opens in November
Chefs Brendan McGill, right, and Brandon Thompson
A popup pizzeria on Bainbridge Island will become a permanent restaurant in November.
Bruciato, a gourmet pizza popup created by Hitchcock chef Brendan McGill and partner Brandon Thompson, is taking over a renovated space in the former Winslow Hardware building.
According to a news release, the 2,000-square-foot restaurant will provide seating for 75, with another 15 spots at the bar.
The interior design showcases exposed beams and metal that "recall the building's history," and white marble that "lightens it up a bit."
Bruciato will feature wood-fired Neapolitan "pizze" and more modern pies, with an emphasis on authenticity. Dough will be mixed by hand, tomatoes imported from Italy and salami cured in house.
Seafood, salads and antipasti will round out the menu. The bar will serve Italian and American spirits, wine and beer.
The restaurant will be open from 11 a.m. to 10 p.m. Sunday through Thursday, and stay ope until 1:30 a.m. on Fridays and Saturdays.
Bruciato isn't the only new eatery McGill has in the works. He plans to open a Café Hitchcock north of Seattle's Pioneer Square in early 2017.
Check Bruciato's Facebook page for updates on the Bainbridge opening.
September 28, 2016 Business, Eating and Drinking, Openings & Closingsbainbridge island, bruciato, dining, hitchcock, opening, pizza, pizzeria, restaurants, winslow
Suquamish Tribe completes casino expansion
The Suquamish Tribe put finishing touches this summer on a three-year expansion and renovation of Clearwater Casino Resort.
The project launched in 2013 when lead contractor Korsmo Construction began work on a 700-stall parking garage attached to the casino.
Additional phases included the creation of a 98-room hotel tower, a fine dining restaurant and café, three commercial kitchens, a sports bar and lounge, a renovated buffet and service area, 3,500 square feet of non-smoking gaming space, and improvements to the existing gambling floor where people will continue to bet in the ncaa tournament but this time around they will have more options!
Construction wrapped up at the end of August with the upgrades to the main entrance, according to a news release from Korsmo. Work finished a month ahead of schedule.
September 26, 2016 Business, Construction & Development, Eating and Drinking, Hotels & Motels, Tourism & Recreationclearwater casino resort, construction, dining, entertainment, expansion, gaming, hotels, korsmo construction, north kitsap, restaurants, suquamish, suquamish tribe
Genuine Burgers calls it quits in Silverdale
Silverdale's Genuine Burgers was a bold culinary experiment.
The restaurant served traditional fast-food fare with a slow-food philosophy, making nearly everything on its menu — the burgers, buns, milkshakes, fries, even ketchup — from scratch each day.
The staff ground grass-fed beef each morning for the fresh burger patties, which were cooked a full 15 minutes on lower heat to avoid drying out the meat.
"We do things a little bit differently here," owner Stephen Foster-Shaner told the Kitsap Sun's Terri Gleich in an interview earlier this year.
The experiment didn't work out in the end.
Foster-Shaner closed Genuine Burgers on Sunday citing a multitude of factors:
You can read our February profile of Genuine Burgers here.
September 12, 2016 Agriculture, Business, Eating and Drinking, Openings & Closingsburgers, central kitsap, closings, dining, food, genuine burgers, restaurants, silverdale
Whiskey Creek Steak House closes; pizzeria coming
Whiskey Creek Steak House, a Keyport restaurant that experienced a brief and ill-fated brush with reality TV fame in 2012, has shut down for good.
A sign on the front door says the steakhouse closed Aug. 5, "to give the new owners time to make changes on the building to start their new adventure."
That adventure, according the sign, will be a restaurant called Trendy's Pizzeria, described as "an authentic East Coast eatery."
Whiskey Creek had been in business since the 1990s and gained national exposure in 2012 when it received a makeover from Food Network program "Restaurant: Impossible:"
The TV show crew stripped Whiskey Creek of its kitschy Old West interior and nixed popular menu items.
The owners came to regret changes made by "Restaurant: Impossible." They moved the restaurant to a larger space across the highway in 2013 and later turned the business over to employees.
Whiskey Creek closed without fanfare last week. It's website and social media pages are already offline.
I'm hoping to get in touch with owners of Trendy's to learn more about their plans.
August 9, 2016 Business, Eating and Drinking, Openings & Closingscentral kitsap, closed, closings, dining, food network, keyport, north kitsap, restaurant: impossible, restaurants, whiskey creek steakhouse
Bainbridge pizzeria featured on Forbes
Forbes.com contributor Micah Solomon interviewed a Bainbridge Island pizzeria owner for an in-depth look at customer service in the pizza business.
That's A Some Pizza owner Will Grant told Solomon about the importance of maintaining quality service in a fast-paced environment, and how Yelp reviews used to keep him up at night.
Grant also recalled the time his Winslow Way shop received a barrage of prank phone calls from Green Bay Packers fans, all ordering cheese pizzas.
You can read the full interview here.
Sadly, they don't discuss That's A Some Pizza's recent rollout of a beer delivery service.
July 21, 2016 Advertising, Brewing & Distilling, Business, Eating and Drinking, Tourism & Recreationbainbridge island, beer, customer service, dining, drinking, eating, forbes, interviews, pizza, restaurants, that's a some pizza
Starbucks, Sherwin-Williams proposed in Poulsbo
Starbucks is continuing its shift to more driver-friendly stores in Kitsap with a proposal for a new location on Highway 305 in Poulsbo.
The city received a permit application earlier this month for a 2,000-square-foot Starbucks coffee shop with drive-thru and 4,000-square-foot Sherwin-Williams paint store on a site adjacent to CVS, just north of Hostmark Street.
(Click the inset image for a rough locator.)
A site layout submitted to the city shows two standalone buildings. The Starbucks would be on the west side of the site, closest to the highway. The paint store would be situated on the east side. The drive-thru lanes would separate the buildings.
The applicant is PacLand Seattle, which has developed a number of retail centers in Washington and Oregon.
Starbucks has been busy in Kitsap of late. The Seattle coffee giant recently added stores with drive-thrus in Silverdale, Kingston and Poulsbo's College Marketplace.
Starbucks relocated stores to the new buildings in Silverdale and College Marketplace. The proposed Highway 305 shop seems well positioned to replace the existing Starbucks in Poulsbo Village, near the recently-abandoned Albertsons.
Sherwin-Williams has outlets in Silverdale and Port Orchard. The company came close to placing a store in College Marketplace in 2011, but the deal was stalled by development restrictions negotiated by Walmart and Home Depot, according to court documents filed in a related lawsuit.
April 29, 2016 Business, Construction & Development, Eating and Drinking, Openings & Closings, Retailcoffee, cvs, north kitsap, poulsbo, restaurants, retail, sherwin-williams, starbucks
Graphic: Updated Trails at Silverdale store locations
Two more tenants — Purpose Boutique and The Habit Burger Grill — were announced for The Trails at Silverdale shopping center last week.
Here's an updated graphic showing where the businesses will be located:
Tenants have not been named for seven spaces at the trails, including the grocery store building. These include a couple of very large retail spaces, and a restaurant space in the northwest corner.
April 26, 2016 Business, Eating and Drinking, Openings & Closings, Retailcommercial property, food, graphics, grocery, restaurants, retail, shopping, trails at silverdale
Where will you get your Christmas tree this year?
I'll buy my tree from a lot or store.
I'll go to a u-cut tree farm.
I'll dust off my trusty artificial tree.
I'll legally harvest a tree.
I don't plan to have a Christmas tree.
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Moctezuma's plans soft opening this week at Kitsap Mall
ARCO station and ampm store proposed in Poulsbo
Toy shop open in old Winslow Drug
State approves St. Anthony Hospital expansion
Home sales remained strong in November
Tad Sooter on Moctezuma's plans soft opening this week at Kitsap Mall
Chris rossi on Moctezuma's plans soft opening this week at Kitsap Mall
D-RENT/D-TIME IS TOO DAMN HIGH on Average apartment rent now $1,134 in Kitsap
Anthony on New Admiral Manor owner wants to help 'revitalize' Bremerton
Anonymous on Poulsbo store hosts state's first Walmart training academy
Kitsap On Tap
Kitsap Peninsula Business Journal
kitsap public health district
Navy & Defense
Port of Bremerton
Senior & Assisted Living
Unions & Labor


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Public Consultation on the Review of the Civil Legal Aid Scheme in Ireland
Public Consultation on the Civil Legal Aid Scheme
In June 2022, the Minister for Justice Helen McEntee, T.D. established the Civil Legal Aid Review Group to review the current operation of the Civil Legal Aid Scheme and make recommendations for its future.
The Civil Legal Aid Scheme is administered by the Legal Aid Board, which provides legal aid and advice to people who qualify for assistance. This legal aid or advice can be in relation to a dispute between one individual and another, or between an individual and an organisation.
It is important to note that Civil Legal Aid is different from Criminal Legal Aid. Civil Legal Aid can only be sought in the case of non-criminal legal matters. Criminal Law cases cover conduct which is against the law, such as theft and fraud.
As part of its work, the Group wants to hear from you about your experience of having a civil, i.e. non-criminal legal issue. The Group would like to know how you might have resolved that issue, whether you accessed the Civil Legal Aid Scheme and if so, how well it worked for you. Your participation lets you have your say on how we can improve things for the benefit of all.
This consultation is designed for members of the public. For more information, please visit: https://www.gov.ie/en/consultation/79e1d-public-consultation-on-the-review-of-the-civil-legal-aid-scheme/

redpajama_set_name: RedPajamaCommonCrawl


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While thoughts of Ontario may start with Toronto, you'll find its cousin, Brampton, to be cheaper when it comes to accommodations. Brampton, Ontario, Canada, offers several cheap hotels that leave you with enough cash in hand to explore in and around the city. The Best Western Plus Brampton provides you with amenities such as a pool, free breakfast, and complimentary Wi-Fi, all for $75 per night. Staying just outside a major city will leave you with more to spend on the rest of your vacation.
The best hotels in Kata Beach are well-placed around one of the favourite destinations in Phuket. Located on Phuket's west coast, it hosts two beaches - Kata Yai and Kata Noi - and a vast choice of restaurants, boutiques, nightlife entertainment venues, and leisure activities' options for the whole family. Kata Beach's accommodation scene is also quite impressive by its eclecticism: from budget guesthouses to mid-range hotels to highly-rated resorts, there is something for every one.
This gorgeous farm hotel is a secluded, serene haven for foodies and nature lovers. Guests can immerse themselves in the beauty of the Appalachians by enjoying the venue's 4,200 acres of land and all the various activities offered. The restaurant, The Barn, offers a true farm-to-table dining experience as a majority of the produce is picked from the property's garden. There's also a stunning, tranquil spa and two pools that visitors can enjoy. Guests can stay in luxurious cottages or in a charming room in the Main House.
Perhaps you want to sway to the jazz in the Deep South, or see the iconic highlights of Washington DC? The USA promise experiences as diverse as the country itself. From theme parks to national parks and dazzling futuristic cities to A-list haunts, American holidays are designed to be as unique as you. To ensure you can perfectly personalise the trip of your dreams, we have an exclusive collection of outstanding boutique hotels, luxury spas and five-star accommodation to suit your USA holiday plans. Browse our stunning selection today and let your American dream begin.
Overlooking an untamed strip of Pacific coast on Vancouver Island (about 195 miles northwest of Victoria), the Wickaninnish Inn is a Relais & Châteaux luxury amid the pines. Guests adore this hotel's rugged setting and isolated locale. All guest rooms boast ocean views, and include balconies, fireplaces, soaker tubs and heated flooring in the bathrooms. Guests can dine on fine, locally-sourced fare at The Pointe Restaurant for Brunch and dinner while the Driftwood Cafe features drinks such as coffee and smoothies, snacks and lunch options. For a bit of relaxation, hotel guests suggest heading to Ancient Cedars Spa, which offers treatments like West Coast Sacred Sea body wraps, or grabbing a drink at sundown at the On The Rocks Bar.
Manhattan? Like, so over. Food, fashion, music, art - it's all happening over the East River in Brooklyn. Of the clutch of hotels that have followed the wave, the 70-room Wythe, which opened in 2012, is the clear winner. This converted barrel factory is in Williamsburg, a five-minute subway ride from the island, and a hotbed of bars, restaurants and shops (Pies 'n' Thighs for Southern grub, Catbird for quirky jewellery). Owners Jed Walentas - scion of the New York real-estate family - Australian hotelier Peter Lawrence and Andrew Tarlow, who runs Brooklyn restaurants Diner and Marlow & Sons, have kept things industrial inside, with exposed brick, mosaic and tiled floors, and beamed ceilings. Bedrooms are particularly minimalist, with polished concrete floors, king-size beds and Manhattan views from floor-to-ceiling windows in west-facing rooms. There's even a thwack of skyline from the little window in the walk-in shower. The hotel's rooftop bar, The Ides, does great cocktails and is a raucous spot in summer, but it's the ground-floor restaurant, Reynard, that is a must for its super-fresh, veg-laden dishes including fluke crudo with fennel and caraway, and grass-fed steak with beets, goat's cheese and watercress. The hotel has no gym of its own, but guests are given a pass to Chalk down the road, a haunt for bench-pressing local hipsters.
This sprawling cream-colored villa is perched on the edge of a cliff overlooking the ocean, and the stunning vantage point is one of the hotel's finest features: Hermanus is known for its rugged natural beauty, and Birkenhead House maximizes that in all directions. Hermanus is a lovely add-on to any South Africa trip, and this is the best hotel in the area by far. If you're a serious whale watcher, it's a no brainer: You can't beat these views.
The No. 1 Best Hotel in Boston, XV Beacon is a shining example of luxury accommodations. The boutique hotel wins favor with travelers and experts for its variety of amenities, which include a 24-hour fitness center, courtesy car service and concierge assistance with all types of requests, from Red Sox tickets to in-room massages. Accommodations blend modern and classic decor and come equipped with fireplaces, canopy or four-poster beds, cashmere blankets and marble bathrooms. (Courtesy of XV Beacon)
The recipient of numerous industry accolades, including Frommer's Exceptional and AAA Four Diamond awards, the No. 1 Best Hotel in New York City sits in the heart of lower Manhattan. Along with its desirable address, travelers also praise The Beekman's superb service, tasty cuisine and trendy vibe. Acclaimed American chefs Tom Colicchio and Keith McNally have outposts here, and guest rooms and suites boast modern features like custom leather headboards, aged oak floors, curated artwork and bathrooms with Carrara marble accents. (Courtesy of The Beekman, A Thompson Hotel)
Guests rave about Wentworth Mansion, applauding its long-standing commitment to the building's history and its ability to deliver on contemporary luxury. Constructed in the late 1800s, the Wentworth Mansion exudes old-world charm, meaning it's also the perfect Charleston home base for history buffs. Lodgers particularly praise the elegant decor, fantastic customer service, on-site spa, evening brandies and sherries, and complimentary hors d'oeuvres. Rooms include spacious bathrooms with whirlpool tubs, fireplaces or outside porches and, in some suites, sunrooms. Though guests say the rooms and overall atmosphere are relaxing, they note that the luxury doesn't come cheap. However, its location is another feather in its cap; The Battery is nearby, as is the South Carolina Aquarium. Also, keep in mind that this hotel is a part of the Small Luxury Hotels of the World, which means that members of the INVITED rewards program can earn and redeem points here.
The Covent Garden Hotel might sit in the heart of theatre-land, but it's no drama queen. It lets other divas in town take the curtain calls. Instead, this place goes for the slow burn, revealing itself subtly and demurely. But when it does, you realise it's a beauty. Take the first-floor Drawing Room, lined in maple wood, shiny as toffee, which originally came from the now demolished League of Nations building near Trafalgar Square. Here too are delicately limbed parlour chairs with 18th-century needlepoint embroidery and a grand old writing desk, inlaid with mother-of-pearl and holding numerous little drawers that surely concealed secret notes over the years. The honesty bar just off the nook of a library is as well stocked as a house party, meaning that nightcaps can be as late as you like. Settle into the yellow and red sofa in front of the log fire, kick off your shoes (it's not frowned upon) and soak up the elegant yet cosy surroundings. Just as lovely is the fourth-floor Terrace Suite, up among the rooftops and chimneys of London like a Mary Poppins eyrie. Parrots peck at blousy dusty-pink flowers on the linen upholstery of the sofa and over-sized headboard and purple and teal ikat-print curtains frame the windows. In the morning, watch the sunrise over the Shard from the little wooden deck. There's a deep bathtub for soaking in, and lavender-and-eucalyptus bathroom lotions by RikRak (a bespoke Firmdale range) that smell so good you'll be sniffing your arm for the rest of the day. Many new names have landed in London recently, but this trouper still holds its head up high. By Grainne McBride
The No. 1 Best Hotel in Vermont also happens to be one of its most unique. Situated on 300 acres of farmland in Barnard, Vermont, this adults-only, all-inclusive property features a spa, a pub and just 20 accommodations equipped with fireplaces and separate showers and bathtubs. Additionally, all guests have access to complimentary laundry service, minifridge snacks and packing and unpacking services, plus daily breakfast, lunch, dinner and alcoholic beverages at the on-site restaurant are included in the room rate. Activities, such as canoeing and kayaking, fly-fishing, tennis and snowshoeing, are also covered. (Courtesy of Twin Farms)
This hotel is the most talked-about hideout on the planet. Out here in the remote lands of southern Utah, where shark-tooth fossils, arrowheads and dinosaur bones poke through the crusty earth, Amangiri materialises out of the wobbling desert air. Seen from a distance, it has a phantasmic appearance, like a train of earth-toned cubes amongst the boulders. Inside, it's a sleek homage to nature, with 34 airy, minimalistic suites and common areas that blend into the landscape. This is where retired rock stars, exhausted A-listers seeking tune-ups and athletes with deep pockets gather for creative South-western-style cooking and stargazing on the decks at night. Scramble up the hilly splendour that goes on as far as the eye can see – about 600 uninhabited acres. Or hike to the Via Ferratas, triumphantly executing the breathtaking, high-altitude treks and hearing all about the hoodoos, promontories, pinnacles, caves and iron-flat mesas of this untrammelled place from the on-site guide and geologist. Then there's the pool, which wraps around an immense boulder in the heart of the grounds, or the spa, where Native American-influenced treatments rule the day. Amangiri, just a four-hour drive from Las Vegas, is a low-rise outpost in the dusty desert that goes beyond satisfying creature comforts: it's an invitation to live deeper. By Becca Hensley
Set just steps from the Magnificent Mile, the Four Seasons Hotel Chicago is central to all of the city's best restaurants, shops and nightlife. Rooms and suites at this Four Seasons outpost offer city or lake views and feature marble bathrooms, private bars and chic contemporary decor. The No. 3 Best Hotel in Chicago is also home to a spa, a large indoor pool and a restaurant serving globally inspired cuisine. (Peter Peirce/Four Seasons Hotel Chicago)
The Taj Mahal Palace is a 1903, grey-and-white stone, red-domed wedding cake of a building that stands sentry over Mumbai's harbor. When your taxi pulls up through the throngs of families and tourists who choke the roads near the Gateway to India arch and you're ceremoniously welcomed by doormen in traditional silk kurtas, you have that pinch-me feeling of Wow, I'm really staying here? You're in good company, as everyone from George Bernard Shaw to Barack Obama has spent the night here too. Because the Taj is such a landmark, there are tourists and locals who come and go from the hotel's restaurants, shops, and bars, as well as the daily Heritage Walks around the property. But some parts of the hotel are off-limits to non-guests, so you quickly leave the bustle of the lobby behind. The Taj has the best pool in Mumbai, and a dozen restaurants, bars, and cafés, including Wasabi by Morimoto, Souk for Tagines, and Kraft Masala for Indian.
Katathani Phuket Beach Resort holds a special place in many return visitors hearts and it has constantly proved popular year after year.The resort comprises 479 low-rise guest rooms and suites - all with private balconies and terraces facing the ocean, pools or tropical gardens.Katathani has a tangible family atmosphere yet with two separate wings, six swimming pools and huge grounds as well as an adjacent 850-metre long beach, things never get too crowded.The resort has six restaurants and five bars.Upstairs from the main dining room Chom Talay, La Scala offers excellent contemporary Italian fare in a classic setting with live piano music. Read More...
The 39-room Post Ranch Inn is one of the most beautiful hotels in the United States -- if not the entire world -- and offers a romantic, intimate stay amid gorgeous natural surroundings. The hotel is built into the cliffs of Big Sur, and the organicarchitecture is breathtaking, seeming to grow out of the ground beside the hotel's surrounding redwoods. The spacious, eco-sensitive rooms have ocean or mountain views (that are sometimes obstructed by the pervasive fog that the area is known for) and many feature floor-to-ceiling windows to better show them off. Rooms also have wood-burning fireplaces, radiant floor heating, outdoor showers or hot tubs, private decks, and organic bath products and linens -- but no televisions or alarm clocks as the hotel strives for a peaceful environment. The award-winning spa focuses on rejuvenating services and even has a shaman on-site; the restaurant, Sierra Mar, is one of the best in Big Sur; the hotel's cliff-top pools are stunning; and free amenities (such as yoga and stargazing) are abundant.
A favorite among professional and leisure travelers alike, this luxury hotel has an inside edge on other hotels by truly coddling its guests. Why should you have to wait until 3 p.m. to check in? The Peninsula Beverly Hills will make your room available to you whenever you need it – even from the moment your plane lands at Los Angeles International Airport. Do you need to hold onto your room until 8 p.m. on your last day? No problem – The Peninsula also allows you to check out whenever is most convenient for you. And the first-class treatment doesn't end there. This hotel on South Santa Monica Boulevard is also known for its sumptuous garden villa suites (which come with complimentary fruit selections, flat-screen TVs, and large marble bathrooms), its rejuvenating Peninsula Spa and the mouthwatering fare served at the on-site see-and-be-seen restaurant, The Belvedere. Recent guests describe the hotel as "perfection" ... but at a price: room rates here are on the expensive side.
With elegant chalet decor and a host of amenities, the Landing Resort & Spa offers a luxury stay across from a private beach on Lake Tahoe and near Heavenly Village and the Stateline casinos. Its 77 stylish rooms have fireplaces, mini-fridges, Keurig coffeemakers, private balconies or patios (some with lake views), and luxurious bathrooms with heated floors and toilet seats. There's a restaurant that serves Greek and Californian fare and has a lovely patio overlooking the lake, though there are reports of slow service. For a dose of pampering, guests can head to the on-site spa, which has a sauna and steam room, and there's also an outdoor pool with a hot tub. Rates are pricey, however, plus there's a mandatory resort fee covering the facilities and services like Wi-Fi and valet parking.
That tiny-island locale is one reason Beth Blair loves Sunset Key Cottages, another top 10 contender. Its air of exclusivity is "magical, and I could go on and on about the top-notch service and views," says the Minnesota travel blogger. But something else won her heart: "The pastry baskets that arrive every morning at the front door are a wow factor," she says. "There's nothing more relaxing than sitting on a beach-facing patio, sipping hot coffee and nibbling on freshly baked muffins."
The people of Quebec City are hardy and quite used to the harsh weather that is typical in the long winter months. Rather than mope and complain they tend to turn lemons into lemonade, or rather snow and ice into sculptures and other works of art. The city holds a winter carnival every year, officially known as Le Carnaval de Quebéc. Despite the brisk temperatures that are experienced at this time, this carnival is as popular among travellers as events held in the summer months. In fact it is the largest carnival of its kind in the world, with more than one million people drawn to view the ice sculptures, take part in winter sports and attend parades and masquerade balls. Bonhomme, a stylised giant snowman, is the delightful official mascot. Those looking for a unique and beautiful place to stay in the deep winter months should head a few miles to the north of the city where the Hôtel de Glace, North America's only ice hotel, is open from January to March each year. The spectacular suites are carved out of the ice by artists and have to be seen to be believed.
Not only will you find your ideal hotel on www.trivago.ca, but you can also browse suggestions for your next vacation. How? trivago lists the Top Deals as well as the most popular destinations. If you're looking for your next dream vacation or you're interested in the top destinations for Canadians, you'll find it on trivago. Additionally, our search engine technology uncovers unique deals on booking sites around the world that travellers would never find without trivago.
The Jefferson wins visitors over time and again with its sophisticated and traditionally decorated accommodations, impeccable service and award-winning cuisine. The hotel's location in downtown Washington is a highlight as well; guests are just a short walk from the White House, the National Mall and top-notch bars and eateries. The Jefferson is the No. 1 Best Hotel in Washington, D.C. for 2017. (Courtesy of The Jefferson, Washington, DC)
Despite its humble tin roofs, this otherwise plush hotel ranked at No. 1 in the U.S. for its location: a private island that's 500 yards from Key West, which is close enough to enjoy the festive vibe, but far enough away to feel tranquil. It also impressed readers with its design, by way of 40 white-washed cottages that come with kitchens, but without any pressure to cook, since a breakfast basket shows up on your veranda in the morning. The hotel also gives you the best of both worlds in terms of recreation: there's a private beach on your side, but full access to the big-resort perks (like a 37-slip marina) across the water at the Westin Key West
This Design Hotels property features eclectic decor that complements its central SoHo neighborhood. Each room boasts a bold patterned headboard, high ceilings, a vibrant accent wall and unique touches like a window seat and a bone inlay dresser. Standard room amenities at the No. 4 Best Hotel in New York City include walk-in showers, flat-screen TVs and Bose Bluetooth speakers, but upgraded suites also offer extras like minibars and fresh flowers. Outside their digs, guests can take advantage of additional perks, such as a screening room, a rooftop garden and The Crosby Bar, a traveler favorite. (Courtesy of Crosby Street Hotel and Simon Brown)
Hilton Phuket Arcadia Resort & Spa is an idyllic 75-acre resort in Phuket, set in lush, tropical gardens surrounded by mountains, waterfalls and golden sandy beaches located on the heart of Karon Beach and 45 minutes from Phuket International Airport.The hotel features Hilton Deluxe rooms all the way up to Royal suites with all rooms offering balconies with either sea view or garden views.Unwind with a traditional Thai massage in the Spa - cool off in one of 5 pools or just relax to the sound of the waterfalls.Sample fresh seafood and award-winning cocktails at Sails restaurant or go local at the romantic Thai Thai Restaurant. Read More...
Hidden among fisherman's casas painted cobalt-blue, pink and pistachio bordering Trancoso's sleepy village square, where the town's elders gather to shoot the breeze, Uxua is almost imperceptible to the passer-by. The only giveaway is the tables of smart Cariocas and international hipsters sipping passionfruit Caipirinhas while watching the early evening scene unfold on the Quadrado. Golden light catches the locals playing football around the whitewashed 16th-century church. This is just how expansive Dutch owner Wilbert Das (Diesel's former creative director) likes it. Surrounded by dense rainforest and teetering high on a ridge overlooking the powder-sand fringed Atlantic, Uxua fits right into the post-hippie utopia of Trancoso. Working with local artisans, Das has turned the hotel into a collection of rustic renovated casas, cottages, an intimate treehouse and a tribal-inspired spa. All are cloaked by hummingbird-flecked tropical gardens and centred around a pool lined with green aventurine quartz, which, for those not up on their healing crystals, is said to be very therapeutic. Interiors are haute-boho: roomy indoor-outdoor sitting rooms and airy living spaces with dazzling-white walls and muslin-canopied beds, accented with lots of reclaimed wood, antiques and vintage finds including brightly painted Virgin Mary statuettes. A decked path runs through mangrove forests to the beach, where there are enormous day beds for post-breakfast snoozing and a beach bar fashioned from an old fishing boat – just stay horizontal and another Caipirinha will soon find its way to you. This is the South American coastal retreat that's on everyone's radar. By Chris Caldicott


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text:
HC declines to ban The Da Vinci Code
via Pioneer News Service | Kochi published on May 25, 2006
The Kerala High Court on Thursday declined to prohibit exhibition of the film The Da Vinci Code in the State, but directed the Information and Broadcasting Ministry to reconsider the certification granted to the movie.
A Division Bench, comprising Chief Justice VK Bali and Justice CR Raman, directed the Information and Broadcasting Ministry to consider the review petition for the certification to the movie and granted three weeks' time to take a decision in the matter.
Petitioner Basil Attipetty had sought a direction to the chairman, Central Board of Film Certification, to reconsider the permission granted for exhibiting the film in the State.
He said the film was a "distorted" version of historical facts and would "affect the freedom of belief".


text:
Q: Sending image to nodeJs server using fetch api I am trying to send an image via fetch API to Nodejs server. The client-side code is below
uploadByFile(file) {
    let formData = new FormData();
    formData.append("image", file);

    return fetch('/editorJS/uploads', {
        method: 'POST',
        body: formData
    })
    .then(res => res.json())
    .then(json => {
        return json;
    })
    .catch(error => console.error(error));
}

But on the server-side, I am getting buffer instead of file. How can I retrieve file there? Below is code
router.post('/editorJS/uploads',  (req, res) => {
    console.log(req.body);
    console.log(req.body.files);
    console.log(req.files);
}

And the output is
<Buffer 2d 2d 2d 2d 2d 2d 57 65 62 4b 69 74 46 6f 72 6d 42 6f 75 6e 64 61 72 79 31 76 56 59 4d 59 4f 73 59 6a 42 67 76 5a 4b 50 0d 0a 43 6f 6e 74 65 6e 74 2d ... 10336 more bytes>
undefined
undefined

A: Use multer package for get file in nodejs, i am put a code below you.
const multer = require('multer');

const localstorage = multer.diskStorage({
    destination: function (req: any, file: any, cb: any) {
        cb(null, '');
    },

    // By default, multer removes file extensions so let's add them back
    filename: function (req: any, file: any, cb: any) {
        cb(null, file.fieldname + '-' + Date.now() + path.extname(file.originalname));
    }
  });

  router.post('/editorJS/uploads',  multer({ storage: localstorage }).single('file')
  (req, res) => {
   console.log(req.body);

  }

A: With this buffer you can create your image and store it on folder in your server.
var fs = require('fs');

try{
   fs.createWriteStream(path_folder_to_store_image).write(your_buffer);
   console.log('image upload');
}catch(error){
   console.log(error)
}

redpajama_set_name: RedPajamaStackExchange


Inside Line reports: In a major development that is expected to spur development of batteries for electric cars in the United States, Tesla Motors has created a new division to sell batteries to other companies. The new division is being lauded as a bold step for Tesla that will help it expand faster while providing a launchpad for other electric-vehicle manufacturers.
Hey, I'm all for more fuel-efficient vehicles out there. And especially supportive of anything that might drop the price of this beauty.


This is part of the conference "Building Partnerships Between Archives and Indian Communities," held at the American Philosophical Society (APS) in Philadelphia, May 2010.
"Welcome Song," Elder Watie Akins, Penobscot Nation.
Timothy Powell, director of special American Indian projects for the American Philosophical Society, holds a microphone for Watie Akins of the Penobscot Nation during "Welcome Song." / Michael S. Wirtz, Philadelphia Inquirer.
"Pipe Ceremony." Larry Aitken, Tribal Historian of the Leech Lake Band of Ojibwe.
Following is a photo gallery of the Pipe Ceremony, all photos by Frank Margeson, Copyright (©) 2010 American Philosophical Society.
This part of the conference "Building Partnerships Between Archives and Indian Communities," held at the American Philosophical Society (APS) in Philadelphia, May 2010.
Robert Miller, Prof. of Law at Lewis and Clark School and Chief Justice of the Court of Appeals of the Grand Ronde Tribe.
"This is an historic moment, a chance to truly share materials together to preserve Native languages and cultures.
"But last week, at a lecture in San Antonio someone asked me, 'Shouldn't you just join the Melting Pot and become a regular American?' My answer is: Absolutely not! Native Americans do not want to lose their language and culture, which makes them separate from Americans and the Melting Pot. But many feel like they are living in two worlds – one of speaking English and being American, and the tribal pull.
"Preserving language is absolutely crucial – language is the key to a separate existence and distinct culture. The English language does not reflect the meanings, ways and degrees [in Native languages]. This is not an academic exercise – it's about keeping the culture alive for the next generation, and the next 1,000 years.
"When Columbus stumbled into the Caribbean in 1492, there were 300 Native languages. In 2000, there were 175 alive in 29 states. But of those 175, only 11 percent were still spoken; of those still spoken, 40 percent were only by the grandparents, and 17 percent only by the parents. In 10 years (this year), it was predicted that 75 percent of the languages would be extinct. The remaining languages are in a precarious existence.
"For the Navajo, in 1980, 90% of 6-year-olds could speak the language, but in 2000 it dropped to 30%. Did television rob them of their language and culture? On the Pine Ridge Indian Reservation, there are 29,000 people but only 5-15% of them are fluent, and of the speakers, 60% are 50 or older. For the Pawnee, in 1965 there were 200 fluent speakers, but the last died in 2006. The loss of language directly leads to the loss of religion, culture and ceremonies.
"How did that happen? This was the goal of the English, French and Spanish. Though the first Bible was translated [into Native languages], soon after they taught English to assimilate the Indian people. From 1819-1873, Congress supported the Civilization Fund that provided schools on and off the reservations. These schools took children away from 5-18 years old, punishing them when they spoke their own language. In 1869, the schools required them to practice Christianity, and in 1875 all Bureau of Indian Affairs (BIA) schools required all communication to be in English. In 1868, the BIA decreed: 'Sameness in language leads to sameness in thought and sentiment.' In 1877, there were 170 BIA schools, while in 1909 there were more than 300. Now there are 85 schools.
"Thomas Jefferson wanted to prove where the Indian people came from. He collected vocabularies from all of the tribes east of the Mississippi, and told Lewis and Clark to collect vocabulary lists. The vocabularies were unfortunately lost when Jefferson moved to Monticello in 1809. Lewis and Clark also collected a questionnaire of every tribe, including military intelligence. Jefferson was the father of the 'Removal Era.' Lewis and Clark found out which tribes would be willing to move west, and also which tribes in the west would accept tribes moving from the east.
"What are the tribes doing? Some are in business development, such as by building casinos. Some languages are being revived, for example Chinook Jargon is being taught, even though it's a trade language with French, English and Spanish words.
Sioux boys as they arrived at the Indian Training School, Carlisle Barracks, Oct. 5th, 1879. / Frank Speck, APS Speck-Choate Photograph Collection.
"Tribes must teach younger children their language. The Blackfoot's Piegan Institute practices language immersion, which is the only way to teach, especially for the first five years in a child's life. Tribal schools have low attendance and high dropout rates. But if they taught the tribal languages in high school, who would be the A student then? It validates the minority people who do not read about themselves in American history textbooks.
"What is the federal government doing today? In 1972, the Indian Education Act supported bilingual education for Indian schools. But 36 states have English-only curricula, and Arizona recently banned ethnic studies programs. In 1990, the Native American Language Act (NALA) said that the United States has a responsibility to act together with Native Americans, and awards special status to Native Americans, including recognizing that separate identity and language are integral to the survival of Indian culture. Student achievement and school pride are tied to the first language of the child. Indian languages should be taught at the elementary, secondary and higher education levels.
Indian boys (from 16 different tribes) at the Indian Training School, April 20th 1880. / Frank Speck: APS Speck-Choate Photograph Collection.
"Oregon passed a law letting the tribes certify who can teach their language, and that it can't require any certification or bachelor's degree. Washington state passed the same in 2007. Since 1992, NALA has awarded only $13 million in 166 grants, only about one-fifth of the $63 million requested. A Senate report showed that this was only policy, and not required by the United States. This shows that the 50 states are not dependable. Tribal people can't wait another 200 years for U.S. to help them.
"Indian students who see themselves in the curriculum helps reduce the dropout rate, just like how a recent Oregonian article showed the same for Latino and African-American students.
"Introduction." APS Executive Officer Pat McPherson.
"As the founding director of the First Nation Studies Program, I can tell you that universities are reawakening the protocols of collaborative partnerships. APS is pivotal for the study of Native American languages and to some extent, of Native Peoples.
Thomas Jefferson, Third President of the United States. He recorded Indian vocabularies. / APS Prints Collection.
"[America's] Founding Fathers classified the indigenous population as a 'cabinet of curiosities,' categorizing them in the natural science field as part of Enlightenment thinking. They also amassed data on the languages of the peoples of America. The Founding Fathers prized something 'American' over the Old World, and identified with Native Americans such as by dressing up as them for the Boston Tea Party.
"Early APS Members who were anchored in philosophy did not conduct anthropological fieldwork, though Wilhelm Van Humboldt called for the need to have accurate data numbers on the languages.
"In the book 'Jefferson and the Indians,' it tells of Jefferson admiring the freedom of native people living outside of civilization. He thought of the Indians as noble but disappearing, and thus needed records to be available for study of them. Jefferson's Indian vocabularies was lost in 1809 when he moved to Monticello, but there are remnants at the APS. He recognized the diversity of the Indian languages, and thought that they were the key to the affinity of nations, though he collected mostly Algonquin vocabularies.
Jefferson's Indian Vocabulary List. List of words, in English, with space for listing the Indian equivalent, 1792. / APS American Indian Vocabulary Collection.
"Jefferson's vision of science is at the core of the APS. Jean Duponceau classified Indian languages on grammar rather than vocabulary, but Jefferson rejected that. But both were mistaken. John Pickering designed a uniform orthography. Albert Gallatin created a map of linguistic groups and a vocabulary. Henry Schoolcraft made Ojibwe narratives. Lewis Cass advised Jefferson on the Lewis and Clark expedition. Daniel Brinton transcribed the Iroquois Bill of Rights, made migration legends and kept Philadelphia on the map for professional anthropology.
"Brinton became the first anthropology professor in the country at the University of Pennsylvania. In 1894 he presented at the World's Fair, and was the first to include South American languages, drawing the hemisphere into a single fold. Franz Boas, whose base remained in academia, wrote the 1911 "Handbook to American Indian Languages." Through the 1920s, he developed and catalogued based on fieldwork, demonstrating that each language has its own structure.
"Greeting." Chief Glenna Wallace, Eastern Shawnee Tribe of Oklahoma.
"The Shawnee are originally from the area. In 1682 we met with William Penn, and again in 1701 with the Indian Tribal Conference. We were forcibly removed from our indigenous land in Ohio in 1832. We were the first tribe after the passage of the 1830 Indian Removal Act. We made the 700-mile trek to Oklahoma. Who we lost and how many, we do not know.
Session 4: Where Do We Go From Here?
We live in an historical era in which new possibilities have arisen for collaboration between archives, museums and indigenous communities. Yet, tremendous challenges lie ahead that must be addressed.
This session concerns the issues of technological resources for curatorship in indigenous communities.
But sometimes that it is not a simple process.
Black and white group portrait of Native American (Zuni) children, two girls and two boys, wearing traditional clothing; ca. 1880. Frank Speck/APS.
Shankhar used the example of the Zuni tribe, who wanted to use the recorded language files for cultural and linguistic education. But the Zuni did not have the IT specialists or digital resources to host the files on their own servers, and transporting the materials by CDs or DVDs presented issues of security and long-term preservation, Shankhar said.
One person who does speak the language of archives and technology is Kimberly Christen, an assistant professor at Washington State University's Department of Comparative Ethnic Studies.
Christen has developed the Mukurtu Archive for the Warumungu community in Tennant Creek, Northern Territory, Australia, and is currently working on the Plateau People's Web Portal, a similar online archival project developed with Washington State University and the three Pacific Northwest tribes of the Coeur d'Alene, Umatilla and Yakama. The open-source software could be adapted by any indigenous community.
Because digital technology can be reproduced so precisely and transported so inexpensively, it has created exciting new possibility for moving materials from archives back into indigenous communities.
This session focused on two groups: Pueblo Isleta developing a traveling exhibit, and Pimachiowin Aki, a proposed UNESCO World Heritage Site in Canada.
Time Exposures: Picturing a History of Isleta Pueblo in the 19th Century, is a traveling exhibit developed by Isleta Pueblo traditional leaders.
They faced the challenge of telling the history of the Isleta people from their point of view, without revealing information that would diminish the privacy or integrity of their lives, practices and beliefs, said Stephanie Zuni, from the Isleta Pueblo Cultural Affairs Office.
The exhibit of 300 photos is divided into: the cycle of the traditional year, the arrival of Americans and how it disrupted Isleta life, and examining the photographs themselves as products of white culture.
Pimachiowin Aki is a proposed UNESCO World Heritage Site, a partnership between four First Nations (Pikangikum, Poplar River, Pauingassi and Little Grand Rapids) and the governments of Manitoba and Ontario, Canada. Its boundaries would contain 40,000 sq. km of vast boreal forest, rivers, lakes and wetlands.
Map of the proposed Pimachiowin Aki UNESCO World Heritage Site, a partnership between four First Nations and the governments of Manitoba and Ontario, Canada.
"The Poplar River Ojibwe are using APS photographs to preserve 40,000 acres of land, on the east side of Lake Winnipeg," said Sophia Rabliauskas, spokeswoman for the Pimachiowin Aki Corporation.
"Developers wanted the land for logging and hydro-development, but the community was against it," Rabliauskas added. "The elders knew we had been there for thousands of years, but we needed to document that. Archaeologists showed that we been there for 6,000 years.


text:
Peto odds ratios demonstrate no advantage over classic odds ratios in meta-analysis of binary rare outcomes
View ORCID ProfileChang Xu, Luis Furuya-Kanamori, View ORCID ProfileLifeng Lin, Suhail A. Doi
Chang Xu
1Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar
2Chinese Evidence-based Medicine Center & Cochrane China, West China Hospital, Sichuan University, Chengdu, China
ORCID record for Chang Xu
For correspondence: xuchang2016@runbox.com sardoi@gmx.net
Luis Furuya-Kanamori
3Research School of Population Health, Australian National University, Canberra, Australia
Lifeng Lin
4Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
ORCID record for Lifeng Lin
Suhail A. Doi
In this study, we examined the discrepancy between large studies and small studies in meta-analyses of rare event outcomes and the impact of Peto versus the classic odds ratios (ORs) through empirical data from the Cochrane Database of Systematic Reviews that collected from January 2003 to May 2018. Meta-analyses of binary outcomes with rare events (event rate ≤5%), with at least 5 studies, and with at least one large study (N≥1000) were extracted. The Peto and classic ORs were used as the effect sizes in the meta-analyses, and the magnitude and direction of the ORs of the meta-analyses of large studies versus small studies were compared. The p-values of the meta-analyses of small studies were examined to assess if the Peto and the classic OR methods gave similar results. Totally, 214 meta-analyses were included. Over the total 214 pairs of pooled ORs of large studies versus pooled small studies, 66 (30.84%) had a discordant direction (kappa=0.33) when measured by Peto OR and 69 (32.24%) had a discordant direction (kappa=0.22) when measured by classic OR. The Peto ORs resulted in smaller p-values compared to classic ORs in a substantial (83.18%) number of cases. In conclusion, there is considerable discrepancy between large studies and small studies among the results of meta-analyses of sparse data. The use of Peto odds ratios does not improve this situation and is not recommended as it may result in less conservative error estimation.
Current healthcare decision making relies heavily on evidence from systematic reviews and meta-analyses [1-3]. Meta-analysis pools findings from related studies and provides comprehensive evidence towards answering clinical questions. In meta-analysis, effect estimates of each study are assigned a certain weight and these weighted estimates are then pooled together into a "weighted average effect" [4-6]. Mostly such weights are based on random error (e.g., using the inverse of the study variance), and thus more weights are assigned to larger studies than smaller ones since larger studies have less random error [7, 8]. As a result, larger studies have predominant influence on the pooled effect of a meta-analysis.
Previous studies have investigated the influence of large trials on meta-analysis. Villar et al compared 35 mega-trials to meta-analyses of small studies with the same topics and observed a 20% discrepancy on the direction of the effect size [9]; LeLorier et al compared 12 mega-trials to 19 meta-analyses (there was more than one meta-analysis within the same topic) of small studies and found that in 32.5% of the cases, the directions of the effect sizes were different [10]. This indicates that when the results of mega-trials are added to a meta-analysis of small studies, up to a third of the time, the direction of the conclusion changes - an intervention initially protective, can become harmful (or vice versa); results of smaller studies therefore are discordant with mega-trials in up to a third of cases and may therefore not be robust or useful for clinical decision making.
For meta-analysis of rare events, the discordance between large studies (of the size of a mega-trial) and small studies has not been studied. Meta-analyses of rare events are generally utilized to assess the adverse effects of interventions because single trials have limited power to capture a sufficient number of events [11, 12]. Due to the extremely low frequency of events (even no event), small studies may have larger random or systematic errors in a meta-analysis of rare events and thus their results may be expected to deviate more from that of a large study [13-16]. Currently it is unclear to what extent a large study (or meta-analysis of large studies) may disagree with the results of meta-analysis of small studies for rare event outcomes. We also do not know if the method of computing binary effect sizes can influence this discrepancy. This is because it has been thought that corrections for zero cell counts are not necessary when using Peto's odds ratios and so it would work well when events are very rare [17].
In this study, we used meta-analyses from the Cochrane Database of Systematic Reviews to empirically explore the extent of agreement between a large study (or pooled large studies if more than one) and the meta-analysis of small studies for rare event outcomes. We also compared meta-analysis results using the Peto odds ratios (no continuity correction) to the classic odds ratios with a continuity correction [15] as many smaller studies will be expected to have study arms with no event.
Cochrane data
The Cochrane Collaboration (https://www.cochrane.org/) is a non-commercial academic organization that aims to provide reliable evidence for health decision. The Cochrane Database of Systematic Reviews (CDSR) contains a comprehensive collection of systematic reviews and meta-analyses, and it has been used for assessing many important meta-analysis issues, including publication bias, missing data and heterogeneity [18-21]. Data from the CDSR were collected from January 2003 to May 2018 using the R package "RCurl" [22].
Meta-analyses with rare events (binary outcome), with at least 5 studies, and with at least one large study were included. Rare events were defined as incidence rates ≤5% in the control group [23, 24]. Studies with sample size ≥1000 were deemed large; this was akin to the size designated for a mega-trial [10, 25]. To ensure an adequate balance between large and small studies, we excluded the meta-analyses if they had more large studies than small studies. Also, to ensure an adequate influence of larger studies, we excluded the meta-analyses in which the total sample size of large studies was less than that of the smaller studies. Meta-analyses that contained studies with both arms containing zero events were also excluded.
The Peto and classic ORs and standard errors (SEs) were estimated for meta-analysis of large studies as well as meta-analysis of small studies (excluding large studies). The Peto OR was based on the Yusuf-Peto method [26], and it is recommended by the Cochrane Handbook for meta-analyses of rare events [27]. The Yusuf-Peto method uses the exponent of the difference of observed events to expected events to obtain the asymptotic estimation of the OR; it has been suggested as a valid solution for zero events in one arm [17, 26, 28]. The Peto OR is computed as follows. Consider a 2-by-2 table structure for the data with elements of each cell being a, b, c, d, where represent the number of events and non-events in treatment and control groups, respectively. Then the Peto OR (on a log scale, lnOR) and its SE are given by:
Peto LnOR = {(a − E[a]) / V}
V = {n1 n2 (a + c)(b + d)} / {N 2(N − 1)}
E[a] = n1(a + c) / N
n1 = a + b; n2 = c + d; N = n1 + n2
On the other hand, we used the classic OR as an alternative; it applied a continuity correction (cc) of 0.5 for studies with zero event in one treatment arm [15]. It is computed as follows:
OR = ad / bc
OR_cc= (a+ 0.5)(d + 0.5)/ (b + 0.5)(c + 0.5)
After study ORs were computed, the meta-analysis was carried out using the inverse variance heterogeneity method [7] (IVhet). This method produces better error estimation and is more robust to "small study effects", compared to the conventional random-effects models, when there is heterogeneity [29]. Also, the normal approximation used by the conventional random-effects model may be poor for small studies or rare events, and this can result in inaccurate estimates [24]. Of note, because of potential heterogeneity, we did not pool studies via the classic fixed-effect approach as is usually done with the Peto approach.
The magnitude and direction of ORs of meta-analyses of large studies versus small studies were compared for each method. The Bland-Altman plot was used to examine the degree of agreement in magnitudes of effect between meta-analysis of small and large studies. This method plots the difference against the average of pooled small and large study results for the lnORs paired by meta-analysis [30]. For the degree of agreement on direction, the kappa statistic was used. The agreement with a kappa within 0-0.4 was treated as weak, 0.41-0.8 as moderate, and 0.81-1.00 as strong [31]. We compared the p-value of meta-analysis of small studies to assess if the two OR methods gave similar results. All data were analysed in Stata/SE 14.0 (Stata, College Station, TX) and the meta-analyses were conducted using the admetan command. The statistical significance was pre-specified as 0.05.
Data characteristics
From the 61,091 meta-analyses of binary outcome, 52,992 failed to meet the definition of rare events. Of the remaining, 272 had studies with zero events in both arms, 6,879 had less than 5 studies, and 460 did not contain large studies. There were 488 meta-analyses of rare events with large studies. After excluding meta-analyses where the total sample size of large studies was less than the total sample size of smaller studies and excluding meta-analyses with more large studies than small studies, 214 were included for the final analysis (Figure 1).
Flow chart of selecting meta-analyses with rare events and large studies.
The number of studies in the meta-analyses ranged from 5 to 18 with a median of 6 (interquartile range [IQR] 5 - 7). The incidence rate in the control group ranged from 0% to 4.92%, with a mean and median of 1.29% (SD 1.24%) and 0.96% (IQR 0.27 - 1.98%), respectively. The sample sizes of small studies ranged from 3 to 730 with a median of 164 (IQR 78 - 299) in the intervention group and from 4 to 498 with a median of 139 (IQR 73 - 258) in the control group. The sample size of the large studies ranged from 53 to 50,053, with a median of 1015 (IQR 678 – 1,678) in the intervention group; and from 82 to 21,555,505, with a median of 952 (IQR 656 –1,706) in the control group. Of note, although individual large study arms had less than 1000 participants, the study size was always ≥1000.
Comparison of large and small studies
Based on the Peto OR, for meta-analyses of small studies, 121 had an OR > 1 and 93 had an OR <1; whereas for the large studies, 115 had an OR > 1 and 99 had an OR <1. Over the total 214 pairs of ORs (pooled small studies versus pooled large studies), 148 (69.16%) had a concordant direction, while 66 (30.84%) pairs had a discordant direction. The degree of agreement was weak (kappa=0.33, Table 1). The mean difference of the paired lnORs of large studies versus small studies was −0.036 with 12 (5.61%) being outside the limits of agreements (Figure 2).
Test of agreement on direction for odds ratios for small studies against large studies.
The Bland-Altman (top) and mountain (bottom) plots of the agreement on the magnitude of lnORs. Left: based on Peto method; Right: based on classic method.
Based on the classic OR, for pooled small studies, there were 117 and 97 meta-analyses that had an OR >1 and <1 respectively; and for large studies, 116 and 98 had an OR >1 and <1 respectively. Over the total 214 pairs of ORs, 145 had a concordant direction (67.76%), while 63 pairs had a discordant direction of effect (32.24%). The degree of agreement on direction again was weak (kappa=0.22, Table 1). The mean difference of the paired lnORs of large studies versus small studies was −0.009, with 11 (5.14%) being outside the limits of agreement (Figure 2).
Comparison of the Peto and classic odds ratios
There was a high consistency on the direction of ORs between the Peto and classic methods. For meta-analyses of large studies, 213 had the same direction and only 1 had different directions (kappa=0.96); for meta-analyses of small studies, only 8 had different directions (kappa=0.96). For the direction of p-values for meta-analysis of large studies, a higher proportion demonstrated statistical significance using the Peto method (65/214 = 30.37%) than using the classic method (55/214 = 25.70%). For small studies, similar results were observed with a higher proportion of significant Peto ORs (55/214 = 25.70%) compared with significant classic ORs (37/214 = 17.29%). Again, there was a strong agreement on the direction of p-values of the Peto and classic methods in both meta-analyses of large studies and small studies (Table 2).
Test of agreement on direction for odds ratios and p-values between the Peto and classic odds ratios.
Difference of p-values (meta-analysis of small studies)
The deviation of p-values for pooled small studies (Peto – classic) is presented in Figure 3. In total, the difference in p-values suggested that Peto ORs resulted in spuriously smaller p-values (mean difference = −0.06) compared to classic ORs in a substantial number of cases (83.18%). The deviations from the classic OR p-values were small and only resulted in a cross-over from >0.05 to <0.05 in 18/214 (8.41%) meta-analyses.
The deviation of p-values for small studies (Peto minus classic). The vast majority (83.18%) of results via Peto demonstrate a spuriously smaller p-value and thus overconfident results. However, only 8.4% of results have a difference sufficient to cross from >0.05 to <0.05.
In this study, we evaluated the extent of agreement and discrepancy of large studies (mega-trial sized) and meta-analysis of small studies for rare event outcomes using empirical data from the CDSR. We found that there was poor agreement in terms of the direction of ORs between large and small trials-about one third of the meta-analyses had a discordant direction of effect. The discrepancy of the effect size between large studies and small studies was similar with the Peto and classic methods of computing ORs. In addition, the differences between the ORs of large versus small trials were comparable across both methods. Where there was more discrepancy in error estimation – the Peto ORs consistently generated smaller p-values and thus had a tendency to produce overconfident results (increase false positive error).
The Peto OR was first proposed as a way to deal with one-arm-zero-events studies by Peto and colleagues in 1985 [26]. An advantage of the Peto OR for such studies is that it does not need a continuity correction to estimate the relative effect and variance. Several simulation studies have shown it to be a more robust effect estimator than the classic OR with continuity correction when the events are rare [15, 28, 32]. We, however, demonstrated no advantage for the Peto ORs in the situation of rare events with large studies; indeed it may lead to less conservative error estimation. The reason our results differ from the existing simulations is that we used real-world data and separated small studies from large studies. Also, we used a more advanced meta-analysis approach (IVhet) that accounts for heterogeneity, rather than the conventional (but unrealistic) fixed-effect model that is associated with the Peto ORs.
For rare events, small studies generally have limited power and insufficient information (zero events) to make a reasonable judgement, even after pooling them together. Large studies tend to have more events allowing a more reliable statistical inference, so some researchers suggest that large studies may be more reliable [33]. This is because meta-analysis incorporates the biases of individual small studies and thus may bring in new sources of bias (e.g. publication bias) [34]. Our study found that one third of smaller studies in a meta-analysis, gave discordant results with the large studies when events are rare. There is therefore a substantial chance of drawing a totally inverse conclusion from small studies when compared to the large studies. This suggests that results of meta-analyses of small studies with sparse results must be viewed with caution.
When there are only smaller studies data available, some additional analyses, such as assessment of publication bias, subgroup analysis and sensitivity analysis, could be potential indicators of the robustness of the results and could provide some guidance. For example, in the case where pooled small studies suggest a positive result, we may need to assess all these other potential sources of uncertainty (additional analyses) before reporting results [35-38]. We can also run a more robust method (e.g. IVhet [7]) as this may be more appropriate to pool the evidence for decision making given the limitations of the random effects method with rare data [24].
To the best of our knowledge, this is the first empirical study comparing the discrepancy between large studies versus meta-analyses of small studies of rare events. In this study, we used the whole dataset of Cochrane meta-analysis of rare events that also included large studies so our findings are expected to be broadly representative. A strength of this analysis was that we did not use the most popular random-effects meta-analysis estimator given its faulty error estimation [24, 39].
Nevertheless, there are some limitations in the current study. We excluded meta-analyses with studies that contained zero events in both arms. In standard meta-analysis, such studies are also generally excluded; more complicated statistical approaches are needed to properly incorporate the information from such studies in a meta-analysis. In addition, the definition of large trials is somewhat arbitrary. Although this definition has been widely accepted and employed, there was no reasonable theoretical or empirical evidence to support our criterion of N≥1000 for defining large studies. We therefore used additional criteria to define the extent of influence of large studies in this analysis
There is considerable discrepancy between the results of large studies and small studies with a third of smaller studies disagreeing with large studies. Results of meta-analyses of small studies with sparse results must be viewed with caution. The Peto OR does not improve this situation and may even worsen error estimation and therefore should no longer be considered the method of choice for the meta-analysis of binary data with rare outcomes.
Data can be obtained from the corresponding authors
All authors approved for publication
Data can be obtained by contacting the corresponding author. The authors downloaded the data from Cochrane Database of Systematic Reviews (CDSR) under the full access through Florida State University (in 2018). Please verify the accessibility on CDSR of your institution in order to get the data.
L.FK is funded by an Australian National Health and Medical Research Council Fellowship (APP1158469).
SD and XC conceived and designed the study; LL conducted the data collection; XC, LFK, and SD programmed the code for data cleaning and analyzed the data; XC drafted the manuscript; SD and LFK provided statistical guidance; SD, LFK and LL provided critical comments, revised the manuscript, and approved the final version.
CDSR
Cochrane Database of Systematic Reviews
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Posted October 16, 2020.
You are going to email the following Peto odds ratios demonstrate no advantage over classic odds ratios in meta-analysis of binary rare outcomes
Chang Xu, Luis Furuya-Kanamori, Lifeng Lin, Suhail A. Doi