Busy Bees Nursery, Rawcliffe York. 01904 674762 - 10% of your fees. T's &C's apply. Free baby group every Monday.
Skelton Community Primary School 10% discount on Nursery fees for 3 to 4 year olds term time on self funded hours.
Skelton Community Primary School10% discount on wraparound care for Reception to Year 6. 07:30 to 8:45 and 15:30 to 18:00.


If you are interested in stamps and coins and you are visiting Madrid then make sure your stay over includes a Sunday. Why? Well simply because there is a marvelous Stamp and Coins market every Sunday morning in Plaza Mayor which is the city's main square.
For tourists it is an interesting way to spend a Sunday morning and for locals it has become a traditional meeting point. Plaza Mayor is a huge square covering around two acres and there are stalls on three sides so be sure to include it in your visit.
Jesusvico Old coins and archaeology items.
E-filatelia World stamps and collections for auction in Spain.
Galeria Filatelica Stamp auctions in Barcelona.
George Alevizos Our public auctions are world famous for containing a wide and diverse array of unusual rare stamps, proofs, essays, and postal history.
Philatino Lots of stamps for auction from all over the world.
Soleryllach Stamps, books, manuscripts and posters for auction.


A fraudulent 'nationalistic' front British First is a setup of the Jewish occupied Government. Using the mailing list of the BNP this party is merely a BNP clone. Again its members are flag waving little Englanders uplifted from the BNP and its activities include crying at the Jewish occupied Government to remove the Muslims they have imported.


South Africa's rand opened firmer on Wednesday, extending gains from the previous session as signs of softening U.S.-China trade tensions boosted risk appetite, while a jump in industrial output locally also spurred demand for the currency.
At 0635 GMT, the rand was 0.33 per cent firmer at 14.2700 per dollar from an overnight close of 14.3175.
U.S. President, Donald Trump, in an interview with Reuters, said talks were taking place with Beijing and he would not raise tariffs until he was sure about a deal.
The currency snapped a four-session losing streak on Tuesday, triggered by doubts over Britain's plan to exit the European Union (EU), and in early trade was near the 14.20 resistance level that has been a recent buy-target.
Focus in the local session is expected to be on November inflation data due at 0800 GMT as investors gauge the next interest rate move after last month's increase by the central bank.
Bonds inched firmer, with the yield on the benchmark 2026 paper down 1.5 basis points at 9.15 per cent.


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Quzan (, also Romanized as Qūzān; also known as Ozan and Uzūn) is a village in Golabar Rural District, in the Central District of Ijrud County, Zanjan Province, Iran. At the 2006 census, its population was 520, in 134 families.

References

Populated places in Ijrud County

redpajama_set_name: RedPajamaWikipedia


text:
Culture.si:Events/2014/Music/Czech Republic
upcoming (0)2018 (2)2017 (4)2016 (4)2015 (4)2014 (7)2013 (10)2012 (7)2011 (1)2010 (1)all years (40)
All countries Australia (1)Austria (34)Belgium (7)Botswana (1)Bulgaria (3)Canada (3)China (1)Croatia (16)Czech Republic (7)Denmark (2)France (10)Germany (25)Hungary (7)India (3)Italy (10)Japan (1)Kosovo (1)Lithuania (1)Macedonia (2)Montenegro (3)Netherlands (3)Norway (2)Oman (1)Poland (4)Romania (3)Russia (2)Serbia (6)Slovakia (2)South Africa (1)Spain (8)Swaziland (1)Sweden (1)Switzerland (6)Taiwan (2)United Kingdom (13)USA (16)
All categories Dance (2)Education (3)Embassies (9)Film (5)Literature (6)Music (7)Photography (1)Puppetry (3)Theatre (8)Visual arts (3)
Events in Czech Republic in 2014 for Music
Pianist Kaja Draksler at the 19th International Jazz Piano Festival, supported by the Embassy of the Republic of Slovenia Prague, at Cathedral of Saint Lawrence in Prague, Czech Republic
20 June to 21 June 2014
A screening of the documentary Fabiani:Plečnik, directed by Amir Muratović (Radio-Television Slovenia (RTV Slovenia)), a concert by Samebabe, and other events at the Slovene days of gastronomy and culture, supported by the Embassy of the Republic of Slovenia Prague, in Prague, Czech Republic
A concert by Baraka featuring Janez Dovč, Goran Krmac, and Nino Mureškič at Jazz Dock in Prague, Czech Republic
A concert by AirString Duo, supported by the Embassy of the Republic of Slovenia in Prague, at Grandhotel Pupp in Karlovy Vary, Czech Republic
17 April to 18 April 2014
Concerts by Laibach in the framework of the world tour promoting the release of the new album Spectre in Olomouc, Prague, Czech Republic
A concert by Cadlag at the Noise Fest 2014 at Boro Klub in Brno, Czech Republic
What if, a performance by Maja Delak, produced by the Emanat Institute and the City of Women Association for Promotion of Women in Culture, at Alfred ve dvoře theatre in Prague, Czech Republic
Retrieved from "https://www.culture.si/en/Culture.si:Events/2014/Music/Czech_Republic"

redpajama_set_name: RedPajamaCommonCrawl


text:
My Hero Academia Is Becoming a Battle Royale
Bandai Namco has announced My Hero Academia: Ultra Rumble – a new free-to-play battle royale game headed to PlayStation 4, Xbox One, Nintendo Switch, and PC via Steam.
My Hero: One's Justice followed in 2018 and its sequel – My Hero: One's Justice 2 – was released in 2020.
Prior to launch, My Hero Academia: Ultra Rumble will have a closed beta test for a select few to try out the game and some of what it has to offer.
My Hero Academia is no stranger to the video game world, and the franchise and its characters have appeared in various forms over the years, beginning with My Hero Academia: Battle for All for the Nintendo 3DS in 2016.


Items where Subject is "G Geography. Anthropology. Recreation > G Geography (General) > G3160 Globes"
Wardani, Weny Widha Kusuma (2014) UPAYA MENINGKATKANAKTIVITAS DAN HASIL BELAJAR SISWA MELALUI MEDIA SMART GLOBE PADA MATERIPEMBAGIAN PERMUKAAN BUMI DI KELAS IX SMP NEGERI 9 LANGSA TAHUN PELAJARAN2013-2014. Undergraduate thesis, UNIMED.
This list was generated on Mon Apr 22 20:32:01 2019 WIB.


text:
Q: How I can select data that is above the third quartile in a R-DataFrame I would like to select cases with values in some variables above the corresponding third quartile (3)
As my dataset is very large I am going to take as an example the 'Air Quality' database that comes in R.
df <- airquality[complete.cases(airquality),]

The objective was to filter by certain columns
('Ozone', 'Solar.R', 'Wind', 'Temp').
Currently I was able to develop this solution:
filtro_Ozone = df$Ozone>quantile(df$Ozone)[4]
filtro_Solar.R = df$Solar.R>quantile(df$Solar.R)[4]
filtro_Wind = df$Wind>quantile(df$Wind)[4]
filtro_Temp = df$Temp>quantile(df$Temp)[4]

df[filtro_Ozone & filtro_Solar.R & filtro_Wind & filtro_Temp,]

With which I obtain:
   Ozone Solar.R Wind Temp Month Day
40    71     291 13.8   90     6   9

Another fancier way to get this?

A: UPDATE: per OP's updated request, you can use filter_at from dplyr to only filter at selected variables:
df <- airquality[complete.cases(airquality),]
filter_at(df, vars(Ozone, Solar.R, Wind, Temp), ~. > quantile(., probs = 0.75))

redpajama_set_name: RedPajamaStackExchange


New emails show how Definers Corporation worked with Scott Pruitt's press office.
Newly obtained emails reveal that officials at the Environmental Protection Agency were misleading about the circumstances under which they hired a Republican opposition research firm known for its aggressiveness and willingness to sling mud. They also show the inner workings of a government press office hijacked by political operatives who adopted a combative attitude to the press, seeking to generate rosy headlines from sympathetic outlets while simultaneously lashing out at reporters and whistleblowers who criticized the agency, including by planting negative stories about them.
The EPA's hiring of Definers Public Affairs stood out in the staid world of government contracting, where any appearance of explicit partisanship of the kind the organization specializes in is studiously avoided. Definers' reputation as partisan and hyper-aggressive has recently helped embroil Facebook in scandal after it was revealed that despite trying to project an inoffensive and bipartisan image in Washington, the Silicon Valley giant had secretly hired the firm to disparage its Washington critics. The lines of attack included spreading supposed evidence showing that opposition to Facebook was fueled by liberal donor George Soros.
After Mother Jones revealed the existence of the EPA's $120,000 Definers contract in December 2017, the agency's press office fought back, claiming the contract had been awarded through the agency's Office of Acquisition Management after a competitive bidding process based solely on cost considerations. "The contract award was handled through the EPA Office of Acquisition Management and was $87,000 cheaper than our previous media monitoring vendor while offering 24-7 news alerts once a story goes public," then-EPA spokesman Jahan Wilcox told Mother Jones last year.
It is only one of the findings that appear in thousands of pages of internal EPA emails reviewed by Mother Jones that contradict the reasons Wilcox said the contract had been awarded. Moreover, the emails provide a detailed picture of how the Trump administration immediately and aggressively tried to realign the agency and route taxpayer dollars for partisan purposes. The campaign to undermine environmental enforcement and oversight at the EPA has not ended simply because Scott Pruitt and several of his staff have left the agency.
For the Trump administration, politicizing government practices is the norm. But the EPA, an agency that some conservatives, including Scott Pruitt, believe should be eliminated, has long provided a special window into how far the administration is willing to go to assert overt partisanship and override recalcitrant career staff in ways that alter the daily work of government.
Definers was one key piece of that strategy inside the EPA. The Virginia-based PR firm has worked for political and corporate clients alike—Marco Rubio's presidential campaign, the Republican National Committee, the United Arab Emirates, and America Rising PAC—promising them its "full-service war room," manned by Republican staffers who bring a unique approach of "intelligence gathering and opposition work." In fulfilling that mission, Definers was caught filing Freedom of Information Act requests for the emails of EPA career staffers who spoke out publicly against Pruitt.
Definers is linked to a deeply interconnected network of conservative political groups run by Joe Pounder, a former campaign staffer for Rubio who has been described as "a master of opposition research," and founded by Matt Rhoades, Mitt Romney's 2012 campaign manager. It lists the same Virginia address as the America Rising PAC and America Rising Squared, a nonprofit that has sent staff to ambush and film environmental activists like Tom Steyer and Bill McKibben. On its website, America Rising Corp.—a separate entity from American Rising Squared, which doesn't have to disclose donors—describes itself as "an opposition research and communications firm whose mission is to help its clients defeat Democrats." The news aggregator Need to Know Network (NTK), which purports to "work with partners and organizations to provide content that is unique and original to our audience," was founded by Pounder and other operatives and shares staff and offices with Pounder and Rhoades' other political entities.
Obtained by the Sierra Club from a FOIA request, the EPA emails show that the press office was interested in Definers and working with NTK from the start, disregarding the cost and concerns about the uncompetitive bid raised by career staff. While one group sought a $120,000 contract, another posted flattering coverage of Pruitt.
A former employee of the EPA's Office of General Counsel told Mother Jones that the "whole notion that the agency is using a group like Definers and [NTK] and manipulating the media coverage of its activities" in ways the public isn't aware of could have violated Congress' appropriations law prohibiting the EPA from using funds for propaganda and publicity purposes. "Somebody reads a story and thinks it's a straight news story, when in fact the agency is putting out misleading information that's very offensive and probably violates the Appropriations Act," the former staffer said.
Jahan Wilcox, a senior strategic adviser in its press office, came from the world of political operatives, working for Rubio's presidential campaign and the National Republican Senatorial Committee before being tapped by the EPA. Wilcox did not return a request for comment, nor did Definers or NTK. The EPA's normal operations have been affected by the government shutdown and also did not return a request for comment.
Shortly after he was appointed to the EPA in March 2017, Wilcox made his first contact with NTK. "With the 100 Days of the Trump Administration coming up, we were curious if Need To Know (NTK) news would like to report on the accomplishments of Scott Pruitt and the EPA?" he emailed Jeff Bechdel, communications director for America Rising PAC and managing editor for NTK the month he arrived.
When Pounder approached the EPA on May 19, he identified himself in the memo he sent to Wilcox pitching Definers as a potential vendor as the president of America Rising Corp. Wilcox and other political appointees immediately warmed up to the idea of hiring Definers, and they pushed EPA career staff to hire them. Career EPA staff raised concerns about the contract, including that it had not gone through a competitive bidding process, but the political staff dismissed those concerns and pressured contracting officials throughout July and August 2017 to complete the deal.
As the months dragged on without Definers being hired, Wilcox and other political staff repeatedly questioned career employees about the holdup. When told that the effort to hire Definers had slowed because the company wasn't even registered as a federal contractor and seemed reluctant to do so, Wilcox forwarded the explanation to Pounder. Shortly after, Pounder sent Wilcox a screenshot showing that the company was now officially registered.
"I don't care how this happens but we need to make this happen as quickly as possible," Wilcox emailed Hull in June. Hull replied at another point, "We cannot move forward without going through a competitive bidding process," including a presentation about the product. Wilcox at first dismissed the importance of a demonstration, saying, "I know the quality of their product." Pounder eventually spoke with a career staffer about the service.
Tiefer acknowledges that while there might have been a legitimate need for a clipping service, Wilcox or any other political staff should not determine the contracting requirements. Career employees are required to vet potential contractors, and Tiefer says he doubts that, given Definers' background in aggressive political opposition work, the company would have been chosen without interference from the political appointees.
"I have been teaching government contracting for over 20 years, and I have never seen a political operative firm getting a government contract," Tiefer says.
Wilcox also was in touch with NTK throughout this period. He emailed Bechdel about an exchange with Eric Lipton of the New York Times, who had reached out to the EPA to confirm details for a story in October 2017. The EPA responded with neither a confirmation nor denial, instead linking to other outlets. Wilcox then framed the story for NTK. "You can report that the New York Times is calling USA Today 'Fake News,'" he wrote. "Let me know if you are interested in this." Bechdel passed on the pitch.
As Definers and the EPA faced calls for an Inspector General audit and for a Government Accountability Office investigation, the EPA and Definers decided it wasn't worth the negative publicity. Five days after the report, and six months after Wilcox first advocated the contract, the EPA and Definers mutually agreed to cancel it. Definers said it would forgo contracts under negotiation with at least four other government agencies, including the Department of Education. By then, Pruitt's trickle of controversies—chartered and first-class flights, a private phone booth, a 24/7 security detail, blurred lines between campaigning and government business—were already becoming regular headlines.
When the mounting investigations into whether he exploited his government position for other gain became too much of a liability, Pruitt resigned from the administration and was replaced by Andrew Wheeler in July. The EPA press shop saw high turnover as well. Wilcox resigned within days of Pruitt's departure, and was most recently working for Wisconsin Republican Leah Vukmir's unsuccessful campaign to defeat Sen. Tammy Baldwin.
But others from Pruitt's time remain, and even though the EPA's media tactics may not be as aggressive as they once were, some of its earlier strategy still continues.
That was clear in late November, when the Trump administration released a thoroughly vetted National Climate Assessment, authored by 13 agencies including EPA scientists. Wheeler responded to the report with a dog whistle, arguing that he "wouldn't be surprised" if the Obama administration told the report's authors to only look at the worst-case scenario of global warming. The echo chamber kicked in: By the end of the day, the Koch-funded Daily Caller had supposedly proved Wheeler's point (in a story disputed by the report's authors), and the EPA blasted it out as a "Fact Check" news alert.


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Federal Agents Take Down Mail Thief Using GPS Tracking
POSTED October 10, 2018 by admin /
Everyone knows that mail theft is a very serious problem in the United States — but one recent study reveals that the issue may be a lot more severe than a lot of us realized.
According to an internal study conducted by the United States Postal Service, about 10,000 criminal suspects are arrested each year — many for mail theft or for the possession of stolen mail. The Postal Inspection Service responds to about 900 postal-related assaults and credible threats each year as well, which itself leads to hundreds of arrests from coast to coast. But the real shocker is the fact that roughly 3,000 new mail fraud cases are opened every year — pointing to a problem that seems to be getting worse over time.
In an effort to help curb this problem as much as possible, federal agents have used a series of increasingly sophisticated techniques to help make sure that this type of thing doesn't happen to you. Case in point: One suspected mail thief was recently arrested using GPS tracking technology in a situation that is absolutely worth keeping an eye on moving forward.
The Case of the Mail Thief and GPS: Here's What Happened
The aforementioned mail thief is a San Antonio man named Jared Lee Jeffries, someone who federal agents had been keeping an eye on for quite some time. According to the recently filed criminal complaint, a postal inspector actually got a federal warrant a few months ago that allowed him to insert a GPS tracking device inside a "dummy" package that was then shipped through the post office, the same as anything else. It had a valid tracking number and was accepted into the mail system like normal.
The package made its way through the system until it arrived at a USPS locker in Possum Tree, Texas. At that point, Jeffries did exactly what he'd always done: He stole the package using a series of counterfeit postal keys that he'd had made at some point in the past.
Jeffries actually thought he was being smart — he waited a full two weeks before he stole the package. But once that package began moving, federal agents were able to pinpoint its exact location using the GPS device hidden inside.
First, the package made its way to a nearby pizza restaurant. It eventually ended its journey about 2.5 miles away from its original location. When the police raided Jeffries home, not only did they find the package — they also found a pizza box from that exact same restaurant.
Interestingly enough, when police examined the USPS locker, they noticed that there was a blood stain on it and that it had clearly been tampered with. When Jeffries was arrested, the police also noticed that his knuckles were bloody — further proof that this was the man that they had been looking for.
It's also important to note that this is not the first time that Jeffries had been on the wrong side of the law. Earlier in 2018, his home was raided and police found illicit narcotics, 500 rounds of ammunition and other concerning items. When he was eventually charged, Jeffries – who was already a convicted felon long before any of this ever started — was hit with one count of possessing stolen mail and another of being a felon in possession of a firearm.
Jeffries, if convicted, faces up to 15 years in prison just for the federal mail theft case alone — to say nothing of how much time could be added to his sentence for the other charges, as well as for at one point a conviction of intoxicated assault and being in possession of a controlled substance.
In the end, let this be a lesson to all would-be postal thieves out there: It's just not worth it. Mail theft is not a victimless crime. It's very serious, which is why it immediately becomes a federal case. The next time you think you're being sneaky and are very close to getting away with it, you need to realize just how wrong you probably are.
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A 11 MW solar farm located south of Canberra in the ACT.
The Williamsdale Solar Farm is the largest of the Solar Income Fund acquisitions. It reached practical completion on 28 April 2017 and was purchased by the Fund on 5 May 2017.
The 11.2 MWp solar farm is expected to generate 21,091 MWh in its first year of operation.
Williamsdale has sun tracking technology to maximise generation from the site. Williamsdale is divided into two systems, so that the facility can participate in both the ACT's large and medium-scale feed-in-tariff schemes.
30km south of Canberra, ACT.
Logs salvaged from the construction of the Williamsdale Solar Farm were included in an initiative to help preserve native fish populations in the Murray Darling Basin, currently at or below 10% of pre-European settlement levels.
The Native Fish Strategy is an initiative of the Murray–Darling Basin Authority that aims to rehabilitate native fish populations across the basin to 60% by 2054 and to ensure sustainable fish populations and communities are present throughout the basin.
As part of this strategy, seven demonstration sites have been developed. One of these is the Upper Murrumbidgee Demonstration Reach (UMDR), which extends from west of Canberra down to NSW slightly south of the southern edge of the ACT. The UMDR aims to improve fish habitat and river health for native fish in the upper Murrumbidgee.
The logs salvaged from the construction of the Williamsdale Solar Farm will be used to create artificial 'logjam' fish habitats. These habitats are intended to assist native fish such as Macquarie Perch, Golden Perch, Murray Cod and Trout Cod as they move along the Murrumbidgee River.


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December 20, 2017 by benderwrite
Celling out cancer
As immunotherapies start to change clinical practice, we hope for more.
For a blockbuster drug, pembrolizumab comes with a strange history, nicely told here by David Shaywitz.
Pembro is a "checkpoint inhibitor", a biologic designed to take the brakes off T cells so that they can wipe out tumors. Back in 2014, it was the first drug that targets the PD-1 protein on the surface of T cells to get FDA approval. Also now known as Keytruda, pembro has received FDA green lights for many kinds of cancers. It accounts for billions of dollars each year and is in more than 500 clinical studies.
But it was born in a small Israeli biotech trying to develop treatments for autoimmune diseases by putting brakes on T cells (yes, the reverse of checkpoint inhibition). The small biotech that created pembro and realized it was a promising cancer drug candidate was soon bought by a larger pharma firm, which was then acquired by Merck & Co. As Shaywitz notes, the giant pharma shut down development not once but twice, before successful trials of other checkpoint inhibitors changed its mind.
Today pembro comes as a colorless liquid in a small IV pouch, looking very much like saline solution. It lists at around $50 a milligram, one case in point for the extremely real concern about how any country can pay for such drugs as they start to become standard of care.
You don't think about costs, however, if you're in a clinic as I was earlier this month, watching a friend with metastatic melanoma joke with the nurse hooking up his IV. You just hope the treatment works.
It's been a pleasure to edit this month's Nature Outlook on cancer immunotherapy. Many thanks to the outstanding authors, editors and designers who put it together! And to Elin Svensson, who created the great cover art above.
| Tagged biomedical research, cancer, cancer immunotherapy, cell therapy, immunotherapy | Leave a comment
Blossoms in biomedicine
The remarkable global push for cancer immunotherapies.
Editing a Nature special report on cancer immunotherapies, I'm struck most by the sheer scale of the development effort. Something like 3,000 clinical trials are underway, 800 of them combining treatments. The FDA has approved five checkpoint inhibitors, designed to unleash T cells against tumors. The agency seems close to approving the first CAR-T cell treatment, in which a patient's T cells are removed, reengineered to attack cancer cells, regrown in volume and returned to the patient. Old dogs of immunotherapies are learning new tricks. Some newer approaches are getting much attention—notably personalized neoantigen vaccines, in which individual tumors are sequenced to give clues on how to best target their unique sets of immune-system-alarming antigens. Some clinical trials fail, some do surprisingly well. The competition is more than intense and trials are not always carefully planned or analyzed. But the landscape is changing.
January 14, 2016 by benderwrite
Mooning cancer
Buzzing around Tranquility Base.
We can only applaud a big push to add resources for attacking cancer, but it's a mistake to call this newly announced federal initiative a moonshot. We won't land on the cancer cure moon in a decade.
Never mind what it says about our society that our only common metaphor for a large successful national effort is more than a half-century old. The metaphor doesn't work here.
The actual moon shot built on existing engineering. And the National Aeronautics and Space Administration created its infrastructure from scratch. That's not possible in our health system, and its irrationalities are increasingly slowing down the grand march toward more personalized medicine.
If the space program had been run like our current health system, computers at Mission Control in Houston and the launch site at Cape Canaveral would not have talked to each other.
Promising efforts like the American Society of Clinical Oncology's CancerLinQ program are threatened by our inability and unwillingness to share clinical data. As Otis Brawley, chief medical and scientific officer for the American Cancer Society, wrote this week in STAT, "real or perceived privacy issues, along with difficulties connecting disparate electronic health records, may scuttle it."
As cancer research rockets ahead in the lab, clinical studies may lag years or decades behind. We can take steps to speed them up, but there's no quick fix.
If NASA had worked like our medical system, the rocket engine makers would have charged whatever they liked. Contrast that with the famous quote from astronaut John Glenn about how he felt before liftoff: "you were sitting on top of two million parts — all built by the lowest bidder on a government contract."
And if we had run space like medicine, all engineering decisions would have been second-guessed by non-engineers.
The world's largest cancer center, MD Anderson in Houston, launched its own Moon Shots cancer program three years ago. The initiative helped MDA raise about $300 million, sharpen its priorities and add a few important efforts. And it seems to have achieved progress in a few fairly narrow treatment areas. That's good news and about what we should expect so far.
There's nothing theoretical to me about the suffering that cancer inflicts on human lives. I'm happy to see our vice president bringing in the best and brightest to plan an initiative, and especially to figure how to connect the data silos.
But we need another metaphor to help us conceptualize the effort. (And no, not the War on Cancer.) Maybe we can try a title based more closely on another major healthcare initiative (Obamacan? Bidencare?). Grand national projects can live or die by their metaphors.
| Tagged big data, cancer, clinical trial, moon shot | Leave a comment
September 14, 2015 by benderwrite
Man petabytes dog
One of the earliest stories I wrote about genomics past the gee-whiz aspects of the Human Genome Project covered the first whole-genome sequencing of a dog. Kerstin Lindblad-Toh of the Broad Institute patiently explained the project to me, and scientists who used dog models to study inherited blindness told me why they were more than excited about the prospects.
More than a decade later as I'm putting together a special report on big data for Nature, the genomic revolution has marched ahead, well, much as predicted.
The cost of genomic sequencing has dropped arguably faster than any other technology in human history. Research initiatives that most of us haven't heard about are gathering genomic data on hundreds of thousands of people. This flood of data is multiplied with data from proteomics and other omics now scaling up to the genomic scale. We talk casually about petabytes (millions of gigabytes). Data scientists, many of them coming in from fields outside biology, are integrating these data and making some astonishingly good predictions about what drugs might work for a given condition, without needing any new wet-lab work. We've seen wonderful progress in stem cells and cellular models and genetic engineering tools. And this revolution is on television, also websites, social media and an entirely sufficient plenitude of TED talks.
Not so much in the clinic, though.
Of course omic research on many diseases is starting to pay off for actual patients—for example, The Cancer Genome Atlas has spun off clues for real advances in many cancers—and its grand march points straight ahead through enormous but movable objects.
But clinical steps are slow. Part of the reason is the sheer complexity of disease, for instance the ways cancers duck and weave to dodge treatments. And, of course, clinical trials can't be rushed.
Last week I asked one neuroscientist why we still lack drugs that treat the causes of neurodegenerative diseases, as opposed to their symptoms. She responded, reasonably enough, that it takes years to build better lab models of the disease and push findings from those models into the long tunnel of pre-clinical work toward trials. She expected that some of the compounds coming from her work will help. She didn't predict home runs.
But we haven't lost the gee-whiz discoveries and our faith that they'll end up in the clinic in our lifetimes. My favorite: Scientists can take a human skin cell, bombard it with select small molecules until it morphs into a reasonable facsimile of an insulin–producing cell (a notoriously fickle beast) and produce such cells in the millions. Maybe those cells will arrive in the next decade, bringing actual cures. And although I don't follow discoveries in dog proteomics, I see that University of California/Berkeley researchers have restored vision to blind dogs via genetic therapy. Progress, yes. Dogged research!
| Tagged AI, big data, cancer, diabetes, Human Genome Project, stem cell, The Cancer Genome Atlas | Leave a comment
November 21, 2014 by benderwrite
Fitting tumors to a T
Registration statements for initial public offerings are the Eeyores of public documents, and the prospectus Juno Therapeutics released on Monday is no exception. It drones on for page after page about the very real and highly numerous risks in launching up a business to treat cancer by re-engineering T cells.
But I like the ambition of the opening statement: "We are building a fully-integrated biopharmaceutical company focused on revolutionizing medicine by re-engaging the body's immune system to treat cancer."
Most of Juno's research and almost all of its early trials are centered on chimeric antigen receptor (CAR) T cells designed to treat B cell leukemias and lymphomas. This technique plucks out some of a patient's own T cells and genetically modifies them to glom onto a certain receptor on the cancer cell and start a snowballing immune attack. The reengineered cells are replicated in large volume and put back into the patient, where the immune attack often can effectively wipe out the disease.
If the attack is too strong, though, it can kill the patient, which apparently happened several times in recent trials. Juno and its clinical partners took steps this spring to minimize that danger, mostly by selecting patients more rigorously. And they're pursuing a technique to make the engineered T cells susceptible to certain chemotherapies, so that the reintroduced cells can be killed off if their onslaught threatens to overwhelm the recipient.
Juno also is investigating another adoptive T cell approach called high-affinity T cell receptor (TCR). These T cells are modified to better seek out fragments of protein brought to the surface of tumor cells by major histocompatibility complex (MHC) cell-surface molecules.
"TCRs recognize proteins that are presented to the immune system as a peptide bound to an MHC, and are therefore restricted to a certain MHC type," the prospectus notes. "Approximately 80% of the U.S. population has one of the four most common MHC types. Due to this variability, multiple different TCR product candidates will be needed to address any given target protein for a broad population."
That requirement further complicates drug development. But unlike CAR T cells, TCR T cells can go after cancer cells that are flagged by peptides presented from inside the cell, which might make them useful against a much broader group of cancers.
Juno is pursuing both technologies to treat not just blood cancers but difficult-to-treat solid tumors, with at least four product candidates scheduled for clinical testing by 2016. Among them is a TCR T cell agent that targets WT-1, an intracellular protein overexpressed in adult myeloid leukemia (AML) and breast, colorectal, non-small cell lung and pancreatic cancers. The company expects to give first results of an AML trial this year, and to begin another trial both for AML and solid tumors next year.
| Tagged adoptive T cell, cancer, cancer immunotherapy | Leave a comment
Nanostepping up against cancer
Most ovarian cancer is discovered at an advanced stage, responds to standard treatments of surgery and chemotherapy, and then relapses. Unsurprisingly, the better the job of surgically removing tumors, the better the patient's prospects.
This month in PNAS, MIT's Angela Belcher and colleagues described a near-infrared imaging system based on an injected nanodevice combining carbon nanotubes with peptides that latch onto ovarian cancer cells, assembled neatly via synthesized bacteriophage virus. In an early surgical test on mice, the technique proved very effective at detecting tiny clumps of cancer cells.
Presenting her work last week at an ovarian cancer event at the Koch Institute for Integrative Cancer Research, Belcher noted that this imaging technique currently works through about 10 cm of tissue, which covers a lot of territory in the human body. She hopes that the method can be extended to gather molecular information about tumor cells that could aid in treatment.
Also at the Koch event, which drew a mix of survivors and researchers, Belcher's MIT colleagues Sangeeta Bhatia and Paula Hammond presented their ongoing work on cancer nanotherapies.
Bhatia and co-workers are developing nanodevices in which various types of short interfering RNAs (siRNAs) designed to attack cancer tumors can be wrapped inside peptides configured to penetrate tumors and pass through cell membranes. Years of painstaking work are paying off in dramatic results in mice models.
Hammond and her research partners take another approach to cluster-bombing cancer (see cartoon below). They assemble nanoparticles layer by layer, starting with a core of doxorubicin or another chemotherapy agent, adding layers of siRNAs and topping off with a "stealth" outer wrapping meant to let the nanoparticles glide through the body until they can glom onto cancer cells.
All very promising, all in early animal research, and the survivors at the Koch event kept politely asking when each advance might reach humans. "We're still vertical," one survivor pointed out.
| Tagged cancer, MIT, nanotechnology, siRNA | Leave a comment
June 7, 2014 by benderwrite
Running interference into the clinic
Writing a story on therapeutics based on RNA interference, so far I've interviewed half a dozen experts, most of them research executives at biotechs leading that charge. There's a steady stream of early clinical trials with RNAi drugs, almost all targeting liver-expressed genes. In the last week of May, for example, Tekmira launched a phase 1/2 trial for liver cancer and Benitec dosed the first patient in a phase 1 hepatitis B trial. The experts emphasize that animal models have proved highly predictive in studying the effects of RNAi and claim that the delivery obstacles that plagued the first wave of RNAi drugs have been overcome, at least for the liver. They also suggest that regulatory authorities, so far, have been pleased by the clear biomarkers and consistent data available for RNAi agents. Of course, everyone is also properly guarded at this stage of clinical research. I'm looking forward to getting more perspectives on June 13 at the Koch Institute's symposium on RNA biology, cancer and therapeutics.
| Tagged cancer, hepatitis B | Leave a comment
Flash mobbing adoptive T cell therapy
Here's the basic idea behind adoptive T cell therapy: Patients whose cancers don't respond to conventional treatments can have some of their own immune cells known as T cells plucked, genetically re-engineered to better target their cancer cells, and reinserted. In recent years these treatments have achieved dramatic early clinical successes, and there's a lot of excitement about them.
This excitement made adoptive T cell therapy a prime candidate for the third annual Biology Flash Mob at the Koch Institute for Integrative Cancer Research at MIT, which drew about 180 volunteers on Friday morning.
We volunteers were a diverse group—by a show of hands, one third of us worked at Koch and one third had never heard of the institute—and several of us were only two years old.
Our Koch hosts divided us into groups of healthy cells (green shirts), cancer cells (red shirts), T cells (blue shirts) and scientists (purple shirts and white lab coats). After a quick rehearsal, the healthy cells marched out and arranged themselves in the center of the quad behind the Koch. They cheered as the T cells filed through them and kept them in line. When one healthy cell popped a red umbrella to show that it had turned cancerous, the T cells took their pom-poms and pummeled it into submission.
But then several healthy cells not only broke bad but hid themselves from the T cells (as real cancer cells do all too often), the T cells wandered around in helpless zombie fashion and dozens of other cancer cells poured in.
Virtue triumphed, however, after the T cells hurried out to be genetically re-engineered (fortified for battle with big foam hands). They charged back into the mass of cancer cells, and swiftly demolished all the bad guys.
The flash mob ended with loud cheers, even from the cancer cells. And we hoped that the cheers will keep echoing in the real world of cancer medicine.
A video of the flash mob will be posted in coming weeks. Meanwhile, you can view the 2012 Koch flash mob, which acted out a targeted cancer therapy technique based on nanoparticles, here.
Photo courtesy Koch Institute for Integrative Research on Cancer at MIT.
| Tagged Cambridge Science Festival, cancer, cancer immunotherapy, Koch Institute for Integrative Cancer Research, science education | Leave a comment
March 29, 2014 by benderwrite
Paying the price (or not)
As PD-1 inhibitors march toward FDA approval, the excitement is warranted–at last, cancer immunotherapies that seem to work for more than a few percent of patients, and maybe even arrive with biomarkers that can identify those patients who can benefit. But the stories about these new drugs, like this one a week ago in the Wall Street Journal, often carry an uneasy undertone about pricing. While the drug makers very understandably don't want to talk about pricing, Citigroup suggests that this new crop might come in at around $240,000 a year, according to the WSJ story. Moreover, these drugs are likely to be combined with other therapies for best results. Paul Workman of the UK Institute of Cancer Research commented that "with combinations, pricing could quickly become completely unsustainable." That could be true not just in the UK but in the US, where patients are often bankrupted by their cancer care. The deep concern among oncologists about this issue is becoming more and more public, one sign being the American Society of Clinical Oncology's plans to assess drug value on cost as well as benefits and toxicity.
| Tagged cancer, cancer immunotherapy | Leave a comment
March 8, 2014 by benderwrite
When centers cannot hold
A million people get cancer each year in India and 980,000 die. "The system is overwhelmed," as one epidemiologist told me. The government is strengthening and expanding national and state cancer institutes, and some cancer treatment is covered by new national insurance programs. However, there's concern that boosted spending on treating patients with advanced cancer in both public and (essentially unregulated) private cancer centers will quickly soak up most funding for cancer care, at the expense of more cost-effective prevention and early detection programs. Such issues in cost-effectiveness may be clear–but they wouldn't be clear to you or me if we were among the million.
| Tagged cancer, developing countries | Leave a comment
February 21, 2014 by benderwrite
Cancer stigma, cancer pain
Writing a story on the tidal wave of cancer in low- and middle-income countries, I expect to hear heartbreaking anecdotes about the lack of funding and other resources. But I also keep hearing about two problems that have relatively little to do with money. One is the combination of fear and social stigma that keeps so many women around the world from fully participating in screening and diagnostic programs. The other is the lack of opiates for palliative care, leaving so many patients in the poorest countries to die in extreme pain. Even in these countries morphine is fairly cheap, but the regulations meant to prevent its illicit use also can keep it from its proper clinical role.
| Tagged cancer, low-income countries, palliative care, screening | Leave a comment


text:
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Question Finder
Americans' Views on the U.S. Role in Global Health
Bianca DiJulio, Mira Norton, and Mollyann Brodie	Follow @Mollybrodie on Twitter
As policymakers react to global crises and the 2016 presidential election season ramps up, it's an important time to understand Americans' views on the U.S. role in global health. The Kaiser Family Foundation has tracked public opinion on global health issues in-depth since 2009. This most recent survey examines views on U.S. spending on health in developing countries and perceptions of barriers and challenges to making progress on the issue.
Two-thirds of Americans (65 percent) overall and majorities of Democrats, independents and Republicans alike, say that the United States should play at least a major role in world affairs, including roughly one in five overall (18 percent) who say the U.S. should take the leading role. However, when it comes to global health efforts specifically, about half (53 percent) say the U.S. government is already doing enough to improve health for people in developing countries, and nearly half (46 percent) feel that the U.S. is doing more than its fair share compared to other wealthy countries. In addition, most Americans prefer a collaborative international approach in global health efforts over the U.S. acting alone, and this sentiment has increased over the past several years. The survey also finds a general skepticism on the part of the American people when it comes to the effectiveness of global health spending, with seven in ten saying the "bang for the buck" of U.S. spending in this area is only fair or poor, and more than half believing that spending more on global health efforts won't lead to meaningful progress (a share that has grown since 2012). Republicans, and to a somewhat lesser extent, independents, are more likely than Democrats to think that more spending will not lead to progress, to feel that the U.S. is already doing enough, and to say the U.S. is doing more than its fair share compared to other wealthier countries, and these differences between Democrats and Republicans have grown over time. Related to this general skepticism towards such spending, many point to a variety of perceived problems, including corruption and misuse of funds, as barriers to improving the health of people in developing countries.
Although many Americans have concerns about the value of global health spending, six in ten say the U.S. spends too little (26 percent) or about the right amount (34 percent) on global health, and three in ten say it spends too much. Most also recognize benefits to such spending, both for Americans at home as well as for people and communities in developing countries. Nearly half (46 percent) say the most important reason for the U.S. to spend money on improving health in developing countries is because it's the right thing to do, outranking other reasons, including improved diplomatic relationships (14 percent), national security (14 percent), or a stronger U.S. economy (11 percent).
Looking forward, while a large majority of Americans think an Ebola or similar disease outbreak is likely in the next five years, two-thirds say the U.S. government is well-prepared to handle such an outbreak.
Views of U.S. Role in World Affairs and in Global Health Efforts
Broadly, the American public is largely supportive of the U.S. playing a large role in trying to solve international problems. About two-thirds of Americans (65 percent) say that the U.S. should play at least a major role in world affairs, including 18 percent who say the U.S. should take the leading role and 47 percent who say the U.S. should play a major role but not the leading one. Despite recent international events, including the Ebola crisis in West Africa as well as the more recent terrorist attacks in Paris, these shares haven't changed substantially since 2012. Majorities across all parties say the U.S. should play a major or leading role, with Republicans more likely to say that the U.S. should play a leading role compared to Democrats.
Figure 1: Most Want U.S. to Play Major or Leading Role in World Affairs
When it comes to global health issues specifically, a slim majority of Americans (53 percent) say the U.S. government is doing enough to improve health for people in developing countries, while four in ten (39 percent) say that it is not doing enough. In addition, half (51 percent) also say religious or faith-based organizations are doing enough and a similar share (46 percent) say the same about international nonprofit organizations. Americans are split on their opinion of the World Health Organization (WHO), the public health arm of the United Nations, with equal shares saying the WHO is doing enough and not doing enough (42 percent each).
On the other hand, majorities say that large international businesses and corporations (64 percent), the United Nations (54 percent), and the governments of other developed countries (51 percent) are not doing enough to improve health for people in developing countries.
Figure 2: Most Say U.S. is Doing Enough to Improve Health in Developing Countries; Two-Thirds Say Large Corporations Are Not
Unlike the bipartisan support for U.S. involvement in world affairs generally, there is a substantial partisan divide in views of U.S. efforts to improve health for people in developing countries. Majorities of Republicans (68 percent) and independents (59 percent) say the U.S. government is doing enough in this area, while a slim majority of Democrats (52 percent) feel the opposite, saying the U.S. is not doing enough. The difference between Republicans and Democrats on views of whether the U.S. is doing enough has widened somewhat since 2009.
Table 1: U.S. Government Doing Enough to Improve Health in Developing Countries
Would you say the U.S. government is doing enough or not doing enough to improve health for people in developing countries? Total Democrats Independents Republicans
Yes, doing enough 53% 38% 59% 68%
No, not doing enough 39% 52% 36% 24%
NOTE: Should not be involved (Vol.) and Don't know/Refused not shown.
Echoing the sentiment of about half of Americans who say the U.S. government is doing enough to improve the health of those in developing countries, nearly half (46 percent) say that the U.S. is doing more than its fair share compared to other wealthy countries, such as England, France, Germany and Japan. About a third (35 percent) say the U.S. contributes about its fair share, and 12 percent say the U.S. contributes less than its fair share. Again, there are partisan differences, with Republicans much more likely than Democrats to say that the U.S. is contributing more than its fair share (62 percent versus 34 percent). Here also, the difference in opinion between Republicans and Democrats has widened over the last few years, from a difference of 17 percentage points in 2012 to 28 percentage points currently.
Figure 3: Nearly Half Say U.S. Contributes More Than Its Fair Share
When it comes to U.S foreign aid aimed at improving health in developing countries, more Americans prefer a collaborative international approach over the U.S. acting alone in these efforts. Two-thirds of Americans (68 percent) prefer to see the country participate in international efforts so that other countries will do their fair share and efforts will be better coordinated. On the other side, a quarter (25 percent) say that the U.S. should operate on its own, allowing the government more control over how the money is spent and giving the U.S. more credit and influence in the country receiving aid. This gap has slowly widened over the past few years, with more Americans today saying that the U.S. should work alongside other countries than in 2009 (68 percent today versus 55 percent in 2009).
Figure 4: More Americans Today Say U.S. Should Participate in International Efforts to Improve Health in Developing Countries
Americans' Views on U.S. Global Health Spending
Most Overestimate U.S. Spending on Foreign Aid and Doubt Value Of Global Health Spending
A large majority of the public overestimates the share of the federal budget that is spent on foreign aid. Just 3 percent of Americans correctly state that 1 percent or less of the federal budget is spent on foreign aid, and nearly half (47 percent) believe that share is greater than 20 percent. On average, Americans say spending on foreign aid makes up 31 percent of the federal budget.
Figure 5: Public Overestimates Share of Budget Going to Foreign Aid
Among the public, critics of U.S. global health funding often point to the poor value or "bang for the buck" of spending aimed at improving health in developing countries, that is, the number of lives saved relative to the amount of money spent. A large majority of Americans (69 percent) express doubt in the value of global health spending, saying that the "bang for the buck" of these dollars is "only fair" or "poor." On the other side, about one in five (21 percent) say the value is "excellent" or "good." There are no substantial partisan differences, with a majority of Democrats, Republicans, and independents reporting that the value of spending is "only fair" or "poor."
Figure 6: Seven in Ten Americans Express Doubt in Value of U.S. Health Spending in Developing Countries
In addition, there is also doubt about the effectiveness of foreign aid from the U.S. and other wealthy nations, with more than half of Americans (55 percent) saying that spending more money will not lead to meaningful progress in improving health for people in developing countries. Still, about four in ten (38 percent) say that more spending on the part of the U.S. and other countries will lead to meaningful progress. This gap has widened somewhat since February 2012, when opinions regarding spending were more evenly divided. Republicans (67 percent) and independents (58 percent) are particularly skeptical, with majorities saying that more spending will not make much difference, compared to nearly four in ten Democrats (38 percent) who say the same. These partisan differences have increased over time, from a margin of 14 percentage points separating Republicans and Democrats who are doubtful that spending more will lead to meaningful progress in 2009, compared to a difference of 29 percentage points today.
Figure 7: Majority Say More Spending Won't Make Much Difference in Improving Health in Developing Countries
Related to the general skepticism towards U.S. global health spending, the American public sees a number of barriers to making progress improving health for people in developing countries. Eight in ten Americans (79 percent) point to corruption and misuse of funds as a major reason for such difficulties. Roughly seven in ten say issues such as lack of infrastructure and resources (73 percent), widespread poverty (72 percent) and lack of political leadership (68 percent) are major reasons for difficulty in improving health, and nearly six in ten (57 percent) cite a lack of effective programs. Many fewer – just about a third (34 percent) – say that a major reason is a lack of money from the U.S. and other wealthier countries.
Although Americans say there are several major reasons for the difficulty of improving health for people in the developing world, when asked which is the single most important reason, the largest share (44 percent) name corruption and misuse of funds, while much smaller shares point to other issues, such as lack of infrastructure (16 percent) or lack of political leadership (15 percent).
Figure 8: Corruption Seen as Biggest Barrier to Improving Health in Developing Countries
Although much of the public doubts the value and effectiveness of global health spending and points to several barriers to progress, 60 percent say the U.S. spends too little (26 percent) or about the right amount (34 percent) on global health, and 30 percent say it spends too much. This is similar to previous Kaiser polls over the past several years.
Figure 9: Trend in Views of U.S. Spending on Health in Developing Countries
More Republicans say the U.S. spends too much on such global health spending than say it spends too little (40 percent versus 13 percent), while more Democrats say the U.S. spends too little, rather than too much (37 percent versus 20 percent). Independents are about evenly split, with about three in ten saying the U.S. spends too much (30 percent) or too little (28 percent). Still half or more of Republicans (52 percent), independents (61 percent) and Democrats (73 percent) say the U.S. is spending about the right amount or too little on efforts to improve global health.
Figure 10: Views of Current Levels of U.S. Global Health Spending by Political Partisanship
Most Say U.S. Global Health Aid Helps Protect Americans' Health and It's the Right Thing To Do
While there is general skepticism about the effectiveness of global health spending, many Americans believe there are a number of benefits to spending money to improve health in developing countries. More than six in ten (63 percent) say that such spending helps protect the health of Americans by preventing the spread of diseases like SARS, bird flu, swine flu, and Ebola and about half say it helps make people and communities in developing countries more self-sufficient (53 percent) and helps improve the U.S. image around the world (52 percent). Fewer Americans, however, say U.S. health spending in developing countries benefits the U.S. economy (33 percent) or helps U.S. national security by lessening the threat of terrorism (31 percent), while about two-thirds of the public thinks it does not have much impact in those areas.
Democrats are generally more likely than Republicans and independents to say that spending money on improving health in developing countries has such impacts, but still about six in ten Republicans and independents say it helps protect Americans' health (58 percent and 62 percent, respectively).
Table 2: Impact of Global Health Spending
Percent who say spending money on improving health in developing countries helps… Total Democrats Independents Republicans
…Protect the health of Americans by preventing the spread of diseases like SARS, bird flu, swine flu, and Ebola 63% 73% 62% 58%
…Make people and communities in developing countries more self-sufficient 53 65 49 43
…Improve the U.S. image around the world 52 64 51 42
…The U.S. economy by improving the circumstances of people who can buy more U.S. goods 33 41 30 27
…U.S. national security by lessening the threat of terrorism originating in developing countries 31 39 34 18
Although many acknowledge there are domestic interests that could benefit from global health aid, nearly half of Americans (46 percent) say that the most important reason that the U.S. spends money on improving health for people in developing countries is because it's the right thing to do. This ranks far above other reasons, such as ensuring national security (14 percent), improving our diplomatic relationships (14 percent), helping the U.S. economy by creating new markets for U.S. businesses (11 percent), or improving the U.S.'s image around the world (9 percent). Americans' views of the reasons for such spending do not vary by political party.
Figure 11: Moral Reason for Global Health Spending Trumps National Self-Interest
Moving Forward: U.S. Preparedness and U.N. Sustainable Development Goals
Most say Disease Outbreak Is Likely in Next 5 Years, But U.S. Is Well-Prepared
Most Americans say that another Ebola outbreak – or an outbreak of an equally serious disease – is likely in the next five years, but many also express confidence in U.S. preparedness in handling such an outbreak. A large majority of Americans (83 percent) say that another serious Ebola outbreak in Africa in the next five years is at least somewhat likely. About as many (87 percent) say it is at least somewhat likely that there will be an outbreak of a different disease, but one that is equally as serious as Ebola.
Although many Americans expect another outbreak, when asked how prepared the U.S. government is to respond to future disease outbreaks around the world, two-thirds overall (66 percent) say the U.S. is at least somewhat well-prepared, including 16 percent who say the country is "very well-prepared." However, about a third (32 percent) say the U.S. government is not well-prepared. There are no substantial differences between political partisans on U.S. preparedness on this issue.
Figure 12: Large Majority Say Ebola or Other Serious Disease Outbreak Likely in the Next Five Years, Many Say U.S. is Well-Prepared
Limited Awareness of United Nations' Sustainable Development Goals
Global health leaders often point to the recent adoption of the United Nations' Sustainable Development Goals as an important multinational initiative for progress in improving health and development globally. These goals focus on economic and human development and the eradication of poverty and are meant to guide all global development efforts, including global health efforts, through 2030. However, a large majority of Americans (79 percent) say they haven't heard of them. Only one in five (20 percent) say they have heard of these goals, including 6 percent who say they know a "fair amount" or "a lot" about them and 13 percent who say they know "only a little" or "almost nothing."
Figure 13: Limited Public Awareness of United Nation's Sustainable Development Goals
TOPLINE & METHODOLOGY
New Survey, Analysis Suggest a Growing Partisan Split About U.S. Government Engagement on Global Health
Foreign Policy and Global Health Experts on the USG's Role in Global Health
The Future of U.S. Global Health Policy & Programs


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Hosni Mubarak Relatives Divided as Egyptians Take Stands on Historic Presidential Election
Divisive
As voters take to the polls for the country's historic presidential election, Egyptians are taking stands on divisive issues. Dan Ephron talks to relatives of Hosni Mubarak about their preferred candidate—and their thoughts on their cousin's legacy. Plus, read Mahmoud Salem on how there is no clear frontrunner in Egypt's election.
Dan Ephron
Ahmed Ali / AP
Across Egypt, the first free presidential election getting underway today is forcing people to take a stand on some of their society's most divisive issues—sometimes defying their own spouses or other family members.
For Basheer Mubarak, it can feel like he's standing against nearly his entire town. The 37-year-old technician lives in Kafr El-Maselha, the birth place of Hosni Mubarak, where cousins of the ousted dictator—Basheer included—fill several buildings along a city block.
Many of them pine for Mubarak's return and back the candidate whose résumé most resembles his.
But not Basheer.
"What did he do for this country? It's one big dump," he says in the garage of his three-story building on Sadat Street, named for the autocrat, Anwar Sadat, who preceded Mubarak.
Basheer's complaints mirror those of the young demonstrators who brought down the regime in January of last year during 18 days of protests: Mubarak suppressed dissent, rigged elections, and kept nearly half the country poor and uneducated. But Basheer is especially incensed at how run-down the country remained during Mubarak's more than three decades of power.
Kafr El-Maselha, about 50 miles north of Cairo, is no exception. While other dictators in the region have invested in their own towns in order to maintain clan loyalty, Kafr El-Maselha is as broken and congested as the rest of Egypt, with ripped-up roads and poor sanitation.
In nearby Quesna, where the former leader moved as a youngster and where more Mubaraks reside, the clamor of old rickshaws drowns out just about everything else.
Residents said Mubarak had hardly visited the areas since he left for the Air Force academy after high school. No one who shared his name had actually met the former leader.
Basheer, who is married and has four daughters, says he'd been bitter about Mubarak's leadership for years, but kept quiet because people who criticized the regime often were jailed. "My father kept telling me, 'Don't say anything.'"
Now, he supports Hamdeen Sabahi, a leftist presidential candidate who helped lead the opposition to Mubarak for years. Two of his posters hang in the back window of Bahseer's car, a Chinese-made Geely. He said a few other Mubaraks in the town are also critics of the old regime.
The other leading candidates include two Islamists and two people who served in Mubarak's regime. More than 50 million Egyptians are eligible to vote. If no candidate gets more than 50 percent of the vote, a runoff will be held next month.
The neighborhood favorite is Ahmed Shafiq, who, like Mubarak, served as a senior Air Force commander and as prime minister briefly last year. Residents of Sadat Street said any time someone hangs a poster of a candidate other than Shafiq, it gets torn down.
Loyalists to the old autocrat include 65-year-old Said Mubarak, who lives in a building adjacent to Basheer's. Roused from his afternoon nap one day recently, he came downstairs in his striped pajamas and flip-flops to talk to two journalists.
"We are bad people because we forget the good things and remember only the bad things," he said. Asked to name one or two of Mubarak's central achievements, he paused and looked off for a long time. Eventually he said: "The record speaks for itself."
Mubarak himself would likely have pointed to his country's strong relationship with the United States, the stability that came from maintaining Egypt's peace treaty with Israel, and his success at keeping Islamists at bay. In parliamentary elections that followed Mubarak's ouster, Islamist parties captured around 70 percent of seats in the legislature.
In Quesna, 70-year-old Sahar Mubarak said she voted for the largest Islamist list, the Freedom and Justice Party, but had since been disappointed. She would now give her vote to Shafiq, she said in the living room of her home.
Others around the room stressed that the Mubarak family name had afforded them no privileges. On the contrary, they said one relative serving in the military who had phoned Mubarak while he was Air Force chief to complain he had been denied home leave ended up regretting it. Mubarak extended his detention.
Nearly all the Mubaraks said corruption in the former regime was perpetrated by cronies but did not extend to Mubarak himself.
Only one family member in the area declined to be interviewed: Mohammed Hosni Mubarak, Sahar's brother and a retired military officer who briefly weighed a run for president. Through an emissary, he asked to be paid $3,000 for the interview. When the emissary phoned him to say the fee had been refused, he said he had meetings and could not talk.


Telegraph station at Weston Point.
May 15th and August 21st.
This place is situated in a pretty spot under Overton Hill. It has a fine old Norman church (from which there is a good view), grammar school graving dock, an old castle given by Edward I, to Llewellyn's brother David, for the betrayal of which he was executed. It was burnt in 1642. It has a population of 1,869, employed in the salt works. Here died T. Hough, aged 141 years; and its inhabitants are celebrated for their longevity.


A well-designed coastal cottage looks comfortable, inviting and effortless but is actually achieved with intention. To get the look in your own home, follow these steps.
Start with a clean, neutral palette. Using white or a very light beige color on the walls will make small spaces feel bright and open by reflecting natural light, lending to the crisp, breezy feel of being at the beach. Expand the palette to mirror colors found on the coast. Subtle blues, browns and even greens all work well in coastal design.
Pops of color, such as coral or sunny yellow, can be surprising and fun, but can feel harsh if overused. Dark, heavy wood pieces can do the same. Limit them to accent pieces such as pillows, a chair or end table, or even light fixtures.
Natural elements are essential to coastal design. Seagrass rugs, linen fabrics, bamboo blinds, rope accents, a piece of driftwood, a jar of shells, a mirror framed in oyster shells, or freshly cut palm fronds are all subtle elements to bring the outdoors in without going overboard. Pulling in nautical pieces, such as a vintage map or ship's instrument, can expand on this. Elements should draw interest without being a distraction to the overall look.
Mix and match furniture pieces and materials, throwing in new, polished items with weathered, vintage finds. A combination of wood, wicker and soft upholstered pieces lends to a relaxing, casual look. Avoid furniture sets, and if you can't find the right vintage piece, create your own by distressing a piece you pick up at a garage sale or thrift store.
At its very essence, coastal design should be relaxing and serene, just like vacationing at the beach. Allow the design to unfold through the tips above for an individualized coastal retreat.


text:
Vladimir Simic Associate Professor at the Faculty of Transport and Traffic Engineering at University of Belgrade, Serbia
Fuzzy sets; Decision support systems; Multi-criteria decision making; Supply Chain Optimization; Transport & Logistics
www.researchgate.net/profile/Vladimir_Simic
vsimasf.bg.ac.rs
h-index: 22
Prof. Vladimir Simic, PhD
Associate Professor at the Faculty of Transport and Traffic Engineering at University of Belgrade
Head of MSc Program in Postal Traffic and Information Technologies
Institutional Erasmus+ Coordinator
Vojvode Stepe 305, 11010 Belgrade, Serbia
Dr. Vladimir Simic was born in Belgrade, Serbia in 1983. He received a Ph.D. degree in Transportation Engineering from the University of Belgrade, Faculty of Transport and Traffic Engineering, Serbia, in 2014.
Since 2020, he is an Associate Professor of the Transport and Traffic Engineering Department at the University of Belgrade, Serbia. He has conducted intensive research on operations research applications in diverse fields of specialization, with a particular focus on developing advanced hybrid multi-criteria decision-making tools and real-life large-scale stochastic, fuzzy, interval, full- and semi-infinite programming optimization models. He published more than 110 research papers, including 56 papers in SCI indexed International Journals (e.g., IEEE Transactions of Fuzzy Systems, Engineering Applications of Artificial Intelligence, Information Sciences, Experts Systems with Applications, Applied Soft Computing, etc.).
Dr. Simic regularly serves as an ad-hoc reviewer of many top-tier journals. He won the "2016 Excellence in Review Award" from Resources, Conservation and Recycling (Elsevier) in 2017. He received eight "Outstanding reviewer" awards and 14 "Recognized reviewer" awards from prestigious Q1 journals. He is a member of the International Solid Waste Association (ISWA). Dr. Simic served as a guest editor for Sustainability, Computer Modeling in Engineering and Sciences, and PeerJ Computer Science.


So I am a new fan of anime, so bare with me. I would like the get to know people to talk to about it and learn new things. I can be pretty quiet, but I get better eventually.
I'm 24 yes old, I'm looking for a guy friend to just chill with and maybe go to my first Anime convention. Not really looking for a relationship.


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Home General News Netflix Reveals Release Date Of 'Travels With My Father Season 3', Details...
Netflix Reveals Release Date Of 'Travels With My Father Season 3', Details Inside
vikas shrivastava
Goes With My dad is back, at that point it's imaginable won't be the first run through Whitehall alongside additionally his daddy team-up. Prior to their Netflix show, they facilitated on the British talk uncovers Backchat together, in this way it is obvious that they appreciate simply one more's conversation at work.
Truly, it could truly be amazed when they neglected to the group again at a level more distant down the trail. ( The irony we let you know!)
For the occasion, nonetheless, we have residence two to the long-distance race — that, in accordance with the Instagram of Whitehall, will watch these stay at Turkey, and Germany, Hungary, Romania, Moldova, Ukraine. What's more, — the Luk Thep doll they earned at Season inch will soon likely perhaps be as one for your insight
In the wake of visiting South East Asia and Eastern Europe, Jack Whitehall and his dad Michael Whitehall will continue voyaging together in season 3. Netflix has uncovered the discharge date of this excursion parody's new season. It will be discharged on September 6 on Netflix.
In the past seasons, to fortify their bond, UK on-screen character, and humorist Jack Whitehall and his father, Michael Whitehall, attempt abnormal and fun voyages to abroad lands. How about we have a recap of the past seasons before tending to season 3.
In the past seasons, the accompanying course occurred,
On September 22, 2017, the primary season running for six scenes was discharged on Netflix. These jaunty yet sagacious scenes are brimming with dazzling territories and parody. In this season, the father and child team are going on a mainstream "hole year way" to South East Asia, including going through nations like Thailand, Vietnam, and Cambodia.
See also 'Succession' Stars Nicholas Braun, Matthew Macfadyen Breaks Down on How To Make a Tomelette
Some decent shots find out voyaging's excellence. Seeing Vietnam neon-enlightened by night and Cambodia's interminable extending geography is flawlessly acknowledged in spite of these minutes were passing, with a large portion of the arrangement focussing fundamentally on parody.
For the subsequent season working for five scenes debuted on Netflix on September 28, 2018, the arrangement has been restored. It's been shot in Eastern Europe. Visiting Germany, Hungary, Romania, Moldova, Ukraine and Turkey alongside the way, Jack and his father.
There's nothing else or diverse in this season we haven't found in the primary season. Those people who appreciated the principal season will appreciate the second very likely. Jack's droll, over the top silliness appears differently in relation to the pessimism of Michael, and their elements are the eager power of the entirety.
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Vikas Srivastava is an editor at dailybayonet.has he worked with various business magazines like Business Today Outlook as a freelancer before joining the team. he is an addicted reader of self-help books, fiction, and journals.
6 Tips on How to Travel the World as a Student
Ten things to remember before you go traveling


Manchin: We're 'On The Verge' Of A Constitutional Crisis Due To Sessions' Firing. China October exports surprisingly strong in race to beat higher U.S. tariffs. U.S. to impose new duties on Chinese aluminum sheet products. Russia clashes with western oil buyers over new deals as sanctions loom. U.S. grants Iraq 45-day waiver over Iran sanctions to import gas, electricity. U.S. Embassy Senate Democrats weigh lawsuit over Trump Justice Department appointment.


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A number of Okanagan Nation Alliance publications are available to order.
Book Order Form
To order please complete the order form & email to: onareception@syilx.org
Take the Indian Out of the Child:
The ONA is proud to share this record of our people's endurance through the darkest chapter of our collective story. While there are now many books about the Indian residential school system, this is the first to speak about the specific ways in which it has touched the Syilx people. This book is in honour of all members of our Nation who have been impacted by the Indian residential school system—past, present, and future.
nsiwɬkwcn The Language of the Water:
For Syilx (Okanagan) People, the ways of knowing water are embedded in our language and bequeathed to us by our ancestors. Maintaining the integrity of water is essential to our identity and is entrenched in our responsibilities to our homelands. Water is our most sacred medicine. This booklet is both of the relationship that we share with water and an invitation to others to reflect on their relationship with this vital gift.
How Coyote Broke the Salmon Dam: This story is an adaptation of the captikwł of How Coyote Broke the Salmon Dam. Such publications provide an opportunity for understanding the living land and teaching each generation how to become a "part of it" as the only way we, the Syilx, have survived.
https://www.syilx.org/wp/wp-content/uploads/2016/09/How-Coyote-Broke-the-Salmon-Dam.mp3
Lazy Boy: A journey about a boy who learns about self-care, wellness and giving back to community.
https://www.syilx.org/wp/wp-content/uploads/2016/09/Lazy-Boy.mp3
Chipmunk and Owl Woman: Tells a story of chipmunk trying to not get caught by owl woman, owl woman who went camp to camp and stole children & ate them.
https://www.syilx.org/wp/wp-content/uploads/2016/09/Chipmunk-and-Owl-Woman.mp3
A Home for Chipmunk: This book illustrates Traditional Family Decision Making from a Syilx perspective and can be used in the oral tradition of the Syilx people to preserve and teach our children the culture and ways of our ancestors.
Go Back To The Root: This learning resource is based on a workshop series designed by the Okanagan Nation Alliance in partnership with the En'owkin Centre. The workshops approached the subject of Syilx families from several perspectives. At the end of the series, participants said: We can't keep these learnings to ourselves-we need to share them. This learning resource was created to do just that.
A series of illustrated books created to ensure that Okanagan children's voices are heard. This book was made possible with the participation of the Okanagan nation schools.
ISBN 978-0-9918128-3-7 – **SOLD OUT**
This book describes the Okanagan Peoples relationship to the land and water. The Syilx People have always governed our land according to principles that are embedded in traditional knowledge, stories, teachings, ceremonies, medicines, dances, and the arts. These principles carry with them a sacred, inherent responsibility to care for the tmxwulaxw (Our Land).


A tribute to the recording engineer whose in-studio innovations helped shape The Beatles' sound—and alter the course of popular music.
Geoffrey Emerick (born 5th December 1945, died 2nd October 2018) was just 16-years-old when, on 6th June 1962, he joined the EMI Studios on Abbey Road as a tape operator. Two days later, he attended the group's first recording session with Ringo Starr on drums. He subsequently assisted on a number of sessions, including those for 'She Loves You' and 'I Want to Hold Your Hand', before replacing Norman Smith as The Beatles' chief engineer in early 1966 and diving straight into the deep end with the first track committed to tape for their landmark 'Revolver' LP: the revolutionary, now-legendary 'Tomorrow Never Knows'. The following year, 'Sgt. Pepper's Lonely Hearts Club Band' won him his first of four Grammy Awards.
In this episode, Richard, Erik, Allan and Craig examine how, together with producer George Martin, Geoff helped realize The Beatles' most far-flung creative ambitions. And there is also an enlightening interview with multi-award-winning engineer John Kurlander, who assisted Geoff on the group's final album, 'Abbey Road'.


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Vaccine rates, state legislation a concern for the Delaware County Board of Health
Corey Ohlenkamp
MUNCIE, Ind. — Decreasing vaccine rates and the Indiana Legislature's bill over what a health department is able to do during an emergency were the two biggest concerns of the Delaware County Board of Health Thursday night.
Vaccine rates still falling in Delaware County
Delaware County Health Department administrator Jammie Bane said healthcare partners were tightening clinic schedules and moving down their appointment availability for the COVID-19 vaccines across the county.
This was because demand for the vaccine is dropping countywide. Even with vaccination sites shortening hours due to lower demand, the vaccine will still be readily available.
One big example of lower requests for vaccine was the state's mass vaccination clinic at the Delaware County Fairgrounds last week. It was seen largely as a failure after vaccinating fewer than 80 people over a three-day period.
"It was kind of a letdown," Bane said.
As of Wednesday, the Indiana State Department of Health reported that 38,676 Delaware County residents, nearly 40% of the county's overall eligible population, had gotten at least their first dose of the vaccine.
►USA TODAY: At least 8 states lift mask mandates
Officials are now left trying to balance how open and available clinics are and the actual needs of the community.
Bane said the health department was moving down availability so it could begin to transition back to the department's normal day-to-day operations.
According to Bane, vaccine issues in Delaware County have a lot of factors at play.
The administrator for DCHD said the community worked hard to build a large network of vaccination sites in a relatively short time, which addressed the early concern over accessibility.
"In any population, you're also going to see a variety of opinions and interest in taking part in something," Bane said via email to questions from The Star Press. "We saw the early adopters lined up with their sleeves rolled up back in December and January, then as eligibility opened, we saw the majority of interested people making their appointments as soon as they were eligible."
►CDC lifts indoor mask guidelines for fully vaccinated people. What does it actually mean?
Bane thinks that those who are still not vaccinated are taking a "wait and see" approach.
That still affects whether the county can reach herd immunity anytime soon, though even with that there is some debate.
"I'm hopeful that the high numbers of people who were previously infected, including those who went un-diagnosed, will contribute towards the concept of herd immunity," Bane said.
Data from different areas of the country point to this being a possibility, but health experts are still debating differences in immunity from actually getting the virus and the immunity through the vaccine.
Health officials have said it's more likely communities could reach herd immunity because of those who have already had the virus rather than through vaccines alone, but they are currently not included in figures with those who are actually immunized.
That still leaves the question of how health officials get more shots into arms.
Education will be key, according to Bane and other officials, with the need for messaging going forward focused less on beating the virus and more on addressing the range of vaccine hesitancy reasons.
"I think the messaging from the CDC needs to evolve to include more explanation and evidence to combat some of the myths that have become prevalent," Bane said. "While this transparency at the national level could help with vaccine hesitancy among a percentage of our population, I acknowledge it will not be a complete solution."
►RELATED: Food and Drug Administration authorized emergency use of a COVID-19 vaccine for people 12 to 15
Statehouse's Senate Bill 5 limits local health officers in an emergency
Local health officials were also concerned about how Indiana's Senate Bill 5 would affect Delaware County, especially when the county faces the next health emergency.
Senate Bill 5 terminates local health orders from local health officials more stringent than ones ordered by the state. In the future, they will need to be approved by local city councils, mayors or county legislative bodies, depending on who has jurisdiction.
In Delaware County's case, that is the Delaware County commissioners.
Adding layers to the decision-making during a health emergency could slow down response times of health officials and limit their flexibility in an emergency. It also complicates who is actually in charge of health policy during an emergency.
Holcomb vetoed the bill, arguing those issues and others. Indiana lawmakers voted to override Gov. Eric Holcomb's veto of the bill on May 10.
The biggest problem with SB 5 is it can pit the health officials against the elected officials if they disagree over rules such as last year's COVID-19 business restrictions.
While the current health department and commissioners have been in agreement during the pandemic, that might not always be the case going forward.
"Obviously you know that we get along great with Jammie," Delaware County Commissioner Shannon Henry said Friday. Once the current set of commissioners leaves office though, Henry said he saw how it could potentially cause problems.
Members of the board of health are not thrilled over the legislation, asking serious questions about how this could affect the next emergency that the county faces.
"I'm still back and forth over how much concern I actually have over this," Bane told the group on Thursday.
Day-to-day enforcement that the health department does is not affected by SB 5, so it only applies in emergencies like the pandemic. One of the bigger concerns from Bane, however, was a clause that allows for the removal of a health officer.
He said this meant in a hypothetical situation that when Delaware County blocked the transfer of nursing home patients at the start of the pandemic, the state health officer could have fired Delaware County Health Officer Donna Wilkins over the block.
That's something that goes against home rule for the county, according to Bane.
Members of the Delaware County Health Board said they were confused by what actual changes would need to happen because of the bill.
There was also confusion over why the legislation was needed in the first place, mainly being viewed as a move against Indianapolis, which has kept up tighter COVID-19 restrictions than the rest of the state.
As for local restrictions, the CDC released new guidelines saying fully vaccinated people can be maskless in many indoor spaces as well as outdoors.
The commissioners likely won't be changing any health restrictions from those currently in place.
"With our declaration now, it's allowing business to require masks or not. It also requires masks in county buildings," Henry said.
Corey Ohlenkamp is the city/county government reporter. Contact him via email at cohlenkamp@muncie.gannett.com or by phone at 765-213-5874. Follow him on Twitter at @Ohlenkamp.


According to a new poll, 45 percent of Republicans believe marijuana use by adults should be legalized nationally. The surge in support, up 5 percent after just 7 months, is likely related to a shifting attitude that marijuana prohibition is ineffective.
For a better idea on how significant attitudes have changed among Republicans recently, consider poll results in recent years. In the same survey done by YouGov last December, Republicans opposed marijuana legalization by 50 percent to 36 percent. Earlier, in January 2014, 60 percent of Republicans responded they were opposed to legalizing marijuana, compared to only 28 percent who voiced they were in support.
While the results align with the shift toward overall greater support for marijuana legalization throughout the U.S., there is also evidence that Republicans overall attitude regarding marijuana has not changed. Forty-three percent of Republicans continue to view marijuana as a gateway to harder drugs, however 54 percent of Republicans believe the government efforts to enforce marijuana laws cost more than they're worth. The results suggest, therefore, that Republicans are in support of legalization not because they believe marijuana to be harmless, but because they believe the war on drugs and prohibition to be ineffective.
That argument serves as the foundation for the Republicans Against Marijuana Prohibition organization, founded by lifelong Republican Ann Lee, which actively supports the end to marijuana prohibition.
Representative Dana Rohrabacher in California was the first Republican congressman to announce support for legalizing recreational marijuana. Rep. Rohrabacher also was the first sitting congressman to admit to using medical marijuana in 2016.
The survey found that 55 percent of American adults overall think the use of marijuana should be legalized. Sixty-three percent of Democrats were found to be in support of legalization, compared to 55 percent of independent voters.
Come November, nine states could have cannabis laws that allow marijuana for adult recreational use. As of now, four states – Colorado, Washington, Oregon, and Alaska – as well as Washington D.C., have passed adult use legislation. Arizona, California, Maine, Massachusetts, and Nevada have recreational marijuana initiatives that have qualified for this year's ballot.


Anyone Else Enjoy Being A Loner?
Sometimes being a loner can give me peace from daily distractions, yet I'm not into yoga or meditation per se. Being alone if forced upon you by death or divorce leads to seeking out others of similar circumstances, because it's human nature. What motivates me to get out and socialize is boredom from a routine. I'm finding a renewed interest in things I compromised on with my spouse because he didn't share the things I loved to do.
I'm not a party animal either--but if some of you are, a new senior community proposed by Jimmy Buffett called Margheritaville is being built. Probably a island setting with Palm trees, tequila, etc --It's 5:00 somewhere.
One of the big things that the 55 communities push is socialization.. I left thinking that I did not really want to be part of a group that got together every day. I would not mind once in a while but I wondered how accepting people would be of that kind of attitude where you did not want to be part of the group every day.
Ewwwww! Eve-r-y Day? No can do. We plan to move into one of these retirement communities shortly before we become too feeble to drive a car. I don't know: maybe we'll be up for everyday contact by then. Maybe we'll lead the daily walk or something then retreat to our apartment. Or maybe we'll resort to starting food fights in the dining hall so they make us eat alone, too ... jk.
I am of the opinion that their attitude about our lifestyle doesn't matter. As paying residents we'd be the boss, not the front office or the activity chair.
I can relate to this. I have no problem living alone. I like doing things with family and friends but usually at their homes or out somewhere and I am sure that is because then I can control how long I stay. One of the big things that the 55 communities push is socialization.. I left thinking that I did not really want to be part of a group that got together every day. I would not mind once in a while but I wondered how accepting people would be of that kind of attitude where you did not want to be part of the group every day.
@ASTRAEA Ye old conundrum of the theoretical versus the actual.
Kind of reminds me of the Charles Schulz' quote, "I love mankind, it's people I can't stand."
The shirt in question had the word "Go" printed on the front and back. I embroidered the word "Away" underneath those. At 15, I found that hilarious, however the missionaries, when they came knocking, scolded me for being rude. What rude, I wondered. Just direct and honest. LOL.
@Soosie - Sorry I missed this post when it first came out! I've been on my own since 1981, except for 2-1/2 years when my elderly aunt moved in with me. I had to bite my tongue when family & friends would say, "Isn't it nice, having company in the house?" I was a caregiver, even when my aunt did most things for herself, and I didn't feel lonesome before or after she was there!
I have a friend who's an extreme extrovert, and thinks that everyone should be or must want to be like her. I read up on extroverts & introverts, and although I can be outgoing & social, I'm just as happy being alone. I find it draining to be out & about at large social events, more than once or twice a week!
Tangentially, I don't like when tradesmen charge by the hour, because it motivates them to slow down, often times wanting to "chat" with me. When I had a handyman in for a bunch of smaller jobs, right after I bought this house, I too couldn't wait for him to finish & leave, by 4 or 5 PM!!
I enjoy being a loner for the most part but I don't want to grow old alone. Does that make sense?
@m933902a Indeed, this does make sense.
This is one of the reasons we plan to move into a retirement community when we are 85ish (whenever it is that we decide living on the road in our RV isn't fun or safe anymore). We are both the youngest in our families and we do not have children, so by that time we might not have have any family left. So we plan to become the table tennis and/or shuffleboard champs of the XYZ community. Ha ha.