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Manchester triage...
Manchester triage system in paediatric emergency care: prospective observational study
BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1501 (Published 22 September 2008) Cite this as: BMJ 2008;337:a1501
Manchester triage system in paediatric emergency care: prospective observational study - September 29, 2008
M van Veen, PhD student1,
Ewout W Steyerberg, professor of medical decision making2,
Madelon Ruige, paediatrician3,
Alfred H J van Meurs, paediatrician3,
Jolt Roukema, resident paediatrics 1,
Johan van der Lei, professor of medical informatics4,
Henriette A Moll, professor of paediatrics1
1Department of Paediatrics, Erasmus Medical Centre, Sophia Children's Hospital, University Medical Centre Rotterdam, PO Box 2060, 3000 CB Rotterdam, Netherlands
2Centre for Medical Decision Making, Public Health, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, Netherlands
3Department of Paediatrics, Haga Hospital, Juliana Children's Hospital, PO Box 60605, 2506 LP, Hague, Netherlands
4Department of Medical Informatics, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, Netherlands
Correspondence to: H A Moll h.a.moll{at}erasmusmc.nl
Accepted 22 July 2008
Objective To validate use of the Manchester triage system in paediatric emergency care.
Design Prospective observational study.
Setting Emergency departments of a university hospital and a teaching hospital in the Netherlands, 2006-7.
Participants 17 600 children (aged <16) visiting an emergency department over 13 months (university hospital) and seven months (teaching hospital).
Intervention Nurses triaged 16 735/17 600 patients (95%) using a computerised Manchester triage system, which calculated urgency levels from the selection of discriminators embedded in flowcharts for presenting problems. Nurses over-ruled the urgency level in 1714 (10%) children, who were excluded from analysis. Complete data for the reference standard were unavailable in 1467 (9%) children leaving 13 554 patients for analysis.
Main outcome measures Urgency according to the Manchester triage system compared with a predefined and independently assessed reference standard for five urgency levels. This reference standard was based on a combination of vital signs at presentation, potentially life threatening conditions, diagnostic resources, therapeutic interventions, and follow-up. Sensitivity, specificity, and likelihood ratios for high urgency (immediate and very urgent) and 95% confidence intervals for subgroups based on age, use of flowcharts, and discriminators.
Results The Manchester urgency level agreed with the reference standard in 4582 of 13 554 (34%) children; 7311 (54%) were over-triaged and 1661 (12%) under-triaged. The likelihood ratio was 3.0 (95% confidence interval 2.8 to 3.2) for high urgency and 0.5 (0.4 to 0.5) for low urgency; though the likelihood ratios were lower for those presenting with a medical problem (2.3 (2.2 to 2.5) v 12.0 (7.8 to 18.0) for trauma) and in younger children (2.4 (1.9 to 2.9) at 0-3 months v 5.4 (4.5 to 6.5) at 8-16 years).
Conclusions The Manchester triage system has moderate validity in paediatric emergency care. It errs on the safe side, with much more over-triage than under-triage compared with an independent reference standard for urgency. Triage of patients with a medical problem or in younger children is particularly difficult.
Emergency departments need systems to prioritise patients.1 Triage should identify those who need immediate attention and those who can safely wait for a longer time or who might not need emergency care. Furthermore, category of urgency related to actual waiting time is used as a quality measure for emergency departments.2
As "subjective" triage by nurses without using a system has low sensitivity and specificity, it is important to develop and evaluate triage systems.3 The Manchester triage system is a five category triage system based on expert opinion.4 The validity of this system has been studied in specific subgroups of adults and was shown to be sensitive in identifying seriously ill patients ("immediate" or "very urgent") and for the detection of high risk chest pain.5 6 Several studies have evaluated inter-rater agreement of triage systems in paediatric emergency care,7 8 9 10 11 12 and some have evaluated trends in resource use and admission.7 13 14 One small retrospective study validated the Manchester system in children.15
We prospectively validated the Manchester triage system for children in paediatric emergency care. We conducted a large prospective study to allow for sufficient statistical power and detailed evaluation of specific categories of patients.
In this prospective observational study we measured validity by comparing the assigned urgency categories of the Manchester triage system with a predefined independent reference classification of urgency.
The study included children aged under 16 attending the emergency departments of two large inner city hospitals. The emergency department of the Erasmus MC-Sophia Children's hospital (Rotterdam) is a university paediatric emergency department visited by about 9000 patients per year; the Manchester triage system has been in use here since August 2005. We included in our study children who attended from January 2006 to January 2007.
The emergency department of the Haga Hospital-Juliana Children's Hospital (The Hague) is a mixed paediatric-adult emergency department of a large teaching hospital visited by nearly 30 000 patients per year, of whom about half are children. The Manchester triage system was implemented at this site in 2003; we included children attending from January to July 2006.
Both hospitals are in the southwest of the Netherlands, which has a population of about four million people and an annual birth rate of 47 000.16
Manchester triage system
Emergency department nurses performed a short assessment and triaged patients using the Manchester triage system. The system is an algorithm based on flowcharts and consists of 52 flowchart diagrams (49 suitable for children) that are specific for the patient's presenting problem. The flowcharts show six key discriminators (life threat, pain, haemorrhage, acuteness of onset, level of consciousness, and temperature) as well as specific discriminators relevant to the presenting problem. Selection of a discriminator indicates one of the five urgency categories, with a maximum waiting time ("immediate" 0 minutes, "very urgent" 10 minutes, "urgent" 60 minutes, "standard" 120 minutes, and "non-urgent" 240 minutes). The presence of key discriminators in different flowcharts will lead to the same level of urgency. Pain is scored on a scale from 0-10 and could assign patients to a higher urgency level. If the nurse does not agree with the assigned urgency category, the system can be overruled. We used a computerised version that uses the official Dutch translation of the flowcharts and discriminators of the first edition (1996).4 17
Patients' characteristics, selected flowcharts, discriminators, and urgency category were recorded in the computerised triage system. Nurses or physicians recorded data concerning vital signs, diagnosis, diagnostic and therapeutic interventions, admission to hospital, and follow-up on structured electronic or paper emergency department forms. Trained medical students gathered and entered the data on a separate database, independent of the triage outcome, using SSPS data entry version 4. The database was checked for consistency and outliers. Data on laboratory tests were obtained from the hospital information system.
Before the study we defined a reference standard based on literature and expert opinion.15 It consists of a combination of vital signs, diagnosis, diagnostic and therapeutic interventions, and admission to hospital and follow-up. Paediatricians and a paediatric surgeon developed the standard in a meeting before the study started.
Patients were considered to be category 1 (immediate) if they had abnormal vital signs according to the paediatric risk of mortality score (PRISM).18 Deviations in heart rate, respiratory rate, and blood pressure predict mortality in children in intensive care.18 Hyperthermia (temperature >41°C) indicates a higher risk for severe bacterial infection.19 Temperature, respiratory rate or pulse oximetry, and mental status are routinely recorded and if deviations from normal occur they are related to resource use and admission.20 21 Nurses fully examined all children; vital signs were measured at the discretion of the nurse or physician. For those presenting with a medical (non-trauma) problem, temperature was measured in 84%, heart rate in 44%, and respiratory rate in 30%. If vital signs were not recorded, they were assumed to be normal.
Patients were considered to be category 2 (very urgent) if their vital signs were within normal range and the presumed diagnosis at the end of their consultation in the emergency department was a potentially life threatening condition (as defined in appendix 1, see bmj.com). Most of these conditions are associated with a high morbidity and mortality and are discussed in the advanced paediatric life support workbook as emergencies.22 23 The expert panel classified aorta dissections and high energy traumas as potentially life threatening conditions. In a systematic review, McGovern et al suggested that patients with an apparently life threatening event (ALTE) should be monitored for 24 hours.24
Patients were allocated to category 3 or 4 (urgent or standard) depending on the performed diagnostics, administered treatment, and the scheduled follow-up.
Patients were considered to be category 5 (non-urgent) if they did not require any of the resources. Previous studies on other triage systems for children showed an association between urgency level and resource use and follow-up. Resource use is associated with the urgency level of the emergency severity index (ESI).7 13
A classification matrix of the reference classification and detailed definitions of the reference standard urgencies are shown in appendices 1 and 2 (see bmj.com). We defined the reference standard for each patient independent of urgency according to the Manchester system and based on a computerised application of the classification matrix.
In our pilot study 1% of the patients were classified as immediate.15 To have at least 100 patients available for assessment of validity in this category,25 we set the sample size at a minimum of 10 000 patients.
We validated the Manchester triage system by comparing the assigned urgency category with the category assigned with the reference standard. We defined over-triage and under-triage as the proportions of patients who had a higher or lower urgency category with the Manchester system, respectively, than with the reference standard.15
We calculated sensitivity, specificity, and likelihood ratios for classification as high urgency and low urgency (likelihood ratio+=sensitivity/(1−specificity) and likelihood ratio−=(1−sensitivity)/specificity).26 Patients categorised as immediate and very urgent were considered as high urgency and those classified as urgent, standard, or non-urgent as low urgency. The validity for subgroups was determined according to age and flowchart. Age was divided into subgroups (<3 months, 3 months-11 months, 1-3 years, 4-7 years, ≥8 years). We distinguished patients with trauma and medical flowcharts. The trauma flowcharts included limb problems, head injury, major trauma, falls, wounds, injury to the trunk, and assault; all other flowcharts were considered to be medical ones. Commonly used medical flowcharts were considered. We calculated the percentage over-triage and under-triage for patients triaged with commonly used discriminators (fever and recent problem). Secondly, we assessed validity for patients with fever divided into age groups. Analyses were performed using SPSS software (version 14.0.1, SPSS, IL). Sensitivity, specificity, and likelihood ratios with 95% confidence intervals were calculated with the VassarStats website (http://statline.cbs.nl/statweb).16
Nurses applied the Manchester triage system in 16 735 of 17 600 children (95%) who attended the emergency department. The distribution of the reference standard did not differ between those who were or were not triaged (P=0.06). Nurses over-ruled the urgency category in 1714 (10%); 735 of whom (43%) had originally been triaged with the Manchester triage system as very urgent compared with 21% of the patients triaged with the Manchester system overall. Of these children in whom the classification of very urgent was over-ruled, 720 (98%) were downgraded by at least one category.
In the 384 and 509 patients triaged into the urgent and standard categories of the Manchester triage system, 73 (19%) and 22 (4.4%), respectively, were downgraded by at least one category. Fever discriminators (27%) and the discriminator of recent problem (22%) were often used if the urgency category was overruled.
In 1467 (9%) children, complete data were unavailable for the reference standard, leaving 13 554 for analysis. Distribution of the urgency category among children in whom the reference standard was missing was comparable with that in those without missing data (P=0.14). Median age was 3.4 years (interquartile range 1.2-8.0), 6631 (49%) children attended the university hospital, 5740 (42%) were female, and 6965 (51%) were not referred by a general practitioner or medical specialist.
Classification of urgency according to the Manchester triage system and the reference standard agreed in 4582 (34%) children. More children were classified as very urgent with the Manchester system than with the reference standard (2897 (21%) v 277 (2%)). Considerably fewer children were classified as non-urgent with the Manchester system than with the reference standard (112 (1%) v 2927 (22%)) (fig 1)⇓.
Fig 1 Manchester triage system compared with reference standard
The Manchester urgency level agreed with the reference standard in 34% (n=4582). Some 5001 (37%) children were over-triaged by one category and 2310 (17%) by more than one category. With the Manchester system 1474 (11%) were under-triaged by one category and 187 (1%) by more than one category. Agreement with the reference standard was particularly low for the very urgent category, with only 119 of 2897 (4%) classified correctly; 2545 (88%) were over-triaged and 233 (8%) patients were under-triaged (fig 1).⇑
Sensitivity, specificity, and likelihood ratios with 95% confidence intervals for different subgroups on age, presenting problem, and medical Manchester triage system flowcharts
The validity of the Manchester system in children triaged with medical flowcharts differed considerably between the top 10 medical flowcharts, with poor validity for the worried parent flowchart (19% correct triage; likelihood ratio+ 0.9, likelihood ratio− 1.0) (fig 2 and table 1)⇓.⇑
Fig 2 Ten commonly used medical flowcharts and validity
Commonly used general discriminators were recent problem (20%), pain discriminators (17%), fever discriminators (15%), recent injury (9%); commonly used specific discriminators were increased work of breathing (4%) and persistent vomiting (4%). Patients triaged with a fever discriminator showed a low validity, especially with increasing age (fig 3).⇓
Fig 3 Patients triaged with discriminator fever: relation of age to validity
Principal findings and interpretation
The Manchester triage system has an overall moderate validity compared with an independent reference standard. The agreement with the reference standard was 34%, with over-triage in 54% and under-triage in 12% (mostly by one category). The sensitivity for high urgency was 63%, implying that 37% of the patients who actually needed to be seen within 10 minutes were not categorised as that urgent. The specificity was 79%, implying that 21% low urgency patients were categorised too high. In particular, patients in the very urgent category were over-triaged.
The validity was lower in children presenting with medical problems compared with those presenting with trauma. Any modifications should therefore be particularly targeted for medical problems. Specific discriminators can be considered for their role in the triage system. For example, children aged <3 months with fever are at greater risk for a serious bacterial infection, whereas children aged ≥3 months with fever might be allocated to a lower urgency category.27 Such a modification was incorporated in the emergency severity index (ESI) (version 4), a commonly used triage system in Europe and the United States.28 A modification of the paediatric CTAS, a Canadian triage system, in which febrile children aged 6-36 months with no signs of toxicity could be triaged to a lower urgency level (from level 3 to 4), has been shown to be safe.29
The validity of triage systems depends on the extent to which the system predicts urgency and on the accuracy of the nurse who applies the system (inter-rater agreement). We previously found a good inter-rater agreement of the Manchester system in children at our two emergency departments, both for written case scenarios (weighted κ 0.83, 95% confidence interval 0.74 to 0.91) and for simultaneous triage of actual patients (0.65, 0.56 to 0.72) (M van Veen, personal communication). We can therefore assume that the validity of the Manchester system compared with the reference standard is mostly due to the predictive value of the system to assess urgency.
Strengths and limitations of the study
In the Manchester triage system, conditions such as shock, inadequate breathing, compromised airway, and unresponsiveness are used to identify children who need to be seen immediately. For the reference standard we classified children as immediate if blood pressure, heart rate, and respiratory rate were abnormal, if they had a decreased consciousness, or if hyperpyrexia or hypothermia was present. As abnormal vital signs predict mortality in children in critical care units18 and the measurement of vital signs is part of triage assessment, they should be used to identify patients who need immediate attention. Our reference standard was based on literature and expert opinion, which admittedly reflects a low grade of evidence.30 The goal of seeing patients in the order of their category of urgency is to decrease morbidity and mortality.31 Mortality, however, is rare in children presenting at the emergency department and thus cannot be evaluated. Also, differences in morbidity are hard to relate to shorter or longer waiting times.
Furthermore, the reference standard is based on a combination of patients' characteristics collected at the time of presentation and at the end of the consultation in the emergency department. Characteristics gathered at the end of the consultation might be less suitable to define urgency because of possible changes in the patient's condition over time. Assessment of true acuity requires more information than is available at the time of triage.
Our reference standard can therefore be seen only as an approximation of an ideal standard as it was previously used to study the Manchester triage system in paediatric emergency care and had the advantage of classifying patients across five urgency categories.15 30 32 33
Another limitation of the study is that nurses over-ruled the Manchester system urgency category in 10% of the patients. Originally, these patients were often allocated to the very urgent category, which showed a low validity. Inclusion of the 10% over-ruled patients would probably have lowered the validity of the Manchester system.
Furthermore, data for the reference standard were missing in 9% of the patients. Selection bias is not likely as the distribution of the Manchester system categories for patients with missing data was similar to that of the patients without missing data.
Finally, the study was performed in a large urban mixed paediatric-adult emergency department and a large university paediatric emergency department with 90% basic paediatric care. Although these two centres might have a relatively larger number of immediate cases, they are likely to be representative of large emergency departments.
Strengths and weaknesses in relation to other studies
In an earlier retrospective evaluation of the Manchester triage system in paediatric emergency care, we found 40% correctly triaged, 15% under-triaged, and 45% over-triaged.15 In the present prospective study we found a lower percentage of correct agreement, but the percentage under-triaged patients was also lower. This can be explained by a difference in fractions of immediate cases.15 The sensitivity and specificity for high urgency is highly comparable between these two studies.
Other triage systems studied in paediatric emergency care show a high validity (Soterion rapid triage system),14 predicted admission (paediatric Canadian emergency department triage and acuity scale),13 and predicted resource use and length of stay (emergency severity index).7 Although all of these studies used outcome measures to correlate with urgency or to identify the high urgency patients (intensive care admission), they did not define a "reference standard" for urgency (table 2)⇓.
Studies on validity of triage systems in emergency care, published 1997-2008
The use of an independent reference standard for each patient will allow for further development and evaluation of modifications to the Manchester triage system. When applying the Manchester triage system in paediatric emergency care, users should be aware of its moderate validity. We need to consider and study modifications for specific flowcharts, discriminators, and age groups for which the triage system has a low validity.
The Manchester triage system shows a moderate validity in paediatric emergency care but errs on the safe side as the percentage over-triage is much larger than under-triage compared with a reference standard for urgency. Triage of patients with a medical problem or younger patients is particularly difficult.
The consensus based five level Manchester triage system is sensitive in identifying seriously ill adults and those with high risk chest pain
Although the system is widely applied, a large prospective study to evaluate the validity on its use in children is lacking
In paediatric emergency care the Manchester triage system shows moderate validity but errs on the safe side as the proportion of over-triage is much larger than under-triage
Triage of children with a medical problem or young patients (aged <1 year) was particularly difficult and the system should be specifically modified to cope with such cases
Cite this as: BMJ 2008;337:a1501
We thank Kevin Mackway-Jones, professor of emergency medicine, Manchester Royal Infirmary, for critical comments on the manuscript, and Marcel de Wilde, department of medical informatics, Erasmus University Medical Centre, Rotterdam, Netherlands, for technical support.
Contributors: All authors substantially contributed to the conception and design of the study. MvV, EWS, JvdL, MR, AHJvM, and HAM contributed to the data analysis. MvV, HAM, EWS, and JvdL drafted the article and analysed the data. All authors revised it critically for important intellectual content and gave their approval of the final version. HAM is guarantor.
Funding: Netherlands Organization for Health Research and Development (ZonMw), and Erasmus University Medical Centre, Rotterdam, Netherlands.
Ethical approval: Institutional medical ethics committee; the requirement for informed consent was waived.
Provenance and peer review: Not commissioned; externally peer reviewed.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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M van Veen, Ewout W Steyerberg, Madelon Ruige, Alfred H J van Meurs, Jolt Roukema, Johan van der Lei et al
Veen M v, Steyerberg E W, Ruige M, Meurs A H J v, Roukema J, Lei J v d et al.
Manchester triage system in paediatric emergency care: prospective observational study BMJ 2008; 337 :a1501 doi:10.1136/bmj.a1501
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BiondVax Pharmaceuticals Ltd, developer of a universal flu vaccine, has announced successful completion of studies in mice that validated the effectiveness of the company's vaccine against an additional group of avian flu strains, the H7 class. The H7 strains are virulent, with 76% of infected people getting sick and a worrying 33% dying. This milestone marks BiondVax' completion of a series of studies which have established the effectiveness of the company's universal flu vaccine, the M-001, against the two major groups of deadly bird flu strains, the H5 and the H7. The study demonstrated that giving a priming administration of the company's vaccine prior to the pandemic avian flu vaccine greatly increases the level of protective antibodies in mice and in this way, provides protection against a flu pandemic. According to FDA standards, it was shown that following vaccination with M-001, the proportion of mice protected against H7 flu viruses was doubled. BiondVax intends to share this data with governmental health organizations across the world in order to promote the company's clinical development of the vaccine.
The results of the latest study underscore the universality of BiondVax's flu vaccine, and support the Company's proposal that giving a priming dose of M-001 immediately after a pandemic flu outbreak starts - and before the specific vaccine against the emerging strain gets to the market - will increase the proportion of the population protected, whether the outbreak is caused by the H5 strain as has been reported by the company a year ago, or by the H7 strain. As noted, the viruses from these classes lead in many cases to severe pneumonia and even death, and this is why various governments around the world are preparing for a flu outbreak by stockpiling vaccines against the H5 and H7 strains.
Dr. Ron Babecoff, BiondVax's CEO: "We are excited by the success of this study against the H7 strain, which supports that giving a priming dose of BiondVax universal flu vaccine as soon as there is a pandemic outbreak would mean more people protected against the deadly disease. This represents a significant milestone for the future preparedness of governments against flu outbreaks, and is also a very important clinical indicator for BiondVax, which we intend to translate into financial resources for the company. We are confident that similarly, in the future, we will demonstrate the effectiveness of our universal flu vaccine against every new pandemic strain that is discovered. The current study compliments data from our clinical trials in humans that show the universal nature of our flu vaccine, particularly the remarkable ability to effectively immunize against seasonal and pandemic flu strains. In future clinical studies we will further demonstrate the universal capabilities of the M-001 vaccine."
Ltd, BiondVax Pharmaceuticals. "Positive results for BiondVax in a study demonstrating the effectiveness of the vaccination against a new class of deadly bird flu viruses." Medical News Today. MediLexicon, Intl., 30 Jul. 2014. Web.


text:
La sonate  163 (113/63) en mi majeur est une œuvre pour clavier du compositeur italien Domenico Scarlatti.

Présentation

La sonate  163, en mi majeur, notée Allegro, est la seconde sonate d'un couple avec un Andante de même tonalité.

Les triolets de doubles (à partir de la mesure 17) sont notés très légèrement, différemment à Parme :

Manuscrits
Le manuscrit principal est le numéro 16 du volume I (Ms. 9772) de Venise (1752), copié pour Maria Barbara ; les autres sont Parme I 16 (Ms. A. G. 31406), Münster (D-MÜp) IV 27 (Sant Hs 3967) et Vienne B 27 (VII 28011 B).

Interprètes
La sonate  163 est défendue au piano, notamment par Gerda Struhal (2007, Naxos, vol. 12), Carlo Grante (2009, Music & Arts, vol. 1) ; au clavecin, elle est jouée par Scott Ross (1985, Erato), Richard Lester (2001, Nimbus, vol. 1) et Pieter-Jan Belder (Brilliant Classics, vol. 4).

Notes et références

Sources

Liens externes

163
Œuvre en mi majeur

redpajama_set_name: RedPajamaWikipedia


If you want to know the Match winner of Pakistan vs New Zealand 1st ODI Match ? then you are in the right place. Get all the latest stats about the stadium, match winner, pitch & condition etc on Cricketwebs.
Pakistan won the last match between them by 2 runs.
Pakistan have won 2 out of 5 matches they have last played. They won their last match against the Australia.
New Zealand have won 2 out of 5 matches they have last played. They lost their last match against the Australia.
The live streaming of PAK vs NZ 1st ODI 2018 will be broadcasted officially by Sony Six Network in India. Catch Pakistan vs New Zealand 1st ODI live scores on Espncricinfo, Cricbuzz and Yahoo Live Score.


text:
Q: java.sql.SQLTransientConnectionException: (conn=15) Too many tables; MariaDB can only use 61 tables in a join I'm a beginner with JPA, and whilst accessing the database from my DAO, an error stating MariaDB being limited to 61 tables in a join pops up.
Here's a portion of an Entity's code
@Entity
@Table(name = "service")
@NamedQuery(name = "Department.findAll", query = "SELECT d FROM Department d")
public class Department implements Serializable {
    private static final long serialVersionUID = 1L;

    @Id
    @GeneratedValue(strategy = GenerationType.IDENTITY)
    private int id;

    @Column(name = "nom")
    private String name;

    private byte status;

    @OneToMany(mappedBy = "department", fetch = FetchType.EAGER)
    private Set<OperatingBloc> operatingBlocs;

    @OneToMany(mappedBy = "depatment", fetch = FetchType.EAGER)
    private Set<Room> rooms;
    ...
}

And a model of my DAO's code
@Stateless
public class DepartmentDAO implements DepartmentDAORemote, DepartmentDAOLocal {
    @PersistenceContext
    EntityManager em;

    @Override
    public List<Department> getAllDepartments() {
        return em.createNamedQuery("Department.findAll", Department.class).getResultList();
    }
    ...
}

Each time I would access the getAllDepartments() methods of my DAO for maybe more than twice or three times, I'd get the following error
org.hibernate.exception.JDBCConnectionException: could not extract ResultSet
...
Caused by: java.sql.SQLTransientConnectionException: (conn=15) Too many tables; MariaDB can only use 61 tables in a join
...

I have an overall of 40 tables thus 40 entities and each entity has its DAO coded the same way as the one above, so my question relates to anything I could've done wrong and how would I correct it.
Using JPA 2.2, MariaDB for the database.

redpajama_set_name: RedPajamaStackExchange


FIA will have a table at The Provincetown Inn the first 2 days. Please stop by to say "Hi!"
And a new event to Family Week – an informal meetup all about family formation options!
At Harbor Lounge on Wednesday August 1st, from 7:30-8:30pm.
We are hoping our wonderful FIA families will come to share their stories with others thinking about adopting.
Look for the BLUE sun tent and HULA HOOPS!


Nova Scotia has one of the most thorough food safety systems in the Country.
Consumers seek assurances that the food they purchase is safe and of high quality. The Department must, therefore, address issues pertaining to production and product standards, food labelling and traceability, monitoring and inspection, bio-security protocols, food handling education and analytical testing.
As consumers, most of us don't give food safety much thought – unless something goes wrong.
There are several ways to get more education on protecting yourself when it comes to what you eat. Whether it is in the home or eating out, knowing will help to keep you healthy.
As the first step in food production, farms are where food safety begins. In recent years, consumers have demanded more and more proof that the food being produced on farms is free of physical, chemical and biological hazards.
Nova Scotia has a rich and varied history in Food Processing. Our manufacturing ranges from small cottage industries to internationally traded commodities.
Food safety at the retail level is probably the most visible to the general public.
You can verify that your caterer has a valid Food Establishment Permit by viewing our Online Food Inspection Reports website.


Support doesn't have to come at the cost of comfort on the bike, and Gore Wear makes a good case for packing both into one piece with the C3 2in1 Shorts+ for Women. These supportive shorts start out with a cycling-specific inner short that wraps your muscles with gentle support, and mesh panels for breathing, optimized with a Active Various chamois that cushions your sit bones from washboard trails and chattery road rides alike. Outside, a relaxed-fitting outer short drapes over it all, leaving something to the imagination underneath, with sleek an simple style that can transition from the parkway to the trail network.


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Aged to perfection, each batch is bottled from deeply charred (#4) barrels.
Rated 96 by Tasting Panel Magazine - One of Tasting Panel's highest rated bourbons.
from an extreme small batch of 19 center cut, hand selected barrels from a single rack.
its journey to become Calumet Farm Single Rack Black 12 Year Old Bourbon Whiskey.


text:
Man United beats Villa 2-1, level on points with Liverpool
MANCHESTER, England (AP) — Bruno Fernandes scoring a penalty has become a very familiar sight for Manchester United. Being among the Premier League frontrunners has not been seen in recent years for the fallen giant.
United went level on points with leader Liverpool with a 2-1 victory that ended Aston Villa's five-game unbeaten run on Friday. The win was secured by Fernandes scoring his ninth spotkick since making his debut 11 months ago.
While United is still behind Liverpool on goal difference, Ole Gunnar Solskjaer's side has won one more and has the team looking well-placed to mount a challenge for a first title since 2013.
"We are building something important — we know that," Fernandes said. "I see in the stands the last two or three minute, everyone shouting and hoping we don't concede the goal and take care of the ball. We have to build this more and more."
Of course, there weren't many to shout. With Manchester in near-lockdown and games closed to fans, just a few hundred key personnel — including players — were allowed into Old Trafford on New Year's Day.
One of them was the most legendary figure in British football: Alex Ferguson, who produced United's record-extending 20th English title before retiring eight years ago.
A day after his 79th birthday, the Scot saw Anthony Martial head United in front in the 40th minute at the end of a counterattack started by Paul Pogba. And it was Pogba who won the penalty — from the restart after Bertrand Traoré's equalizer — that allowed Fernandes to clinch the win in the 61st minute.
Such has been United's decline in the post-Ferguson years that only once — in 2018 under Jose Mourinho — has United finished second and then it was 19 points behind Manchester City.
And when Solskjaer opened 2020 with United 27 points behind eventual champion Liverpool, the manager's days looked numbered.
"It's such a big difference when you look 12 months back," Solskjaer said. "It's a good position to be in but we need to improve and get better."
Key to United's transformation last season that secured a third-place finish was Fernandes arriving in the January transfer window.
But it is the team's costliest player — Pogba — that Solskjaer will need to be making a consistent impact if the trophy is to be collected.
"His physical presence is important for us," Solskjaer said.
After gaining possession five minutes before halftime inside his own half, Pogba headed the ball to Marcus Rashford, who flicked it for Aaron Wan-Bissaka to take down the right flank. A cross was then sent in for Martial to meet with a stooping header planted into the net for his third goal in six games.
It's not easy breaching Villa's defense. This was only the second conceded in six games.
So much of Villa's threat was coming on the left flank from Jack Grealish. At the start of the second half he beat Wan-Bissaka and sent in a cross which led to Ollie Watkins' header being turned over by goalkeeper David de Gea.
But De Gea was beaten by Traoré from close range after Douglas Luiz let Grealish's cross go past him. The move started with a quickly taken free kick by John McGinn inside Villa's half that caught out United.
But the lead didn't last long after Pogba tangled with Luiz's shoulders and almost appeared to trip himself over. But the penalty survived a VAR review for Fernandes to convert for his 11th league goal of the season.
Fernandes did have a chance to extend the lead from open play with a shot pushed over that ensured a nervy conclusion to protect the lead.
In stoppage time, De Gea kept out a powerful shot from Matty Cash and defender Eric Bailly scrambled a clearance to prevent Keinan Davis leveling.
No wonder Bailly was so triumphant, roaring at the final whistle. Fernandes went over to embrace him.
"It's a fantastic block at the end," Solskjaer said. "I didn't enjoy the last 10 minutes that much because I think we could have seen out the game out in a better way."
More AP soccer: https://apnews.com/Soccer and https://twitter.com/AP_Sports

redpajama_set_name: RedPajamaCommonCrawl


The Premier Soccer League has come under threat of losing its exclusivity as the Independent Communications Authority of South Africa (ICASA) intends to amend its regulations.
PSL chairman Irvin Khoza made the announcement at a press briefing following an extraordinary Board of Governors meeting in Johannesburg on Tuesday.
ICASA intend to amend its public broadcast regulations by including all national football – including Bafana Bafana and other national teams – under its framework that regulates the free-to-air rights of sports in the country.
This would see the PSL forfeit their ability to independently sell the broadcast rights to the likes of SuperSport International and the South African Broadcasting Corporation (SABC).
Khoza said this could cripple the PSL with a potential loss of up to 80 percent of its annual revenue and, as a result, lead to the collapse of the organisation and its member clubs, who are dependant on such income.
"ICASA wants to do this after the hard work we have put in? Players would not be getting paid as much if it was not for our current funding model. The current broadcast deal took work and time," said Khoza.
"We did not break the law. Everything we did was within the framework. We did the work necessary. The broadcast deal has had an enormous impact on the state of SA football. Without it the PSL dies.
"Without adequate funding, this industry as we know it will collapse and will be back to what it was back in the 1980s. Clubs will cut support staff to the bone and our grant of R11m to SAFA will no longer be available.
"I hope this is an error from ICASA, but it is also a form of exclusion. They did not consult or try to understand our industry.
"We will defend ourselves rigorously. We will exhaust all options available to us. If it is not resolved, we will shut down the PSL."
ICASA initially set a deadline for submissions on its proposed amendments for February 2019, but federations have since been afforded until March this year to put forward their arguments.


Explore a variety of special phenomena that are among the wonders of the sky. Some, like bright meteors, aurora, and many comets, are largely unpredictable. Others, like eclipses and annual meteor showers, occur at well-known times: although it may require a special trip to see them.


This busy and popular section of the Directory Journal provides details of online guides and directories over the Internet enabling you to list your own travel and tourism website or service to be promoted to the world. Please browse through the guides and directories below that will offer you a host of travel and tourism information, resources and worldwide Internet directory links.
To have your travel and tourism Internet guide or directory listed here to take advantage of the popularity of the Directory Journal please click the Submit site button above.
Travel portal that includes matter-of-fact travel guides, travel advice, detailed maps and travel news for worldwide destinations. Includes maps, information and updates regarding guidebooks, online forums, feature articles, popular message boards, travel services and health information.
Offers a guide to the most popular and most luxurious resorts in Costa Rica. Discover small boutique hotels as well as all-inclusive beach front resorts. Stay in accommodations with toucans, sloths, and howler monkeys that are found locally.
Marriott Hotels and Resorts offer a broad range of hotel and resort experiences in top destinations around the world.
Converts network of trails out of former rail lines into hiking, walking, biking trails and low impact transportation networks.
Web community and guide discussing travel, holiday and tourism. Provides a forum for sharing personal experience, learning and having fun.
Winery Tasting Sicily was created with the aim of promoting wine tourism in Sicily through the knowledge of the wine produced by the Sicilian wineries. The structure of Sicily's wines is both due to the type of vines and to the perferct growing environment, but also to the qualitative improvement and to the refining techniques which have awarded the products in foreign markets. Discover more on their website today.


Justice Lalley in Talksport and Irvine talked about modern commerce, but Art 8 of ECHR might have worked – celeb endorsements: any negative publicity, might be transferred back to product, thereby reducing brand equity, so imp that reputation be maintained.
are we all entitled to t same degree of privacy? - athletes, politicians?, is it relevant that sports stars often treated as role models?
Simon Boyes, SL at NTU Law School Caught behind or following on?
Football (Disorder) Act 2000 - Schedule, Sction 14B, new type of banning order to be more effective o Banning order on complaint (as opposed to conviction) o If suspected hooligan – big leap! - If suspected to have contributed to violence, and if court satisfied, magistrate must impose order - Police watching suspected hooligans, compiling evidence, and proceeding on civil procedure - ME: how long?
was it applied in gough and smith, and are banning orders on complaint a proprtioanl response?
ME: what is basis for concluding that courts are so influenced (out of proprtion) by hooligans on tv?
ME: is it difficult for police to target arrest in big crowds?
Do volunteer coaches have right to refuse responsib to coach people w disabilities?
DDA1999, part 3 – sports coaching is a service, so cannot discrim against a disabled person by refusing to coach or way they do it.
Child w disability takes longer through highschool – rule that only under 19 can play in school sports – so cannot play – but rule is discrim disability?
Does pga have right to set rules? If pga says it is essential, who is the court to say otherwise?
is it a 'reasonable accommodation'?
what is approp scope of review for sport dispute? - how broad are grounds of review? - What is standard of review? - What scope of authority, when error found?
What standard of review to determine whether error?


Give someone a great and unique start to their 17th birthday with a midnight driving lesson! A 90 minute lesson beginning at 11.30pm commences with an explanation of the car controls lasting around 30 minutes. Having then turned seventeen the rest of the lesson can be spent driving the car.
To avoid disappointment please book well in advance and ensure that licence is applied for well ahead of 17th birthday.
MAKES A GREAT BIRTHDAY PRESENT!


text:
Josette Coras, née Josette-Paule-Marie Coras le  à Montain (Jura) et morte le  à Saint-Claude (Jura), est une peintre, graveuse et dessinatrice française.

D'abord formée par Léon Lang, puis à l'École Estienne, elle est connue pour avoir été une figure du paysage artistique franc-comtois. Installée à Baume-les-Messieurs à partir de 1953, elle participe à l'animation et au rayonnement de l'abbaye par ses expositions, par les stages qu'elle organise.

Notes et références

Liens externes

 Qui est Josette Coras
 Racines comtoises
 Josette Coras, une artiste à Baume-les-Messieurs       Livre de Françoise Desbiez et Alain Michaud
 Le Jura n'oublie pas Josette Coras
 Illustration scientifique

Peintre français du XXe siècle
Graveuse française du XXe siècle
Buriniste
Graveur sur cuivre
Dessinatrice française
Élève de l'Académie de la Grande Chaumière
Élève de l'École Estienne
Naissance en mai 1926
Décès en mars 2008
Décès à 81 ans


text:
En farmacología, se conoce como efecto antabus o efecto disulfiram a los síntomas que se producen al ingerir bebidas alcohólicas después de la administración de ciertos medicamentos como el disulfiram (antabus). El efecto antabus se utiliza en la terapéutica de deshabituación de los enfermos alcohólicos.

Síntomas
El efecto antabus se manifiesta por un conjunto de síntomas que consisten en enrojecimiento de la cara, dolor de cabeza, sudoración profusa, taquicardia, náuseas, vómitos y en ocasiones vértigo, hipotensión arterial y síncope.

Estos síntomas se producen porque en circunstancias normales, el etanol se metaboliza a acetaldehído por la acción de la enzima alcohol-deshidrogenasa, y posteriormente el acetaldehído se transforma en acetato por acción de la aldehído-deshidrogenasa. El disulfiram provoca una inhibición irreversible de la enzima aldehído-deshidrogenasa, lo que conduce a una acumulación de acetaldehído en sangre que es la que causa los síntomas citados.

Fármacos
Entre los medicamentos que pueden desencadenar el efecto antabus se encuentran disulfiram, metronidazol, cefoperazona, cloranfenicol, isoniazida, ketoconazol, nitrofurantoína, sulfonamidas y tolbutamida.

Hongos

La ingesta de algunas especies de hongos como Coprinus atramentarius, Boletus lividus y Clytocibe clavipes pueden desencadenar el efecto antabus. Estos hongos contienen una toxina denominada coprina de propiedades similares al disulfiram. Este fenómeno se produce incluso 3 días después de consumir alguno de estos hongos.

Sustancias de origen industrial
Alguna sustancias que se utilizan industrialmente, como el dibromuro de etileno y la dimetilformamida que se emplea como disolvente del poliacrilonitrilo, pueden provocar efecto antabus, sobre todo por absorción en el medio laboral debida a inhalación o contacto cutáneo.

Terapéutica
El efecto antabus se utiliza con fines terapéuticos en el tratamiento de deshabituación de pacientes alcohólicos, para ello se administra bajo control médico disulfiram, el cual provoca los desagradables síntomas del efecto antabus cuando el paciente ingiere bebidas alcohólicas en las horas siguientes.

Referencias

Farmacología clínica


text:
Religious Observance | Registrar | York University
The Senate Policy on Sessional Dates and the Scheduling of Examinations (Section 7.0) states, in part, that:
York University is committed to respecting the religious beliefs and practices of all members of the community and making accommodations for observances of special significance.
Efforts are made by the University to avoid scheduling formal or in-class examinations on days of religious significance which require an absence from the University or prohibit or require certain activities that would make participation in course activities unfeasible. A list of Commonly Observed Dates of Religious Significance will be compiled annually. There are many holy days associated with various faiths, and the absence of such dates on this list should not be interpreted to mean that accommodation will not be provided to students who observe those days. Students will be informed of procedures for requesting and arranging accommodations.
The list of Commonly Observed Dates of Religious Significance is posted on the Registrar's Office website.
Religious Accommodation Guidelines: Final Examinations
Students who have a conflict between a religious commitment and the scheduled date of an examination in either of the December or April formal examination periods must request an alternative date to write the final exam. Using the Religious Accommodation Agreement students contact the course director no later than 21 days prior to the start of the examination period to arrange an alternate examination date. Failure to meet the deadline may result in a denial of the request. The instructor will process requests expeditiously to avoid an academic disadvantage to the student. Completed Agreement forms are submitted to the department offering the course.
In cases where an arrangement between the student and course instructor cannot be made, or if the student is uncomfortable approaching the instructor to request a religious accommodation, the student should contact the Associate Dean of the Faculty in which the course is offered. Students are required to contact the Associate Dean not less than 14 days prior to the start of the examination period. Failure to meet the deadline may result in a denial of the request.
Guided by the student's particular circumstance, the forms of accommodations provided by the Associate Dean may include:
Treating the request as a conflict and accommodating it within the examination period, or
Scheduling a deferred examination as close to the original examination date as possible
Religious Accommodation Guidelines: Term Work/Course Components other than Final Examinations
Students seeking accommodations under the terms of this policy may do so in order to reschedule the date of:
a test
submission of an assignment
any other required form of course evaluation (such as labs or presentations)
Students are responsible for making a formal request (in person or in writing) to their instructor(s) for accommodation within 14 days of the date for which accommodation is sought. If the day of religious significance occurs within 14 days of the start of a term, the student shall contact the course director at the earliest opportunity to request accommodation.
Normally the forms of accommodation provided by the course instructor will be to:
re-schedule the evaluation to an alternative date
provide an alternative evaluation for satisfying the course requirement (including a common date for the class for all deferred tests / mid-term examinations)
provide an alternative assignment for satisfying the course requirement
In exceptional circumstances, re-calculating the evaluation scheme in a course to eliminate the component that has been missed may be determined to be the most appropriate accommodation for individual students. Consistent with the Guideline that the essential learning outcomes of a course must be satisfied (Section II a), no component worth more than 20% may be re-weighted within the grading scheme.
If a course instructor and a student are unable to agree on the form of accommodation, the request will be referred to the Associate Dean to determine the form of accommodation consistent with these Guidelines / Principles and Procedures.
You can find the current list of Commonly Observed Dates of Religious Significance online.


text:
Around the world future
Facebook introduces dystopian concept: a trustworthiness-based rating system
by evolvera 22nd August 2018 7th March 2021
Leave a Comment on Facebook introduces dystopian concept: a trustworthiness-based rating system
The thin line between what could be considered "beneficial to society" and being "dystopian" has gotten even thinner. Has Mark Zuckerberg thought this one through? To combat the idea of fake news, Facebook has now employed 3,000 additional censors who, together with the 4500 already employed, will decide what to delete and what to keep on the social network. This is what was communicated on a blog post and has definitely raised some eyebrows amid the growing suspicion that Facebook has attempted to crack down on users that do not fall in-line with the accepted political narrative. A number of voices online have seen suspicious activity such as PragerU, amongst others, feeling the breath of Facebook down its neck. Where is the cybersociety headed?
The reports of such a system have, according to Facebook themselves, been developed throughout the year. Ever since US President Donald Trump popularized the term fake news, it has appeared on the radar of multiple giant social platforms including Twitter, YouTube and Facebook. I remember the reports about the dystopian nature of a Chinese Social Credit Score, which will be fully integrated into Chinese society by 2020. A number of Western media reports were quick to label it as something from an episode of the TV show Black Mirror – but what they don't understand is that in modern times, large corporate entities and governments intertwine, so for Facebook to introduce a similar system based on trustworthiness is equally worrying.
The rating system is based on the ability of Facebook users to be able to flag your content for false news, which if it reaches a significant number of flaggers labelling it as such, your "trustworthiness" rating will go down ranging from a measure of 0 to 1. 0 in this case being the least trustworthy, and thus your posts have a lower visibility on people's feeds, as filtered by Facebook themselves. I should be careful with this information here, as perhaps this information, could be flagged as fake news if enough people considered it as such. Could this mass-flagging be used for malign purposes or for being on the wrong end of the political spectrum? It could be, but Facebook needs to be careful to not fall into this trap by implementing some sort of system where it doesn't just automatically go down due to third-party decisions.
But that's not the only recent news concerning Facebook…
Facebook is now taking the hard gloves to clear out what is called "hatred", as well. Additional thousands of censors will be employed with the task of deleting offending records. This was announced by the company's vice president of public policy in Europe, the Middle East and Africa, Richard Allan.
"Our current definition of hate speech is something that directly attacks people based on what is known as their protected features," writes Allan. For example, race, ethnicity, national origin, religious affiliation, sexual orientation, sex, gender identity, serious disability or illness are mentioned.
Allan acknowledges that the boundaries can sometimes be difficult. "There is no universally accepted answer for when something crosses the boundary. Even though a number of countries have laws on hate crimes, their definition varies considerably from what is seen as criminal, ". Thus far, the combination of a trustworthiness system and rules against a thinly-lined definition of hate speech could make your experience on Facebook as…a bit invasive, but only if Facebook comes to term with such a misuse – will they be able to take care of it?
The California-based company relies mostly on the two billion Facebook users report posts that they consider to be hateful. Facebook's employees censor, then review the material and decide if it should be deleted. The human censors have been great in doing so thus far.
Facebook is now seeking another 3,000 people for its "community operations team" to assist in reviewing records that may be seen to violate company policies. According to Richard Allan, Facebook currently has 4,500 employees tasked with reviewing reported records.
In the blog post, Allan states that Facebook is aware that it may appear censorship when they delete posts that are considered offensive to others and that the company is therefore working to improve their filtering processes and intend to keep transparency about their standards. He adds that Facebook is currently "experimenting" with techniques that can eventually help automatically filter offensive language.
Earlier this month, Facebook similarly informed about its fight against terrorism online through a combination of artificial intelligence and trained experts. The company said they have more than 150 employees dedicated to terrorism alone according to AP.
It'll be interesting to see if Facebook can tackle this problem without making the line between dystopian measures and benefit to society even thinner. At the same time, people await a new breakthrough social network to appear through the cracks. Kim Dotcom, are you working on something?
Evolvera – always changing, always evolving.
Tags: evolvera news tech
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Jack Knight is a hit urban songwriter and producer whose credits include hit songs by Diddy, Biggie, Total, Carl Thomas, Faith Evans, Keyshia Cole, Jennifer Lopez, Loon, Mario Winans, Christina Aguilera, Monifah, Lil' Kim and others. Jack initially came to the forefront as an urban soul writer and producer, working with the likes of Blackstreet, Rakim, Imagine and Chico DeBarge. Recently, in 2008 Knight established The Jack Knight Songwriting Academy which is an online Songwriting/Educational program designed to help economically disadvantaged youth and adults in the age range of 12 – 24 years old.


With state of the art build function this truly elegant terrace system enhances any space giving a sense of true luxury.
Esthec Terrace offers a range of colours and tones which allows the terrace to be integrated into an overall design scheme. In addition to the obvious aesthetic advantages, the design options and the ease of installation, Esthec also leads the way in the effort to limit the use of scarce natural hard woods in building materials.
Esthec is durable, splinter free, simple to maintain and feels comfortable on bare feet; even when wet, Esthec provides excellent slip resistance. This high quality decking can be used for outdoor application including, but never limited to, terraces at hotels and resorts, beach club patios, high end residential terraces and balconies, spa areas at luxury villas, swimming pool surrounds, rooftop gardens, decks and jetties.
A selection of five basic colours each with three shades that can be mixed to give an interesting tonal effect on your deck.
Colour stability when wet or dry unlike weathered traditional hard wood surfaces.


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New e-cigarette rules frustrate Sac vaping businesses
Rules ban offering free samples, sales to anyone under 18-years-old
Dana Griffin
KCRA/Dana Griffin SOURCE: KCRA/Dana Griffin
A closing sale sign is taped to the door of the Electric Cigarette Lounge on K Street.The owner said he's shutting his doors for good after recent smoking laws and U.S. Food and Drug Administration regulations have snuffed out his business.The new rules halt the sale of e-cigarettes and similar products like e-cigars and hookah to anyone under the age of 18.It also bans free sampling and manufacturers cannot promote the devices as healthy alternatives to smoking.The Vapor Spot may be empty inside but the doors are still open."The rules now, cut us off at the throat. It doesn't allow us to give any actual proper advice on how to use them, assemble them (and) how to work them properly," said The Vapor Spot employee Mario Weaks.Before vaping, Weaks smoked cigarettes for more than 25 years and he said e-cigarettes saved his life."My heart was enlarged by 25 percent. I was actually, I'm getting emotional talking about this because I was literally walking around waiting for a stroke to happen," Weaks said.The new rules make him fear that the vaping industry will disappear now that new and existing products must go through FDA evaluation.Josh Rother has made his own personal product and forgoes vape shops all together."I guess maybe a lot of people will turn to that because it's really easy to do. You just buy like a little scale and you weigh out the measurements and you can design your own recipes for the stuff," Rother said.His friend Robert Blair just hopes he will quit."To actively inject things into our lungs that are chemicals at the end of the day, I mean, I don't care how good they taste, I just have to believe it has a bad impact on your health," Blair said.
SACRAMENTO, Calif. (KCRA) —
A closing sale sign is taped to the door of the Electric Cigarette Lounge on K Street.
The owner said he's shutting his doors for good after recent smoking laws and U.S. Food and Drug Administration regulations have snuffed out his business.
The new rules halt the sale of e-cigarettes and similar products like e-cigars and hookah to anyone under the age of 18.
It also bans free sampling and manufacturers cannot promote the devices as healthy alternatives to smoking.
The Vapor Spot may be empty inside but the doors are still open.
"The rules now, cut us off at the throat. It doesn't allow us to give any actual proper advice on how to use them, assemble them (and) how to work them properly," said The Vapor Spot employee Mario Weaks.
Before vaping, Weaks smoked cigarettes for more than 25 years and he said e-cigarettes saved his life.
"My heart was enlarged by 25 percent. I was actually, I'm getting emotional talking about this because I was literally walking around waiting for a stroke to happen," Weaks said.
The new rules make him fear that the vaping industry will disappear now that new and existing products must go through FDA evaluation.
Josh Rother has made his own personal product and forgoes vape shops all together.
"I guess maybe a lot of people will turn to that because it's really easy to do. You just buy like a little scale and you weigh out the measurements and you can design your own recipes for the stuff," Rother said.
His friend Robert Blair just hopes he will quit.
"To actively inject things into our lungs that are chemicals at the end of the day, I mean, I don't care how good they taste, I just have to believe it has a bad impact on your health," Blair said.


According to the latest figures from Tracker (part of the Tantalum Corporation), the highly desirable Range Rover Sport was the most stolen and recovered vehicle in 2015, knocking the BMW X5 off the number one spot which it has held for the last 6 years. Year-on-year Tracker saw a 12 per cent increase in the number of stolen vehicles recovered in 2015, equating to nearly £12.5 million worth of vehicles being returned to their owners.
Three Range Rover models now appear in the 'Tracker Top 10 Most Stolen and Recovered' table – the Sport, Vogue and Autobiography – demonstrating the popularity of the brand with thieves. The Audi Q7 also makes its first appearance, coming in 10th. The BMW 3 and 5 series make a re-appearance after a number of year's absence, last listed in 2013 and 2009 respectively. The Mercedes Benz C63 climbs six places to number four, having entered the top 10 last year.


A little over ten years ago, Dr. Elaine Johnson obtained funding from the National Science Foundation to start Bio-Link, an Advanced Technology Education center, focused on biotechnology. Since that time, Dr. Johnson has become a national leader in biotech education, enlisting the country's top educators and industry captains to ensure that community college students receive a quality education and the best preparation possible for entering the workforce. In this radio interview from Tech Nation, Dr. Johnson talks with Dr. Moira Gunn about the easiest way to a biotech career.


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Gionee come with full HD display of 18:9 on its new Smartphone M7. With this new brand company want to bring latest tech in display, with another popular features. M7 has 6 inches of borderless AMOLED screen with the resolution of 2160×1080 pixels; it is first Smartphone in market which come with MediaTek Helio P30 processor, 6GB of internal storage which can expand up to 64GB via micro-SD card. In market it cost $ 425, comes in five different colors Black, champagne gold, maple red, sapphire blue and star blue.