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Table 1-Systeme International (SI) units for plasma, serum, or blood concentrations


Aug 1, 1995; 18:1223-1224
Syst[egrave]me International (SI) Units




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Redefining Hypoglycemia in Clinical Trials: Validation of Definitions Recently Adopted by the American Diabetes Association/European Association for the Study of Diabetes

OBJECTIVE

To determine if the International Hypoglycaemia Study Group (IHSG) level 2 low glucose definition can identify clinically relevant hypoglycemia in clinical trials and offer value as an end point for future trials.

RESEARCH DESIGN AND METHODS

A post hoc analysis was performed of the SWITCH (SWITCH 1: n = 501, type 1 diabetes; SWITCH 2: n = 721, type 2 diabetes) and DEVOTE (n = 7,637, type 2 diabetes) trials utilizing the IHSG low glucose definitions. Patients in all trials were randomized to either insulin degludec or insulin glargine 100 units/mL. In the main analysis, the following definitions were compared: 1) American Diabetes Association (ADA) 2005 (plasma glucose [PG] confirmed ≤3.9 mmol/L with symptoms); and 2) IHSG level 2 (PG confirmed <3.0 mmol/L, independent of symptoms).

RESULTS

In SWITCH 2, the estimated rate ratios of hypoglycemic events indicated increasing differences between treatments with decreasing PG levels until 3.0 mmol/L, following which no additional treatment differences were observed. Similar results were observed for the SWITCH 1 trial. In SWITCH 2, the IHSG level 2 definition produced a rate ratio that was lower than the ADA 2005 definition.

CONCLUSIONS

The IHSG level 2 definition was validated in a series of clinical trials, demonstrating its ability to discriminate between basal insulins. This definition is therefore recommended to be uniformly adopted by regulatory bodies and used in future clinical trials.




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A Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers: The TWO2 Study

OBJECTIVE

Topical oxygen has been used for the treatment of chronic wounds for more than 50 years. Its effectiveness remains disputed due to the limited number of robust high-quality investigations. The aim of this study was to assess the efficacy of multimodality cyclical pressure Topical Wound Oxygen (TWO2) home care therapy in healing refractory diabetic foot ulcers (DFUs) that had failed to heal with standard of care (SOC) alone.

RESEARCH DESIGN AND METHODS

Patients with diabetes and chronic DFUs were randomized (double-blind) to either active TWO2 therapy or sham control therapy—both in addition to optimal SOC. The primary outcome was the percentage of ulcers in each group achieving 100% healing at 12 weeks. A group sequential design was used for the study with three predetermined analyses and hard stopping rules once 73, 146, and ultimately 220 patients completed the 12-week treatment phase.

RESULTS

At the first analysis point, the active TWO2 arm was found to be superior to the sham arm, with a closure rate of 41.7% compared with 13.5%. This difference in outcome produced an odds ratio (OR) of 4.57 (97.8% CI 1.19, 17.57), P = 0.010. After adjustment for University of Texas Classification (UTC) ulcer grade, the OR increased to 6.00 (97.8% CI 1.44, 24.93), P = 0.004. Cox proportional hazards modeling, also after adjustment for UTC grade, demonstrated >4.5 times the likelihood to heal DFUs over 12 weeks compared with the sham arm with a hazard ratio of 4.66 (97.8% CI 1.36, 15.98), P = 0.004. At 12 months postenrollment, 56% of active arm ulcers were closed compared with 27% of the sham arm ulcers (P = 0.013).

CONCLUSIONS

This sham-controlled, double-blind randomized controlled trial demonstrates that, at both 12 weeks and 12 months, adjunctive cyclical pressurized TWO2 therapy was superior in healing chronic DFUs compared with optimal SOC alone.




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Central American Immigrants in the United States

While much attention has been paid to recent Central American arrivals at the U.S.-Mexico border, nearly half of the approximately 3.5 million Central Americans resident in the United States in 2017 arrived before 2000. About one-third are naturalized U.S. citizens, and they tend to participate in the labor force at a higher rate than foreign- and U.S.-born adults. Discover more about this population in this data-rich article.




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Inmigrantes centroamericanos en los Estados Unidos

Si bien se ha prestado mucha atención a los centroamericanos recién llegados a la frontera entre los Estados Unidos y México, casi la mitad de los aproximadamente 3.5 millones que vivían en los Estados Unidos en 2017 llegaron antes de 2000. Aproximadamente un tercio son ciudadanos estadounidenses y tienden a participar en la fuerza laboral con más frecuencia que otros extranjeros y estadounidenses. Descubra más en este artículo lleno de datos.




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Promising Strategies for Reintegration of Migrants Returning to Mexico and Central America

This MPI webinar focuses on reception and reintegration services for returning migrants, along with the heightened pressure policymakers in Mexico and Central America are facing to design systems and programs that support both returnees and the communities in which they settle. Authors of a year-long study of reception and reintegration services in Mexico and the Northern Triangle discuss the findings of their fieldwork.




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Stony Brook University opens Center for Implant and Digital Technology

Stony Brook School of Dental Medicine opened Dec. 5 its Center for Implant and Digital Technology, which will serve as a state-of-the-art space for digital dentistry-focused education, patient care and research.




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American College of Dentists celebrates centennial anniversary

As the American College of Dentists celebrates its 100th anniversary, its leaders are ready to continue their mission of advancing excellence, ethics, professionalism and leadership in dentistry.




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Dental schools, industry team up to create innovation centers

The Center for Research & Education in Technology is encouraging dental schools to find out how to participate in its program and learn about the benefits to the school and its students.




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DEA Call Center suspends phone operations

Springfield, Virginia — The Drug Enforcement Administration announced that effective March 23, the DEA Call Center has temporarily suspended phone operations due to COVID-19 pandemic.




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HRSA updates FAQs for health centers during COVID-19

The Health Resources and Services Administration says it is working to keep health centers and health center program partners updated on the latest information regarding COVID-19.




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State oil ADNOC sells 35 percent in refining to Eni, OMV

ADNOC sold a 20 percent state in its refinery operations to Italy's Eni and 15 percent to OMV, from Austria in one of the biggest refinery transactions ever.




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Measles vaccinations in U.S. children fall up to 60 percent since pandemic, CDC says

Pediatric vaccination against measles has declined by as much as 60 percent nationally since the start of the COVID-19 outbreak, according to new data released Friday by the Centers for Disease Control and Prevention.




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Sustainable Reintegration: Strategies to Support Migrants Returning to Mexico and Central America

Reception and reintegration programs for deported and other returning migrants represent a long-term investment for migrant-origin and destination countries, holding the potential to reduce re-migration and permit communities of origin to benefit from the skills migrants learn abroad. This report offers recommendations to make reintegration programs more effective in Mexico and Central America.




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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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Metabolic Factors, Lifestyle Habits, and Possible Polyneuropathy in Early Type 2 Diabetes: A Nationwide Study of 5,249 Patients in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) Cohort

OBJECTIVE

To investigate the association of metabolic and lifestyle factors with possible diabetic polyneuropathy (DPN) and neuropathic pain in patients with early type 2 diabetes.

RESEARCH DESIGN AND METHODS

We thoroughly characterized 6,726 patients with recently diagnosed diabetes. After a median of 2.8 years, we sent a detailed questionnaire on neuropathy, including the Michigan Neuropathy Screening Instrument questionnaire (MNSIq), to identify possible DPN (score ≥4) and the Douleur Neuropathique en 4 Questions (DN4) questionnaire for possible associated neuropathic pain (MNSIq ≥4 + pain in both feet + DN4 score ≥3).

RESULTS

Among 5,249 patients with data on both DPN and pain, 17.9% (n = 938) had possible DPN, including 7.4% (n = 386) with possible neuropathic pain. In regression analyses, central obesity (waist circumference, waist-to-hip ratio, and waist-to-height ratio) was markedly associated with DPN. Other important metabolic factors associated with DPN included hypertriglyceridemia ≥1.7 mmol/L, adjusted prevalence ratio (aPR) 1.36 (95% CI 1.17; 1.59); decreased HDL cholesterol <1.0/1.2 mmol/L (male/female), aPR 1.35 (95% CI 1.12; 1.62); hs-CRP ≥3.0 mg/L, aPR 1.66 (95% CI 1.42; 1.94); C-peptide ≥1,550 pmol/L, aPR 1.72 (95% CI 1.43; 2.07); HbA1c ≥78 mmol/mol, aPR 1.42 (95% CI 1.06; 1.88); and antihypertensive drug use, aPR 1.34 (95% CI 1.16; 1.55). Smoking, aPR 1.50 (95% CI 1.24; 1.81), and lack of physical activity (0 vs. ≥3 days/week), aPR 1.61 (95% CI 1.39; 1.85), were also associated with DPN. Smoking, high alcohol intake, and failure to increase activity after diabetes diagnosis associated with neuropathic pain.

CONCLUSIONS

Possible DPN was associated with metabolic syndrome factors, insulin resistance, inflammation, and modifiable lifestyle habits in early type 2 diabetes.




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Adolescent Obesity and Early-Onset Type 2 Diabetes

OBJECTIVE

Type 2 diabetes (T2D) is increasingly diagnosed at younger ages. We investigated the association of adolescent obesity with incident T2D at early adulthood.

RESEARCH DESIGN AND METHODS

A nationwide, population-based study evaluated 1,462,362 adolescents (59% men, mean age 17.4 years) during 1996–2016. Data were linked to the Israeli National Diabetes Registry. Weight and height were measured at study entry. Cox proportional models were applied.

RESULTS

During 15,810,751 person-years, 2,177 people (69% men) developed T2D (mean age at diagnosis 27 years). There was an interaction among BMI, sex, and incident T2D (Pinteraction = 0.023). In a model adjusted for sociodemographic variables, the hazard ratios for diabetes diagnosis were 1.7 (95% CI 1.4–2.0), 2.8 (2.3–3.5), 5.8 (4.9–6.9), 13.4 (11.5–15.7), and 25.8 (21.0–31.6) among men in the 50th–74th percentile, 75th–84th percentile, overweight, mild obesity, and severe obesity groups, respectively, and 2.2 (1.6–2.9), 3.4 (2.5–4.6), 10.6 (8.3–13.6), 21.1 (16.0–27.8), and 44.7 (32.4–61.5), respectively, in women. An inverse graded relationship was observed between baseline BMI and mean age of T2D diagnosis: 27.8 and 25.9 years among men and women with severe obesity, respectively, and 29.5 and 28.5 years among low-normal BMI (5th–49th percentile; reference), respectively. The projected fractions of adult-onset T2D that were attributed to high BMI (≥85th percentile) at adolescence were 56.9% (53.8–59.9%) and 61.1% (56.8–65.2%) in men and women, respectively.

CONCLUSIONS

Severe obesity significantly increases the risk for incidence of T2D in early adulthood in both sexes. The rise in adolescent severe obesity is likely to increase diabetes incidence in young adults in coming decades.




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Famous birthdays for May 9: Ghostface Killah, Noah Centineo

Rapper Ghostface Killah turns 50 and actor Noah Centineo 24, among the famous birthdays for May 9.




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[ Politics ] Open Question : Libtards, don't get your panties in a bunch when those two Georgia 2nd amendment warriors are found innocent of killing that black guy?

He shouldn't have fought back when the guy pointed the shot gun at him




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Chronicling Migration in the 21st Century Through One Family&#039;s Journey

This event marked the launch of New York Times reporter Jason DeParle's book tracing the arc of migration as a phenomenon, witnessed through three decades observing a particular Filipino family moving from Manila to Texas. The conversation explored both the human and policy aspects of migration and development.




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Five Types of Research, Underexplored until Recently, Could Produce Alzheimer's Treatments

Research into the brain’s protein-disposal systems, electrical activity and three other areas looks promising

-- Read more on ScientificAmerican.com




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New Brain Gain: Rising Human Capital among Recent Immigrants to the United States

Nearly half of immigrant adults arriving in the U.S. since 2011 have a college degree—a far higher share than a quarter-century ago, when just 27 percent did. This striking but little noted shift in the composition of recent immigrant flows, driven in part by rising migration from Asia, comes as some policymakers press for a "merit-based" immigration system. This fact sheet examines rising human capital at U.S. and state levels.




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Recent Asylum Seeker and Refugee Arrivals to Germany Are Getting into Labor Force More Quickly, Survey Finds

WASHINGTON — Asylum seekers and refugees who arrived in Germany in the leadup to and during the 2015-16 European migration crisis have integrated into the labor market at a slightly faster rate than previous refugee cohorts, a Migration Policy Institute (MPI) report finds.




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Vanilla-scented Baked Rice Pudding

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by the Dinner Ladies (Katherine Westwood & Sophie Gilliatt)




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Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes: Results From the Multicenter International REFINE SPECT Registry

OBJECTIVE

Prevalence and prognostic impact of cardiovascular disease differ between patients with or without diabetes. We aimed to explore differences in the prevalence and prognosis of myocardial ischemia by automated quantification of total perfusion deficit (TPD) among patients with and without diabetes.

RESEARCH DESIGN AND METHODS

Of 20,418 individuals who underwent single-photon emission computed tomography myocardial perfusion imaging, 2,951 patients with diabetes were matched to 2,951 patients without diabetes based on risk factors using propensity score. TPD was categorized as TPD = 0%, 0% < TPD < 1%, 1% ≤ TPD < 5%, 5% ≤ TPD ≤ 10%, and TPD >10%. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause mortality, myocardial infarction, unstable angina, or late revascularization.

RESULTS

MACE risk was increased in patients with diabetes compared with patients without diabetes at each level of TPD above 0 (P < 0.001 for interaction). In patients with TPD >10%, patients with diabetes had greater than twice the MACE risk compared with patients without diabetes (annualized MACE rate 9.4 [95% CI 6.7–11.6] and 3.9 [95% CI 2.8–5.6], respectively, P < 0.001). Patients with diabetes with even very minimal TPD (0% < TPD < 1%) experienced a higher risk for MACE than those with 0% TPD (hazard ratio 2.05 [95% CI 1.21–3.47], P = 0.007). Patients with diabetes with a TPD of 0.5% had a similar MACE risk as patients without diabetes with a TPD of 8%.

CONCLUSIONS

For every level of TPD >0%, even a very minimal deficit of 0% < TPD < 1%, the MACE risk was higher in the patients with diabetes compared with patients without diabetes. Patients with diabetes with minimal ischemia had comparable MACE risk as patients without diabetes with significant ischemia.




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Chronicling Migration in the 21st Century Through One Family’s Journey

Marking the launch of New York Times reporter Jason DeParle's book tracing the arc of migration and its impacts through the life of an extended family of Filipino migrants over a three-decade period, from Manila and through Dubai to the Houston area, this conversation with MPI's Andrew Selee and the World Bank's Dilip Ratha explores migration at both a global and very personal level.




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Health Care Transition in Adolescents and Young Adults With Diabetes

Michael E. Bowen
Jun 1, 2010; 28:99-106
Feature Articles




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Diabetes Self-Management in a Community Health Center: Improving Health Behaviors and Clinical Outcomes for Underserved Patients

Daren Anderson
Jan 1, 2008; 26:22-27
Bridges to Excellence




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Review Article – Within a single lifetime: Recent writings on autism

AHP readers will be interested in a review article now available online from History of the Human Sciences “Within a single lifetime: Recent writings on autism.” Written by Gregory Hollin the piece reviews five recent books on autism.




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Riots, escapes and pepper spray: Virus hits juvenile centers




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Riots, escapes and pepper spray: Virus hits juvenile centers




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“There but for the grace of God” : review of recent lawyer misconduct cases / presented by: Anna Jackson, Magistrates Court of South Australia, Alex Ward, Edmund Barton Chambers.




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Confiscation of assets : forfeiture, foreclosure and forlorn : a review of recent decisions under the Criminal Assets Confiscation Act 2005 (SA) / presented by His Honour Judge Tilmouth, District Court of South Australia.




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Restorative justice : an adjunct to the current punitive justice system / presented by Leigh Garrett, CEO OARS Community Transitions, including the Centre for Restorative Justice.




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What SACAT does and recent developments / presented by Barbara Johns, Executive Senior Member, Housing and Civil Stream SACAT.




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Disputing Testamentary Capacity in the 21st Century.




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Recent Disciplinary Decisions and Trends.




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Recent Disciplinary Decisions and Trends.




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Forum 2019 : 4B Privacy law panel : recent developments and isues : slides / presented by Kelly Scott, Crown Solicitors Office.




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Forum 2019 : 4B Privacy law panel : recent developments and isues : slides / presented by Laura Butler, Australian Government Soliciter.




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Forum 2019 : 7B Privilege : recent developments as to privilege self: incrimination and stay of civil proceedings, privilege over investigative reports and privilege over instructions to experts / paper presented by Alex Lazarevich, Anthony Mason Chambers




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Aligning to aliveness : a simple guide to heart-centred living / Robert Beno.




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Waves of unreason : Australian prime ministers in the 21st century / John Biggs.




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Newstart allowance : is it time to raise it? / research undertaken by The South Australian Centre for Economic Studies, University of Adelaide ; funded by the Independent Research Fund.

This paper assesses whether the Newstart Allowance for unemployed people should be increased. It investigates the relationship of the Newstart Allowance to Average Weekly Earnings, the Federal Minimum Wage, and Australian poverty lines, and considers the typical the duration of unemployment and long term unemployment, duration of time on income support, overseas allowances, cost of living, and a comparison with policy makers' remuneration. It finds that the value of the allowance has eroded since it was first set and that unemployment for many is not a transitional situation, and concludes that an increase is warranted to bridge the gap to the poverty line.




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The Australian musical : from the beginning / Peter Pinne and Peter Wyllie Johnston ; foreword by John Kotzas, CEO Queensland Performing Arts Centre ; introduction by Mark Madama, Associate Professor of Musical Theatre, University of Michigan.

Lyricists -- Australia -- Biography.




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On the end of privacy : dissolving boundaries in a screen-centric world / Richard E. Miller.

Clementi, Tyler.




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Designing the John B Fairfax Learning Centre

The John B Fairfax Learning Centre is officially launched and we look forward to welcoming visitors to this fabulous new




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19th Century UK Periodicals Series 2: Empire

An online collection of British magazines, journals and specialty newspapers, 19th Century UK Periodicals provides an in-depth view of British life in the Victorian age. Series 2: Empire addresses the economic as well as the non-mercantile aspects of British expansionism. Wellcome Library also subscribes to Series 1: new readerships.




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19th century British Library newspapers (1800-1900) Part 2

British newspapers from the 19th century selected by the British Library's editorial board. Includes both national and regional newspapers. All newspapers are full text and fully searchable. Full runs are available where possible.




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How Lemonade Stands Are Teaching Kids 21st-Century Business Skills (Video)

Concerned that schools don't notice or nurture business skills, nonprofits are using the humble lemonade stand to foster entrepreneurship.