pheochromocytomas are rare catecholamine producing tumors arising from chromaffine cells in the sympatho adrenal system .
its prevalence is estimated at 0.1% to 0.6% . they secrete various catecholamines , predominantly norepinephrine , and epinephrine to small extent .
these catecholamines are responsible for the manifestations with sustained or paroxysmal symptoms . diagnosis is established by measuring metanephrines in the urine or blood .
localization of the tumor is done using computed tomography ( ct ) or magnetic resonance imaging ( mri ) scans .
thrombosis of the inferior vena cava ( ivc ) has comparable etiological factors to lower limb deep venous thrombosis .
hypercoagulability related to hematological or neoplastic abnormalities , venous stasis secondary to extraluminal pressure from tumors or inflammatory processes , and vessel injury due to trauma have all been implicated as primary mechanism in the pathophysiology of ivc thrombosis .
however , its association with pheochromocytoma in indian subjects has not been reported till date .
a 48-year - old man was admitted to our hospital with complaints of headache , sweating , anxiety , dizziness , nausea and vomiting .
the patient was 164 cm tall and weighed 57 kg . on physical examination , there were no caf au lait spots or neurofibromas .
hematological analysis confirmed normocytic anemia with hemoglobin 11.3 gm / dl , a raised erythrocyte sedimentation rate ( esr ) ( 130 mm fall in the first hour ) , while the total and differential leukocyte counts were normal .
biochemical parameters such as liver and kidney functions , and serum electrolytes , calcium , phosphorous , alkaline phosphatase and d - dimer were within normal limits .
the endocrinological evaluation revealed increased urine catecholamines and urinary vanillyl mandelic acid ( vma ) [ table 1 ] .
baseline biochemical parameters of the patient abdominal ct revealed a well defined , heterogenous mass lesion of size 7.6  5.3  4.8 cms with attenuation score of 35 hu at the upper pole of right kidney without any calcifications [ figure 1 ] .
there was no involvement of renal vein , hepatic veins and veins of lower limbs demonstrated by doppler ultrasound .
magnetic resonance imaging ( mri ) revealed intraluminal thrombus extending proximally up to the confluence of hepatic veins immediately inferior to the right atrium without distal extension to femoral veins bilaterally [ figure 2 ] .
an ivc venogram via the right jugular vein demonstrated multiple filling defects indicating occlusion of the ivc inferior to the right atrium [ figure 3 ] .
there was simultaneous enlargement of distal part of ivc . computed tomography of the abdomen- showing a well defined , heterogeneously enhancing mass lesion of size 7.6  5.3  4.8 cm at the upper pole of right kidney without any calcifications .
the left adrenal gland appeared to be normal t2-weighted axial magnetic resonance imaging demonstrating the mass ( predominantly high signal ) between the inferior vena cava and right kidney ( black arrow ) compressing the overlying inferior vena cava ( white arrow ) ivc venogram showing multiple filling defects indicating occlusion of the inferior vena cava inferior to the right atrium .
there is distal enlargement of inferior vena cava a diagnosis of ivc thrombosis with pheochromocytoma was established , and surgical treatment was planned .
alpha receptor blocking therapy with prazosin was instituted , followed by  blocker , after testing for adequacy of  blockade .
the patient was treated conservatively with subcutaneous low molecular weight heparin followed by oral warfarin .
after 2 weeks , hypertension was well controlled and the remaining symptoms disappeared . with adequate blood pressure control ,
biopsy of the specimen revealed a typical organoid or zellballen pattern with no cytoplasmatic inclusion , pleomorphism , cytological alterations or necrosis ; and , the mitotic index was low [ figure 4 ] . during the postoperative period ,
the patient 's blood pressure remained normal . a 24-hour urine specimen collected for metanephrine and vma , revealed levels within normal limits . at present , the patient is asymptomatic , requires no medications , and is employed as an engineer .
mri imaging demonstrated resolution of the thrombosis and return of patency of the ivc at 4 months [ figure 5 ] . the typical growth pattern of nests of tumor cells ( zellballen ) surrounded by a discontinuous layer of sustentacular cells and fibrovascular stroma in the biopsy specimen of the patient in the study .
blood vessels surrounding tumor nests are composed of round to oval cells t2-weighted axial magnetic resonance imaging comparable in position and image acquisition to figure 2 demonstrating complete resolution of inferior vena cava thrombosis ( white arrow ) after 4-months of oral anticoagulation therapy
two aspects render our case unusual : 1 ) the coexistence of pheochromocytoma with ivc thrombosis 2 ) though there are case reports citing the association between malignant pheochromocytoma and ivc thrombus , to our sincere belief ; this is the first such report citing this uncommon association from india .
although the lifetime incidence of venous thrombosis is 0.1% , it still remains a rare condition especially in patients below 30 years of age .
predisposing factors include alterations in blood flow [ stasis ] , injury to the vascular endothelium and abnormalities in the constitution of blood hypercoagulability ( virchow 's triad ) .
endothelial damage is invariably an acquired phenomenon , whereas hypercoagulability may result from both congenital and acquired risk factors ( especially in the peri - operative period ) .
the classical presentation of ivc thrombus varies according to the level of the thrombosis with up to 50% of patients presenting with bilateral lower extremity swelling and dilatation of superficial abdominal vessels . whilst some patients remain asymptomatic ,
lower back pain , nephrotic syndrome , hepatic engorgement , cardiac failure and pulmonary embolus have also been described .
tsuji et al . reported a series of 10 patients where 40% were pyrexic at presentation , with an associated elevation in d - dimer levels and inflammatory markers ( white cell count , c - reactive protein ) .
our patient had no lower limb , liver or kidney involvement , and this might be ascribed to the partial occlusion of ivc .
we could not explain normal d - dimer levels in the backdrop of such a large thrombus in our patient .
ct scan with contrast enhanced images and mri scan are used to localize adrenal pheochromocytoma .
meta - iodobenzylguanidine ( mibg ) and positron emission tomography ( pet ) scanning ( gallium- dota - toc / noc and dopa - pet perform better than fdg- pet ) are largely reserved for extraadrenal paraganglioma , or very large tumors to rule out metastasis .
heterogeneity , high hounsfield density on ct ( > hu ) , marked enhancement with intravenous contrast and delayed contrast washout ( < 60 % at 10 minutes ) , high signal intensity on t2 weighted mri , cystic and hemorrhagic changes point to pheochromocytoma , adrenocortical carcinoma or metastasis .
however , pheochromocytoma with lipid degeneration can result in low attenuation scores ( < 10 hu ) and > 60% washout at delayed ct scanning .
benign adrenal incidentalomas are characterized by size < 5 cm , sharp margins , smooth contours , lack of demonstrable growth on serial examinations , attenuation scores < 10 hu , and > 60% washout at delayed ct scanning . in our patient , ct scan revealed nonhomogenous mass of hu 35 without any calcification .
histologically , pheochromocytomas are capsulated and are composed of round or polygonal epithelioid / chief cells arranged in characteristic compact cell nests ( zellballen ) or trabecular patterns .
the chief cells have centrally located nuclei with finely clumped chromatin , and a moderate amount of eosinophilic , granular cytoplasm .
tumors of higher grade are characterized by a progressive loss in the relationship between chief cells and sustentacular cells , and a decrease in the number of sustentacular cells . in our patient , typical zellballen pattern was found .
presence of markers like chromogranin a ( cga ) , neuron specific enloase , synaptophsyin serve as additional tools to confirm the neuroendocrine nature of the chief cells .
the only reliable clue to the presence of a malignant pheochromocytoma is local invasion or distant metastases , which may occur as long as 20 years after resection .
benign  on pathologic examination , long term follow - up is indicated in all patients to confirm that impression .
other markers for malignancy are absent or weak expression of inhibin / activin- beta b subunit , and presence of succinate dehydrogenase b ( sdh b ) subunit is seen . in absence of any invasion , we considered the mass in our patient to be benign . the simultaneous occurrence of pheochromocytoma and ivc thrombosis is reported sporadically .
ivc thrombosis in this case could be because of : 1 ) local compression leading to alteration in blood flow and stasis 2 ) sustained hypertension leading to vascular endothelial injury and hypercoagulability , 3 ) association of pheochromocytoma with systemic lupus erythematous and behcet 's disease might explain the triggering of an autoimmune phenomenon leading to a hypercoagulable state , and 4 ) an underlying anatomic abnormality or coagulation disorder .
it also could be a chance association between these 2 conditions . in our case ,
recent advances in the utilization of ultrasound , ct and mri imaging as well as endovascular procedures have resulted in an increase in detection rates of ivc anomalies , as well as an increase in the incidental discovery of such abnormalities during unrelated investigations , therapeutic endovascular or surgical procedures .
contrast venography remains the standard for diagnosis of ivc thrombosis with a low false - positive rate , and the advantage of access for immediate treatment if required .
however , it is an invasive procedure associated with a 2%-10% incidence of post - procedural deep venous thrombosis ( dvt ) .
duplex ultrasound scanning has become an accurate non - invasive method of diagnosing ivc thrombosis and is often the first - line investigative modality .
however , duplex usg is operator dependant and can be limited by body habitus or the presence of bowel gas and may occasionally fail to identify any ivc anomaly .
ct imaging is a rapid non - invasive method which can accurately diagnose and assess the extent of thrombus as well as delineate any associated abdominal or pelvic abnormality .
mri imaging is now replacing ct as the optimal investigative tool avoiding radiation and giving more accurate delineation of thrombus as well as any ivc anomaly .
mri is also used to follow - up patients to determine morphological changes in the thrombus following therapy .
management of patients with coexisting pheochromocytoma and ivc thrombosis needs operative resection of the adrenal mass and medical / interventional management of ivc thrombosis .
the goals of operation include 1 ) removal of the tumor with postoperative normotension , and 2 ) ivc luminal restoration and anticoagulation .
minimally invasive techniques are being increasingly used for resection of adrenal tumors and to treat renal artery lesions .
our patient was subjected to laparoscopic adrenalectomy after adequate preoperative blood pressure control by  blockers , followed by  blockers .
treatment options in the case of ivc thrombus without anatomical variance include anticoagulation , mechanical thrombectomy , systemic thrombolytic therapy , transcatheter regional thrombolysis , pulse - spray pharmacomechanical thrombolysis and angioplasty .
there is no specific literature describing the ideal duration of anticoagulation in these instances ; however , case evidence identifies a trend toward treatment for a minimum of one year with the interplay of hypercoagulability disorders needing to be factored into any decision .
surgical reconstruction of the ivc and bypass of an aberrant section are both recognized modalities reserved for the most severe cases and are associated with morbidity and mortality risk .
endovascular stent placement in combination with angioplasty is recommended in the cases of residual stenosis and chronic ivc occlusion . in the case of ivc thrombus
associated with an aberrant ivc , with no other predisposing factors , treatment involves anti - coagulation .
the duration of this treatment is widely debated with no extensive literature to provide an evidence based approach .
dean et al . took a view , which is quite similar to that of ours , that a caval anomaly is a permanent risk factor for venous stasis and thrombosis and that anticoagulant treatment should be lifelong . since our patient had no anatomic abnormality or any other predisposing factors , we decided to give the treatment for 4 months only and stopped it then after documenting radiologic luminal restoration .
though cases of renal artery stenosis , renal artery aneurysm and inferior vena cava thrombosis have been described , we found the uncommon association with ivc thrombosis in an indian patient .
ct or preferably mri imaging are required to delineate ivc anatomy and ascertain proximal extent of the thrombus .
although invasive therapeutic modalities exist , long - term and commonly life - long anticoagulation is often required .
pheochromocytoma does not seem to have any effect on the outcome of the coexisting ivc thrombosis .

 pheochromocytomas have been described in association with vascular abnormalities like renal artery stenosis .
 a 48-year - old man was admitted to our hospital with the complaints of headache , sweating , anxiety , dizziness , nausea , vomiting and hypertension . for last several days , he was having a dull aching abdominal pain .
 abdominal computed tomography ( ct ) revealed the presence of a left adrenal pheochromocytoma .
 an inferior vena cava ( ivc ) venogram via the right jugular vein demonstrated occlusion of the ivc inferior to the right atrium .
 surgical removal of pheochromocytoma was done , followed by anticoagulant treatment for ivc thrombosis , initially with subcutaneous low molecular weight heparin , and then with oral warfarin , resulting in restoration of patency . to the best of our knowledge ,
 the occurrence of pheochromocytoma in ivc thrombosis has not been reported so far from india .
 possible mechanisms of such an involvement are discussed .


 acute mountain sickness ( ams ) occurs during exposure to high altitude ( ha ) and is a clinical syndrome characterised by headache , insomnia , malaise , and gastrointestinal symptoms .
it is common , developing in 1030% at 25003000 meters   and in up to 60% of those ascending to around 4500 meters .
it causes significant morbidity and is a challenging clinical condition in remote environments . a biochemical marker of ams , particularly one available as a point - of - care test ( poc ) , could have widespread clinical utility .
the pathophysiology of ams is not clearly understood but involves alterations in fluid balance , endothelial function , vascular permeability , inflammation , and oxidative stress .
the renal response to ha is an important factor in acclimatization , and ha exposure leads to renal arteriole constriction and relative hypoxia [ 3 , 4 ] . despite the relative renal hypoxia ,
ngal ( neutrophil gelatinase - associated lipocalin ) is a 25  kda peptide , part of the lipocalin family of small soluble proteins .
it is produced in a number of human tissues , notably the distal nephron but also in the lung   ngal rises rapidly in the nephron in response to a renal insult and an ngal 150  ng / ml following acute kidney injury ( aki ) is predictive of acute renal failure ( arf ) well before creatinine has risen .
ngal is also an acute - phase protein , has a role in inflammation [ 8 , 9 ] , and is upregulated in the lung during inflammation [ 5 , 10 , 11 ] .
ngal is also known to rise in conditions associated with oxidative stress [ 12 , 13 ] , and oxidative stress has been implicated in ams [ 14 , 15 ] .
we therefore hypothesised that ngal would increase at ha secondary to these various stimuli and that the magnitude of any increase might relate to the presence of ams .
we therefore studied a combined cohort of trekkers from 2 expeditions to ha . in order to clarify the relative contribution of ams , hypoxia or exercise to ngal levels
, we also studied a cohort pre- and postexercise at near sea level , and a further cohort exposed to acute normobaric hypoxia .
the potential role of inflammation in stimulating ngal was assessed by the measurement of highly sensitive c - reactive protein ( hscrp ) in a subset of participants .
all study protocols were approved by the ministry of defence research ethics committee , whitehall , uk , and satisfied the requirements of the declaration of helsinki . in all studies informed ,
thirty - two subjects participating in a defence medical services ( dms ) trekking expedition ( trek 1 ) in the khumbu region of nepal were studied .
blood samples were taken from the antecubital fossa at 3 study altitudes : on day 2 at 3400  m , day 6 at 4270  m , and day 10 at 5150  m ( following ascent to everest base camp at 5364  m ) . all samples in this study
were collected immediately following a day trekking (  posttrek  ) to the study altitude .
twenty subjects from a further dms expedition ( trek 2 ) to nepal were also studied .
blood samples were again taken at 3 study altitudes : on day 2 ( 3400  m ) , day 6 ( 4270  m ) , and day 10 ( 5150  m ) ( following ascent to kala patthar ( kp ) , 5643  m ) .
samples in this study were again collected immediately following a day trekking (  posttrek  ) .
additional samples were taken at rest in kathmandu ( kat ) at 1300  m and at rest the next morning at the 3 study altitudes .
as serving members of the military , all subjects were able to fulfil the fitness criteria of their relevant service .
this broadly includes an age - adjusted ability to run 1.5 miles in under approximately 11 minutes and to perform an age - adjusted number of sits - ups and push - ups within two blocks of 2 minutes .
fourteen subjects underwent a 3-hour exposure to normobaric hypoxia ( fio2 11.6% , equivalent to 4800  m altitude ) in a hypoxic chamber .
this exposure included a 5-minute step test ( step height of 25  cm , 1 complete step every 2 seconds ) at 95 minutes .
a group of 22 subjects had ngal assayed at rest and after exercise at sl in the uk following ascent from sea level to 1085  m over 6 hours ( an equivalent gain in altitude and duration of exercise similar to that experienced on a trekking day in nepal ) .
two subjects from trek 2 were part of the sl exercise group , but data collection occurred several months apart .
ngal was analysed in the field on a biosite triage point of care monitor ( alere ltd , stockport , uk ) using a triage ngal test kit .
the triage ngal test is a point - of - care , fluorescence - based immunoassay used which gives a rapid ( 15 minutes ) quantitative measurement of ngal in a range from 60 to 1,300  ng / ml .
oxygen saturation ( digitally on warm hands at rest ) was measured using a nellcor np-20 pulse oximeter ( covidian , ma , usa ) during trek 1 + 2 and in the hypoxic chamber study at the same time as blood samples were taken . during trek 1 + 2 ,
twice - daily ams scores were assessed using the lake louise score ( lls ) questionnaire .
the lls allocates a score of 0 to 3 ( symptom not present to severe ) for symptoms of ams ( headache , gastrointestinal symptoms , fatigue / weakness , dizzy / light - headedness , and difficulty sleeping ) .
a score of 3 or more in the presence of headache is consistent with ams , a score of 6 or more with severe ams .
the commercially available , highly sensitive , immunoturbidimetric assay ( roche diagnostics ) was used to measure crp in trek 2 at the same time points as ngal .
mg / l and a between - run coefficient of variation between 2.5 and 5.7% . for statistical calculations ,
the software package spss 14.0 was used . for subjects with a ngal below the limit of detection of the assay ( 60  ng / ml ) ,
a value of 60  ng / ml was assigned for the purposes of statistical analysis .
all data were tested for gaussian distribution using the kolmogorov - smirnov test and shapiro wilks statistic .   for the analysis of dependent variables that were normally distributed , changes were tested by student 's paired t - test . for independent variables that were normally distributed ,
a within - subjects anova was performed to investigate any serial changes in ngal with ascent at rest and post - trek . a two - way mixed anova with either resting or after trek ngal at each study altitude as the within - subjects factor and the presence of ams ( according to the ll score at multiple altitudes ) as the between - subjects factor
if the mauchly sphericity test was significant , then p values were expressed after multiplication by the greenhouse - geisser epsilon .
correlation analyses for normally distributed data were performed by calculating the pearson coefficient of correlation .
a p value < 0.05 ( two - sided ) was considered significant . as the ascent profile and route were closely matched in trek 1 and trek 2 , data were combined and analysed as a whole . taking medication ( acetazolamide , dexamethasone )
had no apparent effect on ngal values , and therefore these subjects ( n = 11 ) were not excluded from the analysis .
demographic data for the field study ( trek 1 + 2 ) , the controls , and the hypoxic chamber study are shown in table 1 . in the 22 subjects ascending to 1085  m in the uk
, there was no significant ( p = 0.084 ) rise in ngal following exercise : resting sl ngal was 64  11 ( ng / ml , mean  sd , range 60104 ) and postexercise ngal was 71  14 ( ng / ml , mean  sd , range 60100 ) . of the 52 subjects ,
spo2 ( % , mean  sem ) dropped from 97  2 at kat ( 1300  m ) to 84  5 and 79  7 at 4270 and 5150  m , respectively ( p < 0.001 ) .
there was a moderate inverse correlation between ngal and spo2 at 5150  m ( r = 0.477 , p = 0.001 ) ( figure 1 ) with a weaker inverse correlation between ngal and spo2 at 4270  m ( r = 0.340 , p = 0.019 ) .
within the subjects , anova demonstrated a significant change in ngal with ascent both at rest ( p = 0.007 ) and after trek ( p = 0.001 ) ( figure 2 ) .
spo2 ( % , mean  sem ) dropped from 99  0.4 at baseline to a nadir of 79  5 ( p < 0.001 ) . despite an equivalent drop in spo2 to
that seen in trek 1 + 2 , ngal ( ng / ml , mean  sd , range ) showed no change between baseline and 180 minutes : 63  26 ( 2980 ) versus 67  25 ( 2784 ) , p = 0.538 . in trek 2 , serum creatinine { mol / l , mean  sem , ( range ) , ( p value versus baseline at kat ) } was 78  2 ( 6395 ) at baseline ; at 3400 , 4270 and 5150  m it was 87  3 ( 72120 ) ( p = 0.001 ) ; 84  2 ( 72104 ) ( p < 0.001 ) ; and 94  5 ( 76142 ) ( p < 0.001 ) .
according to their ll scores at the highest study altitude ( 5150  m ) , there were 23 subjects with no ams , 16 subjects with mild ams , and 7 subjects with severe ams .
there was a significant difference between ngal depending on the presence or absence of ams at 5150  m ( figure 3 ) with higher values in those with ams and severe ams . a two - way mixed anova revealed a significant change ( p = 0.003 ) in resting ngal with ascent and an interaction with ams at 4270  m ( p = 0.017 ) and 4910  m ( p = 0.002 for change in ngal , p = 0.027 for interaction with ams ) .
hscrp was ( mean  sem , range ) : 1.6  0.4 ( 0.337.53 ) at baseline ; at 3400  m , 4270  m , and 5150  m post - trek : 7  2.9 ( 0.7847.93 ) ( p = 0.002 versus baseline ) ; 25.7  8.1 ( 0.58104 ) ( p < 0.001 versus baseline ) ; 9  3.2 ( 0.5644.62 ) ( p = 0.003 versus baseline ) . at 3400  m , 4270  m , and 5150  m at rest : 6.2  2.9 ( 1.8725.1 ) ( p = 0.001 versus baseline ) ; 21.6  5.7 ( 0.4983.9 ) ( p < 0.001 versus baseline ) ; and 5.8  2.1 ( 0.5426.59 ) ( p = 0.012 versus baseline ) .
ngal at 5150  m , after trek was moderately correlated with hscrp at 5100  m after exercise ( rho 0.526 , p = 0.036 ) .
this is the first report to describe an association between ngal and both the presence and severity of ams at ha .
the significant novel findings are that ngal rises in response to sustained hypobaric hypoxia but not acute normobaric hypoxia or near sl exercise and that this rise is related to ams at 5150  m.   the rise in ngal following trekking ( by day 2 at 3400  m ) was to the levels normally associated with the subsequent development of arf ( > 150  ng / ml ) , but this did not occur .
although creatinine rose significantly with altitude , the rise was very modest , and we suspect that a combination of factors other than a simple renal insult is responsible for the increase in ngal at ha .
our data suggest an inverse correlation between spo2 and ngal at 5150  m ( and to a lesser extent at 4270  m ) . although no such correlation was found at 3400  m , this may still suggest that prolonged renal hypoxia could be a significant drive to ngal release .
in addition to renal hypoxia , we suspect that other factors may also contribute to the rise in ngal at ha .   the significantly greater ngal in those with severe or mild ams versus those without at 5150
indeed , ngal is an acute - phase protein   with a role in inflammation [ 8 , 10 , 11 ] .
exercise stimulates an immune response , and hypoxia is also known to cause a response in immune and endothelial cells with inflammatory markers such as hscrp increasing with ha [ 1922 ] .
consistent with this , we saw a significantly higher hscrp at all altitudes compared to baseline .
limited data have suggested hscrp may be associated with ams   but we did not demonstrate any evidence to support this .
there was a weak correlation between hscrp and ngal at 5150  m but this can not explain the rise in ngal as a whole .
ngal also rises with oxidative stress [ 9 , 12 ] which is increased by exercise , and ha - induced oxidative stress   has been implicated in ams . as such , it is interesting to note that we found a higher ngal following trekking and in those with ams at the highest altitude .   in an attempt to clarify the relative influence of exercise and hypoxia on ngal , we measured ngal before and after exercise of a similar duration ( 6  hrs ) and similar incremental altitude ( 1085  m ) as that experienced daily in nepal and also in a hypoxic chamber . in neither scenario did ngal rise .
this may reflect inadequate duration or severity of stimulus but may also reflect that the ngal response is not due to exercise or hypoxia alone but is multifactorial involving hypoxia , oxidative stress , an inflammatory response , and other , as yet unidentified , stimuli .
we also acknowledge limitations such as a lack of serum markers of oxidative stress and a lack of resting ngal data in trek 1 .
in addition , we did not measure ngal at sl before departure to nepal , although the ngal recorded as a baseline at kat ( 1300  m ) ( 68  ng / ml ) was no different to those recorded at sl in the uk ( 63 and 64  ng / ml ) .
we also acknowledge the fact that although we measured creatinine in trek 2 , we did not continue to monitor it after the cessation of trekking . as a consequence of creatinine rising more slowly in response to a renal insult than ngal ,
in conclusion , there are several interesting and novel findings that are worthy of further exploration .
ngal rises in response to prolonged hypobaric hypoxia ; marked increases in ngal may occur without concomitant arf and the degree of ngal rise at ha is associated with the presence or absence of ams .
the fact that ngal does not appear to rise secondary to acute normobaric hypoxia or exercise in isolation suggests that the rise at ha and relation with ams may have common pathways , perhaps related to prolonged hypoxia and an inflammatory response . with the huge and increasing popularity of recreational sports undertaken at both moderate and high altitude
assessment of ngal takes a matter of minutes using poc testing , and its use in identifying ams requires further evaluation .

 acute mountain sickness ( ams ) is a common clinical challenge at high altitude ( ha ) . a point - of - care biochemical marker for ams could have widespread utility .
 neutrophil gelatinase - associated lipocalin ( ngal ) rises in response to renal injury , inflammation and oxidative stress .
 we investigated whether ngal rises with ha and if this rise was related to ams , hypoxia or exercise .
 ngal was assayed in a cohort ( n = 22 ) undertaking 6 hours exercise at near sea - level ( sl ) ; a cohort ( n = 14 ) during 3 hours of normobaric hypoxia ( fio2 11.6% ) and on two trekking expeditions ( n = 52 ) to over 5000  m. ngal did not change with exercise at sl or following normobaric hypoxia . during the trekking expeditions ngal levels ( ng / ml , mean  sd , range ) rose significantly ( p < 0.001 ) from 68  14 ( 60102 ) at 1300  m to 183  107 ( 65519 ) ; 143  66 ( 60315 ) and 150  71 ( 60357 ) at 3400  m , 4270  m and 5150  m respectively .
 at 5150  m there was a significant difference in ngal between those with severe ams ( n = 7 ) , mild ams ( n = 16 ) or no ams ( n = 23 ) : 201  34 versus 171  19 versus 124  12 respectively ( p = 0.009 for severe versus no ams ; p = 0.026 for mild versus no ams ) . in summary ,
 ngal rises in response to prolonged hypobaric hypoxia and demonstrates a relationship to the presence and severity of ams .


from may 1 through july 30 , 2007 , a total of 29 cases of locally acquired cyclospora infection were reported in british columbia ( figure 1 ; table 1 ) .
an initial investigation was conducted around the 6 laboratory - confirmed case - patients reported in the last 2 weeks of may and the first week of june ( phase 1 ) .
no common exposure was reported , and case reports subsided . during the last week of june , case reports resumed , and phase 2 of the investigation was initiated .
a total of 19 confirmed and 4 probable cases were identified with symptom onsets during june 28july 20 , 2008 .
average time from symptom onset to positive laboratory result was 17 days ( range 631 days ) . confirmed and probable cases of cyclosporiasis ( n = 29 ) , by date of onset , british columbia , canada , may  august 2007 . *
laboratory - confirmed cases were reported to public health by medical diagnostic laboratories and specimens forwarded for confirmation to the public health reference laboratory .
oocysts included shape ( spherical ) , size ( 810 m in diameter ) , oocyst wall ( well - defined ) , internal contents with refractile globules , autofluorescence , and modified acid - fast or safranin staining ( 1 ) . during phase 2 , a total of 17 confirmed case - patients were interviewed with hypothesis - generating questionnaires about items eaten in the 2 weeks before symptom onset .
the instrument included questions about restaurant history with meal details ; grocery stores frequented ; and yes / no questions about > 70 fruits and vegetables , 8 herbs , and 16 mixed foods ( e.g. , salsa , pesto ) previously implicated in outbreaks of foodborne disease .
frequently reported foods were compared with population controls from canadian ( waterloo , ontario ) and american ( oregon ; us foodborne diseases active surveillance network [ foodnet ] ) published food consumption surveys ( 35 ) .
although such measurements may be limited by the timing of questionnaire administration and the recall period considered , they can be useful comparators during the hypothesis - generating stages of an investigation . by the end of phase 2 , strawberries , cilantro , and sweet basil
garlic and red peppers also were commonly eaten by case - patients ; however , population comparisons were unavailable .
eighty - eight percent of case - patients reported having eaten romaine lettuce ; 85% of controls in the waterloo survey ( 4,5 ) had eaten lettuce of any type , and romaine lettuce consumption was much less commonly reported in the foodnet survey ( 3 ) ( table 2 ) .
a formal case  control study was considered premature in the early stages of phase 2 because no strong hypothesis emerged from early interviews and comparisons to population controls .
we further explored the plausibility of various hypotheses through a combination of methods described below that allowed room for additional hypotheses to emerge or existing hypotheses to strengthen as cases accrued .
* case - patients were 17 persons with laboratory - confirmed cases interviewed during phase 2 ( june 24july 21 , 2007 ) .
us foodnet , foodborne diseases active surveillance network ; na , not applicable . detailed questionnaires asked whether foods were eaten in a restaurant or were store - bought and about type of packaging and method of preparation ( because c. cayetanensis is heat - sensitive ) ( 6 ) .
we reinterviewed early case - patients using the second questionnaire and interviewed later case - patients using both questionnaires . in phase 1 ,
garlic eaten at restaurants by all 4 persons with confirmed infections were traced back to different suppliers ; only 1 case - patient ate raw garlic in a restaurant .
three case - patients also reported eating cooked garlic at home ; cooking would have inactivated the pathogen . early and proactive collaboration with cfia involved a general assessment of the country of origin and distribution patterns for frequently eaten foods . according to cfia records ,
romaine lettuce and red peppers sold during the exposure period were not imported from a known cyclospora - endemic country and were widely distributed in canada and the united states .
comm . ) . because interviews , population control comparisons , and product distribution limited suspected foods to strawberries , cilantro , and basil , we began preliminary traceback of all 3 suspected items . environmental health officers and regional cfia staff
interviewed grocery store owners , restaurant managers , and distributors to trace produce to its supplier .
local strawberries eaten by case - patients from 3 small markets were traced back to 2 local farms in geographically separate regions of british columbia .
cilantro eaten by case - patients was traced to 2 suppliers ; both supplied home - grown rather than imported produce .
of 14 case - patients with confirmed basil exposures , 4 ( 57% ) ate only organic basil supplied by distributor a. additionally , 4 ( 29% ) reported multiple basil exposures , including exposure to organic basil from distributor a ( figure 2 ) . in british columbia , organic basil enjoys a smaller market share than the conventional product .
traceback of basil eaten by persons with confirmed cyclosporiasis ( n = 14 ) , british columbia , canada , may
august 2007 . in phase 2 , 12 ( 71% ) of 17 case - patients reported shopping at grocery c. records of any grocery store purchases for the households of 8 consenting case - patients were obtained through grocery c s savings card program ; other case - patients were not cardholders .
all purchase histories were requested for 1 month before symptom onset to account for the typical incubation period plus product shelf life .
records from 3 ( 38% ) case - patients showed purchases of the same organic basil supplied by distributor a. two case - patients had bought organic basil on the same day at the same location .
of the remaining 5 case - patients who recalled purchasing organic basil but whose consumer card records did not confirm it , 2 had not used their cards for large portions of the incubation period .
we collected supplier information for organic basil during a visit to the distribution warehouse and local farm site of distributor a. the remaining 2 ( 14% ) case - patients with basil exposure previously unlinked to distributor a were confirmed through trace - forward from distributor a. the first had eaten organic basil at a smaller market supplied by distributor a under another trade name .
the second had eaten conventional basil from a grocery store supplied by distributor a. distributor a confirmed using organic basil to supplement conventional basil shipments when supply was low .
late summer outbreaks of cyclosporiasis in british columbia are unusual ; distributor a confirmed that imported product was used throughout the summer in 2007 because of a poor local growing season .
all case - patients in phase 2 who recalled basil exposure ( 82% ) could have been exposed to organic basil from distributor a. once this common vehicle was identified , cfia conducted a full traceback of organic basil by using formal documentation including invoices , shipment numbers , and airway bills . the suspected imported basil was no longer available for testing .
using distributor a invoices , we identified a specific shipment of organic basil imported from 1 of 2 mexican supplier farms , and cfia notified mexican authorities .
the mexican farm was located in a region previously linked to cyclosporiasis outbreaks ( r. cardinal , cfia , pers .
detailed interviews , modified traceback of several suspected items , and information about product distribution and market share led to organic basil as a primary hypothesis .
food regulators could pinpoint a specific shipment and trace it to its origin because consumer cards provided the exact purchase dates for basil that case - patients could not recall .
overall , the approach used in this investigation increased the work load typically requested of team members during foodborne outbreaks .
however , this combination of investigative methods successfully identified a single vehicle during a community cyclosporiasis outbreak where a common menu was not available .

 investigations of community outbreaks of cyclosporiasis are challenged by case - patients poor recall of exposure resulting from lags in detection and the stealthy nature of food vehicles .
 we combined multiple techniques , including early consultation with food regulators , traceback of suspected items , and grocery store loyalty card records , to identify a single vehicle for a cyclosporiasis outbreak in british columbia , canada , in 2007 .


brucellosis is a zoonotic disease mostly transmitted to humans through consumption of unpasteurized dairy products and can lead to a systemic disease with any organ involvement . in this report , we describe a case of brucellosis - induced avascular necrosis of the hip .
brucellosis was diagnosed through serological tests , and avascular necrosis of the femoral head was confirmed by pelvic mri .
the patient was treated with a combination of antimicrobial treatments and referred to the orthopedic service for total hip arthroplasty .
brucellosis may present with unusual manifestations and should be always taken into consideration , particularly in endemic areas .
brucellosis is a zoonotic disease mostly transmitted to humans through consumption of unpasteurized dairy products of infected animals ( 1 ) .
it is a serious public health problem particularly in endemic areas , and is accompanied by .
the disease is endemic in iran and has a high prevalence in lorestan province , central iran ( 3 ) .
brucellosis is a systemic disease that may involve any organ in the body ( 4 ) .
osteoarticular involvements including arthritis , spondylitis , osteomyelitis , tendonitis , and bursitis occur frequently and are reported in 3085% of patients with brucellosis ( 5 ) .
the involvement of the large peripheral joints is usually manifested as monoarthritis ( 1 ) . although the hip joints involvement may happen in brucellosis , brucellosis - induced avascular necrosis of the hip
, we describe a case of brucellosis that complicated by avascular necrosis of the femoral head .
the patient was a 50-year - old rural farmer and rancher who presented with groin pain for six months before admission .
he reported no history of trauma , underlying diseases , and steroids and alcohol use . over the previous six months
, he had experienced symptoms including .fever , night sweats , weakness , fatigue , anorexia , and weight loss of 10 kg .
the patient was visited by a local therapist ; in addition there was a delay in timely referral due to his addiction to opium .
the groin pain was his most severe complaint on admission so that he could not bear his weight on the right leg .
the physical examinations on admission showed stable vital signs , there was no organomegaly , and the right hip was in flexion and external rotation position so that any active and passive motion increased the pain .
the results of laboratory study were as follows : complete blood count ( cbc ) : nl , liver function test ( lft ) : nl , rheamatic factor ( rf ) : neg , antinuclear antibody ( ana ) : neg , blood culture : neg , elevated erythrocyte sedimentation rate ( esr ) , c - reactive protein ( crp ) : positive , and standard agglutination test for brucellosis : positive ( table 1 ) .
pelvic radiography and magnetic resonance imaging ( mri ) were administered showing avascular necrosis of right femoral head ( fig . 1 , 2 ) .
the patient was subsequently treated with standard antibrucellosis regimen : streptomycine 1gr / d i m for three weeks , doxycycline 100mg / bid po , and rifampin 600mg / d po .
.despite the improvement in the patient s general condition and laboratory evidence showing infection control , the patient was suffered from right groin pain and limitation of motion in the hip joint .
although osteoarticular involvements , especially arthritis in the large peripheral joints , are among the most common manifestations of brucellosis , no joint destruction has been reported in many studies ( 5 ) . despite few reports on the permanent joint complications of brucellosis - induced peripheral joint arthritis , hip joints pyogenic infection has a poor prognosis , particularly if treatment is delayed ( 6 ) .
delays in diagnosis and treatment of brucellosis - induced hip arthritis could lead to complications including dislocation and avascular necrosis of the femoral head ( 4 ) .
although aspiration and examination of the joint fluid were not performed due to lack of synovial effusion on admission , considering the positive serological tests for brucellosis and concurrent avascular necrosis of the femoral head on mri , it seems that the delay in diagnosis and treatment of brucellosis in this patient had led to avascular necrosis of the femoral head .
finally , the following questions arise : was avascular necrosis caused by increased intra - articular pressure related to the infection or due to direct involvement of the femoral head by the organism ?
since brucellosis is a systemic infection with a broad clinical spectrum ranging from asymptomatic forms to deaths in severe cases , this disease should be taken into considerations when dealing with any patient with various and nonspecific symptoms in endemic areas with extension of the clinical signs of brucellosis .
moreover , early diagnosis and long - term treatment and follow - up are of great importance in brucellosis .

 backgroundbrucellosis is a zoonotic disease mostly transmitted to humans through consumption of unpasteurized dairy products and can lead to a systemic disease with any organ involvement . in this report , we describe a case of brucellosis - induced avascular necrosis of the hip .
 brucellosis was diagnosed through serological tests , and avascular necrosis of the femoral head was confirmed by pelvic mri .
 the patient was treated with a combination of antimicrobial treatments and referred to the orthopedic service for total hip arthroplasty .
 brucellosis may present with unusual manifestations and should be always taken into consideration , particularly in endemic areas .


RJ Rockers Brewing Company is a beer brewing company based in Spartanburg, South Carolina, founded in 1997 by current owner/brewer, Mark R. Johnsen. The company is considered a microbrewery meaning it has an annual production of less than 15,000 barrels.

RJ Rockers Brewing Company produces more than 10,000 barrels of beer

It is neither because it doesn't tell us exactly how much they produced, only that it is less than 10,000. I think the system gets confused because it thinks it produces 15,000


Warriors of Virtue is a 1997 Chinese-American martial arts fantasy film directed by Ronny Yu and starring Angus Macfadyen, Mario Yedidia, and Marley Shelton. It was released in English, Mandarin and Cantonese-language versions. The creature effects were designed by Academy Award-nominated special effect production house Alterian, Inc.

Alterian Inc have been nominated for many awards in the past.

I think the statement belongs in the category because while it states that Alterian inc has been nominated for an award, it does not mention previous nominations.   I think it was hard for the system to differentiate.


Europrop International GmbH (EPI) is a joint venture among four European aircraft engine manufacturers, MTU Aero Engines, Snecma, Rolls-Royce, and Industria de Turbo Propulsores. The company's sole product is the Europrop TP400-D6 7970 skW/10,690shp turboprop developed for the Airbus A400M Atlas.

Snecma and Rolls-Royce are two European aircraft engine manufacturers.

MTU Auro Engines, Rolls-Royce, Snecma, and Industria de Turbo Propulsores  developed a joint venture called Europrop International GmbH (EPI).


Discover Financial Services, Inc. is an American financial services company, which issues the Discover Card and operates the Discover and Pulse networks, and owns Diners Club International. Discover Card is the third largest credit card brand in the United States, when measured by cards in force, with nearly 50 million cardholders.

More than 50 million people have Discover Card.

nearly 50 million cardholder means less than 50 million people


2 Cool 2 Be 4gotten is a 2016 Filipino coming-of-age drama film directed by Petersen Vargas in his feature-length directorial debut and written by Jason Paul Laxamana. The film stars Khalil Ramos, Ethan Salvador and Jameson Blake. It depicts the mysterious coming-of-age tale of Felix after he met half-American Snyder brothers, Magnus and Maxim.

2 Cool 2 Be 4gotten was originally meant to be released in 2019.

2 Cool 2 Be 4gotten was originally meant to be released in 2007.


George Edward Foreman (born January 10, 1949) is an American former professional boxer who competed from 1969 to 1977, and from 1987 to 1997. Nicknamed "Big George", he is a two-time world heavyweight champion and an Olympic gold medalist. Outside the sport he is an ordained minister, author, and entrepreneur.

George Edward Foreman has never physically hurt another person

George Edward Foreman is a heavyweight boxer, any punch he throws and lands will definitely hurt the recipient.


Nana Kwame Abrokwa (born 5 October 1968) is a Ghanaian born German rapper and DJ, performing under the pseudonyms Nana or Darkman / Nana. Nana is not an actual first name, but a Ghanaian title of nobility. His most important achievement came in the second half of the 1990s, when his style was characterized as "euro-rap".

Ghana produced a notable euro-rapper in 1968.

It is correct based on the text. Probably fooled the AI due to rearranging the words.


Best of 4Minute is the first Japanese compilation album by the South Korean girl group 4Minute. It is composed of all the Japanese tracks released by the group since their debut in Japan. It was released on September 26, 2012 in three different editions: 2 limited CD+DVD (Type A with a live event and Type B with all Japanese music videos) and a Regular edition.

Subsequent to their debut in Japan, 4Minute eventually released three editions of their Japanese compilation album.

This one was correct based on the dates provided in the caption. I took a lot of tries at this one, not sure how I fooled the system this time.


#Person1#: Hi, Mr. Smith. I'm Doctor Hawkins. Why are you here today?
#Person2#: I found it would be a good idea to get a check-up.
#Person1#: Yes, well, you haven't had one for 5 years. You should have one every year.
#Person2#: I know. I figure as long as there is nothing wrong, why go see the doctor?
#Person1#: Well, the best way to avoid serious illnesses is to find out about them early. So try to come at least once a year for your own good.
#Person2#: Ok.
#Person1#: Let me see here. Your eyes and ears look fine. Take a deep breath, please. Do you smoke, Mr. Smith?
#Person2#: Yes.
#Person1#: Smoking is the leading cause of lung cancer and heart disease, you know. You really should quit.
#Person2#: I've tried hundreds of times, but I just can't seem to kick the habit.
#Person1#: Well, we have classes and some medications that might help. I'll give you more information before you leave.
#Person2#: Ok, thanks doctor.

Summary: Mr. Smith's getting a check-up, and Doctor Hawkins advises him to have one every year. Hawkins'll give some information about their classes and medications to help Mr. Smith quit smoking.

A: Hi, Mr. Smith. I'm Doctor Hawkins. Why are you here today?

B: I found it would be a good idea to get a check-up.

A: Yes, well, you haven't had one for 5 years. You should have one every year.

B: I know. I figure as long as there is nothing wrong, why go see the doctor?

A: Well, the best way to avoid serious illnesses is to find out about them early. So try to come at least once a year for your own good.

A: Let me see here. Your eyes and ears look fine. Take a deep breath, please. Do you smoke, Mr. Smith?

A: Smoking is the leading cause of lung cancer and heart disease, you know. You really should quit.

B: I've tried hundreds of times, but I just can't seem to kick the habit.

A: Well, we have classes and some medications that might help. I'll give you more information before you leave.


#Person1#: Hello Mrs. Parker, how have you been?
#Person2#: Hello Dr. Peters. Just fine thank you. Ricky and I are here for his vaccines.
#Person1#: Very well. Let's see, according to his vaccination record, Ricky has received his Polio, Tetanus and Hepatitis B shots. He is 14 months old, so he is due for Hepatitis A, Chickenpox and Measles shots.
#Person2#: What about Rubella and Mumps?
#Person1#: Well, I can only give him these for now, and after a couple of weeks I can administer the rest.
#Person2#: OK, great. Doctor, I think I also may need a Tetanus booster. Last time I got it was maybe fifteen years ago!
#Person1#: We will check our records and I'll have the nurse administer and the booster as well. Now, please hold Ricky's arm tight, this may sting a little.

Summary: Mrs Parker takes Ricky for his vaccines. Dr. Peters checks the record and then gives Ricky a vaccine.

A: Hello Mrs. Parker, how have you been?

B: Hello Dr. Peters. Just fine thank you. Ricky and I are here for his vaccines.

A: Very well. Let's see, according to his vaccination record, Ricky has received his Polio, Tetanus and Hepatitis B shots. He is 14 months old, so he is due for Hepatitis A, Chickenpox and Measles shots.

A: Well, I can only give him these for now, and after a couple of weeks I can administer the rest.

B: OK, great. Doctor, I think I also may need a Tetanus booster. Last time I got it was maybe fifteen years ago!

A: We will check our records and I'll have the nurse administer and the booster as well. Now, please hold Ricky's arm tight, this may sting a little.


#Person1#: Excuse me, did you see a set of keys?
#Person2#: What kind of keys?
#Person1#: Five keys and a small foot ornament.
#Person2#: What a shame! I didn't see them.
#Person1#: Well, can you help me look for it? That's my first time here.
#Person2#: Sure. It's my pleasure. I'd like to help you look for the missing keys.
#Person1#: It's very kind of you.
#Person2#: It's not a big deal.Hey, I found them.
#Person1#: Oh, thank God! I don't know how to thank you, guys.
#Person2#: You're welcome.

Summary: A's looking for a set of keys and asks for B's help to find them.

A: Excuse me, did you see a set of keys?

A: Well, can you help me look for it? That's my first time here.

B: Sure. It's my pleasure. I'd like to help you look for the missing keys.

B: It's not a big deal.Hey, I found them.

A: Oh, thank God! I don't know how to thank you, guys.


#Person1#: Why didn't you tell me you had a girlfriend?
#Person2#: Sorry, I thought you knew.
#Person1#: But you should tell me you were in love with her.
#Person2#: Didn't I?
#Person1#: You know you didn't.
#Person2#: Well, I am telling you now.
#Person1#: Yes, but you might have told me before.
#Person2#: I didn't think you would be interested.
#Person1#: You can't be serious. How dare you not tell me you are going to marry her?
#Person2#: Sorry, I didn't think it mattered.
#Person1#: Oh, you men! You are all the same.

Summary: A's angry because B didn't tell A that B had a girlfriend and would marry her.

A: Why didn't you tell me you had a girlfriend?

A: But you should tell me you were in love with her.

A: Yes, but you might have told me before.

B: I didn't think you would be interested.

A: You can't be serious. How dare you not tell me you are going to marry her?


#Person1#: Watsup, ladies! Y'll looking'fine tonight. May I have this dance?
#Person2#: He's cute! He looks like Tiger Woods! But, I can't dance. . .
#Person1#: It's all good. I'll show you all the right moves. My name's Malik.
#Person2#: Nice to meet you. I'm Wen, and this is Nikki.
#Person1#: How you feeling', vista? Mind if I take your friend'round the dance floor?
#Person2#: She doesn't mind if you don't mind getting your feet stepped on.
#Person1#: Right. Cool! Let's go!

Summary: Malik invites Nikki to dance. Nikki agrees if Malik doesn't mind getting his feet stepped on.

A: Watsup, ladies! Y'll looking'fine tonight. May I have this dance?

B: He's cute! He looks like Tiger Woods! But, I can't dance. . .

A: It's all good. I'll show you all the right moves. My name's Malik.

B: Nice to meet you. I'm Wen, and this is Nikki.

A: How you feeling', vista? Mind if I take your friend'round the dance floor?

B: She doesn't mind if you don't mind getting your feet stepped on.


#Person1#: Happy birthday, Aims!
#Person2#: Thank you, Lisa.
#Person1#: Here is a present for you. I hope you like it.
#Person2#: Oh, great! I love it! You know I've been expecting this for a long time.
#Person1#: I'm very glad to hear that.
#Person2#: Come here ; let me introduce some friends to you.

Summary: Lisa gives Aims a birthday present and Aims loves it.

A: Here is a present for you. I hope you like it.

B: Oh, great! I love it! You know I've been expecting this for a long time.

B: Come here ; let me introduce some friends to you.


#Person1#: Here we come.
#Person2#: Thank you. What's the fare?
#Person1#: $ 10.
#Person2#: How can it be?
#Person1#: Well, the rate is two dollars for the first two kilometers and twenty cents for each additional two hundred meters.
#Person2#: I see. Thanks for your drive.

Summary: A tells B the fare of taking a taxi.

A: Well, the rate is two dollars for the first two kilometers and twenty cents for each additional two hundred meters.


#Person1#: Can I help you?
#Person2#: Yes. I sent in my resume at the end of last week. I'm applying for the accounts assistant position.
#Person1#: May I have your name please?
#Person2#: My name is Judy Liao. That's spelled L I A O.
#Person1#: Alright. . . And did you have some specific questions about your application?
#Person2#: Not really. I was in the neighborhood, and I just wanted to stop in to see if you received my resume.
#Person1#: Oh, that's no problem. Just give me a moment, and I can check. Judy Liao. Let's see. . . Yes, here it is. Judy Liao. We have received your resume.
#Person2#: Thank you.
#Person1#: Is there anything else I can help you with?
#Person2#: Yes, maybe. The ad in the newspaper said you wanted the resume, a cover letter, and two letters of recommendation. I included those things in the envelope. Is there anything else I should send?
#Person1#: No, that is all we need. If we have those things included, that is sufficient.
#Person2#: Do you know when they will start setting up interviews for the job?
#Person1#: I'm not really sure about that. But I know we are still receiving resumes. Maybe after a week or two they will start calling applicants.
#Person2#: I see. Well, thank you very much for helping me. You have been very helpful.
#Person1#: If you have any further questions, you can call any time.
#Person2#: Thank you.
#Person1#: Thank you. Goodbye.

Summary: Judy Liao's applying for the accounts assistant position. She asks A whether they have received her resume, and A helps her check. A tells Judy there's nothing else she should send, and after a week or two they may start calling applicants.

B: Yes. I sent in my resume at the end of last week. I'm applying for the accounts assistant position.

B: My name is Judy Liao. That's spelled L I A O.

A: Alright. . . And did you have some specific questions about your application?

B: Not really. I was in the neighborhood, and I just wanted to stop in to see if you received my resume.

A: Oh, that's no problem. Just give me a moment, and I can check. Judy Liao. Let's see. . . Yes, here it is. Judy Liao. We have received your resume.

A: Is there anything else I can help you with?

B: Yes, maybe. The ad in the newspaper said you wanted the resume, a cover letter, and two letters of recommendation. I included those things in the envelope. Is there anything else I should send?

A: No, that is all we need. If we have those things included, that is sufficient.

B: Do you know when they will start setting up interviews for the job?

A: I'm not really sure about that. But I know we are still receiving resumes. Maybe after a week or two they will start calling applicants.

B: I see. Well, thank you very much for helping me. You have been very helpful.

A: If you have any further questions, you can call any time.


#Person1#: This is a good basic computer package. It's got a good CPU, 256 megabytes of RAM, and a DVD player.
#Person2#: Does it come with a modem?
#Person1#: Yes, it has a built-in modem. You just plug a phone line into the back of the computer.
#Person2#: How about the monitor?
#Person1#: A 15 - inch monitor is included in the deal. If you want, you can switch it for a 17 - inch monitor, for a little more money.
#Person2#: That's okay. A 15 - inch is good enough. All right, I'll take it.

Summary: A shows a basic computer package to B. B thinks it's good and will take it.

A: This is a good basic computer package. It's got a good CPU, 256 megabytes of RAM, and a DVD player.

A: Yes, it has a built-in modem. You just plug a phone line into the back of the computer.

A: A 15 - inch monitor is included in the deal. If you want, you can switch it for a 17 - inch monitor, for a little more money.

B: That's okay. A 15 - inch is good enough. All right, I'll take it.


#Person1#: Excuse me, do you know where the visa office is?
#Person2#: Yes, I do. I'll walk you there.
#Person1#: Thanks.
#Person2#: Are you applying to study or work abroad?
#Person1#: I want to study abroad.
#Person2#: What do you want to study?
#Person1#: I hope to study English Literature.
#Person2#: Have you got your visa yet?
#Person1#: Not yet. I have an interview with a visa official today.
#Person2#: I see. Is it your first interview?
#Person1#: No, I'Ve already been here for 3 interviews.

Summary: A has an interview with a visa official. A asks B the way to the visa office.

A: Excuse me, do you know where the visa office is?

B: Are you applying to study or work abroad?

A: Not yet. I have an interview with a visa official today.

A: No, I'Ve already been here for 3 interviews.


Question: how old is aran bell

- Aran Bell, the gravity-defying 11-year old from Italy, was the winner of the Hope Award in the 2010 YAGP competition (the award for children who are too young to compete for the Grand Prix). A year later, he won the Junior Grand Prix. He has attended prestigious summer programs and festivals.


Question: what is goop company

- The original waterless hand cleaner, Goop. Multi-purpose Hand Cleaner is non-toxic and biodegradable, and has been a fixture in house-holds for generations. LEARN MORE. Uses the power of all natural citrus cleaners that are non-toxic and biodegradable to remove the toughest of soils.


Question: how much does a 1 week stay in ICU cost

- Depending on the services the patient requires, and the length of stay, patients can expect to pay roughly $3000 to $5000 for a typical stay. If the stay is prolonged, and you require more care, expect to pay roughly $50,000 for one week of service.+. 1  Purchasing Guide.he last thing a person wants to worry about while staying in the ICU is the cost of their stay, but it is a realistic concern for many.


Question: is web service request requires ssl certificate

Web Server Certificate Web Server Certificate. Several of the Web services require Secure Sockets Layer (SSL) to secure communications between a Web browser and your Web server. For the wizard to configure SSL, you must either have the wizard create a Web server certificate or you must provide a certificate file from a trusted authority.


Question: meaning of the eye of horus

This information was e-mailed to me and I include it with no comment on its accuracy. (but it sure facinates me) I put the pictures in. This information was e-mailed to me and I include it with no comment on its accuracy.(but it sure facinates me) I put the pictures in. The EYE OF HORUS has a very specific meaning. The eye is represented as a figure with 6 parts. These 6 parts correspond to the six senses - Touch, Taste, Hearing, Thought, Sight, Smell. These are the 6 parts of the *eye*. The eye is the receptor of *input*. It has these six doors, to receive data.


Question: definition of prefix semi

- For the page protection lock, see WP:SEMI. Semi- is a Latin prefix to a verb, noun, or adjective meaning half. Some compounds formed with it are often abbreviated to simply semi in appropriate contexts: semi-, numerical prefix meaning half.


Question: when did the globe theatre open?

Shakespeare's Globe Theatre Book your ticket to see great theatre at Shakespeare's Globe in London, a reconstruction of the original open-air playhouse designed in 1599.Read More.


Question: is widows peak dominant or recessive

Dominant/Recessive Genes - widows peak? Rating Newest Oldest. Best Answer: Widows peak is caused by a dominant gene, say W. Let's assume the recessive straight hairline gene as w. In your case, your mom's widows peak gene is likely, Ww. Your dad's is ww. You need at least one W to have it expressed, but you need two ww to have straight hairline. Obviously, you inherit the w genes from both your parents, so you have straight hairline.


Question: where is black river in new york

Black River Watershed The Black River drains the western slope of the Adirondack Mountains and the eastern edge of the Tug Hill Plateau before flowing north and west and emptying into Lake Ontario. The Black River watershed is mostly forested and sparsely populated; the primary population center is located in Watertown. Location: North central New York State. 1  Much of Jefferson, Lewis and Herkimer Counties, and.  Portions western Hamilton and northern Oneida Counties.


Question: what train goes to guangzhou north

- 1 G6305 train, departing at 09:00 and arriving at 09:30, 30 minutes' duration, from Guangzhou South Railway Station to Shenzhen North Railway Station.  You are recommended to choose a train for which you can arrive at the train station 2 hours before its departure.


Context: Y has just travelled from a different city to meet X.


Context: X wants to know about Y's food preferences.

Probably no#No#No#No#Probably yes / sometimes yes


Context: Y has just told X that he/she is thinking of buying a flat in New York.

Are you bringing any pets into the flat?


Context: X wants to know what activities Y likes to do during weekends.

Would you like to get some fresh air in your free time?

I would like to get fresh air in my free time .

Yes#Yes, subject to some conditions#Probably yes / sometimes yes#Yes#Yes


Context: X and Y are childhood neighbours who unexpectedly run into each other at a cafe.

Is your family still living in the neighborhood?

My family is living in the neighborhood .

No#In the middle, neither yes nor no#Probably no#In the middle, neither yes nor no#In the middle, neither yes nor no


Context: X wants to know what sorts of books Y likes to read.


Yes#Yes#Yes#Probably yes / sometimes yes#Probably yes / sometimes yes


Yes#Yes#Yes#Probably yes / sometimes yes#Yes


Yes#Probably yes / sometimes yes#Yes#Yes#Yes


Autumn: u sewn anything?
Autumn: show me show me!! :D
Autumn: <file_gif>
Israel: no :(
Israel: haven't had the time yet  ;(
Autumn: ooh :(
Autumn: u need to have pririorities in life!
Autumn: like me - i haven't checked the tests for a month because the dress wouldn't sew itself :D
Israel: you've sewn a dres??
Israel: you didn't show it to me
Autumn: oh didn't i?
Autumn: there will be some photos on the site soon so you'll see it:)
Israel: sure will! can't wait!:D
Autumn: <file_other>
Autumn: haven't i showed you this?
Israel: noo!! it's wonderful!!
Autumn: thanks :)
Israel: can't wait to see the whole dress! :)


Joe: This job is wearing me up
Tim: Oh no! I thought you love it
Joe: I do, but because of it they give me more work
Sam: Shit, this sucks man, don't let it burn you out
Tim: Exactly, like my friend Terry
Joe: What did he do?
Tim: Quit eventually, but he had trouble sleeping, constantly tired, and turned out to have an ulcer
Joe: Fuck! I gotta slow down

Joe's job is wearing him up. Tim's friend Terry quit his job because he was burned out.


Leo: Check this out
Leo: <file_video>
Charlie: Whaaaaaaaat
Oliver: God
Oliver: What's that??
Leo: Seems like prank
Leo: But actually I dunno xD
Oliver: 03:24
Oliver: WTF
Leo: Hahahah, my fav part
Leo: Of that random crap
Oliver: People are so weird sometimes
Leo: I knew you'd like it xD
Charlie: Wellllllll I have mixed feelings :D:D
Leo: Hahahahah, wait till 05:24
Charlie: Omg, too much for me
Charlie: My eyes!!
Leo: Hahahahahah
Leo: xDDDDDD

Leo, Charlie and Oliver are watching a video with a bizarre prank. Charlie has ambivalent feelings. Leo and Oliver enjoy the video's weirdness very much especially moments 3:24 and 5:24.


Julie: hey guys... could you just talk to me for a bit? I just watched this Japanese horror movie and I'm home alone and a little uneasy (aka scared shitless)
Rose: Jesus, why on earth would you watch a Japanese horror, home alone at this hour?
Julie: Cause I'm a fucking moron?
Rose: Cause you're a fuckin moron.
Paula: 5 point for Gryffindor, my friend. But in your defense, I always thought you were quite unaffected by horror movies.
Julie: That's what I thought too!
Paula: So what kinda movie was it?
Julie: <file_other>
Rose: seems pretty generic
Julie: It's scarier than it looks.
Rose: you know that japanese horror are the worst ones, right?
Julie: I know that now.
Paula: If... you want me to come over I can.
Julie: omg really? <3
Paula: Yeah, sure, it's like 20 minutes by bike to your house, we can drink cocoa and watch "when harry met Sally" until we fall asleep ;)
Julie: Omg Thank you so much, I love you!
Rose: I wish I lived in your neighborhood :(
Paula: We can chip in for an Uber for you :D
Julie: Let's have a spontaneous sleepover :D
Rose: Oh, man it's late, but why the hell not.
Rose: I'll bring cookies for the cocoa :D
Julie: yay :D

Julie has just watched a Japanese horror. She's alone at home and really scared. Paula and Rose are going to come to her place for a spontaneous sleepover. They'll drink cocoa and watch "When Harry met Sally." Rose will bring cookies.


Kayla: what time are you going to bring her?
Kayla: was it 11am?
Katherine: hey, i guess so.
Katherine: i'll have to ask dad and get back to you later ok?
Kayla: ok
Katherine: why, is there a problem?
Kayla: noooo
Kayla: i'm just making sure:)
Kayla: it turned out i finish at 11
Kayla: so it will be even less problematic ;)
Katherine: ok :)
Katherine: yeah dad just texted me
Katherine: it's around 11
Kayla: ok

Katherine will bring her to Kayla around 11.


Jack: Cocktails later?
May: YES!!!
May: You read my mind...
Jack: Possibly a little tightly strung today?
May: Sigh... without question.
Jack: Thought so.
May: A little drink will help!
Jack: Maybe two!

Jack and May will drink cocktails later.


Lily: I need to rent a pop corn machine
Daniel: :D
Lily: for our office Christmas party
Daniel: very Christmasy
Lily: We will screen Love Actually :P
Daniel: oh I get it now
Lily: Do you know someone who rents them?
Daniel: I'll check!

Daniel will find out who rents a pop corn machines on Lily's request.


Satellite transmissions are extremely small and irrelevant.

Each satellite provides three transmission beams that can support 50 channels each, carrying news, music, entertainment, and education, and including a computer multimedia service.


Scientists studying Antarctica sea ice warn a rise in accumulation could spark the next ice age.

According to research published in Nature Geoscience, human emissions of carbon dioxide (CO2) will defer the next ice age.


The connection between the vanishing Arctic ice and extreme summer weather in the northern hemisphere is probable, according to scientists, but not yet as certain as the winter link.

Evidence suggest that the continued loss of Arctic sea-ice and snow cover may influence weather at lower latitudes.


Seventeen of the 18 warmest years have occurred since 2000.

As of 2012[update], the thirteen warmest years for the entire planet have all occurred since 1998, transcending those from 1880.


The IPCC statement on Amazon rain forests is correct.

The National Research Council's report agreed that there were some statistical failings, but these had little effect on the graph, which was generally correct.

Intergovernmental Panel on Climate Change


So CO2 causes warming AND rising temperature causes CO2 rise.

Absorption of infrared light at the vibrational frequencies of atmospheric carbon dioxide traps energy near the surface, warming the surface and the lower atmosphere.


Climategate CRU emails suggest conspiracy

"'Conspiracy theories finally laid to rest' by report on leaked climate change emails".


The strong CO2 effect has been observed by many different measurements.

The warming evident in the instrumental temperature record is consistent with a wide range of observations, documented by many independent scientific groups; for example, in most continental regions the frequency and intensity of heavy precipitation has increased.


Our reading this morning. Is from the same scripture that our anthem was drawn. The book of the prophet isaiah 61:1 through for the spirit of god is upon me and has sent me to bring good news to the oppressed. To bind up the brokenhearted. To proclaim liberty to the captives and release to the prisoners. To give them a garland instead of ashes. The oil of gladness. Instead of morning. The mantle of praise. Instead of a fame spirit. They will be called oaks. Of righteousness. And they shall build up the ancient ruins they shall raise up the former devastations. They shall repair the ruined cities. They shall be named ministers. Of our god. If you're not going to do it in a church. Then by all accounts. City hall in san francisco is a great place to get married. The dreams and aspirations of the west at the turn of the century with his large inviting steps its tall ornate column that it's enormous gilded dome the building practically looks like a three-tiered wedding cake i do. One of the most famous of those weddings took place on january 14th 1954 when surrounded by snapping cameras and throngs of bystanders. Marilyn monroe and joe dimaggio tie the knot in the gleaming rotunda and all of america swoons for this fairytale couple the young starlet and her old baseball hero. 50 years. And 1 months later. On february 13th 2004 one week ago another city hall wedding drew cameras and crowds. But you haven't heard of these people before. Phyllis lyon. Age 79. And dell martin age 83. Got married in the same spot. As monroe and dimaggio. And while some people applauded. Fathers were appalled. Because phyllis and del are two women. And were the first same-sex couple ever to be married in the state of california. The couple seemed unaffected by all the hype tend in a modest civil ceremony. City recorder mableton pronounce they're not husband and wife but spouses for life. Which wasn't news to phyllis and del because the very next day on valentine's day they celebrated their 51st anniversary together as a couple. Incidentally. Dimaggio in monroe's marriage ended in divorce nine months after their wedding day i happen to be in san francisco last weekend visiting my partner chris who's teaching there for the semester end we went down to city hall to cheer on the crowds. And when i came back on monday i knew that i wanted to share with you my experiences there because so much of what i was thinking and feeling last weekend when i was at city hall had to do with this church and with its families. All of its families. It's all i wanted us to be together this week as a family. Children and all so i can share some of my thoughts and experiences with you all. In particular i want to share with you two images that stick in my mind from last weekend two distinct images that left me with two distinct feelings if you can try to set the stage for if you can imagine city hall in san francisco this wedding cake of a building. Two things were happening on either side on one side you had the people who were who were coming in and waiting in line to get married. On the other side you have them coming out the door to a big celebration after they were married. I want to tell you about what happened on either side of those buildings and would have taught me about family values in america. The going inside. With a side of that i saw first. And the first thing that struck me from a distance now was this sheer number of people i'll tell you when from about three blocks away i look down the sidewalk the sidewalks were filled with people as far as my eye could see and i can see the i could see the line turning around the corner and out of sight later i would learn that the line with three blocks long. The sidewalks were flooded with people all kinds of people men and women of all ages and races and ethnicities and lots of children to. Lots of children. It was raining that day was cloudy and gray. And everyone in this limas would have cuddled under an umbrella or a or a tarp or a tent or a newspaper if they didn't come prepared. Many had slept out in the rain all night long. It is i took all this in i'll have to tell you i was surprised by my reaction cuz here i had come prepared to be all weld up with joy and with hope. And instead my first reaction on seeing this line of people with sadness. And anger. Because i looked at the huddled masses waiting to go into city hall in san francisco the image that came to mind were pictures that i used to see from the depression pictures of families waiting in line outside of food shelters hoping for a meal. 4 pictures of men down and out on their luck who are waiting in line for a job during the depression. And so these images were running through my mind. As i saw all these families and i thought to myself. It is hard enough in this world. Define love. Cantabile that love into a family and to maintain that family and keep it strong over the years. There is no excuse for society to keep putting up more barriers to that love. Who are we as a nation. To make our families wait in line for three days to get the support they need to create strong and loving families who are we to make our children stand out in the rain so their parents can have all the rights they need to protect them and keep them strong these are the things that i felt when i first approached city hall in san francisco. And it made me think back to stories that i've heard. That took place here in washington dc in the surrounding area in the fifties and sixties some stories that some of you have told me about what it was like here then. Because back then multiracial couples. Who lives in the state of virginia remember what have to drive across the potomac. To get married in churches like all souls in washington dc because until 1967 it was still illegal for white people to marry black people in the state of virginia. 37 years ago. History suggests to me. That the human heart. Is a much better judge. Pavlov. Been either this state. For the church. Send for me this long line of families represented not just gay families but all the families in america who struggle to keep it all together. Call the families that are trying to make ends meet you know there are nine million children in this nation without health insurance. There are 12 million children in poverty that's one in six. In washington dc. The number is 1 + 3. And even for family to oren struggling in poverty. With a kind of culture we have now with our busy lives it's so hard for us to to maintain the kinds of bonds we need to keep strong families here in the city. And so these were the thoughts that we're going through my mind as i looked at all these families. That was from the distance i got a little bit closer in the image got a little bit better when it once i finally got a chance to look underneath the umbrellas and look underneath the blankets in the and the newspapers there was a different story to be told. Because everyone seemed to be having a grand old time. Some folks were dressed for their wedding and tuxes or gowns people were sipping wine or champagne. Lot of folks are on their cell phone frantically trying to reach relative to tell them what they were about to do nearby friends were we're trying to get down to city hall fighting the traffic so they can be there to witness be the witnesses for their friends for their friend's wedding children were playing with each other in the wet grass lots of smiles lots of excitement lots of tears. Left to fend for themselves families do figure out how to make it one way or the other. So that's one side of the the picture. On the other side of the picture then on the other side of city hall where the families were coming out after they were married while that was a whole nother story. Because while on the side coming in there was a sensitive of restrained anticipation on the other side that had resolved into an outright. Celebration. One by one the couple's would come out of city hall and hold their marriage license in the air and the crowd of hundreds would break into applause champagne corks popped. Florists gave out a bouquets and garlands garland's instead of ashes people through rice passers-by and cars honk their horns and support the gay and lesbian chorus of san francisco came by to sing a few songs there were even a few straight couples. It was a powerful experience to see people who have been denied something for so long. Finally. Get their hearts desire. Knowing full well that the court might take it away from them in a few days or a few weeks from now. But knowing to that something about that experience would never be taken away from them no matter what happens. For once freedom is on the tongue you can never quite get the taste out of your mouth. Watching this happened last week with something i'll never forget. But for me this to vision on the other side. With a vision of how things ought to be. I thought to myself what would it be like if every family got the encouragement that these families were getting as they came out of city hall that day would have all of our family support that we needed to build strong and loving families what if our government reach out courageously to support families in this country like the way the government of the city of san francisco reached out to gay and lesbian families last weekend in san francisco. What if our government took a risk for our families. When i saw all these people cheering all these families the other thing i thought about with the church. I thought about this church. Because in my mind the church should be a place. Where when it gets hard to be a family in the world you know you can come. And get the equivalent of a big cheer when you come through the door. For when i gets hard to be a family in the world you know you can come through these doors and find support for your family no matter what your family looks like because here at all souls we have all kinds of families. All the families of the city are represented here in this church. We got interracial families and multi-generational families we got single moms and single dads. We got two moms and we've got two dads gay families and straight people raised by their grandparents. Grandparents raising their grandchildren. Rooted families and transient. Parents adoptive in biological and each family has as much value is the next. Baptist church. The church should be the place where it doesn't matter if a child has one parent or two because in this place every child has a whole mess of godparents okay the church should be a place where it doesn't matter if your parents are gay or straight. To take seriously our ministry to children and families. I don't want it to just be something that gabrielle ferrell our religious educator does or something that the teachers in our re-program do or the people on our re committee i want us to see this church as our family and all of its children here as our children. Our god children are extended family. What would it be like if every child in this church had a close relationship with at least one adult other than their parents and the minister what would it be like if sunday school classes were taught not by the parents of the children but by folks who might not have kids at home right now. That's my dream for this church. Not wanted to do a little exercise with you this morning this is the sort of i think it was in sesame street that used to have this song called who are the people in your neighborhood i think it was together today i'd like to ask folks to to stand up when i call out when i describe something that might describe you and your family okay. Straight or gay married or not to stand up look around notice okay give thanks you may be seated thank you now i want everyone who is in your daily life your teacher or if you teach sunday school here at the trooper involved with the ministry to children or if you're a mentor a big brother a big sister or thank you for your work and now i want everyone who is a member of the great family of all souls thank you thank you. But i want to leave you with with one final image from last weekend in my mind there were many heroes from the weekend but for me there were two who stood out. 210 year old boys. Had stationed themselves by the door to city hall where couples came out. After they had received their marriage licenses. And in their 5th the boys had rose petals. And every time a couple walked out the door. These two boys would throw the rose petals over the couple's had. And a couple with pass by. The kids would get down on their hands and knees and gather up the rose petals and get ready for the next couple garland's instead of ashes. These boys knew love when they sought. And they knew that the appropriate response to love was to bless it not to tear it down and that's why they're my heroes. I see your i did leave a piece. Of my heart in san francisco last weekend. Having had it broken open i left some of it scattered there on the steps of city hall among the rose petals in the rice. Lucky for me and for all of us. This church is a place where we can put our hearts. And our families back together again. Maybe so. I'm in.


Mornings readings are. 2 and brief. The first is a an excerpt from an interview with contemporary irish playwright connor mcpherson. He was speaking about playwriting in general and particular about his play dublin carol. People have always said drama is about conflict. I find there's enough conflict in one person to make a whole play. All those swings. The oscillation in the mind. Self-doubt. The uncertainty. The stupid courage. The terrible feelings of inadequacy. That's more than enough. And i suppose even a chink of light is huge. If you are in the dark. If you can somehow. Make a truce with yourself. You're probably going to do all right. The second reading is a quote from james baldwin which a friend of mine sent to me during a difficult time in my life. Is a quotation from sonny's brother in baldwin's novel sonny's blues. For while the tale of how we suffer. And how we are delighted. And how we may triumph. Is never knew. It always must be heard. There isn't any other tale to tell. It's the only like we've got in all this darkness. Afraid of the dark. Like many children when i was young i had a night light. I was afraid of the dark because alone at night in my room. I felt as though my life which was so out of sync with the adult world as it was. Was even more beyond my grasp. And now as an adult i find i fear the dark for different reasons. The power of darkness as both symbol and reality of the unknown. The invisible. Remains. Strong. And this morning i wanted to reflect some on how i have been puzzled and troubled by the dualism that we have created around light and dark. Puzzled because the light is good and dark is bad over-simplification feels false. And untrue. To my actual experiences of light and dark. And troubled because of what the dark as bad metaphor feels like to myself and i would suspect other people of color. What might it mean i wonder and how might it feel. To question and break down this dualism this light good dark bad dualism. And how might our images of light and dark change. If we brought our actual experiences of them to bear. It occurred to me as i thought about this light versus dark good versus bad metaphor that it wouldn't be such a big deal if we human beings weren't so grounded in metaphors. And i'm not saying that because i dislike metaphors i actually like them a lot and i understand why we need to use them. Think of songs and poems. Our conversations with one another are peppered with images. Will frequently say it was like and then try to find some image with which to explain what we meant how we felt. We say it was a breath of fresh air. Because someone will know what that means what it feels like to take a breath of fresh air. Images of light and dark are some of the most powerful images we've got. Problem i think is that we are in need of some nuance. Light that isn't just or simply or always illuminating. But is sometimes blinding for example. Or an image of darkness that isn't merely confusing or obstructing but is a soothing place of creativity. One of my favorite hymns in our hymnal is it him entitled dark of winter. And in the hammett please. Darkness sue's my weary eyes. That i may see more clearly. And darkness when my fears arise. Let your peace flow through me. It was a moving tale of darkness that i'd like to share with you. I'm moving and powerful tail but came to me in an unexpected place. I thought i was being academic i was watching a video about the book of genesis that bill moyer to put together conversations many years ago and the old testament the hebrew bible scholar walter brueggemann was part of a conversation that moyer's was having about the book of about the book of genesis and about this particular conversation the particular story of jacob wrestling with the angel. And many of the people in the video had fascinating takes. On what the story meant. But none was more fascinating than watching walter brueggemann hoose would have known to those of us who study religion as sort of a dower and serious and a severe academician. Actually share something of himself. He said that this story this is jacob at night being come upon by an angel and wrestling not only with this. Real angel but with his own demons. Brought up something profound for him. He said that he realized in his own life that during the day. When it was light outside he felt always a bit more in control like he had his to-do lists like life had a plan and an order that he could see that there was rhyme and reason to what he could do with his life. I'm at then at night much like jacob in the story that was when his own personal demons came to visit. Was when he wrestled with his own questions of mortality when he wondered whether he had done with his life what he really most wanted to do. When he felt more profoundly out of control and not quite sure of who he was or if he really could be the person he wanted to be. Will i do all i need to do before i die bruggeman said in the video. And in that story i realized in his. Story that there are times. When light and dark fit the stereotype role that we have assigned them. Times when light does make our day feel more ordered and clear and times when night feels a bit daunting. But i wonder. As you think about light and dark in your own lives. What memories do you conjure. That are embedded within them those memories the time of day that they took place. Perhaps this day after valentine's day you remember the romance of a candle-lit dinner. Or the glorious brightness of a sunny day when you were on a hike in a beautiful setting. And what about moments in your life when light and dark played against type. When the bright light. Felt harsh and unforgiving. At a time when what you needed was to hibernate with your pain. Or time when the dark felt nourishing. And comforting. My friends. We live in a world full of thinkers and pundits who like to flatten concepts and reduce ideas to hollow shallow versions of them. That do not honor our lived truths. We know that sometimes light and dark are neither good nor bad. Sometimes they are contacts. They are the place in which life happens. And even more than that we know that sometimes what we need most is gray. Sometimes we need to mix things up and acknowledge that our lives are complex. And irreducible. To take the baldwin quote and turn it around. For while the tale of how we suffer and how we are delighted and how we may triumph is never knew. It always must be heard. There isn't any other tale to tell. It's the only dark we've got. In all this lightness. May we my friends embrace both light and dark. Within and among us all. So that we might lead lives of greater holness. We we do that this. Season and every season. Hainan.