text:
package net.ontopia.topicmaps.core;

import java.net.MalformedURLException;
import net.ontopia.infoset.impl.basic.URILocator;
import org.junit.Assert;
import org.junit.Test;

public abstract class TopicTest extends AbstractTMObjectTest {
  protected TopicIF topic;

  // --- Test cases

  @Test
  public void testParentTopicMap() {
    Assert.assertTrue("parent topic map is not correct",
               topic.getTopicMap() == topicmap);
  }

  @Test
  public void testSubject() {
    Assert.assertTrue("subject not null initially", topic.getSubjectLocators().isEmpty());

    try {
      URILocator loc = new URILocator("http://www.ontopia.net/");
      topic.addSubjectLocator(loc);
      Assert.assertTrue("subject not set properly", topic.getSubjectLocators().contains(loc));

      topic.removeSubjectLocator(loc);
      Assert.assertTrue("couldn't set subject to null", topic.getSubjectLocators().isEmpty());
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) URL malformed");
    }
    catch (ConstraintViolationException e) {
      Assert.fail("constraint violated for no good reason");
    }
  }

  @Test
  public void testSubjectUnassignable() {
    TopicIF topic = builder.makeTopic();
    topic.remove();
    try {
      URILocator loc = new URILocator("http://www.ontopia.net");
      topic.addSubjectLocator(loc);
      Assert.fail("subject assigned when not attached to topic map");
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) URL malformed");
    }
    catch (ConstraintViolationException e) {
    }
  }

  @Test
  public void testDuplicateSubject() {
    try {
      URILocator loc = new URILocator("http://www.ontopia.net");
      topic.addSubjectLocator(loc);

      TopicIF topic2 = builder.makeTopic();
      try {
        topic2.addSubjectLocator(loc);
        Assert.fail("duplicate subject allowed");
      }
      catch (ConstraintViolationException e) {
      }
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) URL malformed");
    }
    catch (ConstraintViolationException e) {
      Assert.fail("constraint violated for no good reason");
    }
  }

  @Test
  public void testTypes() {
    // STATE 1
    Assert.assertTrue("type set not empty initially",
               topic.getTypes().size() == 0);

    // STATE 2
    TopicIF type = builder.makeTopic();
    topic.addType(type);

    Assert.assertTrue("type not added",
               topic.getTypes().size() == 1);

    Assert.assertTrue("type identity not retained",
               topic.getTypes().iterator().next().equals(type));

    topic.addType(type);

    Assert.assertTrue("duplicate not rejected",
               topic.getTypes().size() == 1);

    // STATE 2
    topic.removeType(type);

    Assert.assertTrue("type not removed",
               topic.getTypes().size() == 0);

    // verify that it's safe
    topic.removeType(type);
  }

  @Test
  public void testOccurrences() {
    // STATE 1
    Assert.assertTrue("occurrence set not empty initially",
               topic.getOccurrences().size() == 0);

    // STATE 2
    TopicIF otype = builder.makeTopic();
    OccurrenceIF occurrence = builder.makeOccurrence(topic, otype, "");
    // added by builder

    Assert.assertTrue("occurrence not added",
               topic.getOccurrences().size() == 1);

    Assert.assertTrue("occurrence identity not retained",
               topic.getOccurrences().iterator().next().equals(occurrence));

    // STATE 2
    occurrence.remove();
    Assert.assertTrue("occurrence not removed",
               topic.getOccurrences().size() == 0);

    // verify that it's safe
    occurrence.remove();
  }

  @Test
  public void testTopicNames() {
    // STATE 1
    Assert.assertTrue("basename set not empty initially",
               topic.getTopicNames().size() == 0);

    // STATE 2
    TopicNameIF basename = builder.makeTopicName(topic, "");
    // added by builder

    Assert.assertTrue("basename not added",
               topic.getTopicNames().size() == 1);

    Assert.assertTrue("basename identity not retained",
               topic.getTopicNames().iterator().next().equals(basename));

    // STATE 2
    basename.remove();
    Assert.assertTrue("basename not removed",
               topic.getTopicNames().size() == 0);

    // verify that it's safe
    basename.remove();
  }

  @Test
  public void testRoles() {
    // STATE 1
    Assert.assertTrue("role set not empty initially",
               topic.getRoles().size() == 0);

    // STATE 2
    AssociationIF assoc = builder.makeAssociation(builder.makeTopic());
    AssociationRoleIF role = builder.makeAssociationRole(assoc, builder.makeTopic(), topic);

    Assert.assertTrue("role not added",
               topic.getRoles().size() == 1);

    Assert.assertTrue("role identity not retained",
               topic.getRoles().iterator().next().equals(role));

    role.setPlayer(topic);
    Assert.assertTrue("duplicate not rejected",
               topic.getRoles().size() == 1);

    try {
      role.setPlayer(null);
      Assert.fail("player could be set to null");
    } catch (NullPointerException e) {
    }
    Assert.assertTrue("player not retained", role.getPlayer().equals(topic));
  }

  @Test
  public void testRolesByType() {
    TopicIF type = builder.makeTopic();

    Assert.assertTrue("roles by non-existent type initially not empty",
               topic.getRolesByType(type).size() == 0);

    AssociationIF assoc = builder.makeAssociation(builder.makeTopic());

    // builder adds role to assoc
    builder.makeAssociationRole(assoc, type, topic);

    Assert.assertTrue("roles of correct type not found",
               topic.getRolesByType(type).size() == 1);

    // builder adds role to assoc
    TopicIF other = builder.makeTopic();
    TopicIF rtype = builder.makeTopic();
    builder.makeAssociationRole(assoc, rtype, other);

    Assert.assertTrue("role with no type found",
               topic.getRolesByType(type).size() == 1);

    Assert.assertTrue("role with no type not found",
               other.getRolesByType(rtype).size() == 1);
  }

  @Test
  public void testSubjectIndicators() {
    // STATE 1
    Assert.assertTrue("indicator set not empty initially",
               topic.getSubjectIdentifiers().size() == 0);

    URILocator indicator = null;
    try {
      // STATE 2
      indicator = new URILocator("ftp://ftp.ontopia.net");
      topic.addSubjectIdentifier(indicator);

      Assert.assertTrue("indicator not added",
                 topic.getSubjectIdentifiers().size() == 1);

      Assert.assertTrue("indicator identity not retained",
                 topic.getSubjectIdentifiers().iterator().next().equals(indicator));

      topic.addSubjectIdentifier(indicator);
      Assert.assertTrue("duplicate not rejected",
                 topic.getSubjectIdentifiers().size() == 1);
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given");
    }
    catch (ConstraintViolationException e) {
      Assert.fail("spurious ConstraintViolationException");
    }

    // STATE 3
    topic.removeSubjectIdentifier(indicator);
    Assert.assertTrue("indicator not removed",
               topic.getSubjectIdentifiers().size() == 0);

    // verify that it's safe
    topic.removeSubjectIdentifier(indicator);
  }

  @Test
  public void testSubjectIndicatorUnassignable() {
    TopicIF topic = builder.makeTopic();
    topic.remove();

    try {
      URILocator loc = new URILocator("http://www.ontopia.net");
      topic.addSubjectIdentifier(loc);
      Assert.fail("subject indicator assigned when not attached to topic map");
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) URL malformed");
    }
    catch (ConstraintViolationException e) {
    }
  }

  @Test
  public void testSubjectIndicatorDuplicate() {
    TopicIF t1 = builder.makeTopic();
    TopicIF t2 = builder.makeTopic();

    try {
      URILocator loc = new URILocator("http://www.ontopia.net");
      t1.addSubjectIdentifier(loc);

      try {
        t2.addSubjectIdentifier(loc);
        Assert.fail("accepted two subject indicators being set to the same URI");
      }
      catch (ConstraintViolationException e) {
      }
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) URL malformed");
    }
    catch (ConstraintViolationException e) {
      Assert.fail("constraint violated for no good reason");
    }
  }

  @Override
  @Test
  public void testTopicSubjectIndicatorSourceLocator() {
    // this is overridden from AbstractTMObject, because in this case
    // the collision is not allowed, but for all other TMObjectIFs it
    // is allowed (to provide reification)
    try {
      URILocator loc = new URILocator("http://www.ontopia.net");

      TopicIF topic = builder.makeTopic();
      object.addItemIdentifier(loc);

      topic.addSubjectIdentifier(loc);
      Assert.fail("allowed subject indicator of one topic to be source locator of another");
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given" + e);
    }
    catch (ConstraintViolationException e) {
    }
  }

  @Override
  @Test
  public void testSourceLocatorTopicSubjectIndicator() {
    // this is forbidden, according to the TMDM
    try {
      URILocator loc = new URILocator("http://www.ontopia.net");

      TopicIF topic2 = builder.makeTopic();
      topic2.addSubjectIdentifier(loc);

      topic.addItemIdentifier(loc);
      Assert.fail("subject identifier of one topic allowed to be item identifier " +
           "of another");
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given" + e);
    }
    catch (ConstraintViolationException e) {
    }
  }

  @Test
  public void testSourceLocatorTopicSubjectIndicator2() {
    // this is forbidden, according to the TMDM
    try {
      URILocator loc = new URILocator("http://www.ontopia.net");
      topic.addItemIdentifier(loc);

      TopicIF topic2 = builder.makeTopic();
      topic2.addSubjectIdentifier(loc);

      Assert.fail("item identifier of one topic allowed to be subject identifier " +
           "of another");
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given" + e);
    }
    catch (ConstraintViolationException e) {
    }
  }

  @Test
  public void testBug652a() {
    try {
      TopicIF topic = builder.makeTopic();
      URILocator loc = new URILocator("http://www.ontopia.net/A");
      topic.addItemIdentifier(loc);
      topic.addSubjectIdentifier(loc);
      topic.removeSubjectIdentifier(loc);
      topic.removeItemIdentifier(loc);
      topic.remove();
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given" + e);
    }
  }

  @Test
  public void testBug652b() {
    try {
      TopicIF topic = builder.makeTopic();
      URILocator loc = new URILocator("http://www.ontopia.net/B");
      topic.addSubjectIdentifier(loc);
      topic.addItemIdentifier(loc);
      topic.removeItemIdentifier(loc);
      topic.removeSubjectIdentifier(loc);
      topic.remove();
    }
    catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given" + e);
    }
  }

  @Test
  public void testBug652c() {
    try {
      TopicIF t1 = builder.makeTopic();
      URILocator loc = new URILocator("http://www.ontopia.net/B");
      t1.addSubjectIdentifier(loc);

      TopicIF t2 = builder.makeTopic();
      t2.addItemIdentifier(loc);
      Assert.fail("subject identifier of one topic allowed to be item identifier of " +
           "another");
    } catch (MalformedURLException e) {
      Assert.fail("(INTERNAL) bad URL given" + e);
    } catch (UniquenessViolationException e) {
      // this is the expected outcome
    }
  }

  @Test
  public void testDeleteInstanceOfSelf() {
    TopicIF topic = builder.makeTopic();
    topic.addType(topic);
    topic.remove();
    Assert.assertTrue("topic was not deleted", topic.getTopicMap() == null);
  }

  @Test
  public void testDeleteTopicWithRole() {
    // first create a ternary association
    TopicIF atype = builder.makeTopic();
    TopicIF other = builder.makeTopic();
    TopicIF roletype = builder.makeTopic();

    for (int ix = 0; ix < 150; ix++) {
      // must do this 100 times to trigger creation of TreeSet
      AssociationIF assoc = builder.makeAssociation(atype);
      builder.makeAssociationRole(assoc, roletype, other);
      builder.makeAssociationRole(assoc, roletype, topic);
    }

    // then delete the topic
    topic.remove(); // boom

    // now verify that it's gone
    Assert.assertEquals("wrong number of topics in TM",
                 3, topicmap.getTopics().size());
    Assert.assertTrue("wrong number of associations in TM",
               topicmap.getAssociations().size() == 0);
  }

  @Test
  public void testOccurrencesByType() {
    TopicIF type = builder.makeTopic();

    Assert.assertTrue("occurrences by non-existent type initially not empty",
               topic.getOccurrencesByType(type).size() == 0);

    builder.makeOccurrence(topic, type, "foo");

    Assert.assertTrue("occurrences of correct type not found",
               topic.getOccurrencesByType(type).size() == 1);

    builder.makeOccurrence(topic, builder.makeTopic(), "bar");

    Assert.assertTrue("occurrence with with incorrect type found",
               topic.getOccurrencesByType(type).size() == 1);
  }

  @Test
  public void testNamesByType() {
    TopicIF type = builder.makeTopic();

    Assert.assertTrue("names by non-existent type initially not empty",
               topic.getTopicNamesByType(type).size() == 0);

   builder.makeTopicName(topic, type, "foo");

    Assert.assertTrue("names of correct type not found",
               topic.getTopicNamesByType(type).size() == 1);

    builder.makeTopicName(topic, builder.makeTopic(), "bar");

    Assert.assertTrue("name with with incorrect type found",
               topic.getTopicNamesByType(type).size() == 1);
  }

  @Test
  public void testAssociations() {

    Assert.assertTrue("associations initially not empty",
               topic.getAssociations().size() == 0);

    builder.makeAssociation(builder.makeTopic(), builder.makeTopic(), topic);

    Assert.assertTrue("associations incorrect count",
               topic.getAssociations().size() == 1);

    builder.makeAssociation(builder.makeTopic(), builder.makeTopic(), topic);

    Assert.assertTrue("associations incorrect count",
               topic.getAssociations().size() == 2);
  }

  @Test
  public void testAssociationsByType() {
    TopicIF type = builder.makeTopic();

    Assert.assertTrue("associations by non-existent type initially not empty",
               topic.getAssociationsByType(type).size() == 0);

    builder.makeAssociation(type, builder.makeTopic(), topic);

    Assert.assertTrue("associations of correct type not found",
               topic.getAssociationsByType(type).size() == 1);

    builder.makeAssociation(builder.makeTopic(), builder.makeTopic(), topic);

    Assert.assertTrue("associations with with incorrect type found",
               topic.getAssociationsByType(type).size() == 1);
  }

  // --- Internal methods

  @Override
  public void setUp() throws Exception {
    super.setUp();
    topic = builder.makeTopic();
    parent = topicmap;
    object = topic;
  }

  @Override
  protected TMObjectIF makeObject() {
    return builder.makeTopic();
  }

}


text:
Efficacy and safety of Jin-shui Huan-xian granule for idiopathic pulmonary fibrosis: study protocol for a multicenter, randomized, double-blind, placebo-controlled trial
Shu-guang Yang1,2,3 na1,
Xue-qing Yu1,2,3 na1,
Jian-sheng Li1,2,3,
Yang Xie1,2,3,
Wei Zhang4,
Chengjun Ban5,
Jihong Feng6,
Lei Wu7,
Xuechao Lu8,
Limin Zhao9,
Yong Meng10,
Miao Zhou11,
Yong He12 &
Weixian Luo13
Trials volume 23, Article number: 725 (2022) Cite this article
Background and rationale
Idiopathic pulmonary fibrosis is a critical disease with a poor prognosis. Although different studies have been conducted for the treatment of idiopathic pulmonary fibrosis, limited treatments are available. Jin-shui Huan-xian granule (JHG), which is a Chinese medicine herbal compound, has shown promising efficacy in reducing frequencies of acute exacerbations, improving exercise capacity the quality of life of patients with idiopathic pulmonary fibrosis. This study is to evaluate the efficacy and safety of JHG for IPF.
This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 312 idiopathic pulmonary fibrosis patients will be enrolled and randomly allocated to one of the two groups with 1:1. After a 2-week washout period, 52-week treatment will also be performed for all the patients. Patients in the experimental group and the control group will be given JHG and JHG placebo, respectively. Outcome measures including acute exacerbations, pulmonary function, dyspnea, exercise capacity, and quality of life will be evaluated in this study.
Based on our previous study, it is hypothesized that JHG will reduce acute exacerbations; improve exercise capacity, pulmonary function, and quality of life; and delay the disease progression-free. High-level evidence-based support for TCM in IPF will also be obtained in this study.
Trial registration
ClinicalTrials.gov NCT04187690. Register on December 11, 2019
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease with poor prognosis and short median survival [1]. The etiology remains not completely clear [2]. With a low prevalence rate, some scholars consider it as a rare disease [3]. In China, it has also been included in the list of rare diseases in 2018. However, different studies show that it has been more common in recent years [4, 5]. After diagnosis, IPF patients will follow a median survival of 2–5 years [5]. Data also shows that IPF patients in Sweden will spend an annual average of $13,975 for hospitalization [6]. In America, a total of 2 billion dollars has been spent on the prevention and treatment of IPF every year [7]. IPF has caused a heavy socio-economic burden.
Although different studies have been performed in recent years, the available treatments remain limited. As reported in the latest international guidelines for IPF, only pirfenidone and nintedanib are recommended in clinical application [8]. They could improve pulmonary function, quality of life, and exercise capacity and delay the disease progression for IPF patients [9,10,11]. However, the related side effects have also been reported. One study showed that a total of more than 10% of IPF patients taking pirfenidone or nintedanib have discontinued medication permanently due to side effects [12], and their long-term effects are still under debate. Up to now, evidences for other drugs are still insufficient [13,14,15,16,17,18,19,20]. Limited researches have also been performed on non-drug treatment for IPF [21]. However, the levels of the available evidences are also low. It is urgent to conduct further researches on the treatments of IPF [22].
Traditional Chinese medicine (TCM) has different treatments and certain efficacy for respiratory diseases. Chinese herbal medicine (CHM) is the most used measures. According to TCM theory and our previous studies, IPF should be treated according to feiwei or feibi, and the core TCM pathogenesis includes vital qi deficiency, lung collaterals obstruction, phlegm and blood stasis, and accumulation of damage. We have also developed a TCM therapeutic scheme for IPF based on the above studies. Then, the CHM formulation has been optimized to Jin-shui Huan-xian granule (JHG) by clinical application and basic experiments.
JHG is a Chinese medicine compound. Our previous study shows it has a potential treatment effect by inhibiting the differentiation of fibroblasts into myofibroblasts in a pulmonary fibrosis mouse model [23]. We have also performed an exploratory trial to assess the efficacy and safety for IPF patients. The results show that JHG could reduce the frequencies of acute exacerbation and improve lung function and exercise capacity with a reliable safety for IPF patients (to be published). To obtain high-level evidence-based supports, we will conduct a randomized controlled trial to confirm the efficacy and safety of the Jin-shui Huan granule for IPF.
The following contents will be paid attention to in our study: (1) to assess JHG in reducing AEs and improving exercise capacity for IPF, (2) to evaluate the JHG in improving clinical symptoms and quality of life, and (3) safety of JHG will also be assessed.
Methods/design
This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. The efficacy and safety of JHG for IPF will be assessed in this study. We will recruit 312 stable IPF patients and randomly assign them into the experimental group or the control group with a ratio of 1:1 after a wash-out period of 2 weeks. Then, all the enrolled patients will be given a 52-week treatment of JHG or placebo. The outcomes assessed in this study include frequencies of acute exacerbations, exercise capacity, proportion of progression-free patients, lung function, all-cause mortality, clinical symptoms and signs, dyspnea, health-related quality of life (HRQoL), and adverse events. The protocol follows the Standard Protocol Items for Clinical Trials with Traditional Chinese Medicine 2018: Recommendations, Explanation and Elaboration (SPIRIT-TCM Extension 2018) [24]. The study will also be conducted in accordance with the Declaration of Helsinki (as revised in 2013). The whole study flow chart is found in Fig. 1.
The whole flow chart for this study
Patients' eligibility and criteria
Diagnosis criteria of IPF
The diagnosis of IPF will be performed referring to the classification and diagnosis standard of idiopathic interstitial pneumonia published by the American Thoracic Society and European Respiratory Society in 2018 [25]: (1) patients with any other known causes of interstitial lung disease (ILD), such as occupational environment exposure, connective tissue disease, or drugs, should be excluded; (2) for the patients without surgical lung biopsy, high-resolution CT (HRCT) should show a representation of usual interstitial pneumonia (UIP); (3) a specific combination of HRCT and lung biopsy histopathological results should be met for the patients with a surgical lung biopsy; and (4) if necessary, a multi-disciplinary discussion would also be adopted for difficult cases.
Diagnostic criteria of TCM syndromes
Because of that, there is a lack of diagnostic criteria for TCM syndromes for IPF; now, the differentiation of TCM syndromes will be referred to the Diagnostic criteria of TCM syndromes for diffuse interstitial lung disease [26]. Two independent TCM researchers will perform the syndrome differentiation blindly. If any disagreement appears, the third researcher will be consulted, and a consensus will be reached. The core TCM pathogenesis, which is the accumulation and damage of collaterals due to deficiency of vital qi, will also be taken into account [27]. So, IPF patients with TCM syndromes including lung qi deficiency, lung-kidney qi deficiency, and yin deficiency and inner heat will also be enrolled in this study.
Any participant should meet all of the following criteria: (1) meeting the diagnostic criteria of IPF; (2) with ages between 40 and 85 years old; (3) meet the criteria of TCM syndrome differentiation: patterns of lung qi deficiency, lung-kidney qi deficiency, and yin deficiency and inner heat [16]; (4) not participating in any other interventional trial within the previous one month before enrollment; and (5) signing the informed consent form.
The patients meeting any of the following criteria will be excluded: (1) pregnant and breastfeeding women or patients with a recent pregnancy plan; (2) delirious, dementia, or with any mental disorder; (3) complicated with severe cardiac insufficiency, liver and kidney diseases, bronchial asthma, chronic obstructive pulmonary disease, tumor, or thoracic deformity; (4) with a condition of limb dysfunction or bedridden; and (5) known to be allergic to any component of the therapeutic drugs.
Drop-out criteria
Drop-out criteria have been set up as follows: (1) not willing to continue the trial with any reason and may induce the incompleteness of study data, (2) should not continue to participate in the trial due to allergy or serious adverse events, and (3) patients who are no longer taking the given medication and physical examination and lost in the visit.
Eliminated criteria
The enrolled patients will also be withdrawn for any of the following criteria: (1) poor adherence to medication with rates of less than 80% or more than 120%, (2) taking any drug prohibited in this program, and (3) discontinued the given drugs themselves. According to our previous study, the withdrawing rate will be not higher than 20%. All the records for all the eliminated patients will also be preserved.
The calculation formula (n = (uα + uβ)2(1 + 1/k)σ2/δ2) based on the comparison of the means of two independent samples has been adopted to calculate the target sample size. N and k*n represent the target sample size of the experimental and control groups, respectively. The total variance (σ2) will be represented by the sample variance (s2). The formulas s2 = (se2 + ksc2)/(1 + k) and δ = |‾xe − ‾xc| have also been adopted. ‾xe and ‾xc represent the means of the experimental and control groups, while se and sc represent the standard deviation (SD), respectively. Two-tailed values of α and β are 0.05 and 0.01, respectively. The ratio of the experimental and control group samples in this trial is 1:1, so the k value is 1.
Based on our previous clinical trial (to be published), the frequencies of AEs and 6-min walking distance (6MWD) have been set up as the primary outcomes in this trial. There was a significant difference between the two groups in our previous study for AE. So, the calculation of sample size in this study will refer to 6MWD.
For 6MWD, the mean was 374.38 m in the experimental group and 342.57 m in the control group. The SD was 87.67 m in the experimental group and 81.18 in the control group. The target sample size in each group was 124. Taking a drop-out rate of 20%, the target sample size is 156 in each group, and the total target sample size is 312.
Ethics, oversight, recruitment, and dissemination
The study has been approved by the Ethical Committees of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine with an identifier (version 2019.07.18.1.0.1.0) 2019HL064-01. Any other revisions of the study protocol will also be submitted to the ethical committee for approval. The whole process of the trial will also be supervised by the Ethical Research Committees of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine. The ethics committee is composed of people with different professions, including non-medical people. The approved protocol will protect the interests of participants. The informed consent will be obtained from all individual participants by the special screener in every research center. Any adverse event will also be submitted to the ethical committees as soon as possible. All the participants will provide written informed consent. Blood and urine samples and exhaled breath condensate will be collected with the participants' consent for further researches. The authors are accountable for the accuracy of all aspects of the study. Any question related to any part of the work will be investigated and resolved.
Open recruitment for IPF patients will be performed both in outpatient and inpatient. Publishing recruitment advertisements will also be adopted, and the enrolled patients will be observed in 11 research centers in China, which are the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Shanghai Shuguang Hospital, Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Hebei Province Traditional Chinese Medicine Hospital, Qingdao Hici Hospital, Henan Provincial People's Hospital, Henan Province Hospital of Traditional Chinese Medicine, Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou Chinese Medicine Hospital, and Zhengzhou First People's Hospital. All the sub-centers have the qualification and experience in performing TCM trials. Recruitment will last for 12 months from September 2020 or until the target sample is completed. The results of this study will be disseminated to the public in peer-reviewed journals without any patient's personal information. The raw data will also be available upon request to the authors.
Randomization and masking
A design of block randomization has been applied to perform the allocation. All the enrolled patients, who meet the inclusion criteria and sign the informed consent, will be randomly assigned to the experimental group or the control group in a ratio of 1:1 after a 2-week wash-out period. The random numbers from 001 to 312 were generated by SAS 9.2 and saved by an independent researcher. The random numbers and corresponding drug codes are the unique identification code of participants. The randomization sequence will be generated in a website program (cloud.medroad.cn) by an independent researcher out of the trial team. After necessary baseline evaluation for each participant who agreed to be enrolled, randomization will be performed. The random number generated by the above website program will be given to a trial team researcher for completing the enrollment. The random sequence will be preserved within opaque, sealed envelopes by an independent researcher for allocation concealment.
All the patients, recruiters, data collectors, outcome assessors, and sponsors will be all blind to the treatment allocation and what each intervention envelope included in the whole process of the trial. In case of emergency, the corresponding random number and treatment allocation will be identified for researchers and supervisors as soon as possible. The randomization design and random numbers are provided by the Jiangsu Famous Medical Technology Co., Ltd. in Nanjing, China.
Procedures and interventions
Patients in the experimental group will be treated with JHG for 52 weeks, while the control group are treated with a JHG placebo. JHG is a Chinese herbal compound medicine. The compounds of one dosage for JHG are found in Table 1. The placebo used in this study will contain 5% of the same components of JHG. All the JHG and placebo will be produced and packed by Jiang Yin Tian Jiang Pharmaceutical Co. Ltd., Jiangsu, People's Republic of China, without any difference in the appearance, color, smell, and weight. The drug quality will be tested by the organization with specific qualifications before application and consistent with the required quality standards. Each dosage of JHG granules or placebo has been produced and packed into 4 bags with 10.9 g per bag (Batch number: 2006337). JHG or JHG placebo will be prescribed 2 bags each time, twice a day orally with 5 days on and 2 days off.
Table 1 Components of Jin-shui Huan-xian granules
At the same time, all the patients will also be treated with conventional modern medicine. Considering the side effects and costs, the application of pirfenidone and nintedanib will not be limited uniformly. During the whole procedure, all the patients will be visited every 13 weeks and receive given physical examinations. Blood and urine samples and exhaled breath condensate will be collected with the participants' consent for further researches. If patients are under AE, the Chinese medicine granule or placebo will be suspended until the condition becomes stable. To improve the patients' adherence, the remaining drugs and empty bags will also be returned except for regular telephone follow-up. The whole procedure for each patient is found in Fig. 2.
Research flow chart for every participants in the study
Assessment will be performed by outcome measures at baseline, end of treatment, and given follow-up points. The primary outcomes include frequencies of AEIPF, 6-min walking distance (6MWD), and the proportion of patients with disease progression-free. The secondary outcomes include pulmonary function, all-cause mortality, clinical symptom and signs, dyspnea, and health-related quality of life (HRQoL).
Exacerbations of IPF
The frequencies of acute exacerbations of IPF, which is assessed by AEIPF-related hospitalization, is the primary outcome measure. AEIPF is characterized by significant respiratory deterioration, with an unknown cause within the past 1 month [28]. If the interval between any two AEIPF-related hospitalizations is less than 7 days, they are considered as one AE. The AE will be recorded at every visit, and the total number in the whole process (1-year treatment period) will be calculated. A higher number in a given period indicate the deterioration of IPF and a worse prognosis. A lower number in the experimental group will indicate better efficacy.
6MWD
6MWD is adopted to assess the exercise capacity of IPF patients. It is evaluated by the distance an IPF patient can walk as fast as he/she can in 6 min. A longer distance indicates better exercise capacity for IPF patients.
Proportion of disease progression-free survivals
The endpoints of free disease progression in this study include any of the following events [29]: forced vital capacity (FVC) decreased by 10%, diffusing capacity percentage of the predicted value (DLCO%) by 15% compared to baseline, patient death, and lung transplantation. At the end of treatment, the proportion of the patients without any of the above endpoints will be calculated.
FVC and DLCO% will be examined at baseline and at the end of the treatment. A positive change will indicate the improvement of pulmonary function.
All-cause mortality
Any death for IPF patients in this study with any cause will be recorded and counted. All-cause mortality will be calculated at the end of the treatment in each group. A lower number in the experimental group indicate a better efficacy for the intervention in improving prognosis.
Clinical symptoms and signs
Assessment will be performed by a clinical symptom assessment questionnaire. The clinical symptoms to be evaluated in this study include cough, expectoration, chest tightness, shortness of breath, wheezing, and cyanosis. A score of 0–3 will be given to every symptom or sign with a higher score indicating a worse condition.
Dyspnea will be assessed by the Modified Medical Research Council (mMRC) scores set up by the American Thoracic Society [30]. A score of 0–4 will be given according to the degree of immediate dyspnea. A higher score indicates worse dyspnea.
Health-related quality of life
HRQoL will be assessed by the COPD Assessment Test (CAT), St. George's Respiratory Questionnaire (SGRQ), 36-Item Short-Form Health Survey (SF-36), and A Tool to Assess Quality of life in IPF (ATAQ-IPF), with a higher value indicating a better HRQoL for SF-36 and a worse HRQoL for CAT, SGRQ, and ATAQ-IPF. CAT [31], which includes 8 items with a value of 0 to 5 for each item, is a self-assessment questionnaire commonly used in COPD evaluation. Because of the similarity of the assessment symptoms, it was adopted in this study. SF-36 [32], which includes 36 items in 8 domains, is a universal scale for the assessment of health impairment in a wide range of field. SGRQ [33], with 50 items in 3 domains, is widely adopted to assess health impairment for respiratory diseases. The total scores of SGRQ and SF-36 will be counted by weighing of each item. ATAQ-IPF is an IPF-specific questionnaire to assess the HRQoL of IPF patients. There are 13 domains and 74 items with a score of 1–5 for each item in ATAQ-IPF [34]. All the questionnaires will be completed by the patients themselves. Patients should choose an option which is most consistent with their current condition for each item. If necessary, the researchers could provide help. Then, the researchers complete the scoring.
Safety outcomes
We will also evaluate the safety of interventions in this study. Safety outcome measures, including routine blood, urine, and stool tests; liver and kidney function tests; and electrocardiography, will be examined. Any adverse events will also be recorded and managed according to the degrees of damage at any time they occur during the treatment period. Then, we will also report to the ethics committee for further management. Based on our previous studies, the possible adverse events are transient gastrointestinal discomfort without the need for intervention.
Pulmonary function, routine blood, urine and stool tests, liver and kidney function tests, and electrocardiography will be tested and recorded at baseline (week 0), at 6 months after treatment (week 26), and at the end of the treatment (week 52). 6MWT, clinical symptoms and signs, MMRC, CAT, SF-36, SGRQ, and ATAQ-IPF will be completed and recorded at week 0, week 13, week 26, week 39, and week 52 in the process of trial.
To help improve the quality of research, different quality control measures will be adopted throughout the whole process. Before the study, a research team including clinicians, statisticians, ethicists, pathologists, and radiologists has been set up to discuss and form the study protocol, and standard operating procedures (SOPs) for each step of the trial, such as registration, recruitment, and visit for all the enrolled patients, have also been formulated by the research team to ensure the accuracy and completeness of the obtained data in the trial. Every researcher in each center will be trained on the SOPs. The research procedures, completion and normalization of case report forms (CRFs) in each center will also be examined periodically by independent researchers, which is another important means to help improve research quality.
Data management and statistical analysis plan
Statistical analysis will be conducted both in the intent-to-treat (ITT) and pre-protocol (PP) data. ITT analysis will be applied to analyze the safety data. All the data from any included patients will be analyzed regardless of their withdrawal from the trial. The PP analysis will be adopted to assess the efficacy of the interventions. If data permit, sub-group analysis will also be performed to help clarify the therapeutic effect of interventions.
All the P values will be set as two-tailed with a significant level of 0.05. Measurement data will be shown with mean ± SD, median, and inter-quartile range. Count data will be presented by frequency or composition ratio. Analysis of variance (ANOVA) will be used to test for the differences in continuous variables, with the chi-square test for categorical variables. If necessary, the paired t-test will be applied to intra-group comparison data with normal distribution and homogeneous variance, and the Wilcoxon signed-rank sum test will be used for non-normal distribution or uneven variance. Repeated-measures ANOVA will be used to test the continuous response variables that are measured at more than two time points for the same patient, such as 6MWT, clinical symptoms and signs, mMRC, and HRQoL. To improve the quality of data, all the data management and statistical analysis will be conducted by the Jiangsu Famous Medical Technology Co., Ltd. in Nanjing, China.
Based on our previous study, it is hypothesized that JHG will reduce the frequencies of acute exacerbations; improve exercise capacity, pulmonary function, and quality of life; and delay the disease progression-free. High-level evidence-based support for traditional Chinese medicine in idiopathic pulmonary fibrosis will also be obtained in this study.
TCM has a long history and certain efficacy in the treatment of respiratory diseases. However, there was still no consensus for disease name and core pathogenesis of IPF in TCM, which also limits the clinical application. We have also conducted abundant researches in TCM for IPF. Based on the summary of the literatures and clinical experience, we hold that IPF should be treated by referring to feiwei or feibi in TCM [35].
We have also conducted an exploratory trial to evaluate the efficacy and safety of TCM treatment based on syndrome differentiation preliminarily. The results preliminarily clarified the efficacy and safety of TCM treatment based on syndrome differentiation and provide evidence-based support for TCM in IPF. However, the interventions were given according to the different patterns of syndrome differentiation. It may be difficult for clinical application, especially for non-TCM doctors. For TCM, treatment based on syndrome differentiation has been the critical method for thousands of years. In general, TCM doctors will discriminate the different patterns of syndromes first according to the clinical performance and characteristics. However, clinical performance and characteristics are atypical, which would limit TCM syndrome differentiation, and the sample size is small, which will limit the level of evidence. Therefore, to obtain high-level evidence-based support and apply it conveniently, further confirmatory study for core TCM pathogenesis and Chinese medicine is urgent. As we also know, this is the first multi-centers large-sample randomized controlled trial to clarify the efficacy and safety of Chinese herbal medicine.
In recent years, different studies have shown the efficacy and safety of TCM for IPF [36, 37]. Most of them were small-sample studies with a deficiency of standard design and research procedures for high-level evidences. Evidence-based supports of TCM for IPF have not been well-presented. The clinical application has also been limited. In view of these deficiencies, we adopted a design of standard RCT based on the discussion and conclusion of the previous studies. The international standard study procedure, such as trial registration, patient enrollment, and follow-up, has also been adopted. To further improve the quality of the study, related SOPs have also been formulated. In the future study process, the implementation of SOPs will be examined and discussed periodically. If necessary, we will adjust the part of unsuitable contents according to the actual state. We believe that this study will also provide some references for the TCM standard researches.
Our previous study has revealed the possible active components and potential targets for JHG in the treatment of IPF [38]. A total of 136 compounds from JHG and 265 potential targets have been found. The compounds could exert a synergistic effect by regulating these similar targets probably. JHG could also ameliorate pathological changes and collagen deposition in bleomycin-induced pulmonary fibrosis rats [23], and inhibited NADPH oxidase 4 (NOX4) levels and increased the nuclear factor erythroid 2-related factor 2 (Nrf2) in lung tissues could also be found. In vitro, transforming growth factor β1 (TGF-β1)-induced differentiation of fibroblasts could also be significantly inhibited by JHG. So, we concluded that JHG may show long-term effects in bleomycin-induced pulmonary fibrosis rats. The clinical efficacy of JHG will also be confirmed by the results of this study.
However, there are still some limitations to this study. This study aims to the core TCM pathogenesis and Chinese medicine for IPF. TCM treatment based on syndrome differentiation is not taken into account. The actual advantages of TCM, such as individualized treatment, will be discounted. However, it is unavoidable under the current research conditions. Combined with studies with other design types, such as cohort studies, the advantages of TCM may be presented better at different levels.
Based on our previous research, this study will confirm the hypothesis that JHG could reduce acute exacerbation, improve exercise capacity, delay disease progression, and improve pulmonary function and quality of life for IPF patients with sound safety. The results will provide high-level evidence-based supports for TCM in the treatment of IPF. The study design will also provide critical references for TCM studies on core pathogenesis.
Trial status
At the moment of manuscript submission, 70 IPF patients have been enrolled in this study and recruitment is in progress.
Data availability is not applicable for this article as no datasets have been generated or analyzed during the current stage.
6MWD:
Six-minute walking distance
AE:
Acute exacerbation
ATAQ-IPF:
A Tool to Assess Quality of life in IPF
CAT:
COPD assessment test
DLCO%:
Diffusing capacity percentage of the predicted value
FVC:
Forced vital capacity
HRQoL:
ILD:
IPF:
JHG:
Jin-shui Huan-xian granule
mMRC:
Modified Medical Research Council
RCT:
SF-36:
36-Item Short-Form Health Survey
SGRQ:
St. George's Respiratory Questionnaire
SOPs:
TCM:
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This study is supported by the Construction Project of Traditional Chinese Medicine in Henan Province Characteristic Disciplines (STS-ZYX-2019029), Special Scientific Research Project of National Clinical Research Base of Traditional Chinese Medicine of China (2018JDZX006), and Henan Provincial Special Support Program for High-level Talent ("Central Plains Thousand Talents Program", 194200510018).
Shu-guang Yang and Xue-qing Yu contributed equally to this work.
Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, 450046, Henan, China
Shu-guang Yang, Xue-qing Yu, Jian-sheng Li & Yang Xie
Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Jin-shui East Road 156, Zhengzhou, 450046, Henan, China
Department of Respiratory Disease, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, Henan Province, China
Department of Respiratory Disease, Shanghai Shuguang Hospital, Shanghai University of Chinese Medicine, Shanghai, 200000, China
Department of Respiratory Disease, Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine, Beijing, 100000, China
Chengjun Ban
Department of Respiratory Disease, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, China
Jihong Feng
Department of Respiratory Disease, Hebei Province Hospital of Traditional Chinese Medicine, Shijiazhuang, 050000, Hebei, China
Department of Respiratory Disease, Hiser Medical Center of Qingdao, Qingdao, 266000, Shandong, China
Xuechao Lu
Department of Respiratory Disease, Henan Provincial People's Hospital, Zhengzhou, 450000, Henan, China
Limin Zhao
Department of Respiratory Disease, Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou, 450000, Henan, China
Yong Meng
Department of Respiratory Disease, The Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, Henan Province, China
Miao Zhou
Department of Respiratory Disease, Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou, 450000, Henan, China
Yong He
Department of Traditional Chinese Medicine, Zhengzhou First People's Hospital, Zhengzhou, 450000, Henan, China
Weixian Luo
Shu-guang Yang
Xue-qing Yu
Jian-sheng Li
Yang Xie
(a) Conception and design: JL and XY. (b) Administrative support: XY. (c) Provision of the study materials or patients: XY, WZ, CB, JF, LW, XL, LZ, YM, YH, and WL. (d) Collection and assembly of the data: SY and YX. (e) Data analysis and interpretation: XY and SY. (f) Manuscript writing: XY, SY, and JL. (g) Final approval of the manuscript: all authors.
Correspondence to Jian-sheng Li.
The protocol has been reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine with an ID 2019HL064-01. All the included patients will provide written informed consent before enrollment.
Auditing: The supervision will be performed by the Ethics Committee of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.
Protocol amendments: Any modification to this protocol will be approved and performed by the Ethics Committee of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.
Ancillary and post-trial care: After the trial, all the participants could also get health guidance and necessary treatment if they need it.
Yang, Sg., Yu, Xq., Li, Js. et al. Efficacy and safety of Jin-shui Huan-xian granule for idiopathic pulmonary fibrosis: study protocol for a multicenter, randomized, double-blind, placebo-controlled trial. Trials 23, 725 (2022). https://doi.org/10.1186/s13063-022-06684-0

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: How to add s7graphview to a subview on ViewController nib? I have a xib with a subview that I set to Class: S7GraphView (if I select it and click on the identity inspector)
When all I have in the (void) didViewLoad { ...
    s7graphView = [[S7GraphView alloc] initWithFrame:[self.view bounds]];
    //[self.view addSubview:s7graphView];
    s7graphView.dataSource = self;
    ...
}

In the nib, I control-hold the file's owner to the subview and select - S7GraphView and it still shows up empty in the simulator.
If I comment all this out, I get a black subview (I do set the background to black) but not graph:
//    s7graphView = [[S7GraphView alloc] initWithFrame:[self.view bounds]];
//    //[self.view addSubview:s7graphView];
//    s7graphView.dataSource = self;
//    [s7graphView release];

If I remove the subview from my view and instead add it programmatically, it works when I add it like this:
s7graphView = [[S7GraphView alloc] initWithFrame:CGRectMake(20., 70., 280.0, 240.0 )];
[self.view addSubview:s7graphView];
s7graphView.dataSource = self; [s7graphView release];

I should be able to add it via the xib too, right?  What do youz think I'm doing wrong?
Thanks!!

A: Have you implemented the delegate and the datasource?

redpajama_set_name: RedPajamaStackExchange


Friday, April 25 sees the start of the 16th edition of Europe's biggest and finest festival for popular Asian cinema -- the Udine Far East Film Festival. During the busy and eventful nine days, attendees will be able to watch some of the most highly praised -- and undoubtedly carefully selected -- regional offerings, many of which will have their International and European premieres. Given that most of the pictures shown in the competition section probably won't be distributed widely across the old continent, it's a wonderful opportunity to catch up on Asian mainstream film right in the heart of Italy's wealthy and welcoming provincial town.
I'll be attending the highly regarded event for the first time this year, and since I've heard so many great things about it from many of my fellow cinephiles, I can't tell you how excited I am right now. As part of preparation for the Far East Film Festival, I created the following ScreenAnarchy list of ten most anticipated films. Nevertheless, there's much more goodness, and many hidden gems, in the impressive line-up, so don't forget to check it out. I'm sure everyone will find something of interest there.
Perhaps the biggest surprise not only of the Berlinale, but also in the festival circuit, Diao Yinan's stylish noir thriller has undeniably become the most talked about Chinese indie of the year. The trailer looks impressive, and so does the plot. Black Coal, Thin Ice is yet another sign of the inexhaustible power that lies in Chinese new wave of filmmaking. Bonus: Diao Yinan will be present at the festival.
Nakamura Yoshihiro (Fish Story, Golden Slumber) is known for his ability to puzzle the viewer with clever plot twists. Set against the backdrop of a world beset by social media addiction, The Snow White Murder Case promises to be a gripping and intense mystery thriller with more than enough fresh material to beguile the audience. It's based on a novel by Minato Kanae, one of Japan's most noted contemporary writers, and stars some of the country's most beloved performers.
Johnnie To is definitely one of Twitch's favorite and one of Hong Kong's most versatile directors working today. Ferris Lin's Boundless is actually a second documentary made about the legendary filmmaker, but as some of you may know Yves Montmayeur's 60min ode Johnnie Got His Gun! (2010) wasn't much of a success. Seeing the first very positive first reviews, Boundless might be the insightful and telling doc that Johnnie To truly deserves.
Fruit Chan aspires to be the most original and creative voice of Hong Kong, and his many absorbing creations verify this claim with unflinching precision. With dark comedy The Midnight After the director ventures into post-apocalyptic territory. Ben Croll saw the film during Berlinale and called it a maddening pop-art apocalypse. Bonus: Fruit Chan will be the festival's guest of honor.
Broken is only Lee Jeong-ho's sophomore feature, but the subject he chose for his second film couldn't be more on the spot. Though some may argue, it's really hard to get tired of Korean revenge films and, if Broken uses the full potential of Keigo Higashino's gripping novel The Hovering Blade, it will surely be more successful than its mediocre Japanese predecessor.
Yakumo Saiji's debut film is Udine's only World Premiere. If you're a fan of Japanese teenage dramas than you'll probably be interested in this story of a young girl named Momose who, due to unforeseen circumstances, is forced to pretend to be a girlfriend of an unpopular high school student, while still being in love with another boy. Sounds very hearty and real, doesn't it? Bonus: Yakumo Saiji will be present at the festival.
I think this film doesn't really need a longer comment. Udine gives its attendees from Europe a rare and early chance to catch the film in a packed theater. In his Sundance review Ryland Aldrich calls The Raid 2 the most epic martial arts film ever made.
Firefighting genre seems to be in a desperate need of a revival, and Derek Kwok's polished, fierce and realistic As the Light Goes Out might be just what the doctor ordered. One of Hong Kong's box office kings of the first quarter of 2014, As The Light Goes Out aims to be Udine's strongest actioner. Bonus: Derek Kwok will be present at the festival.
Let's be honest, any movie that Miyazaki Hayao deems untruthful immediately becomes intriguing. Yamazaki Takashi's The Eternal Zero focuses on a Japanese World War II pilot and, when it comes to aerial footage, looks insanely breathtaking. The film also features "Zero" fighter aircrafts, the same ones designed by Jiro from Miyazaki's The Wind Rises. A lot of controversy surrounds the picture but, as they say, there's no such thing as bad publicity.
Reportedly Malaysia's highest grossing picture of all time, Chiu Keng Guan's joyous and family-friendly road dramedy The Journey takes on the theme of cross-cultural marriage. A film that people from all over the globe can openly relate to, The Journey tackles true meaning of family in a heartfelt manner. Bonus: Chiu Keng Guan will be present at the festival.


text:
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Alaska, Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Montana, Rhode Island, and Utah.
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Hemp and Marijuana are simply broad classifications of Cannabis that were adopted into our culture; however, they are not legitimate nomenclature for the Cannabis plant.
- "Hemp" is a term used to classify varieties of Cannabis that contain 0.3% or less Delta-9-THC content (by dry weight).
- "Marijuana" is a term used to classify varieties of Cannabis that contain more than 0.3% Delta-9-THC (by dry weight) and can induce psychotropic or euphoric effects on the user.
Hemp vs Marijuana: Composition
The defining characteristic between hemp and marijuana is the chemical composition contained within each plant.
Both hemp and marijuana can produce high amounts of CBD, the non-intoxicating cannabis compound; however, THC is produced at very different levels.
Hemp vs Marijuana: Legality
While hemp was previously regulated as an illegal substance under the Controlled Substance Act of 1970, it was removed as an illegal substance under the Agricultural Improvement Act of 2018, which federally legalized hemp and hemp-derived products that contain no more than 0.3% Delta-9-THC.
Marijuana, on the other hand, is still treated as a controlled substance and is federally illegal under the Controlled Substance Act.
Delta (9)-tetrahydrocannabinol is the chemical name for THC for the primary psychoactive ingredient in illicit, medical, and recreational marijuana.
Delta (8)-tetrahydrocannabinol is an isomer of Delta 9 THC, meaning they have the same chemical formula (C21H30O2) but different, distinct structures.
Isomers are molecules with identical formulas but distinct structures.
Agricultural Improvement Act of 2018
(One Hundred Fifteenth Congress of the United States of America)
December 20th 2018: Statement from FDA Commissioner Scott Gottlieb, MD, on signing of the Agriculture Improvement Act and the agency's regulation of products containing cannabis and cannabis-derived compounds
"This new law changes certain federal authorities relating to the production and marketing of hemp, defined as cannabis (Cannabis sativa L.), and derivatives of cannabis with extremely low (less than 0.3 percent on a dry weight basis) concentrations of the psychoactive compound delta-9-tetrahydrocannabinol (THC). These changes include removing hemp from the Controlled Substances Act, which means that it will no longer be an illegal substance under federal law.
Just as important for the FDA and our commitment to protect and promote the public health is what the law didn't change: Congress explicitly preserved the agency's current authority to regulate products containing cannabis or cannabis-derived compounds under the Federal Food, Drug, and Cosmetic Act (FD&C Act) and section 351 of the Public Health Service Act. In doing so, Congress recognized the agency's important public health role with respect to all the products it regulates. This allows the FDA to continue enforcing the law to protect patients and the public while also providing potential regulatory pathways for products containing cannabis and cannabis-derived compounds.
We're aware of the growing public interest in cannabis and cannabis-derived products, including cannabidiol (CBD). This increasing public interest in these products makes it even more important with the passage of this law for the FDA to clarify its regulatory authority over these products. In short, we treat products containing cannabis or cannabis-derived compounds as we do any other FDA-regulated products — meaning they're subject to the same authorities and requirements as FDA-regulated products containing any other substance. This is true regardless of the source of the substance, including whether the substance is derived from a plant that is classified as hemp under the Agriculture Improvement Act. To help members of the public understand how the FDA's requirements apply to these products, the FDA has maintained a webpage with answers to frequently asked questions, which we intend to update moving forward to address questions regarding the Agriculture Improvement Act and regulation of these products generally."
FDA's Regulations for CBD FAQ:
*CBD is legal to sell, but not as dietary supplements, or as food/edibles.
Is it legal for me to buy CBD products?
It depends, among other things, on the intended use of the product and how it is labeled and marketed. Even if a CBD product meets the definition of "hemp" under the 2018 Farm Bill (see Question #2), it still must comply with all other applicable laws, including the FD&C Act. The below questions and answers explain some of the ways that specific parts of the FD&C Act can affect the legality of CBD products.
October 31st 2019: Establishment of a Domestic Hemp Production Program
Article: Hemp is legal. Here comes the tricky part
"The US Department of Agriculture this week posted formal federal guidelines for how hemp — the versatile cannabis varietal used for clothing, plastics, fuel and food — can be grown, harvested, tested, processed, transported and sold. The USDA also established the US Domestic Hemp Production Program to regulate the cannabis plant.
Under the new program, states and Native American tribes will have to submit for approval hemp production plans that meet or exceed the USDA's standards. For those states and tribes that don't submit a plan, these federal guidelines will apply.
The USDA's rules address concerns such as interstate transport — states can't prohibit it — and the acceptable levels of THC in hemp. The USDA didn't address the exportation of hemp and indicated it may consider exports in the future.
The USDA standards help tie up some of the loose ends left from the 2018 Farm Bill that legalized the cannabis varietal that contains no more than 0.3% of the psychoactive tetrahydrocannabinol (THC).
More farmers have turned to the crop as grain prices fall, trade war concerns heat up, the climate changes and cannabis laws shift. Notably, hemp was viewed as a cheaper means of producing the lucrative cannabidiol (CBD), the cannabis compound promoted for health and wellness benefits.
The USDA regulations outline a "measurement of uncertainty" of plus or minus 0.06%; but to be considered hemp and not federally illicit cannabis, the 0.3% of THC must fall within that distribution. Labs that test the plants must be facilities registered with the Drug Enforcement Administration, and plants that exceed the allowed threshold must be destroyed by a DEA agent."
Title 21 United States Code (USC) Controlled Substances Act
SUBCHAPTER I — CONTROL AND ENFORCEMENT
Part A — Introductory Provisions
§802. Definitions
(16)(A) Subject to subparagraph (B), the term "marihuana" means all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds or resin.
(B) The term "marihuana" does not include—
(i) hemp, as defined in section 1639o of title 7; or
(ii) the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted therefrom), fiber, oil, or cake, or the sterilized seed of such plant which is incapable of germination.
7 U.S. Code § 1639o.Definitions
(1)Hemp
The term "hemp" means the plant Cannabis sativa L. and any part of that plant, including the seeds thereof and all derivatives, extracts, cannabinoids, isomers, acids, salts, and salts of isomers, whether growing or not, with a delta-9 tetrahydrocannabinol concentration of not more than 0.3 percent on a dry weight basis.
Final Thoughts on Delta 8
It appears that Delta 8 THC cartridges have been confirmed as federally legal. However, there are several states that have banned Delta-8-THC in their state laws.
These states include:
The US banned all Cannabis / Marijuana with the Controlled Substance Act (Defined in Section 802) This includes all extracts, oils, isomers, etc. However, this law was amended by the 2018 Farm Bill that exempts any cannabinoid that's not Delta 9 THC, and derived from hemp, including Delta 8 THC (derived from hemp).
The 2018 Farm Bill legalized hemp as it's defined in Section 1639o. This means Hemp must have less than 0.3% Delta-9 THC. If Delta 8 THC is derived from hemp, then it is legal under the Farm Bill.
Delta 9 THC and Delta 8 THC are not the same thing. The primary difference being that Delta 8 THC is specifically exempted by the 2018 Farm Bill from the Controlled Substance Act, while Delta 9 THC is not.
In conclusion, Delta-8 carts are legal only if extracted from Hemp already containing 0.3% THC by dry weight.
Converting CBD to Delta-8:
US20040143126A1 - Conversion of cbd to delta8-thc and delta9-thc
Get your very own LEGAL Delta 8 THC Vape Cartridge! Click here!
Laws by State for Delta 8 THC
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As the first and only international privacy standard for the cloud, ISO 27018 addresses the means of keeping customer information confidential and secure, as well as preventing personal information from being used for advertising or data analytics without customer approval. More importantly, adherence to ISO 27018 demonstrates that a CSP's cloud privacy policies and practices are consistent with the industry's best practices, both in the United States and the EU.
Our panel discussed the delineations of ISO 27018 and the potential value ISO 27018 carries as the new standard in industries where protection of sensitive customer or business data is paramount.
What value is provided by third party verification (through accreditation) of ISO 27018 and other data privacy and security practices in cloud computing?


Josh sits alone in a café, happy watching the world go by. Even if that means denying his longing for the waitress, Annie. But when Carrick walks into his life the scene is set for an opportunity that could change Josh forever. Suddenly the ability to spot where truth lies, and lies begin, will make or break you in this edge-of-your-seat thriller.


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January 19, 2021 / by
Did Manafort Prep Trump for the Dossier Lawfare
In the wake of the report that Marc Elias paid for the Steele dossier on behalf of the Democratic party, Ken Vogel linked back to an old story of his, reporting that the day after the Steele dossier came out, Manafort had a conversation with Reince Priebus about it.
It was about a week before Trump's inauguration, and Manafort wanted to brief Trump's team on alleged inaccuracies in a recently released dossier of memos written by a former British spy for Trump's opponents that alleged compromising ties among Russia, Trump and Trump's associates, including Manafort.
"On the day that the dossier came out in the press, Paul called Reince, as a responsible ally of the president would do, and said this story about me is garbage, and a bunch of the other stuff in there seems implausible," said a personclose to Manafort.
According to a GOP operative familiar with Manafort's conversation with Priebus, Manafort suggested the errors in the dossier discredited it, as well as the FBI investigation, since the bureau had reached a tentative (but later aborted) agreement to pay the former British spy to continue his research and had briefed both Trump and then-President Barack Obama on the dossier.
Manafort told Priebus that the dossier was tainted by inaccuracies and by the motivations of the people who initiated it, whom he alleged were Democratic activists and donors working in cahoots with Ukrainian government officials, according to the operative.
I think Vogel retweeted it because the story laid out much of what came next.
But I'm interested in it for several other reasons. First, where did Manafort learn of this? Did he learn of it from the Russians tied to the death, just a few weeks earlier, of one of the suspected sources of the dossier? If so, does Mueller have transcripts of those conversations?
And how broadly were Manafort's comments shared in the White House? Did Brian Benczkowski, then running the transition team at DOJ, but not long later, advising Alfa Bank to sue BuzzFeed over it, learn of Manafort's comments?
I've never been surprised that both Russians and Republicans were engaging in lawfare to expose the underlying circumstances of the dossier's existence. I've just been amazed at how well coordinated that lawfare was. I mean, sure, it didn't take much to understand that's where this was going. But did Manafort serve as a go-between here, to make the lawfare more effective?
And if so, did Priebus tell Mueller about it in his interview?
Copyright © 2021 emptywheel. All rights reserved.
Originally Posted @ https://www.emptywheel.net/tag/steele-dossier/page/2/


NIV 1 A prophecy against Damascus: "See, Damascus will no longer be a city but will become a heap of ruins. NIV 1 A prophecy against Damascus: "See, Damascus will no longer be a city but will become a heap of ruins.
NIV 1 A prophecy against Damascus: "See, Damascus will no longer be a city but will become a heap of ruins.


Freytag Anderson are an award-winning, Glasgow-based design studio, with an impressive and varied body of work. I helped them create a studio showreel to effectively showcase their work. I created multiple logo stings and motion assets to use throughout the reel. Bringing movement to each of Freytag Anderson's already stunning projects helped bring them to life in a fast-paced reel.
I also worked on some motion identities for the design studio, animating their existing brand icon in a way that was new but familiar to their existing look.


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Equinix and Bell Canada Partnership Set to Accelerate Digital Business
Data center acquisition closes, bringing the best of Equinix to Canada and the best of Canada to the world
Andrew Eppich
Managing Director, Canada
Published: October 1, 2020 6 min read
Today we are finalizing the $780 million acquisition of 13 data center sites from Bell Canada, and I'm both excited and humbled by this opportunity. We are not only gaining a fantastic set of assets and people from the number one player in the Canadian market, but we are also forging a powerful partnership to enable us to accelerate Canadian enterprises' digital transformation.
For me personally, this is also somewhat of a "homecoming," as I originally started with Equinix six years ago with the launch of the Toronto International Business Exchange™ (IBX®) TR2 data center, followed by an assignment leading sales teams in Europe for the last few years. The Eppichs are happy to be back closer to family and friends, and I'm thrilled to be a part of this expansion that strengthens interconnection within Canada and between Canada and the rest of the world.
IDC - Worldwide Colocation and Interconnection Services 2019 - 2020 Vendor Assessment
Read this competitive assessment of nine interconnection and colocation service vendors to complement your understanding of key benefits of critical infrastructure provider Equinix.
This article is also published in:
With the Bell Canada acquisition, we are gaining approximately 400,000 square feet of colocation space and over 600 customers. This includes 13 data center sites, representing 25 Bell Canada data center facilities[i] in eight markets. These new Equinix IBX data centers will provide a gateway for Canadian businesses looking to expand their reach globally via Platform Equinix®, with its more than 210 IBX data centers in 55+ metros around the world. They will also provide digital entry points for multinational companies extending their business into Canada.
Together, Equinix and Bell Canada will provide our customers with a joint offering that combines Bell Canada's telecommunications services and expertise with Equinix's global platform of interconnected, vendor-neutral data centers and business ecosystems, including leading networks and cloud service providers (CSPs). Together we'll deliver integrated networking and hybrid multicloud services that will enable Canadian enterprises to bring together and interconnect the foundational digital infrastructure that powers their success. As a result of this partnership, Equinix is already seeing significant customer demand across numerous vertical industries, including financial services, government, tech, regional enterprises and global corporations that want to expand into Canada.
Together, Equinix and Bell Canada will provide our customers with a joint offering that combines Bell Canada's telecommunications services and expertise with Equinix's global platform of interconnected, vendor-neutral data centers and business ecosystems, including leading networks and cloud service providers (CSPs). Andrew Eppich, Managing Director, Canada
Canada is accelerating its digital transformation
Canada is a top-tier global economy with long-term economic cooperation and trade agreements with the U.S. and Europe, providing a strong basis for digital growth. Of the top ten economies, Canada has the second-highest percentage of GDP from trade, along with France.[ii] Canadian companies are at a pivotal point in their digital transformation, and according to Jason Bremner, IDC research vice president, Industry and Business Solutions, "… the growth in 3rd Platform technologies to support digital transformation are increasingly incorporated into outsourcing and managed service engagements."[iii] This is a strong indicator that Canadian enterprises are ramping up their digital transformation. And there is an upside for CSPs with Canadian businesses. IDC reports that Canadian organizations expect to increase their spending on public and private cloud data center services to 12% and 25% of their budget, respectively, this year.[iv] As a vast country with geographically dispersed densities of people and enterprises, it will obviously take longer for CSPs to deploy in multiple metros, so we believe there is pent-up demand for these hybrid multicloud services that Equinix and its partners can offer.
These digital transformation indicators are consistent with our Canadian business experience. Since the launch of TR2, our partners and customers in Canada and across the globe have continually asked, "Where are the other on-ramps to Platform Equinix within Canada?" Now we'll be able to answer this very important call for more geo-diverse Equinix IBX locations within Canada that enable business to interconnect physically and virtually to rich ecosystems of more than 1,800 networks, 2,900 cloud and IT service providers and nearly 10,000 companies around the world.
How policy is shaping Canada's digitization journey
Like other countries, Canadian policymakers and enterprises are increasingly turning to digital innovation to adapt to the challenges introduced by the COVID-19 pandemic. Unsurprisingly, with an increase in remote work, digital learning, online shopping and more, investment in collaboration technologies and cloud-based applications and services is also on the rise. Dense ecosystems of companies that provide these digital solutions on Platform Equinix are readily accessible via direct and secure, high-speed, low-latency connections.
At the same time, data protection and sovereignty are of paramount concern for Canadian policymakers, businesses and citizens. While there are several data privacy regulations, two federal mandates, the Privacy Act and the Personal Information Protection and Electronic Documents Act (PIPEDA), protect how the federal government and businesses handle personal information, respectively. More recently the Government of Canada launched a Digital Charter and outlined several amendments to PIPEDA that would more closely align Canada with the General Data Protection Regulation (GDPR) in Europe. This is important as Canada is one of only 12 countries to have an adequacy decision by the European Union (EU) which allows for free data exchanges between the EU and Canada.[i]
The more than 210 global IBX data centers that are part of Platform Equinix provide the localized data residency that is required to comply with these and other data privacy and protection standards around the world. Dedicated, private interconnection to company and customer data among our customers also can provide greater security against cyberattacks. And, expanded interconnection points within Canada will enable Canadian enterprises to distribute security to the digital edge to scale at speed, while maintaining strong data control and protection.
Canadian enterprises are ramping up their digital transformation. IDC reports that Canadian organizations expect to increase their spending on public and private cloud data center services to 12% and 25% of their budget, respectively, this year. Andrew Eppich, Managing Director, Canada
My vision is simple: bring the best of Equinix to Canada and bring the best of Canada to the world. We plan to do this by:
Learning where our new Equinix customers are at in their digital transformation journey—and understanding how we can help them.
Leveraging Bell Canada and a variety of global partnerships we share to multiply our value
Bringing a rich set of direct and secure interconnection solutions to Canadian enterprise
Providing access to a global platform where Canadian enterprises can increase their digital advantage globally
Equinix is a place where opportunity connects—where our core values ensure for every employee that "I'm safe. I belong. I matter." Bringing the best version of ourselves to work every day ensures that we can bring the greatest value to our teams and customers.
Throughout my career, I have had the pleasure of leading teams across Canada. My experience traveling and leading IT teams in other countries has given me a broad appreciation for two key things: first, there is truly so much to learn from walking a mile in others' shoes, and second, the opportunities and problems we face are much more similar than we first may think.
Canada is a country of people coming from different places who bring fantastic perspectives and ideas to share; collectively, the country has a similar outlook to Equinix core values of "find a better way" and "we before me." Equinix values these complementary strengths to address the needs in the Canadian market. Together with our partners, we can bring the best of Equinix to Canada and bring the best of Canada to the world. I'm excited for the journey to begin, happy to be home and can't wait to get started together!
To learn more about why Equinix is a leader in colocation and interconnection services, read the IDC MarketScape: Worldwide Colocation and Interconnection Services 2019–2020 Vendor Assessment.
You may also be interested in reading IDC's take on the acquisition: Equinix Expands Canadian Presence by Acquiring 13 Bell Datacenters (subscription required).
[i] Note: Equinix counts a building (including a building that has had multiple phased expansions over time) as a single "data center." Bell counts each expansion within a building as a separate data center.
[ii] World Economic Forum, India is now the world's 5th largest economy, Feb 2020; The World Bank Data, Trade (% of GDP), 2019.
[iii] IDC, "Canadian Infrastructure Outsourcing Services Forecast, 2020–2024," Jason Bremner, May 2020, Doc# CA45058420
[iv] IDC, "Buyers Guide 2019: Canadian Data Center Services," Jason Bremner, September 2019, Doc# CA43803919.
[v] Norton Rose Fulbright, Data Protection Report, Data Privacy Day 2020 – Canadian Privacy Law Developments on the Horizon, Jan 2020; European Union, Adequacy decisions.
Together with our partners, we can bring the best of Equinix to Canada and bring the best of Canada to the world. Andrew Eppich, Managing Director, Canada
International Business Exchange (IBX)
Andrew Eppich Managing Director, Canada
Equinix Canada: A Global Gateway to Advancing Digital Business
Interconnecting Canada from Coast to Coast
Jon Lin


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/ Mapchats Blog / All Data Is Health Data When Looking at Social Determinants of Health
November 12, 2019 by Bernie Langer
In August 1854, London was hit with a cholera epidemic that killed over 500 people. A doctor named John Snow teamed with cartographer Charles Cheffins to map where people were getting sick, and was able to trace the illness to a contaminated water pump. This was one of the earliest uses of using mapping to study public health.
Now, as then, where someone lives is a major factor in how healthy they are. But although finding environmental contaminants and tracking the spread of contagions are still important, we now know that social factors play a prominent role in determining their level of health. In the same way that exposure to asbestos might increase one's risk for lung cancer, being in poverty can increase risk for type 2 diabetes. Access to health resources, income, education, and housing quality are just a few of these factors, known as social determinants of health.
For a public health policy analyst, this opens a tremendous number of possibilities. Health outcome data—like number of people with a specific disease—exists, but data available nation-wide is hard to come by, and rarely made available at useful local geographies. But a broad array of data on demographic and economic factors, which we know can directly influence health outcomes, is available at the neighborhood level (such as a ZIP code or census tract).
Looking for Proxy Indicators
For example, let's say you wanted to study coronary heart disease among Latinos in the Pilsen neighborhood of Chicago. Data from the CDC tells us that in Cook County, which encompasses the core of the Chicago metro area, 4,864 people died of coronary heart disease in 2017. That's an important starting point: that's the second highest number of these deaths in any county in the country.
But if we're studying a specific population group in a specific neighborhood, that's not enough information to go on. But knowing that stress is a driver of heart disease, and that poverty is a driver of stress, we can look at poverty data from the Census's American Community Survey (ACS), which can show us group-specific data at a very local level:
This data shows us that among the Latino population, there are pockets of poverty in the Pilsen area, but only in certain areas. This gives a public health policymaker clear guidance on where and how to improve public health in this area.
Studies have shown that higher levels of education lead to better health outcomes. The more education someone has, the more likely they are to have a steady job with sufficient income and health insurance, and they may be more likely to have resources necessary to make healthy decisions (such as following instructions from and communicating with health providers).
Again, looking at the Latino community in Pilsen, we can see a sharp contrast between the southern neighborhoods with lower education levels, and northern neighborhoods, closer to the University of Illinois at Chicago, with higher levels.
Plenty of Data
Once you start thinking about health in terms of its social determinants, the relevance of indicators seemingly unrelated to health becomes apparent. Quality and availability of housing can have direct impacts on stress levels. Availability of health insurance is clearly important to one's ability to find care. Even looking at the type of job someone has could be important. Not to mention more basic indicators like age, sex, and race, which are among the most important determinants of health. This is why our Community Health Report relies on socioeconomic indicators, in addition to data on disease screening and prevalence.
Even more useful is the ability to look at various economic and social indicators broken down for specific populations. For example, for anyone focused on health among Latinos, women, or the elderly, it is possible to explore a range of variables such as homeownership, internet access, economic mobility, workforce trends, incarceration rates, and school enrollment for any population.
We've come a long way from mapping cholera patients. Thanks to our understanding of social determinants of health, data-driven approaches to health policy are more feasible than they've ever been.
Filed Under: Health, Mapchats Blog, Taxonomy
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Home>Education>Olympic Medalist 'Leaps Forward' for Youth
Olympic Medalist 'Leaps Forward' for Youth
D. Kevin McNeir – Senior Editor Follow on Twitter Send an email August 16, 2017
Jackie Joyner-Kersee (Courtesy photo)
East St. Louis native and Olympic medalist Jackie Joyner-Kersee can attest to the importance of having the proper tools for training and a supportive team of coaches in order to perform at the highest possible level.
Now, for the second year, the woman voted by Sports Illustrated as "the Greatest Female Athlete of All Time" has teamed up with Comcast in efforts to spread the word about the company's Internet Essentials Program — helping low-income families and seniors cross the digital divide.
Joyner-Kersee, serving as Internet Essentials' national spokesperson, has joined David L. Cohen, senior executive vice president and chief diversity officer of Comcast Corporation, with the two recently embarking on a multi-city tour that continues through October designed to educate and engage more youth, families and seniors about Comcast's acclaimed initiative.
As the nation's largest and most comprehensive high-speed Internet adoption program, Internet Essentials has connected more than four million low-income Americans to high-speed Internet service at home. But Cohen says Comcast wants to reach even more families.
"We can't make this a success with a press release," Cohen said. "The secret sauce is it's an integrated, holistic program with over 9,000 partners, elected officials, libraries, PTAs, you name it."
"The tours will help us engage with several thousand influencers in cities like Miami and parts of California who we want to then go back to their communities and talk about the program. The key to Internet Essentials' success has been word of mouth — creating an echo chamber in the low-income family community where the conversation is about Internet access."
"When we started this program six years ago, we never imagined four million low-income Americans would benefit from it," Cohen added. "Of course, we can't visit every city and state represented by our footprint, but we have targeted as many as we can. We want to grow the connections. So, don't be surprised if you see me show up in the District with Jackie. She's so amazing with children and senior citizens that wherever we go, people get excited about our program. They want to know more," he said.
"While we have amazing stats, I have to stress that 98 percent of our participants say with Internet Essentials, their children are better equipped to do their homework and they're doing better in school. In city after city, parents and children are sharing their stories. They tell us how much having Internet access has improved the quality of their lives," Cohen said.
Joyner-Kersee said she's seen how much the program has impacted families in ways both big and small.
"Some senior citizens live alone and can't travel much. But with the Internet, now they can connect with their grandchildren and other family members — loved ones who they haven't been able to see for years. Now they're in awe at how easy it is to reach out and touch them."
"As for youth, in today's world having the Internet at home is essential. It helps them do their homework, complete term papers, and stay abreast of the latest news. And parents benefit from it too because they can check on their children's school attendance and grades."
"This is a must for families and they should not be left out just because they may be low-income. If you're not computer savvy these days, you will be left behind."
"Back home in East St. Louis, I have formed my own foundation and community center where I work with children on a daily basis. I don't have any children of my own — but the hundreds that come to our center have embraced me as their mother. And I like that."
"In my post-Olympic career, I've tried to inspire students and athletes to reach for their dreams. They can't do that, however, if they don't work hard or have the tools they need to succeed. The Internet Essentials program gives every child access to a level playing field so we don't leave an entire generation behind," Joyner-Kersee added.
For information about the program, go to www.InternetEssentials.com.
comcast Internet accessibility Internet Essentials jackie joyner kersee
D. Kevin McNeir – Senior Editor
Award-winning journalist and 21-year Black Press veteran, book editor, voice-over specialist and college instructor (Philosophy, Religion, Journalism). Before joining us, he led the Miami Times to recognition as NNPA Publication of the Year.
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