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Undernutrition during critical periods of growth and development may permanently affect lung physiology and function.
To investigate whether acute undernutrition in childhood or young adulthood increases the risk of later hospitalization for obstructive airways disease, chronic obstructive pulmonary disease (COPD), or asthma.
We studied 7,841 women from Prospect-EPIC who experienced the 1944–45 Dutch famine between ages 0 and 21. Pulmonary outcomes were measured by registered hospital admissions and exposure-blinded computed tomography (CT) in a subgroup of 295 women. With Cox proportional hazard regression we explored effects of famine exposure on risk of hospitalization for obstructive airways disease, COPD, and asthma. With logistic regression we explored effects of famine on risk of CT evidence of pulmonary disease.
Risks of hospitalization for obstructive airways disease, COPD, and asthma were increased after moderate famine exposure, and significantly increased after severe famine exposure: hazard ratios for obstructive airways disease were 1.31 (95% CI: 0.97 to 1.77) and 1.57 (95% CI: 1.10 to 2.23) respectively. Associations between famine exposure and hospitalization for COPD were stronger in ever-smokers than in never-smokers.
Citation: van Abeelen AFM, Elias SG, de Jong PA, Grobbee DE, Bossuyt PMM, van der Schouw YT, et al. (2013) Famine in the Young and Risk of Later Hospitalization for COPD and Asthma. PLoS ONE 8(12): e82636. doi:10.1371/journal.pone.0082636
Editor: Michael Scheurer, Baylor College of Medicine, United States of America
Received: July 5, 2013; Accepted: October 25, 2013; Published: December 23, 2013
Copyright: © 2013 van Abeelen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The Prospect-EPIC study was supported by "Europe Against Cancer" Program of the European Commission (SANCO); the Dutch Ministry of Health; the Dutch Cancer Society; ZonMw, the Netherlands Organization for Health Research and Development; World Cancer Research Fund (WCRF). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Respiratory disease is one of the leading causes of non-communicable disease mortality worldwide. In 2008, 4.2 million people died from respiratory diseases globally, accounting for 7% of the total and 12% of the non-communicable disease mortality [1].
There is increasing evidence suggesting that respiratory diseases originate in early life. Undernutrition during critical periods of development, including fetal life, infancy, and childhood, may result in permanent changes in the structure and physiology of the body [2].
Animal studies have demonstrated that starvation in rats resulted in decreased tissue elasticity in the lungs, which was not reversed after resumption of feeding [3], [4]. Furthermore, a study in rabbits has demonstrated that seven days of postnatal malnutrition results in reduced lung weight, lung/birth weight ratio, and number of alveoli and elastic fibers and collagen deposition [5].
A meta-analysis of eight studies showed that birth weight was positively associated with lung capacity [6]. In these studies however, birth weight served as a crude marker of fetal growth as a reflection of the fetal environment. The Dutch Famine Birth Cohort Study directly assessed the long-term effects of acute prenatal undernutrition on atopy, lung function, and obstructive airways disease in adult life [7]. The prevalence of obstructive airways disease was markedly increased in people exposed to famine in mid gestation, the period during which the bronchial tree grows most rapidly [7].
Recently, it has been postulated that alveolarization is not restricted to fetal life and early childhood, but that neoalveolarization continues through childhood and adolescence [8]. Therefore, undernutrition during these periods may affect the development of the lungs and consequently lead to morphological or physiological alterations. However, in contrast to the prenatal period, much less is known about later life pulmonary consequences from a disturbed growth and development in the postnatal period.
As far as we know, there are no individual subject exposure data showing a direct relation between undernutrition during postnatal development and the risk of obstructive airways disease, chronic obstructive pulmonary disease (COPD), or asthma. Here we report on the association between moderate and severe undernutrition during childhood or young adulthood and the risk of hospitalization for obstructive airways disease, and two of its component diseases COPD and asthma. In Text S1 we also report on associations between undernutrition and signs of pulmonary disease on computed tomography (CT)-scans in a subgroup. For this study, we used the Prospect-EPIC cohort data with individual information on exposure to the 1944–1945 Dutch famine. Since smoking is the most important single causal factor for developing COPD [9], we also investigated the association between undernutrition and the risk of hospitalization for COPD separately for never-smokers and ever-smokers.
Subjects and Methods
Ethics statement
All women signed informed consent before study inclusion. The study complies with the Declaration of Helsinki and was approved by the Institutional Review Board of the University Medical Center Utrecht.
The Prospect-EPIC cohort
The Prospect-EPIC cohort consists of 17,357 women aged 49–70 years at recruitment between 1993 and 1997 (response rate 35%). It is part of the European Prospective Investigation into Cancer and nutrition (EPIC). The rationale and design of both EPIC and Prospect-EPIC have been described in detail elsewhere [10], [11]. Briefly, women residing in Utrecht or its vicinity were recruited through a breast cancer screening program.
At enrolment, participants were asked to return a general questionnaire about demographic and lifestyle factors and past and current morbidity, including smoking and level of education. Furthermore, trained assistants measured height, weight, and waist and hip circumferences, and checked the questionnaire for missing information. In addition, 573 women were randomly selected to undergo CT. Details are provided in Text S1.
Famine exposure
The Dutch famine.
The Dutch famine was an acute six month period of severe starvation in the urban western part of the Netherlands at the end of World War II, lasting from October 1944 to May 1945. This famine evolved from an accumulation of circumstances. Liberation of the Northern part came to a halt when the attack to capture the Rhine bridge at Arnhem (operation 'Market Garden') failed. In order to support the Allied offensive, the Dutch government in exile arranged a railroad strike to thwart German transport of troops and ammunition. As a reprisal, the German occupier banned all food transports. At the height of the famine, from December 1944 to April 1945, the official daily rations varied between 400 and 800 kcal [12]. The relative amount of proteins, fats, and carbohydrates remained essentially unchanged during this period [13]. After liberation on May 5th 1945, the food situation improved swiftly, ending the famine abruptly.
Famine exposure assessment.
At the time of enrolment, participants filled out the general questionnaire, which contained questions about place of residence, and experiences of hunger and weight loss during the Dutch famine. Possible responses to these last two famine questions were: 'hardly', 'little', or 'very much'. Responses 'not applicable' or 'I don't know' to one or both famine questions were excluded. Responses were combined into a three-point subjective hunger score: 'very much exposed' to both hunger and weight loss was categorized as 'severely exposed', 'hardly exposed' to both hunger and weight loss as 'unexposed', the rest as 'moderately exposed'.
Exposure age categories.
Age at famine exposure was assessed taking October 1, 1944, the start of the famine, as reference. Exposure age was classified into three categories; childhood (0 to 9 years), adolescence (10 to 17 years), and young adulthood (18 years or older), according to the seven stages in the postnatal human life cycle as defined by Bogin [14]. We defined pre-adolescent childhood, a period of rapid growth with many developmental milestones in physiology, behaviour, and cognition, as the period between 0 and 9 years, just before the growth spurt in women [14], [15]. From the start of the growth spurt, at around 10 years, through age 17 is called adolescence [14], [15]. This period is characterized by the growth spurt including sexual development [14], [15]. From 18 years of age, we considered persons as young adults gradually reaching homeostasis in physiology.
Subject selection
We excluded women born after the famine (n = 2,559) and those who resided outside occupied Netherlands during the famine (n = 1,732). Thus, both famine exposed and not exposed women in our study resided in occupied territory to ensure no differences in stress levels dependent of whether someone lived in an occupied or non-occupied territory. For 8,091 of the remaining 13,066 women the hunger score could be calculated (62%). Women not permitting data retrieval from the municipal administration registries, the National Medical registry, or Statistics Netherlands (n = 246) and women who had an unreliable date of hospital discharge diagnosis (n = 4) were also excluded, leaving 7,841 women for our analyses.
Out of the 573 women who underwent CT, we included 295 women for our analyses. A detailed description of subject selection for CT is provided in Text S1.
Outcome assessment
Data on obstructive airways disease, COPD, and asthma events until 31 December 2007 were provided by linking the cohort with the National Medical Registry (hospital discharge diagnosis) and with Statistics Netherlands (cause of death). Events were coded according to the International Classification of Disease (ICD) coding system version 9 or 10 (main or subdiagnosis): (i) hospital admission ICD-9 codes 490–496 for obstructive airways disease, 491–492 and 496 for COPD, and 493 for asthma; (ii) cause of death ICD-10 codes J40–J47 and J67 for obstructive airways disease, J41–J44 for COPD, and J45–J46 for asthma.
Data analysis
Participant characteristics at enrolment were first tabulated against severity of famine exposure to evaluate potential confounders.
We used Cox proportional hazard regression models to assess the effect of famine on the risk of hospitalization for obstructive airways disease, COPD, and asthma separately. To assess sensitive growth periods during female development in which undernutrition has the largest effect on later risk of hospitalization for obstructive airways disease, COPD, or asthma, we tested for interaction by introducing the cross-products of the famine score and age at start of the famine to the various models. Using logistic regression analyses, we assessed the association between famine exposure and the risk of CT evidence of pulmonary disease (presence of emphysema, airway wall thickening, or bronchiectasis; a more detailed description is provided in Text S1. Both models were used for adjustment for potential confounders, including age at start of the famine, smoking (never/past/current smoker and pack years), and level of education (low/intermediate/high; socioeconomic status proxy). Since undernutrition may affect susceptibility to environmental influences such as smoking, we analysed the association between famine exposure and hospitalization for COPD and CT evidence of pulmonary disease separately among never-smokers and ever-smokers.
We performed all statistical analyses with SPSS Statistics version 17.0 (SPPS, Chicago, IL, USA). P-values were based on two-sided tests with a cut-off level for statistical significance of 0.05. A detailed description of data analysis is provided in Text S1.
At the end of follow-up on 1 January 2008, 7,126 (91%) women were still alive, 666 (8%) had died, and 49 (1%) were lost to follow-up. During follow-up, a total of 247 (3%) had a severe episode of obstructive airways disease (238 hospital admissions and 33 deaths; 558,425 observation years), 213 women had a severe episode of COPD (204 hospital admissions and 33 deaths; 558,719 observation years), and 49 women had a severe episode of asthma (49 hospital admissions and 0 deaths; 559,651 observation years).
Table 1 shows baseline characteristics at recruitment. Overall, severely famine exposed women were on average older at the start of the famine, had higher BMI, waist circumference, and smoked more than unexposed women.
Table 2 shows that overall, the risk of hospitalization for obstructive airways disease and COPD was significantly higher among the moderately and severely famine exposed, in a dose-dependent manner. The risk of hospitalization for asthma was higher among moderately exposed and significantly higher among severely exposed women, also in a dose-dependent manner. Adjustment for age at start of the famine, smoking, and level of education as a proxy for socioeconomic status attenuated the risk estimates for obstructive airways disease and COPD. In the moderately exposed the risk of hospitalization for obstructive airways disease was 31% higher and in the severely exposed it was 57% higher than in unexposed women. For COPD these risk estimates were 32% and 53% for moderately and severely famine exposed women respectively (Table 2). Confounder adjustments did not change the risk estimates for asthma. The risk of hospitalization for asthma was 43% higher among moderately and 112% higher among severely famine exposed compared with unexposed women. Additional adjustment for BMI did not change these results (data not shown).
We did not find a statistically significant interaction between famine exposure and smoking nor between famine exposure and age at start of the famine. Figure 1 shows that among never-smokers, the risk of hospitalization for COPD (adjusted for age at start of the famine and education) among moderately famine exposed was 19% higher (95% CI: 0.67 to 2.12) and among severely famine exposed it was 33% higher (95% CI: 0.64 to 2.78) than in unexposed women (P for trend = 0.40). Among ever-smokers these risk estimates were stronger. The risk of hospitalization for COPD (adjusted for age at start of the famine, smoking, and education) among moderately famine exposed was 38% higher (95% CI: 0.93 to 2.06) and among severely famine exposed it was 62% higher (95% CI: 1.03 to 2.54) than in unexposed women (P for trend = 0.03).
Note below Figure 1: Adjusted hazard ratios and 95% confidence intervals (CI) for the risk of hospitalization for COPD among never-smokers and ever-smokers for women who reported to be moderately or severely exposed to famine compared to those who reported to be unexposed to famine.
Tables 3, 4, and 5 show the relation between famine exposure and subsequent obstructive airways disease, COPD, and asthma hospitalization risk within the exposure age categories. These tables show the crude results and adjusted for the potential confounders age at start of the famine, smoking, and level of education. Although there was no statistically significant interaction between famine exposure and age, we found a statistically significant dose-response relation between the severity of famine exposure and the risk of hospitalization for obstructive airways disease, COPD, and asthma within women aged 10–17 years at start of the famine. The dose-response relations for obstructive airways disease and asthma even remained statistically significant after adjustment for confounding.
The risk of CT evidence of pulmonary disease seemed higher among moderately and severely exposed women, although not statistically significant. Especially among ever-smokers, we found a statistically significant dose-response relation between famine exposure and the risk of CT evidence of pulmonary disease. More detailed results with regard to CT evidence of pulmonary disease are shown in Table S1.
This study demonstrates for the first time that a relatively short period of moderate or severe undernutrition during childhood or young adulthood is associated with an increased risk of hospitalization for obstructive airways disease, COPD, and asthma in adult life, in a dose-dependent manner. The effect of famine on the risk of hospitalization for COPD seems to be stronger among ever-smokers than among never-smokers. These findings were confirmed by CTs of the lungs of a random subset of participants of the Prospect-EPIC study. In these analyses, the association between famine exposure and CT evidence of pulmonary disease was also stronger among ever-smokers, suggesting an early life – later environment interaction.
Before further discussion, some aspects of our study require consideration. The Dutch famine is a 'natural experiment' in history, which gave us the unique possibility to study the long-term effects of acute undernutrition during childhood, adolescence, and young adulthood in otherwise well-nourished girls and women. We used individual famine exposure data in order to enhance the precision of exposure measurement. The drawback of individual data may be its subjective nature. However, our exposure classification agrees with rationing practices at that time. The allocated individual amount of calories was based on age. Young children (1–3 years) were relatively protected from the famine and received about 50%, whereas adults received about 25% of the distributed amount of calories at the start of the famine [12]. These historical facts are reflected by our data, showing that the older women were at the start of the famine, the higher the proportion that reported to have been exposed to famine. Furthermore, the famine was worst in large cities in the Western part of the Netherlands, which is also reflected in our data. The percentage of women who reported to be severely exposed to famine was 12% in those residing in the Western part of the Netherlands, whereas it was 4% for those residing in the Eastern part of the Netherlands. This may be considered in support of the quality of our exposure data. Nevertheless, our individual famine score is still susceptible for misclassification, since it was based on recollection. Especially this may be true for the youngest age group. Although, it is conceivable these young women have learned about their famine experiences from their parents and family. Nevertheless, if recall in the youngest age group during the famine is not as good as in the older women, this would lead to larger exposure misclassification in that age group. However, this misclassification is unlikely to be related to the outcome in this study and would therefore lead to an underestimation of the true association.
Selection bias might be another issue. The findings in this study are conditional on survival until examination between 1993 and 1997. This could have affected our results, but we can only speculate about this. An estimated 22,000 deaths are caused directly by the famine on an estimated population of 4.3 million people who suffered from the famine [16], [17]. Of these fatalities, an estimated 75% were male and 79% were babies or over 65 years of age [16]. Since our study only consists of females and less than 10% are babies, we suspect a minimal direct increase in mortality due to the famine in the source population of our study. Also, mortality before study inclusion at the age of 50 due to obstructive airways disease among women is also very low. To illustrate this; only 34 out of 5,419,598 women aged between 0 and 50 years died due to obstructive airways disease in 1996 [18], [19]. Thus, famine survivors may constitute of a group of women with somewhat better social resources for health and constitution, since the famine may have led to a somewhat increased mortality especially in women and girls with less efficient metabolism and low fat-reserves. However, the above makes the extent of potential selective survival before study inclusion negligible.
We believe we have captured real undernutrition as the determinant of later life outcome with these individual self-reports of famine exposure. However, we cannot exclude that these measures are proxies of other phenomena such as psychological stress, as with all retrospective studies on wartime famine exposure.
Since we identified our cases by means of linkage with the National Medical Registry (hospital discharge diagnosis), we probably included the more severe COPD and asthma cases. As a result, we cannot conclude from this study whether undernutrition during postnatal development leads to an increased incidence of respiratory diseases, to a more severe course of the diseases or to a combination of both.
We studied only women, recruited through a breast cancer screening program. Since there is an increasing body of evidence showing sex specific differences in programming, the generalizability of these results to men is unknown [20].
We found a significant dose-dependent association between famine exposure and the risk of hospitalization for obstructive airways disease, COPD, and asthma in adult life. These findings were confirmed by the CTs. We demonstrated that with increasing famine exposure the risk of CT evidence of pulmonary disease also seem to increase, although we could not demonstrate a statistically significant dose-response relation. This may be due to the small number of cases, since CTs were available for only 295 women.
Analysing the effects of famine on the risk of hospitalization for COPD separately among never-smokers and ever-smokers resulted in stronger associations among ever-smokers. This finding was also confirmed by the CTs. We found a statistically significant dose-response relation between famine exposure and the risk of CT evidence of pulmonary disease among ever-smokers, while among never-smokers we could not demonstrate a dose-response relation. These results might suggest that women who were famine exposed during their childhood, adolescence, or young adulthood were more sensitive for the toxic effects of smoking. As a consequence, the combination of early famine exposure and smoking later on results in the highest risk of hospitalization for COPD in adult life. We consider it very unlikely that these results are due to residual confounding. We measured lifestyle factors, including smoking, with as much precision as possible. We accurately adjusted the analyses within the ever-smokers group for pack years. Furthermore, when adjusting for covariables in the various regression models, we took special care to provide accurate fit of the data. However, we cannot completely exclude the possibility of residual confounding.
We could not demonstrate a statistically significant interaction between the effects of age at start of the famine and famine exposure. However, we found a statistically significant dose-response relation between the effects of famine exposure on the risk of hospitalization for obstructive airways disease, COPD, and asthma within the 10–17 year age category, while no significant dose-response relations were found in the 0–9 year and ≥18 year exposure age categories. One possible explanation for the fact that we could not demonstrate an association between famine exposure and the risk of hospitalization for obstructive airways disease, COPD, or asthma in young childhood could be that early childhood exposure may have been less severe than in older age groups. Young children were relatively protected from the famine within families and by special committees such as the Interchurch Organization [12], [16]. This could have resulted in lower exposure contrast and less power to detect an association in the youngest age group. However, this is in contrast with the previous finding of a higher risk of breast cancer after severe famine exposure in this age group [21]. Since we could not demonstrate a statistically significant interaction, further research into the age specific effects is needed to confirm these findings.
As far as we know there is no previous evidence on the long-term effects of postnatal undernutrition on adult lung function. The results of this study, however, support the autophagy hypothesis. Hereby, critical events like starvation induce adaptation processes by increased activation of autophagy, which in turn is associated with an increased risk of COPD [22]. Besides, a study in anorexia patients has demonstrated an association between chronic malnourishment and emphysema-like changes in the lungs of these patients [23]. The results of the present study agree with and expand the existing literature that besides chronic malnutrition, short-term undernutrition during childhood growth and development also results in an increased risk of hospitalization for obstructive airways disease, COPD, and asthma.
Our findings indicate that moderate or severe undernutrition during childhood or young adulthood is associated with an increased risk of hospitalization for obstructive airways disease, COPD, and asthma in adult life. Famine and undernutrition are still a major problem worldwide; never before have there been so many hungry people in the world [24]. Our findings suggest that famine may not only have short term but also long term consequences especially for those who experienced famine in early life, making them more susceptible to adverse environmental influences, such as smoking.
This study provides the first direct evidence that a short period of moderate or severe undernutrition during postnatal development increases the risk of hospitalization for obstructive airways disease, COPD, and asthma in adult life, which may be due to an increased vulnerability for the toxic effects of smoking.
Supporting Information
Text S1.
Online supplementary text file – methods.
Table S1.
Online supplementary table file – results, tables 6 and 7.
We thank the PHARMO institute and Statistics Netherlands for follow-up data on obstructive airways disease, COPD, and asthma.
The first author of this study (AFMvA) is currently working at Roche Nederland B.V. The research described in this publication was fully conducted and written at the University Medical Center Utrecht and the Academic Medical Center.
Author Contributions
Conceived and designed the experiments: DEG YTvdS. Performed the experiments: AFMvA PAdJ. Analyzed the data: AFMvA. Contributed reagents/materials/analysis tools: AFMvA SGE CSPMU TJR. Wrote the paper: AFMvA. Obtained funding: DEG YTvdS. Interpretation of data: AFMvA SGE PMMB DEG TJR CSMPU. Critically revised manuscript for important intellectual content: SGE PAdJ PMMB DEG YTvdS TJR CSPMU. Final approval of the manuscript: AFMvA SGE PAdJ PMMB DEG YTvdS TJR CSPMU.
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Puppy Dogs' Tales
By (author) Cecil Aldin
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Book DescriptionTo celebrate the centenary of the original publication of A Dog's Life we are completing Cecil Aldin's trilogy of best-loved dog books with this, Sleeping Partners is also in the series. Few people can fail to be cheered and charmed by Aldin's mischievous puppies, which first came to life on the walls of his children's nursery. Each evening, instead of a story, Aldin would draw a picture on the walls of the room until the drawings encircled the room, in the form of a chase with farmyard animals to add to the interest. They became the inspiration for a series of books and from these drawings, full of zest and humour, the illustrations for this book have been selected.
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Books By Author Cecil Aldin
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Cecil Aldin is regarded as Britain's greatest illustrator of animals, this collections features two of his favourite subjects: his dogs Cracker and Mickey.
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First published in 1902 A Dog Day is a day in the life of a lovable scamp, told by the dog himself, that has captivated generations.
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The next elegant edition in the Knickerbocker Classic series, Black Beauty is a moving and suspenseful tale of a horse's life.
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Author Biography - Cecil Aldin
Cecil Aldin was one of England's most illustrious illustrators, he is famous for his sporting prints, children's books and pictures of old inns but he is the unsurpassed master of depicting dogs. Aldin "captured the very soul of a dog." Roy Heron is Aldin's biographer and continues to promote the work of Cecil Aldin.
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Battaglia J.,CNRS Magmas and Volcanoes Laboratory |
Metaxian J.-P.,University of Savoy |
Garaebiti E.,PMB
Journal of Volcanology and Geothermal Research | Year: 2015
We examined one year of seismic recordings collected in 2008 during a temporary experiment at Yasur volcano (Vanuatu). The volcano has a permanent Strombolian activity that was at a relatively high level during most of our experiment with commonly at least one explosion per minute. Associated with this activity, the network recorded intense seismicicity with hundreds of transients per day. Video recordings indicate that most of the high frequency transients are directly related to the strombolian explosions. They also outline the presence of fewer signals which are not accompanied by any surface activity. The classification of transient events recorded at a station close to the summit indicates that a significant part of the events exhibit waveform similarity. This technique allows the identification of characteristic repeating events among the hundreds of thousands of transients recorded during the experiment. Most of the families of similar events are groups of explosion quakes (EQs) but a few are groups of Long Period events related to deeper processes. By scanning the 9. months of continuous data available at the summit station with master events extracted from these families we reconstruct their temporal evolution. Our results show that several families dominate the activity with a few of them lasting for several months. We show that their temporal evolutions can be used to probe changes in the structure or activity of the volcano. We observe that a major change was induced by a M = 7.3 subduction earthquake which occurred on April 9, 2008 about 80. km from the volcano. While this event did not change significantly the surface morphology of the volcano nor the intensity of the eruptive activity, it interrupted the families as none of them is present both before and after the event. This change in the waveforms can be explained by a drop in the seismic velocity of the volcano caused by the distal event. Numerous other transitions between families are observed, sudden or progressive. These can be interpreted as representative of changes in the eruptive dynamics. The presence of similar EQs, especially for impulsive explosions, indicates that the source mechanism is reproducible and has a stable location for some periods. This favors a source process based on the oscillation of the conduit or oscillation of the edifice in response to the explosive decompression of gas slugs at the free surface of the conduit. Our results suggest that the seismic activity of Yasur is characterized by the presence of dominant modes of resonance of the conduit which may be influenced both by external and internal factors. © 2015 Elsevier B.V. Source
Numerical solution of the conti nuity equation for soil water flow using precomputed steady-state fluxes
Ross P.J.,PMB
Vadose Zone Journal | Year: 2011
Numerical methods of calculating water flow in soils usually rely on solving Richards' equation, which is obtained by combining the equation of continuity with Darcy's law for water fluxes. In this study, the one-dimensional equation of continuity was solved using tables of precomputed steady-state fluxes read from disk. This results in simpler and faster code for applications such as field water balance models, which may use relatively large depth spacings and many repeated calculations. There is no speed penalty for the use of more complex property descriptions. Steady-state flux tables were computed by integration of Darcy's law, which results in the same solution as Richards' equation, but in principle they could be obtained in some other way. The method is much faster and more stable than conventional iterative methods both because it is noniterative and because good estimates of steady-state fluxes allow accurate solutions with larger vertical grid spacings, which in turn allow larger time steps. It is also both faster and simpler than other noniterative methods that provide good flux estimates because the fluxes are already available without the extra code and the time needed to compute them. © Soil Science Society of America 5585 Guilford Rd., Madison, WI 53711 USA. All rights reserved. Source
A structural outline of the yenkahe volcanic resurgent dome (tanna island, vanuatu arc, south pacific)
Merle O.,CNRS Magmas and Volcanoes Laboratory |
Brothelande E.,CNRS Magmas and Volcanoes Laboratory |
Lenat J.-F.,CNRS Magmas and Volcanoes Laboratory |
Bachelery P.,CNRS Magmas and Volcanoes Laboratory |
Garaebiti E.,PMB
Journal of Volcanology and Geothermal Research | Year: 2013
A structural study has been conducted on the resurgent Yenkahe dome (5. km long by 3. km wide) located in the heart of the Siwi caldera of Tanna Island (Vanuatu arc, south Pacific). This spectacular resurgent dome hosts a small caldera and a very active strombolian cinder cone - the Yasur volcano - in the west and exhibits an intriguing graben in its central part. Detailed mapping and structural observations make it possible to unravel the volcano-tectonic history of the dome. It is shown that, following the early formation of a resurgent dome in the west, a complex collapse (caldera plus graben) occurred and this was associated with the recent uplift of the eastern part of the present dome. Eastward migration of the underlying magma related to regional tectonics is proposed to explain this evolution. © 2013 Elsevier B.V. Source
Acanthaster planci outbreaks in Vanuatu coincide with ocean productivity, furthering trends throughout the pacific ocean
Houk P.,Pacific Marine Resources Institute |
Raubani J.,PMB
Journal of Oceanography | Year: 2010
This study identifies linkages between regional ocean productivity and the emergence of large Acanthaster planci starfish populations in Vanuatu. Positive correlations were found between wind stress, chlorophyll-a, and upwelling during January-February 2009, corresponding with coral-eating starfish occurrences. Further, temporal associations have existed between monthly wind stress and upwelling since 2000, and were predictors of past starfish events. Links between starfish emergence and oceanographic features are discussed, drawing upon evidence from other asteroid echinoderms. High regional productivity associated with anomalous oceanographic conditions in Vanuatu, and globally, can be used as early warning indicators of probable, future starfish emergence to aid the foundation and success of local management efforts. © 2010 Springer Science+Business Media B.V. Source
Battaglia J.,CNRS Magmas and Volcanoes Laboratory |
Metaxian J.-P.,University of Savoy |
Garaebiti E.,PMB
Geophysical Research Letters | Year: 2012
Large earthquakes are often assumed to influence the eruptive activity of volcanoes. A major challenge to better understand the causal relationship between these phenomena is to detect and image, in detail, all induced changes, including subtle, non-eruptive responses. We show that coda wave interferometry can be used to image such earthquake-induced responses, as recorded at Yasur volcano (Vanuatu) following a magnitude 7.3 earthquake which occurred 80km from its summit. We use repeating Long-Period events to show that the earthquake caused a sudden seismic velocity drop, followed by a slow partial recovery process. The spatial distribution of the response amplitude indicates an effect centered on the volcano. Our result demonstrates that, even if no major change in eruptive activity is observed, volcanoes will be affected by the propagation of large amplitude seismic waves through their structure, suggesting that Earthquake-volcano interaction is likely a more common phenomenon than previously believed. © 2012. American Geophysical Union. All Rights Reserved. Source


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The Google Blog just posted a report on how they feel some of the independent third party click fraud reports published are exaggerating the clickfraud numbers. Google says they have seen some reports that show "1.5 times the number of clicks in our logs," the reason? Well, Google summarized the "two main points" of the larger paper they published on the issue as being; (1) "mischaracterizing events," i.e. clicking the back button and it being characterized as a click and (2) "conflation across advertisers and ad networks," where cookie issues confuse Yahoo clicks with Google clicks. For the full, 17-page report, click here.
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(this is his dominant personality type)
(he also shows elements of this type)
Going Places
He is interested in the big picture and likes to examine large, ambiguous issues and ideas.
In relating to others, he can be well-adjusted, trusting, compassionate, intuitive and interested in people.
He is a die-hard romantic, and must have depth and meaning in his relationships.
A few excerpts from his personality test:
- It is important to respect authority
- I like to figure out how things work
- People should behave in ways that are morally correct
His 14 interests
in his own words...
Thousands of miles away from home, I'm staring down at an untouched wilderness from high above. Glistening lakes, snowcapped mountains, and forests fill the horizon with overwhelming beauty. As our helicopter crests the mountain, I hear the chorus of barking and see what has drawn me there. Tucked on the right side of the glacier, surrounded by sparkling white snow, is the sled camp. My heart pounds as the adrenaline surges through my veins in anticipation of what I am about to do: fulfill another one of my life-long dreams. Dog sledding in Alaska was one of the most thrilling highlights in all my travels. Whether it's sledding in Alaska, privately taking in the ancient "ceremony of the keys" in London, or digging my toes in the sand in St. Thomas, I love to explore the world. I guess it's the kid in me that pushes myself to seek out new and diverse experiences. I'm grateful to have a good job that affords me the opportunity to fulfill these desires. However, my time off is usually spent having a cold beer at the bar with friends, traipsing after that little white ball around the golf course, soaking in the sun outdoors, or cheering for one of my teams on the tube. Another favorite is letting my 80lb lab (who thinks he's still a puppy) take me for a walk. I also enjoy spending time with family (though they are spread around the east coast), especially the time spent with them relaxing, indulging in a delicious meal, and simply having some laughs. I'm looking for a sweet, caring, good hearted girl who is up for an adventure or twelve! She must enjoy the occasional joke or sarcasm and have a smile that lights up the room. Someone that can let her hair down for some fun but look dazzling when needed to. ;-) A girl that can get excited watching a game or snuggle in while watching a movie. If you think we might get along, send me a message or a wink and let's chat…
About him:
Living situation:
- Live with pets
Religious affiliation:
- Christian / Catholic
Relationship history:
- Divorced
- I'd prefer to share this information with my matches later.
Eye color:
- Hazel
Hair color:
- Light brown
Ethnic background:
- White/Caucasian
What he's looking for:
Age Range:
- 25 - 29
relationship history:
- Single (never been married)
- Divorced
- Widowed
- Not at all
- Every once in a while
Ethnic background:
- White/Caucasian
Religious affiliation:
- Christian / Catholic
- Christian / Other
- Not Religious
- Spiritual but not religious
- Other
- Bachelors degree
- Graduate or professional degree
- PhD / Post Doctoral


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Pet Sitting & Drop In Visits in Wooded Valley Estates, MD
Book a pet sitter to stop by your home a few times a day to feed and play with your cat or dog.
Fun, energetic, loves ALL pets!
Harwood, MD, 20776
Dog Boarding, House Sitting, Drop-In Visits, Dog Walking
About: My name is Patricia "Patty" and at 26 years old, I have worked full time for an emergency veterinary hospital in Huntingtown, MD, for 4 years now, ... (more)
French dog lovers for your baby
Upper Marloboro, MD, 20772
Dog Boarding, Drop-In Visits, Doggy Day Care, Dog Walking
"My dog is my baby and I wont leave him with just anyone. What I appreciate most about Aurelie is not just her obvious love for animals but her professional ... (more)"
Pet loving care specialist.
Owings, MD, 20736
Drop-In Visits, Dog Walking
About: After 20 plus years of working and commuting in the Washington DC metro area, I established Sitter 4 Kritters because of my love of animals and my ... (more)
Knowledgeable & unconditional love!
North Beach, MD, 20714
Dog Boarding, House Sitting, Drop-In Visits, Dog Walking
About: I am a loving and experienced animal advocate. I recently graduated from the University of Maryland in May with a degree in Exercise Science, but b... (more)
Animals are my life!
Edgewater, MD, 21037
House Sitting, Drop-In Visits, Dog Walking
About: Growing up I have always had various pets, ranging from lizards, fish, cats, and dogs. I have had all different dogs and sizes from yorkies, boxers... (more)
Animal lover from way back!
North Beach, MD, 20714
House Sitting, Drop-In Visits, Dog Walking
About: I have had dogs my whole life and have done house sitting and pet care since I was a kid. I also have a lot of experience working with veterinarian... (more)
I ❤ my dogs more than most people!
Shady Side, MD, 20764
Drop-In Visits, Dog Walking
About: I have had dogs my whole llife and feel that they should be treated like family! You need to know that when you away your dogs will be well taken c... (more)
Animal lover & Vet tech in training
Dunkirk, MD, 20754
Drop-In Visits
About: I have been around dog most of my life and have been pet sitting in clients homes for some time now. I like dogs of any size and breed Your dogs ar... (more)
Enthusiastic, Reliable Student
chesapeake beach, MD, 20732
House Sitting, Drop-In Visits, Dog Walking
About: I've had to care for 4 dogs growing up. I have house sat while caring for 2 dogs during that time. I now volunteer at Calvert Animal Welfare League... (more)
Experience exceptional service and a personalized match
From start to finish, we'll handle all the details for you.Learn About Premier
Rover also offers pet setting & drop ins in:
|Arbor Greene, MD
|Ashwood Manor, MD
|Dunkirk, MD
|Friendship, MD
|McKendree, MD
|Odyssey, MD
|Owings, MD
|Tracys Landing, MD
|Tuckers Reach, MD
|Wards Meadow, MD
Rover.com is the simple, savvy way to find and book Wooded Valley Estates drop in pet sitting. It's easy to find the perfect pet sitter — many sitters have offered pet sitting on Rover for years, and 95% of reviewed stays have received a perfect five-star rating. You'll get daily photo updates, and every stay booked through Rover also includes premium pet insurance, 24/7 support, and a reservation guarantee. Pet sitters on Rover have the option to complete a free background check, which you can see from their background check badge. Pet sitters are booked on Rover every minute of every day, and 92% of the population lives within a short drive of one of the more 60,000 sitters who've listed their services on Rover, so you're sure to find the perfect pet sitter in Wooded Valley Estates. When you book with one of our trusted pet sitters on Rover you get peace of mind that your home and pets are in loving hands.


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Note the Victorian-style architecture of the 1890 J.T. Sparkman home and step inside to see works of art and crafts by local artisans with a focus on equestrian, western and wildlife.
Tennessee Vacation eGuide
The 2016 eGuide gives you instant access to Tennessee's irresistible attractions and destinations. Peruse venues online, then put in your order to get a free guide delivered to your doorstep.


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It was a nice place to start my weekend at Dartmouth. Nice decor. Good beer choices. Attentive service. We'd definitely go back.
Can a vegetarian person get a good meal at this restaurant?
Does this restaurant have a TV?
Does this restaurant offer free wifi?
Can a gluten free person get a good meal at this restaurant?
Is this restaurant good for special occasions?
Is this restaurant good for business meetings?
Is this restaurant good for lunch?
Is this restaurant good for dinner?
Is this restaurant good for local cuisine?
Is this restaurant good for large groups?
Thanks for helping!Share another experience before you go.
It was a nice place to start my weekend at Dartmouth. Nice decor. Good beer choices. Attentive service. We'd definitely go back.
The atmosphere in Canoe Club is lovely - great decor. Our server was attentive, and our appetizers were tasty (cheese board and salads). Unfortunately, our main courses (chicken entree and mussels) left a lot to be desired. The chicken was incredibly dry and the did not taste right, and the mussels lacked flavor. One entree, the tuna, was good. Overall,... More
Love their locally sourced, homemade food. Suggested by a local and so glad we stopped here. Will be back!
The food items are always creative and tasty. Setting is very nice - better for talking rhan the other DT Hanover dining spots. Only critism : food is not delivered hot...even the soups. More attention to that detail is needed. And, this is based on multiple visits. A small thing to fix....but a big disappointment when the food comes out... More
We chose to dine at the Canoe Club on our second evening in Hanover during a recent visit in mid-December 2016. We were immediately intrigued with the name of the establishment and the potential for ties to the Buffalo Canoe Club on Lake Erie and we were not disappointed. We thoroughly enjoyed our dining experience, from the delicious food and... More
Previously, my one objection was that the restaurateur had been lured by the fashion for Mexican food. That is no longer the case. The menu is replete with temptations, and succumbing to them is gustatory delight. John Chapin continues to be a most welcoming host, a man who takes pride in everything about his establishment and wants to be sure... More
I ordered the Sea Food Stew Special which I found disappointing. It did not appear to contain the ingredients that were described by the waiter - no shellfish, shrimp or scallops. Instead what was presented was a bowl of shredded fish bits surrounding a cake of polenta. Others in our party ordered burgers and appeared to enjoy them. The beer... More
Maybe we got stuck with the leg and a thigh since it was takeout and they figured we wouldn't discover the deceit until we left the restaurant? But when you advertise a chicken breast it should be a breast unless they notify you in advance of a substitution. Risotto and roasted vegetables were so-so. The salmon was done perfectly ($24)... More
Based on the restaurant's decor, the greeting we received, and the live jazz music, I thought we were in for a great dinner. The food, however, was too inferior for that to happen. Our fried calamari appetizer had very little calamari and did not have the lightly fried texture that we enjoy. My wife's veggie burger was thin and so... More
We went after a matinee play in White River and even at 4 pm we got wonderful service and a very nice cheese board.
Own or manage this property? Claim your listing for free to respond to reviews, update your profile and much more.Claim Your Listing


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Published byAlanna Levett Modified over 2 years ago
Draft -- September, 2009
Randomize Agree? Make Patients Aware of Trial Enroll & Start Treatment Screening Consent Discussion Interest ? Eligible? Agree? Done Treatment Consent Discussion Yes No Yes No Yes No Non-Eligibility Letter Decline Questionnaire I-SPY2 Patient Portfolio Decline Questionnaire Optional Peer Support Call Peer Support Call (s) Done? Congratu- tions Letter No Yes Welcome Letter I-SPY2 Brochure Exit Interview Dropped Out No I-SPY2 Patient Website
Recruitment Promotion Consenting Patients Overall Recruitment Expectations Diversity Considerations Tracking Accrual Patient Decline Questionnaire Retention Patient Materials/Website Network of Strength Hotline Site Specific Support Exit Questionnaire
Trial Site Education Sessions, especially with surgeons Advocacy and Clinical Trials Websites Educational Sessions and Materials for Breast Cancer Hotlines National Scientific and Advocacy Education Sessions Local and National Press Release Local and National Press, TV, & Radio Interviews Local and National Advocate Presentations Scientific and Patient Publications Broad Distribution of I-SPY2 Brochure
See draft brochure
Informed Consent documents have undergone careful review by a large number of experienced advocates Training will be developed to reinforce best practices in consenting and summarize I-SPY2 specific information FAQ questions will be made available to consenters Patient website will have fact sheets, patient schedules, and other relevant information available as PDFs to support consenting process
Goal: Summing over trial sites, I-SPY2 patients should reflect the diversity of US women affected by breast cancer Actions: Travel reimbursement for research visits Proactive recruitment of trial sites that over represent minorities Identify potential affiliate and/or satellite hospitals that might partner with main I-SPY2 sites Proactive recruitment of patients from under represented minorities Targeted advocacy organizations (e.g., ICC) Targeted community outreach Targeted publications
Actions Continued: Develop and deliver culturally sensitive and targeted workshops on participation in clinical trials in general and I-SPY2 in particular Ensure that all of our patient materials are culturally sensitive and include pictures that reflect diverse populations Translate the Informed Consent and Recruiting Brochure into Spanish and/or other languages Identify language translation services that are available at each site Identify potential affiliate and/or satellite hospitals that might partner with main I-SPY2 sites
Quarterly by Trial Site Which sites are exceeding expectations? What can we learn from them? Which sites are failing to meet expectations? How can we remedy this? Quarterly by Patient Biomarker Profile and Treatment Plan Bi-annually for adequate diversity
ProblemPotential Solution Too few patients are offered trial Educate clinicians at trial sites Recruit more trial sites Increase national publicity Too many patients decline screening consent Educate consenters Improve patient material Assess reasons for decline Too many patients decline treatment consent Educate consenters Improve patient material Assess reasons for decline Look for variation by treatment arm
ProblemPotential Solution Distribution of patients by biomarker profile does not reflect distribution in population Identify competing trials for specific profiles at specific sites Over recruit from other sites Distribution of patients declining treatment varies by treatment assignment Clarify whether the issue is based on rejecting standard of care or a particular investigational agent Consider over recruiting controls and/or dropping problematic investigational agents Inadequate diversity Recruit sites in more diverse communities Increase targeted promotion
See draft Decline Questionnaire
Recruitment Promotion Consenting Patients Overall Recruitment Expectations Diversity Considerations Tracking Patient Decline Questionnaire Retention Patient Materials/Website Network of Strength Hotline Site Specific Support Exit Questionnaire
Recruiting Brochure New Patient Portfolio Website PDFs Fact Sheets Patient Schedule Trial Site Map, Support Services, Contact Information Peer to Peer Letters
The right amount of the right information at the right time Easy to navigate Attractivewhite space, pictures Text and FAQs PDF of key pages for use by trial site staff
See Prototype http://gemini-grp.com/ISPYPatientindex.htm
24x7 toll free hotline Staffed by trained and certified breast cancer survivors Free to callers Spanish speaking counselors Interpretation available in over 150 languages E-mail option Match programs Patient specific requests (e.g., diagnosis, treatment, demographics) Male breast cancer matches Partners match program
Screening and Treatment Informed Consent Forms request permission for Network of Strength counselor to call patient Patient may, alternatively, take number and call if and when they please A select group of experiences counselors will be specifically trained about I-SPY2 (based on I-SPY2 Website) Supporting, but not pressuring patients, who are considering enrollment Checking in on, encouraging, and supporting patients who are undergoing treatment
Website will provide site specific information Maps Hospital investigators and contact information Hospital services and contact information Locally available advocacy and support groups Encourage all sites to maintain regular communication with patients and continuous express appreciation for participations in I- SPY2 Optionally, local advocates will be identified to work with investigators at specific trial sites
Finalized Recruiting Brochure Develop detailed PR plan and pieces Develop training for consenters Reassess accrual assumptions Obtain site-specific recruitment, accrual, and diversity expectations Finalize tracking reports and data collection plan Finalize data collection and analysis plans for patient declines
Ensure conformance of Informed Consent documents and plan Hot-line support Decline questionnaire Follow-up on Patient Website Finalize material Construct site Pilot test with advocates Follow-up on Hot-line Finalize budget Negotiate terms Select counselors Develop and deliver training Develop Site Specific Support information
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- Home
- About MBA
- Key Entrance Exam
ExamExam Preparation
- Institute Review
North - ZoneWest ZoneEast Zone
- GD, Personal Interview
- GMAT & Foreign MBA
|CAT 2016 Result is round the corner and is to be declared shortly in the 2nd week of January as was earlier announced by IIM Bangalore. Since 1.95 lakhs candidates appeared in CAT 2016 it may become difficult to check the result when it is declared. MBAUniverse.com has launched the initiative to check your CAT 2016 result on real time basis in the fastest manner immediately when it is announced. Be the first to check your CAT result
During the peak hours when the CAT result is declared the CAT site faces technical issues as lakhs of test takers try to login simultaneously and the candidates find it difficult to get access to their score card. You will get the SMS Alert and the result will also be advised to you through SMS on your mobile phone...Read more
|After appearing in a revamped CAT 2016 exam on December 4, 2016, the test takers have started looking for their expected percentile scores based on their performance and know whether they will be shortlisted by IIM Ahmedabad, IIM Bangalore, IIM Calcutta, IIM Lucknow among others on the basis of percentile predicted in their favour.
There is a tendency to claim high accuracy after every CAT exam and it has never been proven to be correct. So the very first thing is that you should not expect more than 80 to 85 percent accuracy in QA and probably...Read more
|Making debut in IIM Ahmedabad, Bangalore, Calcutta, Lucknow, Indore or Kozhikode who provide not only a great learning experience but also high placements and entrepreneurship opportunities, is the dream of all CAT 2016 aspirants. But it is very much important to know the parameters and corresponding weightage that IIMs would award to them at various stages to shortlist you and then to make final admission offer for PGP 2017-19.
In fact your call from IIMs will depend upon various factors apart from your score in CAT 2016. To know whether you will get shortlisted by your preferred IIM A,B,C,L or others and what could lead you to get final admission offer from the IIM, please visit.
|Post CAT 2016 result declaration, all the 20 IIMs including the top ones like IIM Ahmedabad, Bangalore, Calcutta, Lucknow will announce the 1st stage shortlist for final selection round on the basis of CAT 2016 percentile scores and other parameters as announced in their admission policy for PGP 2017-19 batch.
Surprisingly, all the older IIMs have reduced the weightage to CAT 2016 scores. Besides your CAT 2016 scores, now IIMs need number of other things in you before offering admission to their flagship PGP 2017-19 batch. Your 99 percentile may turn into 'zero' percentile as far as call from IIMs is concerned unless you have complied with other key parameters. Almost all the IIMs have changed their admission policy for PGP 2017-19 batch and will look beyond your high overall percentile in CAT 2016 before offering you admission...Read more
|IIM Ahmedabad has announced the lowest qualifying sectional and overall CAT 2016 score for 1st stage shortlisting by this top B-school.
However, one thing to be remembered is that there will be a huge difference between the mandatory qualifying CAT 2016 percentile – sectional as well as overall and the actual CAT 2016 cut-off percentile in shortlisting you for the PI round. If the minimum required sectional and overall CAT 2016 percentile to consider you for shortlisting is 85 and 90 respectively at the IIM, the actual cut off would go beyond 98 or 99...Read more
|Apart from 20 IIMs, there are hundreds of top university affiliated MBA colleges, top ranked private PGDM institutes who accept CAT scores to shortlist candidates for final admission round. A few of such prominent management institutes are-
|CAT 2016 - Exam schedule
for CAT 2016 Exam Updates
Don't miss anything important! Register to receive regular updates, alerts and preparation tips from Toppers
|Considered as the mother of all MBA entrance exams, Common Admission Test, commonly known as CAT Exam, is the largest MBA entrance test to pursue MBA/PGDM in IIMs and other top rated MBA colleges in India. Apart from 20 IIMs there are other top rated B schools like FMS, JBIMS, IMI, IMT, MDI, NITIE, SPJIMR among more than 115 institutes in non-IIM category who will accept CAT 2016 scores for admission to MBA/PGDM 2017-19 programme.
CAT Exam which used to be held in 15 to 20 days testing window till 2013 has now shortened the testing window to 1 day only.
CAT is a yearly exam conducted by Indian Institutes of Management (IIMs). IIM Bangalore has been assigned the responsibility to convene CAT 2016. The best talent of country aspires for IIMs which are highly ranked in imparting management education. There are 2.32 lakhs candidates who have registered for CAT 2016 and are supposed to appear in this most coveted test this year. Return on investment at IIMs is probably the best. 2 years fee and other expenses at IIM come to around Rs.15 to 20 lakhs. Top recruiters from India and the world eye these institutes for their placement season and feel proud when a few of the students from these B- Schools join them. The offered salary packages go as high as Rs.50 to 70 lakhs per annum to the students of these institutes.
|A candidate is eligible to appear in CAT 2016, if he/she holds Bachelor's Degree with at least 50% marks or equivalent CGPA. The candidates belonging to Scheduled Caste (SC), Scheduled Tribe (ST) and Differently Abled (DA) categories need only 45% marks.
Candidates in final year of Graduation are also eligible to apply for CAT 2016. If selected, such candidates will be allowed to join the programme provisionally, only if she/he submits a certificate latest by June 30, 2017 from the Principal/ Registrar of the College/Institute (issued on or before June 30, 2017) stating that the candidate has completed all the requirements for obtaining the bachelor's degree/equivalent qualification on the date of the issue of the certificate.
|Common Admission Test (CAT) 2016 is conducted by IIM Bangalore. It will be an online computer based test. Full length practice test has been provided beforehand to familiarise the candidates about the type and pattern of the test.
Apart from Multiple Choice Questions (MCQs), there will be sufficient number of Non-MCQs in each section of CAT 2016 exam. Each correct answer is awarded 3 marks. While MCQs carry one-third negative marking, there is no penalty of negative marking for Non-MCQs.CAT 2016 exam will be of 3 hours duration. The exam is divided in 3 sections of 60 minutes each. Candidates are not allowed to move between one section to other during the 1 hour assigned to the particular section. Test takers cannot leave their seats during the exam.
|On October 25, 2016, IIM Bangalore, which is organizing CAT 2016 on behalf of all 20 IIMs, released the CAT 2016 Mock Test with 100 questions divided in 3 sections. For the benefit of serious MBA aspirants like yourself, MBAUniverse.com, India's leading MBA aspirants website, and VistaMind, India's leading CAT Coaching Institute, are happy to share Answers & Expert Solutions to IIM Bangalore's Official CAT 2016 Mock Test. This will help you in predicting your CAT 2016 Percentile. Follow the instructions below and check your answers...Read more
|Follow GATE formula
CAT 2016 percentile calculator is on the lines of GATE formula. Sharing the scoring pattern in CAT 2016 exam, IIM Bangalore has declared "In order to ensure fairness and equity in comparison of performances of the candidates across different test sessions, the scores of the candidates shall be subjected to a process of Normalization. The Normalization process shall adjust for location and scale differences of score distributions across different forms. After normalization across different forms, the scores shall be further normalized across different sections. The scaled scores obtained by this process shall be converted into percentiles for purposes of shortlisting. For reporting purposes, Scaled Scores for each section (Section I: Verbal Ability and Reading Comprehension (VARC), Section II: Data Interpretation and Logical Reasoning (DILR), and Section III: Quantitative Ability (QA)) and Total along with the Percentiles shall be published...Read more
|Syllabus for CAT 2016 or for any earlier CAT exams is never predefined by the convening IIM Bangalore or any earlier IIM. It is based on the mentioned guidelines and current structure of CAT exam. Past tendencies advise that CAT overall tests the candidate on Verbal Ability & Reading Comprehension; Quantitative Aptitude; Data Interpretation & Logical Reasoning. CAT Syllabus covers all the major topics on them. CAT 2016 syllabus is proposed to be based on the past paper patterns which contain questions from these sections.
CAT 2016-Verbal Ability & Reading comprehension syllabus
CAT 2016 Quantitative Aptitude Syllabus
CAT 2016-Syllabus for Data Interpretation:
The key topics are Tables; Column Graphs; Bar Graphs; Line Charts; Pie Chart; Venn Diagrams.CAT 2016-Syllabus for Logical Reasoning:
Questions in this section can be in sets or individual ones. Major topics on which questions are based are Clocks, calendars, binary logic, seating arrangement, blood relations, logical sequence, assumption, premise, conclusion, linear and matrix arrangement, etc.
|1.95 lakh test takers out of 2.32 lakh total registered candidates appeared in CAT 2016 divided in morning and afternoon sessions. With both the sessions of CAT 2016 exam over on December 4, now the candidates are waiting for their scores that would lead them to IIMs. Thousands of the students who interacted with us after coming out of the testing hall in the morning and afternoon session shared that the CAT 2016 test paper was moderate except that the Verbal Ability and few questions in Quant were found to be of a little more difficulty level. Most of them agreed that Data Interpretation & Logical Reasoning was not as tough as was in CAT last year but was more lengthy and despite knowing how to solve, the time did not permit to solve all of them...Read more
|CAT 2016 will be held in 138 test cities across the country and at more than 650 test venues.
| CAT 2016 Exam
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Hotfrog Singapore provides information regarding Pocket Full of Posies in Singapore. Pocket Full of Posies is located at 68 Orchard Rd, Plaza Singapura, The Flyin' Bread, Singapore 238839 and provides Retail services. Contact them on 6238 6257.
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A former Super Eagles Captain, Sunday Oliseh, has said Nigeria may, for the umpteenth time, miss out on qualification for the Africa Cup of Nations.
The Eagles were unable to qualify for the 2015 AFCON held in Equatorial Guinea and according to Oliseh, if the disturbing events that has trailed the first qualifying match in the 2017 qualification series are not addressed on time, Nigeria may again be a spectator at the showpiece event fixed to hold in Gabon early 2017.
"Let Nigeria leave side issues and player character attacks aside and face pure football issues. Otherwise we might not be at the next Nations cup again as participants but mere spectators!" Oliseh wrote on his personal blog sundayoliseh.tv.
The former Juventus and Ajax of Amsterdam midfielder faulted how the Nigeria Football Federation has been all over the place in their quest to nail Eagles captain Vincent Enyeama for his supposed "uncomplimentary remarks" about the choice of Kaduna for the AFCON qualifying match against Chad.
The Super who defeated Chad 2-0 in their first outing at the 2017 African Cup of Nations qualifier in Kaduna will take on Tanzania in September in the second game in the series.4years ago My wife left me,because i was too WEAK in bed,but today she calls me Bed Champion.Now i finally discovered a Natural Solution that forces women to ask for more. " - CLICK HERE To See My Breakthrough. Men, eat this fruit & you will get a bigger penis size. How I Permanently Cured My Premature Ejaculation And Low Sperm Count Problem Without Any Side Effects Within 72hrs.And Confidently Last Over 35 Minutes Per Round In Bed.


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I think Sarah would have to keep an eye on her sister.
I think Sarah would have to keep an eye on her sister.
I'm thinking unless things go terribly wrong with Snez Heather is going... She's the only one where Sam hasn't said I'll miss you. She said it but he wasn't as forthcoming as with Lana or Sarah.
If he ends up with Sarah I think they'll run into problems with timing of kids... I don't think he wants to wait 5 or so years which is what she was implying.
Phony (10-09-2015)
Little Chicken is adorable
babyno1onboard (10-09-2015),BettyW (10-09-2015),tootsiegirl (11-09-2015)
How funny were the questions lol bless her little heart
LittleBug'sMum (10-09-2015),tootsiegirl (11-09-2015)
I missed heathers home town visit, was it a disaster?
Dude let Sam eat!!!
Pregnant for the first-time?
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Our Insider Programs for pregnancy first-timers will lead you step-by-step through the 14 Pregnancy Must Dos!


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Starlight by Chris Perrotta
Your spectator uses her own phone's flashlight to focus a single ungimmicked beam of light onto the back of a spectator's card.
In full view the dot of light animates, stretches, then reshapes into an H.
The H then unravels and reshapes itself into the number 8.
The Eight of Hearts is her chosen card!
The "8" then unravels and shrinks down to a single dot of light..where your spectator then blows it out like a candle!
Watch the Starlight Demo now:
Features a super easy PHP no moves, no double-lift switch that allows the chosen card and deck to be examined before and after the light show!
* Super easy to do. No card skills required.
* Starlight can be pre-set before your performance to morph into any card value...any two digit number or any two initials!
* Works under all lighting conditions...from dark to light...indoors and outdoors (When using a borrowed phone's flashlight.)
* Spectator can hold her own phone in her own hand during entire effect.
* Performer has complete control over the light speed...and can stop and start the action at will.
* Resets in seconds.
* Perform any time...sitting, standing and surrounded.


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Skyline Institute of Engineering is one of the leading Engineering Colleges in India. It is rated as best engineering college in Delhi NCR, Noida, greater Noida and UP. You are not only entitled for top education but also are assured of best placement providing engineering college in Noida, greater Noida and UP. Affiliated to UP technical University Skyline Institute boasts of top placement in industry. You get not just high class education and industry training exposure in top engineering institute of Noida UP but we are also committed to delivering a qualified placement support to our student.


text: Great place, very clean with very attentive service. We splurged on a suite with lake view and we loved every minute of it. The decor has been updated and it's very refreshing. The restaurant at the Geneva Inn is a hidden gem. We didn't see any mention of it anywhere, but what a great treat it was. We ended up... More


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12 Reasons Gamers Make The Best Parents
These moms and dads prove that gaming can be an advanced parenting tool.
1. The dad who woke his kid up, adorably, Doom-style.
2. The dad who built his son a barn-side gaming rig.
3. This mom who showed her kids how it's done.
4. The dad who hacked Donkey Kong so his daughter could play as a female character.
5. The parents who rented out an entire movie theater so their son could have a legendary gaming birthday.
6. The Chinese father who hired in-game hitmen to help his son beat his World of Warcraft addiction through pure frustration.
7. The parents who did this.
8. The game-developer dad who built his daughter an entire game for her birthday present.
You can buy it on the app store!
9. The mom who baked this unreal cake.
10. The divorced dad who bought his daughter two Wii U's, so she could game at his house and at her mother's.
11. The mom who sewed this incredible costume.
12. The dad who found a creative way to get his daughter to do her chores.
Joe Bernstein is a senior technology reporter for BuzzFeed News and is based in New York. Bernstein reports on and writes about the gaming industry and web culture.
Contact Joseph Bernstein at email@example.com.
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In The News Today
- Oops: "Moonlight" won Best Picture at the Oscars, but they accidentally gave it to "La La Land" first 😳 ⁉
- Philip Bilden, the businessman nominated by President Trump to be secretary of the Navy, has withdrawn himself from consideration.
- Actor Bill Paxton has died at 61. He starred in classics including "Twister," "Titanic," "Big Love," and "Aliens."
- The Nokia brick phone is making a comeback — it's been reimagined with a colored screen, but the game Snake hasn't gone anywhere 🐍📲
Connect With TechLike Us On Facebook Follow Us On Twitter Follow Us On Apple News Subscribe to our RSS feed
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I'm looking for a: Woman
I like to see the most of the japanies heritages from kioto to the bamboo forest just everything what is posuble in 2-3 weeks
Purpose of Travel: Foodie tour, Road trip, Sightseeing
Finances: Each person pays for himself/herself
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Why See The Dinner Detective Interactive Murder Mystery Show?
The Murder is fake but the laughter is real!
Solve a hilarious murder case while you feast on a fantastic four-course plated dinner. Just beware, the killer is hiding somewhere in the room, and you may find yourself as a prime suspect!
how does it work?
Revolving round a four course sit down dinner the The Dinner Detective Interactive Murder Mystery Show will unfold in the room around you, transporting you into the middle of an interactive and improvised comic murder mystery. Set in the present day, the performers are not dressed in costume, in fact they are dressed just like everyone else and may even be seated at your table, so part of the fun from the beginning is trying to figure out just who is involved in the crime...
A murders and mayhem occur throughout the evening, hidden clues will come forth and our Detectives will help everyone try to solve the crime. In the end, the Top Sleuth will win a prize package when the solve the crime!
The Dinner Detective Murder Mystery Dinner Show performs Saturday nights, with offers for private shows that are customized to your party with roles for your group members to play. Join us for a one-of-a-kind public or private event that your guests will talk about for months.
Additional Information
Opening night: 10 December 2016
Suitable for ages 15 +
Run time
Three hours
Cast and Creative
Bay area actors, improvisors and comedians! The actors are "incognito" so telling you would be ruining part of the fun!
Scott O'Brien
About San Francisco Theater: We are an independent show guide with no affiliation to any venue or show. Some of the tickets offered for sale are resale tickets that may be priced above or below face value.
Next available performancesView all times and dates
Additional Information
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Please note: The term Le Meridien and/or The Dinner Detective Interactive Murder Mystery Show as well as all associated graphics, logos, and/or other tradermarks, tradenames or copyrights are the property of the Le Meridien and/or The Dinner Detective Interactive Murder Mystery Show and are used herein for factual descriptive purposes only. We are in no way associated with or authorized by the Le Meridien and/or The Dinner Detective Interactive Murder Mystery Show and neither that entity nor any of its affiliates have licensed or endorsed us to sell tickets, goods and or services in conjunction with their events.


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I'm looking for a: Woman
I want to rent a Pool Villa and stay there over all the winter. As I work in the Internet I can work from there!
Purpose of Travel: Beach break, Business trip
Finances: I can pay for everyone
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Save the products you like here
This product is out of stock. Customers interested in it also viewed these products
Look stylish and feel comfortable wearing this T-shirt for women from Ajile by Pantaloons. Made from polycotton, this T-shirt has a round neck and short sleeves. You can team this T-shirt with jeans or shorts to complete your casual look.
- FabricCOTTON POLYESTER
- LengthWaist Length
- SleevesCap Sleeves
- NeckRound Neck
- FitRegular
- Wash CareWash & Dry Inside Out, Machine Wash Cold, Wash DarSide Only, Do Not Dry Cleank Colors Separately, Delicate Cycle, Do Not Bleach, Remove Promptly, Flat Dry, Cool Iron on Reverse
- ColorGreen
- StylePrinted
- Model StatsThis model has height 5'8",Bust 34",Waist 24",Hip 35"and is Wearing Size S.
- REVIEWSREVIEWS FOR Green Printed Blouse
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That sun looks so warm and that cat looks so cute and happy.
Tip: Creating a profile and avatar takes just a minute and is a great way to participate in Catster's community of people who are passionate about cats.
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Michael Cook is editor of MercatorNet.com
A completely different way of viewing transgender issues comes from the Oxford Human Rights Hub. Geoffrey Yeung, a Hong Kong activist studying at Oxford, argued last year that restrictions on transgender people are banned by the United Nations Convention Against Torture (CAT).
Date posted: 2017-02-23
Sex reassignment surgery requires the intervention of doctors. But what kind of treatment is it? Is it a therapy for a disease which should be offered only after psychiatric authorization? Or is it a biomedical enhancement which anyone can freely choose.
Date posted: 2017-02-23
Hollywood's A-List has blamed Donald Trump for whipping up hysteria about immigrants. They should take a good look in the mirror. For decades Hollywood has tutored Americans in xenophobia.
Date posted: 2017-02-21
Relatives had to hold her down so that the doctor could give the lethal injection.
Date posted: 2017-02-21
The 1957 Wolfenden report changed the UK for ever. These flimsy arguments never would and never could stem the flourishing of a homosexual culture in Britain. In fact, 60 years later Britons live in a country where same-sex marriage is legal and criticism of homosexuality is taboo.
Date posted: 2017-02-15
Euthanasia only became legal in June and already about 800 people have received a lethal injection at the hands of a doctor.
Date posted: 2017-02-15
The number of autistic kids is skyrocketing. The number of transgender kids is skyrocketing. Is there a link?
Date posted: 2017-02-10
Ellinor Grimmark has been refused employment at several hospitals in the Jonkoping region because she has declared that abortion is against her conscience and her religious convictions.
Date posted: 2017-02-10
On January 27, Germany's Bundestag commemorated the 72nd anniversary of the liberation of the inmates of Auschwitz concentration camp. This year the focus was placed on the 300,000 disabled victims of the notorious Aktion T-4 euthanasia program.
Date posted: 2017-02-10
The US state of Colorado has legalized assisted suicide, but its large Catholic hospital system is refusing to cooperate, according to STAT.
Date posted: 2017-02-03
The new CRISPR gene-editing technology is an incredible tool, but it could be used for ethically-troubling procedures like human eugenics, modification of human germline cells, genetically-modified crops, gene drives to wipe out species and on and on and on. How can its uses be restricted?
Date posted: 2017-02-02
Scientists are close to finding out how to create eggs and sperm in a Petri dish.
Date posted: 2017-01-24
Spain is leading the world in deceased organ donation. An article in the American Journal of Transplantation explains how this happened.
Date posted: 2017-01-24
The dreary design of the website and Facebook page of Find Surrogate Mother (aka surrogacy inc) makes depressing reading. The business describes itself as "a full service Surrogacy Agency in Manila, Philippines, helping to match Surrogate Mothers, Intended Parents, Egg Donors, Sperm Donors [which] provide[s] services for Heterosexual Couple, Gay Couple, Lesbian Couple, Single Woman, Single Man".
Date posted: 2017-01-24
The imminent arrival of eggs and sperm grown from skin cells makes legislative change imperative, three Ivy League professors argue in the journal Science Translational Medicine.
Date posted: 2017-01-24
Well, that didn't take long. Euthanasia became legal in Canada in June and by December Quebec bioethicists had already published an article in the Journal of Medical Ethics calling for organ donation after euthanasia. In fact, they were reflecting the positive opinions of the both the Quebec government and Transplant Quebec.
Date posted: 2017-01-24
Philip Nitschke is one of the world's most famous Australians, although he has recently moved to the Netherlands. He helps people to kill themselves, mostly by directing them to lethal drugs or supplying them with bottled gas.
Date posted: 2017-01-17
The fundamental question in confronting euthanasia is whether life is worth living.
Date posted: 2017-01-17
Five years ago, a paper published in the BMJ came to the startling conclusion that IVF was more dangerous than abortion in the UK.
Date posted: 2017-01-17
Research showing that structural stigma reduces life expectancy is false.
Date posted: 2017-01-17
As clinics offering cheap surrogacy overseas shut their doors to foreigners, pressure is mounting in Australia to permit commercial surrogacy.
Date posted: 2017-01-17
A 14-year-old British girl dying of cancer recently won a court battle to be cryogenically frozen.
Date posted: 2017-01-01


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Status: OK
5 minutes ago: 8 sec
15 minutes ago: 8 sec
Today's average accuracy rate: 96.2 %
(updated every minute)
- Dec 01: RESOLVED - Live Chat Support will be off Today due to maintenance. Please, expect your concerns to be answered within 24hrs or less via http://deathbycaptcha.com/user/contact.
- Nov 20: RESOLVED - Today, the service went through emergency server updates that may have prevented you from using it normally. We sincerely apologize for the inconveniences this may have caused you. The service is now back to 100% and you should be able to use it successfully. If you're not able to do so, or if you were negatively affected by this, please Contact Us (deathbycaptcha.com/user/contact) and we'll help you out. We appreciate your patience and understanding!
- Nov 11: We've been making adjustments to our systems and you should now be getting even higher correctness rates :)!
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College students can duck gas prices, beat the crowds, stay in shape and get to class on time with a lightweight compact folding electric bicycle. Prodeco Technologies has an amazing line of high quality electric bicycles made in the USA to meet the demands of each rider and condition.
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Woman Gives Judge Middle Finger, Gets 30-Day Sentence for ContemptNBC 6 South Florida
Feb. 06, 2013
'Trump Was Right': Migrants Riot, Loot, Fight With Police And Set Cars On Fire In Sweden
Sweden's Migrant Crime Wave Becomes Top National Story As Media's Lies Backfire
FAKE NEWS: Trump Never Said There Was A 'Terror Attack' Last Night In Sweden
College Writing Center Director Says Proper Grammar is 'Racist'
Denmark: Resolution Passed to Prevent Danes From Becoming a Minority
It's not enough to be ruled by them, you have to lick their boots and "respect" them while they work to ruin your life. Despicable petty tyrant. - Chris
A woman facing a drug possession charge got a harsh lesson in justice after a Miami-Dade judge sentenced her to 30 days in jail for flipping him the bird at a hearing Monday.
Penelope Soto, 18, was arrested for possession of Xanax and was brought before Miami-Dade Circuit Judge Jorge Rodriguez-Chomat Monday, where she was asked about her assets.
Soto, who was sporting orange jail clothes and smiled and stroked her hair through the proceeding, laughed when she was asked how much her jewelry was worth.
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Differential Gear Housing Set by Losi
$1.99 Flat Rate Shipping!
|Low Price:
This item is eligible for $1.99 flat rate shipping Learn More
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Please be aware that pricing and product availability in-store may vary from what's available online because each store is independently owned and operated.
This is a replacement Losi Differential Gear Housing Set, and is intended for use with the Losi XXX-SCT, XXX-SCB and Desert Truck.
This product was added to our catalog on June 5, 2008.