When we talk about what DC is doing with "Rebirth," it is not simply the restoration of a pre-Flashpoint continuity, but rather a systematic ticking off of boxes filled with things that people liked from a bygone era of comic books. In the case of Peter J. Tomasi and Patrick Gleason’s Superman, it is a very specific period in time that surrounded the immediate aftermath of the “Death and Return of Superman” saga in the mid-1990s. It’s a particular brand of nostalgia, one that might just be a little too over-reliant on reader memory.

Case in point is the focus of this issue, and the return of the Eradicator. The character was introduced just prior to the madness of the 1990s, and played a pivotal role in Superman’s first “rebirth.” Here Superman has trouble believing that this version of the Eradicator has his best interests at heart, even if he is acting protective. Yet with the nature of the fluctuating powers of the “son of Superman,” the Eradicator is set up as having the key to unlocking the boy’s hidden potential.

The issue exposes some of the key differences between this “restored” Superman and the "New 52" version that died prior to the reboot. The angry and overprotective father act runs the risk of wearing thin really quickly, especially when Clark goes on the immediate attack without finding out the purpose of the new Eradicator. Yet this issue is far from being about nuance, effectively being two fight sequences sandwiching some exposition. It’s fortunate for the reader that both of those elements are filled with enough hooks to carry the whole issue.

Artists Jorge Jimenez and Alejandro Sanchez don’t necessarily have to find something new in the Man of Steel, as depicting as classic version as possible is the chief order of business here. Seeing Clark carrying his injured son with Lois by his side is as stirring as his first face-off with a new version of his old enemy. There’s a particularly magnificent scene where the Eradicator unleashes its power on multiple Kryptonians, and Jimenez’s layouts and pacing create a superbly panelled action sequence. Towards the issue’s conclusion, there’s a series of close-ups of the junior Kent finding his resolve to the repeated “WHAM” of his father’s fists in the background. It’s as powerful image as any in this month’s action-filled issue.

In some ways, “Son of Superman” is still an odd arc to start off the Rebirth version of Superman, effectively reintroducing the old-school through the eyes of a potentially powerful new character in his own right. At the same time, while Tomasi and Gleason don’t rely on prior knowledge of the characters, their assumptions of what readers know about these “classic” versions is a potential roadblock given that it’s been at least five years since this version of Supes has been “current.” Even so, there’s an undeniable classicism in the book, and only time will tell if it’s drawing deep on the legacy, or simply caught up in the spell of nostalgia.

Over 4,000 have been infected with rage, the Red Lanterns are wreaking havoc on Earth, and the Justice League aren’t returning their calls. In other words, it’s a regular day for DC’s Green Lanterns, as it’s up to rookie ringslingers Simon Baz and Jessica Cruz to save the day. Away from Sam Humphries’ twist-and-turn-filled script, Green Lanterns #3 is a veritable kaleidoscope of rotating pencillers, as Tom Derenick, Jack Herbert and Neil Edwards assist Lanterns regular Robson Rocha with mixed results.

Sam Humphries is quick and eager to underline Simon and Jessica’s character flaws to create dramatic tension — Jessica, for example, can’t even make a construct, while Simon has the most powerful weapon in the universe on his finger, but relies on a gun. These two Lanterns are the firm underdogs in their own title, easily quashed by the rampaging Red Lanterns. It’s all best exemplified by Jessica’s internal narrative: “Things are going well. Everything is fine. Omg I am the worst Green Lantern.” Humphries pushes new hero incompetence to new extremes here, but it only makes Jessica Cruz and Simon Baz all the more endearing. They're their own worst enemies, which makes for an absorbing narrative which leads to a deeper conflict than the one-note Red Lanterns can offer.

At the heart of the issue is another new facet of Simon’s burgeoning power. Faced against Red Lantern Bleez, Baz's ring suddenly emanates unimaginable power, cleansing her of the rage. Bleez’s new-found freedom from the power of the Red happens in an instant, and it comes across as a little clumsy. She immediately awakes, dusts herself off and launches into an angsty internal monologue while attempting to disembowel herself. Unfortunately, it’s a sequence littered with cliches: the phrases “It’s so clear to me now,” “You don’t have to do this alone,” and “What have I done?” all appear with maximum sincerity. Humphries usually has a pretty good level of self-awareness, as evidenced by the short and sharp doses of humor aimed squarely at his titular characters, but it all falls apart for a few pages with this moment of epiphany that misses the mark. Of course, Bleez’s sudden shift in alliance doesn’t last, and it’s in these last few pages that Green Lanterns #3 shines. Bleez reverts back thanks to a well-meaning intervention of brute force from Jessica, a move decidedly outside her wheelhouse. Although it comes at exactly the wrong time, it's a moment that shows her as the assertive hero she needs to become. The ensuing argument between Simon and Jessica is solid stuff with real consequences, leading to a memorable final cliffhanger splash page.

A twice-monthly schedule is a tricky thing to maintain, and so DC has drafted in an army of pencillers to contribute to Green Lanterns #3. While Robson Rocha offers up the same detailed musculature and fearsome faces he’s been illustrating Green Lanterns with for the duration of the series, guest artists Tom Derenick, Jack Herbert and Neil Edwards each bring their own distinct styles to the table. From Derenick’s looser and less detailed style to Herbert’s carefully studied figures, Green Lanterns #3 is a mishmash of clashing styles. Although Neil Edwards turns in some solid work that holds much of the issue together, there’s still no denying that the lack of visual consistency from cover to cover hurts the issue’s readability. Color-wise, neon green and bloody crimson unsurprisingly dominates Hi-Fi’s work. The consistent coloring helps to bring together each artists into a slightly more cohesive whole, although one major error casts a shadow over the entire issue. In one important scene, Simon’s gun is erroneously colored as a green construct instead of the black metal that makes up one of humanities’ most dangerous creations. It’s an oversight that editorial really should have caught, and one that confuses one of the issue’s strongest themes (that neither Lantern is particularly adept at actually using their power rings).

To err is human, and that makes Simon Baz and Jessica Cruz more alive than us mere flesh and blood bags. Sam Humphries continues trucking forward with the winning formula that piqued our interest with Green Lanterns Rebirth #1, relishing in Simon and Jessica’s continued trials by fire to become fully fledged Green Lanterns. Despite a whiffed dramatic scene involving Bleez and fill-in artwork and coloring of varying quality, the believable and compelling dynamic between Jessica and Simon still makes Green Lanterns #3 worth a look.

If writer Benjamin Percy has spent the majority of his post-"Rebirth" stories bringing a sense of social justice (and hirsuteness) back to the Emerald Archer, then this latest issue is set to reestablish Green Arrow as a Battling Bowman. Much of Percy’s earlier series had been about Oliver Queen as a man, and when the occasion called for it, as a wolfman. The almost continual action sequence that makes up the first dozen or so pages of the book leaves no doubt as to Ollie’s ass-kickery, but are these the only two modes the modern archer is capable of?

Not for the first time, but Ollie’s world has fallen apart again. Betrayed and on the run from assassins, he breaks into his own building to discover the truth about the Ninth Circle, just as Shado and Emiko hunt him down for termination. Unfortunately, Ollie’s partner Black Canary is mostly sidelined this issue, save for a later suggestion that she will be used as a bargaining chip in a revenge plot against Green Arrow. The implications of this use of a previous headliner as a object are troubling, but more on that if they eventuate in that direction. More broadly, there’s a creeping sense of the familiar to all of this as well.

There’s nothing particularly subtle about Percy’s allegorical references in Green Arrow to date. Following the heavy-handed references to Malthus and Bentham in his “Night Birds” arc, the villain of the Ninth Circle is named Dante. Looking for all the world like a melted Red Skull, he and his minions are more than reminiscent of Percy’s own Bone Hunters, replacing skeletal masks for ones with layers of flesh on them. Which is the major problem that lurks around in this issue, and that’s the distinct lack of identity beyond these repeated memes.

On the other hand, the artwork is beautiful. Otto Schmidt’s work to date has been superb, but Juan Ferreyra’s brings a new level of hyper-reality to the character. Flying in feet-first in the opening splash pages, the painted quality of Ferreyra’s style and rich colors soars in every panel. A sidebar into the underground lair of ‘Virgil’, surrounded by skulls and occult iconography, comes close to the photorealistic horror of Justin Randall’s Changing Ways, with a little bit of Ben Templesmith’s color philosophy thrown in for good measure.

Percy’s Green Arrow works best when it balances a self-awareness of the character’s rich history wth wholesale tributes to the past, but within a contemporary framework of course. Yet this third chapter not only departs tonally from the two issues that preceded it, but it threatens to revisit ground that was covered as recently as Jeff Lemire’s 2013 outing with the character. This current issue doesn’t push far enough into new territory or uncover new aspects of the old, resulting in a solid but heavily familiar tale.


1. Introduction
===============

Hidradenitis suppurativa (HS) is a complex, chronic inflammatory disorder of the follicular epithelium, presenting with recurrent, suppurative lesions at inverse body sites, such as axillary, inguinal, and anogenital regions. Like other immune-mediated inflammatory disorders (IMIDs), HS determines a profound impact on patient\'s quality of life and shares a significant association with cardiovascular and metabolic comorbidities. The treatment of HS is challenging and, currently, immune-modulating treatment is limited to adalimumab, the only officially approved drug for the treatment of moderate-severe disease.^\[[@R1]\]^ The lack of other approved immune-modulatory agents is especially frustrating in the case of patients with multiple comorbidities, resistance, or contraindications to TNF-alpha antagonists.

Recently, apremilast, a new class of oral-small molecules inhibiting phosphodiesterase-4, has been introduced in the treatment of IMIDs, such as plaque psoriasis and psoriatic arthritis (PsA).^\[[@R2]\]^ Preliminary clinical studies have also explored the use of apremilast in the treatment of moderate-severe, nonsyndromic HS, albeit with a low-comorbidity burden.

We report two patients with severe HS associated with PsA and a complex comorbidity profile, successfully treated with apremilast, and review the use of this new molecule in the management of HS.

2. Case report
==============

2.1. Case 1
-----------

A 73-year-old man was presented with the diagnosis of HS since the age of 52 years, previously treated with oral antibiotics. At our observation, physical examination showed multiple fistulas and nodules on gluteal and anal region (Hurley III stage disease), associated with severe inflammation and pain. Clinical and patient-reported outcome measures included: the hidradenitis suppurativa-physician global assessment (HS-PGA = 4/severe), the numerical rating scale for pain (NRS-pain 7/10), the dermatology-life quality index (DLQI = 23), and C-reactive protein (CRP 4.8 mg/dl) (Fig. [1](#F1){ref-type="fig"}A and B). Ultrasound examination confirmed the presence of complex fistulas (Fig. [1](#F1){ref-type="fig"}B). In addition, concomitant PsA (DAPSA = 55), with a peripheral pattern of involvement, and localized plaque psoriasis (PASI = 5) were observed. The patient had a BMI = 21.72 and was a cigarette smoker (60 pack-years). He also had numerous comorbidities including NHYA class-III congestive heart disease, type-2 diabetes, iron deficiency anemia related to chronic bleeding from fistulas, and chronic renal insufficiency. Previous treatments included systemic antibiotics (tetracyclines, rifampicin, and clindamycin) for HS, and systemic steroids and NSAIDs for PsA. Based on the clinical profile and contraindication to TNF-alpha antagonists (congestive heart disease), treatment with apremilast (30 mg twice daily) was chosen. After 16 weeks of treatment, clinical and ultrasound examinations showed reduced inflammation and HS disease activity (HS-PGA = 2/mild disease) (Fig. [1](#F1){ref-type="fig"}C and D). Furthermore, a clinically relevant improvement of PsA (DAPSA = 12.8), inflammatory markers (CRP 2.8 mg/dl), and QoL (DLQI = 6) was achieved. The patient continued treatment with apremilast up to 40 weeks, also during non-HS-related surgical interventions for inguinal hernia. Extensive surgical treatment of gluteal skin lesions was not further indicated due to the complex comorbidity profile. At the last clinical follow-up (week 60), the patient was still on treatment with apremilast, without reporting any adverse event, and maintaining clinical remission of both PsA and HS disease.

![Case 1: (A) Severe Hurley III-hidradenitis suppurativa (HS-PGA 4/5) characterized by complex sinus-tracts and abscesses. (B) Doppler ultrasound examination showing inflamed tunnels on the right buttock, at baseline. (C) Clinical improvement after 16 weeks of apremilast treatment. (D) Decreased inflammation/color-flow signal after 16 weeks of treatment.](medi-99-e18991-g001){#F1}

2.2. Case 2
-----------

A 51-year-old man was examined for a 7-year duration, severe HS (Hurley III) involving the groins and axillae. Physical examination showed multiple sinus-tracts and nodules on the pubic, inguinal, perianal, and axillary regions (HS-PGA = 5/very severe, NRS pain score 8/10, DLQI = 25) (Fig. [2](#F2){ref-type="fig"}A and B). The patient was also affected by localized plaque psoriasis and peripheral PsA (DAPSA = 48.2), type-2 diabetes, hypertension, nonalcoholic steatohepatitis, and nephrolithiasis. He smoked 30 pack-years and had BMI = 24. Previous therapies with systemic antibiotics (carbapenems, cotrimaxozole, beta-lactams), cyclosporine, corticosteroids, methotrexate, retinoids, and multiple biologic agents (infliximab, etanercept, adalimumab, secukinumab) were ineffective for both PsA and HS. Extensive surgical treatment of inguinal disease was postponed due to symptomatic nephrolithiasis and high inflammatory load (CRP 6.2 mg/dl). Due to lack of efficacy of previous treatments (adalimumab) and multiple comorbidities, treatment with apremilast (30 mg twice daily) was thus initiated. Apremilast determined a clinically relevant reduction of inflammatory lesions count, effective control of skin-related pain (NRS-pain score 0/10), and QoL-improvement (DLQI = 9) after 16 weeks of treatment (Fig. [2](#F2){ref-type="fig"}C and D). The course of HS clinical activity was consistent with disease stabilization (HS-PGA = 3/moderate), while PsA showed a marked reduction of disease activity (DAPSA = 16.7, CRP 2.7 mg/dl). Treatment with apremilast was further continued up to 48 weeks, with good tolerability, also during non-HS-related surgical interventions (nephrolithiasis). At the last clinical follow-up (week 72), the patient was still on active treatment with apremilast, with a stable disease course. The option of extensive surgical intervention was discussed with the multidisciplinary surgical team but later refused by the patient due to concern of surgery-associated morbidity.

![Case 2: (A) Very-severe Hurley III hidradenitis suppurativa (HS-PGA 5/5) with extensive involvement of the inguinal, perineal, perianal, and inner thigh areas. (B) Doppler ultrasound examination of left inguinal sinus-tract, at baseline. (C) Clinical improvement after 16 weeks of apremilast treatment. (D) Reduction of inflammation/color-flow signal, after 16 weeks of apremilast treatment.](medi-99-e18991-g002){#F2}

3. Discussion
=============

In both patients presented herein, the numerous comorbidities and concomitant IMID (psoriatic arthritis) posed a significant challenge for the medical management of moderate-severe HS. Other than adalimumab, the only FDA-approved biological drug, the clinical evidence to support the use of immune-modulating agents in HS is currently limited. In our cases, treatment with apremilast allowed to achieve a clinically relevant improvement of both IMIDs, HS-and PsA, and related patient-reported outcomes (pain, quality of life) after a period of 16 weeks. HS disease activity improved progressively in both patients, leading to disease stabilization of Hurley II-III disease and effective pain control. In the case of PsA, improvement of disease activity was more pronounced, as observed in clinical studies. Our patients also had numerous comorbidities that, however, did not impact the efficacy and safety of apremilast during the follow-up period. The patients did not report any adverse effect related to apremilast, nor abnormal laboratory examinations and both could undergo non-HS related surgical procedures, without interrupting treatment. The use of apremilast in the treatment of HS has been recently reported in two pilot clinical studies and in one case series, as summarized in Table [1](#T1){ref-type="table"}, with a total of 59 cases of HS receiving apremilast (30 mg twice daily) for up to 36 weeks.^\[[@R3]--[@R5]\]^ Vossen et al reported the efficacy and tolerability of treatment with apremilast for 16 weeks in a small, double-blind randomized clinical trial, observing a significant clinical response (defined as a 50% improvement of inflammatory lesions count) in 53.3% of patients with moderate-severe disease.^\[[@R3]\]^ In another open-label, noncontrolled study, treatment with apremilast determined a significant clinical response in 60% of patients with mild-to-moderate HS after 24 weeks.^\[[@R4]\]^ An additional case-series of moderate-severe HS patients, who had responded poorly to other treatments, were treated with apremilast for up to 36 weeks, reporting a significant clinical response in five out of nine patients.^\[[@R5]\]^ None of the patients treated in previous studies presented other concomitant IMIDs or a relevant comorbidity burden. The adverse event profile of apremilast in HS patients seem to be consistent with the clinical data available in psoriasis patients, with a majority of mild-moderate events being gastro-intestinal symptoms and depression.^\[[@R2]\]^ Surprisingly, a recent ex-vivo study of lesional HS skin described only a limited effect of apremilast on the expression of key-inflammatory mediators, such as IL-17A, IL-17F cytokines, and S100A12 protein.^\[[@R6]\]^ On the other hand, the clinical evidence supports the role of apremilast in the management of moderate HS (Hurley stage II), especially to reduce inflammatory lesion count and to control disease activity in the long-term. Severe cases (Hurley stage III) patients will probably benefit more from potent, targeted anti-inflammatory treatment regimens in combination with extensive surgery. Other advantages of apremilast include no requirements for laboratory monitoring and a convenient dosing-scheme, which do not require dose-adjustments in patients with high BMI, a typical condition in HS. Combination treatment strategies with apremilast and other systemic agents should consider the risk for drug interactions with strong cytochrome-inducers, such as rifampicin, an antibiotic frequently used in HS.^\[[@R7]\]^

######

Summary of clinical studies of apremilast for the treatment of nonsyndromic hidradenitis suppurativa.

![](medi-99-e18991-g003)

In conclusion, we report the use of apremilast in two patients with severe HS and PsA associated with a complex comorbidity profile. Management of multimorbid adult and elderly HS patients will pose a significant challenge in the near future, as observed in the aging psoriatic patient population.^\[[@R8]\]^ Considering the good safety profile as well as the low-risk of drug interactions, future controlled studies, with adequate sample sizes, should further explore the role of apremilast in the clinical management of hidradenitis suppurativa.

Author contributions
====================

**Conceptualization:** Simone Garcovich, Clara De Simone.

**Data curation:** Simone Garcovich, Giulia Giovanardi, Dalma Malvaso.

**Formal analysis:** Giulia Giovanardi.

**Supervision:** Clara De Simone, Ketty Peris.

**Validation:** Clara De Simone, Ketty Peris.

**Writing -- original draft:** Simone Garcovich.

**Writing -- review & editing:** Ketty Peris.

Simone Garcovich orcid: 0000-0001-8967-6688.

Abbreviations: DAPSA = Disease Activity in Psoriatic Arthritis \[score 0--4 remission; 5--14 low; 15--28 moderate; \>28 high\], DLQI = dermatology-life quality index \[score 0--30\], HS = hidradenitis suppurativa, HS-PGA = hidradenitis suppurativa-physician global assessment \[score 0--5\], Hurley-stage = \[I = mild/solitary or multiple, isolated abscess formation without scarring or sinus tracts; II = moderate/recurrent abscesses, single or multiple widely separated lesions, with sinus tract formation; III = severe/diffuse or broad involvement, with multiple interconnected sinus tracts and abscesses\]; NRS = numerical rating score -- pain score \[score 0--10\], PsA = psoriatic arthritis.

How to cite this article: Garcovich S, Giovanardi G, Malvaso D, De Simone C, Peris K. Apremilast for the treatment of hidradenitis suppurativa associated with psoriatic arthritis in multimorbid patients: Case report and review of literature. *Medicine*. 2020;99:5(e18991).

Patient has provided informed consent for publication of the case.

The authors have no funding to disclose.

The authors have no conflicts of interest to disclose.


Rapid growth in social media technology and computing technology have enabled using social media platforms to broadcast live shows and events, such as concerts and sporting events. However, existing internet and web-based broadcasting services are limited to streaming of an event that is hosted by a single social media influencer.


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Q:

I want to prove some properties about list, but am stuck at induction

I tried following proof,
Require Import List Omega.
Import ListNotations.
Variable X : Type.

Lemma length_n_nth_app_error_same : forall (n:nat) (x:X) (l:list X),
n <= length l -> 0 < n -> nth_error l n = nth_error (l ++ [x]) n .
Proof.
  intros.
  induction l eqn:eqHl.
  - unfold length in H. omega.
  -

but I'm stuck, as what I have is only
1 subgoal
n : nat
x : X
l : list X
a : X
l0 : list X
eqHl : l = a :: l0
H : n <= length (a :: l0)
H0 : 0 < n
IHl0 : l = l0 ->
       n <= length l0 ->
       nth_error l0 n = nth_error (l0 ++ [x]) n
______________________________________(1/1)
nth_error (a :: l0) n = nth_error ((a :: l0) ++ [x]) n

I've met some similar cases also for other proofs on lists.
I don't know if the usual induction would be useful here.
How should I prove this?
Should I use generalize?

A:

Your theorem is wrong. Maybe your understanding of nth_error is incorrect.
Specifically, when n = length l, nth_error l n returns None while nth_error (l ++ [x]) n returns Some x.
Require Import List Omega.
Import ListNotations.

Lemma length_n_nth_app_error_not_always_same :
  (forall (n:nat) (X:Type) (x:X) (l:list X),
  n <= length l -> 0 < n -> nth_error l n = nth_error (l ++ [x]) n)
  -> False.
Proof.
  intros.
  assert (1 <= 1) by omega. assert (0 < 1) by omega.
  specialize (H 1 nat 2 [1] H0 H1). simpl in H. inversion H. Qed.

On the other hand, proving a similar theorem with fixed inequality is easy:
Lemma length_n_nth_app_error_same : forall (n:nat) (X:Type) (x:X) (l:list X),
n < length l -> nth_error l n = nth_error (l ++ [x]) n .
Proof.
  induction n; intros.
  - simpl. destruct l; simpl in *.
    + omega.
    + reflexivity.
  - simpl. destruct l; simpl in *.
    + omega.
    + apply IHn. omega. Qed.

Note that I used induction n instead of induction l. It is mainly because nth_error does recursive calls on decreasing n.
Also, if you felt like an induction hypothesis is not general enough, it is probably because your order of intros and induction was wrong. The rule of thumb is to start the proof by induction, and then intros the variables. If it is still not enough, you can revert dependent all the variables other than the one to do induction, and then induction x; intros.


Education Resources

Health Highlights: Dec. 6, 2012

Here are some of the latest health and medical news
developments, compiled by the editors of HealthDay:

Duchess of Cambridge Leaves Hospital

The Duchess of Cambridge was discharged from hospital Thursday
after being admitted on Monday for treatment for severe morning
sickness.

As she left King Edward VII Hospital in London, the duchess
smiled and posed briefly with her husband, Prince William, before
getting into a waiting car, the
Associated Pressreported.

The duchess will spend of few days of rest at Kensington Palace
in London, the royal couple's office said.

Royal officials were forced to announce that the duchess was
pregnant after she was admitted to hospital. They said that the
duchess is not yet 12 weeks pregnant with the couple's first child,
the
APreported.

-----

CPSC Takes Action Against Nap Nanny Maker

Six infant deaths have prompted the U.S. Consumer Product Safety
Commission to take action against the maker of a portable baby
recliner called the Nap Nanny.

In an administrative complaint, the CPSC alleges that the Nap
Nanny "poses a substantial risk of injury and death to infants,"
the
Associated Pressreported.

The CPSC is seeking an order that would force the manufacturer,
Baby Matters of Berwyn, Pa., to alert the public about what the
agency considers a serious product defect, and to offer consumers a
full refund.

An email from Baby Matters said the company went out of business
a month ago, the
APreported.

About 155,000 of three Nap Nanny models were sold since
2009.

-----

Federal Government Denied Rehearing on Graphic Cigarette
Warnings

The U.S. government's request for a rehearing on graphic health
warnings on cigarette packages has been denied by the U.S. Court of
Appeals in Washington, D.C.

The court did not provide any reason for its decision to deny
the government's request for the full court or a panel to rehear
the case, the
Associated Pressreported.

In August, a three-judge panel upheld a lower court ruling
blocking the Food and Drug Administration's proposed health
warnings that included photos of diseased and dead smokers. The
judges ruled that the warnings violated the First Amendment's free
speech protections.

The government has 90 days to appeal the decision to the U.S.
Supreme Court, the
APreported.

-----

States Spending Less on Tobacco Prevention: Report

Despite record high revenues from tobacco taxes and the national
tobacco settlement, states are spending less on tobacco prevention
programs, according to a report released Thursday by the Campaign
for Tobacco-Free Kids.

The group said the amount spent by states on tobacco prevention
in the past two years is the lowest in any period since the
national tobacco settlement in 1998,
The New York Timesreported.

States will collect a record $25.7 billion in tobacco taxes and
settlement money in the current fiscal year, but less than two
percent of that will be spent on tobacco prevention, according to
the document.

The tobacco settlement awarded states an estimated $246 billion
over its first 25 years and give states complete control over how
they spend the money. Many use the funds to fill budget gaps or for
programs unrelated to tobacco,
The Timesreported.

Tobacco use is the leading cause of preventable death in the
U.S., killing more than 400,000 people a year, according to the
Centers for Disease Control and Prevention.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


I've begun a political gaming project called Resist. This game will allow the user to play as a fictional anti-Trump "resistance" dedicated to toppling the president. I plan for this game to be cross-platform and for there to be a linux version of it.
If anyone could help develop this game the repository is here. There will be a CLI and a GUI version of the game. I'd like this game to be ported to as many platforms as possible. If anyone cpuld help develop the game please assist in doing so. (It could be by designing UI,submitting media for the game, or programming or anything else)

GustyGhostIt has been two days and not a single line of code has appeared in the repo. You don't expect other people to build this game for you?

I'm really sorry, I had to reinstall the OS lately and have been setting it up again the past few days. Anyway what I've gotten around to before then is in the command-line-based branch.
Sorry for taking so long to respond.


Send this page to someone via email

The union representing more than 5,000 Metro Vancouver transit workers says it is launching a legal challenge against recent layoffs.

TransLink announced Monday that 1,492 employees were temporarily let go across the company, citing financial losses of $75 million a month amid the COVID-19 crisis.

2:06 TransLink makes sweeping cuts to Meto Vancouver transit workforce TransLink makes sweeping cuts to Meto Vancouver transit workforce

Unifor said in a statement Thursday says it will challenge the move, saying the Coast Mountain Bus Company, a TransLink subsidiary, breached the Labour Relations Code by laying off workers without giving 60-days’ notice. The union will seek to have the layoffs rescinded, or have workers paid during the 60 days.

Story continues below advertisement

TransLink CEO Kevin Desmond said Monday that recent financial losses left the transit authority with no other option, adding that he expected affected employees would be recalled when regular operations resume.

2:04 TransLink faces a financial crisis due to the coronavirus TransLink faces a financial crisis due to the coronavirus

In a virtual Translink Mayors’ Council meeting held Thursday, Desmond said TransLink’s projected revenue shortfall could top $680 million this year, and help is needed from senior levels of government.

[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]

TransLink Mayors’ Council Chair Jonathan Cote said he’ll be speaking to the House of Commons finance committee via teleconference on Thursday morning to call for emergency relief from the federal government.

“As we get into the June-July period, if partnerships with the provincial and federal government are not materializing, TransLink is still losing money each month and may be forced to consider even further, more dramatic cuts,” he said.

Story continues below advertisement

As for Unifor’s legal challenge, Cote says the Coast Mountain Bus Company believes it has followed the collective agreement and will respect the decision made by the labour relations board.

The union is urging its members to write to their member of parliament to demand emergency funds for public transit.

“Other critical transportation networks, such as airlines, have been granted access to federal subsidies,” Unifor Western Regional Director Gavin McGarrigle said in a statement.

“Let’s show essential services workers that we are committed to getting them to work safely and efficiently.”

Earlier this month, BC Ferries said it was rescinding temporary layoff notices “as an act of company support for our valuable employees at this uncertain time.”

About 1,400 ferry workers were laid off amid the COVID-19 pandemic and the BC Ferry and Marine Workers Union filed a complaint of unfair labour practice.

— With files from Janet Brown and Amy Judd


Q:

How does one change the color for text highlighting in Xcode 4 for warnings and errors?

Possible Duplicate:
Fix for Xcode's indiscernible highlighting of inline errors?

Does anyone know how to change the color of the in-line highlighting for warnings and errors in Xcode 4? With almost every theme, the yellow warning highlight makes the underlying code impossible to read.
Example picture

A:

Just came across this, which seems to be able to modify some of Xcode's behaviors by creating some sort of plugin. Maybe one can be developed to change text highlight color. http:/github.com/davekeck/Xcode-4-Fixins
Update:
I've finally managed to implement a Xcode "fixin" to do it.

You just need to open the project and build it. Doing so will install an Xcode plugin called "XCFixin_CustomizeWarningErrorHighlights.xcplugin" into ~/Library/Application Support/Developer/Shared/Xcode/Plug-ins. You can of course customize the colors to your liking.
Get the "fixin" here:
https://github.com/armadillu/Xcode-4-Fixins/tree/master/XCFixin_CustomizeWarningErrorHighlights


1. Field of the Invention
The present invention relates to systems and methods for protecting vehicle occupants from injury. More specifically, the present invention relates to airbag cushions with integrated inflator hardware.
2. Description of Related Art
The inclusion of inflatable safety restraint devices, or airbags, is now a legal requirement for many new vehicles. Airbags are typically installed in the steering wheel and in the dashboard on the passenger side of a car. Additionally, airbags may be installed to inflate beside the passenger to provide side impact protection, in front of the knees or under the legs to protect the knees and/or maintain the posture of the occupant during impact, or at other strategic locations.
In the event of an accident, an accelerometer within the vehicle measures the abnormal deceleration and triggers the ignition of an explosive charge. Expanding gases from the charge fill the airbags, which immediately inflate to protect the driver and/or passengers from impact against the interior surfaces of the vehicle. During normal vehicle operation, airbags are typically stowed behind covers to protect them from tampering and to provide a more attractive interior facade for the vehicle.
Typically, the expanding gases are expelled into the cushion from an inflator that contains the gas in compressed form or generates gas through the ignition of a pyrotechnic. In certain airbag modules, the inflator is positioned within the cushion. Thus, the inflation gas is able to reach the cushion faster, and installation of the module may be simplified.
Unfortunately, the process of manufacturing, inserting, and attaching the inflator in place can add significantly to the cost of the airbag system. According to known methods, the inflator is often manufactured in a process entirely separate from that of the airbag cushion. Hence, two separate manufacturing processes must be used, and the products of both must be brought together to provide the complete module. The shipping, inventory, and general management costs associated with managing the separate production lines can be considerable.
Furthermore, installation of inflators for known airbag systems typically requires the use of nuts, bolts, clamps, retaining rings, and other pieces of installation hardware. Such hardware adds to the cost of the airbag system. Installation of the inflator may require considerable time from an operator, who may be required to use expensive, customized tooling to carry out the installation process.
When the inflator is to be installed in the cushion, the cushion may have to be sealed after installation of the inflator. Inflators installed outside a cushion may need to be connected to the cushion by gas guides or other expensive hardware designed to channel the inflation gas. The inflators used must often include baffles, screens, or other parts designed to cool the inflation gas and remove particulates to protect the cushion from damage.
Accordingly, a need exists for airbag modules and associated manufacturing and installation methods by which the inflator and cushion can be more easily combined for installation in a vehicle. Such modules and methods should preferably minimize the amount of time and hardware required for inflator/cushion integration. Additionally, such modules and methods should preferably be compatible with simplified, low-cost inflator designs. Furthermore, such modules and methods should preferably minimize the overall cost of the airbag module and the associated installation process.


[Technic and results of computed tomography of the base of the nose and orbit with multiplanar reconstructions].
The additional use of a 3-D display programme provides valuable information in cases of trauma to the mid-face and tumours of the bony orbits. The computer programme provides important additional information for the radiologist and, in future, will influence treatment significantly.


Britain's ad bodies have warned that the government's proposed digital services tax targeting tech giants such as Facebook, Google and Twitter could threaten the UK's position as "a leader in digital innovation" and pose a challenge to a digital ad market that's already "facing an uncertain economic and regulatory climate".

While ISBA, the UK Internet Advertising Bureau and the Advertising Association cautiously welcomed the content of chancellor of the exchequer Philip Hammond's Budget 2018, they sounded a note of caution around plans to introduce a digital services tax.

From 2020, tech giants will have to pay tax on the sales they generate in the UK. The proposed legislation will only affect "established tech giants", such as the likes of Facebook, Google, Amazon and Twitter, rather than start-ups, Hammond promised. The idea is to prevent tech companies from negotiating the gaps between international tax laws by shifting sales and profits between jurisdictions.

But the IAB said that the tax could present a "disincentive for competitors to set up and grow in the UK", while ISBA said it was "vital that the UK does not lose its position as a leader in digital innovation".

"The strength of our digital economy is based on the UK being a welcoming environment for digital businesses of all sizes," Phil Smith, director-general of ISBA, said.

"ISBA recognises the need to update international tax treaties and domestic tax legislation to reflect the needs of modern business. We welcome the work of both the EU and OECD in driving for a multinational approach and note their belief that it would be inappropriate to seek to treat digital businesses differently from businesses in other sectors.

"It is essential that the UK delivers a rounded, modern and attractive tax regime. ISBA await more detail as to the consultation, but would urge government to proceed on a multilateral basis, in an evidence-led fashion."

Hammond has previously mooted the idea of a digital services tax. At the Conservative conference in September, he said that "the best way to tax international companies is through international agreements, but the time for talking is coming to an end and the stalling has to stop".

"If we cannot reach agreement, the UK will go it alone with a digital services tax of its own," Hammond added.

But for Jon Mew, chief executive of IAB, such a tax poses "a significant challenge to the UK digital advertising market at a time when it is already facing an uncertain economic and regulatory climate".

He added: "It might create a disincentive for competitors to set up and grow in the UK and may also impact on mid-market players who drive competition and provide choice.

"The commitment of an extra £500m for Brexit preparations is good news but, above all, we need clarity as there are still a lot of unanswered questions around talent and data flows. We sincerely hope the government is indeed committed to leading the world in innovation-friendly regulation that supports the growth of the tech sector."

Meanwhile, the AA broadly welcomed the Budget, "with its emphasis on growing productivity" and preparing the UK for Brexit.

However, Stephen Woodford, the AA's chief executive, added: "We also note the chancellor’s desire to see international agreement on taxing the global tech platforms, as action in this area will be much more effective with cross-border co-operation.

"Mr Hammond’s commitment to introduce a UK-only tax – to be implemented if international agreement is not forthcoming by 2020 – will need to ensure in its detail that Britain remains attractive to international tech investment, especially at a time of great change for the UK’s relationship with the EU and the wider world."

The ad industry's reaction echoes that of the Confederation of British Industry, which has likewise warned that tax changes should not damage the UK's global competitiveness.


Since
it has been taught that dukkha means: "Yadani - cam tam dukkham
- whichis transient and therefore, 'suffering'; the five
khandhas not being lasting, are dukkha (suffering). Of
these khandhas, only dukkhavedana, the sensation of suffering
which is one of the constituents of vedanakhandha, ismisery,
for being distressful. The rest of the four khandhas and sukhaupekkha
are not the miserable conditions which are causing harm and distress.
However, since they are devoid of pleasure for being impermanent or
transitory by nature, they are to be termed "dukkha".And
also because it cause the distressing sensation - dukkhavedana -
andis likely to cause trouble and pain, it is said to be
"dukkha".Let's recite a motto as shown below:

"Impermanent are
the Five Khandhas which are in reality dukkha, suffering."

These
five khandhas being incessantly arising and dissolving are always
causing pain and suffering. These khandhas by causing stiffness,
hotness, etc., are often ill-treating. That is why it is termed as "dukkha"
- terriblymiserable. This nature of constant suffering and
misery is to be understood as the characteristic or mark of dukkha.
Let's recite a motto which is composed as follows:

"Constant ill-treatment
caused by the arising and dissolution of khandhas is the characteristic
of dukkha (dukkhanupassana).

A
Yogi who is continuously contemplating on the arising phenomena of rupa
and nama, perceives the formation or arising of new khandhas
following instantaneously without appreciable interval upon the
dissolution of the old. He realises the causation of unbearable pain
and suffering, and becomes satisfied finding them as being miserable
and frightful
through his personal insight-knowledge. This is the real 'dukkhanupassana-nana'
Ihave coined a motto which may be recited as follows:

"Awareness of
suffering and misery for having found the transient nature of arising
and dissolution at the moment-of-contemplation and noting, is dukkhanupassana-nana.

Let
us now recite by developing metta as: "May all be happy" while
contemplating the manner of ill-treatment caused by the condition of
arising and dissolution of things, and developing dukkhanupassana.
Please follow the recitation.


The District of Columbia Department of General Services is issuing this Request for Proposals to engage a Design-Builder to develop a design, renovate the existing Palisades Recreation Center and construct the new expansion at Palisades, located at 5200 Sherier Place, NW, Washington, DC. The existing Palisades Recreation Center was constructed in 1936 and consists of approximately 6,600 GSF of space. The Project must achieve a minimum of LEED Gold Certification.


Q:

Period of 3 implies chaos

Let $f(x)$ be a continuous function from $\mathbb{R}\rightarrow\mathbb{R}$.
Let's denote $k$-times repeated application of the function, $f(f(f(...f(x)...)))$ as $f^{(k)}(x)$.
Let's call any $x$ a periodic point with period $n$ if $f^{(n)}(x)=x$.
Is it true that if a point with period 3 exists, then points with all possible periods exist?
In other words is it true that
$$\exists x:f^{(3)}(x)=x\Rightarrow \forall n>0 \exists y:f^{(n)}(y)=y$$
and if so, why?

A:

I believe you want Sharkovsky's Theorem.
A reasonable explanation is in:
Kaplan, Harvey. "A cartoon-assisted proof of Sarkowskiĭ's theorem."
Amer. J. Phys. 55 (1987), no. 11, 1023–1032.
MR917121
DOI:10.1119/1.14928"

A:

See the Monthly paper of that exact title Period three implies chaos - which made the JSTOR All-Stars list as the third most frequently accessed Monthly article. See also A simple proof of Sharkovsky's theorem and this paper for some history on Sharkovsky's theorem.

A:

I found Chaos: An Introduction to Dynamical Systems by Kathleen T. Alligood, Tim D. Sauer, and James A. Yorke, to be a sensible text.  A small section of the text contains a brief explanation of Sharkovsky's Theorem.
In short, Sharkovsky uses this unique ordering of the natural numbers in such a way as to ensure that for each natural number n, the existence of a period-n point implies the existence of periods containing all the periods of orders higher than n. In my opinion, the text provides a reasonable simplification of this ordering and gently walks one through a decipherable step by step proof.


Food resources of low-income households in Southwest Mississippi.
Demographic data and food resources were studied for 1,400 households in seven counties in Southwest Mississippi. The results were compared for industrialized and non-industrialized counties and the urban areas. Household incomes and the educational levels of household heads were far below the national level. Hunger is still prevalent among those with the lowest incomes and the least education. Since most of the household heads with lower incomes either were unemployed or had unskilled jobs, the government was their main food resource. Welfare accounted for 25% and Food Stamps for 30%. The next important source was the school. Such critical conditions as lower income, limited education, unemployment, hunger, and need for government assistance were more prevalent in non-industrialized counties than in industrialized counties and the urban areas. The government assistance programs for food are necessary to prevent hunger, to maintain nutritional adequacy, and, consequently, to reduce medical bills. This is especially true for the poverty-level families, who need the federal food programs for daily survival.


This step by step course is intended for everyone who wants to start working with CSS Flexbox and CSS Grid

A basic knowledge of HTML, CSS would be preferred.

We will cover what is CSS Flexbox and CSS Grid, how to add CSS Flexbox and CSS Grid to our projects, how to start working with CSS Flexbox and CSS Grid and step by step we will cover CSS Flexbox and CSS GRID syntax. After that we will dive deep into world of CSS Flexbox and CSS Grid by creating interesting website projects (small and big) because learning the syntax is only the first step - IF YOU WANT TO BECOME CSS FLEXBOX and CSS GRID NINJA - you need to know how to implement CSS Flexbox and CSS GRID in real world situations.


Subtle political messages are abundant in the film. When asked to stop the Armenians' rebellion against the Ottoman Empire by his superior, Col. Halil (played by Haluk Bilginer), Veli asks, “How are we to know who are rebels and who are villagers?” Halil replies, “The rebels are the ones firing at you.”

Set in Turkey’s eastern province of Van in 1914, it's a love story between American nurse Lillie (Hera Hilmar) and a Turkish lieutenant, Ismail Veli (Michiel Huisman). American doctor Jude (Josh Hartnett), the reason Lillie came to Van’s hospital in the first place, is also in love with her. The tense triangle comes across in several scenes such as the two men’s fistfight at the hospital over Lillie’s honor and an angry clash of words over ethics as Jude accuses the Ottoman Empire of being an accomplice to the killing of “Christians” by doing nothing to protect them.

Despite the attention it has received in the media due to its subject matter, the film has not done well at the local box office , totaling 41,578 viewers so far.

With its story of a love triangle between a strong-minded American nurse, a rugged Ottoman soldier and a zealous American doctor, it would be easy to classify “The Ottoman Lieutenant” as a classical romance set in a picturesque Anatolian town at the dawn of World War I. Yet the film, which takes place in the Turkish city of Van — a scene of bloodshed between Turks and Armenians — has been the cause of wide controversy both in the West and Turkey.

According to one of the film’s Turkish producers, Yusuf Esenkal, in an April 15 interview with the state-run Anatolia News Agency, the film could be called the first Turkish film in Hollywood. He described the film as classic love story, saying, “There is a common pain — and that pain is war.” Stephen Brown, one of the film's producers who will work with Esenkal on another film about the medieval poet Rumi, said he wanted to give an objective account of the common suffering of both Turks and Armenians. "We wanted to show the audience what happened during World War I in Eastern Anatolia, a subject that has not been handled before," he said.

Its reception in the West has been marked by controversy, and terms like “revisionist” and “denialist” have been thrown around. “The Ottoman Lieutenant” was compared to “The Promise,” another recently released film on a similar topic but told from the opposite perspective. “Battle over 2 Films Reflects Turkey’s Quest to Control a Bitter History,” reported The New York Times. The Hollywood Reporter saw the two films as a “battle over the Armenian genocide.”

Back in Turkey, reactions have been mixed. Pro-government newspapers have shown unwavering support of the film, which presents the Armenian “deportation” as reasonable and necessary.

Serdar Akbiyik from the pro-government Star daily describes “The Ottoman Lieutenant” as a love and action film set in the time of “Armenian deportation,” but without pretensions of broad statements regarding historical events. He explains 1915 Turkey as follows: “Think of a country stabbed in the back by a minority that for hundreds of years was considered brotherly — eating, drinking together. … This minority and enemy armies would slaughter the people of the region, and then when the wind turned would pay the price for what they had done, and 100 years later still try to take revenge.”

Ali Saydam from pro-government Yeni Safak took a similar position in his column. Calling the movie a truly professional work, he said that it highlights “the official Turkish understanding of history” on an international scale through cinema. Saydam also emphasized the aggressive political outrage of Armenian lobby groups prior to and during the film’s release in the United States.

Respected Turkish film critic Atilla Dorsay said he found the film "impartial and honest, without maligning any particular camp and leaving little room for objection" but "pretty close to our national views.” However, he expressed astonishment that the famous church on Akdamar Island in Lake Van was briefly mentioned in passing and its beautiful murals were not shown. According to Dorsay, it could have been a powerful message, particularly for Western viewers, to show them and say, “Even in those complicated times, we saved these treasures.”

Other Turkish critics found the film too faithful to the Turkish narrative. Senay Aydemir from the leftist Gazete Duvar panned the film from both political and cinematic angles. Aydemir, who doesn’t shy from using the word “genocide” to describe the events of 1915, slammed the film as devoid of feelings, consistency and narrative tempo. Aydemir cynically described a scene in which Veli saves 20 Armenians from another “evil-hearted” Ottoman lieutenant and lambasted the film's light tone and thin plot that completely omits historical points of interest, such as the political context that led to the Ottoman Empire's decision to deport the Armenians. He also criticized the film's blaming of the Russians for provoking Turkish-Armenian enmity, ignoring the roles played by Germany and the UK.

The plot and actors' performance also got a dose of Turkish criticism: Hurriyet's Ugur Vardan described the story as weak and not believable. He called the performance of Hera Hilmar “expressionless” and Josh Hartnett's “mediocre.” Burak Goral of the secularist Sozcu mocked the censoring of kissing scenes in the version of the film shown in Turkish theaters: “As if an Ottoman lieutenant’s kiss on the mouth of a beloved Christian woman would spoil our Turkishness or our faith!”

Clearly, the film hasn’t found much acclaim in the box office or among critics. Yet it may still be valuable as a depiction of the common Turkish perspective on the deadly Armenian “deportation,” defined by many in the West as genocide.


Polled & Horned Genetics

Horned

Horned goats.Most Nigerian Dwarfs are born with horns. If a breeder chooses to leave the kid's horns intact, the horn buds will break through the skin at just days after birth and begin growing usually at a quite rapid rate. Horns can be wonderful to some people and pretty to look at as well as providing the goat with some kind of defense if needed. They also help the goat stay cool during hot weather. The large blood vessels in the horns are a natural way for the goat to regulate and cool it's body temperature. Some owners think the horns are dangerous or obnoxious. There are goats that always seem to get their horns caught on a fence which can be dangerous for the animal. An accidental bump from a goat's horns can actually be quite painful. Another downside to having horns left on a Nigerian Dwarf is that most registries will not allow horned goats to be shown and if you need to clip or milk your goat in the stanchion, those horns tend to get in the way. Whether a breeder/owner chooses to disbud or dehorn their goats or kids is a personal choice which has both down and up sides.

Polled

What does polled mean?A goat that is born naturally without horns is polled. There is no disbudding or dehorning required for these goats which can be nice to some breeders, meaning one less kid to disbud. In place of the horns, there are two, usually small, bumps or nubs that you can feel. Newborn or very young polled kids can sometimes be distinguished among horned kids (whose horn buds have not yet come in) by the lack of "swirl" of fur where the buds would come in. Most horned kids will have a tiny swirl of fur where the buds will start to break through the skin; polled kids usually don't have this.The polled gene is a dominant gene, just like blue eyes in goats. This means that a goat can only be polled if one or both of it's parents are polled. Lets look at the chart below.PP - Homozygous polled. Cannot produce horned offspring, regardless of mate.Ph - Heterozygous polled. Can produce both polled and horned offspring, unless bred to a homozygous polled mate.hh - Horned. Cannot produce polled offspring unless bred to a polled mate.

Disbudded

What does it mean if your goat is disbudded?When a kid is just a few weeks old, some breeders will choose to remove the horn buds by disbudding which will kill the horn tissue therefore permanently making the goat "hornless." Most breeders you an electric iron specifically designed to burn the horn tissue from the young kids. Other ways of removing the horns would be through banding, surgical (done by a vet), or with disbudding paste. The photos above show some kids weeks after disbudding, minutes after disbudding, and goats as adults after being disbudded as kids. On your disbudded, adult goats you can feel a little rough or flat area where the horns would be.

Scurs

Scurs occur from an improper disbudding that does not remove or kill all the horn tissue. The leftover tissue will cause part of the horn to grow in an unusual shape.Scurs can come in many shapes and sizes, from little nubs to large curls. Some of these scurs can become dangerous to the goat if they start to curl around towards or into the head, not to mention, they are a little unsightly on some goats. They also tend to break easier or get bumped off sometimes causing an open wound, blood loss, or even possibly and infection if left untreated. From my experience, I have not had a problem with scurs breaking off except when bucks start getting rough with each other and on fencing during rutt (breeding season).

The disbudding procedure.

Done with an electric dehorning iron. This is a perfect disbudding job.


def raises(exception: Exception) -> ExceptionInfo: ...


The diffusion of fluorescein in the stroma of rabbit cornea.
The diffusion rate and the distribution ratio of fluorescein in the stroma was studied in rabbit cornea. A strip of corneal stroma was mounted in a chamber and fluorescein in a phosphate buffer solution was circulated across the end of the strip for 24 hr. The change in fluorescence intensity was measured along the strip and the diffusion coefficient was calculated using Fick's diffusion equation. The mean coefficient of diffusion was 1.21 +/- 0.24 (+/- S.D.) X 10(-6) cm2/sec at 19 degrees C. The ratio of fluorescence between the stroma and the solution was 1.34 to 1.33 for the concentrations ranging from 0.1 to 10 g/ml.