You’ve seen it everywhere - that little thumbnail preview of a website mentioned in a tweet, the expanded description in a Slack channel, or in WhatsApp group chat.

Figure 1: The preview shown in a group chat provides a hint of what the real webpage looks like

These link previews are so commonplace that we hardly pay any attention to how our site design might be impacting the generated preview. Yet, these previews can be the most influential part for attracting new audiences and increasing engagement - possibly more than SEO. Even more alarming is that most web analytics are blind to this traffic and can’t show you how these Microbrowsers are interacting with your site.

As we close out the year, here are five essential questions and ideas that every web dev should know about Microbrowsers.

1. What are Microbrowsers? How are they different from “normal” browser?

We are all very familiar with the main browsers like Firefox, Safari, Chrome, Edge and Internet Explorer. Not to mention the many new browsers that use Chromium as the rendering engine but offer unique user experiences like Samsung Internet or Brave.

In contrast, Microbrowsers are a class of User-Agents that also visit website links, parse HTML and generate a user experience. But unlike those traditional browsers, the HTML parsing is limited and the rendering engine is singularly focused. The experience is not intended to be interactive. Rather the experience is intended to be representational - to give the user a hint of what exists on the other side of the URL.

Creating link previews is not new. Facebook and Twitter have been adding these link previews in posts for nearly a decade. That used to be the primary use case. Marketing teams created backlog items to adopt different microdata - from Twitter Cards and Open Graph annotations for Facebook. LinkedIn likewise embraced both Open Graph and OEmbed tags to help generate the previews

<meta name="description" content="seo description long"> <meta name="keywords" content="seo keyword list"> <link rel="shortcut icon" href="favicon.ico" type="image/x-icon"> <link rel="icon" href="favicon_32.png" sizes="32x32"> <link rel="icon" href="favicon_48.png" sizes="48x48"> <link rel="icon" href="favicon_96.png" sizes="96x96"> <link rel="icon" href="favicon_144.png" sizes="144x144"> <meta property="og:title" content="Short title here" /> <meta property="og:description" content="shortish description" /> <meta name="twitter:title" content="Short title here"> <meta name="twitter:description" content="shortish description"> <meta property="og:image" content="https://res.cloudinary.com/.../hero-img.png" /> <meta name="twitter:image:src" content="https://res.cloudinary.com/.../hero-img.png">

As group chats and other collaboration tools have become more prevalent, we have seen many features from the big social media platforms emerge. Particularly in recent years we’ve seen the adoption of the link unfurling behaviour in these chat platforms. Rather than reinventing the wheel, each platform looks for pre-existing microdata to generate the preview.

But which data should be used? How should this be arranged? As it turns out, each platform behaves slightly differently; presenting information in slightly different ways.

Figure 2: The same amazon link shared in iMessage (left), Hangouts and WhatsApp (right)

2. If Microbrowsers are everywhere, why don’t I see them in my analytics reports?

It’s easy to miss the traffic from Microbrowsers. This is for a number of reasons:

First, page requests from Microbrowsers don’t run JavaScript and they don’t accept cookies. The Google Analytics <script> block won’t be run or executed. And all cookie will be ignored by the rendering agent.

Second, if you were to do a log analysis based on HTTP logs from your CDN or web stack, you would see a relatively small volume of traffic. That is assuming you can identify the User-Agent strings. Some of these Microbrowsers impersonate real browsers and others impersonate Facebook or twitter. For example, iMessage uses the same User-Agent string for all these requests and it hasn’t changed since iOS 9.

User-Agent: Mozilla/5.0 (Macintosh; Intel Mac OS X 10_11_1) AppleWebKit/601.2.4 (KHTML, like Gecko) Version/9.0.1 Safari/601.2.4 facebookexternalhit/1.1 Facebot Twitterbot/1.0

Finally, many platforms - particularly Facebook Messenger and Hangouts use centralized services to request the preview layout. This, in contrast to WhatsApp and iMessage where you will see one request per user. In the centralized consumer approach your web servers will only see one request, but this one request might represent thousands of eyeballs.

3. Microbrowser are probably more important than google bot

We all know the importance of having our web sites crawled by search engines like googlebot. These bots are the lifeblood for lead generation and for discovering new users.

However, the real gold for marketers is from word-of-mouth discussions. Those conversations with your friends when you recommend a TV show, a brand of clothing, or share a news report. This is the most valuable kind of marketing.

Last year when assembling the data for Cloudinary’s State of the Visual Media report, I discovered that there was a very prominent usage pattern over the USA holiday season. During thanksgiving, all the way to Black Friday, the rate of link sharing skyrocketed as group chats shared deals and insights.

Zooming out (and normalizing for time-of-day), we can see that there is a daily cadence of link sharing and word of mouth referrals. It probably isn’t a shock to see that we predominantly share links in Slack between Monday and Friday, while WhatsApp is used all week long. Likewise, WhatsApp is most often used during our ‘break’ times like lunch or in the evening after we put the kids to bed.

While the link preview is increasingly common, there are two user behaviours to balance:

Users can be skeptical of links sent via SMS and other chats. We don’t want to be fooled into clicking a phishing links and so we look for other queues to offer validation. This is why most platforms use the preview while also emphasize the website url host name.

Skimming. I’m sure you’ve had the experience coming out of a meeting or grocery store to find a group chat with 100 messages. As you scroll to catch up on the conversation, links can easily be skipped. In this way, users expect the preview to act as a summary to tell them how important it is to visit the link.

Figure 4: Nielsen Norman Group summarizes the research in a dynamic image preview

Figure 5: A mockup of how an ecommerce product could create compelling previews showcasing colors, stock and price in the preview

4. Microbrowsers are not real browsers (they just play one on TV)

As I previously mentioned, Microbrowsers pretend to be a browser in that they send the right HTTP headers and often send impersonating User-Agent strings. Yet, there are several characteristics that a web dev should be aware of.

First, Microbrowsers try to protect the User’s privacy. The user hasn’t decided to visit your site yet, and more importantly, the user is having a private conversation. The fact that your brand or website is mentioned should just make your ears burn, but you shouldn’t be able to listen in to the conversation.

For this reason, all Microbrowsers:

don’t execute JavaScript - so your react application won’t work

ignore all cookies - so your A/B or red/green cookies will be ignored

some will follow redirects, but will quickly time out after a few seconds and give up trying to expand the link.

there won’t be a referer: HTTP header when the user clicks the link for the full browser. In fact, a new user will appear as ‘direct’ traffic - as though they typed in the url.

Second, Microbrowsers have a very small brain and very likely don’t use an advanced network algorithm. Most browsers will use a tokenizer to parse the HTML markup and send requests to the network stack asynchronously. Better yet, browsers will do some analysis of the resources needed before sending the async request to the network.

Based on observational experimentation, most platforms simply use a glorified for loop when parsing the HTML and often request the resources synchronously. This might be ok for fast wifi experiences, but it can cause inconsistent experiences on flaky wifi.

For example, iMessage will discover and load all <link rel="icon" > favicon, all <meta property="og:image" images, and all <meta name="twitter:image:src" before deciding what to render. Many sites still advertise 5 or more favicon sizes. This means that iMessage will download all favicons regardless of size and then not use them if it decides to instead render the image.

For this reason the meta markup that is included is important. The lighter the content, the more likely it will be to be rendered.

5. Markup Matters

Since Microbrowsers are simple-brained browsers, it is all the more important to produce good markup. Here are a few good strategies:

It’s almost 2020, you only need one favicon size. Remove all the other <link rel="shortcut icon" and <link rel="icon" references.

and references. Based on observational experimentation, the most commonly recognized microdata tags for preview are the Open-Graph tags. When the OG and twitter card tags are missing, the default SEO <meta name="description" is used. However, since the description is often nonsensical SEO optimized phrases, users’ eyes will likely glaze over.

On that note, use good descriptive text

Provide up to three <meta property="og:image" images. Most platforms will only load the first one, while others (notably iMessage) attempts to create a collage.

Figure 6: Amazon uses User-Agent detection which results in many link previews using the description meta tag.

Use <meta property="og:video* with progressive (not streaming) video experiences.

<meta property="og:type" content="video.other"> <meta property="og:video:url" content="https://shoesbycolin.com/blue.mp4"> <meta property="og:video:secure_url" content="https://shoesbycolin.com/blue.mp4"> <meta property="og:video:type" content="video/mp4"> <meta property="og:video:width" content="1280"> <meta property="og:video:height" content="720">

Don’t use UA sniffing to hide the <meta> tags. Sites like Amazon do this to try and show only Facebook/Twitter the microdata annotated website. But this can cause problems for some Microbrowsers that don’t use the same impersonation convention. The result is a simple link without a preview.

tags. Sites like Amazon do this to try and show only Facebook/Twitter the microdata annotated website. But this can cause problems for some Microbrowsers that don’t use the same impersonation convention. The result is a simple link without a preview. Use the opportunity to tell your product story or summarize your ideas.

Summary

As more of our conversations happen in group chats and slack channels, link previews are an important way for you to engage users before they start the journey on your site. Unfortunately, not all websites present good or compelling previews. (And now that you know what to look for, you won’t be able to unsee bad examples - I’m sorry). To help users take the leap and visit your site, we need to make sure that all our pages are annotated with microdata. Better yet, we can use these previews to create compelling visual summaries.


Warframe’s Next Expansion Brings an Open World

Warframe is set to escape its procedurally-generated levels later this year with a brand new expansion that’ll introduce open worlds into the third-person shooter.

These new open-worlds, called Landscapes, will be introduced in the game’s Plains of Eidolon later this year and will allow players the freedom to roam around these vast landscapes completing quests from NPCs found in a town called Cetus.

These Landscapes will also offer day/night cycles which will vary the gameplay experience for players. In the day time, the only threat will be waves of Grindeer clones, however at night a new enemy, called Eidolons, will make an appearance. These huge enemies require teamwork to defeat.

“The intent since day one was to take leaps, create and add to the game in an organic way where we listen to and surprise our players,” community manager, Rebecca Ford, told PC Gamer. “So in a way the game has evolved into a mash of genres that we didn’t necessarily plan specifically, but so far we’ve managed to make sense of.”

These open worlds introduced in the upcoming expansion will support up to 50 players, which is impressive. Unfortunately it looks like we may have to wait some time as the expansion is yet to receive a release date.


#!/usr/bin/env node
const { hasTSConfig, injectPropTypes } = require("./utils");

const cwd = process.cwd();

if (hasTSConfig(cwd)) {
  injectPropTypes(cwd);
}


Q:

What does the 'watt' specified for a motor mean?

What does the watts specification on a motor mean?
For example, there are motors with "power: 1500 watts" written on them. Does this mean that motor is capable of output power of 1500 watts?
And what is an 'LBC 05' series motor?
And if I wanted to drive two wheels of a car (x kg car) what are the factors that I will need to keep in mind while selecting the motor? Does the car weight matter?
Thank you. I am a newbie to this and trying to build an electric car :) Any help will be appreciated.
 EDIT : P.s Please what are poles of a motor ?

A:

International standards require the rated output mechanical power to be marked on a motor's rating plate. That would suggest that a motor with "1500 watts" marked on it should be capable of delivering 1500 watts of mechanical power to a load. However there is no guarantee that any particular motor conforms to international standards un less the literature or rating plate indicates that the motor conforms to IEC, NEMA or some other international standard. There may be also a marking on the motor that indicated whether or not it is rated for continuous duty. A 1500 watt motor rated for continuous duty should be capable of delivering 1500 watts of mechanical power 24 hours per day, 365 days per year.
A motor's frame size usually designates the physical dimensions, particularly the mounting and shaft dimensions. A given motor frame size can accommodate a range of speed, and power ratings. The torque rating for a given frame size may vary, but over a smaller range than the speed and power ratings.


1. Field of the Invention
This invention relates to an image forming apparatus in which, after forming an unfixed image on a recording material carried by a recording-material carrying member (such as a transfer drum or the like), the image on the recording material, separated from the recording-material carrying member, is fixed.
2. Description of the Related Art
Recently, in accordance with an increasing demand for color image forming apparatuses, a method has been adopted in which, after sequentially transferring multiple images onto a recording material carried by a transfer drum, the images are simultaneously (at one time) fixed.
In an approach proposed in U.S. Pat. No. 4,549,803, the fixing speed is changed in accordance with the detected type of the recording material so that fixability is invariable irrespective of the properties of the recording material.
For example, when forming an image on an OHP (overhead projector) sheet comprising a resin film, the fixing speed is reduced to about half that of ordinary paper so that the fixing time is doubled.
FIG. 8 is a cross-sectional view of a full-color copier which includes a transfer drum, which can change its fixing speed, and which therefore provides the background of the present invention.
A copier 1 includes a photosensitive drum (an image bearing member) 2 which rotates in the direction of arrow R1, and a charging unit 3, a developing device 6 comprising developing units 6M, 6C, 6Y and 6BK for magenta, cyan, yellow and black toners, respectively, and a cleaning unit 7, sequentially disposed in the direction of the rotation of the photosensitive drum 2.
After an exposure unit 5 sequentially forms electrostatic latent images corresponding to respective colors on the photosensitive drum 2 charged by the charging unit 3, the developing unit 6 sequentially forms toner images.
The toner images are sequentially transferred onto a printing medium P wound around a transfer drum (transfer member) 9. The printing medium P is accomodated in a paper-feeding cassette 10 provided at a lower portion of the image forming apparatus, and is supplied to the transfer drum 9 via a paper-feeding roller 11, registration rollers 12 and a pressing roller 13. The leading-end portion of the supplied printing medium P is grasped by a gripper (not shown) of the transfer drum 9, and the entirety of the printing medium P is wound around the surface of the transfer drum 9 by an electrostatic force. The toner images are sequentially transferred onto the printing medium P at a transfer position M1. That is, a single-color toner image is transferred onto the printing medium P at the transfer position M1 at every rotation of the photosensitive drum 2. Four full-color toner images are transferred onto the printing medium P by four rotations of the photosensitive drum 2. The leading-end portion of the printing medium P on which the images have been transferred is released from the gripper, and a separation charger (a separation unit) 15 separates the printing medium P from the photosensitive drum 2 at a separation position M2 facing the separation charger 15. The printing medium P separated from the transfer drum 9 is guided to a fixing unit 17 by a conveying unit 16 including a conveying belt 16a rotatable in the direction of arrow R3.
A pair of fixing rollers 17a rotating in the direction of arrow R5 are provided in the fixing unit 17. The toner images on the printing medium P are mixed and fixed on the printing medium P as a full-color image by a sufficient pressure of the pair of fixing rollers 17a and by heating the medium P. The printing medium P on which the toner images have been fixed is discharged onto a paper-discharge tray 20 by paper-discharging rollers 19.
The above-described fixing operation of the toner images is performed at a fixing speed which differs in accordance with the properties of the printing medium P. For example, if the printing medium P comprises a thick film, such as an OHP sheet, it is necessary to sufficiently press and heat the toner images. For that purpose, the fixing time is elongated by reducing the fixing speed. The fixing speed is reduced by reducing the rotating speed of the fixing rollers 17a.
When the fixing speed is reduced in such an apparatus, in order to prevent the occurrence of deviations between toner images or corrugation in the printing paper P caused by a speed difference between the transfer drum 9 and the pair of fixing rollers 17a, the distance Ls between the separation position M2 (where the printing medium P is separated from the transfer drum 9) and the fixing position (which is at a nip of the pair of fixing rollers 17a) is set to be longer than the maximum length of the used printing medium P.
This hinders a reduction of the size of the copier 1. Furthermore, since a conveying force is not provided to the printing medium P until the printing medium P reaches the fixing unit 17 after leaving the transfer drum 9, it is necessary to provide the conveying unit 16 between the transfer drum 9 and the pair of fixing rollers 17a.


Various attempts have been made to reduce or eliminate sidestream smoke emanating from a burning cigarette. The applicant developed various approaches to cigarette sidestream smoke control systems as described in its Canadian patents 2,054,735 and 2,057,962; U.S. Pat. Nos. 5,462,073 and 5,709,228 and published PCT applications WO 96/22031; WO 98/16125 and WO 99/53778.
Other sidestream smoke control systems have been developed which use filter material or adsorptive material in the tobacco, filter or paper wrapper. Examples of these systems are described in U.S. Pat. Nos. 2,755,207 and 4,225,636; EP patent application 0 740 907 and WO 99/53778. U.S. Pat. No. 2,755,207 describes a low sidestream smoke cigarette paper. The cigarette paper on burning yields a smoke substantially free of obnoxious components. The cigarette paper is cellulosic material in fibre form. It has intimately associated therewith a finely divided mineral type siliceous catalyst material. The cigarette paper which is essentially non-combustible and refractory remains substantially unchanged during combustion of the cigarette paper and functions like a catalyst in modifying the combustion of the paper. Suitable siliceous catalysts include acid-treated clays, heat-treated montmorillonite and natural and synthetic silicates containing some hydrogen atoms which are relatively mobile. Suitable mixed silica oxides include silica oxides with alumina, zirconia, titania, chromium oxide and magnesium oxide. Other silicas include the oxides of silicon and aluminum in a weight ratio of 9:1 of silica to alumina.
U.S. Pat. No. 4,225,636 describes the use of carbon in the cigarette paper to reduce organic vapour phase components and total particulate matter found in sidestream smoke. In addition, the carbon results in a substantial reduction in visible sidestream smoke emitting from a burning cigarette. Activated carbon is preferred as the carbon source. The use of the activated carbon results in a slight drop in visible sidestream smoke. Up to 50% of the cigarette paper may be finely divided carbon. The carbon-coated papers may be used as the inner wrap for the tobacco rod in combination with a conventional cigarette.
European patent application 0 740 907 published Nov. 6, 1996 describes the use of zeolites in the tobacco of the cigarette to alter the characteristics of the mainstream smoke and in particular remove various components from the mainstream smoke such as some of the tars. The zeolite as provided in the tobacco, also apparently change the characteristics of the sidestream smoke. The zeolites used were of a particle size between 0.5 mm to 1.2 mm.
Published PCT patent application WO 99/53778 describes a non-combustible sheet of treatment material for reducing sidestream smoke emissions. The sheet is used as a wrap and is applied over conventional cigarette paper of a conventional cigarette. The wrap has a very high porosity to allow the cigarette to burn at or close to conventional free-burn rates while at the same time reduce visible sidestream smoke emissions. The non-combustible wrap includes non-combustible ceramic fibres, non-combustible activated carbon fibres as well as other standard materials used in making the wrap. The wrap also includes zeolites or other similar sorptive materials and an oxygen donor/oxygen storage metal oxide oxidation catalyst. The non-combustible wrap provides an acceptable degree of sidestream smoke control, however, due to the non-combustible nature of the wrap, a charred tube remains.
U.S. Pat. Nos. 4,433,697 and 4,915,117 describe the incorporation of ceramic fibres in a cigarette paper manufacture. U.S. Pat. No. 4,433,697 describes at least 1% by weight of certain ceramic fibres in the paper furnish in combination with magnesium oxide and/or magnesium hydroxide fillers to reduce visible sidestream smoke emanating from the burning cigarette. The furnish of fibre pulp, ceramic fibres and fillers are used to make a paper sheet on conventional paper making machines. The ceramic fibres may be selected from the group of polycrystalline alumina, aluminum-silicate and amorphous alumina. A filler of magnesium hydroxide or magnesium oxide is used and is coated on or applied to the fibres of the sheet.
Ito, U.S. Pat. No. 4,915,117 describes a non-combustible sheet for holding tobacco. The thin sheet is formed from ceramic materials which upon burning produces no smoke. The ceramic sheet comprises a woven or non-woven fabric of ceramic fibre or a mixture of paper and ceramics thermally decomposed at high temperature. The ceramic fibre may be selected from inorganic fibres such as silica fibre, silica-alumina fibre, alumina fibre, zirconia fibre, or alumino borosilicate and glass fibre. The ceramic sheet is formed by binding these materials by inorganic binders such as silica gel or alumina gel. The fibres are a preferably 1 to 10 micrometers in diameter.
Sol gels have been applied to conventional cigarette paper in order to reduce sidestream smoke, particularly sol gels made from a magnesium aluminate, calcium aluminate, titania, zirconia and aluminum oxide, as described in Canadian Patent 1,180,968 and Canadian Patent application 2,010,575. Canadian Patent 1,180,968 describes the application of magnesium hydroxide in the form of an amorphous gel as a cigarette paper filler component to improve ash appearance and sidestream smoke reduction. The magnesium hydroxide gel is coated on or applied to the fibres of the sheet of the cigarette paper. Canadian patent application 2,010,575 describes the use of gels produced by a solution gelation or sol-gel process for controlling the combustion of wrappers for smoking articles. The gels may be applied as coatings to paper fibres before the paper is formed into wrappers. The wrappers are useful for reducing visible sidestream smoke. The metal oxides for the sol gels may be aluminum, titanium, zirconium, sodium, potassium or calcium.
Catalysts have also been directly applied to cigarette paper, such as described in Canadian Patent 604,895 and U.S. Pat. No. 5,386,838. Canadian Patent 604,895 describes the use of platinum, osmium, iridium, palladium, rhodium and rhuthenium in the cigarette paper. These metals function as oxidation catalysts to treat vapours arising from combustion of the paper wrapper. Optimum catalytic effect has been provided by the metal palladium. The metal particles in a suitable medium are dispersed onto the face of a paper wrapper before it is applied to the cigarette.
U.S. Pat. No. 5,386,838 describes the use of a sol solution comprising a mixture of iron and magnesium as a smoke suppressive composition. The smoke suppressive composition is made by co-precipitating iron and magnesium from an aqueous solution in the presence of a base. The iron magnesium composition demonstrates high surface area of approximately 100 m2/g to approximately 225 m2/g when heated to a temperature between 100° C. and approximately 500° C. The iron magnesium composition may be added to paper pulp which is used to make smoke suppressive cigarette paper. The iron magnesium composition apparently functions as an oxidation catalyst and reduces the amount of smoke produced by the burning cigarette. The catalyst may also be applied to the tobacco, for example, as described in U.S. Pat. No. 4,248,251, palladium, either in metallic form or as a salt, may be applied to the tobacco. The presence of palladium in tobacco reduces the polycyclic aromatic hydrocarbons in the mainstream smoke. Palladium is used in combination with an inorganic salt or nitric or nitrous acid. Such nitrates include lithium, sodium, potassium, rubidium cesium, magnesium, calcium, strontium, lanthanum, cerium, neodymium, samarium, europium, gadolinium, terbium, dysprosium, erbium, scandium, manganese, iron, rhodium, palladium, copper, zinc, aluminum, gallium, tin, bismuth, hydrates thereof and mixtures thereof Catalysts have also been used in tubes to reduce sidestream smoke such as described in published PCT application WO 98/16125.
Catalytic materials have been used in aerosol types of cigarettes which do not produce sidestream or mainstream smoke per se, but instead a flavoured aerosol. Examples of these aerosol cigarettes include those described in U.S. Pat. Nos. 5,040,551, 5,137,034 and 5,944,025, which use catalysts to provide the necessary heat generation to develop the aerosol. Such catalyst systems include oxides of cerium, palladium or platinum.
Although the prior art contemplates various sidestream smoke control systems, none of them have provided a system which effectively reduces sidestream smoke by simply incorporating active components in the combustible cigarette paper so that the cigarette burns like a normal cigarette without appreciably affecting cigarette taste. Accordingly, this invention provides a sidestream smoke control system which not only looks and tastes like a conventional cigarette but as well, in accordance with aspects thereof, ashes like a normal cigarette.


INTRODUCTION
============

Chronic respiratory disease accounts for 4 million deaths annually, 4% of the global burden of disease, and 8.3% of chronic disease burden.[@B1] Chronic obstructive pulmonary disorder (COPD) is one of the main causes of mortality in Korea.[@B2] The prevalence of asthma, allergic rhinitis (AR), and rhinosinusitis is also increasing and has become the major health priority in Korea.[@B3][@B4][@B5][@B6] These preventable chronic respiratory diseases have a major adverse impact on quality of life, disability, and productivity, resulting in an increased socioeconomic burden.

Several recent retrospective analyses have used in Korean national health insurance databases to estimate the economic burden of asthma, AR, and COPD.[@B7][@B8][@B9][@B10][@B11] These studies have provided an immediate insight into the economic burden to the Korean healthcare system; however, there is a lack of data assessing the broader impact of respiratory disease on patients (*e.g.*, symptoms and impact on work productivity). Furthermore, there is limited data exploring the overall disease burden of multiple respiratory diseases using a standardised approach. A comprehensive understanding of the overall disease burden is important for identifying key signaling symptoms for respiratory disorders and for identifying cost-effective treatment strategies to minimize their impact and to appropriately allocate healthcare resources.

The Asia-Pacific Burden of Respiratory Diseases (APBORD) study is a cross-sectional, observational one which has used a standard protocol to examine the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across the Asia-Pacific redion.[@B12][@B13] Here, we report the burden of respiratory diseases, including symptoms, healthcare resource use (HCRU), work impairment, and associated costs in Korea.

METHODS
=======

Study design
------------

This study formed part of the large multi-country, cross-sectional, observational study of adult patients receiving care for respiratory disease across 6 countries in the Asia-Pacific region (India, Korea, Malaysia, Singapore, Taiwan, and Thailand). The study consisted of site-based surveys administered to patients and physicians presenting with a primary diagnosis of respiratory disease during a routine visit to a healthcare provider. In Korea, subjects were recruited from 2 hospitals and 6 clinics between November 2012 and February 2013. The study was approved by Institutional Review Boards at Seoul National University Medical Center and Konkuk University Medical Center.

Patients
--------

Patients presenting consecutively at each study site were assessed by the physician (respiratory specialist or primary care physician) during a routine consultation. The physician ascertained that the primary reason for the patient\'s visit was to receive care for respiratory disease. All patients receiving care for respiratory disease were screened for eligibility to participate in the study. Eligibility criteria included consecutive patients aged ≥18 years receiving care for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis. Subjects were excluded if they had participated in any interventional clinical study within the 12 weeks prior to entering the current study. A patient could only participate in the study once, and no follow-up visits were recorded. Eligible patients were invited to participate in the study, and informed consent was obtained from each patient.

Data collection
---------------

During the study visit, physicians completed the Screening and Consent Log as well as the Physician Survey. The Consent Log captured the basic demographics and respiratory diagnosis of each eligible patient, and information on whether an eligible patient consented to participate in the study. The Physician survey comprised questions regarding to the patient\'s respiratory diagnosis. Physicians indicated which of the 4 diseases was the primary diagnosis and whether the patient had any other of the 4 diseases in addition to the primary diagnosis. Physicians also recorded medication use 4 weeks prior to the study visit and medications prescribed at the current visit.

The diagnosis of respiratory disease was defined by ICD-10 classifications.[@B14] This excluded some infectious and parasitic diseases that may affect the respiratory system (*e.g.*, tuberculosis) as well as neoplasms of the respiratory system. Diagnosis was made by the attending physician using criteria based on international guidelines for asthma, AR, COPD, and rhinosinusitis.[@B15][@B16][@B17][@B18] The physician was required to indicate the clinical criteria for the diagnosis from a list of disease criteria adapted from these clinical practice guidelines for any patients with a new diagnosis of any of the 4 diseases. The patients\' clinical management and physicians\' usual diagnostic practices were not intended to be influenced by participation in the study; however, some patients may have been diagnosed using a more rigorous and standardized approach than prior to commencement of the study. No attempts were made to independently verify or confirm the patient\'s diagnosis, and no follow-up diagnostic tests were conducted.

Consenting patients completed the Patient Survey which included questions regarding to general demographics, respiratory symptoms, HCRU, and work productivity. Patients listed their respiratory-related symptoms at the current visit and identified their main symptoms leading to the current visit. HCRU included the number of visits to a general practitioner (GP), medical specialist, alternative and traditional medicine practitioner, pharmacist, emergency department, and hospital admissions in previous 4 weeks.

Work productivity was assessed using the Work Productivity and Activity Impairment-Specific Health Problem (WPAI-SHP) questionnaire.[@B19] The WPAI-SHP measures amounts of absenteeism (work time lost) and presenteeism (lost on-the-job productivity) as well as daily activity impairment attributable to a specific health problem. The recall period in this questionnaire is 7 days.

Costs
-----

A broad societal perspective was adopted for cost analysis. The costs were collected based on government and patient costs. Unit costs were sourced from Health Insurance Review and Assessment (HIRA) and Korean Statistical Information Service (KOSIS). Average costs were calculated using the unit cost of the healthcare resource use item multiplied by reported HCRU in previous 4 weeks plus the current visit to the GP or specialist. For each medication class, one medication representative of the most commonly prescribed medication for respiratory disease was identified. The Dosing and duration of medication use was according to therapeutic guidelines.[@B12] Lost productivity costs were calculated by multiplying the overall productivity lost from the WPAI questionnaire by the average monthly wage (estimated at KRW 3,259,799 from ILO Global Wage Database 2012). Four-week costs were multiplied by 2 to estimate annual costs. Costs were presented in USD using the exchange rate for September 15, 2014: 1 USD=1,040.20 KRW.

Statistical analysis
--------------------

Statistical analyses were performed using SAS® for Windows, version 9.3 (SAS Institute Inc., Cary, NC, USA). The demographics and clinical characteristics of the patients were described using mean (SD) for continuous variables and number (percentage) for categorical variables. The percentage and 95% confidence intervals of the patient with each disease entity was calculated using the exact (Clopper-Pearson) method.

RESULTS
=======

Patient demographics
--------------------

A total of 4,439 patients were diagnosed with a respiratory disease and subsequently screened across 2 hospitals and 6 clinics in Korea. Of these, 4,439 patients 1,779 (40.1%) were considered eligible after screening, with 999 (56.2%) patients consenting and being enrolled in the study.

The mean (SD) age of the enrolled patients was 48.2 (SD 17.28) years, 58.4% of whom were female ([Table](#T1){ref-type="table"}). There were 50.6% of patients employed full-time or part-time. Sixty-four percent of the patients had never smoked. Of patients who had ever smoked, 39.3% were current smokers.

Frequency of respiratory disease
--------------------------------

The most frequent primary diagnosis was AR (55.7%, 95%CI: 52.5%, 58.8%), followed by asthma (31.8%, 95%CI: 29.0%, 34.8%), rhinosinusitis (6.9%, 95%CI: 5.4%, 8.7%), and COPD (5.6%, 95%CI: 4.3%, 7.2%). Patients were frequently diagnosed with multiple respiratory diseases ([Fig. 1](#F1){ref-type="fig"}). Overall, 428 (42.8%) of patients were diagnosed with a combination of the 4 diseases of interest. In particular, a large percentage of patients were diagnosed with a combination of one or more of the 4 diseases of interest (74.3%). The most common combination was AR plus asthma, with or without other conditions (232 patients, 23.2% of the total patients enrolled) and AR plus rhinosinusitis, with or without other conditions, (154 patients, 15.4% of the total patients enrolled).

Symptoms
--------

To identify the main symptoms associated with each disease, patients were asked to report which symptom was their main reason for their current visit and to list all their current symptoms at the current visit ([Fig. 2](#F2){ref-type="fig"}). Cough or coughing up phlegm was the most frequently reported main reason for the hospital visit for patients diagnosed with COPD (47.5%), and asthma (33.7%). For patients with a primary diagnosis of rhinosinusitis, blocked nose or congestion (21.7%) and cough or coughing up phlegm (20.3%) were the most frequently reported main reasons for the hospital visit. For patients with a primary diagnosis of AR, watery, runny nose (24.0%), and blocked nose and congestion (23.3%) were the most common main reasons.

Healthcare resource utilisation
-------------------------------

Enrolled patients reported their HCRU associated with their main respiratory symptom in the 4 weeks prior to the hospital visit ([Fig. 3](#F3){ref-type="fig"}). A larger percentage of patients with a primary diagnosis of AR and rhinosinusitis reported GP and specialist visits than those with asthma and COPD. A larger percentage of patients visited specialists than GP (rhinosinusitis 68.1% vs 23.2%, AR 65.9% vs 24.1%, asthma 44.2% vs 19.1%, and COPD 32.5% vs 10.0%). Few patients reported hospital admission or emergency department attendance for all the 4 diseases.

Medication use was high, with 70.4% of the patients prescribed medicines in the 4 weeks prior to the current visit and 98.3% prescribed medicine at the visit ([Fig. 4](#F4){ref-type="fig"}). Patients with a primary diagnosis of COPD reported the highest previous medication use (87.5%), followed by those with asthma (80.2%), AR (64.0%), and rhinosinusitis (62.3%). The most frequently used medication was fixed-dose combination inhalers for asthma and inhaled anticholinergics for COPD. Patients with AR and rhinosinusitis most frequently used antihistamines.

Work productivity loss and activity impairment
----------------------------------------------

Patients completed the WPAI questionnaire to assess the impact of AR, asthma, COPD, and rhinosinusitis on activity impairment and work productivity loss ([Fig. 5](#F5){ref-type="fig"}). Across all conditions, presenteeism (percentage impairment at work) was a more significant contributor to the productivity loss reported than absenteeism (percentage work time missed). On average, patients with AR (39.5%, SD 28.74) or rhinosinusitis (38.7%, SD 28.93) reported higher productivity loss than those with a primary diagnosis of asthma (32.6%, SD 30.05) and COPD (15.4%, SD 23.30). Activity impairment was similarly impacted across all conditions.

Costs
-----

Total costs by primary diagnosis are presented in [Fig. 6](#F6){ref-type="fig"}. Overall, the mean annual cost for patients with a respiratory disease was US\$8,853 (SD 11,245) per capita. For patients who reported impairment at work as a result of the disease, the mean annual cost was US\$16,367 (SD 11,999) with productivity loss of the highest cost component being US\$14,859 (SD 11,947). Patients with a primary diagnosis of rhinosinusitis and asthma had the highest direct medical costs. Medication use was the main driver of direct medical costs for patients with a primary diagnosis of asthma (58.0% of direct medical costs), COPD (57.4%), rhinosinusitis (49.5%), and AR (40.5%). The main driver of direct non-medical costs was specialist visits for all 4 diseases (AR, 42.9%; COPD, 39.9%; rhinosinusitis, 38.7%; and asthma, 34.3%).

DISCUSSION
==========

This study investigated the disease burden of 4 highly prevalent respiratory diseases in Korea using a standard protocol. Results of this study demonstrate that patients are frequently diagnosed with multiple respiratory disorders. The mean annual cost for patients with a respiratory disease was US\$8,853, with lost productivity being the main contributor to overall costs.

Previous research has shown that patients with concomitant respiratory disease have greater morbidity and health care resource use.[@B20] The present study found that patients were frequently diagnosed with multiple respiratory disorders (42.8%), with asthma/AR and AR/rhinosinusitis being the most frequently diagnosed combinations. This finding is consistent with those of previous studies showing that AR is strongly associated with the development of asthma and rhinosinusitis.[@B5][@B21] Early identification of patients with concomitant respiratory disease can lead to improvement in patient outcomes. Kim et al.[@B22] found that following continual treatment, patients with asthma and concomitant rhinosinusitis had similar lung function and HCRU as those with asthma only. Therefore, it is important to identify symptoms that indicate the potential presence of multiple respiratory disorders.

In our study, cough or coughing up phlegm was the primary reason for the medical visit for patients with a primary diagnosis of asthma or COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the main reasons in those with AR or rhinosinusitis. Interestingly, a large percentage of patients with rhinosinusitis also reported cough or coughing up phlegm as a main symptom. For patients with AR, the presence of cough may reflect a concomitant respiratory condition, such as asthma and rhinosinusitis. A larger number of patients with asthma or rhinosinusitis present with cough and their frequent association with AR, which suggests that patients with AR presenting with cough should be investigated comprehensively for other serious disorders, especially asthma and rhinosinusitis.

Globally, COPD and asthma have been established as significant contributors to the burden of disease.[@B1] This study found that the economic burden of AR and rhinosinusitis was as great as that of asthma and COPD. Considering the high prevalence of AR and rhinosinusitis in Korea[@B4][@B6] and the high frequency with which healthcare providers attended AR patients (approximately half of patients in the current sample had a primary diagnosis of AR), the economic burden of AR in Korea is substantial.

The primary driver of costs for all 4 diseases was indirect costs due to work productivity loss. Previous retrospective cost studies of respiratory diseases in Korea only included lost work productivity from absenteeism due to medical visits and hospitalization.[@B7][@B8][@B9][@B10][@B11] Subsequently, indirect costs due to work productivity loss were found to be a less significant contributor to overall costs. The current study interviewed patients directly to assess lost work productivity using the WPAI. Presenteeism was shown to be a far bigger contributor factor to lost work productivity than absenteeism from work. WPAI scores were similar between previous studies in the US and European populations.[@B23][@B24][@B25] Therefore, medical interventions that prevent lost work productivity would greatly reduce the economic impact of respiratory disease.

Interestingly, patients with a primary diagnosis of COPD had relatively lower costs compared to the other respiratory diseases included in this analysis. There are several potential reasons for this finding. On average, patients with COPD were older and more likely to retire. Therefore, COPD has a less impact on indirect costs associated with lost work productivity. Furthermore, the present study only recruited patients visiting specialists and GPs. Patients with severe COPD are more likely to be managed in hospitals rather than in outpatient departments or clinics. Previous research found that direct healthcare costs were approximately 3 times higher in high-grade COPD compared to milder COPD, with inpatient hospital services being the main driver of costs.[@B9] Finally, evidence suggests that COPD is underdiagnosed and undertreated in Korea.[@B2] Therefore, some patients with COPD may not have been identified for inclusion in this study.

The most significant contributors to direct medical costs were medications and specialist visits for all 4 respiratory diseases. Hospitalization was very infrequent and thus did not contribute significantly to direct medical costs in this study. Similar findings of more frequent medication and outpatient services but low inpatient hospital costs have previously been observed in retrospective cost analyses for AR and asthma.[@B7][@B8][@B9][@B10][@B11] Furthermore, a previous survey reported that a vast majority of allergic patients in Korea are treated by otolaryngologists rather than GPs.[@B26] Previous studies demonstrated that proper management and high medication use are associated with a reduction in exacerbation requiring hospitalizations and overall direct medical costs.[@B27][@B28] The overall results of APBORD documented that hospitalization was a main driver of costs across the Asia-Pacific region. This suggests that management of patients in Korea can reduce acute exacerbations requiring hospitalizations.

A limitation to the current analysis is that the impacts of respiratory illness on a person\'s inability to care for family, loss of income, psychological factors, and quality of life were not included. Such intangible costs have been shown to considerably add to the economic burden of respiratory disease.[@B10] This study recruited adult patients presenting to primary care physicians and specialist medical practices in urban settings of convenience; it was not the intention of the study to obtain prevalence estimates that are generalizable to the entire population of the country. As such, study participants may not be entirely representative of the broader population with respiratory disease. Furthermore, only adult patients were recruited from urban center, and results may not be generalizable to either patients under 18 years of age or to rural populations.

In summary, this study provides an insight into the identification and economic burden of respiratory disease in Korea. Timely identification of symptoms is important in implementing effective disease management, especially in patients with multiple respiratory diseases. A future goal for disease management should not only be to reduce direct healthcare costs, such as hospitalisations, but also to prevent work productivity loss.

The authors would like to thank Geunhee Yi and Jiyun Lee, both from MSD Korea, for their assistance. Geunhee Yi assisted with review of this manuscript while Jiyun Lee provided project management services during the study duration.

This work was supported by Merck and Co. Shalini Bagga, Shiva Shajjan and Rab Faruqi were employees of Merck and Co. at the time of the study. Santwona Baidya provided consulting services for conduct of this research and manuscript preparation.

There are no financial or other issues that might lead to conflict of interest.

![Percentage of the enrolled patients (N=999) with a combination of diseases.](aair-8-527-g001){#F1}

![Main reasons for medical visits and all current symptoms reported by primary diagnosis. COPD, chronic obstructive pulmonary disease.](aair-8-527-g002){#F2}

![Percentage of patients with HCRU in the previous 4 weeks by primary diagnoses. Numbers above columns are the mean number of visits for patients that reported at least one visit. COPD, chronic obstructive pulmonary disease; GP, general practitioner/primary care physician.](aair-8-527-g003){#F3}

![History of medication use for respiratory disease and medications prescribed at the medical visit by primary diagnoses. COPD, chronic obstructive pulmonary disease.](aair-8-527-g004){#F4}

![Mean WPAI scores by primary diagnoses. COPD, chronic obstructive pulmonary disease; WPAI, work productivity and impairment.](aair-8-527-g005){#F5}

![Annual direct and indirect costs for the study population by primary diagnoses. Work productivity costs calculated only for patients that reported impairment at work as a result of the disease. COPD, chronic obstructive pulmonary disease; GP, general practitioner/primary care physician.](aair-8-527-g006){#F6}

###### Patient demographics by primary diagnoses and practice types

![](aair-8-527-i001)

  -------------------------------- -------------
  Gender, n (%)
   N                               999
   Female                          583 (58.4%)
   Male                            416 (41.6%)
  Age, years
   Mean ± SD                       48.2±17.28
   Range                           18-93
  Ethnicity, n (%)
   N                               999
   Korean                          990 (99.0%)
   Chinese                         6 (0.6%)
   Indian                          1 (0.0%)
   Mongolian                       2 (0.0%)
  Employment status, n (%)
   N                               999
   Full-time                       405 (40.5%)
   Part-time                       101 (10.1%)
   Retired                         149 (14.9%)
   Student                         102 (10.2%)
   Unemployed                      97 (9.7%)
   Other                           145 (14.5%)
  Smoking history
   Ever smoked, n (%)
    N                              991
    Yes                            357 (36.0%)
    No                             634 (64.0%)
   Current smoking status, n (%)
    N                              338
    Current smoker                 133 (39.3%)
    Former smoker                  205 (60.7%)
  -------------------------------- -------------

Not all patients responded to all questions. Calculation of percentage excludes missing.


) = -7*t + w*t + 6*t. Let h(o) = 3*o**2. Calculate h(f(r)).
12*r**2
Let m(q) = -7479*q. Let f(r) = -7*r**2. Determine m(f(a)).
52353*a**2
Let g(d) = 225*d**2. Let r(x) = -x**2 + 2433*x - 2433*x. Give g(r(m)).
225*m**4
Let m(t) = t**2. Let y(w) be the third derivative of 0*w**3 + 0*w**4 + 0*w + 0 + 23/60*w**5 + 7*w**2. Determine m(y(z)).
529*z**4
Let r(n) = n. Let i(l) = -l**2 - 6*l - 1. Let q be i(-4). Suppose -5*w + 2*p = -20, 3*w + 8 = 2*w - 2*p. Let g(x) = -w*x - 2*x + q*x. Determine r(g(h)).
3*h
Let o(t) be the third derivative of -t**6/360 + t**3/2 + t**2. Let r(l) be the first derivative of o(l). Let b(i) = 8*i. Determine r(b(m)).
-64*m**2
Let n(a) = -114*a. Let h(x) be the first derivative of -2*x**3/3 + 21. Give h(n(q)).
-25992*q**2
Let l(s) = -5*s. Let n(o) = -24*o. Let w(v) = -28*l(v) + 6*n(v). Let t be ((-1)/3 + 1)*21. Let x(g) = -2*g - 6*g + t*g. Give x(w(j)).
-24*j
Let w(f) = 3 + 2*f**2 + 44*f - 44*f - 3. Let d(v) = -451*v**2. What is d(w(t))?
-1804*t**4
Let s = -8 + 10. Let l(g) = s - 3 + g + 1. Let o(c) = 5*c. Let b(u) = 2*l(u) - o(u). Let t(f) = -5*f. Determine b(t(x)).
15*x
Let h(j) = 238*j**2 + 4. Let m(y) = 105*y**2. Give h(m(k)).
2623950*k**4 + 4
Let o(k) = -70*k. Let f(d) = -7*d. Suppose 0 = 3*s - 9 - 0. Suppose -s*u + 2*u - 2 = 0. Let y(j) = u*o(j) + 21*f(j). Let c(g) = -g. Calculate c(y(b)).
7*b
Let x(s) = 2*s**2. Suppose -4*g = -4*b - 0 - 28, 0 = -5*g - 3*b + 3. Suppose -2*f - 2*r + 8 = -3*r, g*f - 5*r = -2. Let n(y) = -4*y + 6 - f. Calculate n(x(a)).
-8*a**2
Let y(x) = -56*x - 94. Let p(n) = -n**2. Give p(y(b)).
-3136*b**2 - 10528*b - 8836
Let g(j) = -62*j + 187*j - 66*j - 58*j. Let l(o) be the second derivative of -o**4/12 + o. What is g(l(z))?
-z**2
Let v(m) = m**2. Let h(t) = -8*t + 3 - 4 + 4 + 80*t. Calculate h(v(c)).
72*c**2 + 3
Let w(k) = k + 27. Let p(f) = 138*f - 2. What is w(p(j))?
138*j + 25
Let r(b) = 177*b**2. Let a(h) = 14*h. Calculate r(a(l)).
34692*l**2
Let d(u) = -265*u**2 + 4*u - 409. Let f(x) = -2*x**2. Give d(f(a)).
-1060*a**4 - 8*a**2 - 409
Let y(c) = 9*c. Let f(d) = d**2 - 122*d + 4. Determine y(f(g)).
9*g**2 - 1098*g + 36
Let v(h) = -h**2. Let q be 0 - 0 - (-19 + 31 - 18). Let o(c) be the first derivative of -3/2*c**2 - q + 0*c. Determine v(o(t)).
-9*t**2
Let r(h) = -6*h. Let u(o) = o**3 + 6*o**2 + 5*o + 2. Let g be u(-5). Let w = 202 - 178. Let t(j) = -w*j**2 + 59*j**g - 34*j**2. Calculate t(r(c)).
36*c**2
Let v(d) = d**2. Let k(q) be the second derivative of -15*q**4/2 - q + 5. What is k(v(b))?
-90*b**4
Let j(x) = -79925*x. Let g(f) = f**2. What is g(j(r))?
6388005625*r**2
Let k(l) = 7*l**2. Let u be (-1000)/(-144) - (-4)/18 - 7. Let b(x) be the second derivative of -8*x + 0 - u*x**3 + 0*x**2. Determine b(k(j)).
-7*j**2
Let u(g) = 39*g**2. Let a(p) = 4*p + 39. Give u(a(q)).
624*q**2 + 12168*q + 59319
Let h(b) = -4*b**2 - 3*b - 6. Let z(n) = 7*n**2 + 7*n + 14. Let q(w) = -14*h(w) - 6*z(w). Let m(j) be the first derivative of j**3/3 - 1. Calculate m(q(d)).
196*d**4
Let b(f) = -112*f**2 - 61*f**2 + 54*f**2. Let j(t) = 2*t**2. Determine b(j(l)).
-476*l**4
Let n(s) = 8*s. Let f(g) = 314460*g**2. Calculate f(n(c)).
20125440*c**2
Let n(t) = 2*t**2 + 3*t. Let z(a) = -4*a**2 - 7*a. Let r be (4 + -11)*(2 - 3). Let v(x) = r*n(x) + 3*z(x). Let b(h) = 4*h. Calculate v(b(q)).
32*q**2
Let h(w) = -38*w + 4. Let c(j) be the second derivative of j**4/6 + j + 60. Calculate h(c(u)).
-76*u**2 + 4
Let m(p) = -2*p. Let q(r) = 15*r + 30*r + 20*r + 6*r - 116*r. Calculate q(m(d)).
90*d
Let r(s) = 3*s. Let z(y) be the first derivative of -y**6/90 + 2*y**3 - 9. Let u(v) be the third derivative of z(v). Determine u(r(o)).
-36*o**2
Let x(w) = -2*w**2 - w + 1. Let o(a) = -8*a**2 + 27*a + 5. Let f(b) = -o(b) + 5*x(b). Let n(s) = s**2. Calculate f(n(q)).
-2*q**4 - 32*q**2
Let m(p) = 32*p**2. Let a(h) = h. Let d(v) = -2*v. Let i(x) = 3*a(x) + 3*d(x). Calculate m(i(l)).
288*l**2
Let m(a) = 8*a - 4. Let r(f) = -9*f. Give m(r(y)).
-72*y - 4
Let c be 2*15/40 + (-33)/12. Let g(w) = -25*w**2 + 2*w + 2. Let n(i) = -76*i**2 + 7*i + 7. Let r(a) = c*n(a) + 7*g(a). Let p(o) = 2*o**2. Determine p(r(l)).
1058*l**4
Let d(y) = -3*y**2 - 2*y. Suppose -2*b = -b - 61. Let o(i) = 61 - b - 2*i. Give o(d(h)).
6*h**2 + 4*h
Let h(d) = -18*d**2. Let o(r) = 5*r - 27. Let p be o(6). Let m(z) = 3 + z**2 + 0 - p. Determine h(m(y)).
-18*y**4
Let w(i) = -3*i. Let s(c) = 9*c**2 + c**2 + 8*c**2 + 11*c**2. Determine s(w(n)).
261*n**2
Let i(c) = -6*c**2 + 5*c. Let o(s) = -s**2 + s. Let j(r) = -2*i(r) + 10*o(r). Let u(x) be the second derivative of x**3/3 - 6*x. Give u(j(m)).
4*m**2
Let o(p) = -36*p**2 - 37*p**2 + 26*p**2. Let b(x) = -x. Calculate o(b(r)).
-47*r**2
Let j(d) = 4 - 9*d + 9 - 12*d. Let p(z) = 10*z - 6. Let c(a) = -6*j(a) - 13*p(a). Let n(b) = 82 - 2*b - 82 + 0*b. Determine c(n(m)).
8*m
Let w(y) be the first derivative of 49*y**3/3 + 2*y + 229. Let o(f) = -3*f. What is o(w(x))?
-147*x**2 - 6
Let f(k) = k**2. Let r(s) = 22*s**2 - 5*s + 10. Let t(g) = -341*g**2 + 77*g - 154. Let u(d) = 77*r(d) + 5*t(d). Calculate f(u(b)).
121*b**4
Let v(z) = 27*z**2 - 9*z. Let n(s) = -7*s**2 + 2*s. Let x(k) = -9*n(k) - 2*v(k). Let i(a) = -87*a + 79*a + 6*a. What is i(x(u))?
-18*u**2
Let d(c) = -1283702*c + 1. Let w(q) = q**2. Determine d(w(h)).
-1283702*h**2 + 1
Let p(j) = 5*j. Let w(k) = -36611*k. Give w(p(a)).
-183055*a
Let q(v) = 41*v + v**2 - 41*v. Let c(n) = -2*n + 0 + 8*n + 0. Determine c(q(b)).
6*b**2
Let k(c) = -7*c**2 - 302. Let b(i) = -34*i. Determine b(k(l)).
238*l**2 + 10268
Let a(o) = o**2. Let f(p) = -p + 769. What is a(f(z))?
z**2 - 1538*z + 591361
Let p(d) = -d**2. Let m(u) = 3*u - 3. Let r(k) = -4*k + 3. Let h(b) = -6*m(b) - 7*r(b). Determine p(h(x)).
-100*x**2 + 60*x - 9
Let w(c) be the first derivative of 5*c**3/3 + 51. Let y = 1 - 1. Let d(l) = -3*l + y*l + l. Give d(w(j)).
-10*j**2
Let a(h) = h**3 - 5*h**2 - 13*h - 5. Let q be a(7). Let g(l) = 48*l**q - 26*l**2 - 23*l**2. Let i(c) = -4*c - 2. Give i(g(j)).
4*j**2 - 2
Let w(u) = 2*u. Let a be 6/4*2 - (10 + -10). Let g(k) = 0 + 3 - a + 4*k. Determine w(g(z)).
8*z
Let k(y) = -2*y. Let x(h) = 158739*h**2 + h. Give k(x(u)).
-317478*u**2 - 2*u
Let z(f) = 2*f + 4*f - 2*f. Let i(l) = 8*l + 5. Let m(j) = 9*j + 6. Let k(r) = 6*i(r) - 5*m(r). Let g(p) = 5*p. Let s(q) = -2*g(q) + 5*k(q). Calculate s(z(u)).
20*u
Let m(r) = -8*r + r + 0*r + 5*r + 55. Let h(k) = k**2. What is h(m(n))?
4*n**2 - 220*n + 3025
Let f(i) = 46296*i. Let j(y) = 20*y**2. Give j(f(k)).
42866392320*k**2
Let h(a) = 6*a. Let q(r) be the third derivative of r**5/30 + 25*r**4/24 + 37*r**2. Determine h(q(x)).
12*x**2 + 150*x
Let w(d) = -6*d**2. Let s(h) = 2*h**2. Let n(p) = -17*s(p) - 6*w(p). Suppose -3*v + 8 = v. Let t(a) = -112*a + 112*a - a**v. Calculate t(n(i)).
-4*i**4
Let g(q) be the first derivative of 2 + 0*q + 1/2*q**2. Let z(t) = -9*t. What is g(z(s))?
-9*s
Let b(q) = -3. Let x be (7 + (-5 - -2))*(-3)/2. Let w(f) = -f - 13. Let p(j) = x*w(j) + 26*b(j). Let g(r) = 7*r**2. What is p(g(n))?
42*n**2
Let f(i) = -192702*i**2. Let o(n) = -3*n. What is o(f(j))?
578106*j**2
Let v(t) = 185*t**2 - 539*t**2 + 177*t**2 + 183*t**2. Let d(o) be the first derivative of o**2/2 - 2. What is d(v(r))?
6*r**2
Let j(l) = -120*l**2. Let y(a) = 11*a + 5. Let s(z) = 26*z + 12. Let n(q) = 5*s(q) - 12*y(q). Give n(j(u)).
240*u**2
Let g be (1 - 5)/(10/(-10)). Let i(w) = w**2 - g*w**2 - 3*w**2 - 2*w**2. Let q(o) = -3*o. Give i(q(h)).
-72*h**2
Let d(y) = -41847*y. Let w(x) = -6*x. Give d(w(u)).
251082*u
Let y(o) = -o - 6. Let a(r) = -3*r - 11. Let i(p) = -3*a(p) + 5*y(p). Let w(n) = 2*n. Give i(w(v)).
8*v + 3
Let j(z) = z. Let v(q) = 7*q**2 - 6*q - 198. Let u(n) = -6*n**2 + 5*n + 197. Let o(c) = 6*u(c) + 5*v(c). Calculate o(j(h)).
-h**2 + 192
Let n(p) = 187768*p - 2. Let s(v) = 2*v. Calculate s(n(i)).
375536*i - 4
Let v(f) = -108776*f. Let z(y) = 3*y**2. Calculate v(z(m)).
-326328*m**2
Let b(u) = -u. Let o(d) be the first derivative of -4*d**3 + 7*d - 44. Let r(q) = 35*q**2 - 20. Let x(p) = -17*o(p) - 6*r(p). Give x(b(w)).
-6*w**2 + 1
Let o(m) be the second derivative of m**4/12 + m. Let a = -18 - -21. Let g(x) = a*x**2 + 2*x**2 - x**2 - 3*x**2. Determine o(g(j)).
j**4
Let p(r) be the first derivative of -1/3*r**3 + 4 + 0*r**2 + 0*r. Let v(w) be the first deri


Tennis at the 1924 Summer Olympics – Women's doubles

The women's doubles tennis competition was one of five tennis events at the 1924 Summer Olympics.

Draw

Finals

Top half

Bottom half

References
ITF, 2008 Olympic Tennis Event Media Guide

1924

Women's doubles
Category:1924 in women's tennis
Ten


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These Processes Become Improperly Regulated When The Liver Is Damaged, As It Can Be By Overeating, Especially If Meals Have A High Meat Content.

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Online boyfriend said she had tens of millions of dollars to keep women in custody and lost 260,000 by routine.

On March 3, Nanjing Drum Tower Police reported that a citizen, Ms. Jiang, had met a netizen some time ago, who claimed to be an American special soldier on a field mission in Afghanistan. With the deepening of contacts, the other side said that tens of millions of dollars of property need to be entrusted to Ms. Jiang for safekeeping, but to Ms. Jiangs surprise, eventually she did not see the money, but was cheated by the other side more than 260,000 yuan.

Transfer Records Between Ms. Jiang and Netizens

Modern Express reporters learned that half a year ago, Ms. Jiang met an online friend who claimed to be a soldier from the United States, named Smith, and is currently working in Afghanistan. With more and more frequent online contacts between the two sides, Smith expressed his love for Ms. Jiang and said that he found a large amount of cash hidden in the fight against terrorists. He wanted to leave the United States to develop in China with the money and needed to find a trusted friend to help keep it.

Chat screenshot of Ms. Jiang and netizens

Ms. Jiang was dubious at first, but the other party chatted with her every day, and often sent some pictures of him to Ms. Jiang. She said that she had treated Ms. Jiang as her girlfriend, and the most trusted person was her. He told Ms. Jiang that his wife died in a car accident four years ago and that his son studied in Britain without any other relatives. Because he was on a mission in Afghanistan and was not allowed to use electronic bank accounts, the tens of millions of dollars he received in cash could only be sent to Ms. Jiang and entrusted to her custody.

Chat screenshot of Ms. Jiang and netizens

Under the huge interests and the sweet words of the other side, Ms. Jiang believed in Smith and told her family address to the other side, ready to receive the huge amount of cash from the other side. To Ms. Jiangs surprise, after a period of time, the other side claimed that the money was intercepted by the customs, which required a series of handling fees, such as high air bill of lading fee, inspection certificate fee and certificate fee of source of funds. After many deceptions, Ms. Jiang eventually remitted several sums to several accounts, totaling more than 260,000 yuan. Later, the other side also asked Ms. Jiang to pay another million dollars, only in this way can we get tens of millions of dollars. Ms. Jiang felt that the number of people she wanted was too large. The more she thought about it, the worse it was. Finally, Ms. Jiang decided to call the police for help.

At present, the police have intervened in the investigation.

Nanjing Drum Tower Public Security Bureau Ninghai Road Police Station, the police said, This kind of fraud routine is generally fraudsters pretending to be a national soldier or oil tycoon and other foreign high-ranking and handsome people, deceiving the victims information, and in the name of friendship and love with the victim, and then to send a huge amount of cash as an excuse to induce the victim to transfer money. This kind of fraud is usually committed jointly by domestic and foreign fraudsters, with high success rate and great difficulty in cracking down.

The police reminded the general public that if they encounter such situations in daily life, they should not be credulous and pies will not fall from the sky. For requests for postage fees, customs clearance fees, customs fines and other money, we must resolutely refuse, and report the case to the police in time. If unfortunately deceived, we must keep relevant chat records, remittance screenshots, and report to the public security organs in time.