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Mental illness affects roughly one in five Americans, but about a third of the U.S. population lives in areas underserved by mental health professionals. That's a problem that can take solution cues from music and meal kit mobile subscription services, says TAO Connect founder Dr. Sherry Benton and CEO Bob Clark. In October's Subscription Commerce Tracker, they discuss with PYMNTS how their platform works to help patients overcome geographical and societal barriers to mental health access.
According to the latest figures available from the National Institute of Mental Health, approximately one in five Americans — 45 million people — are afflicted by some type of mental health condition. Despite the fact that mental health is a widespread problem in the U.S., there are several barriers to accessing services — including geography. The U.S. Health and Human Services Department reports that roughly 111 million people live in "mental health professional shortage" areas, making it challenging for patients to reach local professionals.
TAO Connect believes that smartphones could offer a gateway, virtually connecting patients to mental health services through a subscription-based pricing model, similar to that of over the top (OTT) streaming services and meal kit deliveries.
TAO, which stands for Therapy Assistance Online, offers subscribers access to screening services, video conferencing with mental health professionals, educational modules, gamified tools and other interactive resources that can be accessed via smartphone. Subscription plans can be purchased as either a monthly or yearly plan.
In a recent interview with PYMNTS, Clark and Dr. Sherry Benton, TAO Connect's founder and chief science officer, explained how the company relies on evidence-based tools and machine learning (ML) to gauge a patient's needs, and help therapists and patients better understand their progress.
TAO Connect licenses its services to colleges, universities, hospitals and medical networks, which then make the service available to the students or patients they cover. In addition to this B2B service, the company also offers subscriptions directly to consumers.
The inspiration for the service came from Benton's earlier work as the director of counseling for a university. The university's counseling center often struggled to meet the high volume of demand from students, and placing students on a waitlist can prolong their mental health problems, exacerbate their effects and even take a toll on their academic careers.
"If you make a student who is pre-med wait five weeks to start treatment for depression, they're going to lose their whole semester and it could affect their entire future," Benton said.
TAO decided to offer a B2C option after hearing that undergraduate students, who used the service while under the coverage of their college or university, wanted to continue using it after graduation.
Making mental health services available through a smartphone could also address why some don't seek treatment in the first place. A subscription-based telemedicine approach means users don't have to show up to counseling centers or fit appointments into their schedules. Instead, they can engage with the platform and communicate with mental health professionals at their convenience.
Subscription-based models also offer another benefit: users who might feel uncomfortable visiting a mental health center can access resources with their privacy largely intact.
Easier access, however, does not always ensure engagement. Earlier iterations of TAO Connect offered resources that relied on people talking to each other and working with educational materials that, while insightful, ultimately failed to retain users. To turn this trend around, the company reimagined the model by offering gamification, animations and more engaging content.
TAO Connect's dashboard now uses ML to detect when and how a patient interacts with the platform's content, giving mental health professionals the ability to more effectively measure how these patients are engaging with the material.
TAO is designed to make accessing mental health feel more like taking an online class or playing a mobile game, which encourages greater engagement in hopes that patients continue to use the service beyond a video session.
The service encourages users to engage with materials more evenly between sessions, and the data tools tell providers which patients remained engaged, and which ones scrambled to review the materials before the start of a new video session.
"That accountability encourages people to distribute their package throughout the week instead of doing everything 30 minutes before their next session," Benton said.
These factors could help broaden the reach of mental health services, providing services to those who have previously been unable to access it.
Consumers are staying increasingly connected to their smartphones, and the continued rise of subscription services could eventually make mental health resources as easy to access as music and meal kits.


2018 The Hand Magazine no. 20, Printmaking special.
/Beyond Reality/. Group Exhibition of contemporary Estonian printmaking. Tartu Artists House 24.08.-17.09.
I have worked as a designer since 2005. Designing layouts, books, flyers, study books and making illustrations for various publishers and companies.


This week sales of most popular racing game "Dirt 4" started. The game have been created by "Codemasters".
This year game has all the major teams in the most powerfull "Supercar" class, however less powerfull class "Super 1600" has only few selected teams. Among those teams is only one team who have been in European RX rallycross championship, and this team isn't the champion team. Game developers choose Lithuanian team's "ES motorsport" car "Volkswagen Polo Super 1600" which have been driven by Ernestas Staponkus.
ESmotorsport rallycross team have many years of experience in different kind of racing, mainly in autocross and rallycross. Previously known as European championship competitor in Super 1600 class racing driver Ernestas Staponkus.


text:
ph-0114 - ph-0114 - Medical Policies
ph-0114
Soliris® (eculizumab)
Policy Number: PH-0114
Last Review Date: 06/06/2022
Date of Origin: 06/21/2011
Dates Reviewed: 09/2011, 12/2011, 03/2012, 06/2012, 09/2012, 12/2012, 03/2013, 03/2014, 06/2014, 09/2014, 12/2014, 03/2015, 06/2015, 09/2015, 12/2015, 03/2016, 06/2016, 09/2016, 12/2016, 03/2017, 06/2017, 09/2017, 10/2017, 03/2018, 06/2018, 10/2018, 02/2019, 08/2019, 8/2020, 09/2020, 10/2021, 06/2022
FOR PEEHIP Members Only -Coverage excludes the provider-administered medication(s) outlined in this drug policy from being accessed through a specialty pharmacy. It must be obtained through buy and bill.
Length of Authorization
PNH and aHUS: Coverage will be provided for twelve (12) months and may be renewed.
gMG and NMOSD: Initial coverage will be provided for six (6) months and may be renewed annually thereafter.
Dosing Limits
A. Quantity Limit (max daily dose) [NDC Unit]:
Loading Doses:
3 vials Days 1, 8, 15, & 22; then 4 vials Day 29
Maintenance Dose:
4 vials every 14 days
B. Max Units (per dose and over time) [HCPCS Unit]:
Loading Doses
Maintenance Dose
60 billable units Days 1, 8, 15, & 22; then 90 billable units Day 29
90 billable units every 14 days
aHUS, gMG, NMOSD
90 billable units Days 1, 8, 15, & 22; then 120 billable units Day 29
120 billable units every 14 days
Initial Approval Criteria 1
Depending on member benefits, additional criteria may apply for coverage of this drug in an outpatient facility setting. Verify any Site of Service requirements with the member's plan and refer to the Voluntary Site of Service Policy or the Mandatory Site of Service Policy for additional information.
Coverage is provided in the following conditions:
Patient is at least 18 years of age (unless otherwise specified); AND
Prescriber is enrolled in the Soliris Risk Evaluation and Mitigation Strategy (REMS) program; AND
Universal Criteria 1
Submission of medical records related to the medical necessity criteria is REQUIRED on all requests for authorizations. Records will be reviewed at the time of submission. Please provide documentation via direct upload through the PA web portal or by fax.
Patient must be vaccinated against meningococcal disease at least two weeks prior to initiation of therapy and will continue to be revaccinated according to current medical guidelines for vaccine use (If urgent Soliris therapy is indicated in an unvaccinated patient, administer meningococcal vaccine(s) as soon as possible and provide patients with two weeks of antibacterial drug prophylaxis); AND
Patient does not have an unresolved, serious systemic infection (e.g., Neisseria meningitidis, etc.); AND
Will not be used in combination with other immunomodulatory biologic therapies (i.e., efgartigimod, ravulizumab, pegcetacoplan, satralizumab, inebilizumab, etc.) [Note: a 4-week run-in period is allowed when transitioning from eculizumab to pegcetacoplan]; AND
Paroxysmal Nocturnal Hemoglobinuria (PNH) † Ф 1,2-6,9,16,23
Patient must have tried and had an inadequate response or intolerance to, or a contraindication to Ultomiris OR Empaveli prior to consideration of Soliris; AND
Diagnosis must be accompanied by detection of PNH clones of at least 10% by flow cytometry diagnostic testing; AND
Demonstrate the presence of at least 2 different glycosylphosphatidylinositol (GPI) protein deficiencies (e.g., CD55, CD59, etc.) within at least 2 different cell lines (e.g., granulocytes, monocytes, erythrocytes); AND
Patient has laboratory evidence of significant intravascular hemolysis (i.e., LDH ≥1.5 x ULN) with symptomatic disease and at least one other indication for therapy from the following (regardless of transfusion dependence):
Patient has symptomatic anemia (i.e., hemoglobin < 7 g/dL or hemoglobin < 10 g/dL, in at least two independent measurements in a patient with cardiac symptoms
Presence of a thrombotic event related to PNH
Presence of organ damage secondary to chronic hemolysis (i.e., renal insufficiency, pulmonary insufficiency/hypertension)
Patient is pregnant and potential benefit outweighs potential fetal risk
Patient has disabling fatigue
Patient has abdominal pain (requiring admission or opioid analgesia), dysphagia, or erectile dysfunction; AND
Documented baseline values for one or more of the following (necessary for renewal): serum lactate dehydrogenase (LDH), hemoglobin level, packed RBC transfusion requirement, and history of thrombotic events
Atypical Hemolytic Uremic Syndrome (aHUS) † Ф 1,7,8,10,17
Patient must have tried and had an inadequate response or intolerance to, or a contraindication to Ultomiris prior to consideration of Soliris; AND
Patient is at least 2 months of age; AND
Patient shows signs of thrombotic microangiopathy (TMA) (e.g., changes in mental status, seizures, angina, dyspnea, thrombosis, increasing blood pressure, decreased platelet count, increased serum creatinine, increased LDH, etc.); AND
Thrombotic Thrombocytopenic Purpura (TTP) has been ruled out by evaluating ADAMTS-13 level (i.e., ADAMTS-13 activity level ≥ 10%); AND
Shiga toxin E. coli related hemolytic uremic syndrome (STEC-HUS) has been ruled out; AND
Other causes have been ruled out such as coexisting diseases or conditions (e.g., bone marrow transplantation, solid organ transplantation, malignancy, autoimmune disorder, drug-induced, malignant hypertension, HIV infection, Streptococcus pneumoniae sepsis or known genetic defect in cobalamin C metabolism, etc); AND
Documented baseline values for one or more of the following (necessary for renewal): serum lactate dehydrogenase (LDH), serum creatinine/eGFR, platelet count, and plasma exchange/infusion requirement
Generalized Myasthenia Gravis (gMG) † Ф 1,11,12, 18-22
Patient must have tried and had an inadequate response or intolerance to, or a contraindication to Ultomiris AND Vyvgart prior to consideration of Soliris; AND
Patient has Myasthenia Gravis Foundation of America (MGFA) Clinical Classification of Class II to IV disease §; AND
Patient has a positive serologic test for anti-acetylcholine receptor (AChR) antibodies; AND
Patient has had a thymectomy (Note: Applicable only to patients with thymomas OR non-thymomatous patients who are 50 years of age or younger); AND
Physician has assessed objective signs of neurological weakness and fatiguability on a baseline neurological examination (e.g., including, but not limited to, the Quantitative Myasthenia Gravis (QMG) score, etc.); AND
Patient has a MG-Activities of Daily Living (MG-ADL) total score of ≥6; AND
Patient will avoid or use with caution medications known to worsen or exacerbate symptoms of MG (e.g., certain antibiotics, beta-blockers, botulinum toxins, hydroxychloroquine, etc.); AND
Patient had an inadequate response after a minimum one-year trial with two (2) or more immunosuppressive therapies (e.g., corticosteroids plus an immunosuppressant such as azathioprine, cyclosporine, mycophenolate, etc.); OR
Patient required chronic treatment with plasmapheresis or plasma exchange (PE) or intravenous immunoglobulin (IVIG) in addition to immunosuppressant therapy
§ Myasthenia Gravis Foundation of America (MGFA) Disease Clinical Classification 19:
Class I: Any ocular muscle weakness; may have weakness of eye closure. All other muscle strength is normal.
Class II: Mild weakness affecting muscles other than ocular muscles; may also have ocular muscle weakness of any severity.
IIa. Predominantly affecting limb, axial muscles, or both. May also have lesser involvement of oropharyngeal muscles.
IIb. Predominantly affecting oropharyngeal, respiratory muscles, or both. May also have lesser or equal involvement of limb, axial muscles, or both.
Class III: Moderate weakness affecting muscles other than ocular muscles; may also have ocular muscle weakness of any severity.
IIIa. Predominantly affecting limb, axial muscles, or both. May also have lesser involvement of oropharyngeal muscles.
IIIb. Predominantly affecting oropharyngeal, respiratory muscles, or both. May also have lesser or equal involvement of limb, axial muscles, or both.
Class IV: Severe weakness affecting muscles other than ocular muscles; may also have ocular muscle weakness of any severity.
IVa. Predominantly affecting limb, axial muscles, or both. May also have lesser involvement of oropharyngeal muscles.
IVb. Predominantly affecting oropharyngeal, respiratory muscles, or both. May also have lesser or equal involvement of limb, axial muscles, or both.
Class V: Defined as intubation, with or without mechanical ventilation, except when employed during routine postoperative management. The use of a feeding tube without intubation places the patient in class IVb.
Neuromyelitis Optica Spectrum Disorder (NMOSD) † Ф 1,13-15
Patient has a confirmed diagnosis based on the following:
Patient was found to be seropositive for aquaporin-4 (AQP4) IgG antibodies; AND
Patient has at least one core clinical characteristic §; AND
Alternative diagnoses have been excluded (e.g., multiple sclerosis, sarcoidosis, cancer, chronic infection, etc.); AND
Patient has a history of at least 2 relapses in the last 12 months OR 3 relapses in the last 24 months, with at least 1 relapse in the last 12 months; AND
Patient has an Expanded Disability Status Score (EDSS) of ≤ 7.0 (i.e., presence of at least limited ambulation with aid); AND
Patient is receiving concurrent corticosteroid therapy of 20 mg per day or less and those receiving immunosuppressive therapy (e.g. azathioprine, glucocorticoids, mycophenolate, etc.) are on a stable dose regimen; AND
Patient has not received therapy with rituximab or mitoxantrone in the last 3 months; AND
Patient has not received intravenous immune globulin (IVIG) in the last 3 weeks; AND
Patient had an inadequate response, or has a contraindication or intolerance, to rituximab OR inebilizumab; AND
Patient will not concomitantly receive therapy with any of the following:
IL6-inhibitor (e.g., satralizumab); AND
Anti-CD20-directed antibody (e.g., rituximab); AND
Anti-CD19-directed antibody (e.g., inebilizumab)
§ Core Clinical Characteristics of NMOSD 15
Acute myelitis
Area postrema syndrome: episode of otherwise unexplained hiccups or nausea and vomiting
Acute brainstem syndrome
Symptomatic narcolepsy or acute diencephalic clinical syndrome with NMOSD-typical diencephalic MRI lesions
Symptomatic cerebral syndrome with NMOSD-typical brain lesions
† FDA Approved Indication(s); ‡ Compendia Recommended Indication(s); Ф Orphan Drug
Renewal Criteria 1-6,23
Coverage may be renewed based upon the following criteria:
Patient continues to meet the universal and other indication-specific relevant criteria identified in section III; AND
Absence of unacceptable toxicity from the drug. Examples of unacceptable toxicity include: serious meningococcal infections (septicemia and/or meningitis), infusion reactions, serious infections, thrombotic microangiopathy complications (TMA), etc.; AND
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Patient has not developed severe bone marrow failure syndrome (i.e., aplastic anemia or myelodysplastic syndrome) OR experienced a spontaneous disease remission OR received curative allogeneic stem cell transplant; AND
Disease response indicated by one or more of the following:
Decrease in serum LDH from pretreatment baseline Stabilization/improvement in hemoglobin level from pretreatment baseline
Decrease in packed RBC transfusion requirement from pretreatment baseline (i.e., reduction of at least 30%)
Reduction in thromboembolic events
Atypical Hemolytic Uremic Syndrome (aHUS)
Decrease in serum LDH from pretreatment baseline
Stabilization/improvement in serum creatinine/eGFR from pretreatment baseline
Increase in platelet count from pretreatment baseline
Decrease in plasma exchange/infusion requirement from pretreatment baseline
Generalized Myasthenia Gravis (gMG)
Patient experienced an improvement (i.e., reduction) of at least 3-points from baseline in the Myasthenia Gravis-Specific Activities of Daily Living scale (MG-ADL) total score; OR
Patient experienced an improvement of at least 5-points from baseline in the Quantitative Myasthenia Gravis (QMG) total score
Neuromyelitis Optica Spectrum Disorder (NMOSD)
Patient has stabilization and/or improvement of neurologic symptoms as evidenced by a decrease in acute relapses, EDSS, hospitalizations, or plasma exchange treatments
Dosage/Administration
Dose*
Loading dose:
600 mg intravenously every 7 days for the first 4 weeks, followed by 900 mg intravenously for the fifth dose 7 days later
900 mg intravenously every 14 days
900 mg intravenously every 7 days for the first 4 weeks, followed by 1,200 mg intravenously for the fifth dose 7 days later
1200 mg intravenously every 14 days
Patients < 18 years
5 kg - <10 kg:
300 mg weekly x 1 dose, 300 mg at week 2, then 300 mg every 3 weeks
10 kg - <20 kg:
20 kg -<30 kg:
600 mg weekly x 2 doses, 600 mg at week 3, then 600 mg every 2 weeks
≥ 40 kg:
900 mg weekly x 4 doses, 1200 mg at week 5, then 1200 mg every 2 weeks
Generalized Myasthenia Gravis (gMG) and Neuromyelitis Optica Spectrum Disorder (NMOSD)
Dose Adjustment for adult patients with aHUS (includes pediatric patients), gMG, and NMOSD in case of Plasmapheresis, Plasma Exchange or Fresh Frozen Plasma Infusion
Type of Plasma Intervention
Most Recent Soliris Dose
Supplemental Soliris With Each Plasma Intervention
Timing of Supplemental Soliris Dose
Plasmapheresis or plasma exchange (PE)
300 mg per each plasmapheresis or PE
Within 60 minutes after each plasmapheresis or PE
≥ 600 mg
Fresh frozen plasma infusion (FFP)
300 mg per each infusion of FFP
60 minutes prior to each infusion of FFP
*Doses should be administered at the above intervals, or within two days of these time points.
Billing Code/Availability Information
HCPCS Code:
J1300 – Injection, eculizumab, 10 mg; 1 billable unit = 10 mg
NDC:
Soliris 300 mg/30 mL single-dose vials for injection: 25682-0001-xx
Soliris [package insert]. Boston, MA; Alexion Pharmaceuticals, Inc; November 2020. Accessed May 2022.
Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. Borowitz MJ, Craig FE, DiGiuseppe JA, Illingworth AJ, Rosse W, Sutherland DR, Wittwer CT, Richards SJ. Cytometry B Clin Cytom. 2010 Jul;78(4):211-30. doi: 10.1002/cyto.b.20525.
Effect of eculizumab on hemolysis and transfusion requirements in patients with paroxysmal nocturnal hemoglobinuria. Hillmen P; Hall C; Marsh JC; Elebute M; Bombara MP; Petro BE; Cullen MJ; Richards SJ; Rollins SA; Mojcik CF; Rother RP. N Engl J Med 2004 Feb 5;350(6):552-9.
The complement inhibitor eculizumab in paroxysmal nocturnal hemoglobinuria. Hillmen P; Young NS; Schubert J; Brodsky RA; Socie G; Muus P; Roth A; Szer J; Elebute MO; Nakamura R; Browne P; Risitano AM; Hill A; Schrezenmeier H; Fu CL; Maciejewski J; Rollins SA; Mojcik CF; Rother RP; Luzzatto L. N Engl J Med. 2006 Sep 21;355(12):1233-43.
Multicenter phase 3 study of the complement inhibitor eculizumab for the treatment of patients with paroxysmal nocturnal hemoglobinuria. Brodsky RA; Young NS; Antonioli E; Risitano AM; Schrezenmeier H; Schubert J; Gaya A; Coyle L; de Castro C; Fu CL; Maciejewski JP; Bessler M; Kroon HA; Rother RP; Hillmen P. Blood. 2008 Feb 15;111(4):1840-7. Epub 2007 Nov 30.
Parker C, Omine M, Richards S, et al. Diagnosis and management of paroxysmal nocturnal hemoglobinuria. Blood. 2005 Dec 1. 106(12):3699-709.
Loirat C, Fakhouri F, Ariceta G, et al. An international consensus approach to the management of atypical hemolytic uremic syndrome in children. Pediatr Nephrol. 2016 Jan;31(1):15-39.
Taylor CM, Machin S, Wigmore SJ, et al. Clinical practice guidelines for the management of atypical haemolytic uraemic syndrome in the United Kingdom. Br J Haematol. 2010 Jan;148(1):37-47.
Sahin F, Akay OM, Ayer M, et al. Pesg PNH diagnosis, follow-up and treatment guidelines. Am J Blood Res. 2016;6(2): 19-27.
Cheong HI, Kyung Jo S, Yoon SS, et al. Clinical Practice Guidelines for the Management of Atypical Hemolytic Uremic Syndrome in Korea. J Korean Med Sci. 2016 Oct;31(10):1516-1528.
Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis-Executive Summary. Neurology. 2016 Jul 26; 87(4): 419-25.
Howard JF Jr, Utsugisawa K, Benatar M, et al. Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study. Lancet Neurol. 2017 Dec;16(12):976-986.
Trebst C, Jarius S, Berthele A, et al. Update on the diagnosis and treatment of neuromyelitis optica: recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol 2014; 261:1.
Pittock SJ, Berthele A, Fujihara K, et al. Eculizumab in Aquaporin-4-Positive Neuromyelitis Optica Spectrum Disorder. N Engl J Med 2019.
Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul;85(2):177-89. Epub 2015 Jun 19.
Patriquin CJ, Kiss T, Caplan S, et al. How we treat paroxysmal nocturnal hemoglobinuria: A consensus statement of the Canadian PNH Network and review of the national registry. Eur J Haematol. 2019;102(1):36. Epub 2018 Oct 25.
Lee H, Kang E, Kang HG, et al. Consensus regarding diagnosis and management of atypical hemolytic uremic syndrome. Korean J Intern Med. 2020;35(1):25-40. doi:10.3904/kjim.2019.388.
Narayanaswami P, Sanders D, Wolfe G, Benatar M, et al. International consensus guidance for management of myasthenia gravis, 2020 update. Neurology® 2021;96:114-122. doi:10.1212/WNL.0000000000011124.
Jayam-Trouth A, Dabi A, Solieman N, Kurukumbi M, Kalyanam J. Myasthenia gravis: a review. Autoimmune Dis. 2012;2012:874680. doi:10.1155/2012/874680
Gronseth GS, Barohn R, Narayanaswami P. Practice advisory: Thymectomy for myasthenia gravis (practice parameter update): Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2020;94(16):705. Epub 2020 Mar 25.
Sussman J, Farrugia ME, Maddison P, et al. Myasthenia gravis: Association of British Neurologists' management guidelines. Pract Neurol 2015; 15: 199-206.
Institute for Clinical and Economic Review. Eculizumab and Efgartigimod for the Treatment of Myasthenia Gravis: Effectiveness and Value. Draft evidence report. July 22, 2021. https://icer.org/wp-content/uploads/2021/03/ICER_Myasthenia-Gravis_Draft-Evidence-Report_072221.pdf. Accessed December 22, 2021.
Cançado RD, Araújo AdS, Sandes AF, et al.Consensus statement for diagnosis and treatment of paroxysmal nocturnal haemoglobinuria. Hematology, Transfusion and Cell Therapy, v43, Iss3, 2021, 341-348. ISSN 2531-1379, https://doi.org/10.1016/j.htct.2020.06.006.
National Government Services, Inc. Local Coverage Article: Billing and Coding: Eculizumab (A54548). Centers for Medicare & Medicaid Services, Inc. Updated 06/25/2021 with effective dates 07/01/2021. Accessed May 2022.
Appendix 1 – Covered Diagnosis Codes
ICD-10 Description
D59.3
Hemolytic-uremic syndrome
Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli]
G36.0
Neuromyelitis optica [Devic]
G70.00
Myasthenia gravis without (acute) exacerbation
Myasthenia gravis with (acute) exacerbation
Appendix 2 – Centers for Medicare and Medicaid Services (CMS)
Medicare coverage for outpatient (Part B) drugs is outlined in the Medicare Benefit Policy Manual (Pub. 100-2), Chapter 15, §50 Drugs and Biologicals. In addition, National Coverage Determination (NCD), Local Coverage Articles (LCAs), and Local Coverage Determinations (LCDs) may exist and compliance with these policies is required where applicable. They can be found at: https://www.cms.gov/medicare-coverage-database/search.aspx. Additional indications may be covered at the discretion of the health plan.
Medicare Part B Covered Diagnosis Codes (applicable to existing NCD/LCA/LCD):
Jurisdiction(s): 6; K
NCD/LCA/LCD Document (s): A54548
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54548&ver=20&bc=0
Medicare Part B Administrative Contractor (MAC) Jurisdictions
Applicable State/US Territory
CA, HI, NV, AS, GU, CNMI
Noridian Healthcare Solutions, LLC
F (2 & 3)
AK, WA, OR, ID, ND, SD, MT, WY, UT, AZ
KS, NE, IA, MO
Wisconsin Physicians Service Insurance Corp (WPS)
MN, WI, IL
National Government Services, Inc. (NGS)
H (4 & 7)
LA, AR, MS, TX, OK, CO, NM
Novitas Solutions, Inc.
MI, IN
FL, PR, VI
First Coast Service Options, Inc.
TN, GA, AL
Palmetto GBA, LLC
NC, SC, WV, VA (excluding below)
DE, MD, PA, NJ, DC (includes Arlington & Fairfax counties and the city of Alexandria in VA)
K (13 & 14)
NY, CT, MA, RI, VT, ME, NH
KY, OH
CGS Administrators, LLC
SOLIRIS® (eculizumab) Prior Auth Criteria
Proprietary Information. Restricted Access – Do not disseminate or copy without approval.
©2022, Magellan Rx Management
Node: bclrgrpappp1001.corp.bcbsal.org:8080

redpajama_set_name: RedPajamaCommonCrawl


Female Impersonator Jean LaRue with the Red Calhoun Orchestra (from "Woman's a Fool to think her man is all her own" -- Nationwide Production, 1947 -- available from ACinemaApart.com) Not the Jean La Rue that Clarence Tenpenny told me about. La Rue seems to have been a popular stage name for female impersonators (i.e. the famous British entertainer Danny La Rue).


In this blog Joanne Walker, CIOT and LITRG technical officer, takes a look at some of the effects.
2019/20 sees the continuation of the five-band structure of Scottish income tax, which was introduced in 2018/19, setting the tone for greater divergence between the Scottish and UK income tax rates and bands.
Under the five-band structure the basic rate band has effectively been split into three – the starter, basic and intermediate rate bands. The additional rate band has been renamed the top rate band, and the higher and top rates have each been set at one percentage point higher than their UK income tax equivalents, at 41% and 46% respectively.
As in 2017/18 and 2018/19, there continues to be a difference in the higher rate threshold from that in the rest of the UK, and this difference has increased further. The higher rate threshold for Scottish taxpayers, in respect of earned income (including rents), is £43,430 for 2019/20 (the same as it was in 2018/19), assuming eligibility for the personal allowance. In the rest of the UK, the higher rate threshold is £50,000 from 6 April 2019, which is also the threshold that applies to Scottish taxpayers in respect of their savings and dividend income.
Non-savings and non-dividend income includes income such as employment salary, income from pensions, profits from self-employment and rental profits. In the remainder of this blog we refer to "earned income" as a convenient shorthand for non-savings and non-dividend income.
While Scottish taxpayers with earned income of less than £26,993 in 2019/20 will pay less income tax than taxpayers in the rest of the UK earning the same level of income, this tax reduction is relatively small, at a maximum of around £20 for the year. Scottish taxpayers with earned income of more than £26,993 will pay more income tax than taxpayers in the rest of the UK earning the same level of income.
A Scottish taxpayer with total income of £50,000 (assuming this is all earned income) will have a tax liability of £9,044.07 in 2019/20 (personal allowance of £12,500; £2,049 at 19%; £10,395 at 20%; £18,486 at 21%; £6,570 at 41%); meanwhile, a taxpayer subject to the UK rates and bands will have a tax liability of £7,500 (personal allowance of £12,500; £37,500 at 20%). A difference of £1,544.07.
A Scottish taxpayer with total income of £100,000 (assuming this is all earned income) will have a tax liability of £29,544.07 in 2019/20 (personal allowance of £12,500; £2,049 at 19%; £10,395 at 20%; £18,486 at 21%; £56,570 at 41%); meanwhile, a taxpayer subject to the UK rates and bands will have a tax liability of £27,500 (personal allowance of £12,500; £37,500 at 20%; £50,000 at 40%). A difference of £2,044.07.
These points of divergence may also create some complexities for Scottish taxpayers.
Since the Scottish rates and thresholds apply to earned income only, a Scottish taxpayer who has both earned income and taxable savings income, such as bank interest, and/or dividend income may have to consider both the UK rates and thresholds and the Scottish rates and thresholds in order to work out their income tax liability. This complexity also arose in 2017/18 and 2018/19.
By way of example, a Scottish taxpayer with earned income of £49,000 and savings income of £2,000 in 2019/20 will have to work out their tax liability as follows. Their total income is £51,000, but this is reduced to £38,500 by their personal allowance (51,000 – 12,500). This means they have to pay income tax on £36,500 of their earned income (49,000 – 12,500), according to the Scottish rates and bands – so at 19% on £2,049, at 20% on £10,395, at 21% on £18,486 and at 41% on £5,570. They also have £2,000 of taxable savings income. Now, they have to consider the UK rates and bands, while also taking into account the income that is taxable according to the Scottish rates and bands. Note that the UK basic rate band is £37,500 – the taxable earned income, subject to Scottish income tax, has used up £36,500 of this band, leaving £1,000. Firstly, the taxpayer is entitled to the personal savings allowance; since their total taxable income is £51,000, their marginal rate of tax in terms of the UK rates and bands is the higher rate. This means they are entitled to a personal savings allowance of £500 meaning no tax is due on the first £500 of savings income; this also uses up £500 of their UK basic rate band. So, of the remaining £1,500 of taxable savings income £500 is taxable at the UK basic rate of 20%, and £1,000 at the UK higher rate of 40%. By means of a sense check, we can see that this is correct, as the total taxable income of £51,000 exceeds the UK higher rate threshold of £50,000 by £1,000.
In addition, the rates of capital gains tax depend on the UK rates and thresholds. So, a Scottish taxpayer with both earned income and capital gains may also have to consider both UK and Scottish rates and thresholds.
In addition to income tax, employment income and self-employment profits are generally subject to National Insurance contributions (NIC). These have their own rates and bands, but the Upper Earnings Limit for Class 1 NIC and the Upper Profits Limit for Class 4 NIC are aligned with the higher rate threshold set by the UK Parliament – £50,000 for 2019/20.
As a consequence, Scottish taxpayers with earned income that is subject to NIC will find themselves paying a joint Scottish income tax – NIC marginal rate of 53% (if employed) or 50% (if self-employed) on earned income that falls between the Scottish higher rate threshold of £43,430 and the UK higher rate threshold of £50,000. Taxpayers who pay UK or Welsh income tax will not face this 'spike'.
The marriage allowance (more information on the LITRG website) is available to married couples and civil partnerships, where one party has some unused personal allowance in a tax year and the other party does not pay tax at any rate other than those specified in the legislation. Broadly, this means a taxpayer is eligible provided they do not pay tax at the higher or top (additional) rates of tax.
If the higher earner is a Scottish taxpayer in 2019/20, and has total taxable income between £43,430 and £50,000, on which they pay Scottish income tax at the higher rate, they are not eligible for the marriage allowance. Whereas, if they paid tax according to the UK rates and thresholds, they would be eligible, as they would only be paying tax at the basic rate.
It is possible to apply for the marriage allowance after the end of the tax year. This means that taxpayers who are not sure whether or not they will be eligible during the tax year may still have the chance to benefit from this relief, once they have established their total income for a particular tax year.
In addition, it may be possible for a Scottish taxpayer in this position to extend their basic rate band by making Gift Aid donations or pension contributions. If, as a result of such payments, they do not actually pay any higher rate tax, even though their total income is above £43,430, they would be eligible for the marriage allowance.
Currently, charities do not have to identify whether or not a donor is a Scottish taxpayer – they simply claim tax relief at 20% from HMRC on Gift Aid donations. This continues to be the case. Scottish taxpayers who pay tax at a rate higher than 20% are able to claim extra tax relief. As always with Gift Aid, it is essential for a taxpayer to have paid enough tax during the tax year to cover the amount of tax relief claimed by the charity.
Scottish taxpayers who make pension contributions under net pay arrangements have their pension contributions deducted from their pay before income tax is applied. This means that they receive tax relief automatically at their marginal rate of tax.
For relief at source pension arrangements, pension providers continue to claim tax relief at 20% for all Scottish taxpayers.
HMRC will not recover the difference between the Scottish starter and Scottish basic rate, where a Scottish taxpayer receives 20% relief but has only paid tax at the starter rate of 19%.
Scottish taxpayers who are liable to income tax at the Scottish intermediate rate of 21% are entitled to claim the additional 1% tax relief due on some or all of their contributions. If they already complete a tax return, they can do this through Self Assessment. Otherwise, they need to contact HMRC.
Scottish taxpayers who are liable to income tax at the Scottish higher rate (41%) and Scottish top rate (46%) are able to claim additional relief on their contributions up to their marginal rate of tax in the usual way, either through Self Assessment or by contacting HMRC.
HMRC have published separate Scottish payroll tax tables for tax years 2016/17 onwards, to deal with the different Scottish higher rate threshold and now the five rates and bands of Scottish income tax. This continues for 2019/20, and should allow the PAYE system to deal with Scottish taxpayers who have typical 'L-suffix' tax codes, such as S1250L.
Note that there are additional codes to deal with second employments, for example SBR, SD0, SD1 and SD2, which apply Scottish income tax at the flat rates of 20%, 21%, 41% and 46% respectively.
Although the Scottish Parliament has set rates and thresholds for income tax payable by Scottish taxpayers on certain types of income, HMRC continue to collect and administer all income tax. This means that if you have any questions about your income tax, you should continue to contact HMRC.
If you are a Scottish taxpayer and have PAYE income, you should have a Scottish PAYE tax code (an "S" pre-fixed code).
The Low Incomes Tax Reform Group (LITRG) website provides Scottish income tax guidance in its tax basics section.


Even despite taking all possible precautionary measures, accidents can happen. Our public liability insurance cover protects your property and also gives you peace of mind that your in the best hands. Unlike some other operators in Perth, we offer $20 Million insurance to safeguard your assets from any type of harm, rather than $5 Million.


What really happened to Flight MH370? This probing investigation reveals shocking new information about the sequence of events in the minutes and hours following the plane's disappearance, and talks exclusively to the family of the pilot at the eye of the storm. Forensically reconstructing the time-line, this incisive doc throws up some uncomfortable questions for the Malaysian authorities. Could this great modern aviation mystery have been averted altogether?
Average teenager Peter Parker is transformed into an extraordinary super hero after he is accidentally bitten by a radioactive spider. When his beloved uncle is savagely murdered during a robbery, young Peter vows to use his powers to avenge his death. Deeming himself "Spider-Man ," he sets about ridding the streets of crime, bringing him into conflict with malevolent super-villain "Green Goblin."
In November 2013, the Philippines were struck by strongest typhoon in recorded history. Known as Yolanda, the storm caused thousands of deaths and billions in damage. This is the story of one small group of people who were caught directly in the path of the typhoon. Sent to the coastal city of Tlacoban to report live from the storm-besieged community, newscaster Jiggy Manicad and his crew could not prevent themselves from becoming part of the story when they were forced to walk for six hours through the aftermath of the storm's devastation, interviewing survivors and documenting the damage along the way.
Misery loves company as Kathy Bates, Jennifer Jason Leigh and Christopher Plummer star in an atmospheric whodunit that's part mystery, part human drama, and wholly entertaining. A haunting adaptation of Stephen King's novel and from the director of The Devil's Advocate.


The Kroc Center offers a wide variety of both free and drop-in fitness classes to meet the needs and fitness levels of our members. Drop-In classes are first come, first served. Class Passes are available at the Welcome Desk or online. All attendees are required to pick up a class pass to give the instructor. Instructors and classes are subject to change. Minimum attendance required for a class to take place. Unless otherwise noted, the minimum age for drop-in classes is 16+.
FREE TO GOLD MEMBERS & INCLUDED WITH PURCHASE OF DAY PASSES!
Develop strength and balance with this relaxing form of aquatic bodywork. Aqua Yoga is a low impact aqua bodywork performing Yoga poses in warm water. Aqua Yoga helps you develop strength, static balance and range of motion.
This is accomplished in coordination with diaphragmatic breathing and long exhalations.
Known as the Zumba "pool party," Aqua Zumba integrates the stretching, twisting, even shouting with water exercise. It is all brought together in a safe, challenging water based workout that is cardio-conditioning, body toning and most of all,exhilarating beyond belief!


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December 10 (Saturday)
Winter Wonderland Festival | Sun Valley Resort
Dec 10 – Dec 31 all-day Sun Valley Resort
Festivities abound this holiday season with a variety of activities for the whole family around the Sun Valley Village. Throughout the season, join us for the Tree Lighting Ceremony, Open Air Holiday Market, performances by the Sun Valley Carolers, Brunch with Santa, ice carving demonstrations, gingerbread houses and the Christmas Eve Torchlight Parade and fireworks.
December 16 (Friday)
Dec 16 – Dec 22 all-day Magic Lantern Cinemas
December 20 (Tuesday)
Beg, Borrow & Steele
Dec 20 – Dec 31 all-day Friesen + Lantz Fine Art
BEN STEELE: "Beg, Borrow & Steele" Friesen+Lantz announces the final exhibition of our inaugural 2022 season: "Beg, Borrow & Steele" which features whimsical new work from acclaimed contemporary artist Ben Steele. With an education built upon classical training, Steele utilizes the processes of the old masters with a contemporary sensibility; never staying in one place for too long. The result is a clever, wide-ranging body of work – from still life to portrait to landscape (and often somewhere in between) – melding art history and pop culture references in his ever-changing process. "Building this exhibition was a diverse experience, from dabbling in sculptural work to developing a multi-piece interpretation of Warhol's Campbell's Soup through the lenses of some of my favorite artists and art styles," says Steele. "Getting to study and emulate the style and craft of these images throughout my career has brought me immense purpose. And I think that getting to recontextualize these works – as other artists have done before me – allows for them to continue to exist in other forms. Otherwise, they could disappear quietly into an Oligarchs private collection or are only available to those who can visit them in the Louvre. I hope ...
Free Winter Workshop – 12 Crafts
Dec 20 @ 11:00 am – 2:00 pm Sun Valley Museum of Art
Play, create, discover and have fun! Join SVMoA for Winter Workshop: 12 Crafts, four days of three wintery-themed craft activities. Families and friends are invited to visit the Museum, explore the current exhibition DAMS: Reservoirs, Reclamation, Renewal, and energize their creative spirits with a variety of art projects in the classroom. Projects will change daily.
Sun Valley Culinary Institute Tuesday Night Takeout – Flavors of America
Dec 20 @ 4:00 pm – 6:00 pm Sun Valley Culinary Institute
Who has time to cook the week before Christmas in Sun Valley? The Sun Valley Culinary Institute crew has created a delicious meal to enjoy and to help you save time to enjoy the holidays. Quantities are limited, so please order by 8 pm, Sunday, December 18. Pick up on Tuesday, December 20, between 4 and 6 pm.
Trivia at Sawtooth Brewery Public House
Dec 20 @ 7:00 pm Sawtooth Brewery Public House
Trivia Night at the Public House in Ketchum! Trivia Returns to Sawtooth Brewery Public House! Games will be held in Ketchum every Tuesday. Games are at 7:30pm & 8:30pm with tabs to the winner! Free-to-play & all ages welcome. Come early to grab a bite & beer!
December 21 (Wednesday)
Dec 21 @ 12:00 pm – 1:00 pm Flourish Foundation
Christmas Story Time at Sun Valley Resort
Dec 21 @ 3:30 pm – 4:30 pm Sun Valley Resort
Children's Librarians from The Community Library will read Christmas stories at Sun Valley Resort. Join us from 3:30 – 4:30 pm in the cozy Sun Room, located upstairs in the Sun Valley Lodge for some of your holiday favorites, old and new. This story time is geared toward preschool and school age children. At the conclusion, cookies will be provided by Sun Valley.
Winter Solstice party
Dec 21 @ 5:00 pm – 7:00 pm Ketchum Town Square
In 2018, Ketchum was awarded designation by the International Dark-Sky Association as a Dark Sky Community and is included in the Nation's first International Dark Sky Reserve. You are invited to come join us in Ketchum Town Square on Wednesday, December 21, at 5pm. It will be cold, but there is lots to warm the soul. Live music, fire pits, Warfield's hot toddies and LeRoy's hot cocoa and cookies are sure to get the blood flowing. This is also another chance to learn about our Central Idaho Dark Sky Reserve and there will be a telescope to gaze at the stars if the clouds permit. Please stop by to celebrate our longest night.
Dark Sky Dinners
Dec 21 @ 5:30 pm – 8:00 pm Sawtooth Botanical Garden
Enjoy the Sawtooth Botanical Garden in winter on the darkest nights of the year! Dark Sky Dinner events feature a "farm to greenhouse" catered meal with wine for 40 people in our heated greenhouse, a "snow bar" and warming fire pits outside the greenhouse, and night sky viewing telescopes outside on the darker, north side of the Visitor Center. Prepare to bundle up! When: Tuesday, November 22, 2022 Friday, December 21, 2022 Saturday, January 21, 2023 Monday, February 20, 2023 Doors open at 5:30pm Where: Sawtooth Botanical Garden | 9 Gimlet Road | 4 miles south of Ketchum (Located at the southern gateway to the Central Idaho Dark Sky Reserve!)
December 22 (Thursday)
Dec 22 @ 10:00 am Sun Valley Culinary Institute
The Nutcracker – Holiday Story Event
Dec 22 @ 10:30 am – 11:30 am The Community Library
children will listen to a storybook reading of The Nutcracker then join Dores André, principal dancer from San Francisco Ballet, as the Sugar Plum Fairy in a movement lesson. Don't forget your cameras or phones as kids can pose with the Sugar Plum Fairy in a festive photo op. This will be followed by a craft for children. Cookies and milk will be served. This holiday event is presented in partnership between The Community Library and Ballet Sun Valley.
Limelight Lounge – Live Music Series
Dec 22 @ 5:30 pm – 8:30 pm Limelight Lounge
Throughout the year, The Limelight Lounge is the place to be in Ketchum for live local music. It's the perfect way to unwind after a day on the mountain. Order a beer and a few apps (or go all out with dinner from our menu), and enjoy some of the best local talent in an intimate setting. Live music schedule: January: Sun 1st– Aaron Golay Mon 2nd– Cadillac Carl Thurs 5th– Kevin Ware Fri 6th– Mark Mueller Sat 7th– Jordan Shaw Sun 8th– Andy Crosby Mon 9th– Andy Crosby Thurs 12th– David Henry Fri 13th– David Henry Sat 14th– Tyler McFarlane & Ben Breiding Sun 15th– Travis McDaniel Mon 16th– Aaron Golay Thurs 19th– Kevin Ware Fri 20th– Mark Mueller Sat 21st– Kevin Ware Sun 22nd-Wes Urbaniak Mon 23rd– Greg Shochet Thurs 26th– Kevin Ware Fri 27th– David Henry Sat 28th– David Henry Sun 29th-Travis McDaniel Mon 30th-Spencer Dahl February: Thurs 2nd– Kevin Ware Fri 3rd– Mark Mueller Sat 4th– Tyler McFarlane Sun 5th– Moonshine Schubert Mon 6th– Doublewide Thurs 9th– Kevin Ware Fri 10th– Mark Mueller Sat 11th– Bryan Speth Sun 12th– No Music, Super Bowl Mon 13th– Johnny & Jen Pisano Thurs 16th– Kevin Ware Fri 17th– Sadie ...
Ketchum Menorah Lighting Celebration
Annual Chanukah Celebration at Ketchum Town Square with community leaders and Mayor Neil Bradshaw.
Brunch with Santa
Dec 23 @ 9:00 am – 2:00 pm Sun Valley Clubhouse
A special holiday buffet on December 23rd and 24th at the Sun Valley Clubhouse with kid friendly dishes and traditional favorites, plus live and festive holiday music! $79/adults, $39/kids, reservations required, please call 208-622-2919
Dec 23 @ 7:00 pm – 9:00 pm Hailey Ice
Overland Sheepskin Christmas Party
Dec 24 @ 4:00 pm – 6:00 pm Overland Sheepskin Co.
Come join us one final night of Christmas shopping. Enjoy beverages and light refreshments while trying on our newest winter collection. Also, take advantage of our Giving Tree to support those in need during this holiday season and time of giving.
Christmas Eve Torchlight Parade & Fireworks
The Sun Valley Carolers will take the stage at 5:30pm with some Christmas favorites. Additional programming to follow with the annual torchlight parade making its way down Dollar Mountain on Christmas Eve! As always, complimentary cookies and cocoa will be served for all to enjoy!
December 25 (Sunday)
December 26 (Monday)
Second Annual Apres with Esta at the Sun Valley Culinary Institute
Esta Hornstein is back for another Après with Esta at SVCI. Come and hang out to celebrate delicious homestyle cooking from one of the Valley's best.
"Hawking: Can you hear me?" Film Screening and Q&A
Dec 27 @ 6:00 pm – 7:00 pm The Community Library
The remarkable human story of Stephen Hawking – the international icon and feted genius. In this definitive theatrical feature doc, unseen archive and unrivalled access to his closest family, reveal, for the first time, both the scale of Hawking's triumphs and the true cost of his disability and success. The film, released in 2021, runs 90 minutes and will be followed by a Q&A with BAFTA and Emmy award-winning producer Anthony Geffen. Registration strongly recommended to reserve your seat. More about the film: Catapulted to rock star status and global fame by his book A Brief History of Time, Hawking became the most famous scientist on the planet. He sought to uncover the ultimate answers to the Universe and find a Theory of Everything – one mathematical theory that would let us know, in his words "the mind of God." Yet Hawking also faced a life-threatening and debilitating illness that had changed his life. Motor Neurone Disease robbed Hawking of his ability to walk, move and breathe and ultimately deprived him of his voice. Hawking passed away in 2018. Now, his immediate family comes together to reveal the triumphs and tragedies of his dramatic personal story. Along with Stephen's insights ...
SVFF Winter Screening Series- Wildcat
Dec 27 @ 6:30 pm The Argyros
Join the Sun Valley Film Festival for the screening of the award contending film Wildcat. Back from war in Afghanistan, a young British soldier struggling with depression and PTSD finds a second chance in the Amazon rainforest when he meets an American scientist, and together they foster an orphaned baby ocelot. Filmmaker Trevor Frost joins us after the film for a Q+A. Free to SVFF Patrons


Mid-market HR today is being asked to be a business partner in areas that range from compliance to employee engagement. They need to be able to connect the dots among various sources of employee data to deliver better-informed business decisions to help achieve strategic goals.
Connecting those dots and delivering those results demands more HR firepower and greater data visibility than the manual or homegrown processes and systems often used by mid-market organizations can deliver. On the other hand, most mid-market companies aren't ready for the intricacies or expense of human capital management (HCM) systems designed for enterprise-level organizations.
The answer for forward-thinking HR leaders who want to boost their team's capabilities and play a greater role in their company's future is having core HR functionality designed into an integrated benefits administration solution.


I do love Facebook, but let's face it...Instagram is quick and fun! I love getting to see quick glimpses into my friends lives. And another plus...no politics or griping! I've loved sharing my school side as well as my home side on Insta. Here's my Top picks from the year for you! Be sure to check out all of the other Teacher Bloggers over at Teachery Tidbits linky!
I don't usually get a smile out of my honey, but I got lucky last New Years! We actually went OUT rather to bed early. Snore.......I'm usually a sleepyhead!
It's not impossible to get snow in Alabama, but it sure is fun when it arrives! I thought it was pretty funny to see all the snow around my rain gauge! I really don't USE this thing, but it is one of MANY frogs given to me over the years.
Near the beginning of my clip art addiction, I grabbed these cute froggies for my kids' Valentine's Day cards. The kids were ALL about Smencils last year! I rocked it with this find!
School or home laminating .... Which do you prefer? Me? My 3mm sheets at home! Shiny, bright, durable.
Anyone else just LOVE their laminator? So crazy! I love how it makes things just a bit shinier and brighter! Its the little things, for sure.
Delayed Christmas gift...tickets to Wicked in Nashville! Hubby let our oldest go with me for a great girls day. It was AWESOME!!
Another paper trap tamed today. All set for a little task card fun for tomorrow!
Miracles do happen.....this was one of those days. A clean desk!! I think the next time it was this neat was when....hmmm...... I packed up for the summer! AAAH!
Nothing like a little Girls Weekend and some fun, fruity drinks! Taking time away is a rarity, but I am so blessed to to have such wonderful friends!
My new best friend! Warning, Mr. Robinson!
A temporary extra student in my room. What is that? A stinking air conditioner! I won't lie....it helped....but he was very loud. I was glad when he moved away.
Oh my, that's a big ole AC! Love my laminator, too. Doesn't everything look better wrapped in shiny plastic???


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Q: get spark error 'No Encoder found for java.io.Serializable' for case class w/ one attribute defined as 'Serializable' When I run the code below in Failing Code I get the error message mentioned in the title, with a stack trace something like what is shown below in Error and Stack Trace.
As you can see i have tried to make an encoder available as an implicit, but perhaps I made
some mistake along the way with that.
Side note:  one approach that DID WORK to some extent was to use Kryo encoder (this is currently commented out).   But the downside to this is that when you do a show() on the Dataset you get a bunch of hex bytes as output.. Not so useful for debugging.
My next approach will be to try to use a Java bean instead
of case class.
I will post the results.. hopeully it will work.   But I'm wondering if there is some
way to do this and retain the case class approach.  Many thanks !
Error and Stack Trace
No Encoder found for java.io.Serializable
- field (class: "java.io.Serializable", name: "value")
- root class: "com.Item"
java.lang.UnsupportedOperationException: No Encoder found for java.io.Serializable
- field (class: "java.io.Serializable", name: "value")
- root class: "com.Item"
        at org.apache.spark.sql.catalyst.ScalaReflection$.$anonfun$serializerFor$1(ScalaReflection.scala:591)
        at scala.reflect.internal.tpe.TypeConstraints$UndoLog.undo(TypeConstraints.scala:73)
        at org.apache.spark.sql.catalyst.ScalaReflection.cleanUpReflectionObjects(ScalaReflection.scala:904)
        at org.apache.spark.sql.catalyst.ScalaReflection.cleanUpReflectionObjects$(ScalaReflection.scala:903)
        at org.apache.spark.sql.catalyst.ScalaReflection$.cleanUpReflectionObjects(ScalaReflection.scala:49)
        at org.apache.spark.sql.catalyst.ScalaReflection$.serializerFor(ScalaReflection.scala:432)
        at org.apache.spark.sql.catalyst.ScalaReflection$.$anonfun$serializerFor$6(ScalaReflection.scala:577)
        at scala.collection.immutable.List.map(List.scala:297)
        at org.apache.spark.sql.catalyst.ScalaReflection$.$anonfun$serializerFor$1(ScalaReflection.scala:562)

Failing Code
import com.typesafe.scalalogging.LazyLogging
import org.apache.spark.sql.catalyst.encoders.ExpressionEncoder
import org.apache.spark.sql.{Encoder, SparkSession}
import org.testng.annotations.Test

case class Item(name: String, value: java.io.Serializable)

object TestSessionFactory {
  def getSession(master: String = "local"): SparkSession = {
    SparkSession.builder
      .master(master)
      .config("spark.driver.bindAddress", "127.0.0.1")
      .appName("test").getOrCreate()
  }
}

class CaseClassWithSerializableTest extends LazyLogging {

  @Test
  def testWrite(): Unit = {
    val sparkSession: SparkSession = TestSessionFactory.getSession()

    import sparkSession.implicits._

    implicit val theSerializableEncoder: Encoder[java.io.Serializable] = ExpressionEncoder()
   // implicit val myCaseClassEncoder: Encoder[Item] = org.apache.spark.sql.Encoders.kryo[Item]

    val innerValue : java.io.Serializable = new java.lang.String("innerValue")
    val innerValue2 : java.io.Serializable = new java.lang.Integer(200)
    val list =
      List(
        Item("joe", innerValue),
        Item("joe", innerValue2)
      )

    val dataset = list.toDS().as[Item]

    dataset.printSchema()
    dataset.show()
  }

redpajama_set_name: RedPajamaStackExchange


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Home > News Articles > Editor's Top Picks from 2018
Editor's Top Picks from 2018
2018 was a busy year for Africa's oil and gas sector. Here are some of the top interviews, news and articles from Africa Oil & Power's year of covering the continent's oil and power sectors.
Interview: Secretary General: OPEC seeks 'long-term commitment'
In an interview with Africa Oil & Power, H.E. Mohammed Barkindo, Secretary General of the Organization of the Petroleum Exporting countries, talks about the long-term commitment planned between OPEC and the non-OPEC member countries behind the Declaration of Cooperation. This interview is the first article in a three-part series.
Missed it? Read more here.
Editorial: An African Perspective: No Good Will Come From NOPEC
Throughout the years I spent as an undergraduate and law school student in the U.S., one of the things I truly admired was American ingenuity. I loved following news stories about U.S. startups that scraped together enough money to go overseas, explored for oil – and despite overwhelming odds, achieved success.
These companies were creating opportunities both for Americans and the people in their host countries.
It was the American Dream playing out before my eyes. There is no doubt in my mind that those stories inspired my career trajectory in Africa where I have had a chance to advise many African governments on oil matters and improving relations with one another.
Article: Funding Africa's Oil and Gas Megaprojects
Africa is a home to giants — boasting some of the world's top oil and gas discoveries and a wealth of investment opportunities in power generation from oil and gas.
"One of the big things that is coming through — and this is something that is being talked about AOP — is the development of mega projects, where you have multi-billion-dollar projects that represent a high percent of the country's GDP, and in many cases are in new resource countries," said Paul Eardley-Taylor, Oil & Gas Coverage, Southern Africa for Standard Bank.
But getting these major projects off the ground, both petroleum and infrastructure projects alike, requires substantial investment. Africa's oil industry alone will require $1.6 trillion in cumulative infrastructure investment between 2013 and 2035, with a further $721 billion needed for gas infrastructure over the same period.
News: Nigeria to hold bidding round
Nigeria on Wednesday announced that it will hold a bidding round for the licencing of subsurface hydrocarbon property for flared natural gas uptake in the Niger Delta Basin.
This type of bidding round, which has not taken place in eleven years, is open to Nigerian and non-Nigerian entities. Preferred bidders are, however, required to use a Nigerian partner or establish a Nigerian entity as a precondition of the bidding process.
Video: Africa Oil & Power 2018 Recap
Missed it? See it here.
مؤتمر ومعرض حوض غرب إفريقيا MSGBC (الأحرف الاولى لدول موريتانيا، السنغال، غامبيا، غينيا بيساو وغينيا كوناكري) للنفط والغاز والطاقة لعام 2023 المُقرر انعقاده في موريتانيا
Leveraging Oil and Gas to Develop Positive Growth Economies in Africa
Sonangol Plans to list on Angolan Stock Exchange by 2027
Energy Capital & Power
Energy Capital & Power is the African continent's leading investment platform for the energy sector. Through a series of events, online content and investment reports, we unite the entire energy value chain – from oil and gas exploration to renewable power – and facilitate global and intra-African investment and collaboration.
South Sudan's Triple A Confirmed as Silver Sponsor for SSOP 2023
Triple A, a South Sudanese wholesale and retail supplier of petroleum products, to sponsor, speak at South Sudan Oil & Power 2023 conference.
MSGBC Oil, Gas & Power 2023 to Drive Regional Energy Cooperation and Industry Growth
The 2023 edition of the MSGBC Oil, Gas & Power Conference to promote regional cooperation on energy developments and investment opportunities across the region's growing oil, gas, green hydrogen and entire energy ecosystem.
La publicación Invertir en energía: Guinea Ecuatorial 2023 (Energy Invest: Equatorial Guinea 2023) muestra la prometedora situación de la nación de África Central en el año que asume la presidencia de la OPEC y el FPEG
Energy, Capital & Power se complace en anunciar el lanzamiento de la cuarta edición de Invertir en energía: Guinea Ecuatorial e invita a las partes implicadas a participar en este nuevo informe.


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25 Hot Jobs That Pay More Than $100,000 a Year
Choosing a career can be an overwhelming decision thanks to the vast array of options available to you. So, aiming high and setting a six-figure salary goal could be a smart move — it narrows down your choices and might even help you secure a bright financial future.
To find jobs where you can earn more than $100,000 a year, GOBankingRates analyzed occupations from the Bureau of Labor Statistics (BLS) that paid a median salary between $100,000-$150,000 in 2018. In addition, the study found the employment growth outlook and the top-paying metropolitan areas for each job. If shooting for a six-figure salary right out of the gate seems too ambitious, GOBankingRates also compiled a separate section with occupations that have the potential to make over $100,000 annually — once you work your way to the top.
25. Aerospace Engineer
Salary: $117,100
Aerospace engineers earn a pretty penny by keeping their head in the clouds. These engineers design aircraft, missiles, satellites and spacecraft, and they often specialize in products such as commercial airplanes or remotely piloted rotorcraft. This occupation is expected to see a 6% growth in employment between 2016-26, which equates to a gain of 4,200 jobs. You can earn a mean salary of $136,720 per year if you manage to find work as an aerospace engineer in the metropolitan area encompassing Arlington, Virginia; Alexandria, Virginia; and Washington, D.C.
24. Postsecondary Economics Teacher
Postsecondary economics teachers — aka professors or faculty members — teach economics courses at colleges and professional schools, in addition to conducting research in many cases. For the most lucrative positions, head to the metropolitan area centering on the cities of Bryan and College Station in Texas, where you can earn a mean wage of $176,330 per year. Overall employment for postsecondary teachers is expected to grow by a whopping 197,800 jobs between 2016-26, which is an increase of 15%.
23. Computer Hardware Engineer
As a computer hardware engineer, you'll work on developing computer systems and components such as circuit boards, memory devices, networks, processors and routers. It may come as no surprise, but high-paying jobs in this field can be found in California, around San Jose, Sunnyvale and Santa Clara — the home of Silicon Valley. There, the annual mean wage is bumped up to $144,230. Overall, computer hardware engineers can expect to see employment growth of 5% between 2016-26, which equals an increase of 4,000 jobs.
22. Optometrist
The optometry field is projected to see impressive employment growth of 18% — or 7,200 jobs — between 2016-26. Beyond prescribing glasses or contact lenses, these professionals diagnose and treat different eye conditions and diseases. In particular, optometrists working in the Hartford, East Hartford and West Hartford metropolitan area in Connecticut earn $203,390 per year, on average, which is significantly more than the mean optometrist salary in the U.S.
21. Air Traffic Controller
Air traffic controllers perform a critical role in coordinating aircraft to maintain safe distances between them in the air and on the ground. These workers can rake in an annual mean wage of $151,960 if they find jobs around the Sacramento, Roseville and Arden-Arcade metropolitan area in California. Overall, this field will likely see employment growth of 3% between 2016-26, totaling 900 jobs.
20. Judge, Magistrate Judge or Magistrate
Judges, magistrate judges and magistrates are taxed with many different duties in a court of law, such as sentencing a defendant in criminal cases or determining the liability of a defendant in civil cases. To become one, you'll typically need to earn a law degree and gain work experience as a lawyer first. The Sacramento, Roseville and Arden-Arcade metropolitan area in California pays the highest average salary for these positions, at $198,490 per year. Overall, opportunities are projected to grow by 5% between 2016-26 — an increase of 2,200 jobs in this field.
19. Training and Development Manager
Training and development managers coordinate programs that are designed to boost employee knowledge and skills at an organization. Employment is projected to grow by 10%, or 3,600 jobs, between 2016-26. The top-paying metropolitan area for this field is located around San Jose, Sunnyvale and Santa Clara in California — aka Silicon Valley. Training and development managers earn $165,370 per year, on average, in that region.
18. Personal Financial Advisor
Are you passionate about money and making an impact? Personal financial advisors help people manage their finances by providing advice on matters such as college savings, estate planning, investments, mortgages, retirement and taxes. These savvy individuals can earn an average salary of $215,840 per year if they choose to work in the Gainsville, Georgia, metropolitan area. Overall, employment for personal financial advisors is expected to grow by 15%, or 40,400 jobs, between 2016-26.
17. Postsecondary Health Specialties Teacher
These professors or faculty members teach courses in health specialty fields such as dentistry, pharmacy, public health, therapy, veterinary science and more. The Jackson, Mississippi, metropolitan area offers the most competitive pay for postsecondary health specialties teachers, at $191,070 per year. In general, postsecondary teachers can expect to see employment grow by 197,800 jobs — or 15% — between 2016-26.
16. Pharmacist
The pharmacist at your local CVS is in charge of dispensing prescription medications to patients and educating them on the safe usage of their prescribed drugs. Some of the highest-paid pharmacists can be found in the Tyler, Texas, metropolitan area earning $174,870 per year, on average. Employment for pharmacists is projected to increase by 6% — or 17,400 jobs — between 2016-26.
15. Computer and Information Research Scientist
If you're leaning toward a career in computer and information science, you're in luck — it's one of the fastest-growing industries on GOBankingRates' list. The annual mean wage for these positions in the San Jose, Sunnyvale and Santa Clara metropolitan area in California is $167,990. With employment projected to shoot upward by 19%, or 5,400 jobs, between 2016-26, there's a good chance that your master's degree will pay for itself in record time.
14. Physicist
Fascination with the physical world can pay off in a big way for physicists, who earn an average salary of $169,550 per year in the Buffalo, Cheektowaga and Niagara Falls metropolitan area in New York. Job growth is solid as well, with a change of 14% — or 2,800 jobs — expected through 2026. As a physicist, you'll conduct research, develop theories based on experiments and observation and come up with ways to apply physical laws and theories.
13. Purchasing Manager
Purchasing managers oversee buyers and purchasing agents who negotiate contracts, evaluate suppliers and more in order to acquire products and services for other organizations to resell. Managers typically handle more complex tasks, so you'll need a few years of experience in procurement to become one. Aim for purchasing manager jobs in the Morgantown, West Virginia, metropolitan area if you want to earn the annual average wage of $174,470.
12. Human Resources Manager
If you love working with people, a job as a human resources manager might be right for you — once you ascend the ranks in the field. These professionals serve as the bridge between management and employees at an organization, and they coordinate the company's staff and human resources activities. For the highest-paying jobs, head to the Bridgeport, Stamford and Norwalk metropolitan area in Connecticut, where the mean wage for human resources managers is $182,230 per year.
11. Postsecondary Law Teacher
These professors and faculty members teach courses in law at colleges and professional schools, sometimes in conjunction with conducting research. The most in-demand jobs for this field can be found around the metropolitan area of Minneapolis; St. Paul, Minnesota; and Bloomington, Wisconsin. There, postsecondary law teachers earn a mean wage of $161,380 per year. Overall, employment for postsecondary teachers is projected to grow by 15% between 2016-26 — an increase of 197,800 jobs.
10. Public Relations and Fundraising Manager
After accumulating years of work experience, you can aim for a position as a public relations and fundraising manager. These professionals create materials to enhance the public image of their employer, and they also direct campaigns to raise donations for their organization. Employment in the field is projected to grow by 10% or 7,700 jobs. The best opportunities are located in the metropolitan area encompassing Arlington, Virginia; Alexandria, Virginia; and Washington, D.C. — the annual mean wage for public relations and fundraising managers in this region is $181,100.
9. Compensation and Benefits Manager
Compensation and benefits managers determine competitive wage rates, devise an organization's benefits and pay structure, ensure compliance with federal and state regulations and manage benefits vendors, among other responsibilities. Hartford, West Hartford and East Hartford in Connecticut make up the highest-paying metropolitan area for this field, with an annual mean salary of $178,860. Employment for compensation and benefits managers is expected to grow by 5% through 2026 — an increase of 800 jobs.
8. Advertising and Promotions Manager
Creative types who don't quite fit the mold for public relations and fundraising might want to consider advertising and promotions instead. Employment in both fields is projected to grow by 10% between 2016-26, but there will be a greater number of positions available for advertising and promotions managers — 23,800 additional jobs — and it pays more. Advertising and promotions managers in Silicon Valley sit within comfortable reach of $200,000, as the mean wage for this field in the San Jose, Sunnyvale and Santa Clara metropolitan area in California is $197,130 per year.
7. Natural Sciences Manager
Natural sciences managers can find work in the government and a variety of industries, such as manufacturing and consulting. However, hot jobs in this field are generally located in the Bridgeport, Stamford and Norwalk metropolitan area in Connecticut, where the annual mean wage for natural sciences managers is a whopping $240,800 — over $100,000 more than the U.S. average. Overall, employment in the field is expected to grow by 10% between 2016-26, which is an uptick of 5,600 jobs.
6. Sales Manager
Sales managers direct the sales teams at organizations, which includes setting goals, analyzing data and establishing training programs for sales representatives. Overall employment in the field is projected to increase by 28,900 jobs — a growth of 7%. For high-paying sales manager positions, check out the metropolitan area encompassing New York; Newark, New Jersey; and Jersey City, New Jersey. There, the average salary for these professionals is $195,680 per year.
5. Lawyer
Lawyers are well-known for their lucrative paychecks, but becoming one isn't easy — it requires years of law school and passing your state's written bar examination. However, you'll be handsomely rewarded in your career, especially if you work in Silicon Valley. Lawyers in the San Jose, Sunnyvale and Santa Clara metropolitan area in California earn an annual mean wage of $207,950. Better yet, overall employment is expected to grow by 8% through 2026 — an increase of 65,000 jobs for lawyers.
4. Financial Manager
Financial managers are tasked with the financial well-being of an organization, and their responsibilities include directing investment activities, producing financial reports and developing long-term strategies to meet the goals of their employers. The job outlook for financial managers is overwhelmingly positive: Employment is projected to grow by a staggering 19% between 2016-26, which means an increase of 108,600 jobs. The highest-paid financial managers can be found earning an annual mean wage of $208,670 in the metropolitan area encompassing New York; Newark, New Jersey; and Jersey City, New Jersey.
Marketing managers assess the market demand for services and products from an organization and its competitors. They also identify potential customers and develop pricing strategies to maximize their employer's profits. These professionals are especially well off in Silicon Valley; marketing managers working in the San Jose, Sunnyvale and Santa Clara metropolitan area in California earn an annual mean wage of $197,130. Overall, employment is projected to grow by 10% through 2026, which equates to an increase of 23,800 jobs.
2. Podiatrist
To diagnose and treat complications with the human foot, you'll need to earn a doctorate in podiatric medicine, complete a three-year residency program and become licensed. However, investing in your education will certainly pay dividends in your career — especially if you work in the Charlotte, Concord and Gastonia metropolitan area in North Carolina. Podiatrists in that region take home a staggering $256,950 per year, which is over $100,000 more than the U.S. average. Overall, these doctors can expect an increase of 1,100 positions in their field between 2016-26 — a growth rate of 10%.
1. Architectural and Engineering Manager
Taking the top spot on GOBankingRates' list, architectural and engineering managers offer the highest mean pay compared to all the other occupations in this ranking. These professionals are in charge of activities such as proposing budgets, supervising staff, leading projects and reviewing for quality, among other responsibilities, in architectural and engineering companies. Overall, employment in this field is projected to grow by 6% through 2026 — an increase of 9,900 jobs. Generally, the highest-paid architectural and engineering managers can be found earning $199,650 per year, on average, in Silicon Valley.
These Jobs Pay $100K — If You Can Make It to the Top
It's not easy to land a six-figure salary without extensive education or significant experience in the workplace. While the jobs in the following section didn't make the cut in terms of average pay, there's potential for you to earn $100,000 or more if you choose the right employer, work in certain geographical areas or gain a specialization, among other options. Making the right moves in your career — and working hard, of course — could make it possible for you to become one of the top 10% of earners in your field.
Health Diagnosing and Treating Practitioner
This category includes healthcare providers other than physicians and surgeons, such as acupuncturists, naturopaths and orthoptists, who diagnose and treat vision disorders. The bottom 10% of practitioners earn a mean wage of just $40,910, but at the 75th percentile, earnings jump to $109,610, and the top 10% earn $141,330.
In addition to excellent pay, these jobs are plentiful, and they're increasing at a faster than usual rate. Most opportunities are government positions, but other healthcare practitioners, hospitals and doctors' offices also employ significant numbers and pay salaries in the upper range. Practitioners working in psychiatric and substance abuse hospitals have the highest mean earnings — $119,880.
Power Plant Operator, Distributor and Dispatcher
The expected job growth for power plant operators, distributors and dispatchers is stagnant at -1%, but this job category made the list because it's the only high-income one surveyed that doesn't require postsecondary education. The primary academic requirement is a high school education, and you can qualify for one of these positions after an extended period of on-the-job training.
The 90th percentile of workers holding these positions earn a mean wage of $111,250. Most distributors and dispatchers work at electric power or gas distribution facilities, but other potential employers include paper and pulp mills.
Continue on to Yahoo Finance to read the complete article.


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Favorite Friend Friday,Christopher J. Rapuano, MD
This week's Favorite Friend Friday is a celebrity in the world of ophthalmology. Any patient of Chris Rapuano, MD can attest to his incredible work ethic, personality, and skills. Dr. Rapuano has been a member of the Medical Advisory Board of Lions Eye Bank of Delaware Valley since 1991. He attended college at Brown University, medical school at Columbia University, completed his residency at Wills Eye Hospital from 1987-1990 and a Corneal Fellowship at the University of Iowa from 1990 to 1991. Since 1991 he has been on staff in the cornea department at Wills Eye Hospital. He is Chief of the Cornea Service at Wills Eye Hospital and a Professor of Ophthalmology at Sidney Kimmel Medical College of Thomas Jefferson University. He is also the author of several books, numerous book chapters, and more than 150 articles in the peer-reviewed literature on corneal disease, refractive surgery, and excimer laser PTK surgery. During his ophthalmology residency, Dr. Rapuano co-authored the best-selling textbook in ophthalmology, The Wills Eye Manual.
I had the pleasure of getting to sit down with Dr. Rapuano last week to learn a little more about his life and work. This is hist story:
"Growing up, no one in my family was a Doctor, so I didn't know much about the medical field. My father was a Dentist, he liked being able to fix things and take care of problems, so going into medical school I thought I wanted to be a surgeon. By my third year of school however, I knew that ophthalmology was for me." Dr. Rapuano explains when asked if he always knew he wanted to be an ophthalmologist.
Not all ophthalmologists come to specialize in corneas and go on to be the Chief of the Cornea Service Department. Dr Rapuano explains that there were two specific things that drew him to corneas. "First off, you could just look at the slit lamp and see what was going on with a cornea. You didn't need a lot of other testing or dilating. I appreciated the visual analysis cornea docs could do to make a diagnosis. Second, I liked the delicacy of cornea surgery and the positive results for patients afterward."
Continuing with the idea of positive patient results, Dr. Rapuano explains exactly what it is that makes his job so rewarding. "As cornea surgeons, we have the ability to change people's lives, sometimes quickly and sometimes not as quickly. From removing the corneal opacity from a baby to treating corneal swelling from Fuchs dystrophy to performing emergency corneal transplant for a severe infection or cornea perforation, we can make a real and lasting difference. That's why I come to work every day."
A large part of Dr. Rapuano's job is working with and treating young children born with various eye disorders, one being Peters Anomaly. "The kids that we treat are a very special group. They are the most appreciating and satisfying patients to work with but are also some of the most heartbreaking when the surgeries don't work out." Dr. Rapuano tells the story of a young boy he first met at 3 months old who he worked with for many years. Eventually it became apparent that his vision was not going to improve at all, and he still remembers this 8 or 9 year old's response when Dr. Levin gave him this news. The young patient replied, "It's OK, I'm so happy for what you've done because I've been able to see my mother's beautiful face for the past 5 years."
When Dr. Rapuano is not improving lives and restoring vision, he is spending time with his wife and kids. He has four children, 3 boys and a girl, all of whom have worked either at his office or at Wills at some point in their lives. His second oldest son Pat, actually worked for a summer in High School as a recovery technician for LEBDV, and is going to be starting his residency at Wills Eye this July! His wife Sara has been helping out with Give Kids Sight Day at Wills Eye for about ten years, and now fully runs the event.
From all of us at Lions Eye Bank, and all of your patients, thank you so much for all that you do Dr. Rapuano, you are so appreciated!
Favorite Friend Friday, Rickey Colomy Jr. 3rd
This week for Favorite Friend Friday we have the honor of sharing the story of Rickey Colomy Jr. 3rd. Rickey was a bright light and a beacon of hope for everyone whose path he crossed. We will always remember his life and legacy. Over the years we have grown very close with Rickey's mom, Dawn Ortiz. The story shared below is an excerpt from our interview with her a few years ago. We thought this would be a meaningful and impactful way to begin the New Year. This is Rickey's story:
Remembering Rickey
"If this could help another child to not have to go through what I do than let's do it," Dawn remembers hearing Rickey say. "Where and when" was Rickey's philosophy as he offered his blood, saliva and time participating in research studies at Children's Hospital of Philadelphia (CHOP). "He was always thinking about other people and never expected anything in return," says Dawn.
Richard Scott Colomy Jr. 3rd, who everyone called Rickey, was born with vascular malformation. As part of Rickey's life-long care at CHOP, he had endless doctor's appointments, follow-up visits, surgeries and therapies.
"Something that impressed me about my son was that nobody knew he was sick. If you didn't know his circumstances, you would never know. With as much as Rickey had gone through, intense and invasive surgeries, it can take a toll on someone's body and mind but he always smiled. I think that's what always captivated people. The nurses and surgical coordinators would say that his smile was infectious."
On January 13, 2015 Rickey had surgery number 18. It took longer than expected. When he was finally in recovery, Rickey came out smiling, but seemed concerned. "He told me that something was different, but couldn't explain what it was."
As part of recovery, Rickey was on injections twice a day. He was sore, but that was to be expected. One to never sit around, Rickey began leaving the house again. He went out to visit his girlfriend and called to check in that night. "I said I love you buddy. He said I love you too Momma", recalls Dawn. "That was the last time I talked to my son."
Rickey suffered from a pulmonary embolism and passed away in the middle of the night.
Rickey had a wide range of friends. He never judged people. He accepted everyone. "I didn't realize how many people relied on Rickey," Dawn recalled. "There was a young lady that Rickey was friends with since grade school. Her family didn't have a lot of money and her medication would upset her stomach. She would get nauseous from taking her medication on an empty stomach and so she wouldn't take it. This young girl truly needed her medication. I found out later that Rickey would bring this girl chips and soda every day to homeroom to make sure she would take her medicine. He had a profound impact on that young lady."
Rickey was a beautiful, kind and caring soul. Before Rickey passed away he introduced his mother to his friend's father. "He kept asking me to go out with him, I remember thinking what is wrong with him," recalls Dawn. After attempting to cancel on a coffee date, Rickey pleaded that she go. John made Dawn the happiest she had been in a long time and Rickey loved him. "Rickey introduced me to my husband," says Dawn. "He made sure that I was taken care of before he left."
Dawn honored her son's wishes to donate his corneas. "It was his decision that he made solely on his own," says Dawn, "I wasn't surprised he wanted to be a donor. I couldn't be more proud, I couldn't be more pleased. Giving back is Richard." Rickey's eyes saved the sight for two individuals.
"Child loss will truly rip you from everything that you are. It's been a long journey I but I continue to hear Richard in my ear because after every surgery that Richard would have which was very intense and very invasive, I would always say to him you don't give up you keep fighting you keep going and that is what I keep hearing in my head. 'Don't give up keep fighting you're not a quitter.' And the days when I feel like I can't get out of bed those are the words that I hear. It's hard, I do struggle, but then I think of Richard and I know I have to get up today."
Thank You For All Your Support This Year
Favorite Friend Friday, Kacey Heisler
Favorite Friend Friday, Peyton Barkalow
Favorite Friend Friday, Herbert J. Ingraham, MD
Favorite Friend Friday, Cameron Whittle
Favorite Friend Friday, Sadeer Hannush, M.D.
Favorite Friend Friday, Mary Jackson
Favorite Friend Friday, Nolan Bourgeois
Favorite Friend Friday, PCT Ann E. Reiver
Favorite Friend Friday, Mila Stier
Favorite Friend Friday, Alex Cummings
Favorite Friend Friday, 1st VDG Arthur Pecht
Favorite Friend Friday, Melissa Williams
Favorite Friend Friday, Michael Cruz
Favorite Friend Friday, PDG David E. Jones
Favorite Friend Friday, Carly's Story
Don't miss Gift of Sight Awareness Day on Sunday, September 15, 2019!
Lions Eye Bank of Delaware Valley Announces Promotion
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Select a guide to local attractions in The Valley using PrivateGuide Service.
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Q: If FLT_HAS_SUBNORM is 0, then shall conversion (float)1E-45 return 0x1p-149? Simple question: If FLT_HAS_SUBNORM is 0, then shall conversion (float)1E-45 return 0x1p-149?
Reason of the question: ISO/IEC 9899:2011 (E) specifies behavior of FLT_HAS_SUBNORM / DBL_HAS_SUBNORM only wrt floating-point operations. According to H.2.3.2 (Floating-point operations) conversion between floating-point precisions (term which is taken from F.3 Operators and functions) is not floating-point operation. Hence, behavior specified for FLT_HAS_SUBNORM / DBL_HAS_SUBNORM is irrelevant for conversion between floating-point precisions. Therefore, the conclusion is that conversion (float)1E-45 shall return 0x1p-149. Is this conclusion correct?
UPD: Explanation of the reasons of these questions: currently I have tests which test the correctness of results generated by FP operations (conversions included). I run these tests under environments with FLT_HAS_SUBNORM is 0 and with FLT_HAS_SUBNORM is -1. The main issue is that in some combinations of compiler options some tests are failing.
For example: under FLT_HAS_SUBNORM is 0:

*

*HW (FPU) FP: (float)1E-45 returns 0x1p-149f

*SW (libfp) FP: (float)1E-45 returns 0.0f
Reference value in test: 0.0f.
Therefore, there is a need to understand if:

*

*Test has a bug (written incorrectly: for example, no check for HAS_SUBNORM); or

*Compiler has a bug; or

*SW (libfp) FP has a bug; or

*HW (FPU) FP has a bug (bug in simulator; it happens too); or

*All possible combinations of the previous cases.

The first step is to read the standards (C / IEEE 754) and try to answer the open questions. However, it turns out that wrt FP many aspects are not explicitly defined. Hence, what is the most rational way to handle the situation with existing failing tests?
Please also note that ideally tests are written independently and in a "generic way" (examining the features of the system / environment: checking feature macros, checking limits, etc.), i.e. w/o knowing a particular FP details of a particular compiler used for FP computations (or as people call it FP environment).


Description Spring Canyon train of quarry stone at Stout Depot. Most of the Stout buildings were sold and moved; and some demolished when Horsetooth Reservoir, a part of the Colorado-Big Thompson project, was built 1946-1949. Some of the buildings' remains are still under the reservoir.


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The 3.2L Power Stroke is an inline 5 cylinder, DOHC diesel engine developed by Ford Motor Company. The engine, based on Ford Global's "Puma" engine family, was developed for commercial Transit Van applications in the United States. A properly equipped Ford Transit powered by the 3.2L Power Stroke diesel is rated to carry up to 4,300 lbs of cargo and can tow up to 7,500 lbs. The engine is mated to Ford's 6R80 six speed automatic transmission. Its torque curve is relatively flat, maintaining a minimum 346 lb-ft of torque between 1,500 and 2,750 rpm. In meeting Federal emissions requirements, the 3.2L Power Stroke employs a single brick system (SBS) combination DOC/DPF in addition to selective catalytic reduction (SCR) and exhaust gas recirculation (EGR) systems. The diesel particulate filter regeneration system features a user controlled manual regeneration mode in addition to the typical active regen strategy.