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MET-values of standardised activities in relation to body fat: studies in pregnant and non-pregnant women
Elisabet Forsum ORCID: orcid.org/0000-0001-9060-00661,
Birgitta Janerot-Sjöberg2,3,4 &
Marie Löf5,6
Physical activity is associated with health in women. Published MET-values (MET: metabolic equivalent of task) may assess physical activity and energy expenditure but tend to be too low for subjects with a high total body fat (TBF) content and therefore inappropriate for many contemporary women. The MET-value for an activity is the energy expenditure of a subject performing this activity divided by his/her resting energy expenditure, often assumed to be 4.2 kJ/kg/h. Relationships between TBF and MET have been little studied although overweight and obesity is common in women. Available data indicate that MET-values decrease during pregnancy but more studies in pregnant contemporary women are needed.
Using indirect calorimetry we measured energy expenditure and assessed MET-values in women, 22 non-pregnant (BMI: 18–34) and 22 in gestational week 32 (non-pregnant BMI: 18–32) when resting, sitting, cycling (30 and 60 watts), walking (3.2 and 5.6 km/h) and running (8 km/h). Relationships between TBF and MET-values were investigated and used to predict modified MET-values. The potential of such values to improve calculations of total energy expenditure of women was investigated.
The resting energy expenditure was below 4.2 kJ/kg/h in both groups of women. Women in gestational week 32 had a higher resting energy metabolism (p < 0.001) and 7–15% lower MET-values (p < 0.05) than non-pregnant women. MET-values of all activities were correlated with TBF (p < 0.05) in non-pregnant women and modified MET-values improved estimates of total energy expenditure in such women. In pregnant women, correlations (p ≤ 0.03) between TBF and MET were found for running (8 km/h) and for walking at 5.6 km/h.
Our results are relevant when attempts are made to modify the MET-system in contemporary pregnant and non-pregnant women. MET-values were decreased in gestational week 32, mainly due to an increased resting energy metabolism and studies describing how body composition affects the one MET-value (i.e. the resting energy metabolism in kJ/kg/h) during pregnancy are warranted. Studies of how pregnancy and TBF affect MET-values of high intensity activities are also needed. Corrections based on TBF may have a potential to improve the MET-system in non-pregnant women.
The physical activity of men and women is extensively studied since it is associated with chronic disease [1]. Of special interest is that physical activity during pregnancy tends to counteract preeclampsia, gestational diabetes and excessive weight gain [2,3,4]. The positive effect of physical activity is, at least partly, mediated by the increased energy expenditure and this increase may be used to assess how physically active human subjects are. Thus, the metabolic equivalent of task (MET)-system [5,6,7] is useful if the time spent in different activities is known. A MET-value is then assigned to each activity describing it's intensity. Such information can, if the resting energy expenditure (the basal metabolic rate, BMR, or the resting metabolic rate) is known, be used to calculate the total energy expenditure (TEE). Estimates of TEE are required when conducting nutritional evaluation and when evaluating the validity of energy intakes [8].
The MET-value of an activity is often defined as the energy expenditure of a subject when performing this activity divided by his/her resting energy expenditure [9]. Published MET-values [5,6,7] assume the latter to be 4.2 kJ (1 kcal) per kg body weight and hour [10]. However, body composition accounts for a large part of the variation in the resting energy metabolism and published MET-values may be too low for overweight subjects [9]. McMurray et al. [11] reported the average resting metabolic rate of women to be only 0.84 kcal per kg body weight and hour which may lead to errors in the MET-system and Kozy et al. [12] proposed a correction to increase MET-values of overweight subjects. It has been noted [13,14,15] that published MET-values are too low for subjects with a high body fat content but, to our knowledge, there are no systematic studies on the relationship between total body fat (TBF) and MET-values.
The effect of variations in the body fat content on MET-values is of special concern in women. The prevalence of overweight and obesity in female populations has increased during recent years [16] and the body fat content may be quite variable [17]. Furthermore, the correction proposed by Kozy et al. [12] may not be appropriate since the equation used to predict BMR tends to be inaccurate in females [18]. Finally, insufficient information is available regarding effects of pregnancy and body fat on MET-values.
Studies in pregnant women have sometimes been conducted using MET-values developed in non-pregnant subjects [19, 20]. However, during gestation, both TEE and BMR increase [21]. Prentice et al. [21] compiled studies of how weight bearing and non-weight bearing activities affect energy expenditure during pregnancy and found that MET-values decrease towards the end of pregnancy mainly due to increased BMR. The results of the studies in their review [21] varied considerably, possibly due to variations in design and intensities of the investigated activities. Furthermore, some of these studies were conducted in developing countries and some before the worldwide increase in the prevalence of overweight and obesity. It was recommended that the MET-system should not be used in pregnancy without modification [21] but there is little help available when formulating such modifications. This paper attempts to suggest some guidelines in this area.
We recruited two groups of women, one pregnant and one non-pregnant to a study with the following two objectives: 1) To assess the effect of gestational week 32 on MET-values for activities with varying intensity; 2) To identify relationships between TBF and MET-values for such activities. Using previously published data [22], we had a third objective: 3) To investigate the possibility to improve calculated TEE before pregnancy and in gestational week 32 using relationships between TBF and MET-values, identified in objective 2.
Objectives 1 and 2
Subjects and study outline
Forty-four healthy, non-smoking women (22 non-pregnant and 22 pregnant) were recruited during 2007 and 2008 by means of advertisements in the local press. Results obtained in some of these women have been published [23, 24]. All pregnant women had uncomplicated pregnancies and were investigated in gestational week 32. Age, occupation and exercise habits were assessed using a questionnaire. For women in gestational week 32 the questionnaire targeted the situation before pregnancy and included weight before conception. After delivery these women were asked about weight and length at birth of their infant and about their maximal weight during gestation. For women in the pregnant group recorded information were, as far as possible, confirmed using medical records. All women collected two or three urine samples at home and brought those to the measurement session which started with an assessment of BMR, body weight (KCC 150, Mettler-Toledo, Albstadt, Germany) and height. Then women consumed a breakfast containing cornflakes, juice and 3% fat milk providing 30 kJ per kg body weight with 15% energy from protein. After breakfast women performed six standardised activities when their energy expenditure was measured. These activities were: sitting, walking on a treadmill (3.2 and 5.6 km/h), running on a treadmill (8 km/h) and cycling at 30 and 60 watts. The woman could terminate vigorous activities earlier if she felt any discomfort. One pregnant woman did so when walking at 5.6 km/h. One non-pregnant and 13 pregnant women declined the running activity. After this session women received a dose of water, labelled by stable isotopes and were asked to collect six urine samples during the following 14 days carefully noting the time of sampling.
Assessment of energy expenditure and MET-values
To assess BMR, oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured during 20 min in the supine position after an overnight fast and 45 min of rest using a ventilated hood system (Deltratrac Metabolic Monitor, Datex Instrumentarium Corp, Helsinki, Finland). To assess energy expenditure when performing standardised activities a spirometer (CPX/D, Spiropharma, Klampenborg, Denmark) was used to measure VO2 and VCO2 during 15 s-periods for six minutes. The woman was connected to the spirometer through a mouthpiece and wore a nose clip. The session started with the sitting activity followed by standing. The woman was then transferred to a treadmill board, adjusted to make her walk at 3.2 km/h followed by walking at 5.6 km/h and then running at 8 km/h. Subsequently she was allowed to rest for 20 min after which she mounted a test bicycle where she cycled at 30 watts and then at 60 watts. VO2 and VCO2 were recorded throughout the six minutes when each standardised activity was performed and steady state was always reached after two to three minutes. The validity of the response, both of the Deltatrac and the Spiropharma, was controlled according to instructions provided by the manufacturer. This involved calibration using gases with defined concentrations of O2 and CO2 before each test. For each activity average of values recorded during the fifth of the six minutes was used to calculate energy expenditure and MET-values. The recorded VO2 and VCO2 values confirmed that all subjects were in a steady state when values used to calculate energy expenditure were recorded. Energy expenditure was calculated using the Weir equation [25] and MET-values as energy expenditure of a woman when performing a standardised activity divided by her BMR.
Assessment of TBF
Each woman consumed an accurately weighed dose of stable isotopes (0.09 g 2H20 and 0.23 g H2180 per kg body weight) per os. Isotope enrichment of dose and urine samples was analyzed as previously described [13]. 2H-space (ND) and 18O-space (NO) were calculated from zero-time enrichments obtained from the exponential isotope disappearance curves providing estimates of the fractional turnover rates for the two isotopes [13], i.e. the back-extrapolation approach [26]. Analytical precision for results in ppm were 0.22 for 2H and 0.03 for 18O. Total body water was calculated as (ND/1.04 + NO/1.01)/2 and fat-free mass as total body water divided by 0.732 (non-pregnant) [26] or 0.747 (gestational week 32) [27]. TBF was body weight minus fat-free mass. ND / NO was 1.032 ± 0.005 (n = 44). Analyzing dose and urine samples from one subject nine times gave the following CV: 0.3% (total body water), 0.3% or less (fractional turnover rates) all well within the recommended criteria [28]. Assessment of total body water and calculation of body fat using the two-component model provides valid body composition data in healthy non-pregnant adults [26] and in gestational week 32 [27].
Sample size justification
When comparing MET-values of pregnant and non-pregnant women, 20 subjects in each group gave a power above 0.8 to detect a difference of 10% between groups while assuming the CV of MET-values to be 10%. A correlation coefficient of at least 0.45 for linear relationships between MET-values and TBF would be significant with 20 observations.
We have previously investigated and published the physical activity pattern and TEE of 23 women before pregnancy and in gestational week 32 [22]. Before pregnancy their mean age was 30 ± 4 years, body weight 67.2 ± 12.0 kg, BMI 24.2 ± 4.8 kg/m2 and TBF 32.7 ± 7.8%. Their TEE was assessed during 14 days using the doubly labeled water (DLW) method (TEEDLW) [22]. A few days after this assessment the women completed a questionnaire recording time spent in the following physical activity categories: sleeping, very light, light, moderate, vigorous and very vigorous [22]. The questionnaire covered all 14 days (20,160 min) when TEEDLW was assessed [22]. In the present paper we use this recorded activity pattern to calculate TEE of the 23 women [22] during the 14 day period using either published MET-values (TEEpubMET) or modified MET-values, predicted by means of the relationships between TBF (%) and MET-values (TEEmodMET) identified in the present study. Then TEEpubMET and TEEmodMET are both compared to TEEDLW.
Values are given as means ± standard deviations (SD). Significant differences between mean values were identified using t-test for paired or unpaired observations after confirming that values were normally distributed. If a normal distribution could not be confirmed Wilcoxon's test was used. Linear regression analysis was also used. Significance (two-sided) was accepted when p < 0.05. Statistical analyses were conducted using Statistica, version 8.0 (Statsoft, Scandinavia AB, Uppsala, Sweden).
Characteristics of women
The pregnant and non-pregnant women recruited to the study are described in Table 1. Means and ranges for age, height and non-pregnant BMI were similar among the two groups. Before conception, pregnant women were engaged in similar occupations and had similar exercise habits as the non-pregnant women. On average pregnant women (n = 22) gained 12 ± 4 kg body weight during the complete pregnancy and all of them delivered one healthy full-term infant, weight and length at birth being 3410 ± 390 g and 50 ± 2 cm, respectively.
Table 1 Characteristics of non-pregnant and pregnanta womenb
Energy expenditure at rest and during standardised activities for pregnant and non-pregnant women
Table 2 shows VO2, VCO2 and energy expenditure at rest (BMR) and when performing the standardised activities. For pregnant women, BMR in kJ/kg/h was 94% of 4.2 kJ/kg/h and the corresponding value for non-pregnant women was 88%. When expressed in kJ/min, BMR was significantly (p = 0.000037) and 18% higher of pregnant than of non-pregnant women. For all activities except running energy expenditure (kJ/min) of the pregnant women was slightly higher than the corresponding values for the non-pregnant women but only the values for walking at 5.6 km/h were significantly different. In pregnant women, energy expenditure minus resting energy expenditure (the net energy expenditure) was on average 0.60 ± 0.58, 9.84 ± 0.89, 16.2 ± 1.0, 10.1 ± 1.0, 19.7 ± 2.7 (n = 21) and 36.4 ± 4.4 (n = 9) kJ/min when sitting, cycling at 30 and 60 watts, walking at 3.2 and 5.6 km/h and running at 8 km/h, respectively. In the non-pregnant group the corresponding values were: 1.04 ± 0.35, 10.1 ± 0.8, 16.2 ± 0.9, 10.1 ± 1.9, 18.2 ± 3.4 and 37.3 ± 5.9 (n = 21) kJ/min, respectively. The value for sitting was significantly lower for pregnant women (p = 0.0039). No significant differences between the groups were found for any other activity.
Table 2 Oxygen consumption, carbon dioxide production and energy expenditure of non-pregnant (n = 22) and pregnanta (n = 22) women at rest and when performing standardised activitiesb
MET-values of pregnant and non-pregnant women
Table 3 shows MET-values for the standardised activities assessed in the two groups of women. For the walking and running activities our values for non-pregnant women tended to be slightly higher than published values. All MET-values were significantly lower for pregnant than for non-pregnant women. For sitting, and for cycling at 30 and 60 watts, values for pregnant women were 11, 12 and 12% lower than the corresponding values for non-pregnant women, respectively. Lower figures were also obtained for walking at 3.2 km/h (11%), at 5.6 km/h (7%) and for running (15%).
Table 3 MET-valuesa obtained when six standardised activities were performed by non-pregnant women and by pregnant women in gestational week 32b
Relationships between TBF and MET-values
Table 4 shows that, for non-pregnant women, significant linear relationships for all standardised activities were found when measured MET-values were regressed on TBF (%). For sitting and for cycling at 30 and 60 watts, these relationships were negative (r ranging from − 0.44 to − 0.59) while for walking, both at 3.2 and 5.6 km/h, and for running they were positive (r ranging from 0.53 to 0.56). Significant correlations were also found for non-pregnant women when measured MET-values were regressed on TBF (kg), with r ranging from − 0.61 to − 0.68 (p ≤ 0.003) for sitting and cycling activities and from 0.43 to 0.52 (p ≤ 0.044) for walking and running activities. For pregnant women significant correlations between MET and TBF (%) were found for the running activity (n = 9) (r = 0.78, p = 0.012) and for walking at 5.6 km/h (n = 21) (r = 0.47, p = 0.03). The correlation between MET and TBF (kg) was significant for the running activity (n = 9) (r = 0.82, p = 0.007). No other significant correlations between MET and TBF (%, kg) were found in pregnant women.
Table 4 MET-valuesa (y) regressed on total body fat (%) (x) for non-pregnant women (n = 22) when performing standardised activitiesb
Investigating the possibility to improve calculated TEE
All investigated correlations between measured MET-values and TBF were significant for non-pregnant women while only a few such correlations were significant for pregnant women. Therefore, we investigated the possibility to improve calculations of TEE only in non-pregnant women. As shown in Table 5, we used regression equations in Table 4 to predict modified MET-values for each activity category. These values as well as published MET-values were then used to calculate energy expenditure of the women in our previous study [22] when they were in the pre-pregnant state. For the very light activity category we used eq. 1 in Table 4, a calculation which produced significantly lower energy expenditure than did the corresponding calculation based on the published MET-value. As also shown in Table 5, we used eqs. 4, 5 and 6 in Table 4 for moderate, vigorous and very vigorous activity categories, respectively. We selected these equations based on knowledge of the physical activity pattern of the women in our previous study [22] where the predominant activities were walking and running rather than cycling. Table 5 shows that for each of these three activity categories women were found to expend significantly more energy when the modified rather than the published MET-values were used. Finally, as also shown in Table 5, when energy expenditure during 24 h was calculated TEEpubMET was 9710 ± 2110 kJ/24 h and significantly lower than TEEDLW. This value was 10,510 ± 1500 kJ/24 h [22] while TEEmodMET was 10,060 ± 2660 kJ/24 h and not significantly different from TEEDLW.
Table 5 Minutes per 24 h and energy expenditure in six activity categoriesa calculated using published [7] and modifiedb MET-valuesc
Summary of main results
In healthy women we found MET-values to be lower in gestational week 32 than in non-pregnant women, an observation mainly explained by the increased BMR during pregnancy. We identified significant relationships between TBF and measured MET in non-pregnant women while for pregnant women such relationships were found for activities with high intensity but not for activities of lower intensity. When relationships between measured MET and TBF were used to predict modified MET-values calculated TEE of our non-pregnant women was improved.
Comments on design and methods
When the inferences of our results are considered body fatness of our women becomes of interest. The average as well as the variability in their body fat content represents relevant information. In population studies body fatness is commonly assessed as BMI rather than by means of a suitable body composition method. This may be appropriate since relationships between BMI and TBF (%) have been identified [17] but is not always satisfactory since this relationship may be different in different populations [29]. In our study overweight and obesity was present in 27 and 28% of non-pregnant and pregnant women, respectively. This is slightly lower than such figures for contemporary Swedish women [30] but higher than this value in most of the studies of MET-values during pregnancy as reviewed by Prentice et al. [21]. Furthermore, the variability in TBF (%) expressed as CV, was 25.8 and 16.8% for our non-pregnant and pregnant women, respectively. This is similar to corresponding previously reported values, 23.5 [13] and 16.9 [31] % for non-pregnant women and for women in gestational week 32, respectively. These comparisons indicate that the body composition of our women may be quite typical for many contemporary women. However, our samples are small and recruited from only one area in Sweden. It should also be emphasized that contemporary populations of women may well have a lower, as well as a higher, body fatness. Unfortunately, there is a lack of body composition studies in such populations making this kind of comparisons difficult.
When assessing activity energy expenditure of a woman to establish MET-values it is relevant to consider her feeding status. In the fed state the recorded energy expenditure will include dietary induced thermogenesis i.e. the increase in energy expenditure following food intake which represents about 10% of the energy content of the food consumed and lasts for at least six hours [32]. Published MET-values are often assessed in the fed state [5, 33] and therefore include dietary induced thermogenesis. Our women were fed a standardised breakfast and thus MET-values of both groups would be equally affected by dietary induced thermogenesis.
The four-component model represents the best available method to assess body composition in vivo of human subjects while two- and three-component models are less accurate because they rely on assumptions [34]. Assessment of total body water and application of the two-component model to calculate fat-free mass and subsequently TBF assumes that the degree of hydration is known and relatively constant, assumptions generally considered acceptable for healthy adults [26]. Löf and Forsum investigated these assumptions in pregnant women and concluded that this way to assess body composition is as least as valid in gestational week 32 as it is in non-pregnant subjects [27]. The validity of these assumptions during other parts of pregnancy has not been satisfactorily confirmed. Therefore we selected gestational week 32 of pregnancy for our study. This assessment of TBF will include the TBF of the fetus. However, in gestational week 32, this represents only about 0.4% of the TBF of the mother [31].
This study is focused on the relationship between TBF and MET-values since published research shows that body fatness is a relevant factor when MET-values are assessed and applied. Note, however, that our study does not provide a complete description of how body composition and MET-values interact.
Effects of pregnancy in gestational week 32 on MET-values
For all investigated non-resting activities differences in energy expenditure between pregnant and non-pregnant women were small and the net increase in energy expenditure tended to be quite similar for the two groups. However, all measured MET-values were significantly lower in gestational week 32. Obviously, this is due to the increased BMR at this stage of pregnancy.
An effect of pregnancy is to increase body weight and it has been suggested that pregnancy influences MET-values of weight bearing and non-weight bearing activities differently. For a non-weight bearing activity such as cycling, we found MET-values to be on average 0.42 (30 watts) and 0.62 (60 watts) units lower for pregnant than for non-pregnant women. This effect is similar to the corresponding average effect in gestational week 32 obtained in the studies compiled by Prentice et al. [21]. For weight bearing activities, such as walking (both at 3.2 and 5.6 km/h) our average MET-values were 0.4 units lower for pregnant than for non-pregnant women. Again this agrees reasonably well with the estimated effect of pregnancy in gestational week 32 on MET-values for walking [21]. However, we also observed that the measured MET-value for a vigorous activity, i.e. running at 8 km/h, was as much as 1.5 units lower for pregnant than for non-pregnant women suggesting that the effect of pregnancy on MET-values is influenced by the intensity of the activity. Thus our findings for women in gestational week 32 confirm and extend previously presented observations [21].
Relationships between MET and TBF
All relationships between MET-values and TBF were significant in non-pregnant women, while only relationships for activities with higher intensity were significant for pregnant women. This may reflect that the influence on energy metabolism by factors associated with pregnancy, such as fetal metabolism, overrides the influence of TBF unless the activity is of sufficient intensity.
In our study, sitting and cycling can be considered to represent non-weight bearing activities while walking and running represent weight bearing activities. For non-pregnant women it is of interest to note that relationships between MET and TBF (%) were negative for sitting activities (including cycling) and positive for walking and running. This suggests that TBF may affect MET-values for the two kinds of activities differently but studies with a larger selection of activities are required for firm conclusions on this issue.
Application of the MET-system during pregnancy
This study confirmed that the increase in BMR is an important factor behind the effect of pregnancy on MET-values. Thus it becomes important to investigate how pregnancy influences the one MET-value. Using published data [35] we found BMR to be equivalent to 81% of the conventional MET-value before pregnancy and until gestational week 20. This value increased to 87 and 88% in gestational weeks 32 and 35, respectively. In the present study, this figure was 94% in gestational week 32. Melzer et al. [36] showed this figure to be close to 100% in gestational weeks 35–41. This value is also likely to differ between populations which, for various reasons, differ in body fatness. There is a lack of studies of how the one MET-value varies during the course of pregnancy in populations with variations in body composition.
Our observations suggest that the effect of pregnancy on MET-values may be influenced by the intensity of the activity and also that body composition may influence MET values of high intensity activities. Consequently, there is a need for systematic studies regarding the effect of body fatness and activity intensity on MET-values during pregnancy if appropriate modifications of the MET-system for pregnant women are to be developed.
BMR, MET and calculated TEE of non-pregnant women
Women as well as overweight and obese subjects tend to have BMR below 4.2 kJ/kg/h [11] and high MET-values when these are assessed using measured resting energy expenditure. The BMR of our non-pregnant women was also low and their MET-values tended to be high (Table 3).
This study showed that modified MET-values, predicted using the relationships in Table 4, improved calculated TEE in non-pregnant women. However, depending on the activity category, energy expenditure calculated using modified MET-values were either lower (very light activity) or higher (moderate, vigorous and very vigorous activity) than energy expenditure calculated using published MET-values. According to Table 4, TBF (%) is negatively associated with MET-values in eq. 1, which is used for very light activity, but positively associated with MET-values in eqs. 4, 5 and 6 which are used for moderate, vigorous and very vigorous activities, respectively. Our results suggest that a correction based on the TBF content may represent a possible way to improve the MET-system for women. More work is needed to find out if such a correction is superior to the correction proposed by Kozy et al. [12] which is based on BMI and resting energy metabolism predicted using weight, height and age.
Strengths and limitations of this study
Strengths are that we measured MET-values of non-pregnant and pregnant women, both with valid estimates of TBF, and that both non-weight bearing and weight bearing activities were included. In non-pregnant women we established relationships between TBF (%) and measured MET-values for standardised activities and demonstrated that such relationships may improve calculated TEE. A limitation of our study is the small number of subjects.
A valid MET-system is important when physical activity levels and energy intake of human subjects are assessed. This kind of information is needed by health workers and researchers within several different areas, for example nutrition and public health. This study deals with issues related to application of the MET-system and provides suggestions for improving this system. Correcting MET-values based on TBF of subjects may represent a possibility to improve this system for non-pregnant women. Our results indicate that for pregnant women more work is needed to develop a valid MET-system. Studies describing how body composition influences the one MET-value throughout gestation and how pregnancy and body fat affect MET-values for high intensity activities may be useful in this context.
BMR:
DLW:
Doubly labelled water
Metabolic equivalent of task
ND :
2H dilution space
No :
18O dilution space
TBF:
Total body fat
TEE:
TEEDLW :
Total energy expenditure assessed using doubly labelled water
TEEmodMET :
Total energy expenditure calculated using modified MET-values
TEEpubMET :
Total energy expenditure calculated using published MET-values
VCO2 :
Carbon dioxide production
VO2 :
Oxygen consumption
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Graviditetsregistret. Annual report 2014. http://www.barnmorskeforbundet.se/aktuellt/forbundet/graviditetsregistret-arsrapport-2014 Accessed 15 Jun 2018.
Henriksson P, Löf M, Forsum E. Parental fat-free mass is related to the fat-free mass of infants and maternal fat mass is related to fat mass of infant girls. Acta Paediatr. 2015;104:491–7.
Westerterp KR. Diet induced thermogenesis. Nutr Metabol. 2004; https://doi.org/10.1186/1743-7075-1-5.
Passmore R, Durnin JVGA. Human energy expenditure. Physiol Rev. 1955;35:801–40.
Elia M. Body composition analysis: an evaluation of 2 component models, multicomponent models and bedside techniques. Clin Nutr. 1992;11:114–27.
Löf M, Olausson H, Boström K, et al. Changes in basal metabolic rate during pregnancy in relation to changes in body weight and composition, cardiac output, insulin-like growth factor I, and thyroid hormones and in relation to fetal growth. Am J Clin Nutr. 2005;81:678–85.
Melzer K, Heydenreich J, Schutz Y, et al. Metabolic equivalent in adolescents, active adults and pregnant women. Nutrients. 2016;8:438. https://doi.org/10.3390/nu8070438.
The authors thank all women in the study. Hanna Henriksson helped during the data collection, Elisabet Forsström assessed activity energy expenditure and Karin Boström provided clinical coverage.
Authors'contributions
ML and EF designed the study which was carried out by ML. ML and EF wrote the manuscript. BJS assessed energy expenditure during the standardised activities. All authors reviewed and approved the final manuscript.
Supported by Formas, the Östergötland County Council, the M Bergvall's foundation, Thuring's foundation and the Swedish Society of Medicine.
The datasets supporting the conclusions of this article are included in the article.
Department of Clinical and Experimental Medicine, Linköping University, 581 85, Linköping, SE, Sweden
Elisabet Forsum
Division of Cardiovascular Medicine, Department of Medical and Health Science, Linköping University, Linköping, Sweden
Birgitta Janerot-Sjöberg
Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden
Marie Löf
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
Search for Elisabet Forsum in:
Search for Birgitta Janerot-Sjöberg in:
Search for Marie Löf in:
Correspondence to Elisabet Forsum.
This study was conducted according to the Declaration of Helsinki and was approved by the central ethics board, Stockholm, Sweden (May 30, 2007; Dnr Ö 13–2007). Informed consent, witnessed and formally recorded, was obtained from all women.
The authors declare they have no competing interests.
Forsum, E., Janerot-Sjöberg, B. & Löf, M. MET-values of standardised activities in relation to body fat: studies in pregnant and non-pregnant women. Nutr Metab (Lond) 15, 45 (2018) doi:10.1186/s12986-018-0281-z
DOI: https://doi.org/10.1186/s12986-018-0281-z
Energy expenditure
Metabolic equivalent


text:
Tunisia have been hit by a COVID-19 outbreak in their camp at the Africa Cup of Nations and could have as many as seven players unavailable for their last group game against Gambia on Thursday, the Tunisian Football Federation said on Wednesday. Tunisia, who have three points from their opening two games, would be seeking at least one more point to make...
Group D Permutations – Egypt hoping not to suffer same fate as Ghana
"We are Ghana. We will win our next match (against Comoros Islands) and go through" – those were the infamous words of Ghanaian star player, Andre Ayew following their 1-all draw to Gabon in the second group match. However, as history would have it, that proved to be a deadly sense of confidence and entitlement against the lowly-ranked islanders. Following The Black Stars' dramatic exit...
NMB Nedbank Ultra marathon set to attract top field of elite runners, increases price money
The star of the Nelson Mandela Bay Nedbank Ultra marathon is rising and this year's race is set to attract a top field of elite runners from across the globe. The 50 km race has been awarded elite label status by world athletics and all eyes are now focused on the March 6, 2022 race day. Ntombesintu Mfunzi and Kelly...
Female referee becomes first to take charge of Afcon match
Rwandan referee Salima Mukansanga on Tuesday became the first woman to officiate an Africa Cup of Nations game when she took charge of the match between Zimbabwe and Guinea in Cameroon. Mukansanga walked out onto the pitch holding the match ball accompanied by three male match officials with Zimbabwe going on to win the game 2-1. After the match, supporters from Zimbabwe...
New Zealand's limited-overs series in Australia postponed
New Zealand's limited-overs tour of Australia has been postponed indefinitely due to uncertainty over when the visitors would be able to return home due to COVID-19 protocols, the cricket boards of both countries said on Wednesday. The tour, scheduled for January 24-February 9, comprised three one-day internationals in Perth, Hobart and Sydney and a solitary Twenty20 match in Canberra. New...
Ghana bundled out of the Afcon after Comoros defeat
Ghana's Africa Cup of Nations campaign came to a humiliating end on Tuesday as they were beaten 3-2 by debutants Comoros Islands at Garoua's Roumde Adjia Stadium to finish bottom of Group C with just a single point. El Fardou Ben Mohamed scored Comoros' first ever goal at the continental finals before Ahmed Mogni added a second just past the hour-mark. Goals...
Ghana bundled out of Cup of Nations after Comoros defeat
Ghana's Africa Cup of Nations campaign came to a humiliating end on Tuesday as they were beaten 3-2 by debutants Comoros Islands at Garoua's Roumde Adjia Stadium to finish bottom of Group C with just a single point. FULL TIME: Ghana 2 – 3 Comoros Islands Morocco finish top of Group C, Gabon as runners-up. Comoros Islands third with 3...
Morocco fight back to draw with Gabon and finish top of group
Morocco twice came from behind to draw 2-2 with Gabon in Yaounde on Tuesday and finish top of Group C at the Africa Cup of Nations in Cameroon. Achraf Hakimi hit a stunning free kick six minutes from the end to save Morocco from an upset defeat against a Gabon side which had eight players ruled out due to COVID-19 infections, including...
Zimbabwe upset Guinea at final Afcon Group B match
Already-eliminated Zimbabwe upset Guinea with a 2-1 win at the Africa Cup of Nations finals in Yaounde on Tuesday, although Guinea will still advance to the last 16 as runners-up in Group B. Captain Knowledge Musona and Kudakwashe Mahachi both scored in the first half to earn Zimbabwe a farewell win after losing their opening two matches as they finished last in...
Blunt Senegal held by Malawi but top Afcon Group B
Heavyweights Senegal failed to fire again and were fortunate not to concede a penalty in a 0-0 draw with unfancied Malawi on Tuesday but they still finished in top spot in Group B at the Africa Cup of Nations. Senegal won the group with five points, despite scoring only once in their three matches via a late Sadio Mane penalty against...
GROUP C Permutations – Can Ghana to turn the tables around?
Ghana will be hoping to turn fortunes in their favour when they take on what seem to be the whipping boys of Group C, Comoros Islands, on Wednesday evening. Following a 1-0 loss to Morocco and a 1-all draw against Gabon, the Black Stars of Ghana are finding themselves with the possibility of failing to qualify for the next round – an unusual...
Group B Permutations – Malawi smelling inaugural knockout stage at Senegal's expense
Smelling qualification for the knockout stages, Monday saw underdogs, Cape Verde, deny hosts Cameroon three points, and then snatching a point that currently leaves them on the cusp of qualifying for the Round of 16 as one of the four best thirds. It is this kind of motivation that could leave Senegal unable to qualify for the next stages when they come up against The Flames of Malawi in the decisive group stage...
Murray wins against Basilashvili in thriller to reach second round
Andy Murray dipped into the depth of his defensive skills to tame big-hitting Nikoloz Basilashvili during a thrilling 6-1 3-6 6-4 6-7(5) 6-4 win on Tuesday to reach the second round of the Australian Open for the first time in five years. The former world number one, a five-time finalist at Melbourne Park, has seen his ranking plummet since hip...
EXPLAINER: Go through or fall through – what qualifies a team to the knockout stages of the Afcon
With the final round of Africa Cup of Nations group matches under way in Cameroon, many teams, and fans alike, will be trying to figure out who will proceed through to the Round of 16 and who will be packing their bags to join Ethiopia, Zimbabwe, Comoros and Mauritania on their way home. Automatically, the teams who finish top and runners up qualify for...
Referee Mukansanga to lead all-female officiating line-up at the Afcon
Rwandan referee Salima Mukansanga will lead an all-female line-up of match officials at the Africa Cup of Nations encounter between Guinea and Zimbabwe on Tuesday, the Confederation of African Football (CAF) announced. It will be the first time only women will officiate a game at Africa's flagship international tournament. Mukansanga will take charge alongside assistants Carine Atemzabong from Cameroon and Fatiha Jermoumi...
Undercooked Kvitova bows out after 'painful' defeat
Twice former Wimbledon champion Petra Kvitova said she was unsurprised at bowing out of the Australian Open in the opening round on Tuesday after a difficult month Down Under. The 2019 Australian Open finalist was ousted by Sorana Cirstea for the second successive year at Melbourne Park, the Romanian veteran easing to a 6-2 6-2 victory on John Cain Arena....
Lewandowski and Putellas win FIFA Best awards
Bayern Munich's Polish striker Robert Lewandowski won the FIFA Best Men's Player award for 2021 with Barcelona's Spanish midfielder Alexia Putellas winning the FIFA Best Women's Player prize at Monday's ceremony. The prolific Lewandowski won the award for the second straight year after a season in which he beat Gerd Mueller's 49-year old record of 40 goals in a single...
Hosts Cameroon top Afcon Group A despite draw
Cameroon gave up a second-half goal to the Cape Verde Islands as they were held to a 1-1 draw on Monday but the hosts still finished top of Group A in the Africa Cup of Nations. Captain Vincent Aboubakar scored his fifth goal of the tournament to put Cameroon in the lead in the 39th minute before halftime substitute Garry...
Burkina Faso into second round after draw with Ethiopia
Burkina Faso secured a place in the knockout stage at the Africa Cup of Nations after Cyrille Bayala's first half goal helped them to an uninspiring 1-1 draw with Ethiopia and second place in Group A at the Kouekong Stadium in Bafoussam on Monday. Bayala netted midway through the opening period but his goal was cancelled out by an 82nd...
Afcon Group A Permutations – All to play for, for the Blue Sharks of Cape Verde
Previous results Cameroon results Cameroon 2 – 1 Burkina Faso (WIN)Cameroon 4 – 1 Ethiopia (WIN) Burkina Faso results Burkina Faso 1 – 2 Cameroon (LOSS)Burkina Faso 1 – 0 Cape Verde (WIN) Cape Verde results Cape Verde 1 – 0 Ethiopia (WIN)Cape Verde 0 – 1 Burkina Faso (LOSS) Today's fixtures Burkina Faso vs EthiopiaCape Verde vs Cameroon The permutations: As the curtain comes down on group stage matches for Group A, Cape Verde will...

redpajama_set_name: RedPajamaCommonCrawl


you'll be awarded according to your size.
Meet requirements to unlock new skins and trails for your ball. There're many customizing options for you, both skins and tails.
Constant updates will happen here in Delicious Land! New skins, new tails, new maps, or even new game modes are on the way.
Stay hungry, stay foolish. So just don't. Come to Decilious.io and eat something!


text:
Reflections: Celebrating a lifelong love for books and writing
FeaturedLeave a comment
Anthologies, Promote, Recommended booksBooks by Erin Fanning, Erin Fanning
The Demon Inches: Finding comfort in the written word
May 3, 2017 Erin8 Comments
The email arrived on February 22, 2016—a time of sickness and worry; fear and hospital visits.
"Erin," the message read, "I have to say, I profoundly enjoyed your story: your style, vision, and command of atmosphere, irony, and character are tremendously effective. It would be an honor to showcase your enormous literary talent in this year's journal."
The email, from Michael G. Kellermeyer, Editor of Oldstyle Tales Press, went on to say that my short story, The Demon Inches, had been accepted for The Yellow Booke, an annual journal of original horror, ghost stories, and weird fiction.
I was flattered, of course, by Mr. Kellermeyer's generous words. He certainly knew how to find his way into a writer's affections; particularly when most authors receive many, many (get the idea?) more rejections than acceptances.
But what Mr. Kellermeyer didn't realize, had no way of knowing, was that his email would become a beacon, guiding me through a bleak landscape. It reminded me of literature's unique power, how healing can be found through emptying oneself onto paper. And that by getting lost between the pages of a story, one might emerge a better person at the end. Books can be both escape and redemption, lifeboats for navigating the restless seas of time.
It also made me think of the unknown effect we can have on others. A smile or compliment, sincere at the time then forgotten, often imprints on another's psyche. Or, as in my case, a particularly kind acceptance letter, despite the writer suspecting the editor of exaggeration, arrives at the perfect moment.
So now Demon Inches, my own form of speculative fiction, has been published. It's a genre I return to again and again. My mind explores the remote lakes, woods, and mountains of central Idaho and northern Michigan, the two states I call home.
I wonder what waits at the end of twisting two-tracks, disappearing into dusk, or the secrets contained within the walls of an abandoned cabin. And, like in Demon Inches, I question what resides within the shadows of our minds, and where the line between reality and imagination splits.
My stories may be speculative, exploring a world of fantasy, but I never speculate about two characteristics—bravery and hope, inspired by the people who surround me and embedded in everything I write. Horror creeps up on us, in novels but also in life, and without these core traits, we might find ourselves blinded by darkness.
The literary landscape in which I navigate also reinforces my optimism, finding endless comfort in the written word. It illuminates everything I do and has become a lifelong travel companion, as a well-timed email from a kind editor reminded me not so long ago.
The Yellow Booke: Demon Inches, The Old House, The Little Madness: and Other Terrors
Amazon ~ Old Style Tales Press
A compendium of original horror stories (some written in the vein of classic supernaturalists such as M. R. James, J. S. Le Fanu, H. P. Lovecraft, Ambrose Bierce, and William Hope Hodgson, others written to push, test, and redefine the boundaries of the postmodern horror tale) "The Yellow Booke" is an original publication from Oldstyle Tales Press, whose annotated and illustrated critical editions of classic horror have piqued international interest from fans and scholars alike. "The Yellow Booke" contributes to Oldstyle Tales' mission of invigorating interest in the classial past of the horror genre, while inspiring and encouraging those who would participate directly in its future. In these pages you will find mystery, weird fiction, body horror, science fictions, ghost stories, dark fantasies, and other strange tales written by living authors — some professional, some amateur, and all deeply talented in conveying what Monty James called "a pleasing terror…" Featuring the imaginative, powerful talent of Ever Dundas, G. L. McDorman, Joseph Burt, Silvia Barlaam, Columbkill Noonan, David Groveman, Erin Fanning, Greg Howes, Thomas Olivieri, M. Grant Kellermeyer, Daniel Pietersen
Anthologies, CWTR, For fun, Promote, Recommended books, UncategorizedHorror, Michael G. Kellermeyer, Oldstyle Tales, Speculative Fiction, The Yellow Booke
A Souvenir of My Reading Self
July 15, 2015 Erin3 Comments
Fifty Best American Short Stories 1915-1965 sits on my bedside table. It's an unusually heavy book and has burst from its spine, as if weighed down by the importance of the stories and authors contained in its covers. Pages tumble from the book like leaves falling from a tree or perhaps a branch, when a larger chunk of papers breaks apart from the binding.
But I have no intention of discarding it.
I keep it because I admire Editor Martha Foley's confidence, no equivocation–so sure of herself. "These are the best short stories spanning fifty years," she seems to say, "and I dare you to disagree."
It's also a reminder of forgotten authors—Elsie Singmaster, Morley Callaghan—along with familiar ones—Ernest Hemingway, John Updike: a symbol of both the transitory and permanent nature of literature. But, most importantly, the book was a gift from my sister Kelly, which she rescued from a used book sale, knowing my love for unusual collections of short stories.
It also joined me one summer while traveling along the north shore of Michigan's Upper Peninsula. It became my literary companion, as dark and somber as the depths of Lake Superior, which were always in view.
The collection began to disintegrate during that trip. At night, I'd grasp several pages and read Flannery O'Connor, James Thurber, or Bernard Malamud. I considered scattering pieces of these great stories across the U.P.–John Cheever in Grand Marais, a few pages of Dorothy Parker for Munising, and a smattering of Lionel Trilling in Marquette.
And now I wish I had… a souvenir of my reading self everywhere I went, to be picked up by a walker strolling next to a park bench or a waiter bussing a table, creating an endless cycle of reading and sharing, just as Martha Foley intended.
Anthologies, For fun, Recommended booksFifty Best American Short Stories 1915-1965, Martha Foley, short stories
Monday Markets: From Filipino fiction to travel writing
February 10, 2014 ErinLeave a comment
Filipino Fiction For Young Adults: "Open Call For Submissions–Science Fiction: Filipino Fiction For Young Adults – Editors Dean Francis Alfar (publisher of the Philippine Speculative Fiction anthologies) and Kenneth Yu (publisher of Philippine Genre Stories), and co-editors for Horror: Filipino Fiction For Young Adults, announce an open call for short fiction submissions for Science Fiction: Filipino Fiction for Young Adults."
Till Death Do Us Part: "Burnt Offerings Books is planning on publishing a series of monthly anthologies in 2014. The tentative title and theme of the anthology will be Till Death Do Us Part."
Thirteen Press Anthologies (scroll down to Feb. 6 entry) – Accepting submissions for three anthologies – War, Wildwood, and Pyromania.
Dark Heart Volume Two: "With the theme of 'Mirrors and Tears' writers (both new and established) are invited to write a short story from 1,000-10,000 words for this anthology. The theme is open to interpretation and we look forward to reading a diverse range of YA tales."
The Best Women's Travel Writing: "Women writers, please send us your best stories about travel throughout the world for our annual series, The Best Women's Travel Writing. We're looking for the full range of experience: adventurous, mystical, funny, poignant, cuisine-related, cross-cultural, transformational, funny, illuminating, frightening, or grim-as well as solo travel and travel with friends, partners, and families."
Anthologies, Markets, Tween/Teen Short Story MarketsBurnt Offering Books, Markets, Thirteen Press
"The universe is not made of atoms; it's made of tiny stories."-The Tiny Book of Tiny Stories
January 5, 2012 January 4, 2012 ErinLeave a comment
Finally confirmation for what I've always believed: "The universe is not made of atoms; it's made of tiny stories."
The Tiny Book of Tiny Stories: Volume 1
" To create The Tiny Book of Tiny Stories: Volume 1, Joseph Gordon-Levitt — known within the hitRECord community as RegularJOE — directed thousands of collaborators to tell tiny stories through words and art. With the help of the entire creative collective, Gordon-Levitt culled, edited and curated over 8,500 contributions into this finely tuned collection of original art from 67 contributors. Reminiscent of the 6-Word Memoir series, The Tiny Book of Tiny Stories: Volume 1 brings together art and voices from around the world to unite and tell stories that defy size."
AnthologiesJoseph Gordon Levitt, The Tiny Book of Tiny Stories
Blood Spatters and Greek Myths: Short Story Collections For Teens
July 13, 2011 July 14, 2011 ErinLeave a comment
A new short story collection from Tamora Pierce means it's time to take a break from writing and get busy reading:
Tortall and Other Lands by Tamora Pierce: From Amazon – "Collected here for the first time are all of the tales from the land of Tortall, featuring both previously unknown characters as well as old friends. Filling some gaps of time and interest, these stories, some of which have been published before, will lead Tammy's fans, and new readers into one of the most intricately constructed worlds of modern fantasy."
And while you're at it, check out these other short story collections for teens:
Drollerie Press's Playthings of the Gods (includes my story "Naiad"): From Black Sun – "Playthings of the Gods is one of Drollerie Press' strongest anthologies to date, filled with tales both heart wrenching, and empowering. One thing that really ties the anthology together, aside from the theme, is the very lyrical prose. While each author has a style of their own, some stories compliment each other so beautifully you would swear it was intentional."
As long as I'm doing a little self-promotion then take a look at my collection of short stories from Sam's Dot Publishing, The Curse of Blackhawk Bay – "Around Lake Trillium strange events occur. Children disappear, ghosts appear, and a man bursts into flames. The lake itself is inhabited by something vast and dark. With each event there appears a crow–but what does it want? Who will be next to confront the secret of the lake and of Blackhawk Bay?"
Bloody Horowitz by Anthony Horowitz: From Booklist – "With the blood spatters from Horowitz Horror (2006) and More Horowitz Horror (2007) nearly dry, in steps the titular tale spinner bringing another 14 tales of the macabre."
The Poison Eaters and Other Stories by Holly Black: From Kirkus Reviews – "Black's first story collection assures her place as a modern fantasy master…. Sly humor, vivid characters, each word perfectly chosen: These stories deserve reading again and again."
The Kissing Game: Short Stories by Aidan Chambers: From Amazon – " These provocative stories beautifully lend themselves to discussion, and once again Chambers treats us to his fiercely intelligent, finely crafted prose and his incisive understanding of the wonderings of young people on the verge of adulthood."
AnthologiesAidan Chambers, Anthology, Anthony Horowitz, Drollerie Press, Holly Black, Sam's Dot Publishing, Tamora Pierce
U.K. Publisher Seeks Unique YA Stories
May 10, 2011 May 10, 2011 Erin1 Comment
Wyvern Publications began in 2008 with the goal of championing "teen fiction that may have been rejected from popular publishing houses for being 'too unique'." With titles like The Faerie Conspiracies, Dragontales: Short Stories of Flame, Tooth, and Scale, The Voices of Ire, Mertales, and The Howling Moon, Wyvern has accomplished that goal. Their books promise stories infused with fantasy, mystery, horror, and romance.
The publisher continues its mission to find unique voices with Wyvern Magazine, an ezine for teen fiction. In this interview, editor Holly Stacey talks about what she's looking for, her favorite authors, and what's new at Wyvern.
What do you look for in a story? Are there any specific types of stories or plots that you wish writers would send you?
I personally look for character led stories that fit the basic genre of what we have advertised for – teen!. For the magazine we get so many stories, it's sometimes impossible to choose and of course, we don't just have fiction. I always look for strong, well-rounded characters with an original storyline (or a new twist on an older tale) and well paced action. I want to feel what the main character is feeling and be taken through his or her story absolutely gripped and convinced that they are real. First person limited and third person limited are our preferred narrations, and all the editors on the Wyvern team will tell authors to not jump from one character's point of view to another. The magazine usually has slots for two to three short stories, some flash fiction and maybe a poem or two.
As for particular stories or plots, we are generally open and like to be surprised! As long as it fits well within our readership, has a strong narration and original voice, we're interested.
Why would you pass on a story?
If a story was good but had so many grammatical errors that I wanted to give up reading, I'd pass on the story. I'd also pass if it was boring, switched viewpoint mid paragraph, was unoriginal, or just poorly written. Excessive foul language, graphic sex, or violence are also a no for us. For the anthologies, the editors will sometimes find stories that they like but need improving on. When this happens, we contact the author and tell them what we'd like changed if the author is willing. For main submissions, however, there are just too many to give personal feedback on, which is a shame because there are some amazing stories that come our way (and some very poor ones, but there is a learning curve for all writers).
What do you enjoy the most about editing Wyvern Magazine?
That's a tough one to answer. I think when it all comes together at the end is when I'm most enjoying it, but I love the point of sending out acceptance e-mails (the worst is having to reject, but it comes with the territory). Of course, there are times when things seem to go terribly wrong. These are usually technical hitches such as images not uploading on the website properly, or my PDF deciding to reformat.
Who are some of your favorite authors and why? Favorite short stories? Is there a story (or two) that was completely unforgettable… changed your life or outlook in some way?
I absolutely love Neil Gaiman! Bram Stoker, Wilkie Collins (I do love turn of the century fiction), Holly Black, Tolkien, Poe, Crissida Cowell, Diana Wynne Jones, ah, I could go on forever. Derek Landy also is one of my favourites. Aubrie Dionne, who we are lucky enough to have as one of our authors also keeps me gripped when I read her tales. I think it's the magic in the stories that keeps me wanting more; there is something almost bewitching about the way they write and I end up getting so emotionally involved with the plot and characters that they will creep into my dreams.
One of my favourite short stories is by Poe – where the lunatics in an asylum break out and pretend to be the doctors. It always makes me laugh, but also reminds me that life's 'rules' are always dictated by those in power, no matter how insane they are. For teen fiction, my favourite short story is by Alice Godwin called Clearskin. It was the winner of the short story competition for Wyvern Publications last year and it left me in gooseflesh for days afterwards it was so beautiful.
Anything new coming to Wyvern Magazine this year?
We've got the 'Assistant Editor's Corner' which is good fun as it allows our assistant editor to use some of his own fiction to highlight some do and don't for writing. Other than that, it's the usual articles, fiction and interviews.
Anthologies, Interviews, Markets, Tween Markets, Tween/Teen Short Story MarketsHolly Stacey, Wyvern Magazine


text:
The Constitution is the basic law governing the Democratic Republic of the Congo. The Constitution has been changed and/or replaced several times since its independence in 1960.
The Democratic Republic of Congo is now under the regime of the constitution which was approved in a referendum by the Congolese people and promulgated on 18th February 2006, by President Joseph Kabila Kabange. It is the Democratic Republic of Congo's sixth constitution since 1960.
Over the last decade, the DRC Government has worked to build a new Congo with an inclusive, transparent and democratic government that can provide a better future for all citizens. Having emerged from the conflict under the leadership of President Joseph Kabila Kabange, the Congolese people have taken critical steps in pursuing democratic aspirations guided by the DRC's Constitution, which guarantees freedom of speech and religion.
Click here to download The Constitution of The Democratic Republic of the Congo


text:
Q: How to get configurable attribute label and value in magento 2? To use Object Manager is not a proper way but this code is for testing purpose only.
I want to get attribute value which is available in configurable products. I have tried with below code, but I get an all Attribute value which is assigned in the attributes drop-down list.
Please See below code
   <?php
    $objectManager  = \Magento\Framework\App\ObjectManager::getInstance();
    $repository = $objectManager->create('Magento\Catalog\Model\ProductRepository');
    $product    = $repository->getById($p_coll->getId());
    $data = $product->getTypeInstance()->getConfigurableOptions($product);
    $options = array();

    foreach ($data as $attr) {
        foreach ($attr as $p) {
            $options[] = $p['attribute_code'];
        }
    }

    $statu = 0;

    $eavConfig = $objectManager->get('\Magento\Eav\Model\Config');
    foreach (array_unique($options) as $code) {
        $attribute     = $eavConfig->getAttribute('catalog_product', $code);
        $options       = $attribute->getSource()->getAllOptions();
        $optionsExists = array();
        if ($options) {
            echo $code;
            echo "<select>";
            foreach ($options as $option) {
                    //$optionsExists[] = $option['label'];
                if ($option['label']) {
                    echo "<option value='" . $option['label'] . "'>" . $option['label'] . "</option>";
                }
            }
            echo "</select>";
        }

    }
    ?>

Please see below screen shot

There are only 2 colours available for this configurable product, but all colour options show in my collection. Please see below screenshot.

A: Please try below code and please enter product id to get the value
<?php

use Magento\Framework\App\Bootstrap;
require __DIR__ . '/app/bootstrap.php';
// adding bootstrap
$bootstraps = Bootstrap::create(BP, $_SERVER);
$object_Manager = $bootstraps->getObjectManager();

$app_state = $object_Manager->get('\Magento\Framework\App\State');
$app_state->setAreaCode('frontend');

$objectManager = \Magento\Framework\App\ObjectManager::getInstance();
$product = $objectManager->create('Magento\Catalog\Model\Product')->load(**product id**);

$productTypeInstance = $objectManager->get('Magento\ConfigurableProduct\Model\Product\Type\Configurable');
$productAttributeOptions = $productTypeInstance->getConfigurableAttributesAsArray($product);
foreach ($productAttributeOptions as $key => $value) {

    $tmp_option = $value['values'];
    if(count($tmp_option) > 0)
    {
        echo "
".$value['label']."
";
        echo "<select id='".$key."_".$value['label']."'>";
        foreach ($tmp_option as $tmp)
        {
            echo "<option value='".$key."_".$tmp['value_index']."'>".$tmp['label']."</option>";
        }
        echo "</select>";
    }
}

A: public function execute()
{
    $collection = $this->_collectionFactory->create()
     ->addFieldToFilter(
        'frontend_input',
        'select'
    )->addFieldToFilter(
        'is_user_defined',
        1
    )->addFieldToFilter(
        'is_global',
        1
    );

    foreach($collection as $attributes)
    {
        $attributeId = $attributes->getAttributeId();
        echo $attributeId."
";
        $attribute =$this->eavConfig->getAttribute('catalog_product', $attributeId );//"color" is the attribute_code
        $allOptions = $attribute->getSource()->getAllOptions(true, true);
            foreach ( $allOptions as $instance ) {
                $id = $instance['value']; //id of the option
                echo $id ;
                $value = $instance['label']; //Label of the option
                echo $value;
            }
        }
    return $this->_pageFactory->create();
}

This will give all configurable product attribute .place this code wherever you want!!!!!
This will give you attribute id and all its value

A: $shouldSave = false;
foreach ($productSkuList as $productSku) {
    /** @var \Magento\Catalog\Model\Product $product */
    $product = $this->productFactory->create();
    $productId = $product->getIdBySku($productSku);
    $product->load($productId);
    if (empty($productId)) {
        continue;
    } elseif (!$shouldSave) {
        $shouldSave = true;
    }
    $buyRequest = ['product' => $productId, 'qty' => 1];
    if (!$product->isVisibleInSiteVisibility()) {
        $parentIds = $this->productIndexer->getRelationsByChild($productId);
        if ($parentIds) {
            $buyRequest['product'] = $parentIds[0];
            /** @var \Magento\Catalog\Model\Product $parentProduct */
            $parentProduct = $this->productFactory->create();
            $parentProduct->load($buyRequest['product']);
            $configurableCode = \Magento\ConfigurableProduct\Model\Product\Type\Configurable::TYPE_CODE;
            if ($parentProduct->getTypeId() == $configurableCode) {
                /** @var \Magento\ConfigurableProduct\Model\Product\Type\Configurable $productType */
                $productType = $parentProduct->getTypeInstance();
                $buyRequest['super_attribute'] = [];
                foreach ($productType->getConfigurableAttributes($parentProduct) as $attribute) {
                    $attributeCode = $attribute->getProductAttribute()->getAttributeCode();
                    $buyRequest['super_attribute'][$attribute->getAttributeId()] = $product
                        ->getData($attributeCode);
                }
                $product = $parentProduct;
            } else {
                continue;
            }
        } else {
            continue;
        }
    }

redpajama_set_name: RedPajamaStackExchange


In 2005, when government established the original Revelstoke Higher Level Plan Order (RHLPO), it included a provision that it might review the order, should subsequent recovery efforts for caribou adversely affect timber supply. Hence, a 2011 amendment was intended to recover a volume of harvestable timber to compensate for that set aside in 2009 to protect caribou habitat. This investigation determined that the amendment, without altering the area reserved for caribou, reduced and re-arranged the amounts, location and security of old and mature forest required to be protected for biodiversity conservation. Ultimately, though less old and mature forest is now protected, the reduced amount is not substantive relative to the original RHLPO, provided forests that are currently considered inoperable remain unharvested.


text:
import os,sys
import paramiko as pmk
#! /usr/bin/env python
# -*- coding:utf8 -*-
import MySQLdb as mdb
conn=mdb.connect(host="localhost",user='root',passwd='abcxxx123',db='yjy_xiyizonghe',unix_socket='/tmp/mysql.sock')
cursor=conn.cursor()

def get_param(name):
	if name == 'liuzhongbao':
		chapter_id = '29'
	elif name == 'xuqi':
		chapter_id = '30'
	else:
		print "传参错误!"
		sys.exit(1)
	return [chapter_id,name]

def change_media_url(name):
	medias = []
	chapter_id = get_param(name)[0]
	try:
		cursor.execute("select `id`,`name`,`media_url` from yjy_im_chat_aes where chapter_id="+chapter_id+" and media_url != '';")
		datas = cursor.fetchall()
		dates = []
		for data in datas:
			date = data[2].split('/')[-3]
			original_media = date + '_' + str(dates.count(date)) + '.mp4'
			medias.append(original_media)
			sql="update yjy_im_chat_aes set original_media = '%s' where id=%d;"%(original_media,data[0])
			#print sql
			#cursor.execute(sql)
			conn.commit()
	except mdb.Error,e:
		print e
		conn.rollback()
   		conn.close()
	return medias

def change_file(name):
	name = get_param(name)[1]
	original_medias = change_media_url(name)
	print original_medias
	pmk.util.log_to_file('/tmp/syslogin.log')
	web_dir = '/data/original/zhibo/'
	ssh = pmk.SSHClient()
	ssh.load_system_host_keys()
	ssh.connect(hostname = '10.46.180.21',username = 'root',port=2282)
	for media in original_medias:
		media_date=media.split('_')[0]
		media_dir = web_dir + name + os.sep + media_date + os.sep
		stdin,stdout,stderr = ssh.exec_command('ls ' + media_dir)
		file=media_dir + stdout.read()
		new_file = media_dir + media
		c1 = 'mv ' + file.split('\n')[0] + ' ' + new_file
		stdin,stdout,stderr = ssh.exec_command(c1)
		print stdout.read()
	ssh.close()

if __name__ == '__main__':
	names = ['liuzhongbao','xuqi']
	for name in names:
		#change_media_url(name)
		change_file(name)

redpajama_set_name: RedPajamaGithub


text:
Артур Фергюсон (, 1883—1938) — шотландский мошенник, который, как утверждается, стал известен «продажами» национальных памятников и других объектов национального достояния в 1920-х годах.

Биография
Утверждается, что в 1920-х годах Фергюсон продал ряд знаменитых памятников. В частности речь шла о Колонне Нельсона на Трафальгарской площади (на сумму 6000 фунтов стерлингов), башне Биг Бен (с первоначальным взносом в 1000 фунтов стерлингов) и Букингемском дворце (за 2000 фунтов стерлингов первоначального взноса). Во всех случаях покупателями выступали доверчивые американские туристы.

В 1925 году Фергюсон эмигрировал в США. Там он продолжил свои аферы. В частности «продал» Белый дом богатому владельцу ранчо в рассрочку. Ежегодные выплаты должны были осуществляться в размере 100 000 долларов. Затем Фергюсон попытался продать Статую Свободы зажиточному туристу из Австралии. Но тот заподозрил неладное и обратился в полицию. Фергюсона арестовали и заключили в тюрьму. Он освободился в 1930 году и перебрался в Лос-Анджелес. Здесь мошенник до самой смерти в 1938 году продолжал обманывать доверчивых обывателей.

Критика
Согласно мнению Дейна Лава, описавшего Фергюсона в своей книге «Человек, который продал колонну Нельсона», существование самого мошенника может быть обманом. Возможно это выдумки журналистов. Лав пытался отследить доказательства, которые подтвердили бы истории об аферах. Но не удалось обнаружить никаких документов об аресте Фергюсона, о суде над ним или о его пребывании в тюрьме. Нет также никаких следов его могилы в Лос-Анджелесе. При этом основные материалы о мошенничестве появились в 1960-е годы.

Литература

 Ayto, John and Ian Crofton. Brewer's Britain & Ireland. London: Weidenfeld & Nicolson, 2006. ISBN 0-304-35385-X.
 Love, Dane. The Man Who Sold Nelson's Column and Other Scottish Frauds, Birlinn Ltd, 2007. ISBN 978-1-84158-612-0.
 (Editor), Reader's (1981). Strange Stories, Amazing Facts. Sydney: Readers Digest. pp. 470–471. ISBN 0-89577-028-8.

Примечания

Мошенники Великобритании
Аферисты

redpajama_set_name: RedPajamaWikipedia


A wide range of tub chairs in a choice of styles, materials and finishes including leather tub chairs, fabric tub chairs and twin seat tub chairs. All our Contract tub chairs are manufactured to the highest standards and suitable for commercial environments. Talk to our sales team about upholstering some of our tub chairs in custom fabric.
Tub Chairs unique style and design are popular choice for a wide range of environments. From reception areas to informal dining areas, tub chairs are a practical, cost effective solution for soft seating. We have sourced the very best tub chairs from a wide range of manufacturers providing an extensive range, with a tub chair to suit any venue, reception area or office.
The range of tub chairs also includes 2 seater tub sofas, ideal when space is at a premium offering a compact and stylish alternative to traditional sofas, taking up little room while still seating two adults. Our tub sofas are suitable for use in any commercial environment and are available to complement key pieces in the tub chair range.
Contract commercial grade tub chairs are made to an exacting standard. Featuring higher quality frames and materials than domestic use tub chairs, our well made, hardwearing commercial tub chairs look great in any environment and will stand up to vigorous, heavy use in commercial environments.
Choose from real leather, faux leather or a combination of leather facing tub chairs for a long lasting durable tub chairs in a range of both classic and modern designs. Leather tub chairs are a popular choice for the hospitality industry, as they are an easy to clean and a practical option for pubs, restaurants and eating establishments.
An extensive range of fabric options are available for all tub chairs but we also provide the option to customise your tub chair by selecting the fabric yourself and our team of experts will upholster for you.
Further custom options for tub chairs include selecting the wood stain finish or wooden RAL colours and special finishes. If you have a certain specification of tub chair and don't see it in our Tub Chair range, please call the sales team to discuss your requirements.
If you're interested in multiples or a bulk purchase of tub chairs, please contact us to discuss your requirements, we are always happy to offer contract tub chair sale discounts for large contract customers.


eTruancy is an online attendance monitoring system implemented in SVUSD in 2008. Changes to the implementation were made at the start of the 2009/2010 school year to improve effectiveness as it relates to the early stages of the SARB process. eTruancy automatically generates letters in regards to truancy (any non reported//unexcused absence) and an excessive excused absences. All absences must be reported within five days. Questions regarding this process please feel free to contact the school office. Thank you for your cooperation and understanding.


Abortion pill are basic to end unwanted pregnancy (1) - Abortion pills online are effective to terminate the unwanted motherhood. It also reduces frequent visit to clinic. Purchase top quality abortion pill from leading pharmacy store at low cost.
Abortion pills online are effective to terminate the unwanted motherhood. It also reduces frequent visit to clinic. Purchase top quality abortion pill from leading pharmacy store at low cost.


text:
Assets of Community Value
Part 5, Chapter 3 of the Localism Act 2011 provides for a scheme called 'assets of community value'. Under this Act, Stratford-on-Avon District Council is required to maintain a list of 'community assets'.
Assets of Community Value - the list includes land nominated by unsuccessful community nominations within the Stratford-on-Avon District Council area
Nominations for community assets can be made by parish councils or by defined groups with a connection with the community. Individuals cannot nominate community assets. If the nomination is accepted, the group will be given time to come up with a bid for the asset when it is sold. A nomination form is available to assist in the preparation of nominations.
The right to bid only applies when an asset's owner decides to dispose of it. There is no compulsion on the owner of that asset to sell it. The scheme does not give first refusal to the community group (unlike the equivalent scheme in Scotland), and it is not a community right to buy the asset, just to bid. This means that in some instances the local community bid may not be the successful one.
Certain types of land, most notably residential property, are exempt from being placed on the register. Owners of property placed on the register may appeal against its listing and can claim compensation if they can demonstrate its value has been reduced. Also, certain types of transfer of land or assets do not count as disposal for the purposes of the legislation.
The scheme was brought into effect on 21 September 2012.
Contact: The Customer Services team
Energy & Warmth
Resettlement and Refugees
Rural England Prosperity Fund
Safeguarding Vulnerable Adults and Children
Social Inclusion Statement
UK Shared Prosperity Fund (UKSPF)
Voluntary and Community Services
Stratford-on-Avon Foodbanks
Assets of Community Value (206 KB) - Assets of Community Value
Assets of Community Value Nomination Form (105 KB) - Assets of Community Value Nomination Form
Localism Act 2011 - Assets of Community Value


תיאור: This book focuses on the Jewish colony of Clarion Utah and an attempt to revive the agrarian life. In 1911, 81 Jewish families left eastern US cities to farm land in Clarion with the encouragement of the governor of Utah and the Mormon church financially aided the community, however the community died by 1916 and the last settlers leaving in the mid 1920's. 196 pages.


Sputum analysis in patients with "disharmony of stomach"
 U. S. Department of Health and Human Services, National Institute of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program, "Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma," Full Report 2007, http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.
 R. A. Nathan, C. A. Sorkness, M. Kosinski et al., "Development of the asthma control test: a survey for assessing asthma control," Journal of Allergy and Clinical Immunology, vol. 113, no. 1, pp. 59–65, 2004.
 S. Wenzel, "Severe asthma in adults," American Journal of Respiratory and Critical Care Medicine, vol. 172, no. 2, pp. 149–160, 2005.
 N. Kalach, L. Gumpert, P. Contencin, and C. Dupont, "Dual-probe pH monitoring for the assessment of gastroesophageal reflux in the course of chronic hoarseness in children," Turkish Journal of Pediatrics, vol. 42, no. 3, pp. 186–191, 2000.
 B. D. Havemann, C. A. Henderson, and H. B. El-Serag, "The association between gastro-oesophageal reflux disease and asthma: a systematic review," Gut, vol. 56, no. 12, pp. 1654–1664, 2007.
 C. Astarita, D. Gargano, M. Cutajar, A. Napolitano, F. Manguso, and G. F. Abbate, "Gastroesophageal reflux disease and asthma: an intriguing dilemma," Allergy, vol. 55, no. 61, pp. 52–55, 2000.
 O. Sacco, B. Fregonese, M. Silvestri, F. Sabatini, G. Mattioli, and G. A. Rossi, "Bronchoalveolar lavage and esophageal pH monitoring data in children with "difficult to treat" respiratory symptoms," Pediatric Pulmonology, vol. 30, no. 4, pp. 313–319, 2000.
 R. N. Patterson, B. T. Johnston, J. E. S. Ardill, L. G. Heaney, and L. P. A. McGarvey, "Increased tachykinin levels in induced sputum from asthmatic and cough patients with acid reflux," Thorax, vol. 62, no. 6, pp. 491–495, 2007.
 P. J. Barnes, "Neurogenic inflammation in the airways," Respiration Physiology, vol. 125, no. 1-2, pp. 145–154, 2001.
 S. M. Harding, M. R. Guzzo, and J. E. Richter, "The prevalence of gastroesophageal reflux in asthma patients without reflux symptoms," American Journal of Respiratory and Critical Care Medicine, vol. 162, no. 1, pp. 34–39, 2000.
 M. D. Crowell, E. N. Zayat, B. E. Lacy, A. Schettler-Duncan, and M. C. Liu, "The effects of an inhaled β2-adrenergic agonist on lower esophageal function: a dose-response study," Chest, vol. 120, no. 4, pp. 1184–1189, 2001.
 K. Thakkar, R. O. Boatright, M. A. Gilger, and H. B. El-Serag, "Gastroesophageal reflux and asthma in children: a systematic review," Pediatrics, vol. 125, no. 4, pp. e925–e930, 2010.
 M. Ay, E. Sivasli, Z. Bayraktaroglu, H. Ceylan, and Y. Coskun, "Association of asthma with gastroesophageal reflux disease in children," Journal of the Chinese Medical Association, vol. 67, no. 2, pp. 63–66, 2004.
 "British Thoracic Society/Scottish Intercollegiate Guidelines Network, British guidelines on the management of asthma," Thorax, vol. 58, supplement 1, pp. i1–i94, 2003.
 J. J. Leggett, B. T. Johnston, M. Mills, J. Gamble, and L. G. Heaney, "Prevalence of gastroesophageal reflux in difficult asthma: relationship to asthma outcome," Chest, vol. 127, no. 4, pp. 1227–1231, 2005.
 A. H. Liu, R. Zeiger, C. Sorkness et al., "Development and cross-sectional validation of the childhood asthma control test," Journal of Allergy and Clinical Immunology, vol. 119, no. 4, pp. 817–825, 2007.
 K. W. Bundy, J. F. Gent, W. Beckett et al., "Household airborne Penicillium associated with peak expiratory flow variability in asthmatic children," Annals of Allergy, Asthma and Immunology, vol. 103, no. 1, pp. 26–30, 2009.
 M. A. Biltagi, A. A. Baset, M. Bassiouny, M. A. Kasrawi, and M. Attia, "Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study," Acta Paediatrica, International Journal of Paediatrics, vol. 98, no. 4, pp. 737–742, 2009.
 V. Khoshoo, R. Haydel, and E. Saturno, "Gastroesophageal reflux disease and asthma in children," Current Gastroenterology Reports, vol. 8, no. 3, pp. 237–243, 2006.
 J. Kwiecien, E. MacHura, F. Halkiewicz, and J. Karpe, "Clinical features of asthma in children differ with regard to the intensity of distal gastroesophageal acid reflux," Journal of Asthma, vol. 48, no. 4, pp. 366–373, 2011.
 J. P. Lazenby, M. R. Guzzo, S. M. Harding, P. E. Patterson, L. F. Johnson, and L. A. Bradley, "Oral corticosteroids increase esophageal acid contact times in patients with stable asthma," Chest, vol. 121, no. 2, pp. 625–634, 2002.
 S. M. Harding, "Gastroesophageal reflux and asthma: insight into the association," Journal of Allergy and Clinical Immunology, vol. 104, no. 2 I, pp. 251–259, 1999.
 C. L. Liu, K. F. Lai, R. C. Chen et al., "The role of airway neurogenic inflammation in gastro-esophageal reflux induced cough," Zhonghua Jie He He Hu Xi Za Zhi, vol. 28, no. 8, pp. 520–524, 2005.
 G. F. Joos, P. R. Germonpré, and R. A. Pauwels, "Role of tachykinins in asthma," Allergy, vol. 55, no. 4, pp. 321–337, 2000.
 V. Khoshoo and R. Haydel, "Effect of antireflux treatment on asthma exacerbations in nonatopic children," Journal of Pediatric Gastroenterology and Nutrition, vol. 44, no. 3, pp. 331–335, 2007.
 V. Khoshoo, S. Mohnot, R. Haydel, E. Saturno, D. Edell, and A. Kobernick, "Bronchial hyperreactivity in non-atopic children with asthma and reflux: effect of anti-reflux treatment," Pediatric Pulmonology, vol. 44, no. 11, pp. 1070–1074, 2009.
 H. Yüksel, O. Yilmaz, C. Kirmaz, S. Aydogdu, and E. Kasirga, "Frequency of gastroesophageal reflux disease in nonatopic children with asthma-like airway disease," Respiratory Medicine, vol. 100, no. 3, pp. 393–398, 2006.
 Y. Yoshida, M. Kameda, T. Nishikido, I. Takamatu, and S. Doi, "Gastroesophageal reflux disease in preschool children with asthma," Arerugi, vol. 57, no. 5, pp. 529–535, 2008.
 S. M. Harding, J. E. Richter, M. R. Guzzo, C. A. Schan, R. W. Alexander, and L. A. Bradley, "Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome," American Journal of Medicine, vol. 100, no. 4, pp. 395–405, 1996.
 C. Calabrese, A. Fabbri, A. Areni, C. Scialpi, D. Zahlane, and G. Di Febo, "Asthma and gastroesophageal reflux disease: effect of long-term pantoprazole therapy," World Journal of Gastroenterology, vol. 11, no. 48, pp. 7657–7660, 2005.
 K. St?rdal, G. B. Johannesdottir, B. S. Bentsen et al., "Acid suppression does not change respiratory symptoms in children with asthma and gastro-oesophageal reflux disease," Archives of Disease in Childhood, vol. 90, no. 9, pp. 956–960, 2005.
 I. V. Maev, E. S. Viuchnova, N. N. Balashova, and M. I. Shchekina, "Use of omeprazole and esomeprazole in patients suffering from bronchial asthma with associated gastroesophageal reflux disease," Experimental & Clinical Gastroenterology, no. 3, pp. 26–116, 2003.
 H. Teichtahl, I. J. Kronborg T, N. D. Yeomans, and P. Robinson, "Adult asthma and gastro-oesophageal reflux: the effects of omeprazole therapy on asthma," Australian and New Zealand Journal of Medicine, vol. 26, no. 5, pp. 671–676, 1996.
 M. J. Boeree, F. T. M. Peters, D. S. Postma, and J. H. Kleibeuker, "No effects of high-dose omeprazole in patients with severe airway hyperresponsiveness and (a)symptomatic gastro-oesophageal reflux," European Respiratory Journal, vol. 11, no. 5, pp. 1070–1074, 1998.
 T. R. Levin, R. M. Sperling, and K. R. McQuaid, "Omeprazole improves peak expiratory flow rate and quality of life in asthmatics with gastroesophageal reflux," American Journal of Gastroenterology, vol. 93, no. 7, pp. 1060–1063, 1998.
 T. O. Kiljander, E. R. M. Salomaa, E. K. Hietanen, and E. O. Terho, "Gastroesophageal reflux in asthmatics: a double-blind, placebo-controlled crossover study with omeprazole," Chest, vol. 116, no. 5, pp. 1257–1264, 1999.
 D. Sifrim, L. Dupont, K. Blondeau, X. Zhang, J. Tack, and J. Janssens, "Weakly acidic reflux in patients with chronic unexplained cough during 24 hour pressure, pH, and impedance monitoring," Gut, vol. 54, no. 4, pp. 449–454, 2005.
 R. Shaker and W. J. Hogan, "Reflex-mediated enhancement of airway protective mechanisms," American Journal of Medicine, vol. 108, no. 4, pp. 8–14, 2000.


Charles and Conceição Solis founded the REACH Family Institute in May of 1998 to bring their message of hope and possibility to the world.
REACH is a federally tax-exempt 501(c) 3 non-profit educational and charitable organization.
The REACH Family Institute provides parents and professionals working with children, an unprecedented ability to ensure that the next generation can accomplish their dreams.
For parents frustrated from trying to alleviate their struggling child's pain, REACH is the source of realistic hope that leaves passive acceptance behind on the path of positive proactivity.
Parents seeking to maximize their child's physical, intellectual and social development rely on REACH to set the course, establish critical steps and guide them through an expanded role in the nurturing process.
Professionals, tired of traditional dead ends, come to REACH to develop their understanding, learn new approaches to classroom methods and gain a foothold on results driven rehabilitation tactics.
REACH's vision is the creation of a world in which all children are valued, compassionate and capable. Toward that end we are creating a vast community of parents and professionals who truly believe in the extraordinary potential of every child and who are dedicated to helping them achieve it.
REACH's mission is to empower parents and professionals with knowledge and practical tools related to human brain development and purposeful parenting.
As an organization, and as individuals, we value human dignity, growth, excellence, integrity, responsibility, and teamwork. We are committed to our families and partners and have a passion for children. We take on big challenges, and pride ourselves on seeing them through. We hold ourselves accountable to our families and partners by honoring our commitments, providing results, and striving for the highest quality.


The steps to form a 501(c)(3) nonprofit corporation in Indiana.
Most nonprofits are 501(c)(3) organizations, which means they are formed for religious, charitable, scientific, literary, or educational purposes and are eligible for federal and state tax exemptions. To create a 501(c)(3) tax-exempt organization, first you need to form an Indiana nonprofit corporation. Then you apply for tax-exempt status from the IRS and the State of Indiana. Here are the details.
In Indiana, your nonprofit corporation must have three or more directors.
2. Choose a name for your Indiana nonprofit corporation.
The name of your nonprofit corporation cannot be the same as the name of another corporation on file with the Indiana Secretary of State. To see if your proposed name is available, you can search Indiana's name database available on the Indiana Secretary of State's website.
In Indiana, your nonprofit corporation name must include "corporation," "incorporated," "limited," "company," or an abbreviation.
You will need to create and file nonprofit articles of incorporation with the Indiana Secretary of State. The Indiana Secretary of State has a fillinable articles of incorporation form on its website which you can use to create and mail in your articles. Or, you can file your articles online. Follow the instructions on the Secretary of State's website for completing and filing your articles.
You must include the following statement in your articles: "This corporation is a public benefit corporation." Your articles also must contain the street address of the corporation's initial registered office in Indiana and the name of the corporation's initial registered agent; the name and address of each incorporator; and whether or not the corporation will have members. See Ind. Code 23-17-3-2 for more on what is required in nonprofit articles of incorporation under state law.
For more information on IRS requirements for articles of incorporation, including sample provisions, see IRS Publication 557, Tax-Exempt Status for Your Organization (available on the IRS website). You can also refer to How to Form a Nonprofit Corporation, by Anthony Mancuso (Nolo) for guidance on drafting articles that satisfy both state and IRS rules for 501(c)(3) nonprofits. Be sure to include both the state and federal tax-exempt required language in the articles you create.
4. Prepare bylaws for your Indiana nonprofit corporation.
You'll need to prepare bylaws that comply with Indiana law and contain the rules and procedures your corporation will follow for holding meetings, electing officers and directors, and taking care of other corporate formalities required in Indiana. Your bylaws do not need to be filed with the Indiana Secretary of State -- they are your internal operating manual.
For more information, see Nolo's article Nonprofit Formation Documents: Articles of Incorporation, Bylaws, and Organizational Minutes or, for help creating your bylaws, see Nolo's book How to Form a Nonprofit Corporation, by Anthony Mancuso (Nolo).
2. Obtain your Indiana state tax exemptions.
Once you have your federal tax exemption, you can obtain your Indiana state tax exemptions by providing the Indiana Department of Revenue with a copy of the IRS Federal Determination letter showing your exemption from federal tax. Nonprofits who want a sales tax exemption must file a Nonprofit Application for Sales Tax Exemption (Form NP-20A) with the Indiana Department of Revenue (Form NP-20A) and then annually thereafter a Nonprofit Organization's Annual Report (Form NP-20). Check the Indiana Department of Revenue website for more information on exemptions from income, property, sales, and other state taxes for Indiana 501(c)(3) nonprofits.
Indiana does not require nonprofits to register with the state before soliciting contributions from state residents. You may have to register your nonprofit in other states before you engage in any out-of-state solicitations.


Retinoids are very effective in reducing appearance of wrinkles, acne and stretch marks, but you should avoid them when you are pregnant. Retinoids make skin cells die rapidly and make way for new cell growth underneath. They are available in oral and topical forms. The oral form of retinoids has been found to cause birth defects.
Salicylic acid has been commonly used as an active ingredient in treating acne, blackheads and pimples. It helps to exfoliate dead skin cells that may cause clogging of pores. But, you may have to think twice before taking it orally during pregnancy as it can cause complications and even birth defects.
Hyrdoquinone is a controversial ingredient used to reduce brown spots. But, experts suggest that pregnant women should avoid its use. Instead of using hydroquinone, you can keep dark spots at bay by using a chemical-free sunscreen that contains zinc oxide or titanium dioxide. After delivery, you can talk to your dermatologist on how to lighten spots that may be left.
The nail paints you apply on your nails may not get into your bloodstream, but it is still a good choice to help you avoid polishing your nails when you are pregnant. Also, if you want to go for a manicure or pedicure, make sure your manicurist does not chop off your cuticles or removes calluses as doing so may increase your risk of cuts and infection.
Pollution in China causes Birth Defects?


Learn the meaning of the word "kakorrhaphiophobic" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "apocryphal" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "purloin" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "iconoclast" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "adulation" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "obsequious" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "laceration" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "hyperbole" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "harbinger" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "malapropism" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "disingenuous" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "tenacity" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "supercilious" through Dictionary Head's guessing game in rhyme.
Learn the meaning of the word "smellfungus" through Dictionary Head's guessing game in rhyme.
Learn the meaning of "pugnacious" through Dictionary Head's guessing game in rhyme.
Learn the meaning of "prevaricate" through Dictionary Head's guessing game in rhyme.
Learn the meaning of "despotic" through Dictionary Head's guessing game in rhyme.
Learn the meaning of "Innate" through Dictionary Head's guessing game in rhyme.
Teaching the meaning of "equivocating" through Dictionary Head's guessing game in rhyme.