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Luis de Guindos: Presentation of the European Central Bank Annual Report 2019 to the Committee on Economic and Monetary Affairs of the European Parliament

Introductory remarks (by videoconference) by Mr Luis de Guindos, Vice-President of the European Central Bank, to the Committee on Economic and Monetary Affairs of the European Parliament, Frankfurt am Main, 7 May 2020.




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Top-spec 13-inch MacBook Pros can handle 87W adapters, but benefits are limited



Apple's higher-end 13-inch MacBook Pros are equipped to take advantage of 87W power adapters, though users won't see any charging speed benefits from the change.




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Wohin mit dem Dieb?




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Freedom Climbers reach Kilimanjaro summit

After five days of strenuous hiking and altitude sickness, the Freedom Climbers rejoice at the summit of Mt. Kilimanjaro, fittingly called Uhuru (freedom) Peak.




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Agitation in Patients With Autism Spectrum Disorder Admitted to Inpatient Pediatric Medical Units

OBJECTIVES:

Our goals for this study were to characterize the frequency of agitation in patients with autism spectrum disorder (ASD) admitted to an inpatient pediatric medical unit and to identify risk factors associated with agitation.

METHODS:

Through a retrospective chart review, we identified every patient between 8 and 19 years of age with a documented ASD diagnosis admitted to a pediatric medical unit over a 5-year period. We performed a detailed review of each admission, with a focus on factors hypothesized to be correlated with risk of agitation.

RESULTS:

One or more episode of agitation occurred during 37 (12.4%) of the 299 admissions and for 31 (18.5%) of the 168 patients who met inclusion criteria. History of agitation (risk ratio 21.9 [95% confidence interval 5.4–88.3] for history of severe agitation; P < .001) and documented sensory sensitivities (risk ratio 2.3 [95% confidence interval 1.3–3.8]; P < .001) were associated with a significantly increased risk of agitation during admission. History of past psychiatric admissions was associated with increased risk before, but not after, controlling for history of agitation and sensory sensitivities. Psychiatric comorbidity, intellectual disability, acute pain on admission, number of preadmission psychotropic medications, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ASD diagnosis, age, and sex were not significantly associated with increased risk.

CONCLUSIONS:

Hospitalization can be challenging for patients with ASD. A subset of these patients experience episodes of agitation during admission, posing a safety risk to patients and staff. Characterizing risk factors associated with these behaviors may allow for identification of at-risk patients and guide targeted intervention to prevent negative behavioral outcomes.




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Office-Based Screening for Sexually Transmitted Infections in Adolescents

Almost 1 in 4 adolescents have a sexually transmitted infection (STI). These infections are preventable through safe sexual practices and routine screening. Pediatricians are the first line of clinical care for adolescents and are well positioned to offer sexual and reproductive health care counseling and services to their patients; yet, there is a paucity of sexual health screening provided at routine health supervision visits. This article addresses the epidemiology of STIs in adolescents, reviews the evidence of current clinical practice, presents recommended STI screening from government and medical agencies, and offers strategies to address barriers to providing care for adolescents and for sexual health screening in primary care.




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Gypsy Smith in Serbian

OM EAST is publishing Rodney “Gypsy” Smith’s autobiography to help inspire Roma believers in Serbia.




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Andy Murray admits he may need another operation

ANDY MURRAY may need to have another operation as he continues his bid to return to top-level tennis.




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Decline in air traffic in Tegel and Schönefeld in April / Covid 19 pandemic puts a limit to air traffic in the capital

27,593 passengers departed from and landed at Berlin's airports Schönefeld and Tegel in April. That is just 1 per cent of air traffic in comparison to April 2019. 22,079 passengers flew from Tegel, and 5,541 from Schönefeld.




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Contactless payment limit to increase to £45 - what you need to know

THE limit for in-store card transactions by contactless-enabled cards is to increase soon.




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Graeme Macpherson: Limited expectations and dreaming big key for fans of smaller clubs

THE most important lesson in life is to always travel in hope rather than expectation. That way the almost inevitable disappointment that follows isn’t quite as crushing. A cheery thought for these troubled times.




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Film view with Damien Smith

RADIOACTIVE (12A)




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Setting Class-Size Limits

A majority of states have at least one policy that limits the number of students that may be in a general education classroom, according to the Education Commission of the States. Among states that have changed their class-size policies since 2008, all have opted to relax those constraints.




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The urgent imperative to limit future conflicts and injustice

VE DAY in 1945 was obviously an occasion for major celebration in Britain and throughout Europe. But there is reasonable debate as to what we should make of it now.




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Opinion: Mark Smith: Sing as if you don’t know that one day the singing ends

CAN I tell you how I feel? I feel, sometimes, like everyone in my life has suddenly been reduced to flat, distant images on a computer screen, like we’re in Star Trek. And I don’t like it.




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Referee talents strive for the summit

Europe's up-and-coming referees are urged to make the most of their potential, as the UEFA referee talents and mentors programme continues to prove value for the future.




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Association Between Sexually Transmitted Diseases and Young Adults' Self-reported Abstinence

The extent to which young adults' laboratory-confirmed sexually transmitted disease results and self-reported sexual behaviors are consistent has not been assessed in a nationally representative sample.

The primary purpose of this study was to determine whether young adults' reports of recent sexual behavior (presence of penile/vaginal sex in the previous 12 months) correspond with the presence of laboratory-confirmed nonviral STDs assessed by nucleic acid amplification testing. (Read the full article)




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Symptoms and Time to Medical Care in Children With Accidental Extremity Fractures

A delay in seeking medical care for children with significant injury often raises a concern about child abuse, but there are few data describing the range of responses children display after accidental fracture for providers to use in comparison.

This study presents the range of responses exhibited by children after accidental fractures and identifies factors associated with a delay in seeking medical care. No child was asymptomatic, although a minority did not manifest all expected responses after their injury. (Read the full article)




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Childhood Gender Nonconformity: A Risk Indicator for Childhood Abuse and Posttraumatic Stress in Youth

Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or with posttraumatic stress disorder.

We identify gender nonconformity before age 11 years as a risk indicator for physical, sexual, and psychological abuse in childhood and lifetime probable posttraumatic stress disorder in youth. (Read the full article)




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Rising National Prevalence of Life-Limiting Conditions in Children in England

For children and young people with life-limiting conditions, palliative care services should be available, but few national or local data are available to estimate the burden of these conditions.

The prevalence of life-limiting conditions in children and young people in England was double the previously reported estimates, at 32 per 10 000 population. This identifies a need for specialist pediatric palliative care services. (Read the full article)




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Limitations and Opportunities of Transcutaneous Bilirubin Measurements

Transcutaneous bilirubinometry was originally developed as a potential replacement for invasive blood sampling, but its clinical application is still limited to a screening method for hyperbilirubinemia. Reasons for this limited clinical value may be diverse.

This study provides insight into the reasons for the limited clinical value of transcutaneous bilirubinometry. This aids to both better interpretation of the measured TcB value from a patient and to possible improvement of the clinical value of the technique. (Read the full article)




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The Outcome of ELBW Infants Treated With NCPAP and InSurE in a Resource-Limited Institution

The survival of extremely low birth weight infants in resource-limited situations is dismal due to limited neonatal intensive care facilities. Nasal continuous positive airway pressure resulted in an increased survival of these infants, but many still require back-up ventilation.

Nasal continuous positive airway pressure and intubation, surfactant, and extubation practiced in a neonatal high care ward with limited resources and limited back-up ventilatory facilities can improve the survival of extremely low birth weight infants. (Read the full article)




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Infant Outcomes After Maternal Antiretroviral Exposure in Resource-Limited Settings

Information on infant safety after exposure to maternal antiretroviral regimens during pregnancy in international clinical trials is lacking. As antiretroviral drugs are released to populations in resource-limited settings through clinical trials, it becomes critical to collect pediatric outcome data.

The study demonstrates the feasibility of reporting infant outcomes following adult antiretroviral trials in developing countries, provides HIV-free infant survival and prospective growth data in association with maternal parameters, and details morbidity, mortality, and genetic defects following maternal antiretroviral exposure. (Read the full article)




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Attributable Risks for Childhood Overweight: Evidence for Limited Effectiveness of Prevention

Childhood obesity is a public health concern. Although determinants of childhood overweight have been identified and their effect sizes have been calculated, prevention as well as treatment have had limited success.

We have calculated the population-based relevance of determinants of childhood overweight by using attributable risks, which can be interpreted as maximum success rates of preventive measures. New concepts were applied to estimate the relative contribution of each risk factor. (Read the full article)




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Carnitine Palmitoyltransferase I and Sudden Unexpected Infant Death in British Columbia First Nations

The CPT1A p.P479L variant is common to northern aboriginal populations, leads to reduced enzyme activity, and may be associated with increased infant mortality rates.

The p.P479L variant is common in British Columbia First Nations with a coastal distribution correlated with regions of high infant mortality. Homozygotes display an altered acylcarnitine profile and are overrepresented in cases of sudden unexpected infant death in these areas. (Read the full article)




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Protective Factors Can Mitigate Behavior Problems After Prenatal Cocaine and Other Drug Exposures

Prenatal cocaine exposure is associated with the trajectories of childhood behavior problems. Exposure effects may also be related to maternal use of other substances during pregnancy, and risk factors other than prenatal exposure may augment the detrimental cocaine effects.

The balance between cumulative risk and protective indexes predicts behavior outcomes, independent of prenatal drug exposure. A high protective index even with a high level of risks can mitigate the detrimental effects of drug exposure on behavior problem trajectory. (Read the full article)




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Computer-Generated Reminders and Quality of Pediatric HIV Care in a Resource-Limited Setting

Of more than 2 million children infected with HIV, almost 90% live in resource-limited settings where pediatric HIV care is often suboptimal. Implementing electronic health records with computerized decision support offers a potential tool for improving care.

This randomized, controlled trial demonstrates that computer-generated clinical reminders can significantly improve clinician compliance with HIV care guidelines for children in a resource-limited setting. This intervention is scalable as developing countries implement electronic health record systems. (Read the full article)




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Warts Transmitted in Families and Schools: A Prospective Cohort

Current recommendations to prevent warts focus on limiting the personal spread of human papillomavirus and transmission in public places, such as swimming pools; however, evidence on risk factors for developing warts is limited.

Cutaneous human papillomavirus in primary schoolchildren is primarily transmitted in the family and school class. This suggests that recommendations should shift toward reducing transmission in families and school classes. (Read the full article)




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Effect of Early Limited Formula on Duration and Exclusivity of Breastfeeding in At-Risk Infants: An RCT

Public health policy focuses on reducing formula use for breastfed infants during the birth hospitalization. Observational evidence supports this approach, but no previous studies have examined the effect of early use of small volumes of formula on eventual breastfeeding duration.

Use of limited volumes of formula during the birth hospitalization may improve breastfeeding duration for newborns with high early weight loss. Reducing the use of formula during the birth hospitalization could be detrimental for some subpopulations of healthy term newborns. (Read the full article)




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Inpatient Characteristics of the Child Admitted With Chronic Pain

Children with chronic pain complaints seem to represent an increasing portion of general pediatric inpatient services. Few data exist, however, on the characteristics of this population, their length of stay, or the best approach to their evaluation and management.

This study defines the demographic, diagnostic, procedural, and episode of care characteristics for children admitted to the acute care setting with chronic pain syndromes. Admission rates are rising, lengths of stay are substantial, and comorbid diagnoses are common. (Read the full article)




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Hypospadias and Residential Proximity to Pesticide Applications

Some studies suggest a contribution of environmental exposures such as pesticides to risk of hypospadias, whereas others do not. One of the challenges that has limited current knowledge is the lack of detailed exposure data.

This study examined a more detailed assessment of exposure to pesticides than previous studies. Exposure assignments, whether to groups of chemicals, specific chemicals, or a composite involving a number of chemicals, showed a general lack of association with hypospadias. (Read the full article)




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Resuscitation of Preterm Neonates With Limited Versus High Oxygen Strategy

Preterm infants can be successfully resuscitated with <100% oxygen (O2); however, initiation with room air remains controversial. Current Neonatal Resuscitation Program (NRP) guidelines suggest using air or blended O2 to titrate O2 to meet target preductal saturation goals.

This is the first trial to compare a limited O2 strategy to target NRP–recommended transitional goal saturations versus a high O2 strategy in preterm infants. The limited O2 strategy decreased integrated excess oxygen and oxidative stress and improved respiratory outcomes. (Read the full article)




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Cotinine in Children Admitted for Asthma and Readmission

Serum and salivary cotinine have previously been identified as reliable biomarkers for exposure to tobacco smoke.

We found that detectable serum and salivary cotinine is common among children admitted for asthma and is associated with readmission. This finding may inform clinical care for children at increased risk of asthma morbidity. (Read the full article)




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Sensitivity of the Limited View Follow-up Skeletal Survey

A previous study suggested that spine and pelvis views may be omitted from the follow-up skeletal survey protocol for suspected child abuse, when these views are normal on the initial skeletal survey, without limiting the sensitivity of the study.

This multicenter study provides estimates of the risk of missing occult fractures in the evaluation of suspected child abuse with omission of spine and pelvis views from the follow-up skeletal survey protocol. Results may be used to update practice recommendations. (Read the full article)




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Adolescents' Perceptions of Light and Intermittent Smoking in the United States

Light and intermittent smoking are harmful, but increasingly common, smoking patterns. It is unknown how adolescents perceive these smoking patterns, and whether these views differ by sociodemographic characteristics, and exposure to and use of tobacco.

US adolescents perceive light and intermittent smoking as significantly less dangerous than heavier smoking. One in 4 adolescents believes intermittent smoking causes little to no harm. Perceptions of relative safety were common among smokers. (Read the full article)




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From the NFL to MIT: How John Urschel Is Making Math More Interesting

Teachers must reject the idea that math is like eating vegetables, says former offensive lineman and current mathematician John Urschel.




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How Does Current Law Limit Betsy DeVos' Power to Waive Education Mandates?

Several of the already existing restrictions on U.S. Secretary of Education Betsy DeVos' authority to waive federal education law deal with school funding.




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Setting Class-Size Limits

A majority of states have at least one policy that limits the number of students that may be in a general education classroom, according to the Education Commission of the States. Among states that have changed their class-size policies since 2008, all have opted to relax those constraints.




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Fin24.com | EU allegedly mulling no-deal Brexit summit as pressure mounts

United Kingdom and European Union negotiators were working through Sunday as the outcome of Brexit talks hung in the balance.




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Fin24.com | Trump seeks to limit birthright citizenship in constitution

US President Donald Trump says he plans to sign an executive order ending birthright citizenship for babies of non-citizens and unauthorised immigrants born on US soil.




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Thioridazine is an efflux pump inhibitor in Mycobacterium avium complex but of limited clinical relevance [Susceptibility]

Treatment of Mycobacterium avium complex pulmonary disease (MAC-PD) is challenging partly due to high efflux pump expression. Thioridazine might block these efflux pumps. We explore thioridazine's efficacy against M. avium using minimum inhibitory concentrations (MICs), time-kill combination assays, ex vivo macrophage infection assays and efflux assays. Thioridazine is bactericidal against M. avium, inhibits intracellular growth at 2x MIC and blocks ethidium bromide efflux. However, its toxicity and low plasma concentrations, make it unlikely to add efficacy to MAC-PD therapy.




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Concurrent local delivery of diflunisal limits bone destruction but fails to improve systemic vancomycin efficacy during Staphylococcus aureus osteomyelitis [Clinical Therapeutics]

Staphylococcus aureus osteomyelitis is a debilitating infection of bone. Treatment of osteomyelitis is impaired by the propensity of invading bacteria to induce pathologic bone remodeling that may limit antibiotic penetration to the infectious focus. The nonsteroidal anti-inflammatory drug diflunisal was previously identified as an osteoprotective adjunctive therapy for osteomyelitis, based on the ability of this compound to inhibit S. aureus quorum sensing and subsequent quorum-dependent toxin production. When delivered locally during experimental osteomyelitis, diflunisal significantly limits bone destruction without affecting bacterial burdens. However, because diflunisal's "quorum-quenching" activity could theoretically increase antibiotic recalcitrance, it is critically important to evaluate this adjunctive therapy in the context of standard of care antibiotics. The objective of this study is to evaluate the efficacy of vancomycin to treat osteomyelitis during local diflunisal treatment. We first determined that systemic vancomycin effectively reduces bacterial burdens in a murine model of osteomyelitis, and identified a dosing regimen that decreases bacterial burdens without eradicating infection. Using this dosing scheme, we found that vancomycin activity is unaffected by the presence of diflunisal in vitro and in vivo. Similarly, locally-delivered diflunisal still potently inhibits osteoblast cytotoxicity in vitro and bone destruction in vivo in the presence of sub-therapeutic vancomycin. However, we also found that the resorbable polyurethane foams used to deliver diflunisal serve as a nidus for infection. Taken together, these data demonstrate that diflunisal does not significantly impact standard of care antibiotic therapy for S. aureus osteomyelitis, but also highlight potential pitfalls encountered with local drug delivery.




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HIV Testing Among Adolescents With Acute Sexually Transmitted Infections

BACKGROUND AND OBJECTIVES:

Rates of sexually transmitted infections (STIs) have increased over the decade. Guidelines recommend HIV testing with incident STIs. Prevalence and factors associated with HIV testing in acute STIs are unknown in adolescents. Our objective was to determine the prevalence of completed HIV testing among adolescents with incident STIs and identify patient and health care factors associated with HIV testing.

METHODS:

Retrospective study of STI episodes (gonorrhea, Chlamydia, trichomoniasis, or syphilis) of adolescents between 13 and 24 years old from July 2014 to December 2017 in 2 urban primary care clinics. We performed mixed effects logistic regression modeling to identify patient and health care factors associated with HIV testing within 90 days of STI diagnosis.

RESULTS:

The 1313 participants contributed 1816 acute STI episodes. Mean age at STI diagnosis was 17.2 years (SD = 1.7), 75% of episodes occurred in females, and 97% occurred in African Americans. Only half (55%) of acute STI episodes had a completed HIV test. In the adjusted model, female sex, previous STIs, uninsured status, and confidential sexual health encounters were associated with decreased odds of HIV testing. Patients enrolled in primary care at the clinics, compared with those receiving sexual health care alone, and those with multipathogen STI diagnoses were more likely to have HIV testing.

CONCLUSIONS:

HIV testing rates among adolescents with acute STIs are suboptimal. Patient and health care factors were found to be associated with receipt of testing and should be considered in clinical practice.




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Educational Technology Has Limitations

Deep and lasting learning can best come from the relationship between teachers and their students.




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Hintzes commit $100,000 for emergency aid to students

Two of Penn State’s most generous supporters and prominent alumni leaders have made a new commitment to support students impacted by the COVID-19 crisis. Helen S. Hintz, 1960, and Edward “Ed” R. Hintz, 1959, have directed $100,000 to the Student Care and Advocacy Emergency Fund.




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COVID-19: Researchers to model novel coronavirus for spread mitigation

In an effort to help mitigate the disruptive effects of the deadly COVID-19 virus, an interdisciplinary team of Penn State researchers are developing a novel methodology to analyze its spread and the impacts on policy to create better-prepared and more-resilient health care systems.




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New decontamination protocol permits reuse of N95 respirators

A new protocol using aerosolized hydrogen peroxide to decontaminate N95 respirators could allow them to be safely reused in hospital settings. The protocol, optimized by a team of Penn State researchers, inactivates viruses without deforming or damaging the respirator and could help hospitals overcome the current respirator shortage due to the COVID-19 pandemic.




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Amazon Music Unlimited vs. Spotify: How Do They Compare?

The big difference between Spotify and Amazon Music Unlimited is Amazon offers an affordable tier of service available on just one Echo device. Here's how else they differ.




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The 10 Best Titles For New Comixology Unlimited Subscribers

Comixology Unlimited lets you dive into more than 20,000 digital comics for just $5.99 per month. Make the most of your subscription by starting with these 10 titles.




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David Smith: VE Day and World In A Day can bring us together when we're socially distant

I was just sitting down to write this week's column when the Red Arrows flew right over my head.