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Internal Medicine/Anemia and Polycythemia

Hamatopoiesis
Hematopoiesis is the process through which the various components of blood are manufactured in the body. It is a carefully orchestrated sequence that originates with hematopoietic stem cells, capable of producing a wide array of blood cells, including red blood cells, different white blood cells, platelets, and immune system cells. The exact genetic mechanisms governing the stem cell's commitment to a specific blood cell lineage remain incompletely understood.

In mice, it has been observed that erythroid cells, the precursors of red blood cells, stem from a common erythroid/megakaryocyte progenitor, which depends on the expression of specific transcription factors like GATA-1 and FOG-1. As the differentiation process unfolds, hematopoietic progenitor and precursor cells become increasingly subject to the control of growth factors and hormones. In the context of red blood cell production (erythropoiesis), the hormone erythropoietin (EPO) plays a principal role. EPO is necessary for the survival of committed erythroid progenitor cells; without it, these cells undergo programmed cell death (apoptosis). The entire regulated process of red blood cell production is termed erythropoiesis.

Within the bone marrow, the earliest identifiable erythroid precursor is the pronormoblast. It can undergo multiple cell divisions, ultimately yielding 16 to 32 mature red blood cells. Enhanced production of EPO or EPO administration as a medical treatment can boost the number of early progenitor cells, which in turn leads to an increased output of red blood cells. The regulation of EPO production is intrinsically linked to tissue oxygen levels.

In mammals, oxygen is transported to tissues by binding to hemoglobin within red blood cells. Mature red blood cells lack a nucleus, are disk-shaped, about 8 μm in diameter, and are highly flexible to navigate through tiny blood vessels. The cells generate ATP internally to maintain their membrane integrity. Normal red blood cell production replaces approximately 0.8-1% of the body's circulating red blood cells every day, as the average red blood cell lives for about 100-120 days. The system responsible for red blood cell production is called the erythron, which consists of a rapidly proliferating pool of bone marrow erythroid precursor cells and a large population of circulating mature red blood cells. The size of the erythron reflects the equilibrium between the production and destruction of red blood cells. Understanding the physiological mechanisms behind red blood cell production and destruction is crucial for comprehending the causes of anemia.

The hormone EPO is the central regulator of red blood cell production and is produced and released primarily by specialized cells lining the capillaries in the kidneys, known as peritubular capillary lining cells. A smaller amount of EPO is produced by hepatocytes in the liver. The primary trigger for EPO production is the availability of oxygen to meet the metabolic needs of body tissues. A key element in EPO gene regulation is hypoxia-inducible factor (HIF)-1α. When oxygen is plentiful, HIF-1α is hydroxylated, leading to its degradation via the proteasome pathway. But when oxygen is limited, this critical hydroxylation step does not occur, allowing HIF-1α to activate the EPO gene and others.

Factors that can impair kidney oxygen delivery include a decreased red blood cell mass (anemia), difficulties with oxygen loading onto hemoglobin or the presence of high-affinity mutant hemoglobin (hypoxemia), or in rare cases, impaired blood flow to the kidney (e.g., renal artery stenosis). EPO governs day-to-day red blood cell production, and its levels in the bloodstream can be measured with sensitive immunoassays, with normal levels ranging from 10-25 U/L. As hemoglobin levels drop below 10-12 g/dL, plasma EPO levels rise in proportion to the severity of the anemia. In circulation, EPO has a half-clearance time of 6-9 hours. EPO acts by binding to specific receptors on bone marrow erythroid precursors, stimulating their proliferation and maturation. Under EPO stimulation, red blood cell production can increase significantly over a period of 1-2 weeks, provided there are adequate nutrients, especially iron, available. Hence, the proper functioning of the erythron relies on the normal production of EPO by the kidneys, a functional erythroid marrow, and an adequate supply of materials for hemoglobin synthesis. A deficiency in any of these key components can lead to anemia. Typically, anemia is identified in the laboratory when a patient's hemoglobin or hematocrit levels fall below expected values for their age and sex.

To initially categorize anemia, essential elements of erythropoiesis—EPO production, iron availability, bone marrow's ability to produce red blood cells, and effective maturation of red cell precursors—are used as reference points.

Clinical Manification of Anemia
Clinical manifestations of anemia are typically identified through abnormal results in routine laboratory tests, as patients with advanced anemia and its related symptoms are less frequently encountered. Acute anemia is typically caused by blood loss or hemolysis. When blood loss is minimal, the body compensates for reduced oxygen levels by modifying the oxygen-hemoglobin dissociation curve, primarily driven by a drop in pH or an increase in CO2 (known as the Bohr effect). In cases of acute blood loss, the most prominent issue is hypovolemia, overshadowing hematocrit and hemoglobin levels, which do not accurately reflect the amount of blood lost. Clinical indications of vascular instability emerge when there is an acute loss of 10-15% of the total blood volume. In such cases, the primary concern is not anemia but rather hypotension and reduced organ perfusion. When more than 30% of the blood volume is lost suddenly, the usual mechanisms of vascular contraction and regional blood flow changes fail to compensate. Patients tend to prefer a supine position and may exhibit postural hypotension and increased heart rate. If blood loss exceeds 40% (equivalent to more than 2 liters in an average-sized adult), signs of hypovolemic shock manifest, including confusion, difficulty breathing, profuse sweating, low blood pressure, and rapid heart rate. Such patients have significant deficits in vital organ perfusion and require immediate volume replacement.

In the case of acute hemolysis, the symptoms and signs vary based on the mechanism leading to the destruction of red blood cells. Intravascular hemolysis, with the release of free hemoglobin, can be associated with sudden back pain, the presence of free hemoglobin in the plasma and urine, and renal failure. For chronic or slowly progressive anemia, the symptoms experienced depend on the patient's age and whether critical organs are receiving an adequate blood supply. Symptoms associated with moderate anemia typically include fatigue, reduced stamina, shortness of breath, and an increased heart rate, especially during physical exertion. However, due to the body's built-in compensatory mechanisms that govern the oxygen-hemoglobin dissociation curve, the gradual onset of anemia, especially in young patients, may not display signs or symptoms until the anemia becomes severe (hemoglobin levels drop below 70-80 g/L or 7-8 g/dL). When anemia develops over days or weeks, the total blood volume remains normal to slightly increased, and adjustments in cardiac output and regional blood flow help compensate for the overall loss in oxygen-carrying capacity. Some of the compensatory responses to anemia are due to changes in the position of the oxygen-hemoglobin dissociation curve. In chronic anemia, intracellular levels of 2,3-bisphosphoglycerate increase, causing the dissociation curve to shift to the right, facilitating the unloading of oxygen. However, this compensatory mechanism can only maintain normal tissue oxygen delivery in the face of a 20-30 g/L (2-3 g/dL) hemoglobin deficit.

Furthermore, protection of oxygen delivery to vital organs is achieved by diverting blood away from organs that have relatively abundant blood supply, particularly the kidneys, gut, and skin.

Several medical conditions are commonly linked to anemia. Chronic inflammatory states (e.g., infection, rheumatoid arthritis, cancer) often result in mild to moderate anemia, while lymphoproliferative disorders such as chronic lymphocytic leukemia and specific B-cell neoplasms may lead to autoimmune hemolysis.

Diagnosis of Anemia
Evaluating a patient with anemia requires a thorough examination of their medical history and a physical assessment. This assessment should also include an exploration of the patient's nutritional history, drug or alcohol use, and family history of anemia. Additionally, it's important to consider certain geographic and ethnic backgrounds, as they can be associated with a higher risk of inherited hemoglobin or intermediary metabolism disorders. For instance, individuals of Middle Eastern or African descent, including those of African descent, have a higher prevalence of conditions like glucose-6-phosphate dehydrogenase (G6PD) deficiency and specific hemoglobinopathies. Other valuable information to gather includes potential exposure to toxic substances or drugs, as well as symptoms related to disorders commonly linked to anemia. These symptoms and signs may encompass bleeding, fatigue, general weakness, fever, unexplained weight loss, night sweats, and other systemic symptoms. Physical examination findings that may offer clues to the underlying cause of anemia include signs of infection, the presence of blood in the stool, lymph node enlargement (lymphadenopathy), an enlarged spleen (splenomegaly), or small, reddish-purple spots on the skin (petechiae). Splenomegaly and lymphadenopathy may suggest underlying lymphoproliferative diseases, whereas petechiae may indicate platelet dysfunction. Past laboratory test results can also provide insights into the timeline of the anemia's onset.

In an anemic patient, a physical examination might reveal a strong heartbeat, robust peripheral pulses, and a systolic "flow" murmur. If hemoglobin falls below 8-10 g/dL (80-100 g/L), the skin and mucous membranes could appear pale. It's essential to focus the examination on areas where blood vessels are close to the surface, such as the mucous membranes, nail beds, and the palmar creases. An indication of anemia might be when the palmar creases are lighter in color than the surrounding skin when the hand is hyperextended.

Laboratory Assessment
A standard complete blood count (CBC) is a crucial part of the evaluation and includes measurements of hemoglobin, hematocrit, and red cell indices: mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). MCH is the least useful of these indices and typically mirrors MCV. Numerous physiological factors can influence the CBC, including age, gender, pregnancy, smoking, and altitude. High-normal hemoglobin levels can be observed in individuals living at high altitudes or heavy smokers due to the replacement of oxygen by carbon monoxide (CO) in hemoglobin binding. Additional valuable information is derived from the reticulocyte count and iron-related measurements, such as serum iron, total iron-binding capacity (TIBC), serum transferrin, and serum ferritin. Significant deviations in red cell indices are typically indicative of maturation disorders or iron deficiency. A careful analysis of the peripheral blood smear is essential, and clinical laboratories often provide descriptions of both red and white blood cells, a white blood cell differential count, and the platelet count. In cases of severe anemia and irregularities in red cell morphology or a low reticulocyte count, a bone marrow aspirate or biopsy may be necessary for diagnosis. Additional tests that may be helpful in diagnosing specific anemias are discussed in chapters focusing on specific disease states.

The components of the CBC also aid in classifying anemia. Microcytosis is indicated by an MCV below the normal range (<80), while values above the normal range (>100) indicate macrocytosis. Hypochromia, reflecting defects in hemoglobin synthesis, is mirrored by MCHC. Automated cell counters provide data on the red cell volume distribution width (RDW), but the MCV, representing the peak of the distribution curve, may not always detect small populations of macrocytes or microcytes. Experienced laboratory technicians can often identify minor populations of unusually large or small cells or hypochromic cells on the peripheral blood film before the red cell indices change.

Peripheral Blood Smear
The peripheral blood smear is a valuable tool for detecting defects in red cell production. Alongside the red cell indices, it reveals variations in cell size (anisocytosis) and shape (poikilocytosis). The degree of anisocytosis is usually linked to changes in RDW or the range of cell sizes. Poikilocytosis suggests issues in the maturation of red cell precursors in the bone marrow or the fragmentation of circulating red cells. The blood smear might also show polychromasia, which represents red cells that are slightly larger than normal and appear bluish-gray when stained with Wright-Giemsa stain. These cells are reticulocytes that have been prematurely released from the bone marrow and their color indicates residual ribosomal RNA. They enter the bloodstream in response to erythropoietin (EPO) stimulation or due to structural damage in the bone marrow (such as fibrosis or infiltration by malignant cells) that leads to their unregulated release. The presence of nucleated red cells, Howell-Jolly bodies, target cells, sickle cells, and other variations can offer hints regarding specific disorders.

Reticulocyte Count
An accurate reticulocyte count plays a crucial role in the initial classification of anemia. Reticulocytes are red cells that have been recently released from the bone marrow. They can be identified through staining with a supravital dye that precipitates ribosomal RNA. These precipitates appear as blue or black punctate spots and can be counted manually or with modern techniques involving fluorescent dyes that bind to RNA. This residual RNA is metabolized within the first 24-36 hours of a reticulocyte's lifespan in circulation. Under normal circumstances, the reticulocyte count ranges from 1% to 2% and represents the daily replacement of approximately 0.8-1.0% of the circulating red cell population. A corrected reticulocyte percentage or the absolute number of reticulocytes provides a reliable measure of effective red cell production.

To estimate the marrow's response based on the reticulocyte count, two corrections are necessary. The first correction adjusts the reticulocyte count based on the reduced number of circulating red cells. In cases of anemia, the percentage of reticulocytes may appear elevated while the absolute number remains constant. This correction factor takes into account the patient's hemoglobin or hematocrit relative to the expected hemoglobin/hematocrit for their age and sex. This provides an estimate of the reticulocyte count corrected for anemia. To convert the corrected reticulocyte count into an index of marrow production, an additional correction is needed, which depends on whether some of the reticulocytes in circulation have been released prematurely from the bone marrow. For this second correction, the peripheral blood smear is examined to check for the presence of polychromatophilic macrocytes. These cells, representing prematurely released reticulocytes, are referred to as "shift" cells, and the relationship between the degree of shift and the necessary shift correction factor is detailed in a figure. The correction is necessary because these prematurely released cells remain in circulation as reticulocytes for more than a day, leading to a falsely high estimate of daily red cell production. If polychromasia is increased, the reticulocyte count, which is already corrected for anemia, should undergo an additional correction by a factor of 2, accounting for the prolonged reticulocyte maturation time. A correction factor of 2 is often used for simplicity. If the blood smear does not show polychromatophilic cells, the second correction is unnecessary. The reticulocyte count, now doubly corrected, becomes the reticulocyte production index, offering an estimate of marrow production relative to the normal range. In many hospital laboratories, the reticulocyte count is reported as both a percentage and an absolute number, in which case no correction for dilution is required.

Premature release of reticulocytes usually occurs due to heightened EPO stimulation. However, when the integrity of the bone marrow release process is compromised by tumor infiltration, fibrosis, or other disorders, the presence of nucleated red cells or polychromatophilic macrocytes should still trigger the second reticulocyte correction. The shift correction should be consistently applied to patients with anemia and very high reticulocyte counts to provide an accurate index of effective red cell production. In cases of severe chronic hemolytic anemia, red cell production can increase by as much as six- to sevenfold. This alone confirms that the patient has a proper EPO response, a normally functioning bone marrow, and sufficient iron for new red cell formation. If the reticulocyte production index falls below 2 in the context of established anemia, a defect in erythroid marrow proliferation or maturation must be present.

Tests for Iron Supply and Storage
Laboratory measurements that reflect the availability of iron for hemoglobin synthesis include serum iron, total iron-binding capacity (TIBC), percent transferrin saturation, and serum ferritin. Percent transferrin saturation is calculated by dividing serum iron levels by TIBC and then multiplying by 100. Normal serum iron levels range from 9 to 27 μmol/L (50-150 μg/dL), while TIBC ranges from 54 to 64 μmol/L (300-360 μg/dL), and the normal transferrin saturation is 25-50%. There is a diurnal variation in serum iron levels, leading to changes in percent transferrin saturation. Serum ferritin is used to assess overall body iron stores. In adult males, the average serum ferritin levels are around 100 μg/L, representing iron stores of about 1 gram. Premenopausal adult females have lower serum ferritin levels, averaging around 30 μg/L, reflecting lower iron stores of around 300 mg. A serum ferritin level of 10-15 μg/L indicates depletion of body iron stores. It's important to note that ferritin is also an acute-phase reactant and, in the presence of acute or chronic inflammation, its levels may rise significantly. Typically, a serum ferritin level exceeding 200 μg/L suggests the presence of some iron in tissue stores.

Bone Marrow Examination
In certain cases, a bone marrow aspirate, smear, or needle biopsy can be helpful in evaluating patients with anemia. Patients with hypoproliferative anemia, normal renal function, and normal iron status may require a bone marrow examination. This assessment can help diagnose primary marrow disorders like myelofibrosis, defects in red cell maturation, or infiltrative diseases. An evaluation of the balance between different cell lineages (myeloid vs. erythroid) in a bone marrow smear is obtained through a differential count of nucleated cells, referred to as the myeloid/erythroid (M/E) ratio. In patients with hypoproliferative anemia and a reticulocyte production index below 2, an M/E ratio of 2 or 3:1 is expected. In contrast, patients with hemolytic diseases and a production index exceeding 3 are likely to have an M/E ratio of at least 1:1. Maturation disorders are identified through the discrepancy between the M/E ratio and the reticulocyte production index. Either the bone marrow smear or biopsy can be stained to assess the presence of iron stores or iron in developing red cells. Iron stores are typically found in the form of ferritin or hemosiderin. Small ferritin granules can normally be seen under oil immersion in 20-40% of developing erythroblasts on carefully prepared bone marrow smears. These cells are called sideroblasts.

Classification of Anemia
Anemia is a complex and multifaceted medical condition, with a wide array of underlying causes and manifestations. It's essentially a deficiency in the number of red blood cells or a decrease in the quality or quantity of hemoglobin in the blood. These red blood cells are essential for transporting oxygen from the lungs to the body's tissues and organs. When anemia occurs, it can lead to a range of symptoms and health issues, depending on its severity and root causes.

To fully understand and classify anemia, medical professionals employ a functional classification that divides it into three major categories:

 * 1) Marrow Production Defects (Hypoproliferation): This category is marked by a low reticulocyte production index, indicating that the bone marrow isn't generating red blood cells at an adequate rate in response to the anemia. Moreover, there's little to no significant change in the morphology of the red blood cells. Consequently, this type of anemia results in a normocytic and normochromic anemia, where the size and hemoglobin content of red blood cells appear to be within the normal range.
 * 2) * The majority of hypoproliferative anemias can be traced back to underlying causes like iron deficiency, chronic inflammation, marrow damage due to factors such as drug toxicity, or inadequate stimulation by erythropoietin (EPO) because of issues like renal dysfunction.
 * 3) * In these cases, red blood cells often exhibit characteristics typical of a normocytic, normochromic anemia, with the red blood cells appearing to be of normal size and hemoglobin content. However, there can be instances where microcytic, hypochromic cells emerge, particularly in cases of mild iron deficiency or prolonged chronic inflammatory conditions.
 * 4) * The diagnostic process for these anemias usually involves a battery of tests, including assessments of serum iron, iron-binding capacity, renal function, thyroid function, and a possible bone marrow examination to determine the presence of damage or infiltrative diseases. Additionally, serum ferritin is measured to gauge iron stores within the body.
 * 5) Red Cell Maturation Defects (Ineffective Erythropoiesis): This class of anemias presents with a reticulocyte production index that is somewhat elevated when compared to normal values. This elevated index is accompanied by the appearance of macrocytic or microcytic red cell indices on a peripheral blood smear. Macrocytic anemia is characterized by the presence of larger-than-normal red blood cells, while microcytic anemia features smaller cells with less hemoglobin.
 * 6) * Nuclear maturation defects can be linked to various causes, such as deficiencies in vitamin B12 or folic acid, damage due to specific drugs, or myelodysplastic syndromes. Medications that interfere with cellular DNA synthesis, including methotrexate or alkylating agents, can induce a nuclear maturation defect. Alcohol, when consumed excessively, may lead to macrocytosis and anemia, often related to folic acid deficiency.
 * 7) * Anemia arising from a deficiency in vitamin B12 or folic acid typically falls under the category of macrocytic anemia, characterized by larger-than-normal red blood cells. To pinpoint the specific cause of these anemias, the measurement of folic acid and vitamin B12 levels is critical since these reflect different pathogenetic mechanisms.
 * 8) * In contrast, cytoplasmic maturation defects often result from severe iron deficiency or abnormalities in globin or heme synthesis. Here, iron deficiency occupies an interesting position in the classification of anemia. Mild to moderate iron deficiency leads to a blunted erythroid marrow response and is thus classified as hypoproliferative. However, if iron deficiency becomes severe and prolonged, the erythroid marrow's proliferation becomes hyperplastic, and the anemia is categorized as ineffective erythropoiesis with a cytoplasmic maturation defect.
 * 9) * In both cases, the reticulocyte production index is inappropriately low, and a peripheral blood smear typically reveals either macrocytosis or microcytosis and hypochromia. Specialized iron studies help in distinguishing iron deficiency from other cytoplasmic maturation defects, such as the thalassemias.
 * 10) Decreased Red Cell Survival (Blood Loss/Hemolysis): Anemia resulting from reduced red cell survival, which can occur due to blood loss or hemolysis (the premature destruction of red blood cells), exhibits an increased reticulocyte production index, often exceeding 2.5 times normal values. This elevation of the index signals the bone marrow's response to compensate for the rapid loss of red blood cells.
 * 11) * Blood loss anemia can manifest as either acute or chronic, with acute cases usually marked by a reticulocyte production index that's not significantly elevated. This is because it takes some time for the body to respond to the sudden decrease in red blood cell count by increasing erythropoiesis.
 * 12) * Subacute blood loss, on the other hand, may result in modest reticulocytosis as the body starts to compensate for the loss of red blood cells.
 * 13) * The evaluation of blood loss anemia is typically less challenging than other forms of anemia. However, complications may arise when a patient presents with an increased red cell production index as a result of an episode of acute blood loss that went unrecognized.
 * 14) * Hemolytic disease, on the other hand, is among the least common forms of anemia. Hemolysis leads to a high reticulocyte production index, reflecting the bone marrow's ability to compensate for the loss of red blood cells. The extent of this response depends on the severity of the anemia and the nature of the underlying disease.
 * 15) * Hemoglobinopathies, like sickle cell disease and the thalassemias, often present a mixed picture. The reticulocyte index may be high, but it is inappropriately low for the degree of marrow erythroid hyperplasia.
 * 16) * Hemolytic anemias can present in various ways. Some occur suddenly as acute, self-limited episodes of intravascular or extravascular hemolysis, often observed in patients with autoimmune hemolysis or inherited defects in specific metabolic pathways. On the other hand, individuals with chronic hemolytic diseases, such as hereditary spherocytosis, may not present with anemia but rather with complications stemming from prolonged increased red cell destruction, like symptomatic bilirubin gallstones or splenomegaly.
 * 17) * Chronic hemolysis can also make patients susceptible to aplastic crises when an infectious process interrupts red cell production.
 * 18) * The differential diagnosis of an acute or chronic hemolytic event requires the careful integration of family history, clinical presentation, and a thorough examination of the peripheral blood smear. Precise diagnosis may necessitate specialized laboratory tests, such as hemoglobin electrophoresis or screenings for red cell enzymes. Acquired defects in red cell survival are often immunologically mediated and require tests like direct or indirect antiglobulin tests or cold agglutinin titers to detect the presence of hemolytic antibodies or complement-mediated red cell destruction.

Anemia is a broad and intricate medical condition with various underlying mechanisms and clinical presentations. A thorough understanding of the specific type of anemia is crucial for appropriate diagnosis and treatment, as each category requires a distinct approach to address the underlying issues and alleviate the patient's symptoms.

Treatment of Anemia
A fundamental guiding principle is to commence the treatment of mild to moderate anemia only when there's a precise diagnosis. On rare occasions, in urgent situations, when anemia is exceptionally severe, red cell transfusions might be necessary even before a specific diagnosis can be established. Whether the anemia develops suddenly or gradually, the choice of the most suitable treatment hinges upon the identified cause or causes of the anemia. Frequently, the origins of the anemia can be multifaceted. For instance, a patient grappling with severe rheumatoid arthritis, who has been prescribed anti-inflammatory medications, might exhibit a hypoproliferative anemia linked to persistent inflammation and, concurrently, chronic blood loss due to sporadic gastrointestinal bleeding. In all scenarios, a thorough assessment of the patient's iron levels is of paramount importance both before and during the course of treating any type of anemia.

Over the last three decades, there has been a remarkable expansion in therapeutic options for addressing anemias. The utilization of blood component therapy has not only become more prevalent but also notably safe. The introduction of recombinant erythropoietin (EPO) as a complement to managing anemia has been transformative, significantly improving the quality of life for patients with chronic renal failure undergoing dialysis and decreasing the necessity for transfusions in individuals with anemia resulting from cancer treatments like chemotherapy. Moreover, there is a promising future on the horizon, where patients dealing with inherited disorders related to the synthesis of globin or those with specific mutations in globin genes, such as sickle cell disease, might eventually reap the benefits of targeted genetic therapies.

Polycythemia
Polycythemia is characterized by an elevation in hemoglobin levels beyond the normal range. This elevation may be real or only apparent, often due to a reduction in plasma volume, a condition known as spurious or relative polycythemia. While some people use the terms "erythrocytosis" and "polycythemia" interchangeably, a subtle distinction can be made: erythrocytosis implies that an increase in red cell mass has been documented, whereas polycythemia simply refers to any rise in red cell count. Typically, individuals with polycythemia are identified when their hemoglobin or hematocrit levels are incidentally found to be elevated. Concern usually arises when hemoglobin levels reach or exceed 17 g/dL (170 g/L) in men and 15 g/DL (150 g/L) in women. Hematocrit levels surpassing 50% in men or 45% in women might also raise concern, while hematocrit levels above 60% in men and 55% in women are almost always indicative of an increased red cell mass. Since the machines used to measure red cell parameters primarily assess hemoglobin concentrations and calculate hematocrits, hemoglobin levels may be a more reliable indicator.

To aid in the differential diagnosis, certain aspects of the patient's medical history can be quite informative. These include factors such as smoking, residing at high altitudes, a history of diuretic use, congenital heart disease, sleep apnea, or chronic lung conditions.

Patients with polycythemia may either have no symptoms or experience various issues related to the elevated red cell mass or the underlying condition causing this increase. The primary symptoms resulting from an increased red cell mass are often linked to hyperviscosity and an increased risk of thrombosis, both venous and arterial, due to the logarithmic rise in blood viscosity when hematocrit levels exceed 55%. These manifestations encompass neurological symptoms like vertigo, tinnitus, headaches, and visual disturbances. Hypertension is frequently observed. Patients with polycythemia vera may experience aquagenic pruritus, as well as symptoms associated with hepatosplenomegaly, easy bruising, nosebleeds, or gastrointestinal bleeding. Peptic ulcers are common in this group. Some patients may also present with issues like digital ischemia, Budd–Chiari syndrome, or thrombosis in hepatic or splenic/mesenteric veins. Those with low oxygen levels might develop cyanosis with minimal exertion or report symptoms such as headaches, reduced mental alertness, and fatigue.

During a physical examination, individuals with polycythemia often exhibit a ruddy or reddish complexion. The presence of splenomegaly suggests a diagnosis of polycythemia vera. The occurrence of cyanosis or evidence of a right-to-left shunt may point to congenital heart diseases that present in adulthood, particularly conditions like tetralogy of Fallot or Eisenmenger's syndrome. Elevated blood viscosity can lead to increased pulmonary artery pressure, while hypoxemia can raise pulmonary vascular resistance, together potentially leading to cor pulmonale.

Polycythemia can have spurious causes, often related to reduced plasma volume (a condition known as Gaisbock's syndrome), or it can be of primary or secondary origin. Secondary causes are typically associated with the hormone erythropoietin (EPO), either due to a physiologically appropriate response to tissue hypoxia (as seen in lung diseases, high-altitude living, carbon monoxide poisoning, or high-affinity hemoglobinopathies) or an abnormal overproduction of EPO (resulting from conditions like renal cysts, renal artery stenosis, or tumors with ectopic EPO production). In rare instances, a familial form of polycythemia may occur, characterized by normal EPO levels but hyperresponsive EPO receptors due to specific genetic mutations.


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Chess Variants/Tamerlane Chess

Introduction
Tamerlane chess is a large medieval chess variant from Central Asia.

History
Tamerlane chess, like the modern game, was derived from shatranj. The game is named after Tamerlane, the first ruler of the Timurid Empire that covered Iran, Afghanistan and large parts of Central and West Asia during the early 15th century. It is believed that he was the creator of the game.

Rules
Tamerlane chess is played on an uncheckered board of 10 by 11 squares. There are two special squares called "citadels" that protrude from the right side of each player's second rank. The citadels can only be occupied by the opposing king - the game ends in a draw if this happens. Unlike modern chess, stalemate is considered a win for the player delivering the stalemate.

The players both have an army of 28 pieces of 21 different types. There are ten different types of standard pieces, and eleven types of pawns, which each promote in their own way.

The player who moves first is decided by a dice roll.

The pieces
Each of the pieces moves as follows:

 * Chess_kll45.svg The king (shah in Persian) moves like his modern counterpart - one square in any direction. Once per game, he is allowed to trade places with one of his own pieces to evade check(mate) or stalemate.
 * Chess_qll44.png The general (ferz in Persian) moves one square diagonally.
 * Chess_gll44.png The vizier (wazir in Persian) moves one square horizontally or vertically.
 * Chess_Gll45.svg The giraffe (zurafa in Persian) first moves one square diagonally, then a minimum of three squares horizontally or vertically.
 * Chess_bll44.png The picket (tali'a in Persian) moves like a modern bishop, but it must move a minimum of two squares.
 * Chess_nll44.png The knight (faras in Persian) moves like its modern counterpart.
 * Chess_rll44.png The rook (rukh in Persian) moves like its modern counterpart.
 * Elephant_white.png The elephant (fil in Persian) jumps two squares diagonally and is allowed to jump over pieces.
 * Chess_sll44.png The camal (shutur in Persian) moves like an extended knight - rather than jumping two squares then one, it jumps three squares then one.
 * Chess_mll44.png The war engine (dababba in Persian) moves two squares horizontally or vertically and is allowed to jump over pieces.
 * Chess_pll44.png The pawns all move like their modern counterparts but with no double-step move (and by extension no en passant). There are eleven different types of pawns, each of which is associated with a type of piece. So there is a pawn of pawns, a pawn of giraffes, a pawn of war machines, and so on.

Pawn promotion
If a pawn manages to reach the other side of the board without capture or mishap, it is allowed to promote to the type of piece it is representing. So for example the pawn of rooks promotes to a rook. There are two exceptions to this rule: The pawn of kings and the pawn of pawns are promoted in special ways.

When the pawn of kings promotes, it promotes to a piece called a prince, which moves exactly like the king. Indeed, it actually is a king - if a player manages to obtain a prince alongside their king, normal checkmate and stalemate rules are temporarily suspended and instead the opponent must capture one of those pieces (king or prince) as they would a normal piece, and only then can they checkmate/stalemate the other royal piece to win.

The pawn of pawns is more complex. It must reach the end of the board three times before it may be promoted:

 * The first time the pawn of pawns reaches the end of the board, it just simply sits there as an obstacle that cannot be captured.
 * After that, if ever the situation arises where the opponent cannot escape losing a piece to a pawn, or a pawn can fork two opponent pieces, the pawn of pawns must be moved to the location where that action can be done. If a piece is already on that square it is removed from the board regardless of its loyalty.
 * Then the pawn of pawns continues advancing up the board. Once it reaches the end of the board for the second time it is immediately moved to the starting position of the pawn of kings.
 * Once the pawn of pawns reaches the end of the board for the third time it may promote

Once the pawn of pawns finally does promote, it promotes to a piece called an adventitious king. This piece moves exactly like the king, and it is also royal, so like the prince and king if the adventitious king is on the board it must be captured alongside the other royals before the opponent may claim victory.

Citadels
As already stated, the citadels (husun in Persian) are the two spaces that protrude from the right side of each player's second rank. Under normal circumstances the citadels may only be occupied by the opposing king - if the opponent manages to move their king into one's own citadel, the game ends in a draw.

The exception to the citadel rule is that if one obtains an adventitious king by promoting their pawn of pawns, that piece may occupy one's own citadel to stop the opposing king from moving in, the only piece with this honour.

If a player has a prince on the board and their king is captured, the prince takes the king's role and gains the ability to enter the opposing citadel. If the prince is captured whilst a friendly adventitious king is on the board, said adventitious king will be allowed to enter the opposing citadel.

Other rules

 * If a player has multiple royal pieces they may move one into check if they want, although this is obviously a bad idea.
 * There is no castling - the move had not been created yet. There is also no 50-move rule.
 * Baring the opponent's king is not considered a win as said opposing could still enter your citadel.

Sub-variants
This chess variant does not have any notable sub-variants.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Chess Variants/Tamerlane Chess


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Outsourcing/Introduction

Definition
Outsourcing is the process of contracting out a specific task or function to a third party, rather than performing it in-house. This can be done for a variety of reasons, such as to reduce costs, gain access to specialized expertise, or free up internal resources for other tasks.

The global outsourcing market is dominated by two sub-industries: IT outsourcing (ITO) and business process outsourcing (BPO).

Business Functions

 * Accounting and finance
 * Human Resources
 * Customer service
 * IT support
 * Manufacturing
 * Marketing and Sales
 * Research and development
 * Web development
 * Shipping and Logistics

Outsourcing relationship management (ORM)
ORM  is the business discipline widely adopted by companies and public institutions to manage one or more external service providers as part of an outsourcing strategy. ORM is a broadly used term that encompasses elements of organizational structure, management strategy and information technology infrastructure.

title: Outsourcing/Introduction


text:
Chess Variants/Anti-King Chess

Introduction
Anti-King Chess is a variant that adds a piece known as the "anti-king" to the chessboard. There are two versions of the variant, named with the Roman numerals I and II.

History
Both versions of Anti-King chess were created by chess variant creator Peter Aronson in 2002, inspired by losing chess. Inspired by previous variants that simply replaced the king with an anti-king, Aronson got the idea to have both the king and anti-king on the board to add dynamic tension to the game.

Rules
Both versions of Anti-King chess play mostly like the standard game, with the addition of the anti-king to the typical set of pieces.

The anti-king (reresented by an inverted king) moves exactly like a standard king. The difference between the two is that the anti-king must be kept attacked by enemy pieces at all times, and the anti-king is considerd to be in "anti-check" if it not attacked by an opposing piece. If a player's anti-king is in anti-check and the player is unable to move the anti-king to a square where it is attacked by an enemy piece that anti-king is in "anti-checkmate" and its owner has lost the game.

Because of the unique nature of the anti-king, it cannot capture or be captured by enemy pieces. This means that the anti-king cannot deliver check to the enemy king, and likewise the enemy king cannot attack the anti-king. However the anti-king does possess the ability to capture friendly pieces.

Anti-King Chess I uses several additional rules:

 * The pawns are replaced with Berolina pawns, which move diagonally and capture forward. See the Berolina chess page for more information. Unlike in Berolina chess the Berolina pawns in this game do not get the options of a first-move double-step (and hence, there is no en passant).
 * There is no castling. Instaed, if the king or anti-king have not yet moved in the game they may amke their first move as a knight's leap to an empty square, provided it is not attacked (for the king) or attacked by the enemy (for the anti-king).

Sub-variants
This chess variant does not have any notable sub-variants.

title: Chess Variants/Anti-King Chess


text:
Chess Variants/Tutti-Frutti Chess

Introduction
Tutti-Frutti Chess is a variant that adds the three classic knight compound pieces (chancellor, archbishop and amazon) to the 8x8 board.

History
Tutti-frutti chess was created by chess variants creators Ralph Betza and Philip Cohen in 1978. The variant has enjoyed some popularity in tournaments, especially those hosted by the Italian Association of Chess Variants (Associazione Italiana Scacchi Eterodossi).

Rules
Tutti-frutti chess is played mostly like the standard game, but with three new pieces added:

In the starting position, the queen's rooks are replaced by empresses, the queens by amazons, the king's bishops by queens and the king's knight by princesses.
 * The princess (Chess_all45.svg) moves like a combination of a bishop or a knight. It may slide diagonally like a bishop or jump like a knight, but not both in one move.
 * The empress (Chess_cll45.svg) moves like a combination of a rook or a knight. It may slide horizontally or vertically like a rook or jump like a knight, but not both in one move.
 * The amazon (Chess_gll45.svg) moves like a combination of a queen or a knight. It may slide in any direction like a queen or jump like a knight, but not both in one move.

The king may castle with the empress as he may with the queen's rook in standard chess, provided all the castling conditions are met.

Pawns may promote to the three new pieces in addition to the standard options.

Sub-variants
This chess variant does not have any notable sub-variants.

title: Chess Variants/Tutti-Frutti Chess


text:
Talk:Minecraft/Netherite

Incorrect note
A note says "

 * This item, and all items it can be used to create, cannot be destroyed with lava or fire.

"

This is not always true, for example, a lodestones can burn in lave. This appears to be an oversight from Mojang, but the note is still wrong in the latest version game. And that's just speculation, maybe lodestones are purposefully even more of a scam. 64.107.129.228 (discuss) 16:49, 27 October 2023 (UTC)

 * Fixed. -what is lave- Cintilo (discuss • contribs) 03:32, 11 November 2023 (UTC)

title: Talk:Minecraft/Netherite


text:
Open Scholarship Press Curated Volumes: Connection

Graham Jensen (UVic), Tyler Fontenot (Independent), Alan Colín-Arce (U Autónoma del Estado de México), Alyssa Arbuckle (UVic), Vitor Yano (Concordia), Anna Honcharova (European Students' Forum), Caroline Winter (UVic), and Ray Siemens (UVic), with the INKE and ETCL Research Groups

Table of Contents
This volume is included in the Open Scholarship Press Curated Volumes .

''Where possible, original resources have been uploaded via Wikisource and linked to here. All other original resources are also linked to via this introduction.''

 Introduction: Digital Knowledge Commons, Scholarly Connection, and the Evolution of Open Scholarship

Graham Jensen

Historicizing the Knowledge Commons: Open Access, Technical Knowledge, and the Industrial Application of Science Shawn Martin

From Social Networks to Publishing Platforms: A Review of the History and Scholarship of Academic Social Network Sites Katy Jordan

Open Knowledge Commons versus Privatized Gain in a Fractured Information Ecology: Lessons from COVID-19 for the Future of Sustainability Martin Hensher, Katie Kish, Joshua Farley, Stephen Quilley, and Katharine Zywert

A Social Networking Site Is Not an Open Access Repository Katie Fortney and Justin Gonder

‘Facebook for Academics’: The Convergence of Self-Branding and Social Media Logic on Academia.Edu Brooke Erin Duffy and Jefferson D. Pooley

What Does Academia.Edu’s Success Mean for Open Access? Gary Hall

Academia, Not Edu Kathleen Fitzpatrick

Digital Theoria, Poiesis, and Praxis: Activating Humanities Research and Communication through Open Social Scholarship Platform Design Jon Saklofske

Beyond Friending: BuddyPress and the Social, Networked, Open-Source Classroom Matthew Gold

Foundations for the Canadian Humanities and Social Sciences Commons: Exploring the Possibilities of Digital Research Communities Caroline Winter, Tyler Fontenot, Luis Meneses, Alyssa Arbuckle, Ray Siemens, and the ETCL and INKE Research Groups


text: Category:Book:Open Scholarship Press Curated Volumes: Connection


text:
Open Scholarship Press Curated Volumes: Policy

Caroline Winter (UVic), Alyssa Arbuckle (UVic), Jesse Thomas Kern (UVic), Vitor Yano (Concordia), Anna Honcharova (European Students' Forum), Tyler Fontenot (Independent), Graham Jensen (UVic), Alan Colin Arce (U Autónomo del Estado de México), and Ray Siemens (UVic), with Tanja Niemann (Érudit) and Lynne Siemens (UVic), and the INKE and ETCL Research Groups

Table of Contents
This volume is included in the Open Scholarship Press Curated Volumes .

''Where possible, original resources have been uploaded via Wikisource and linked to here. All other original resources are also linked to via this introduction.''

 Introduction: Open Scholarship Policy in Focus

Caroline Winter

Bethesda Statement on Open Access Publishing Patrick O. Brown et al.

San Franscisco Declaration on Research Assessment DORA

Policy Recommendations for Open Access to Research Data RECODE Project Consortium

Access John Willinsky

Foundations for Open Scholarship Strategy Development Jonathan Tennant, Jennifer Elizabeth Beamer, Jeroen Bosman, Björn Brembs, Neo Christopher Chung, Gail Clement, Tom Crick, et al.

From the Ground Up: A Group Editorial on the Most Pressing Issues in Scholarly Communication Nicky Agate, Gail Clement, Danny Kingsley, Sam Searle, Leah Vanderjagt, and Jen Waller

ARL White Paper on Wikidata: Opportunities and Recommendations Stacy Allison-Cassin et al.

Developing a Persistent Identifier Roadmap for Open Access to UK Research Josh Brown

'''[https://unescochair-cbrsr.org/wp-content/uploads/2020/07/OS_For_and_With_Communities_EN.pdf Open Science Beyond Open Access: For and With Communities. A Step Towards the Decolonization of Knowledge]''' Leslie Chan, Budd Hall, Florence Piron, Rajesh Tandon, and Lorna William

How Significant Are the Public Dimensions of Faculty Work in Review, Promotion and Tenure Documents Juan Pablo Alperin, Carol Muñoz Nieves, Lesley Schimanski, Gustavo E. Fischman, Meredith T. Niles, and Erin C. McKiernan

Scholarly Communications and Social Justice Charlotte Roh, Harrison W. Inefuku, and Emily Drabinsky


text: Category:Book:Open Scholarship Press Curated Volumes: Policy


text:
Open Scholarship Press Curated Volumes: Training

Randa El Khatib (UTSC), Alan Colín-Arce (U Autónoma del Estado de México), Vitor Yano (Concordia), Anna Honcharova (European Students' Forum), and Ray Siemens (UVic), with the INKE and ETCL Research Groups

Table of Contents
This volume is included in the Open Scholarship Press Curated Volumes .

''Where possible, original resources have been uploaded via Wikisource and linked to here. All other original resources are also linked to via this introduction.''

 Introduction: Open Digital Pedagogy and Training

Randa El Khatib

Curating Digital Pedagogy in the Humanities Rebecca Frost Davis, Matthew K. Gold, and Katherine D. Harris

Notes from the Field: Student Perspectives on Digital Pedagogy Colette Colligan and Kandice Sharren

Collaborative Knowledge Creation and Student-Led Assignment Design: Wikipedia in the University Literature Class Laura Estill

Play, Collaborate, Break, Build, Share: "Screwing Around" in Digital Pedagogy Katherine D. Harris

Critically Engaging with Data Visualization through an Information Literacy Framework Steven Braun

From OER to Open Pedagogy: Harnessing the Power of Open Robin DeRosa and Scott Robison

MOOCs and OER in the Global South: Problems and Potential Monty King, Mark Pegrum, and Martin Forsey

Teaching with OER during Pandemics and Beyond Jennifer Van Allen and Stacy Katz


text: Category:Book:Open Scholarship Press Curated Volumes: Training


text:
Telugu/Questions

 * What is your name? - Mee Peru emiti? ( మీ పేరు ఏమిటి?)
 * What is your mother's name? - Mee Amma Peru emiti? (మీ అమ్మ పేరు ఏమిటి?)
 * What is your father's name? - Mee Nanna Peru emiti? ( మీ నాన్న పేరు ఏమిటి?)

title: Telugu/Questions


text:
User:Bijibila

bijibilla

title: User:Bijibila


text:
Chess Opening Theory/1. d4/1...f5/2. h3

2.h3 - Dutch Defence, Korchnoi Attack
The Korchnoi attack is a theory based, sound, aggressive way to play against the Dutch. This Attack has been named after the Russian Grandmaster, Viktor Lvovich Korchnoi.

Viktor Lvovich Korchnoi (Russian: Виктор Львович Корчной, IPA: [vʲiktər lʲvovʲɪtɕ kɐrtɕˈnoj]; 23 March 1931 – 6 June 2016) was a Soviet (before 1976) and Swiss (after 1980) chess grandmaster (GM) and chess writer. He is considered one of the strongest players never to have become World Chess Champion.

Black has to respond differently right from the start. Black strongest responses are: In both variation in the spirit of the Dutch Defence, black will fight in most sound and aggressive way possible. In the event of the open variations white can go for
 * for the open variations with 2...d6 3...e5 4...Nc6,
 * for the closed variations with 2...d5 3...c5 4...e6,
 * for the classic variation with 3.g6... 4.Bg5... 5.e5...
 * for the normal variation with 3.Nf3... 4.c4... 5.Nc3...
 * for the modern variation with 3.Nc3... 4.e5 fxe5 5.Nxe5...

In the case of the Dutch Defence, Korchnoi Attack, open Variations there is high probability to castle on opposing sites, which can lead to very exciting positions.

Theory table
1. d4 f5 2.h3

title: Chess Opening Theory/1. d4/1...f5/2. h3


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Template:Ingredient summary

{	"params": { "Name": { "aliases": [ "name" ],			"description": "The name of the ingredient. Defaults to PAGENAME if not set.", "type": "string", "autovalue": "" },		"Image": { "aliases": [ "image" ],			"description": "An image of the ingredient", "example": "", "type": "unbalanced-wikitext", "suggested": true },		"Category": { "aliases": [ "category" ],			"description": "Category of the ingredient.", "example": "Sweeteners", "type": "unknown", "suggested": true }	},	"description": "Infobox for ingredients in the cookbook", "paramOrder": [ "Name", "Image", "Category" ],	"format": "block" }

title: Template:Ingredient summary


text:
Template:Ingredient summary/doc

Usage

 * All parameters to the template are optional.
 * The "Category" tries to resolve to an actual category, but does not include the recipe in that category.

title: Template:Ingredient summary/doc


text: Category:Squashes

title: Category:Squashes


text:
Cookbook:Policy/Ingredient template

This is the recommended template for ingredients in the cookbook. Please note that this is a guideline; feel free to omit sections that are not applicable.

When writing ingredient pages, be careful not to be too encyclopedic in style. Remember that this is a cookbook, and the information here should primarily serve this purpose.

Include first, with image and category. The image should be no more than 300px in order to maintain consistent style and formatting across the cookbook.

Follow with, along with additional navigation links as appropriate:

Preparation
Note any special preparation an ingredient may need before being used in cooking.

Use
Describe how an ingredient is used in various dishes and cuisines.

Recipes
Use to add an index of recipes that uses this particular ingredient.

title: Cookbook:Policy/Ingredient template


text:
History of video games/Platforms/Analogue Mega Sg

History
The system had a launch MSRP of $189.99.

The final production run of Mega Sg consoles was set for pre-orders October 28, 2022, with an MSRP of $199.

Technology
The system was based on an FPGA.

In 2019 the system was compatible with the original Mega CD add on, but not the 32X.

Games

 * Ultracore - Pack In title


text:
History of video games/Platforms/Analogue Super NT

History
The system initially sold for $190 USD.

The final production run of Super Nt consoles was set for pre-orders October 28, 2022, with an MSRP of $199.

Technology
The system is based on an FPGA.

Firmware was updated via the SD card slot.

A micro-USB port is used to provide power to the console.


text:
History of video games/Platforms/Analogue Nt mini

History
At launch the system cost $449 USD or 349 British Pounds.

In late 2020 it was announced that further production of the system would end.

Technology
Unlike the prior Analogue Nt, the Analogue Nt mini was based on an FPGA.

A unibody case made out of anodized aluminum was used for the casing of the system.


text:
Cookbook talk:Iresi Eyin (Yoruba Palm Oil Native Rice)

Note, change the title
Iresi Eyin is not "Yoruba jollof rice", its palm oil rice as the name states. Yoruba jollof rice is the popular Party jollof rice in the Yoruba regions of West Africa. Researcherofgreatness (discuss • contribs) 00:12, 29 October 2023 (UTC)


text:
History of video games/Platforms/Analogue Nt

Technology
The system was designed as an artpiece, leading to unconventional methods in PCB and casing design.


text:
History of video games/Platforms/Analogue Pocket

History
The system was announced by late 2019. The launch of the system was significantly delayed.

A transparent version was sold starting September 29th, 2023.


text:
History of video games/Platforms/AYANEO Slide

History
A sliding formfactor AYANEO Handheld was announced in January 2023. More details were released in September 2023.

The system is commonly compared to the GPD Win 4.


text:
History of video games/Platforms/GPD Win 4

Technology
The system was based on the Ryzen 7 6800U processor.


text:
History of video games/Platforms/Analogue Duo

History
The system was announced by late 2020.

On May 19, 2023 pre-orders for the system were opened.


text:
History of video games/Platforms/Analogue 3D

History
The system was announced in October 2023.

Technology
The system was based on an FPGA.

The system supports WiFi on the 2.4 GHz spectrum and Bluetooth.

The system is said to run Analogue OS.


text:
History of video games/Platforms/AYANEO Flip

History
The system was announced in DS and KB models. The DS model was noted for it's similarity to the Nintendo DS.

Technology
The systems use AMD Ryzen 7 7840U processors.

The system features a display capable of 120 Hz.


text:
History of video games/Platforms/Tassei Denki Project Nadeshiko

History
The system was shown at Tokyo Game Show 2023, and was not meant to be a production model.


text:
History of video games/Platforms/Retroid Pocket Flip

History
The system cost $170 at launch.

Technology
The Retroid Launcher served as the system UI.


text:
History of video games/Platforms/Retroid Pocket 3

History
The system cost between $119 and $160.


text:
History of video games/Platforms/Retroid Pocket 3+

History
The system was released in September 2022.


text:
History of video games/Platforms/Tassei Denki Saturn

History
The system was shown at Tokyo Game Show 2023 without the intention of retail production.

Technology
The system used an FPGA to provide compatibility with Sega Saturn games.


text: History of video games/Platforms/AYANEO Next II


text:
JSON/Data types

Quick Review
JSON is a notation language that stores data. An example is storing playerData.

Data Types
Integers are easy to make. Just put the integer! 2, 10, 5

Strings are in double quotes "Hello, World!"

Booleans are either true or false true

Arrays
Arrays are pretty much lists of data. [1, 3, 10, 15] ["Hello","Goodbye","World"] To get data from an array do this array = ["Hello","World"] string0 = array[0] // array[0] = "Hello" string1 = array[1] // array[1] = "World" string2 = string0 + " " + string1 // Hello World

Objects
And the best part! Objects, Objects are the core of JSON You can't have json without objects! To make a object just add curly brackets and (i can't come up with something, ill just show it in code) {   "MyName": "Streamer", "MyPassword": "catinabowl" }

title: JSON/Data types


text:
User:SebtheRETROprogrammer

Hello i am SebTheRetroProgrammer! I love old languages.

title: User:SebtheRETROprogrammer


text:
Outsourcing/Human Resource Management

Human resource management (HRM) is the strategic and coherent approach to the effective and efficient management of people in a company or organization such that they help their business gain a competitive advantage.

It is designed to maximize employee performance in service of an employer's strategic objectives.

Human resource management is primarily concerned with the management of people within organizations, focusing on policies and systems. HR departments are responsible for overseeing employee-benefits, employee recruitment, training and development, performance appraisal, and reward management, such as managing pay and employee benefits systems.

Services
Recruitment and Talent Acquisition: HR consulting firms assist organizations in identifying, attracting, and hiring the right talent to meet their business needs.

Talent Management: HR consulting firms help organizations develop strategies to effectively manage their workforce, including employee engagement, retention, succession planning, and career development.

Compensation and Benefits: HR consultants advise organizations on designing competitive compensation and benefits packages to attract and retain talent.

Employee Relations: HR consulting firms provide guidance on managing employee relations issues, such as conflict resolution, employee grievances, and workplace investigations.

Training and Development: HR consultants help organizations develop and implement training programs and professional development opportunities for their employees.

Performance Management: HR consulting firms assist organizations in designing and implementing performance management systems to evaluate employee performance and align it with organizational goals.

Legal Compliance: HR consulting firms ensure that organizations are compliant with labor laws and regulations, including employment standards, workplace safety, and anti-discrimination policies.

Professional Employment Organization
A PEO works on behalf of small and mid-sized businesses (SMBs) to manage HR management, employee benefits, compliance, payroll, retirement planning, and more. The client company may also be able to offer a better overall package of benefits, and thus attract more skilled employees. The PEO model is therefore attractive to small and mid-sized businesses and associations, and PEO marketing is typically directed toward this segment.

Virtual Human Resources
Technology has a significant impact on HR practices. Utilizing technology makes information more accessible within organizations, eliminates time doing administrative tasks, allows businesses to function globally, and cuts costs. Information technology has improved HR practices in the following areas:

E-recruiting
Recruiting has mostly been influenced by information technology. In the past, recruiters relied on printing in publications and word of mouth to fill open positions. HR professionals were not able to post a job in more than one location and did not have access to millions of people, causing the lead time of new hires to be drawn out and tiresome. With the use of e-recruiting tools, HR professionals can post jobs and track applicants for thousands of jobs in various locations all in one place. Interview feedback, background checks and drug tests, and onboarding can all be viewed online. This helps HR professionals keep track of all of their open jobs and applicants in a way that is faster and easier than before. E-recruiting also helps eliminate limitations of geographic location.

Human resources information systems
HR professionals generally handle large amounts of paperwork on a daily basis, ranging from department transfer requests to confidential employee tax forms. Forms must be on file for a considerable period of time. The use of human resources information systems (HRIS) has made it possible for companies to store and retrieve files in an electronic format for people within the organization to access when needed, thereby eliminating the need for physical files and freeing up space within the office. HRIS also allows for information to be accessed in a timelier manner; files can be accessible within seconds. Having all of the information in one place also allows for professionals to analyze data quickly and across multiple locations because the information is in a centralized location.

Training
Technology allows HR professionals to train new staff members in a more efficient manner. This gives employees the ability to access onboarding and training programs from virtually anywhere. This eliminates the need for trainers to meet new hires face-to-face when completing necessary paperwork for new employees. Training in virtual classrooms makes it possible for HR professionals to train a large number of employees quickly and to assess their progress through computerized testing programs. Some employers choose to incorporate an instructor with virtual training so that new hires are receiving training considered vital to the role. Employees have greater control over their own learning and development; they can engage in training at a time and place of their choosing, which can help them manage their work–life balance. Managers are able to track the training through the internet, which can help to reduce redundancy in training and training costs.

title: Outsourcing/Human Resource Management


text:
Chess Opening Theory/1. d4/1...f5/2. c4/2...g6/3. Nc3/3...Nh6

=Bladel=

2.c4 g6, 3.Nc3 Nh6 - Dutch Defence, Bladel Variation
Welcome to the Bladel variation. It used to be played in the past but has fallen out of fashion in modern times. It has a surprising amount of theory.

The question is, why does black places his or her knight on the edge on the board. Nf6 is much more natural looking. Black breaks some fundamental rules of development early on. Put your pawns in the center. Develop your piece without moving them 2 times in a row. But the thing is; white is going to play h4 followed by h5 or white is going to play e4 followed by exf5. In either case black will be forced sooner than later to move the knight a second time anyway.

Black has 5 ideas behind Nh6.
 * The idea number one is to be flexible. Depending how white attack, black can place the knight either on f5 or g4.
 * The second idea behind Nh6 is to not interfere with the dark bishop along the long diagonal.
 * The third idea is to not block the rook. Black anticipates white most common move in this line which is e4 -> forcing a trade, in which case black lost control over the e4 square. The whole point of playing the dutch is to prevent white from playing e4 in the first place. In this case black wants to create the semi open f-file for the rook -> after castling of course.
 * The fourth and most important idea behind Nh6 is a hyper modern approach. Black allows white to have a strong center in the beginning but seeks to control the center from outside with the minor pieces.
 * In the event of white playing e4, white is making a long term commitment for the end game. White gives up a central pawn for a side pawn. White is now committed to play aggressively and deliver a checkmate. If white fails to deliver a checkmate in the middle game, black will have a significant advantage in the end game because of the additional center pawn.

White has different attacking lines to choose from.
 * for the open variations which will lead to the modern variations with 4.e4 fxe4 5.Nxe4 Bg7 6.Ng3,
 * for the closed variations with 4.Nf3 ... 5.e3 ... 6.Bd7 ...,
 * for the classic variations with an early h-pawn push which can lead to the Beijing Attack 4.h4 Bg7 5.h5 c5 6.d5 ...

The Bladel is a sharp and tactical Variation for black to play the Dutch Defence. It is not only a battle of white versus black. It is also a battle of ideas. In the event of the Bladel Modern Variations white wants to deliver a checkmate in the middle game. Black wants to win the endgame with an additional center pawn.

Closed Variations
4.Nf3 c6 5.e3 d6 6.Be2 Bg7

This is a more positional approach by white. White is going to expand on the queen side maintain a space advantage. Black can either decide to castle long and launch a king side attack. Typically however black castles short and tries to prepare for the e5 push. White can, however, decide to push the h-pawn and make an attack later on.

Beijing Attack
'''4.h4 Bg7 5.h5 c5 6.d5 d6. 7.Nf3'''

This is very aggressive approach by white. White however wont be able to get any king safety in the long run. With correct play however, black can not only equalize but create some serous counter play on the queen side. But if black is not prepared, black can lose the game very quickly. This has been proven to be unsound for white. Therefore it is not considered to be the main line.

Modern Variations
4.e4 fxe4 5.Nxe4 Bd7 6.d5 This is sound and aggressive way for white to combat the Bladel. It a commitment for white to go for this line. White has given up central pawn for a side pawn. White will have to deliver a mate in the middle game. Black will try to hold on into the end game. In the end game, black has extra central pawn which has proven to be an advantage in the end game. In the immediate future black will fight back in the center with c6 fallowed by d5 with tempo. The knight will eventually move. However white has a strong plan here. White will trade the light bishop for a knight in order to create an outpost c5 for the knight.

This happens in the Main Line with: 6. ... c6 7.Bd3 d5 8.cxd5 cxd5 9.Bb5+ Nc6 10.Bxc6+ bxc6 11.Nc5

White gets a so called "octopus"  knight on black's territory. Black has no efficient way to remove it. As a result of that, white has reached complete dominance in the center. This line has been proven to be the most contesting line against the Bladel. If black is not careful, black may lose the game very quickly. White creates tactical AND positional threats. Most of people can handle one threat at a time. But two threats, that is a completely different animal.

Theory table
1.d4 f5 2.c4 g6 3.Nc3 Nh6


text: Category:Apricot recipes

title: Category:Apricot recipes


text: Category:Acorn recipes

title: Category:Acorn recipes


text: Category:Extracts and flavorings

title: Category:Extracts and flavorings


text: Category:Arugula recipes

title: Category:Arugula recipes


text: Category:Asafoetida recipes

title: Category:Asafoetida recipes


text:
Chess Variants/Chaturanga and Shatranj

Introduction
Chaturanga and shatranj are the ancient games that serve as the ancestor of modern chess and its Asian cousins.

History
It is belieed that chaturanga originated in India in the sixth century CE. The name of the game means "four limbs" in Sanskrit, referring to the four arms of the ancient Indian army - the infantry, cavalry, elephants and chariots. When the game was brought to Persia around 600 CE, the name became "shatranj", and the rules were somewhat modified.

Rules
(Note that historians disagree somewhat on the exact rules of the game. This article describes the most common interpretation)

It is believed that chaturanga was played on an uncheckered 8 by 8 board called a ashtāpada, borrowed from another board game. This board has special marking on certain squares, but these are not involved in chaturanga.

Like its descendant chaturanga is a game of war between two armies, with each trying to checkmate the other's raja (king). Like modern chess, White moves first.

The pieces move as follows:

 * Chess_kll45.svg The raja (king) moves like his modern counterpart. There is no castling in chaturanga - the move had not been invented yet.
 * Chess_gll44.png The mantri (minister) moves one square diagonally.
 * Chess_rll44.png The ratha (rook) moves like its modern counterpart.
 * Elephant_white.png The gaja (elephant) moves two squares diagonally. It is allowed to jump over pieces in the way of its move.
 * Chess_nll44.png The aśva (knight) moves like its modern counterpart.
 * Chess_pll44.png The padati (pawns) all move like their modern counterparts, expect they are not allowed a double-step move on their first move (and subsequently there is no en passant). They only get the option to promote to mantris upon reaching the far side of the board.

There are two other rules one should know:

 * Stalemate is considered a win for the player delivering the stalemate.
 * If a player manages to capture all of their opponent's pieces and leave them with a bare raja, they win the game. However if the bared opponent is able to bare the player's raja on the next turn, the game instead ends in a draw.

Shatranj was played with basically the same rules as chaturanga, with the sole expection that the players were allowed to choose which of the two centre squares their raja and mantri started on at game start.

Sub-variants

 * Chaturaji is a version of chaturanga played with four players.

title: Chess Variants/Chaturanga and Shatranj


text:
User talk:SodiumTitanium

Creative Commons has been deleted. Please stop recreating this page / book. Reading Using Wikibooks to learn more about this project. Encyclopedic articles belong on Wikipedia, not Wikibooks.--Xania   talk 01:49, 30 October 2023 (UTC)

title: User talk:SodiumTitanium


text:
User:Rhelwig/sandbox

The Carlsbad “Bud” Desalination Plant is a water treatment facility located in Carlsbad, California, in San Diego County. Completed in 2015, it serves to deliver around 8-10% of the county’s total water supply, and some of the only water that is not imported.

Narrative
In response to continual droughts in the region and growing concerns with regard to water security, several counties have experimented with water desalination since the 1990’s. Poseidon, the developer and manager of the Carlsbad “Bud” Lewis Desalination plant, first partnered with the San Diego Water Authority in 1998 with the plans of developing sustainable water security for San Diego’s future, with a few ideas for the plant.

The RFP was first issued in 2006, and before bidding even ended, the project, as well as many other projects throughout the state, received massive setbacks in the form of fourteen different lawsuits placed against construction. This was before any of the many environmental and regulatory approvals could be processed. Most of these suits were filed from the Surfrider Foundation’s San Diego chapter with most of their and interested group’s main objections being environmental in nature. Even since the plant’s completion in 2015, groups such as Sierra Club have criticized the re-entry of brine extracted from the water back into the ocean, increasing the average salinity of the water, as well as putting in danger species which lay eggs and microorganisms which live where the water is extracted. They have also echoed the popular expectation that the plant would account for more than just 8-10% of the San Diego water supply, not to mention that 90% of the remaining water balance is exported from the Colorado river.

Trouble did not end at the lawsuits, however. The San Diego Water Authority broke away from planning and constructions obligations in 2006, leaving Poseidon to fend for itself in terms of construction. Poseidon did eventually find a site for construction, however, next to the Encina Power station in Carlsbad.

Despite these objections, the plant’s designs and concepts still eventually gained approvals and awards to begin construction in 2009. In 2011, after a lengthy legal battle, the California supreme court upheld lower-court rulings in favor of the plant’s construction. Objections among interest groups continue elsewhere for similar plants throughout California, but most recently, the California Coastal Authority overturned their long-standing refusal of such a facility in Orange County.

The plant finished construction in 2015, and on average, adds $5 to the cost of water in San Diego. While both the San Diego Water Authority and Poseidon have vowed to bring its cost down, as of 2021, it is still some of the most expensive water-per-gallon that exists. Other outlets have also echoed the sentiments of the Sierra Club and Surfrider Foundation. A production shortage of 9,200 acre feet of water caused the SDWA to issue $3.5 million penalty in 2017. This is, however, coupled with the $97.5 million the SDWA owed to Poseidon from water that the county did actually receive. That said, even the more critical outlets cite the plant’s ability to produce more water than designed, sometimes at 53 million gallons daily, compared to the 50 million target.

Desalination
Desalination is the process by which salt water, or otherwise salinized water, is converted into fresh water. The process by which the Carlsbad Plant achieves this is highly technical.

The process begins by extracting salt water from the ocean in the San Diego area. This used to be done by the Encina Power Plant next-door to the Carlsbad plant but is now done completely internally by the Carlsbad plant. The water is then filtered traditionally through filters to get out larger material and marine life, like algae and plankton, in addition to larger materials. After that, the water is then processed through a long series of membranes, through long tubes throughout the facility, in which the water flows. In these, “reverse osmosis” occurs, where the membranes have thin enough holes to where water can pass through, but salt cannot as easily. After many layers, the salt is eventually separated from the non-diluted water. These membranes also catch viruses and bacteria, further purifying the water. The leftover materials are then put back into the sea. The distilled water is then treated with minerals, chlorine and then integrated with the San Diego water supply.

== List of Actors ==

San Diego County Water Authority (the “Water Authority”)
The Water Authority is a county water authority organized and existing under the County Water Authority Act, California Statutes 1943, Chapter 545, as amended (the “Water Authority Act”). The Water Authority was organized on June 9, 1944 for the primary purpose of supplying water to San Diego County for wholesale distribution to the Water Authority’s member agencies in order to meet their respective needs for beneficial uses and purposes. The Water Authority is authorized to acquire water and water rights within or outside the State of California; to develop, store and transport such water; to provide, sell and deliver water for beneficial uses and purposes and to provide, sell and deliver water of the Water Authority not needed or required for beneficial purposes of its member agencies to areas outside the boundaries of the Water Authority. The Water Authority has 24 member agencies, consisting of 6 cities, 17 special districts, and the Pendleton Military Reservation.

General Resolution. On May 11, 1989, the Water Authority adopted its Resolution No. 89-21, entitled “A Resolution of the Board of Directors of the San Diego County Water Authority Providing for the Allocation of Water System Revenues and Establishing Covenants to Secure the Payment of Obligations Payable from Net Water Revenues” (as thereafter amended and supplemented, the “General Resolution”). The General Resolution requires the Water Authority to pay Maintenance and Operation Costs (which include water purchase payments under the Water Purchase Agreement) prior to the payment of any other expenses.

Poseidon Resources (Channelside) LP (the “Company”) and Equity Investors
Poseidon Resources (Channelside) LP (The “Company”) is a special purpose entity, or special purpose vehicle (SPV) that was created to finance, construct, own and operate the Plant and to construct the Pipeline. The Company’s general partner is Poseidon Resources Channelside GP, Inc. (“Poseidon GP”). The Company’s sole limited partner is Poseidon Resources Channelside Holdings LLC (the “Limited Partner”). The Limited Partner owns all the equity interests in Poseidon GP.

Orion Water Partners, LLC (“Orion”) owns all of the equity interests of the Limited Partner. Orion’s members are Poseidon Carlsbad LLC (“Poseidon Carlsbad”) and Orion Water Acquisitions LLC (“Orion Water Acquisitions”). Poseidon Carlsbad is an indirect subsidiary of Poseidon Water LLC (“Poseidon Water”) which, together with its affiliates, developed a desalination facility in Tampa, Florida, a wastewater treatment plant in Cranston, Rhode Island and five wastewater treatment facilities in Mexico. The management team at Poseidon Water has operated several large and successful projects in the private infrastructure market, including the electric power, water treatment and natural gas supply and transportation industries. The management of Poseidon Water has collectively structured, arranged and closed over $10 billion of project and corporate financings. Poseidon Water has offices in Stamford, Connecticut and Huntington Beach and San Diego, California. Orion Water Acquisitions is an affiliate of Stonepeak Partners LP, an independent investment firm that, together with its affiliates, specializes in investing in North American infrastructure assets with approximately $790 million in capital commitments. Its founding partners, Trent Vichie and Michael Dorrell, collectively have almost 30 years of infrastructure investing experience and have invested over $2 billion of equity into North American infrastructure investments. The firm was formerly the infrastructure investment division of The Blackstone Group.

Kiewit Shea Desalination: JV between Kiewit Infrastructure West Co. (“Kiewit Infrastructure West”) and J.F. Shea Construction, Inc. (“J.F. Shea”).
Kiewit Infrastructure West is a wholly owned, direct subsidiary of Kiewit Infrastructure Group, Inc. (“Kiewit Infrastructure”) which focuses on constructing complex infrastructure projects throughout the western United States. Kiewit Infrastructure West began operations in Southern California in the late 1940s with an emphasis on building water/wastewater projects since 1983. Since then, Kiewit Infrastructure West has completed hundreds of water/wastewater projects ranging from advanced treatment plants with reverse osmosis, microfiltration, ultra violet and ozone, to primary and secondary treatment plants, pump stations, and force main conveyance lines.

Kiewit Infrastructure Co.; Kiewit Co. Kiewit Infrastructure is a wholly owned direct subsidiary of Kiewit Corporation (“Kiewit”). Kiewit Infrastructure is Kiewit’s largest operating group, encompassing nearly half of all the company’s work. Kiewit has more than 127 years of experience with large projects, a substantial portion of which are in the civil construction segment. Kiewit Infrastructure Co. (the “EPC Guarantor”), a wholly owned subsidiary of Kiewit Infrastructure Group, is guaranteeing the obligations of the EPC Contractor under the EPC Contracts.

J.F. Shea Construction, Inc. J.F. Shea is a wholly owned subsidiary of J.F. Shea Co., Inc., which is one of the oldest and largest privately held construction companies in the United States. Through its affiliates and parent company, J.F. Shea has over 131 years of heavy construction experience in civil engineering projects. J.F. Shea’s projects include the construction of primary features on the Golden Gate and San Francisco - Oakland Bay Bridges, the Hoover, Bonneville and Parker Dams, San Francisco’s Bay Area Rapid Transit System and, more recently, Metropolitan Transportation Authority New York City’s $1.5 billion Manhattan Number 7 Subway Tunnel, Orange County Water District’s $300 million Advance Water Treatment System - a 75-million gallon per day Reverse Osmosis and Micro Filtration Treatment Plant, Orange County Sanitation District’s $180 million trickling filters, Metropolitan Water District of Southern California’s $65 million San Diego Pipeline 6, and the Massachusetts Water Resources Authority’s $138 million Walnut Hill Water Treatment Plant in Boston, Massachusetts. J.F. Shea Construction has completed in excess of 441,000 feet of pipeline construction for water systems throughout the southern California area, of which over 70,000 feet of pipeline construction has been completed for the San Diego County Water Authority.

IDE Americas; IDE Technologies Ltd.
IDE Americas, Inc. is a wholly owned subsidiary of IDE Technologies Ltd (“IDE”). Established in 1965, IDE is engaged in the business of the turnkey delivery of large seawater desalination projects. It specializes in research and development of saline water desalination processes, concentration and purification of industrial steam, wastewater treatment, heat pumps and ice/snow machines. In addition, IDE provides maintenance and support for plants delivered to its customers. Its clients include government agencies, process industries, power utilities, refineries, hotel developers, municipal, and defense authorities. IDE has designed and constructed more than 360 desalination facilities in nearly 40 countries worldwide. IDE designed, built, and is currently operating the two largest reverse osmosis seawater desalination facilities in the world: (a) the 106 MGD (approximately 118,735 AFY) reverse osmosis facility in Hadera, Israel and (b) the 87 MGD (approximately 97,452 (AFY) reverse osmosis facility in Ashkelon, Israel. IDE is headquartered in Israel.

Cabrillo
Cabrillo Power I LLC (“Cabrillo”) owns the Power Station and is the lessor under the Ground Lease. Cabrillo is an indirect wholly owned subsidiary of NRG Energy, Inc. (“NRG”), a New York Stock Exchange-listed integrated wholesale power generation and retail electricity company.

== Project Bonds == The Project Bonds are being issued to fund the majority of the costs of acquiring, constructing and installing a desalination project (the “Project”) to supply potable water (“Product Water”) to the San Diego County Water

Authority (the “Water Authority”).

Bond issuer: The California Pollution Control Financing Authority to pay a portion of the cost of constructing a reverse osmosis desalination plant (The “Plant”) and a pipeline to connect a plant (the “Pipeline”), together the “Project”.

The Series 2012 Plant Bonds will be issued as term bonds in the aggregate principal amount of $530,345,000 and will mature as shown in the Table 2.

The Series 2012 Pipeline Bonds will be issued as term bonds in the aggregate principal amount of $203,215,000 and will mature, as shown in the Table 3.

The Project Bonds will be issued pursuant to separate trust indentures and the Issuer will lend (a) the proceeds of its Series 2012 Plant Bonds to the Company to pay a portion of the costs of constructing the Plant and (b) the proceeds of the Series 2012 Pipeline Bonds to the San Diego County Water Authority Financing Agency (the "Water Authority Financing Agency") to pay the costs of constructing the Pipeline pursuant to separate loan agreements. The Water Authority Financing Agency will make the proceeds of its loan available to the Water Authority under an installment sale agreement. The Water Authority will make installment payments to the Water Authority Financing Agency, which will be the sole source of payment of the Water Authority Financing Agency's payments to the Issuer under its loan agreement. The Water Authority will not be obligated to make any installment payments unless and until the Project is completed. A capitalized interest account will be established for each issue of Project Bonds that will be funded from the related bond proceeds in an amount sufficient to pay interest on the related Project Bonds for six months after the date by which the Company's contractor has guaranteed to complete construction of the Project. If the capitalized interest account for the Pipeline Bonds is depleted prior to completion of construction, the Company must pay delay damages to the Water Authority in an amount sufficient to pay debt service on the Pipeline Bonds until completion. The contractor will have a corresponding obligation to the Company up to a maximum amount. During operations, the Company must pay performance damages to the Water Authority for its failure to deliver Product Water to the Water Authority in accordance with the terms of their water purchase agreement. The Water Authority's obligations to make installment payments will be reduced by the amount of such performance damages, whether or not paid. The Water Authority Financing Agency's obligation to make loan repayments will be reduced by the amount of such performance damages, whether or not paid. The Water Authority has assigned its right to receive both delay and performance damages to the Water Authority Financing Agency to secure its obligations under the installment sale agreement, and the Water Authority Financing Agency has, in turn, assigned its rights to receive such damage payments to the trustee for the owners of the Series 2012 Pipeline Bonds. The Company's obligations under the loan agreement for the proceeds of the Series 2012 Plant Bonds and its obligations to pay delay damages with respect to the Pipeline will be secured on parity with the Collateral described herein. The Water Authority's obligations to make installment payments are unsecured but will have the benefit of certain covenants, including a rate covenant, made by the Water Authority in respect to its secured debt.[IVT1]

The Project Bonds are limited obligations of the issuer and neither the faith and credit nor the taxing power of the State of California. The Issuer has no taxing power, which means that the issuer promises to pay back the money they borrowed when they sell these bonds. But, State of California or any local government isn't guaranteeing that payment. So, if the issuer can't pay, the state won't step in to cover the bill. The issuer also can't raise taxes to gather the funds.

Table 2. Series 2012 Plant Bonds. Maturity and Interest rate

Table 3. Series 2012 Pipeline Bonds. Maturity and Interest rate

Risk Matrix
== Costs and Financing Structure ==

Poseidon Resources (Channelside) LP Desalination Project Sources and Uses
(2) Includes interest earned on funds held in the various accounts within the Plant Project Fund and Pipeline Project Fund. The assumed earnings rate on funds in these accounts is 0.20% for the life of construction.

(3) Represents the EPC Contract Prices under the Plant EPC Contract and Pipeline EPC Contract (inclusive of contingencies for any expected change orders), respectively, without any changes to said price arising from the occurrence of certain uncontrollable circumstances.

(4) Represents capitalized interest on the Plant and Pipeline Bonds accruing six months after the Scheduled Commercial Operation Date. The Company expects Plant Bond debt service after the Scheduled Commercial Operation Date to be paid from project revenues.

(5) Includes pre-development costs incurred by the Company related to the project through December 2012.

(6) Includes underwriter's discount, up-front and capitalized costs associated with the equity contribution, and costs of issuance.

(7) Includes insurance, environmental, Company management, land usage and ground lease costs during construction

(8) Please refer to sections "SOURCES OF PAYMENT AND SECURITY FOR THE PLANT BONDS; POSEIDON PIPELINE CONSTRUCTION OBLIGATIONS; AND CONTRACTED SHORTFALL PAYMENTS" and "SOURCES OF PAYMENT AND SECURITY FOR THE PIPELINE BONDS" of this Limited Offering Memorandum for a description of the various reserve funds.

(9) At closing, the Plant Bonds Debt Service Reserve Fund will be funded via deposit of an irrevocable direct pay letter of credit in favor of the collateral agent.

== Contracts ==

Purchase of the Plant Option
The Water Authority has the option to purchase the Plant at the end of the term of the Water Purchase Agreement for one dollar. The Water Authority will also have an option to purchase the Plant before the end of term as follows:

at any time after the 10th anniversary of the Commercial Operation Date at a purchase price equal to (a) the net present value of the Equity Return Charge that would have been payable through the remaining term of the Water Purchase Agreement plus (b) the aggregate principal amount of the outstanding Plant Bonds and the Approved Permitted Debt plus (c) costs incurred due to terminating current employees and IDE Americas breakage costs; The Water Authority has no obligation to purchase the Plant under any circumstances.

Takeaways
The Carlsbad “Bud” Lewis Desalination Plant has undergone a tremendous number of hurdles to achieve full operational capacity. It is an example of how lack of trust within technological infrastructure development can lead to delays for P3 projects, and how studying the success and full story of a P3 comes from a full understanding of the political context surrounding creation, rather than just financial analysis. However, its pioneering technology and essential nature brings its success under more scrutiny. Following Poseidon’s contract to its conclusion will prove essential for future, similar projects elsewhere in California especially, due to their continuing drought. Its lack of success in the eyes of its detractors and somewhat unaddressed environmental concerns has delayed other projects, like in Orange County, from State-Level authority. But if their eventual acceptance of a desalination project is anything to go by, even non-P3 endeavors will likely enter the news soon.

[IVT1]Page #1

title: User:Rhelwig/sandbox


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User talk:75.167.27.71

Pages you recently created have been moved to Cookbook:Grilled Pizza and Cookbook:Lighthouse Inn Potatoes. Please make sure that Cookbook recipes start with Cookbook:--Xania   talk 04:57, 30 October 2023 (UTC)

title: User talk:75.167.27.71


text:
User:FireWOOFwolf/Collections/CLikes

C, C#, and C++ guide

 * C Programming
 * C Sharp Programming
 * C++ Language

title: User:FireWOOFwolf/Collections/CLikes


text:
User talk:EverhallST

Welcome!
Welcome, EverhallST!

If you have any questions, you can ask in the assistance reading room or possibly contact me personally.

--Xania   talk 04:53, 31 October 2023 (UTC)

title: User talk:EverhallST


text:
Saluto, Jonathan! (Ido)/Chapitro 11

Iniciala pagino – Chapitro 10 – Chapitro 11 – Chapitro 12

Dek-e-unesma chapitro

La konverso inter Jonathan e Komto Dracula duras. Jonathan volas savar ulo. Lu dicas: “Dracula, hiere me vidis blua flamo. Quo ol esis?”

Dracula: “La blua flamo es flamo quan on povas vidar dum nur un nokto en la yaro. La blua flamo es la loko ube on povas trovar trezoro. En mea lando, la historio es longa. Multa personi habitis en ol, multa richa personi, e nun li es mortinta. La personi qui nun esas mortinta havis multa trezoro.”

Jonathan: “Takaze, pro quo la personi ne serchas la trezoro dum ta nokto dil yaro?”

Dracula: “Pro ke li es stupida! Dum la nokto kande esas la blua flami, li ne volas irar fore. Li ne prizas la blua flami. Anke vu ne prizas la blua flami, ka ne?”

Jonathan: “To esas vera. Me ne volas irar fore dum ke esas la blua flami. Li es stranja.”

Dracula: “Advere. Bone, parolez a me pri London e mea domo en London. Me volas savar quale esas mea domo en London.”

Jonathan: “Bone, vartez. Mea libri esas en mea chambro.” Jonathan iras a su chambro, e serchas su libri, e trovas su libri. Lu retroiras e parolas a Dracula pri lua domo. Dracula es tre inteligenta; lu es inteligentega. Dracula questionas Jonathan multafoye, e lu semblas savar multa kozi pri London.

Dracula: “Me havas questiono, Harker Jonathan… ah, pardonez a me; Jonathan Harker. En Rumania on dicas la familionomo, e pose la prenomo. Vua familionomo es Harker. Bone, ankorfoye… Jonathan Harker. Dicez a me, ka la domo esas anciena?”

Jonathan: “Yes, ol es anciena; ol evas sepacent (700) yari, me kredas. La nomo dil domo es Carfax. Carfax esos la domo di Komto Dracula en London. Ol es tre granda. Cirkum la domo esas multa arbori, ed aquo. Proxime es dementerio por lunatiki.”

Dracula: “Dementerio por lunatiki? Takaze, domo por stranja personi?”

Jonathan: “Yes, dementerio es domo e lunatiko es stranja persono. Ma la altra kozi esas bona.”

Dracula: “No, me ne havas problemi pri lunatiki qui habitas en dementerio. Me pensas ke la domo es bona. Me amas anciena domi, antiqua domi. Anke me esas tre olda… vartez! Me retrovenos.”

Jonathan vartas, e vartas.

Jonathan vartas plus, e pos un o du hori, Dracula retrovenas.

Dracula: “Ah, vu laboras ankore! To es bona, ma vu devas manjar. Me… ja manjis. Ma ni povas parolar dum ke vu manjas.” Jonathan manjas dum ke Dracula questionas lu. Dracula questionas lu pri omno. Li parolas dum hori e hori. Ma nun li audas la sono di hanulo.

Dracula: “Ah! La matino arivos balde. Vu es fatigita e la tempo venas por dormar. Til rivido!”

Jonathan eniras su chambro e vidas la cielo. Ol es griza. Lu pensas pri quon Dracula facis. Kande la matino venis, lu dicis “til rivido”, quo es vidar su ankorfoye. “Takaze, me vidos lu morge, e ankore posmorge. Pro quo lu dicas ‘til rivido’ kande la matino venas? Ka Dracula ne prizas la matino? Tre stranja…” Vidante la griza cielo, lu dormas.

antehiere, hiere, hodie, morge, posmorge
Hodie es 5 mayo. Hiere esis 4 mayo, e antehiere (o prehiere) esis 3 mayo. Morge esos 6 mayo, e posmorge esos 7 mayo.

retro-

 * Jonathan iris fore de Dracula. Pose, lu retrovenis (lu esis itere kun Dracula).

habitar vs vivar

 * Jonathan vivas = Jonathan ne esas mortinta
 * Jonathan habitas en Anglia = lu ne habitas en altra loko

Vortaro

 * advere
 * antiqua = tre, tre anciena
 * audar
 * cielo
 * dementerio
 * durar
 * evar
 * fatigita
 * griza
 * habitar
 * hanulo 🐓
 * ja
 * konverso
 * longa
 * lunatiko
 * nomo
 * familionomo
 * prenomo
 * posmorge
 * proxime
 * retro-
 * retroirar
 * retrovenar
 * takaze = en ta kazo
 * til rivido
 * trezoro
 * uzar

Iniciala pagino – Chapitro 10 – Chapitro 11 – Chapitro 12

title: Saluto, Jonathan! (Ido)/Chapitro 11


text:
Category:CS1 Korean-language sources (ko)

__HIDDENCAT__


text:
Chess Opening Theory/1. d4/1...f5/2. c4/2...g6/3. Nc3/3...Nh6/4. e4

=Bladel Open Variations=

2.c4 g6, 3.Nc3 Nh6, 4.e4 - Dutch Defence, Bladel Variation Open
The move e4 changes the character of this opening entirely. The move e4 transposes from a a semi closed game to an open game. The whole point of the Dutch Defence is to gain control over the e4 square. The idea is to prevent white from playing e4. Typically, black is going to fallow it up with Nf6 and gain even more control over the e4 square. But now white plays e4 anyway. The e-pawn has now support from the knight on c3.

Black has different responses to choose from.
 * for the open variations without entering modern variations with 4...d6 5.Nf3 Bg7 6.exf5 Bxf5
 * ... or 4...d6 5.Nf3 Bg7 6.exf5 Nxf5
 * ... or 4...d6 5.Nf3 Bg7 6.exf5 gxf5
 * for entering the modern variations 4...fxe4 5.Nxe4 Bg7 6.Nf3 c6 7.Bd3 d5

Black must not play d5 right away. The move d5 will be met with exd4. Black is going to loose control over the center. As a result of that, black's king side will fall apart. Therefore black should play the bladel, especially the open variations, in hyper modern fashion. Instead of pushing blindly into the center, black seeks to control the center from the outside with the minor pieces. The bishop needs to go to the g7 square as soon as possiple to gain some control towards the center. If black wants to fight the center with d5, it needs to prepared with c6 before hand.

Theory table
1. d4 f5 2.c4 g6 3.Nc3 Nh6 4.e4


text:
Talk:Meteorology/El Niño and La Niña

why the eastern half of Australia would receive heavy rain during la Nina

41.116.140.159 (discuss) 11:44, 31 October 2023 (UTC)

title: Talk:Meteorology/El Niño and La Niña


text: Template:Pronunciation

title: Template:Pronunciation


text: User:Sriveenkat

title: User:Sriveenkat