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Early Estimates of Bivalent mRNA Vaccine Effectiveness in… – CDC
Early Release / December 16, 2022 / 71
Mark W. Tenforde, MD, PhD1; Zachary A. Weber, PhD2; Karthik Natarajan, PhD3,4; Nicola P. Klein, MD, PhD5; Anupam B. Kharbanda, MD6; Edward Stenehjem, MD7; Peter J. Embi, MD8,9; Sarah E. Reese, PhD2; Allison L. Naleway, PhD10; Shaun J. Grannis, MD9,11; Malini B. DeSilva, MD12; Toan C. Ong, PhD13; Manjusha Gaglani, MBBS14,15; Jungmi Han3; Monica Dickerson1; Bruce Fireman, MA5; Kristin Dascomb, MD, PhD7; Stephanie A. Irving, MHS10; Gabriela Vazquez-Benitez, PhD12; Suchitra Rao, MBBS13; Deepika Konatham16; Palak Patel, MBBS1; Kristin E. Schrader, MA2; Ned Lewis, MPH5; Nancy Grisel, MPP7; Charlene McEvoy, MD12; Kempapura Murthy, MBBS16; Eric P. Griggs, MPH1; Elizabeth A. K. Rowley, DrPH2; Ousseny Zerbo, PhD5; Julie Arndorfer, MPH7; Margaret M. Dunne, MSc2; Kristin Goddard, MPH5; Caitlin Ray, MPH1; Yan Zhuang, PhD2; Julius Timbol, MS5; Morgan Najdowski, MPH17; Duck-Hye Yang, PhD2; John Hansen, MPH5; Sarah W. Ball, ScD2; Ruth Link-Gelles, PhD17 (View author affiliations)
What is already known about this topic?
Bivalent mRNA COVID-19 booster doses containing an Omicron BA.4/BA.5 sublineage component were recommended on September 1, 2022. The effectiveness of these updated vaccines against COVID-19–associated medical encounters has not been established.
What is added by this report?
Bivalent booster doses provided additional protection against COVID-19–associated emergency department/urgent care encounters and hospitalizations in persons who previously received 2, 3, or 4 monovalent vaccine doses. Because of waning of monovalent vaccine-conferred immunity, relative effectiveness of bivalent vaccines was higher with increased time since the previous monovalent dose.
What are the implications for public health practice?
All persons should stay up to date with recommended COVID-19 vaccinations, including receiving a bivalent booster dose if eligible.
During June–October 2022, the SARS-CoV-2 Omicron BA.5 sublineage accounted for most of the sequenced viral genomes in the United States, with further Omicron sublineage diversification through November 2022.* Bivalent mRNA vaccines contain an ancestral SARS-CoV-2 strain component plus an updated component of the Omicron BA.4/BA.5 sublineages. On September 1, 2022, a single bivalent booster dose was recommended for adults who had completed a primary vaccination series (with or without subsequent booster doses), with the last dose administered ≥2 months earlier (1). During September 13–November 18, the VISION Network evaluated vaccine effectiveness (VE) of a bivalent mRNA booster dose (after 2, 3, or 4 monovalent doses) compared with 1) no previous vaccination and 2) previous receipt of 2, 3, or 4 monovalent-only mRNA vaccine doses, among immunocompetent adults aged ≥18 years with an emergency department/urgent care (ED/UC) encounter or hospitalization for a COVID-19–like illness.† VE of a bivalent booster dose (after 2, 3, or 4 monovalent doses) against COVID-19–associated ED/UC encounters was 56% compared with no vaccination, 31% compared with monovalent vaccination only with last dose 2–4 months earlier, and 50% compared with monovalent vaccination only with last dose ≥11 months earlier. VE of a bivalent booster dose (after 2, 3, or 4 monovalent doses) against COVID-19–associated hospitalizations was 57% compared with no vaccination, 38% compared with monovalent vaccination only with last dose 5–7 months earlier, and 45% compared with monovalent vaccination only with last dose ≥11 months earlier. Bivalent vaccines administered after 2, 3, or 4 monovalent doses were effective in preventing medically attended COVID-19 compared with no vaccination and provided additional protection compared with past monovalent vaccination only, with relative protection increasing with time since receipt of the last monovalent dose. All eligible persons should stay up to date with recommended COVID-19 vaccinations, including receiving a bivalent booster dose. Persons should also consider taking additional precautions to avoid respiratory illness this winter season, such as masking in public indoor spaces, especially in areas where COVID-19 community levels are high.
Monovalent COVID-19 mRNA vaccines were developed against the spike protein of the ancestral SARS-CoV-2 virus and were found to provide cross-reactive immune protection against Alpha and Delta SARS-CoV-2 variants (2). The SARS-CoV-2 Omicron variant emerged in November 2021 and diversified into sublineages. These Omicron sublineages were associated with decreased protection from vaccination with monovalent vaccine (3). A single booster dose of bivalent mRNA vaccine (Pfizer-BioNTech or Moderna) containing an updated BA.4/BA.5 component was recommended by CDC on September 1, 2022, (1) for adults who had completed a primary series with any Food and Drug Administration–approved or –authorized monovalent vaccine or who had previously received a monovalent booster dose ≥2 months earlier.§
The VISION Network¶ evaluated the effectiveness of a bivalent booster dose among immunocompetent adults during September 13–November 18, 2022, a period during which the Omicron BA.5 sublineage predominated and additional Omicron sublineages emerged. Seven health systems in nine states contributed data for this analysis. VISION methods have been described (3). Briefly, ED/UC encounters and hospitalizations associated with a COVID-19–like illness among adults who received a SARS-CoV-2 molecular test result during the 14 days before through 72 hours after the encounter were included.** Patients were classified as unvaccinated (zero doses received), vaccinated with 2, 3, or 4 doses of a monovalent-only mRNA vaccine, or vaccinated with 2, 3, or 4 monovalent doses plus a bivalent booster dose ≥60 days after receipt of their last monovalent dose. Encounters were excluded if 1) the patient likely had an immunocompromising condition (4); 2) only one mRNA monovalent vaccine dose was received, a second monovalent vaccine dose was received <14 days before the encounter date, or a third or fourth monovalent vaccine dose or a bivalent booster dose was received <7 days before the encounter date; 3) any dose of a non-mRNA vaccine (e.g., Janssen [Johnson & Johnson]) was received; or 4) a vaccine dose was received before being recommended by CDC.†† VE was estimated using a test-negative case-control design, comparing the odds of having received versus having not received a bivalent booster dose among case-patients (those who received a positive SARS-CoV-2 test result) and control patients (those who received a negative SARS-CoV-2 test result).
Odds ratios and 95% CIs were calculated using multivariable logistic regression, adjusting for age, race and ethnicity, sex, calendar day (days since January 1, 2021), geographic region, and local SARS-CoV-2 circulation (percentage of SARS-CoV-2–positive results from testing within the counties surrounding the facility on the date of the encounter). Age, calendar day, and local circulation were modeled as natural cubic splines. A single, combined model was fit for each outcome (ED/UC encounters and hospitalizations) with those who had received a bivalent booster dose (after 2, 3, or 4 monovalent doses) as the referent group with the following vaccination groups: those who had received no vaccine doses (unvaccinated) (i.e., absolute VE) and those who had received 2, 3, or 4 monovalent doses but not a bivalent booster dose (i.e., relative VE). Varying time intervals between the last dose and the index date (2–4, 5–7, 8–10, or ≥11 months)§§ were used to calculate relative VE. Analyses were conducted using R (version 4.2.2; R Foundation). This study was conducted consistent with applicable federal law and CDC policy and was reviewed and approved by Institutional Review Boards at participating sites or under reliance agreement with the Institutional Review Board of Westat, Inc.¶¶
Among 78,303 ED/UC encounters with COVID-19–like illness that met inclusion criteria, 9,009 (12%) case-patients and 69,294 (89%) control patients were identified (Table 1). Overall, 24,142 (31%) were unvaccinated. Among persons who had not received a bivalent dose, 18,812 (24%), 23,042 (29%), and 8,402 (11%) had received 2, 3, and 4 doses of monovalent mRNA vaccine, respectively. Among the 3,905 (5%) adults who had received a bivalent booster dose (median interval since receipt of bivalent booster dose = 25 days), 216 (6%) had received 2 monovalent doses, 1,679 (43%) had received 3 monovalent doses, and 2,010 (51%) had received 4 monovalent vaccine doses. Bivalent booster dose recipients were older (median age = 68 years) than were those who had not received a bivalent booster dose (median age = 55 years). VE of a bivalent booster dose (after 2, 3, or 4 monovalent doses) against ED/UC encounters for COVID-19–associated illness was 56% (95% CI = 49%–62%) compared with no vaccination, 31% (95% CI = 19%–41%) compared with receipt of last monovalent dose 2–4 months earlier, and 50% (95% CI = 43%–57%) compared with receipt of last monovalent dose ≥11 months earlier (Table 2).
Among 15,527 hospitalizations with COVID-19–like illness that met inclusion criteria, 1,453 (9%) case-patients and 14,074 (91%) control patients were identified (Table 3). Overall, 4,092 (26%) were unvaccinated. Among those who had not received a bivalent dose, 3,355 (22%), 4,766 (31%), and 2,531 (16%) had received 2, 3, and 4 doses of monovalent mRNA vaccine, respectively. Among the 783 (5%) adults who had received a bivalent booster dose (median interval since receipt of bivalent booster dose = 23 days), 49 (6%) had received 2 monovalent doses, 252 (32%) had received 3 monovalent doses, and 482 (62%) had received 4 monovalent doses. Bivalent booster dose recipients were similar in age to vaccinated adults who had not received a bivalent booster dose (median age = 76 and 73 years, respectively). VE of a bivalent booster dose (after 2, 3, or 4 monovalent doses) against hospitalization for COVID-19–associated illness was 57% (95% CI = 41%–69%) compared with no vaccination and 45% (95% CI = 25%–60%) compared with receipt of last monovalent doses, with last dose ≥11 months earlier (Table 2).
Analysis of data from the multistate VISION Network found that during September–November 2022, when the BA.5 and other Omicron sublineages were the predominant circulating SARS-CoV-2 variants in the United States, bivalent booster doses (after receipt of 2, 3, or 4 monovalent doses) were effective in preventing medically attended COVID-19 compared with no previous vaccination among immunocompetent adults and provided additional protection when compared with previous monovalent mRNA vaccine doses only. VE was similar against COVID-19–associated ED/UC encounters and hospitalizations, which might reflect changing severity of hospitalized cases over time (5). Additional studies are needed to evaluate VE against outcomes such as COVID-19–associated severe respiratory illness or death. The IVY Network, an adult inpatient VE network, recently found higher estimated VE in adults aged ≥65 years compared with estimates for those aged ≥18 years included in this analysis (6). This might reflect differences in population subgroups evaluated. Long-term durability of bivalent booster vaccination protection also could not be assessed because of the short period of observation since bivalent dose receipt. In a recent analysis from VISION, during BA.4/BA.5–predominant circulation, 3-dose monovalent VE against COVID-19–associated hospitalization was observed to wane from 68% at 7–119 days after vaccination to 36% at ≥120 days (5). This might explain why, among patients who had received 2, 3, or 4 monovalent vaccine doses only, a longer interval since the most recent dose was associated with more relative protection after receipt of the bivalent booster dose.
Bivalent COVID-19 booster vaccines were developed to improve protection against circulating Omicron sublineages because of immune escape potentially associated with these subvariants and waning of monovalent vaccine-conferred protection over time (7). Real-world data suggest that bivalent boosters provide a modest degree of protection against symptomatic infection among adults compared with receipt of 2, 3, or 4 doses of monovalent vaccines only (8). Results from this study also demonstrate protection against ED/UC encounters and hospitalization during a period when BA.5 and other Omicron sublineage viruses predominated in the United States. With co-circulation of multiple respiratory viruses, including SARS-CoV-2, influenza, and respiratory syncytial virus, vaccination against respiratory diseases for which vaccines are available is especially important to prevent illnesses resulting in health care encounters and to reduce strain on the health care system (9). Additional studies will be critical to evaluating the durability of added protection, especially with circulation of sublineages of the BA.4/BA.5 Omicron variants such as BQ.1 and BQ.1.1.
The findings in this study are subject to at least six limitations. First, previous SARS-CoV-2 infection was not accounted for in this analysis. A large proportion of the population has now experienced SARS-CoV-2 infection which decreases the risk of future medically attended COVID-19 illness and might affect observed VE due to background immunity (10). Second, although models adjusted for relevant confounders, residual confounding is possible, including by behavioral differences and use of COVID-19 treatments such as nirmatrelvir/ritonavir (Paxlovid). Third, sublineage-specific VE could not be estimated. Fourth, this analysis did not compare product-specific bivalent booster VE estimates. Fifth, relative VE was estimated using the interval since receipt of last monovalent dose; this study was not statistically powered to estimate whether relative VE differed by number of previous monovalent vaccine doses received. Finally, because these data are from nine states, the patients in this analysis might not be representative of the entire population of the United States. Further, this analysis included adults who received bivalent booster doses shortly after authorization who might not be fully representative of the vaccine-eligible population. For example, over one half of bivalent booster recipients had previously received 4 monovalent vaccine doses. Additional VE studies are needed as coverage of bivalent boosters increases.
In this early study of immunocompetent adults, significant protection from a booster dose of bivalent mRNA COVID-19 vaccine (after receipt of 2, 3, or 4 monovalent doses) compared with no vaccination was found, as well as significant relative benefits of a bivalent booster dose when compared with previous receipt of monovalent doses only. These findings support efforts to improve coverage with bivalent vaccines, although optimal timing for receipt of bivalent vaccine booster doses needs to be established. All eligible persons should stay up to date with recommended COVID-19 vaccination, including receiving a bivalent booster dose. In addition, persons should consider taking other precautions to avoid respiratory illness this winter season, including masking in public indoor spaces, especially in areas where COVID-19 community levels are high, to protect themselves and others and reduce strain on the health care system during an ongoing surge in multiple respiratory viruses.
Corresponding author: Mark W. Tenforde, media@cdc.gov.
1Influenza Division, National Center for Immunization and Respiratory Diseases, CDC; 2Westat Inc., Rockville, Maryland; 3Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York; 4New York Presbyterian Hospital, New York, New York; 5Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California; 6Children's Minnesota, Minneapolis, Minnesota; 7Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah; 8Vanderbilt University Medical Center, Nashville, Tennessee; 9Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana; 10Kaiser Permanente Center for Health Research, Portland, Oregon; 11School of Medicine, Indiana University, Indianapolis, Indiana; 12HealthPartners Institute, Minneapolis, Minnesota; 13School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; 14Department of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott & White Health, Temple, Texas; 15Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas; 16Department of Research Analytics and Development, Baylor Scott & White Research Institute, Baylor Scott & White Health, Temple Texas; 17National Center for Immunization and Respiratory Diseases, CDC.
All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Nicola P. Klein received grants from Pfizer, Merck, GlaxoSmithKline, and Sanofi Pasteur. Allison L. Naleway received grants from Pfizer and Vir Biotechnology. Suchitra Rao received grants from GlaxoSmithKline. Charlene McEvoy received grants from AztraZeneca. No other potential conflicts of interest were disclosed.
* SARS-CoV-2 variant proportions are monitored by CDC, and available online. https://covid.cdc.gov/covid-data-tracker/#variant-proportions
† Medical events with a discharge code consistent with COVID-19–like illness were included. COVID-19–like illness diagnoses were obtained from International Classification of Diseases, Tenth Revision (ICD-10) discharge codes. The specific codes used were: COVID-19 pneumonia: J12.81 and J12.82; influenza pneumonia: J09.X1, J10.0, J10.00, J10.01, J10.08, J11.0, J11.00, and J11.08; other viral pneumonia: J12*; bacterial and other pneumonia: J13, J14, J15*, J16*, J17, and J18*; influenza disease: J09*, J10.1, J10.2, J10.8*, J11.1, J11.2, and J11.8*; acute respiratory distress syndrome: J80; chronic obstructive pulmonary disease with acute exacerbation: J44.1; asthma acute exacerbation: J45.21, J45.22, J45.31, J45.32, J45.41, J45.42, J45.51, J45.52, J45.901, and J45.902; respiratory failure: J96.0*, J96.2*, and R09.2; other acute lower respiratory tract infections: J20*, J21*, J22, J40, J44.0, J41*, J42, J43*, J47*, J85, J85.0, J85.2, J85.3, J85.1, and J86*; acute and chronic sinusitis: J01* and J32*; acute upper respiratory tract infections: J00*, J02*, J03*, J04*, J05*, and J06*; acute respiratory illness signs and symptoms: R04.2, R05, R05.1, R05.2, R05.4, R05.8, R05.9, R06.00, R06.02, R06.03, R06.1, R06.2, R06.8, R06.81, R06.82, R06.89, R07.1, R09.0*, R09.01, R09.02, R09.1, R09.2, R09.3, and R09.8*; acute febrile illness signs and symptoms: R50*, R50.81, R50.9, and R68.83; acute nonrespiratory illness signs and symptoms: R19.7, R43*, R43.9, R51*, R51.9, M79.1*, M79.10, M79.18, R65*, R53.81, R53.83, R57.9, R41.82, R40*, R40.0, R40.1, R53.1, R11*, R11.0, R11.1, R11.10, R11.11, R11.15, R11.2, R21*, R10*, R10.0, R10.1*, R10.2, R10.3*, R10.8, R10.81, R10.81*, R10.84, and R10.9. All ICD-10 codes with * include all child codes under the specific parent code.
§ https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
¶ Sites from the CDC-funded VISION Network that contributed data for this analysis were Baylor Scott & White Health (Texas), Columbia University Irving Medical Center (New York), HealthPartners (Minnesota and Wisconsin), Intermountain Healthcare (Utah), Kaiser Permanente Northern California (California), Kaiser Permanente Center for Health Research (Oregon and Washington), and University of Colorado (Colorado).
** The encounter date was either the date of collection of a respiratory specimen associated with the most recent positive or negative SARS-CoV-2 test result before the admission or visit date, or the date of the medical visit if testing occurred only after the admission or visit.
†† Encounters were excluded if a first mRNA booster dose (third dose) was received before it was recommended by CDC on September 23, 2021; the interval between the second and third doses was <5 months, a second mRNA booster dose (fourth dose) was received before it was authorized for adults aged ≥50 years on March 29, 2022; the interval between the third and fourth doses was <4 months; a bivalent booster dose was received before recommended and generally available to the public (September 6, 2022); or the interval between the last monovalent vaccine dose (second, third, or fourth dose) and the bivalent booster dose was <2 months. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
§§ Sixty–149 days was classified as 2–4 months, 150–239 days as 5–7 months, 240–329 days as 8–10 months, and ≥330 days as ≥11 months.
¶¶ 45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.
Abbreviations: BV = bivalent; ED/UC = emergency department/urgent care; KPNC = Kaiser Permanente Northern California; KPCHR = Kaiser Permanente Center for Health Research; MV = monovalent; NH = non-Hispanic; SMD = standardized mean or proportion difference.
* ED/UC encounters with a discharge code consistent with COVID-19–like illness were included. COVID-19–like illness diagnoses included acute respiratory illness, respiratory signs or symptoms, or febrile signs or symptoms using diagnosis codes from the International Classification of Diseases, Tenth Revision. Clinician-ordered molecular assays (e.g., real-time reverse transcription–polymerase chain reaction) for SARS-CoV-2 occurring ≤14 days before to <72 hours after the encounter date were included.
† California (Sep 13–Nov 18, 2022), Colorado (Sep 13–Nov 7, 2022), Minnesota and Wisconsin (Sep 13–Nov 18, 2022), New York (Sep 13–Nov 18, 2022), Oregon and Washington (Sep 13–Nov 14, 2022), Texas (Sep 13–Nov 13, 2022), and Utah (Sep 13–Nov 18, 2022).
§ Vaccination was defined as having received the last monovalent or bivalent dose within the specified range of months or days before the ED/UC encounter date, which was the date of respiratory specimen collection associated with the most recent positive or negative SARS-CoV-2 test result before the encounter start date or the encounter start date if testing only occurred after the admission.
¶ An absolute SMD >0.20 indicates a nonnegligible difference in variable distributions between ED/UC encounters for vaccinated versus unvaccinated patients or for patients with positive SARS-CoV-2 test results versus patients with negative SARS-CoV-2 test results. For mRNA COVID-19 vaccination status, a single SMD was calculated by averaging the absolute SMDs obtained from pairwise comparisons of each vaccinated category versus unvaccinated. Specifically, it was calculated as the average of the absolute value of the SMDs for 1) vaccinated with only monovalent doses, ≥11 months earlier versus unvaccinated, 2) vaccinated with only monovalent doses, 8–10 months earlier versus unvaccinated, 3) vaccinated with only monovalent doses 5–7 months earlier versus unvaccinated, 4) vaccinated with only monovalent doses 2–4 months earlier versus unvaccinated, and 5) vaccinated with bivalent booster ≥7 days earlier versus unvaccinated.
** Other race includes Asian, Hawaiian or other Pacific Islander, American Indian or Alaska Native, other not listed, and multiple races. Because of small numbers, these categories were combined.
†† Previous SARS-CoV-2 infection was defined as having a positive SARS-CoV-2 test result (molecular or antigen) documented in the electronic health record ≥15 days before the hospital admission date. This does not capture previous infections in which testing was not performed or testing was performed but not available in the electronic health record (e.g., at-home testing).
Abbreviations: BV = bivalent; ED/UC = emergency department/urgent care; MV = monovalent; NA = not applicable; Ref = referent group; VE = vaccine effectiveness.
* VE was calculated as ([1 − odds ratio] x 100%), estimated using a test-negative case-control design, adjusted for age, sex, race and ethnicity, geographic region, calendar time (days since January 1, 2021), and local virus circulation (percentage of positive SARS-CoV-2 test results from testing within the counties surrounding the facility on the date of the encounter).
† California (Sep 13, 2022–Nov 18, 2022), Colorado (Sep 13, 2022–Nov 7, 2022), Minnesota and Wisconsin (Sep 13, 2022–Nov 18, 2022), New York (Sep 13, 2022–Nov 18, 2022), Oregon and Washington (Sep 13, 2022–Nov 14, 2022), Texas (Sep 13, 2022–Nov 13, 2022), and Utah (Sep 13, 2022–Nov 18, 2022).
§ Dashes indicate that estimated VE had a CI width ≥50%. Estimates with CI widths ≥50% are not shown here because of imprecision. The associated data are also omitted.
Abbreviations: BV = bivalent; ICU = intensive care unit; KPNC = Kaiser Permanente Northern California; KPCHR = Kaiser Permanente Center for Health Research; MV = monovalent; NH = non-Hispanic; SMD = standardized mean or proportion difference.
* Hospitalizations with a discharge code consistent with COVID-19–like illness were included. COVID-19–like illness diagnoses included acute respiratory illness, respiratory signs or symptoms or febrile signs or symptoms using diagnosis codes from the International Classification of Diseases, Tenth Revision. Clinician-ordered molecular assays (e.g., real-time reverse transcription–polymerase chain reaction) for SARS-CoV-2 occurring ≤14 days before to <72 hours after the encounter date were included.
§ Vaccination was defined as having received the last monovalent or bivalent dose within the specified range of months/days before the hospitalization encounter date, which was the date of respiratory specimen collection associated with the most recent positive or negative SARS-CoV-2 test result before the admission date or the admission date if testing only occurred after the admission.
¶ An absolute SMD >0.20 indicates a nonnegligible difference in variable distributions between hospitalizations for vaccinated versus unvaccinated patients or for patients with a positive SARS-Cov-2 test result versus patients with a negative SARS-CoV-2 test result. For mRNA COVID-19 vaccination status, a single SMD was calculated by averaging the absolute SMDs obtained from pairwise comparisons of each vaccinated category versus unvaccinated. Specifically, it was calculated as the average of the absolute value of the SMDs for 1) vaccinated with only monovalent doses, ≥11 months earlier versus unvaccinated, 2) vaccinated with only monovalent doses, 8–10 months earlier versus unvaccinated, 3) vaccinated with only monovalent doses 5–7 months earlier versus unvaccinated, 4) vaccinated with only monovalent doses 2–4 months earlier versus unvaccinated, and 5) vaccinated with bivalent booster ≥7 days earlier versus unvaccinated.
†† Previous SARS-CoV-2 infection was defined as having a positive SARS-CoV-2 test result (molecular or antigen) documented in the electronic health record ≥15 days before the hospital admission date. This does not capture infections in which testing was not performed or testing was performed but not available in the electronic health record, e.g., at-home testing.
§§ In-hospital death was identified at each individual site and was defined as a death while hospitalized and ≤28 days after admission.
Suggested citation for this article: Tenforde MW, Weber ZA, Natarajan K, et al. Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompetent Adults — VISION Network, Nine States, September–November 2022. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2022. DOI: http://dx.doi.org/10.15585/mmwr.mm715152e1.
The Huanan Seafood Wholesale Market in Wuhan was the early … – Science
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Jimmie Johnson lands Carvana for sponsor on his No. 48 Chip Ganassi Racing car for IndyCar jump
Jimmie Johnson and Chip Ganassi Racing's partnership for a two-year IndyCar program, announced last month, has always had a small caveat. Call it the "fine print" of the news release.
They needed a sponsor, which everyone around the paddock assumed would only be a matter of time for a seven-time NASCAR Cup champion making his American open-wheel debut.
The green flag landed Saturday when the duo announced online auto retailer Carvana will be featured on the Honda car in a primary sponsorship role next year that will carry his longtime No. 48 number. Johnson, who watched Saturday's series practice closely in-person, will make his IndyCar debut March 7 back in St. Petersburg after tests Nov. 2 at Barber and Nov. 10 at Laguna Seca, among others.
"It's incredible to have a guy so excited about joining our series and such a competitive person with some runway in front of him," team owner Chip Ganassi said in Saturday's news conference. "To bring in a new company like Carvana is just another feather in both of our caps, and it's an honor to bring in an industry dealer in as a sponsor.
"When this (driver) partnership was broached to me six months ago, I said, 'No, he doesn't want to come (to IndyCar)', but yes he does. Believe me, you've got to pinch me that I'm sitting here today announcing this."
Added Carvana CEO Ernie Garcia: "To me, it's just a David and Goliath story, but the new David is the old Goliath. That's really, really cool, and we're just really excited to be part of this and to support Jimmie and Chip Ganassi Racing in any way that we can."
Johnson, presently planning to run a 13-race road and street course-only program for CGR, originally tested for the team on the IMS road course in late-July with managing director Mike Hull, team owner Chip Ganassi and veteran driver Scott Dixon all on hand. The longtime stock car driver had expressed great interest in diving into open-wheel racing in 2021 after he retires from full-time Cup series racing ever since his appearance at February's open test at Circuit of the Americas.
More on Jimmie Johnson's jump into INDYCAR:
Franchitti on Jimmie Johnson's move to IndyCar: 'This isn't some vanity project'
Jimmie Johnson joining Ganassi for two-year IndyCar road and street program
'Third time's a charm': Jimmie Johnson impresses Ganassi team in first IndyCar test
Then a guest of Arrow McLaren SP at COTA, Johnson said this summer he had been in talks with numerous IndyCar teams and had cooperation from longtime partner Chevy to expand his searching into Honda territory as well. On Sept. 9, after AMSP had said they wouldn't pursue testing Johnson until at least the offseason, the 45-year-old driver and Ganassi announced their partnership.
But as it turns out, Ganassi and Johnson needed help from AMSP to finalize the program. The latter team had taken over ownership of the No. 48 earlier this year, likely in anticipation of working out a program with Johnson, but Johnson said Saturday that through talks with IndyCar president Jay Frye, they were able to work out a deal to pick up his longtime number to be stylized in CGR's font.
Ganassi also affirmed Saturday that he plans for the No. 48 to run all 17 races in 2021 and for it to be the team's fourth entry, with an oval-only driver to be announced at a later date.
"This is huge. I'm as happy as anybody to be able to drive for Chip," Johnson said Saturday. "It's something I want to be part of, and I'm so thankful to have been given this opportunity to help bring this relationship to the finish line and bring a new sponsor into motor sports and the IndyCar series.
"I look forward to having that Carvana car on the track very soon."
Email IndyStar motor sports reporter Nathan Brown at nlbrown@gannett.com. Follow him on Twitter: @By_NathanBrown.nd to

redpajama_set_name: RedPajamaCommonCrawl


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German Federal Agency for Nature Conservation (BfN)
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Helsinki Convention on the Protection of the Marine Environment of the Baltic Sea Area (Helsinki Convention) (1992)
Convention on the Protection of the Marine Environment of the Baltic Sea Area
Contracting parties:
All nine Baltic Sea riparian states (Denmark, Estonia, Finland, Germany, Latvia, Lithuania, Poland, Russia, Sweden) and the EU.
While the precursor 1974 Helsinki Convention was concerned primarily with issues of technical pollution control and the pollution of the Baltic Sea as such, the 1992 "New Helsinki Convention" is concerned with the entire marine environment of the Baltic Sea area. Its purpose is to prevent and eliminate pollution in order to promote the ecological restoration of the Baltic Sea area and the preservation of its ecological balance. Its geographical scope covers not only the entire Baltic Sea including the seafloor and coastal zones, but also its drainage area.
To attain the joint conservation goals, the Helsinki Commission (HELCOM) was created. This body meets annually. Recommendations on environmental and conservation issues which are to be implemented by the parties are an important instrument of HELCOM. The commission is supported by working groups on the various aspects of the convention, such as HELCOM-HABITAT, which deals with nature conservation and biological diversity. Further activities include monitoring programmes and status reports. Important outcomes of conservation activities include the development of a system of Baltic Sea Protected Areas (BSPAs) and the production of a first red list of endangered habitat types of the Baltic Sea.
Helsinki Commission (HELCOM)
Baltic Marine Environment Protection Commission
Katajanokanaituri 6 B
Fax.: +358 9 622 02239
E-Mail: helcom@helcom.fi
BfN activities:
BfN takes part in the Nature Conservation and ICZM (Integrated Coastal Zone Management) working group (= HELCOM HABITAT), in meetings of the Helsinki Commission and in meetings of heads of delegation.
Website of the Helsinki Convention
Habitat Mare: Helsinki Commission
BMU: Helsinki Convention (in German)
Text of the Helsinki Convention
Last Change: 26/03/2018


It was the last official day of Boot Camp for the summer. I was expecting a fun morning of dodge ball or maybe even some relay races, but the Marines had different plans.
We finally finished our workout and were called in for the "shirt ceremony". We also gave some gifts to the two Marines who were graduating and being commissioned. This is always my favorite part of Boot Camp.
One of those Marines is a guy named Bradford Parr and his graduation has even more importance for me. About two years ago he made me really think about what I was doing to myself. He was talking about the fact that you just can't come to Boot Camp and then go out and eat at Hardees (that was a little freaky, because that's exactly what I was doing). He talked about eating right and fueling your body. For whatever reason, something clicked inside of me and I made a huge change.
For the next six months Parr made a point of checking on me to see how I was doing. Around Christmas of that year and after I had lost about twenty pounds he gave me a Citadel Marine shirt. The shirt was nice, but it was a medium so I said thanks and figured I would just put it away. Ninety pounds later I put that shirt on and I still wear it. In fact, its the red shirt I am wearing in my "after" picture on my blog site.
I am honored to be invited to their commissioning ceremony and tomorrow at noon I plan on walking from my office to join the rest of the Boot Campers who will be in attendance.


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Two Pickleball Entrepreneurs Taking the Dancing Pickles Out of Pickleball One T-Shirt at a Time
Lori Bosch and Jodi Wudjkowski traveled from their Michigan homes last year to play in their first pickleball tournament, the Arizona Grand Slam.
The two pals had started out as tennis partners, but when Lori developed knee trouble, she switched to pickleball, and persuaded her good friend to make the switch too.
They had been pickleball doubles partners for nearly two years when they traveled to Arizona for the tournament. It was, in part, a way to get beyond the COVID-19 restrictions in their home state.
"We planned this girl's trip, and said, 'Jodi, we've got to find something cute to wear so we look like a team," Lori said.
"But we couldn't find anything we'd want to wear," she said.
The Navy and white outfits they wore, Lori said, were "lackluster, just like the way we played in that tournament."
That tournament planted a seed, and spawned a business idea between the two women. They decided to come up with their own company that specialized in on- and off-the-court pickleball clothing – mostly T-shirts, hoodies and caps – they wouldn't mind wearing themselves.
They would sell "pickleball wear with flair" and the rules would be simple: "No dancing pickles, no pickleballs with smiley faces, and no fluorescent green."
Naming their company hit an unexpected snag. Their first idea was to make it a combination of their first names and call it "Jolo Pickleball Wear." But their lawyer told them that might make them the target of a trademark infringement lawsuit from pop culture icon Jennifer Lopez and her "J.Lo" brand.
So, the budding pickleball entrepreneurs took the legally safe route, and called the company jojo+lo. In a little over a year, they have created six different collections – retro, hipster, America, chill, flair and statement – and set up pop-up shops in tournaments around the country.
Their products are being sold in Pickleball Central, some brick-and-mortar retailers around the country, and online at their jojoandlo.com website.
Their clothing has also been adopted as the stage costumes in the live-theater comedic play, "Pickleball", which is written by actor Jeff Daniels and currently being performed at his Purple Rose Theatre in Chelsea Michigan. The Pickler featured a story about this production: Dinking, Stage Right: Actor Jeff Daniels Writes Pickleball Live-Theater Comedy.
As pickleball grows, pickleball fashion is starting to blossom. This year, the clothing chain J Crew has teamed up with Recess, a pickleball paddle and accessories company, to produce a new line of branded paddles and accessories.
Jo and Lori aren't surprised that pickleball is starting to get its own clothing identity that's separate from tennis and other sports.
"Now that pickleball is becoming popular, people want to show that they're pickleball players," Lori said. "It's becoming part of our identity."


text:
Everything You Need To Know About Game of Thrones(GoT)
You are sure to expect the unexpected twist and turns when watching every season of the Game of Thrones. HBO's one of the biggest blockbuster's last season was nothing more than a roller coaster ride with a lot of oooh and aahh! As the end game is near, major characters have been dropped off the ship and king in the North (Jon Snow) , Queen of Seven Kingdoms (Cersei Lannister) and mother of the Dragons (Daenerys Targaryen) are taking respective charges of their own throne as well as the white walkers are heading towards those humans who are intermingled among their own disputes.
Keeping a track of all the 100 characters each with its utmost importance can become a tedious list to maintain. The magical and fictional land of Westeros has a history that goes back thousand years. Let's acquaint you with all the to know events, death and what made 'Game of Thrones' the most awaited show of all time.
Season 1: When the Starks smiled, for the last time!
Major Deaths: Ned Stark's beheading literally caused a pool of tears world over, Robert Baratheon's death by a boar left everyone wondering as to the king of seven kingdoms died that way, Viserys Targaryen's head was covered with hot molten gold as his priceless demand with that of a king's rule and lastly Khal Drogo got cursed by a white witch?
Every show or series needs that one righteous character or characters which make the show fall under the great light, for Game of Thrones that's the Stark family. These characters are the very raw and first characters you get introduced to as the show begins. In the beginning, you actually feel that the show is all about the Starks. All praises to the series of unfortunate events through which made the Starks spread all over Westeros.
Need the Starks whereabouts? Here's what happened in the Season 1
Ned Stark: Beheaded while two daughters are left unprotected in King's Landing.
Catelyn Stark: On a path of revenge and hostility post-Ned Stark's death with her Rob Stark to King's Landing.
Robb Stark: Eldest of the Stark ready to avenge his father's tragic beheading with the north behind him to fight for him.
Sansa Stark: Stark lady gets engaged to a narcissist and psychotic king Joffery getting physically and emotionally drained.
Arya Stark: The youngest but the brave stark runs away from cerise and is on her way to the Wall to find her Jon Snow the bastard of Ned Stark.
Jon Snow: The bastard who has sworn his life to protect the wall.
Bran Stark: The second Stark son who is bedridden after being pushed from a high tower by Jamie Lannister.
Rickon Stark: The youngest of the Stark siblings is stark that is mostly seen somewhere while the story is taking its pace.
Season 1's core story is mainly centered on the Starks being scattered around. Meanwhile, the season's curtain falls down when Daenerys Targaryen stands in midst of the fire with three hatched eggs which are nothing but three baby dragons. The death of Robert Baratheon makes one of the hated conclusion's the iron throne has seen by Joffrey Baratheon being the next in line for the throne, and lastly Ned Stark's revelation of an incest relationship between Jaime and Cersei Lannister and their three children (Not from Robert Baratheon).
Season 2: Season of the Lannisters
Major Deaths:
Renley Baratheon, Robert Baratheon's brother – One more brother who gets killed in an anonymous way by an evil smoke monster.
Starks with being scattered now, the show gives us a shift from the righteous family to the most powerful family 'The Lannisters' who are the owners of Casterly Rock. Power is what drives them. You also get aquatinted with the battles of the Baratheon brothers and cruelty of the Greyjoys.
Season 3: Where love dies with your favorite characters dying!
Major Deaths: Rob Stark, Talisa & Lady Stark killed at the Red wedding by the house of Freys!
The season that actually stabbed everyone's heart. Rob Stark's gets into all the more worse circumstances when Lady Stark refuses to release Jamie Lannister. Then the Red event occurs with killing everyone you love. Theon Greyjoy gets pushed into insanity by Roose Bolton's bastard.
Season 4: This is where Justice reigns
Major Deaths: The oldest Lannister gets killed by his dwarf son Tyrion Lannisters, Iron throne claimed by Joffery was poisoned at his own wedding and Lysa Arryn sister of Lady Stark gets pushed out of moon door by Little Finger (Petyr Baelish).
This season served justice to major characters who died and also showcased death of major characters. Characters are met with the disastrous fate. Tyrion Lannister uncle of Joffrey Baratheon has forced a trial for a crime he didn't commit.
Season 5: When Jon Snow died and the world stopped breathing!
Major Deaths: The Baratheon family comes slowly to an end when Stannis Baratheon is killed by Brienne of Tarth, Shireen Baratheon killed by her own father's blind faith on a witch and Selyse Baratheon hanged herself seeing her daughter being tortured to death and Myrcella Baratheon poisoned to death. Meanwhile Sansa Stark is on a run after being sold off to the bolt-ons.
Season witnesses fall of the house of Baratheon with Starks trying to get back on their feet.
Season 6: You finally get hold of everything you ever wanted and oh yes Jon Snow is ALIVE!
Major Deaths: Roose Bolton (gets what he sowed and is stabbed by his own son Ramsay Bolton). The north comes for the house of Frey when Arya Stark slits the throat of Walder Frey. While Cersei Lannister blows the scepter killing the house of Tyrell. Baratheon clan comes to an ill ending when the last Baratheon King Tomen jumps out of the window.
Season 7: The Night King destroys the Wall!
White walkers & guards of the wall get into a heavy battle and get outnumbered. Daenerys Targaryen comes to the rescue but the Dragon is hit by the Night King and the Dragon wakes up with a blue eye. Jon Snow labeled as bastard is not a bastard anymore but he is the Mad king's Son Aegon Targaryen. Daenerys and Jon Snow get into an intimate Moment while Cersei Lannisters gets pregnant and Jamie Lannister leaves for the North.
So how did you enjoy the recap of all the episodes and all the seasons? All the characters have jumbled up inside your head? Well, re-read the article once again and it might make better sense to you. I hope you have a great time watching the next season. Oh, wait! Did you know that this season doesn't have 10 episodes but only has 6 episodes? Well, don't be disappointed because the makers have extended the duration per episode. So you now are going to enjoy this gripping tale for a little longer till you die time and again waiting for the next episode.
Before signing off, here is something that I want to tell all you Game of Thrones fans – Winter Is Coming.
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Containing the single family Peripatidae, now divided into about four genera. A single specimen is on record from Sumatra, and Mr. H. N. Ridley informs me. That the Skeat expedition recently obtained it in the Malay Peninsula. This very interesting animal has somewhat the general external appearance of a caterpillar it has a pair of antennae, and in the Sumatran Specimen 24 pairs of legs (t. Sedgwick, Cambridge Nat. Hist., vol. V, 1895, p.
of Sir James Brooke, K.


Lola Berry: My name is Lola Berry, I'm a nutritionist, author and yoga teacher. I'm a health nerd, love nature and believe that dreams do come true.
Lola Berry: Well, I'm a nutritionist. So, I'm often writing recipes or working on some form of health content. I work in media, so sometimes I'm talking on TV about health or radio. but I'm often testing a recipe or doing yoga!
Times of Youth: What sparked your initial interest in becoming Nutritionist?
Lola Berry: I went on a summertime detox as I just wanted to shed a few kilos. Then I realized how awesome you could feel when you eat real food, and that's how my interest sparked and then I was reading about whole foods any moment I got!
Times of Youth: When were you most satisfied/dissatisfied with your work?
Lola Berry: For me, I try to only do things that I love. I believe in finding a "flow" because that's when time stops. So you're doing what you love so much, that the time doesn't matter. I try to live in that space as much as possible, and I feel very lucky that I do.
Lola Berry: I was 20 when I started studying nutritional medicine, yes everyone has been super supportive. Dad always made sure I had enough money for textbooks!
Times of Youth: On a scale of 1-10, how would you rate yourself as a Nutritionist, honestly?
Lola Berry: That's a tricky question. I love what I do so I'm happy leaving it at that.
Times of Youth: Times of Youth: If not this, what else would you have taken up as your 2nd career of choice and why?
Lola Berry: Hmmm… I love nature and animals and my Dad's a vet, so maybe an I'd be a zoologist?
Times of Youth: Do tell us how has your experience has been in your current field so far.
Lola Berry: It's been great. I work mainly in media so there are often setbacks, but I find that even more inspiring in a weird kind of way. I love that.
Lola Berry: Well, I used to be a DJ. So I'm a huge music fan. I would love people to ask me about what music I love. I love all music but I have Oliver Tank, Chet Faker, Dead mans bones and Lisa Mitchelle on repeat at the moment!
Lola Berry: I loved filming and working at West Harlem soup kitchen in New York, it was a very humbling experience. I've loved filming in Hawaii and working with food heroes in London. I feel very lucky but the stuff I love most is working with the souls who inspire me.
Lola Berry: Living the dream. In whatever form that is. I love spreading the health message through media and books, so I'm looking forward to seeing that grow.
Lola Berry: Have the courage to live your dreams, you're the only person who can get you there and you're the only person who can stop you.


Over the last six months, our lives have taken twists and turns. God has given grace and sometimes I reach out and take it, while other times I reject his goodness and instead, edge closer to that deep pit called Self Pity.
A cycle of sleepless nights, tears, doubts and anxieties have hit me like a ton of bricks. I have spent more time in the Word and prayer, even when it seemed pointless. I have rejected real feelings that I knew weren't true, but feelings that threatened to destroy the sound mind I've been promised, nonetheless.
I've cried out to God, remembered that His Word sustains and asked others to hold me up in prayer. And I think that is so very important. To admit weakness and frailty isn't glorying in sin or making light of the grace of God. It is giving others the opportunity to bear burdens. To weep with those who weep. We don't give others a true picture of gospel grace if we never allow others to see that we too have issues and that we must hold to an anchor. Why would there be any need for an anchor if we could hold steady all on our own? The treasure we have in jars of clay is to show the surpassing power "belongs to God and not to us."
So I am here today, to do just that. No blog, no book, no human being however wise, can anchor our souls but Christ Jesus, especially when seasons change, afflictions arise or the soul is downcast. And what's more--we must remember that we battle not with flesh and blood.
This morning, my husband sent me this quote below. Since "there is nothing new under the sun" I know there are others of you out there who may need this good word too. And Kevin added some thoughts at the bottom as well, so please read to the end. (He said I could include it if I didn't make him sound like a better man than he is, in this blog post. So I tell you, he is not perfect, but his love and understanding, and bearing with me as a weaker vessel, has encouraged me so greatly today).
"Since the first hour in which goodness came into conflict with evil, it has never ceased to be true in spiritual experience, that Satan hinders us. From all points of the compass, all along the line of battle, in the vanguard and in the rear, at the dawn of day and in the midnight hour, Satan hinders us.
If we toil in the field, he seeks to break the ploughshare; if we build the wall, he labours to cast down the stones; if we would serve God in suffering or in conflict- everywhere Satan hinders us. He hinders us when we are first coming to Jesus Christ. Fierce conflicts we had with Satan when we first looked to the cross and lived. Now that we are saved, he endeavours to hinder the completeness of our personal character.
You may be congratulating yourself, "I have hitherto walked consistently; no man can challenge my integrity." Beware of boasting, for your virtue will yet be tried; Satan will direct his engines against that very virtue for which you are the most famous. If you have been hitherto a firm believer, your faith will ere long be attacked;if you have been meek as Moses, expect to be tempted to speak unadvisedly with your lips.The birds will peck at your ripest fruit, and the wild boar will dash his tusks at your choicest vines. Satan is sure to hinder us when we are earnest in prayer. He checks our importunity, and weakens our faith in order that, if possible, we may miss the blessing.
This made me think of your labors here at home. Anything worthwhile for the kingdom of God will be opposed. Thankfully we have the encouragements of scripture to spur us on. Galatians 6:9 '"let us not grow weary while doing good, for in due season we shall reap, if we do not lose heart." 1 Corinthians 15:58 "therefore my beloved brethren be steadfast, immovable, always abounding in the work of The Lord, knowing that your labor is not in vain in The Lord. "
The Lord is your help. He takes your efforts performed in faithfulness and multiplies their effectiveness for His own glory. You may not see fruit of your labors now, but in time, there will be a season for reaping. Remember, God is not mocked, for whatever a man sows, that he will also reap. I love you. Will pray the joy of The Lord will be your strength today.
Used with permission by Bambi Moore at In the Nursery of the Nation.
Wow. Beautiful -- and powerful. I really love those examples of how Satan attacks our strongest points. I've always thought about how he pushes us on our weaker points -- it's an easy win. But I see the truth in this, too. If he can get us on our "strong" points... wow. He feels he really has something to boast about then, doesn't he?


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The Imperial Debris of War
by Stephanie Savell and Tom Engelhardt Posted on September 20, 2019 September 19, 2019
Originally posted at TomDispatch.
Today's piece by Stephanie Savell, co-director of the invaluable Costs of War Project at Brown University's Watson Institute, goes hand-in-hand with the release of a new report by that very group, "The Human and Financial Costs of the Explosive Remnants of War in Afghanistan." You can read the report itself by clicking here.
Just in case you hadn't heard the good news, the last man from the president's foreign policy "team" still standing, Trump whisperer Secretary of State Mike Pompeo, recently left National Security Advisor John Bolton in the dust. Bolton, who was axed or resigned, depending on who's telling the tale, can now write his memoirs (Wars I Meant to, But Never Got to, Fight), while raising money for Republican congressional candidates who are eager to start yet more conflicts across the planet.
Even before the abrupt cancellation of, and imbroglio about, Trump's invitation to Taliban leaders to visit Camp David, which evidently precipitated Bolton's hasty departure, Pompeo had some genuinely good news to offer Americans about their 18-year-old war in Afghanistan. Not that it's over, of course, not yet, but that we've essentially won anyway! (Feel free to start chanting "USA! USA!" now.) Or rather, to quote the secretary of state, we "delivered" big time in that country and so have been highly "successful" in our mission there! As he put it in early September, "If you go back and look at the days following 9/11, the objectives set out were pretty clear: to go defeat al-Qaeda, the group that had launched the attack on the United States of America from Afghanistan. And today, al-Qaeda… doesn't even amount to a shadow of its former self in Afghanistan."
So victory at last, not just over John Bolton but over al-Qaeda, too! Forget that al-Qaeda offshoots have sprouted and thrived from Africa to Syria, Yemen to Afghanistan in the course of the never-ending wars that began with the Afghan invasion. Forget as well that the American war there, particularly in the air, intensified in recent months amid peace talks – above all, the war of bombast in which Pompeo (like the president) recently bragged that we were hitting the Taliban big time, even as Trump declared peace talks with that movement's leaders "dead."
"In just the last 10 days alone," Pompeo said proudly, with an evident urge to revive the Vietnam-era body count, "we've killed over 1,000 Taliban." Such bragging aside, the Afghan War is not only the longest in our history and getting longer by the day, but obviously a lost war as well. And while the president is still pondering the withdrawal of about 5,000 American troops from Afghanistan (putting U.S. forces more or less back where they were when his generals convinced him to send in 4,000 troops in mid-2017), military figures, active and retired, continue to promote an American presence there into eternity and the media continues to raise fears of a "premature" withdrawal from that country. All of this may seem perfectly normal in the age of Trump, but looked at another way, as TomDispatch regular Stephanie Savell, co-director of the Costs of War Project, does today, it also couldn't be sadder. In part, this is because, given the ordnance the U.S. has already expended in that country, the war there may never end for many Afghans. But let Savell explain. ~ Tom
Why Ending the Afghan War Won't End the Killing
By Stephanie Savell
I've never been to Afghanistan, but I am the mother of two young children. So when I imagine what life must be like there after 18 years of war, my mind conjures up the children most vividly – the ones who have been affected by the conflict – and their parents. I think of the 12-year-old boy who was carrying water to a military checkpoint in a remote part of that country, earning pennies to help sustain his family, whose legs were blown off by a landmine. Or the group of children at a wedding party, playing behind the house where the ceremony was taking place. One of them picked up an unexploded shell, fired from a helicopter, that hadn't detonated in battle. It blew up, killing two children, Basit and Haroon, and wounding 12 others. What must it be like to care for a five year old – the age of my oldest child – who is maimed and who needs to learn how to walk, play, and live again with ill-fitting prosthetics?
A major legacy of the U.S. war on terror in Afghanistan, which began in October 2001 and shows little sign of actually ending anytime soon, will be the "explosive remnants of war" – a term for all the landmines and unexploded bombs and other weaponry that have been left behind in the earth. This debris of America's endless war, still piling up, is devastating in many ways. It makes it so much harder for an agricultural population to sustain itself on the land. It wreaks havoc on Afghans' emotional wellbeing and sense of security. And it poses special hazards for children, who are regularly injured and killed by the left-behind explosives of an already devastating war as they play, herd livestock, or collect water and firewood.
Given the expected drawdown of American troops in Afghanistan – despite the recent breakdown in peace negotiations with the Taliban, President Trump continues to indicate that he may pursue such a path – and the possibility of an official end to the U.S. war there, this topic is both pressing and relevant to public debate in America. Offering aid and reparations for the horrific ongoing costs of explosive military waste should be a priority on Washington's future agenda.
"The Human and Financial Costs of the Explosive Remnants of War in Afghanistan," a new report issued today by the Costs of War project, which I co-direct, at Brown University's Watson Institute for International and Public Affairs, offers a sense of the scale of the damage in Afghanistan. According to the report's authors, Suzanne Fiederlein and SaraJane Rzegocki of James Madison University, at least 5,442 people have been killed and 14,693 people have been injured by devices embedded in or left on the ground since the start of the US-led war in 2001.
Of those victims, the great majority are boys and men. A casualty analysis by the Danish Demining Group in 2017 suggested that boys are particularly vulnerable because of their day-to-day activities and chores, but women and girls, too, are increasingly becoming casualties of unexploded ordnance, particularly when traveling. In 2017, the United Nations Mission in Afghanistan expressed concern about a "65% jump in the number of children killed or wounded by explosive remnants as fighting has spread to heavily populated civilian areas."
The U.S. has provided significant financial support for humanitarian mine-clearing programs in Afghanistan. In recent years, however, that funding has been dropping. According to the United Nations Mine Action Service, Afghanistan has made some genuine progress toward its goal of freeing itself of landmines and other unexploded debris by 2023. Yet international financial support for such activities has dropped to 41% of what it was in 2011. Even if the Afghan War truly ended tomorrow, a sustained commitment of financial aid over many years would be necessary to clear that country of all the ordnance sewn into its soil as a result of the last 18 years of America's war.
A Legacy of War
The new Costs of War report reveals that the leading weapons causing such damage have changed over time. Even before 2001, when the U.S.-led coalition invaded Afghanistan, that country stood near the top of the list of those afflicted by abandoned landmines. The devices remained from the 1980s conflict between the Soviet Union and extremist Islamist rebels, the mujahedeen, backed by Washington and funded and supported by the CIA.
In the wake of the Soviet withdrawal from Afghanistan in 1989, international and Afghan clearance groups worked hard to clean up those minefields. Their efforts were, however, often thwarted by brutal new conflicts, including an Afghan civil war from 1992 to 1996 and the period from 1996 to 2001 in which the Taliban largely controlled the country. Still, over the past few decades, such groups managed to remove two million pieces of unexploded ordnance.
As the latest data indicates, landmines from the Soviet conflict have still been causing 7% of remnant-related casualties since 2010. Most of those hurt by explosive ordnance, however, are victims of the ongoing, complex armed conflict that emerged from the U.S.-led invasion – that is, a range of weapons used and left behind by American forces, Taliban fighters, and Islamic State-affiliated groups. These include grenades, projectile weapons, mortars, cluster munitions, and large bombs that failed to explode as intended, but are still live and prone to going off if touched or moved at a later date. Taliban and ISIS militants are also increasingly relying on improvised explosive devices (IEDs) set off by someone stepping on them or otherwise unwittingly activating them. If not triggered at the time of battle, they can kill or injure civilians long after, even in areas in which there is no longer active fighting.
Since 2015, casualties from explosive remnants of war and abandoned IEDs have been rising rapidly. One reason is an increase in fighting between the U.S.-backed Afghan National Security Forces and both the Taliban and ISIS, as well as intensifying conflict between these extremist groups themselves. According to report author Suzanne Fiederlein, improvised explosive devices are growing more common in Afghanistan and other conflicts across the Middle East, partly thanks to the Internet, which has spread knowledge of how to build them. Such information, she writes, is "commonly available now, not just on dark-web sites. Such knowledge is also linked to the manufacture of more sophisticated and complex devices, such as anti-handling devices (booby traps)."
In addition, since 2017, the U.S. has dramatically increased its airstrikes against the Taliban and other militant groups in Afghanistan, while the Taliban itself, as it gains ever more territory, has expanded its attacks on government targets as well as on Afghan and international security forces. In the past year, as U.S. and Taliban officials have engaged in peace talks, both sides have only ramped up their aggression further, assumedly in order to strengthen their hands in the negotiatons.
Finally, in recent years, as the American-led coalition has closed down bases in advance of a prospective U.S. military withdrawal, more and more Afghans have died or been injured by military waste exploding in abandoned areas once used by international security forces as firing ranges. From 2009 to 2015, the United Nations recorded 138 casualties from explosions in or around such former training facilities. Seventy-five percent of those victims were children.
Living with Explosive Military Waste
It's important to grasp just how long explosive remnants of war can remain active in a landscape after a conflict ends. If uncleared, they pose a danger to people living nearby or passing through for generations. In Belgium, for instance, more than a century later, significant numbers of explosive shells are still being removed from former World War I battlefields. Many countries struggle with this problem, including Bosnia-Herzegovina, Colombia, Korea, Laos, and Vietnam, but Afghanistan has been one of the hardest hit.
As of 2018, roughly 1,780 square kilometers of that country are considered contaminated by military waste. As the Costs of War report points out, this is "roughly ten times the area of Washington, D.C., but spread across a country almost as large as Texas." Danger zones include farms and grazing land, roads that people regularly use to get to markets, schools, and hospitals, and lands surrounding militant strongholds, allied military bases, and those former firing ranges.
From the research I've done, it's clear why people continue to use such contaminated lands. At the most basic level, it's a story of inequality. Many Afghans undoubtedly know which areas pose a threat. In addition, risk education programs have made progress in getting teachers, midwives, and police officers to spread awareness of how to recognize and avoid such dangers. However, poverty often forces Afghans to make terrible and terrifying decisions about the risk of injury and death.
Dilemmas of this sort are commonly faced in places marked by such legacies of conflict. Anthropologist David Henig, for instance, describes how rural villagers in the Bosnia-Herzegovina highlands still knowingly enter contaminated forest areas to gather firewood. For them, living with the danger of landmines left over from the Bosnian War of the 1990s is a matter of economic survival. Many Afghans face a similar plight. I can only suppose that the boy who stepped on a landmine while carrying water for soldiers would not have been earning money in that fashion if his family had any other way to scrape together an existence.
While people learn to live with the presence of explosive waste in their landscapes, doing so exacts a grim toll. Imagine the fear and emotional distress you might feel at merely passing through places where a misstep could kill you, no less your children. Henig recounts how one Bosnian woman, returning from a mined part of the forest where she had filled her wagon with wood, broke down and cried, yelling feverishly, "Why, why do we have to do this?"
In Afghanistan, the Costs of War report points to the "deep psychological impact" of such long-lasting contamination: "For Afghans, the fear of being harmed by these weapons is magnified by knowing or seeing someone injured or killed." People are terrorized and traumatized by the threat of explosions, and this continuous sense of foreboding must create an undertone of anxious melancholy that runs through every minute of the day.
Then there are the thousands of Afghans who live not only with the fear of such explosions, but also with the need to rebuild their lives after being maimed by one. The International Committee of the Red Cross (ICRC) physical rehabilitation program in Afghanistan manufactures over 19,000 artificial legs, arms, and other orthopedic devices each year. Groups like the ICRC and Handicap International post photos of children on their websites as they are being fitted with and trained to use prosthetic legs. In one, a boy of no more than five looks bleakly at the camera, his hands resting on two parallel bars at his sides, the stumps of his legs settled uncomfortably in new plastic devices. In another, Nilofar, a young woman in a wheelchair, prepares to shoot a basketball; hers is a remarkable story of recovery, of moving from complete paralysis, after a back injury due to an explosion, to partial mobility. Today she works for the ICRC's Kabul Orthopedic Center as a data entry operator, a job that has given her an income, a sense of purpose, and renewed hope.
The United Nations Mine Action Service has called for more long-term support for survivors of such wounds. They need such care to learn to walk on and use prosthetic limbs, as well as to deal with the depression and other psychological effects that accompany such injuries. According to the ICRC, they also require "a role in society and to recover dignity and self-respect." All of the more than 800 staff at the seven ICRC orthopedic centers across Afghanistan are former patients. But there are thousands of others and no one can doubt that, in a war seemingly without end, there will be thousands more.
Imperial Debris and U.S. Responsibility
Scholars have called landmines and other explosive remnants of war "imperial debris" – the detritus, in particular, of imperial America and its expansive global military footprint, including its forever wars around this planet. Even if U.S. troops are finally withdrawn, as Afghans encounter such debris from the war on terror and find their lives eternally shaped by it, the association with the American project in their country will remain alive for years into the future, as such weaponry keeps right on killing. In the process, it will undoubtedly seed hatred of the United States for generations to come.
Sadly, American funding for the humanitarian mine-clearing program in Afghanistan has been in decline since 2012. Afghanistan today has some of the best-trained demining technicians on the planet, but the scale of the problem is massive and the money available for it far too modest. The very goal of achieving mine-free status by 2023, a project once expected to cost $647.5 million, is likely unattainable, even if the fighting ends, because funding targets have fallen so far short of being fulfilled.
The U.S. has been the single largest donor to that program, making $452 million in contributions since 2002. Since 2012, however, it's been another story, as Washington has dispatched much of its funding and resources for such programs to Iraq and Syria instead. In fiscal year 2018, the Mine Action Programme of Afghanistan raised just $51 million of its $99 million funding goal and only an estimated $20 million of that came from Washington, less than half what it gave between 2010 and 2012.
Americans have an obligation to clear explosive hazards in that country, a large portion of which are of U.S. origin. Given the taxpayer dollars Washington has already spent on or committed to the war on terror through fiscal year 2019 – $5.9 trillion, according to the estimate of the Costs of War project – what it's donated to deal with imperial debris in Afghanistan is scarcely more than a drop in the bucket. A multiyear funding commitment to clear the explosive remnants of the war on terror there would be one small way to carry out a tiny portion of America's responsibility to the Afghan people after so many years of destruction.
Someday, Afghanistan stands every chance of becoming America's forgotten war. The conflict will be anything but forgotten in that country, however, and therein lies one of the saddest stories of all.
Stephanie Savell, a TomDispatch regular, is co-director of the Costs of War Project at Brown University's Watson Institute for International and Public Affairs. An anthropologist, she conducts research on security and activism in the U.S. and in Brazil. She co-authored The Civic Imagination: Making a Difference in American Political Life.
Follow TomDispatch on Twitter and join us on Facebook. Check out the newest Dispatch Books, John Feffer's new dystopian novel (the second in the Splinterlands series) Frostlands, Beverly Gologorsky's novel Every Body Has a Story, and Tom Engelhardt's A Nation Unmade by War, as well as Alfred McCoy's In the Shadows of the American Century: The Rise and Decline of U.S. Global Power and John Dower's The Violent American Century: War and Terror Since World War II.
Copyright 2019 Stephanie Savell
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Jack Straw Farm Currently uses Godfrey Brothers Butcher Shop for our butchering needs. They are a USDA inspected facility and are located in Loganville Pennslyvania. 7137 Susquehanna Trail, Loganville PA. 717-428-1602.
See our beef page for more information on our grass fed beef.


Search engine marketing is a selection of webpage aspects and activities that can increase rankings in lookup success. Research engines test to figure out what the internet pages are about and how appropriate they are. Research engine optimization begins with key word study and opposition investigation and then continues with website page preparing and advertising. Backlink developing is an vital element of Web optimization and getting great internet pages for hyperlink alternatives is not effortless. But the most crucial portion of Search engine optimisation is monitoring of website page positions. If you can not see any enhancement in position then all the Search engine optimization attempts are a finish squander of time. The summary is incredibly easy–you have to have proper resources.
This ought to generally be the very first step in any Website positioning task.
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You have to have to obtain key terms or search phrases that have large research volume, small competition and some industrial value. There are some freely readily available tools that can assistance us to find appropriate keyword phrases. One these types of instrument is the Google AdWords Key phrase Device. This resource is superior if you have almost nothing to start out with but for genuine get the job done it simply just does not present adequate info. You need a resource that will present not only search phrases and research quantity, you want also info about opposition and possibility to eliminate if not unsuitable key terms.
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The expansion opened up the possibility of incorporating significant new commercial routes to the port, given that it can accept larger vessels.
The expansion of the navigation channel is the most significant project carried out at the Port of Salina Cruz for several decades, given its relevance and the size of the investment. A total of 115 metres of the existing breakwater were cut away, and 165 metres of new breakwater were built in order to deepen the harbour from a bottom depth of 80 metres to 120 metres, and thus allow access by larger vessels than previously, as well as the installation of appropriate lighting for the area.
This expansion makes it possible to open up nighttime operations and improve the safety of the vessels, enabling the port to be integrated into new significant commercial routes and attract new market segments in foreign and domestic traffic.
Dry dock and lay-up berth, built on land reclaimed from the sea, the first infrastructure of its kind in Mexico.


Actually if you want to charge the paypal fees to the customer you should say NO there. "Charge for the paypal extra fees " "charge_paypal_fee"
This setting is a bit confusing. and at first glance it seems backwards.
I understand the above to mean: "set it to YES if you want to pay for the charges and NO if you want the customer to pay for it."
the spelling should be "Activated" and "assume".
"YES if you want to charge the paypal fees to the customer"


In Australian Aboriginal culture, all birds were once people. Stories about a particular bird species vary across Australia and are a part of Aboriginal cultural knowledge, reflecting their ties with the land. This paper investigates the stories of three birds that are widely distributed across Australia (Emu, Australian Bustard and Willie Wagtail) and incorporated into Indigenous culture. It examines similarities and differences amongst the stories and whether the patterns of knowledge reflect geographic distance between language groups, recorded trade routes or other influences.


If you read my Huda Beauty liquid lippies review you might have noticed the sneaky side note I wrote at the end comparing hers to the Girlactik liquid lipsticks…what I didn't write in that side note was that the Girlactik ones are 100 times better!
MY ALL TIME FAV, TOP, #1, BESSSSTTTESSST liquid lipstick brand is Girlactik…their liquid lipsticks are simply the best.
I own so many liquid lipsticks but they just don't live up to the standard set so high by the quality of Girlactik liquid lipsticks.
There's not much to say expect go check my lip swatch video* of the shades I own and pick the colors you like and BUY THEM IMMEDIATELY!
* Click here to see my lip swatch video on insta!
This wasn't a detailed review…I wouldn't even say a review per say…it's more like a guuurrrllll go getttt it noowwww if you ainnn't got it!


To ease the work of locating their neighbouring shisha lounges, Shisha local has listed down best of all the shisha lounges of India and abroad.
Shisha Local, established in 2017, has gained much of reputation within the short period. Their idea of listing all the shisha lounges was to make the public get the proper information of their requirement. Apart, from that they even sell shisha products which are not available easily in India.
With Shisha Local, fast and wondrous navigation system, anyone from anywhere can locate his/her shisha lounges within minutes. Moreover, one can also search by locating the lounge in 100kms by their radius filter.
Shisha lounges ideal for couples.
Shisha lounges that offer food.
Owner's View: Karan, the founder of Shisha Local is die hard shisha lover. Being a Shisha lover, he looks out for places where he can get best quality shisha, which of course takes a load of time as there is no site or app where anyone can locate only neighbouring shisha lounges. So, to solve this problem, Karan and his team came up with an idea of making a website that covers all the shisha lounges of India and rest of the world. In Shisha Local, they have listed all the shisha lounges of every city.
And they are also planning to cover other countries shisha lounges such as UK, USA, Aus, UAE, Germany, France and more.
Connect with them on other social media channels to see their latest posts and news.


(1) Get folks outside -- up close and personal to the habitats, trails, & rivers we work so hard to protect.
(2) Create space(s) for individual and families in our community to interact with each other and develop healthy relationships focused around our environment.
(3) Provide a casual and fun learning environment to foster natural curiosity in our local habitats.
Our first hike will feature Bill Stangler, Congaree Riverkeeper, as he guides us along the Timmerman Trail. He'll be talking all things river-related, as well as pointing out indigenous plants, insects, and animals that support our river habitats. In addition, he'll have SPOOKY historical lore to share about the specific trail/area we'll be hiking.
About the Timmerman Trail: The Timmerman Trail trail is paved, and for our specific hike, will be about 2.5 miles total. This is considered an easy/less-strenuous hike, and the trail is stroller & wheelchair accessible. The trail itself runs along the Congaree River as well as Congaree Creek, along the outskirts of Cayce near I-77 & SCANA headquarters. It is part of the Cayce Riverwalk and begins just west of the 12th street extension. Parking is abundantly available.
Bring: comfortable clothes, walking shoes, and water if you need it.
Note: there are no public restrooms at this site.


High energy storage in low profile SMT package (0.150" / 3.81mm).
Low EMI, self-shielding toroid based magnetics.
Pins: 100% matte Sn over Ni plating over brass.
Feet available to RoHS reflow temps.
Solder-foot bond quality and wetting can be viewed after reflow.
Parallel DCR = DCR per winding / Series DCR = DCR per winding x 2.
Max. current measured at 25˚C, 20% inductance roll-off. Above 85˚C operating temp., max. current is reduced.
Plots of Inductance vs. Current available for all above parts. Contact BH.
T&R available: 1,000 per 13" reel; 250 per 7" reel. Smaller quantities shipped in JEDEC trays.
Highlighted part numbers are standard products. Others are available as non-standard parts with longer lead times.
Max. current measured at 25˚C. Max. temp and inductance values stable at high temps. Contact us for details.
T&R available: 1,250 per 13" reel, 250 per 7" reel. Smaller quantities shipped in JEDEC trays.
Cores have been tested at 200˚C for 10,000 hours with no harmful effects.
For above inductor/transformer values that can operate to 200˚C, see Page 23.


text:
One Salon
Awaken yourself
With a New Type of Community
Most men lead lives of quiet desperation and go to the grave with the song still in them.
-Henry David Thoreau
What is One Salon?
The One Salon is a social, cultural, intellectual gathering every week that focuses on engaging in stimulating scheduled talks and wonderful ad hoc conversations with each other.
At its core, Salon is a weekly gathering with an open environment full of thoughtful, creative, and passionate people. But that doesn't begin to capture the energy of Salon.
Salon is a place to learn, to draw inspiration, and to be surrounded by doers and creators. It is a place to let our creativity run wild, to expose ourselves to new topics and new viewpoints, and to inject serendipity into each and every week.
With eight chapters and growing, Salon is also growing to become an international community around these values, so that a Saloner can visit any city and immediately have a community of people that hold our values important.
To many attendees, their experience at Salon has become an integral part of their week and even their lives. But whether someone comes every week or for a single evening, Salon is thought-provoking, fun, and provides a unique experience for every attendee.
What Happens at Salon?
Every night is unique and every night is memorable. Each week there are both regulars and new-comers, and everyone knows to expect the unexpected. We start the night by breaking reality, playing games taken from the improv world to loosen up and allow us to share a bit about ourselves.
Most Salons include a scheduled talk, on topics as diverse as Tango, Creativity, Healthcare, or Rhetoric. Some talks are meant to teach, some to create an experience, and some to inspire. All talks however, invite participation - either through activities, discussion, or thoughtful responses.
While Salon is planned around a talk, it is only a diving board - the real magic of Salon happens between the attendees. We create an open environment, bringing together a group of thoughtful, creative, and passionate minds - and we just let sparks fly.
How Salon Began
The original Salon was started in Palo Alto. Since then, we have spread to 16 cities, from San Francisco to NYC to Paris to Nairobi to Beijing.
Find chapter near me
Max Song
Max grew up in Beijing, Shanghai and Chicago, and studied machine learning and diplomacy at Brown University. He previously worked at NASA Ames on genetic engineering as a Teaching Fellow at Singularity University, co-founded Brown's first startup accelerator, and worked in Silicon Valley as Ayasdi's youngest data scientist.
In the last few years, he co-published a book on data science, modeled Citibank's 2015 Stress Test, stated a international, entrepreneurship-based high school summer camp in Shenzhen called Prometheus, and started the One Salon—an intellectual, emotional and experiential community that spread from Stanford to 12 cities around the world.
He's currently based in Beijing, and developing an interest in investing, global economics and politics at Schwarzman College, Tsinghua. In his spare time, he explores exponential technologies, the implications of AI in biotech, sustainability, and renewables.
Rafael Cosman studied Computer Science at Stanford University and did machine learning research at Palantir and Google Brain. When he's not working he enjoys swimming and blues dancing. He is now co-founding a startup in San Francisco.
Rafael was a founding member of the first Salon chapter, at Stanford, where he brought an indelible welcoming presence, rigorous science and the most delicious snacks to feed the intellect and bellies of the Salon. The "short talks", "boom volcano", "high fives" were all part of Rafael's creative contributions, and Salons around the world continue to build on his ground breaking endeavors.
Samanee Mahbub
Originally from Bangladesh, Samanee has now travelled to 24 countries. She's currently studying History at Brown, but that hasn't stopped her from exploring the works of Marx to financial accounting and everything in between.
She went on to work at Morgan Stanley but soon realized finance wasn't for her. Some called her crazy to leave a golden opportunity but instead, she created her own golden opportunity by leaving Brown for a year to explore and learn. Over the year she's worked in non-profits in LA, startups in Berlin and is now currently based in NY.
Her interests include storytelling, blogging, tech trends that can change the world, and finding what lights up your eye in a conversation.
If you thirst to rekindle that sense of curiosity, if you are tired of living a life of quiet desperation, if you want to find a chance to sing your song- send us a message using this form. We can't wait to hear from you and will respond as soon as possible!


Below are some hints and tips for you to use on the day.
Be positive: Keep smiling, make eye contact and be enthusiastic. People respond really well to positivity, and you'll have a much more fun day.
Don't be shy: Feel free to chat to people. Say good morning or good afternoon. You can ask them for a donation; just don't overdo it. If people want to talk to you about their experiences, talk to them.
Say thank you: And not just to those who give a donation. Thank people who have chosen not to donate at that time as they may well donate a later point.
Location, location, location: If you have a choice over where you can stand, then look for places where there are plenty of pedestrians – supermarkets, busy shopping precincts, near zebra crossings, etc.
Find your own space: Don't stand too close to your fellow collectors. You don't want to create a barrier or cause an obstruction.
Check the regulations: Your collection organiser will give you specific instructions for your area. Make sure you follow these and if you have any questions, don't hesitate to ask them.
Equipment check: You'll be given a tin to collect your donations in and a box to hold the crosses. If you need to empty the tin please do this into one of the grey bags provided and store in a safe place. Your collection organiser will be able to refill your box with crosses.
What to wear: Fancy dress is welcome – Believe it or not collectors raise a significant amount more when dressed up – even if it's just a wig or a hat! If you're outside make sure you check the forecast the day before. The essentials are a good pair of shoes and warm clothing but the rest is up to you. You will be given a tabard to wear over your outfit so don't worry about wearing specific colours or any branded clothing you may have.
Have fun: We want you to have a fun day and enjoy your day volunteering! Don't forget to take Take photos and share these online with #ImTheYellowCross.
If you have any additional questions please feel free to give our office a call on 0300 3045 999.


text:
1/43 2001 Jaguar Ford-Cosworth R2 - Luciano Burti
The Jaguar R2 was the car with which the Jaguar team competed in the 2001 Formula One season. It was driven by Eddie Irvine, who was in his second year with the team, and Luciano Burti, who had deputised for Irvine at the 2000 Austrian Grand Prix. However, the Brazilian was replaced by Pedro de la Rosa after only four Grands Prix.
SKUMAG KG21
Manufacturer: Jaguar
Model: R2
Team: Jaguar Racing
Driver(s): Luciano Burti
Series: Formula 1
Driver(s)
Luciano Burti


How medical debt and other collection items are tallied in a credit score is changing, potentially increasing the credit scores of millions of people.
Called the FICO 9, the new credit score changes how medical collections are treated from non-medical changes, such as credit cards. A medical debt will now damage a credit score less than paying a credit card bill on time, for example.
FICO 9 came out in 2014, but the improved credit scores could just now be coming to fruition for many consumers because it can take a few years for banks and other lenders to implement the new system.
The new FICO 9 score should give responsible borrowers better access to credit and lower rates on existing credit once the changes are accepted by the industry.
Part of the thinking behind the changes is that for many people facing medical debt collections, it isn't something they have a lot of control over. People get sick or are in an accident and can't control how high their medical bills are, and may not even know that their medical debt is in collections.
More than 64 million Americans have some kind of medical collection record on their credit reports, according to Experian, a credit bureau. Almost all medical debts are reported to credit bureaus by collection agencies.
The FICO score is the most widely used credit score in the country, and is used by companies selling mortgages, credit cards, personal loans and more.
Another change with FICO 9 is that older collection items will have less impact on a credit score. Other types of debt that are sold to a collection agency—such as an unpaid utility bill or phone bill, school loan or rent—can still be reported to a credit bureau, but older collections will have less impact on a credit score. If the collection item is paid back, the score will improve.
I hope you found this real estate information helpful. Please contact me for all your real estate needs today!


From concept to completion, turn to the professional design team at Orlys Draperies & Interiors Inc for timeless designs that reflect your style and needs. Our collaborative creative partnership with you results in an amazing transformation of your rooms and spaces. To learn about our outstanding Warranties, services, and more, contact us today!
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Veteran of WWII and Korea, and former prisoner of war. A public affairs expert who served his country for more than 30 years. Speaker, volunteer, farm boy, grandfather. Member of the Greatest Generation. Learn more about C.B. Perdue, Jr.
Hear from a member of the Greatest Generation with his story of survival in WWII to better understand why freedom isn't free. Click here to contact C.B. today.
See photos and videos of C.B. Whether he is speaking to a group, making a visit to a local news station, or going on an Honor Flight trip, he is happy to share his story with others.
C.B. is always on the go, so don't miss a beat. Check out what's new now. Click on C.B.'s blog here.