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Continuous Glucose Monitoring in Pregnancy: Importance of Analysing Temporal Profiles to Understand Clinical Outcomes

OBJECTIVE

To determine if temporal glucose profiles differed between 1) women who were randomized to real-time continuous glucose monitoring (RT-CGM) or self-monitored blood glucose (SMBG), 2) women who used insulin pumps or multiple daily insulin injections (MDIs), and 3) women whose infants were born large for gestational age (LGA) or not, by assessing CGM data obtained from the Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT).

RESEARCH DESIGN AND METHODS

Standard summary metrics and functional data analysis (FDA) were applied to CGM data from the CONCEPTT trial (RT-CGM, n = 100; SMBG, n = 100) taken at baseline and at 24- and 34-weeks gestation. Multivariable regression analysis determined if temporal differences in 24-h glucose profiles occurred between comparators in each of the three groups.

RESULTS

FDA revealed that women using RT-CGM had significantly lower glucose (0.4–0.8 mmol/L [7–14 mg/dL]) for 7 h/day (0800 h–1200 h and 1600 h–1900 h) compared with those with SMBG. Women using pumps had significantly higher glucose (0.4–0.9 mmol/L [7–16 mg/dL]) for 12 h/day (0300 h to 0600 h, 1300 h to 1800 h, and 2030 h to 0030 h) at 24 weeks with no difference at 34 weeks compared with MDI. Women who had an LGA infant ran a significantly higher glucose by 0.4–0.7 mmol/L (7–13 mg/dL) for 4.5 h/day at baseline; by 0.4–0.9 mmol/L (7–16 mg/dL) for 16 h/day at 24 weeks; and by 0.4–0.7 mmol/L (7–13 mg/dL) for 14 h/day at 34 weeks.

CONCLUSIONS

FDA of temporal glucose profiles gives important information about differences in glucose control and its timing, which are undetectable by standard summary metrics. Women using RT-CGM were able to achieve better daytime glucose control, reducing fetal exposure to maternal glucose.




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A Randomized Trial Evaluating the Efficacy and Safety of Fast-Acting Insulin Aspart Compared With Insulin Aspart, Both in Combination With Insulin Degludec With or Without Metformin, in Adults With Type 2 Diabetes (Onset 9)

OBJECTIVE

To evaluate the efficacy and safety of fast-acting insulin aspart (faster aspart) compared with insulin aspart (IAsp), both with insulin degludec with or without metformin, in adults with type 2 diabetes not optimally controlled with a basal-bolus regimen.

RESEARCH DESIGN AND METHODS

This multicenter, double-blind, treat-to-target trial randomized participants to faster aspart (n = 546) or IAsp (n = 545). All available information, regardless of treatment discontinuation or use of ancillary treatment, was used for evaluation of effect.

RESULTS

Noninferiority for the change from baseline in HbA1c 16 weeks after randomization (primary end point) was confirmed for faster aspart versus IAsp (estimated treatment difference [ETD] –0.04% [95% CI –0.11; 0.03]; –0.39 mmol/mol [–1.15; 0.37]; P < 0.001). Faster aspart was superior to IAsp for change from baseline in 1-h postprandial glucose (PPG) increment using a meal test (ETD –0.40 mmol/L [–0.66; –0.14]; –7.23 mg/dL [–11.92; –2.55]; P = 0.001 for superiority). Change from baseline in self-measured 1-h PPG increment for the mean over all meals favored faster aspart (ETD –0.25 mmol/L [–0.42; –0.09]); –4.58 mg/dL [–7.59; –1.57]; P = 0.003). The overall rate of treatment-emergent severe or blood glucose (BG)–confirmed hypoglycemia was statistically significantly lower for faster aspart versus IAsp (estimated treatment ratio 0.81 [95% CI 0.68; 0.97]).

CONCLUSIONS

In combination with insulin degludec, faster aspart provided effective overall glycemic control, superior PPG control, and a lower rate of severe or BG-confirmed hypoglycemia versus IAsp in adults with type 2 diabetes not optimally controlled with a basal-bolus regimen.




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2017 American Academy of Pediatrics Clinical Practice Guideline: Impact on Prevalence of Arterial Hypertension in Children and Adolescents With Type 1 Diabetes

OBJECTIVE

In 2017, the American Academy of Pediatrics introduced a new guideline (2017 Clinical Practice Guideline of the American Academy of Pediatrics [AAP 2017]) to diagnose arterial hypertension (HTN) in children that included revised, lower normative blood pressure (BP) values and cut points for diagnosing high BP in adolescents. We studied the impact of the new AAP 2017 guideline on prevalence of HTN in children with type 1 diabetes mellitus (T1DM).

RESEARCH DESIGN AND METHODS

Up to September 2018, 1.4 million office BP measurements in 79,849 children and adolescents (aged 5–20 years) with T1DM have been documented in the DPV (Diabetes Prospective Follow-up) registry. BP values of the most recent year were aggregated, and BP values of 74,677 patients without antihypertensive medication were analyzed (median age 16 years and diabetes duration 5.3 years and 52.8% boys). BP values were classified according to AAP 2017 and the references of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) (2011) and the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (fourth report) (2004).

RESULTS

Of the patients, 44.1%, 29.5%, and 26.5% were hypertensive according to AAP 2017, KiGGS, and fourth report, respectively. Differences in prevalence of HTN were strongly age dependent: <10 years, AAP 2017 31.4%, KiGGS 30.7%, fourth report 19.6%; 10 to <15 years, AAP 2017 30.9%, KiGGS 31.2%, fourth report 22.4%; and ≥15 years, AAP 2017 53.2%, KiGGS 28.4%, fourth report 30.0%. Among teenagers ≥15 years, 59.1% of boys but only 46.3% of girls were classified as hypertensive by AAP 2017 but only 21.1%/26% of boys and 36.7%/34.4% of girls by KiGGS/fourth report, respectively.

CONCLUSIONS

Classification of BP as hypertension depends strongly on the normative data used. Use of AAP 2017 results in a significant increase in HTN in teenagers ≥15 years with T1DM, particularly in boys. AAP 2017 enhances the awareness of elevated BP in children, particularly in patients with increased risk for cardiovascular disease.




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Wilson Disease With Novel Compound Heterozygote Mutations in the ATP7B Gene Presenting With Severe Diabetes

OBJECTIVE

To determine the relationship between ATP7B mutations and diabetes in Wilson disease (WD).

RESEARCH DESIGN AND METHODS

A total of 21 exons and exon-intron boundaries of ATP7B were identified by Sanger sequencing.

RESULTS

Two novel compound heterozygous mutations (c.525 dupA/ Val176Serfs*28 and c.2930 C>T/ p.Thr977Met) were detected in ATP7B. After d-penicillamine (D-PCA) therapy, serum aminotransferase and ceruloplasmin levels in this patient were normalized and levels of HbA1c decreased. However, when the patient ceased to use D-PCA due to an itchy skin, serum levels of fasting blood glucose increased. Dimercaptosuccinic acid capsules were prescribed and memory recovered to some extent, which was accompanied by decreased insulin dosage for glucose control by 5 units.

CONCLUSIONS

This is the first report of diabetes caused by WD.




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Erratum. Predicting 10-Year Risk of End-Organ Complications of Type 2 Diabetes With and Without Metabolic Surgery: A Machine Learning Approach. Diabetes Care 2020;43:852-859




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Clinical and Public Health Implications of 2019 Endocrine Society Guidelines for Diagnosis of Diabetes in Older Adults

OBJECTIVE

Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample.

RESEARCH DESIGN AND METHODS

We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7 to ≥9%). OGTT screening costs were estimated using Medicare fee schedules.

RESULTS

Diabetes prevalence was 15.7% (~5.0 million) using the Endocrine Society’s approach and 7.3% (~2.3 million) using the standard approach. Treatment eligibility ranged from 5.4 to 0.06% and 11.8–1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (~18.3 million) with OGTT could cost between $737 million and $1.7 billion.

CONCLUSIONS

Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.




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Decreased Vagal Activity and Deviation in Sympathetic Activity Precedes Development of Diabetes

OBJECTIVE

The objective of this study was to examine whether altered heart rate variability (HRV) could predict the risk of diabetes in Asians.

RESEARCH DESIGN AND METHODS

A cohort study was conducted in 54,075 adults without diabetes who underwent 3-min HRV measurement during health checkups between 2011 and 2014 at Kangbuk Samsung Hospital. We analyzed the time domain (SD of the normal-to-normal interval [SDNN] and root mean square differences of successive normal-to-normal interval [RMSSD]) and the frequency domain (total power, normalized low-frequency power [LF], and normalized high-frequency power [HF] and LF/HF ratio). We compared the risk of diabetes until 2017 according to tertiles of heart rate and HRV variables, with tertile 1 serving as the reference group.

RESULTS

During 243,758.2 person-years, 1,369 subjects were diagnosed with diabetes. Both time and frequency domain variables were lower in the group with diabetes, with the exception of those with normalized LF and LF/HF ratio. In Cox analysis, as SDNN, RMSSD, and normalized HF tertiles increased, the risk of diabetes decreased (hazard ratios [95% CIs] of tertile 3: 0.81 [0.70–0.95], 0.76 [0.65–0.90], and 0.78 [0.67–0.91], respectively), whereas the risk of diabetes increased in the case of heart rate, normalized LF, and LF/HF ratio (hazard ratios [95% CIs] of tertile 3: 1.41 [1.21–1.65], 1.32 [1.13–1.53], and 1.31 [1.13–1.53), respectively) after adjusting for age, sex, BMI, smoking, drinking, systolic blood pressure, lipid level, CRP, and HOMA of insulin resistance.

CONCLUSIONS

Abnormal HRV, especially decreased vagal activity and deviation in sympathovagal imbalance to sympathetic activity, might precede incident diabetes.




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Screening and Treatment Outcomes in Adults and Children With Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study

OBJECTIVE

To describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD.

RESEARCH DESIGN AND METHODS

Asymptomatic patients (8–45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring over 12 months.

RESULTS

Adults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9–8.2%, N = 1,298] vs. 4.7% [95% CI 3.4–5.9%, N = 1,089], P = 0.035) with lower rates of prior CD screening (6.9% vs. 44.2%, P < 0.0001). Fifty-one participants were randomized to a GFD (N = 27) or GCD (N = 24). No HbA1c differences were seen between the groups (+0.14%, 1.5 mmol/mol; 95% CI –0.79 to 1.08; P = 0.76), although greater postprandial glucose increases (4-h +1.5 mmol/L; 95% CI 0.4–2.7; P = 0.014) emerged with a GFD.

CONCLUSIONS

CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD.




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Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus

OBJECTIVE

Preanalytical processing of blood samples can affect plasma glucose measurement because on-going glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined.

RESEARCH DESIGN AND METHODS

All pregnant women in the Australian Capital Territory (ACT) are recommended for GDM testing with a 75-g OGTT using the World Health Organization diagnostic criteria. From January 2015 to May 2017, OGTT samples were collected into sodium fluoride (NaF) tubes and kept at room temperature until completion of the test (delayed centrifugation). From June 2017 to October 2018, OGTT samples in NaF tubes were centrifuged within 10 min (early centrifugation).

RESULTS

A total of 7,509 women were tested with the delayed centrifugation protocol and 4,808 with the early centrifugation protocol. The mean glucose concentrations for the fasting, 1-h and 2-h OGTT samples were, respectively, 0.24 mmol/L (5.4%), 0.34 mmol/L (4.9%), and 0.16 mmol/L (2.3%) higher using the early centrifugation protocol (P < 0.0001 for all), increasing the GDM diagnosis rate from 11.6% (n = 869/7,509) to 20.6% (n = 1,007/4,887).

CONCLUSIONS

The findings of this study highlight the critical importance of the preanalytical processing protocol of OGTT blood samples used for diagnosing GDM. Delay in centrifuging of blood collected into NaF tubes will result in substantially lower rates of diagnosis than if blood is centrifuged early.




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A Randomized Controlled Trial Comparing Glargine U300 and Glargine U100 for the Inpatient Management of Medicine and Surgery Patients With Type 2 Diabetes: Glargine U300 Hospital Trial

OBJECTIVE

The role of U300 glargine insulin for the inpatient management of type 2 diabetes (T2D) has not been determined. We compared the safety and efficacy of glargine U300 versus glargine U100 in noncritically ill patients with T2D.

RESEARCH DESIGN AND METHODS

This prospective, open-label, randomized clinical trial included 176 patients with poorly controlled T2D (admission blood glucose [BG] 228 ± 82 mg/dL and HbA1c 9.5 ± 2.2%), treated with oral agents or insulin before admission. Patients were treated with a basal-bolus regimen with glargine U300 (n = 92) or glargine U100 (n = 84) and glulisine before meals. We adjusted insulin daily to a target BG of 70–180 mg/dL. The primary end point was noninferiority in the mean difference in daily BG between groups. The major safety outcome was the occurrence of hypoglycemia.

RESULTS

There were no differences between glargine U300 and U100 in mean daily BG (186 ± 40 vs. 184 ± 46 mg/dL, P = 0.62), percentage of readings within target BG of 70–180 mg/dL (50 ± 27% vs. 55 ± 29%, P = 0.3), length of stay (median [IQR] 6.0 [4.0, 8.0] vs. 4.0 [3.0, 7.0] days, P = 0.06), hospital complications (6.5% vs. 11%, P = 0.42), or insulin total daily dose (0.43 ± 0.21 vs. 0.42 ± 0.20 units/kg/day, P = 0.74). There were no differences in the proportion of patients with BG <70 mg/dL (8.7% vs. 9.5%, P > 0.99), but glargine U300 resulted in significantly lower rates of clinically significant hypoglycemia (<54 mg/dL) compared with glargine U100 (0% vs. 6.0%, P = 0.023).

CONCLUSIONS

Hospital treatment with glargine U300 resulted in similar glycemic control compared with glargine U100 and may be associated with a lower incidence of clinically significant hypoglycemia.




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&quot;Merit-Based&quot; Immigration: Designing Successful Selection Systems

With the U.S. administration calling for the United States to adopt a more “merit-based” immigrant selection system, this conversation focused on what policymakers should consider in designing—and managing—immigrant selection systems in a time of intense labor-market and demographic change.




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Protecting the DREAM: The Potential Impact of Different Legislative Scenarios for Unauthorized Youth

With the Trump administration having announced the end of the DACA program, Congress is facing growing calls to protect unauthorized immigrants who came to the U.S. as children. This fact sheet examines DREAM Act bills introduced in Congress as of mid-2017, offering estimates of who might earn conditional legal status—and ultimately legal permanent residence—based on educational, professional, and other requirements in the legislation.




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Mexican Migration to Canada: Temporary Worker Programs, Visa Imposition, and NAFTA Shape Flows

Mexicans migrate to Canada in much smaller numbers than to the United States, yet over the last 30 years the country has become an increasingly attractive destination. Canada prioritizes highly skilled, educated Mexicans for permanent residency, but also attracts temporary workers from Mexico. This article examines Mexican migration to Canada and how it has been shaped by visa requirements, trade policy, and more.




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House probe: Trump admin failed to adequately screen travelers from South Korea, Italy for COVID-19

The Trump administration failed to conduct effective screening of passengers from South Korea and Italy for the coronavirus when those countries were experiencing rapid expansion in COVID-19 cases.




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Labor Dept.: U.S. economy lost 20.5M jobs in April, unemployment near 15%

The United States economy shed more than 20 million jobs last month, the greatest month-to-month decline in history, the Labor Department said Friday in its monthly employment analysis.




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Supreme Court puts temporary block on release of evidence in Mueller probe

The Supreme Court on Friday granted a Justice Department request to temporarily block release of secret grand jury material from special counsel Robert Mueller's probe to Congress.




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Migration &amp; Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed the state of play around the globe surrounding COVID-19 and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




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Side-by-Side Comparison of 2013 Senate Immigration Bill with 2006 and 2007 Senate Legislation

This fact sheet compares key components of immigration reform outlined in the 2013 Senate immigration bill against provisions included in bills considered by the Senate in 2006 and 2007: border security, detention, and enforcement; worksite enforcement; visa reforms; earned legalization of unauthorized immigrants; strengthening the U.S. economy and workforce; and integration of new Americans.




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Side-by-Side Comparison of the 2013 Senate Immigration Framework with 2006 and 2007 Senate Legislation

MPI has completed an analysis of the major provisions in the 2013 framework, comparing them to provisions of the legislation the Senate considered in 2006 and 2007. 

This fact sheet is formatted as a chart comparing the framework of comprehensive immigration reform outlined in the 2013 Senate immigration bill against provisions included in bills considered by the Senate in 2006 and 2007.




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Side-by-Side Comparison of 2013 Senate Immigration Bill with Individual 2013 House Bills

This fact sheet offers a detailed review of the comprehensive immigration reform legislation approved by the U.S. Senate in June 2013 and compares its major provisions with those of the five targeted immigration bills approved by the House Judiciary Committee and the House Homeland Security Committee.




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Curbing the Influence of &quot;Bad Actors&quot; in International Migration (Transatlantic Council Statement)

This Transatlantic Council on Migration Statement assesses the continuum of policies needed to disrupt illegal migration-related activities and addresses the conditions that make them possible. It examines the role of migration "bad actors"—human traffickers and unscrupulous employers, among them—who operate and profit in this environment, and considers how governments can deploy resources to discourage their actions.




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Trump’s First Year on Immigration Policy: Rhetoric vs. Reality

Looking back after one year in office, it is striking how just closely the Trump administration’s actions on immigration have hewed to priorities Donald Trump outlined in an uncommonly detailed policy speech in August 2016. This report revisits those pledges to assess where the administration has made the most and least headway, and what its policy agenda ahead might look like.




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Shifting Gears, Trump Administration Launches High-Profile Worksite Enforcement Operations

An unannounced sweep of 98 convenience stores by U.S. immigration authorities—resulting in the arrest of 21 unauthorized workers—may signal a new approach to worksite enforcement under the Trump administration, moving away from a strategy of paper-based audits that resulted in higher employer fines and fewer worker arrests. This article explores worksite enforcement over recent decades.




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Will Immigration Reform Ever Succeed Again? The Legacy of IRCA &amp; Its Enduring Lessons

This provocative discussion showcases Charles Kamasaki's book, Immigration Reform: The Corpse That Will Not Die, and explores the lessons that can be learned from the Immigration Reform and Control Act of 1986, its intended and unintended consequences, and how the law’s legacy has shaped contemporary politics surrounding immigration.




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Ask Ariely: On Team Tragedy, Airport Anxiety, and Grumpy Gift-wrapping

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Hi Dan, I have a hard time watching...




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Ask Ariely: On Irrational Investments and Company Complaints

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, One of my credit cards bears...




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Ask Ariely: On Simple Savings, Better Bonuses, and Revised Resolutions

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, My partner and I are students,...




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Mike Pompeo to travel to Israel, meet with Benjamin Netanyahu, Benny Gantz

Secretary of State Mike Pompeo plans to travel to Israel next week to meet with Prime Minister Benjamin Netanyahu in his first international trip since coronavirus-related restrictions were put in place.




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White House press secretary Kayleigh McEnany: President Donald Trump can revive economy again

Presidential press secretary Kayleigh McEnany said Friday the Trump administration is confident in a major economic recovery after several weeks of closures due to the coronavirus pandemic.




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On This Day, May 9: Freighter collapses Tampa Bay bridge, killing 35

On May 9, 1980, a Liberian freighter rammed a bridge in Florida's Tampa Bay, collapsing part of the span and dropping 35 people to their deaths.




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Entertainer Roy Horn of Siegfried & Roy dies of COVID-19 complications at 75

German-born entertainer Roy Uwe Ludwig Horn, one half of the stage duo Siegfried & Roy, has died of complications from the coronavirus. He was 75.




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&quot;Merit-Based&quot; Immigration: Designing Successful Selection Systems

MPI and OECD experts discuss what policymakers should consider in designing and managing immigrant selection systems in a time of intense labor-market and demographic change.




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“Merit-Based” Immigration: Trump Proposal Would Dramatically Revamp Immigrant Selection Criteria, But with Modest Effects on Numbers

The Trump administration’s plan to create a "merit-based" U.S. immigration system, lessening the longstanding focus on family reunification in favor of more economic migrants, has met with a lackluster response from Democrats and Republicans alike. This Policy Beat article explores how the Trump proposal would reshape immigration to the United States, and how it compares to selection systems in other countries and past debates about changing the U.S. system.





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[ Cell Phones & Plans ] Open Question : What is the closest android equivalent to the 1st generation iPhone SE?

I am torn, I know it is time to upgrade my phone, but I don't know whether to upgrade to just accept the larger phone size and go with the 2nd gen SE or go with an android. I'd be interested to know what the closest equivalent android device there is to the 1st gen SE. I am open to a bigger screen size, but not a bigger phone. So, if there was an andriod that was all screen on the front, but was similar size to the original SE, I would be open to that.




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[ Religion & Spirituality ] Open Question : Christians, why do some people keep lying by saying trans been using other Gender's room for long time but that lie?

i even got this from pro trans page that say they have laws banning men from women's room & trans aka GD was put into mad house, & even then there been alot of time where rapists &perverted freaks been using other Gender's bath room too doesn't make it right, they go to prison if they find out




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[ Singles & Dating ] Open Question : Muslim man looking for relief?

I know it's Ramadan, but I've been feeling urges for a few years now and it's just getting more and more now. I always imagine about sex and loving my to-be wife. Right now, I'm studying medicine, so my parents told me it's too early to get married (24 years old). I just don't know really what to do. I prone masturbate to get some relief. What should I do?




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[ Polls & Surveys ] Open Question : Poll: Is it okay if I make love to my gin and tonic instead ?

It's lockdown after all. 




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[ Investing ] Open Question : What does an investor do when his stock notifies him...the company confirms a record date for a forward two for one stock split?




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[ Earth Sciences & Geology ] Open Question : Are earthquakes necessary to release the earth's energy?




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[ Law & Ethics ] Open Question : Law and Ethics: Do you think gore should be illegal?

I certainly do, it doesn't make sense how someone crazy recording someone getting killed isn't illegal but CP is! That shouldn't be because, they should be either running away or trying to stop that super duper crazy person. Why can't both of them be illegal?




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[ Religion & Spirituality ] Open Question : Does God love it when you call him Big Poppa?




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[ Singles & Dating ] Open Question : I miss my ex girlfriend's daughter what can I do ?

Hello I am a man 36 years old and, My ex girlfriend and I and I were together from January to August 2012, my ex girlfriend's daughter was very affectionate with me, I miss her what I can do I was very fond of her, what can I do ?




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[ Singles & Dating ] Open Question : WHAT TO DO, TO MAKE FRIENDS? I NEED ADVICE?




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[ Politics ] Open Question : Is Camp David going to be the new Trump “White House“ since Melania’s White House is at the top of the avoidance list for germaphobes?




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[ Politics ] Open Question : How is Trump's new White House Press Secretary doing?

Good or bad? Better or worse than Huckabee?




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[ Polls & Surveys ] Open Question : Did you ever take your cat on the tube/subway and listen to music with him?




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[ Politics ] Open Question : Is Trump going to have to invade California?

The state leads the nation in poverty and homelessness while it's socialist elites live in absolute luxury. It's like some third world nation the US is obligated to invade on the basis of humanitarianism.




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[ Law & Ethics ] Open Question : If a relict population of Neandertals were found to be living in a certain cave, on a certain remote island, or in a certain house on?

Pennsylvania Avenue, would placing some of them in zoos be unethical? Would they be considered human enough to receive human rights?




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[ Religion & Spirituality ] Open Question : My mother keeps turning water into wine, walking on water and resurrecting from the dead. Is she a witch?