title: Galactus

text: Galactus returns to the universe, and after an encounter with Squirrel Girl, is forced into his own incubator by the Ultimates, who are determined to end his threat. Galactus re-emerges as a Lifebringer instead of a Devourer of Worlds, his first act being to restore Archeopia, the first planet that he ever consumed. The entity later rescues the team at the behest of Eternity, and learns that the latter has been imprisoned by an unknown force. Galactus also comes into conflict with fellow cosmic entities Master Order and Lord Chaos, who, along with the Molecule Man, wish for Galactus to return to his former role as a Devourer of Worlds and thereby restore order to the universe. Galactus locates the hero Anti-Man outside the Multiverse and, after transforming him into a Herald of Life, sends him to recruit the recently disbanded Ultimates to help discover the identity of Eternity's captor, who is later revealed to be the First Firmament, the first iteration of the cosmos. Master Order and Lord Chaos bring Galactus to trial before the Living Tribunal, still seeking to restore Galactus to his former state for the sake of the cosmic balance. Although Galactus successfully argues that the balance of the new Multiverse is different and that his old role is obsolete, the Tribunal is destroyed by a Firmament-influenced Master Order and Lord Chaos. After a brief battle, Master Order decides to create a new cosmic order, which it and Lord Chaos would control. Their former servant, the In-Betweener, is forcibly merged with them into a new cosmic being called "Logos". After destroying several Celestials, Logos forcibly transforms Galactus back into the Devourer of Worlds. The process is reversed when Anti-Man sacrifices his life to restore Galactus as the Lifebringer. Galactus then swears to free the imprisoned Eternity.


title: Galactus

text: During the "Infinity Countdown" story line, the Silver Surfer requests Galactus's aid in defeating Ultron/Hank Pym by consuming the planet Saiph, which is overrun by Ultron drones. Galactus reluctantly agrees. After consuming Saiph, Galactus's hunger returns and the Silver Surfer becomes his herald again as he takes Galactus to find an uninhabited planet.


title: Galactus

text: Returning to Earth, Galactus has a confrontation with Doctor Doom and the Fantastic Four, with Doom revealing his plans to harness Galactus's power as an energy source. Banished to the mystical realms by an alien sorcerer, Galactus becomes entangled in the schemes of Dormammu and Mephisto. Galactus begins to consume mystical energy, eventually absorbing Dormammu and other mystical entities, and in so doing goes insane and destabilizes reality. Doctor Strange intervenes and – with the aid of Eternity and the Living Tribunal – is able to undo the damage wrought by Galactus.


title: Galactus

text: An injured Galactus crash-lands on Asgard, apparently seeking asylum from the cause of his universe's destruction: the Black Winter (Fimbulwinter). Galactus reveals to All-Father Thor that he had a vision of Thor being responsible for his death. In a bid to destroy the Black Winter, Galactus turns Thor into his Herald of Thunder. Thor later learns that the Black Winter considers Galactus to be his herald. This causes an angered Thor to drain Galactus of his energies enough to turn him into a desiccated husk. When the Black Winter moves in to claim Galactus's body, Thor uses it as a bomb to decimate the Black Winter.


title: Galactus

text: The first (and oldest) living entity in the universe, Galactus was created during the union of the Sentience of the (previous) Universe and Galan of Taa, and is described as "the physical, metamorphosed embodiment of a cosmos." Although not an abstract, non-corporeal entity, his true form cannot be perceived by most beings; each species sees Galactus in a form they can comprehend, similar to their race or a deity of their religion. Galactus can also appear as a humanoid star when addressing fellow members of the cosmic hierarchy. Through his actions of consuming planets, Galactus embodies a living force of nature whose existence is necessary to correct the imbalances between the conceptual entities: Eternity and Death, as well as to serve as a cosmic test of survival for civilizations. Additionally, the continued existence of Galactus ensures the confinement of the cosmic entity Abraxas. As Galactus requires planets with the potential to support life, his existence also causes the extinction of entire extraterrestrial civilizations.


title: Galactus

text: The consumption of planets is what maintains Galactus' life and power. He usually employs the Elemental Converter, which converts matter into energy more efficiently, even though he is capable of feeding without it. Alternatively, Galactus can absorb energy directly from cosmic beings and even mystical entities — though with unpredictable results. Processing this cosmic energy allows Galactus to utilize a force known as the Power Cosmic to perform great feats, which have included universal cosmic awareness, telepathy, telekinesis, energy projection; size alteration; transmutation of matter; teleportation of objects across space, the creation of force fields and interdimensional portals;the creation of life, the resurrection of the dead, manipulating souls, memories and emotions, and mass-scale events such as recreating dead worlds in every detail (including illusions of their entire populations) and destroying multiple solar systems simultaneously.


title: Galactus

text: To aid in his search for suitable planets, Galactus frequently appoints an individual as his herald, granting each one in turn a small fraction of the Power Cosmic. This power replaces the auras (or souls) of the recipient, with each wielder's physical form adapting to store the energy and in turn allow manipulation for feats such as energy projection. Galactus is also capable of removing the Power Cosmic from the herald. Galactus has on occasion been severely weakened due to a lack of sustenance, and on one occasion was defeated while in this state by the combined efforts of both the Fantastic Four and the Avengers. In this weakened condition, Galactus has also shown susceptibility to Ikonn's spell, which forces him to remember all of the beings that he has killed due to his feeding.


title: Galactus

text: Galactus also possesses scientific knowledge that is beyond comprehension as the oldest living entity in the universe. He is capable of building massive starships of his own design, humanoid robots called Punishers used to battle foes beneath his attention, the Ultimate Nullifier (a superweapon capable of destroying and remaking the Multiverse), and the solar system–sized and Möbius strip-shaped space station named Taa II. Mr. Fantastic has speculated that Taa II may be the greatest source of energy in the universe.


title: Galactus

text: The Silver Surfer is a recurring ally and herald of Galactus, and was the first herald to be introduced into the Marvel Universe. Other characters have also filled the role of a herald intermittently.


title: Galactus

text: The final issue of "The Adventures of the X-Men" reveals that the previous universe from which Galan originates was Earth-92131, which was being destroyed when the Dweller-in-Darkness used the M'Kraan Crystal to feed of the energies of the dying universe. Galan's rebirth as Galactus is depicted as being observed by the Living Tribunal and the Brothers from "DC vs. Marvel".


title: Galactus

text: In the Amalgam Comics universe that combines Marvel and DC characters, Galactus is combined with DC's Brainiac to create Galactiac, a being that consumes planetary energy but also leaves some of the world intact for his own personal study.


title: Galactus

text: In the five-issue miniseries "Bullet Points" (January – May 2007), Galactus arrives on Earth with the Silver Surfer and kills most of Earth's heroes. Their sacrifice inspires the Surfer to turn on Galactus, who subsequently flees Earth.


title: Galactus

text: In the limited series "Earth X", Galactus is one of the three entities in the universe responsible for keeping cosmic entities the Celestials in check. By destroying planets (the "eggs" of the Celestials), Galactus prevents the beings from overpopulating the universe. Franklin Richards eventually adopts Galactus's identity.


title: Galactus

text: The series "Exiles" features a version of Galactus that restores rather than destroys worlds, and empowers the being Sabretooth to defeat a renegade Silver Surfer.


title: Galactus

text: In the alternate future of Earth-691, the original Guardians of the Galaxy witness the formation of a symbiotic relationship between Galactus and the former Silver Surfer, now known as the Keeper. Having been named a Protector of the Universe by Eon and further empowered with the Quantum Bands, the Keeper possesses sufficient power to constantly supply Galactus with energy, ending his need to consume worlds.


title: Galactus

text: "Fantastic Four" (vol. 2) features a pocket universe created by Franklin Richards after the events of the "Onslaught" saga, and includes a version of Galactus with five heralds, all of whom are worshiped by the Inhumans.


title: Galactus

text: Galactus appears as a gigantic, planet-sized life form — complete with a single massive eye and tentacles — covered with a number of life forms ("Galactus spores"), which aid its digestion.


title: Galactus

text: "Marvel Adventures" — aimed at a younger audience — concluded its "Fantastic Four" imprint with issue #48. Set at the end of time, Galactus summons the present-day Fantastic Four to his side to battle the last surviving villains in the universe. The Fantastic Four eventually retreat to Galactus' ship, unable to defeat the villains, only to witness Galactus dismiss them with a gesture. The comic ends with the Fantastic Four returning to their present-day, realizing that Galactus had summoned them to the end of time out of loneliness, before he continued on as the only living being towards the next iteration of the universe.


title: Galactus

text: The limited series "Marvel Zombies" features the Earth-2149 universe, which is infected by a virus changing sentient beings into flesh-eating zombies. Galactus's power is absorbed when consumed by the infected Avengers.


title: Galactus

text: The MC2 title "Last Planet Standing" features a future version of Galactus that eventually merges with the Silver Surfer and vows to repair rather than destroy worlds.


title: Galactus

text: The trilogy introduced the threatening entity Gah Lak Tus. First mentioned by the robot Ultimate Vision and subsequently by the Kree, Gah Lak Tus is a group mind of city-sized robotic drones. To prepare for the arrival, the drones send telepathic broadcasts of "fear", then use envoys (similar to the Silver Surfer), who introduce a flesh-eating virus into planets. Gah Lak Tus is also involved in the "Chitauri-Kree" War, and temporarily merged with Galactus after a temporal rift sends the latter to the Ultimate Marvel universe. Mahr Vehl stated the Gah Lak Tus swarm was originally built by the ancient Kree eons ago to eliminate all foes and "purify" the universe, but subsequently escaped their control and evolved into its current form.


title: Galactus

text: In the timeline of an aged and future King Thor, Galactus comes to a deserted Earth to finally consume it. The entity eventually bonds with All-Black the Necrosword and becomes "Galactus the World Butcher", devouring multiple planets. Galactus is finally consumed by an All-Black-empowered Ego the Living Planet.


title: Galactus

text: In an alternate universe, in order to resurrect Galactus, the Silver Surfer used the remnants of Ultron, creating a fusion of Ultron and Galactus.


title: Galactus

text: Galactus of Earth-TR666 created a new Herald — the Cosmic Ghost Rider — in a failed attempt to stop Thanos.


title: Galactus

text: During "Reckoning War", as punishment for his interference, Uatu is forced by his father to watch the world where he never interfered to warn the Fantastic Four about Galactus's original attack. Without Uatu's aid, Galactus's attack leaves the FF with various injuries, including Sue being blinded and Johnny burning himself while Reed is damaged by the radiation in Galactus's ship, but Reed is able to analyze the energy Galactus feeds on and create a weapon that assaults Galactus with energy on a frequency opposite to the type of energy that sustains him, killing Galactus and providing that alternate Earth with a new form of energy.


title: Galactus

text: A version of Galactus — called "Gah-Lak-Tus" in the novelization — appears in the 2007 film "", as a cosmic hurricane-like cloud. Fox apparently wished for the character to remain "discreet"—hence the altered appearance. Visual effects studio Weta Digital convinced Fox to add hints of the character's comic-book appearance, including a shadow and a fiery mass inside the cosmic cloud resembling Galactus' signature helmet. Director Tim Story said he created Galactus as a cosmic cloud so a future "Silver Surfer" spin-off film would be unique as the character had yet to appear in comic-book form. Film writer J. Michael Straczynski stated "You don't want to sort of blow out something that big and massive for one quick shot in the first movie."


title: Olivia Culpo

text: Olivia Frances Culpo (born May 8, 1992) is an American model, fashion influencer, social media personality, and actress. After winning the Miss Rhode Island USA competition, she went on to be crowned Miss USA, and then Miss Universe in 2012.


title: Olivia Culpo

text: Culpo was born in Cranston, Rhode Island, to parents Susan and Peter Culpo. She is the middle child of five siblings. Her restaurateur father co-owns businesses around Boston. She was raised in the Edgewood neighborhood of Cranston, and is of Italian descent with some Irish ancestry from her mother's side. Culpo has two older siblings, Pete and Aurora, and two younger siblings, Gus and Sophia.


title: Olivia Culpo

text: Culpo attended St. Mary Academy – Bay View and later, Boston University, but did not graduate. She began studying the cello in second grade, and has played in the Rhode Island Philharmonic Youth Orchestra, the Rhode Island Philharmonic Chamber Ensemble, the Bay View Orchestra, and the Rhode Island All-State Orchestra. She attended the Brevard Music Center, in Brevard, North Carolina for two summers, and has performed with the Boston Accompanietta.


title: Olivia Culpo

text: After winning the 2012 Miss Rhode Island USA competition on the first pageant she entered, she went on to win the Miss USA pageant on June 3, 2012.


title: Olivia Culpo

text: On July 6, 2012, the city of Cranston, Rhode Island held a homecoming celebration for Culpo for her pageant win. At an outdoor ceremony held at Cranston City Hall, Mayor Allan Fung presented Culpo with the key to the city.


title: Olivia Culpo

text: Culpo represented the United States at the 61st Miss Universe pageant that was held on December 19, 2012, in Las Vegas, Nevada. She won the competition, becoming the eighth representative from the United States to win the title and the first since Brook Lee was crowned Miss Universe 1997. Culpo has also become the first Rhode Islander to win the title. She succeeded outgoing titleholder Leila Lopes from Angola.


title: Olivia Culpo

text: In January 2013, Culpo visited Indonesia for three weeks and helped crown the winner of Puteri Indonesia 2013 on February 1 in Jakarta. She also visited Yogyakarta, Surabaya, and Bali during her visit. In Jakarta, Culpo hosted a discussion with young Indonesians for the United Nations Population Fund on HIV and youth prevention at the United States Embassy's cultural center of America.


title: Olivia Culpo

text: On August 25, 2013, Cranston's city council approved a resolution adding Culpo's name to Albert Avenue, which runs the length between Broad Street and Narragansett Boulevard in Edgewood.


title: Olivia Culpo

text: On September 10, 2013, Culpo walked in the Sherri Hill fashion show held at the Trump Tower in New York City. Culpo was in India from September 27 until October 6. On November 9, 2013, she crowned Gabriela Isler of Venezuela as her successor. In doing so, she became the 3rd Miss Universe from the USA to pass the title off to Venezuela, after Shawn Weatherly in 1981 and Chelsi Smith in 1996


title: Olivia Culpo

text: Culpo became a social media personality after gaining a significant following on Twitter, Instagram and YouTube, and has partnered and collaborated with several beauty and fashion brands like L'Oréal, Kipling, and Uberliss as an influencer. Culpo was also featured in the "Sports Illustrated Swimsuit Issue," and appeared on the cover of the 2020 issue alongside Jasmine Sanders and Kate Bock. She also appeared in the reality television show "Model Squad" (2018). In addition, Culpo had roles in the films "The Other Woman", "I Feel Pretty", "Reprisal", and was cast as female lead in "Venus as a Boy".


title: Olivia Culpo

text: From 2013 to 2015, Culpo dated musician Nick Jonas. She was romantically linked to athlete Tim Tebow until November 2015. Culpo was in an on-again-off-again relationship with football player Danny Amendola from February 2016 to April 2019. Since the summer of 2019, she has been dating football player Christian McCaffrey.


title: Thundercat (musician)

text: Stephen Lee Bruner (born October 19, 1984), better known by his stage name Thundercat, is an American bass guitarist, singer, producer, and songwriter from Los Angeles. First coming to prominence as a member of crossover thrash band Suicidal Tendencies, he has since released four solo studio albums and is noted for his work with producer Flying Lotus and his appearances on Kendrick Lamar's 2015 album "To Pimp a Butterfly". In 2016, Thundercat won a Grammy for Best Rap/Sung Performance for his work on the track "These Walls" from "To Pimp a Butterfly". In 2020, Thundercat released his fourth studio album titled "It Is What It Is", which earned him a Grammy Award for Best Progressive R&B Album.


title: Thundercat (musician)

text: Bruner was born into a family of musicians, including his father Ronald Bruner Sr., a drummer, and his mother Pam a flutist and percussionist. They raised him in Compton and other parts of Los Angeles. His father played drums for The Temptations, The Supremes, and Gladys Knight amongst others. After Bruner Sr. sobered from dealing with cocaine, the children would watch him play gigs at the Crenshaw Christian Center. Bruner attended Locke High School, playing in the school's jazz band. His teacher, Reggie Andrews, produced and co-wrote Let It Whip and collaborated with Rick James. Andrews re-introduced Bruner to Kamasi Washington, who originally met as children through their fathers’ play in a gospel fusion band. The reunited duo would sneak into jazz concerts, driving around in a worn down 1982 Ford Mustang to do so. They would later get to play the same venues as the performers they watched. They also sessioned with Terrace Martin in Washington's father's garage during this time. Bruner is a Christian, and incorporates many of the religion's themes in some of his music.


title: Thundercat (musician)

text: Bruner was a close friend of the rapper Mac Miller, and the two often spent time together in their personal lives. Mac Miller's death in 2018 made Bruner confront his own substance abuse and alcoholism causing him to drink less and adopt better eating habits. "It’s sex, drugs and rock’n’roll. It’s real. You ride the line, you don’t know how close you are sometimes. Do I think he meant to die? No, I don’t think he did. Even though that sometimes creeps in there because you’re always on the edge of a knife. Sometimes you mess up. That happens a lot," Bruner shared in a 2020 interview with the Guardian.


title: Thundercat (musician)

text: Bruner is a big fan of Anime and cartoons, and will wear outfits that reflect this such as a Pikachu backpack or cat-ear headbands. His stage name bears influence to this, deriving from Thundercats, the 1985 cartoon series.


title: Thundercat (musician)

text: Bruner began playing the bass at an early age, listening to bass players such as Stanley Clarke and Marcus Miller for inspiration. By the age of 15, he had a minor hit in Germany as a member of the boy band No Curfew. A year later he joined his brother Ronald Jr. as a member of the Los Angeles Crossover thrash band Suicidal Tendencies, replacing former bass player Josh Paul. Bruner's earliest studio album appearances include playing electric bass on Kamasi Washington's "Live at 5th Street Dick's" and "The Proclamation".


title: Thundercat (musician)

text: Erykah Badu was credited with helping Bruner find his stage presence and identity as Thundercat. Around this time, Bruner would play in live bands for Raphael Saadiq and Snoop Dogg, both would make quips towards his playing style. Bruner credited Flying Lotus with pushing him to start singing and making his own projects.


title: Thundercat (musician)

text: He released his first solo album in 2011, "The Golden Age of Apocalypse", which featured production from Flying Lotus, and was influenced by 1970s fusion artists such as Stanley Clarke and George Duke who his brother also later toured with. The next two years saw a return to the recording studio with fellow Brainfeeder artist Flying Lotus, with contributions to the Lotus's "Until the Quiet Comes" (2012) and "You're Dead!" (2014), and the release of Thundercat's second album "Apocalypse" (2013).


title: Thundercat (musician)

text: In 2004, Bruner collaborated with Kamasi Washington, as well as Cameron Graves and Ronald Jr, under the name the Young Jazz Giants.


title: Thundercat (musician)

text: Along with his band duties, Bruner is also a session musician, acclaimed for his work on Erykah Badu's "New Amerykah" (2008) and Flying Lotus' "Cosmogramma" (2010).


title: Thundercat (musician)

text: Bruner was a major contributor to Kendrick Lamar's critically acclaimed album "To Pimp a Butterfly" in 2015, and has been described as being "at the creative epicenter" of the project. Longtime Thundercat collaborators Flying Lotus, Kamasi Washington, and Terrace Martin were also major contributors to the album.


title: Thundercat (musician)

text: Bruner was a frequent collaborator on Mac Miller's tracks. On August 6, 2018 Bruner played bass during Mac's Tiny Desk Concert, during which the two played the track they collaborated on "What's the Use?"


title: Thundercat (musician)

text: In 2022, he collaborated with virtual band Gorillaz on their single Cracker Island, the first released single and title track for their upcoming album of the same name. The song was released on April 30 2022.


title: Thundercat (musician)

text: On June 22, 2015, Thundercat released "The Beyond / Where the Giants Roam" EP, which was developed during the production of "To Pimp a Butterfly". The EP includes tributes to his friend and collaborator Austin Peralta, a jazz pianist who was signed to Brainfeeder before his death in 2012. The EP also includes a feature from Herbie Hancock and was the first appearance of "Them Changes".


title: Thundercat (musician)

text: In 2016, Bruner revealed to XXL that he was working on a new album with Flying Lotus as a main contributor. In May of that year, Bruner appeared live with Red Hot Chili Peppers to play additional bass on their song "Go Robot" at iHeartRadio's release party for the band's 2016 album "The Getaway". In August 2016, Bruner appeared live with singers Kenny Loggins and Michael McDonald in Chicago.


title: Thundercat (musician)

text: In June 2017, Thundercat appeared on "The Tonight Show Starring Jimmy Fallon" to promote his studio album "Drunk" with Michael McDonald and Kenny Loggins. "Them Changes" contains a drum sample from the 1977 track "Footsteps in the Dark" by the Isley Brothers, the same sample used in Ice Cube's "It Was a Good Day" (although the latter more heavily sampled the original).


title: Thundercat (musician)

text: In October 2018, Thundercat premiered the song "King of the Hill" from his then upcoming album "It Is What It Is". The second single, "Black Qualls" featuring Steve Lacy, Steve Arrington, and Childish Gambino was released on January 16. Another single, "Dragonball Durag", was released on February 17. "It Is What It Is" released on April 3, 2020, and was met with critical acclaim. Thundercat dedicated the album to friend and frequent collaborator Mac Miller. In 2020, "It Is What It Is" won Best Progressive R&B Album at the 63rd Annual Grammy Awards.


title: Thundercat (musician)

text: In 2021, he received the Libera Awards for "Best R&B Record 2021" for his album "It Is What It Is" (Brainfeeder Records) by the American Association of Independent Music (A2IM). The album was also nominated as "Record of the Year," but lost to Phoebe Bridgers' album "Punisher".


title: Thundercat (musician)

text: In 2022, he made a guest appearance in the fourth episode of "The Book of Boba Fett" as a "Mod Artist" that Boba Fett enlists to save Fennec Shand's life in a flashback where he replaced her damaged parts with cybernetic replacements.


title: Thundercat (musician)

text: Bruner is most often seen playing his Ibanez Custom Shop model bass, possessing six strings (which are tuned to BEADGC), a hollowed out maple body, five-piece maple/jatoba neck, and rosewood fingerboard. It utilizes EMG magnetic pickups, Graph Tech Ghost piezo saddles, and a MIDI program In/Out.


title: Titanoboa

text: Titanoboa (; ) is an extinct genus of very large snakes that lived in what is now La Guajira in northeastern Colombia. They could grow up to , perhaps even long and reach a body mass of . This snake lived during the Middle to Late Paleocene epoch, around 60 to 58 million years ago following the extinction of all non-avian dinosaurs. Although originally thought to be an apex predator, the discovery of skull bones revealed that it was more than likely specialized in preying on fish. The only known species is Titanoboa cerrejonensis, the largest snake ever discovered, which supplanted the previous record holder, "Gigantophis garstini".


title: Titanoboa

text: In 2009, the fossils of 30 individuals of "T. cerrejonensis" were found in the Cerrejón Formation of the coal mines of Cerrejón in La Guajira, Colombia. These specimens consist of the holotype, a large precloacal vertebrae, the paratype, also a vertebrae, and 184 additional remains identified as additional vertebrae and ribs (some of which found in articulation), amounting to a total of 28 specimens in addition to the holotype and paratype. Before this discovery, few fossils of Paleocene-epoch vertebrates had been found in ancient tropical environments of South America. The snake was discovered on an expedition by a team of international scientists led by Jonathan Bloch, a University of Florida vertebrate paleontologist, and Carlos Jaramillo, a paleobotanist from the Smithsonian Tropical Research Institute in Panama. Field work continued following these initial discoveries, recovering multiple additional specimens including three skulls with associated postcranial bones.


title: Titanoboa

text: The scientific name combines the Greek word "Titan" with "Boa", the type genus of the family Boidae. The species name on the other hand is a reference to the Cerrejón region.


title: Titanoboa

text: Most material of "Titanoboa" consists of vertebrae that in life would be located before the cloaca. They are robust with a uniquely T-shaped neural spine. The skull is only briefly described in a 2013 abstract. According to it, "Titanoboa" is unique in the high amount of palatal and marginal tooth positions compared to others boids, the quadrate bone is oriented at a low angle and the articulation of both the palatine to pterygoid and pterygoid to quadrate are heavily reduced. The teeth themselves are weakly ankylosed, meaning they are not strongly connected to the jawbone.


title: Titanoboa

text: Based on the size of the vertebrae, "Titanoboa" is the largest snake in the paleontological record. In modern constrictors like boids and pythonids, increased body size is achieved through larger vertebrae rather than an increase in the number of bones making up the skeleton, allowing for length estimates based on individual bones. Based on comparison between the undistorted "Titanoboa" vertebrae and the skeleton of modern boas, Head and colleagues found that the analysed specimens fit a position towards the later half of the precloacal vertebral column, approximately 60 to 65% back from the first two neck vertebrae. Using this method, initial size estimates proposed a total body length of approximately (± ). The later discovery of skull material allowed for size estimates based on skull to body length proportions. Applying anaconda proportions to the skull of "Titanoboa" results in a total body length of around (± ). Weight was determined by comparing "Titanoboa" to the extant green anaconda and the southern rock python, resulting in a weight between and (mean estimate ). These estimates far exceeds the largest modern snakes, the green anaconda and the reticulated python and the previous record holder, the madtsoid "Gigantophis". The existence of eight additional specimens of similar size to the one used in these calculations implies that "Titanoboa" reached such massive proportions regularly. In 2016, Feldman and his colleagues estimated that a long individual would have weighed at maximum based on their equation to estimate the body size of boids.


title: Titanoboa

text: Vertebrae morphology places the snake in the family Boinae alongside other large constrictors of the Americas such as anacondas and typical boas. The skull material confirmed "Titanoboa"s initial placement within the family, now also supported by the reduced palatine choanal. Specifically, the 2013 abstract recovered the giant snake being closely connected to taxa from the Pacific Islands and Madagascar, linking Old World and New World boids and suggesting that the two lineages must have diverged by the Paleocene at the latest. This would place "Titanoboa" at the stem of Boinae, a result later collaborated by a study in 2015.


title: Titanoboa

text: Due to the warm and humid greenhouse climate of the Paleocene, the region of what is now Cerrejón was covered by wet tropical rainforests that covered coastal plains that housed large river systems, which were inhabited by various freshwater animals, especially reptiles. Among the native reptiles are three different types of dyrosaurs, crocodylomorphs that survived the KPG extinction event independently from modern crocodilians. The genera that coexisted alongside Titanoboa included the large, slender-snouted "Acherontisuchus", the medium sized but broad-headed "Anthracosuchus" and the relatively small "Cerrejonisuchus", which may have been relatively more terrestrial than its relatives. Turtles also thrived in the tropical wetlands of Paleocene Colombia, giving rise to several species of considerable size such as "Cerrejonemys" and "Carbonemys", two genera of Podocnemididae, and "Puentemys", a bothremydid.


title: Titanoboa

text: The rainforests of the Cerrejón Formation mirror modern tropical forests in regards to the families that make up much of the vegetation, however unlike today, these Paleocene forests were relatively low in diversity. Although it is possible that this low diversity is the result of the wetland nature of the depositional environment, samples from other localities corresponding with this time frame suggest that the forests that arose shortly following the Cretaceous Paleogene mass extinction were of similar composition. This would indicate that the low plant diversity of the time may be a direct result of the mass extinction preceding it. Plants found in these Paleocene forests include Zingiberales, "Salvinia" and Araceae among others.


title: Titanoboa

text: Initially, "Titanoboa" was thought to have acted much like a modern anaconda based on its size and the environment it was deposited in, with researchers suggesting that it may have in part fed on the local crocodylomorph fauna. However, in a 2013 abstract Jason Head and colleagues note that the skull of this snake displays multiple adaptations to a piscivorous diet such as the anatomy of the palate, tooth count and the anatomy of the teeth themselves. These adaptations bear resemblance to modern caenophidian snakes with a piscivorous diet and is unique among boids. Such a lifestyle would be supported by the extensive rivers of Paleocene Colombia, as well as the fossil fish (lungfish and osteoglossomorphs) recovered from the formation.


title: Titanoboa

text: In the 2009 type description Head and colleagues correlate the gigantism observed in "Titanoboa" with the climate conditions of its environment. As a poikilothermic ectotherm, "Titanoboa"s internal temperature and metabolism were heavily dependent on the ambient temparture, which would in turn affect the animal's size. Accordingly, large ectothermic animals are typically found in the tropics and decrease in size the further one moves away from the equator. Following this correlation, the authors suggest that the mean annual temperature can be calculated by comparing the maximum body size of poikilotherm animals found in two localities. Based on the relation between temperatures in the modern Neotropics and the maximum length of anacondas, Head and colleagues calculate a mean annual temperature of at least 32–33 °C for the equatorial region of Paleocene South America. The estimates are consistent with a hot Paleocene climate model as suggested by a study published in 2003 and slightly higher (1-5 °C) than estimates derived from the oxygen isotopes of planktonic foraminifer. Although these estimates exceed temperatures of modern tropical forests, the paper argues that the increase in temperature is balanced out by higher amounts of rainfall.


title: Titanoboa

text: However, this conclusion was questioned by several researchers following the publication of the paper. J. M. Kale Sniderman used the same methodology as Head and colleagues on the Pleistocene monitor lizard "Varanus priscus", comparing it to the extant Komodo dragon. Sniderman calculates that following this method, the modern tropics should be able to support lizards much larger than what is observed today, or in the reverse, that "Varanus priscus" is much larger than what would be implied by the ambient temperature of its native range. In conclusion it is argued that Paleocene rainforests may not have been any hotter than those today and that the massive size of "Titanoboa" and "Varanus priscus" may instead be the results of lacking significant mammalian competition. Mark W. Denny, Brent L. Lockwood and George N. Somero also disagree with Head's conclusion. They note that although this method first employed by Makarieva is applicable to smaller poikilotherms, it is not constant across all size ranges. As thermal equilibrium is achieved through the relation between volume and surface area, they argue that the large size of "Titanoboa" coupled with the high temperatures proposed by Head "et al." would mean that the animal would overheat easily if resting in a coiled up state. The authors conclude that several key factors influence the relationship between "Titanoboa" and the temperature of the area it inhabited. Varying posture could help cool down if needed, basking behavior or heat absorption through the substrate are both unknown and the potentially semi-aquatic nature of the animal creates additional factors to consider. Ultimately, Denny and colleagues argue that the nature of the giant snake renders it a poor indicator for the climate of the Paleocene and that the mean annual temperature must have been 4 to 6° C (7 to 11 °F) cooler than the current estimate.


title: Titanoboa

text: These issues, alongside adjustments suggested by Makarieva, were addressed by Head and his team the same year, arguing that Denny and colleagues misunderstand their proposed model. They retort that the method takes into account variation caused by body size and that it's furthermore based on the largest extant snakes, making it an appropriate method. They also add that the results recovered are consistent with large extant snakes, which are also known to perform thermoregulation through behavior. Sniderman's proposal that the correlation between body size and temperature is inconsistent with modern monitor lizards is addressed twofold. For one, Head argues, Komodo dragons are a poor analogy as they are geographically restricted to the islands of Indonesia, limiting the size they could grow to while both green anacondas and "Titanoboa" are mainland animals. Secondly the response notes that the size estimates utilized for "Varanus priscus" are overestimates and unreliable, being based on secondary reports that do not match better supported estimates indicating a range for the monitor.


title: Greenland (film)

text: Greenland is a 2020 American disaster thriller film directed by Ric Roman Waugh and written by Chris Sparling. The film stars Gerard Butler (who also produced), Morena Baccarin, Roger Dale Floyd, Scott Glenn, David Denman, and Hope Davis, and follows a family who must fight for survival as a planet-destroying comet races to Earth.


title: Greenland (film)

text: Originally scheduled to be theatrically released in the United States, "Greenland" was delayed several times due to the COVID-19 pandemic. The film was released domestically by STXfilms, through video on demand on December 18, 2020, and then played on HBO Max and Amazon Prime. It was still released theatrically in other territories, beginning with Belgium on July 29, 2020. The film received generally positive reviews from critics and grossed $52.3 million worldwide with a production budget of $35 million. A sequel, "Greenland: Migration", is in development, with Waugh, Butler, Baccarin and Floyd all returning.


title: Greenland (film)

text: Structural engineer John Garrity lives in Atlanta, Georgia with his estranged wife, Allison, and their diabetic son, Nathan. He returns home to watch the near-earth passing of a recently-discovered interstellar comet named "Clarke", along with his family and neighbors.


title: Greenland (film)

text: While at the grocery store, John receives an automated DHS message saying that he and his family have been selected for emergency sheltering. He then returns home just as a comet fragment is seen entering the atmosphere on live television. Previously expected to land in the ocean near Bermuda, the fragment instead strikes Tampa, Florida, vaporizing it along with most of the state. John then receives a call with instructions to head to Robins Air Force Base for an evacuation flight, as Clarke is on a direct collision course with Earth and the entire planet will be bombarded with hundreds of fragments over the next two days in a cataclysmic event, with one fragment large enough to cause an extinction-level event. John, Allison, and Nathan pack up and flee, unable to take anyone else with them as they would be denied boarding.


title: Greenland (film)

text: At Robins, Nathan's insulin gets left behind in the car. When John goes to retrieve it, Allison is escorted off the base after Nathan's medical condition is discovered, disqualifying him. John returns and boards a plane but quickly jumps off upon realizing Allison and Nathan were probably left behind. As John exits the base, a panicked mob breaks in, destroying several evacuation planes when gunfire ignites jet fuel. Returning to the car, John finds Allison's note saying she and Nathan are going to her father's home in Lexington, Kentucky. After getting medical supplies from a looted store, Allison and Nathan get a ride from Ralph and Judy Vento, only for Ralph to kidnap Nathan, to Judy's dismay, in order to use him and the wristbands to board a flight. Quickly, Allison tries to get help, but everyone is too busy and passes her and a now hopeless Allison starts crying.


title: Greenland (film)

text: John hitches a ride on a truck where a young man named Colin says it is headed to Osgoode, Ontario, where private planes are flying to Greenland, the apparent evacuation site. However, another man attempts to take John's wristband, causing the truck to crash and kill Colin, and John is forced to kill the man in self-defense. At another airport, the Ventos attempt to pose as Nathan's parents, but are arrested when the soldiers quickly discover that Nathan is not theirs. Allison and Nathan are reunited shortly after at a nearby FEMA camp. The following morning, John learns that millions have died in global impacts and that the largest fragment will hit in approximately 24 hours.


title: Greenland (film)

text: Stealing a car, John reaches his father-in-law, Dale's house, and Nathan and Allison arrive shortly after. The family learn about a complex of underground bunkers near Thule Air Force Base in Greenland where the evacuees are being sent. The family has just enough time to reach Osgoode, so John and Allison decide to go while Dale chooses to stay behind and die in the impact, while giving them his truck. Reaching Upstate New York, the family is caught in a traffic jam. As a shower of molten debris rains down, they take refuge below an underpass, then continue on to Canada. While making steady progress to Osgoode, the family learns over the radio that Clarke's largest fragment, which is wide, will hit Western Europe and destroy it. The family arrives at the Osgoode airport barely in time to board that night's last flight out. As they reach Greenland, a comet fragment strikes off the coast, and the shockwave causes the plane to crash-land, killing the pilots. The Garritys and the rest of the passengers flag down a military truck and enter the bunker complex right as the largest fragment enters the atmosphere and hits, devastating civilization.


title: Greenland (film)

text: Nine months later, the bunkers attempt to make radio contact with other potential survivors as various cities are shown in total ruin, including Sydney, Mexico City, Paris, and Chicago. The Garritys and other occupants exit the shelter to a radically changed landscape, and Greenland makes contact with other stations around the globe. All are relieved to hear each other and report that the atmosphere is finally clearing, giving the survivors the chance to rebuild.


title: Greenland (film)

text: In May 2018, Chris Evans joined the cast of the film, with Neill Blomkamp directing from a screenplay by Chris Sparling. In February 2019, it was announced Blomkamp would no longer direct the film. That same month, Ric Roman Waugh joined the project as director, with Gerard Butler being added to the cast of the film, replacing Blomkamp and Evans respectively, with Butler producing under his G-Base banner. In June 2019, Morena Baccarin joined the cast of the film. In July 2019, Scott Glenn, Andrew Bachelor and Roger Dale Floyd also joined, as did David Denman, in August.


title: Greenland (film)

text: In March 2019, STX Entertainment acquired distribution rights to the film. It was originally scheduled to be theatrically released on June 12, 2020, but was delayed to July 30, 2020, and then August 14, 2020, due to the COVID-19 pandemic. Its domestic release was again delayed on July 24, moving to September 25, 2020. The film's release schedule includes Belgium (July 29), France (August 5), and Scandinavia (August 12). On September 14, it was announced the film's American release has been delayed again, this time to sometime later in 2020.


title: Greenland (film)

text: On September 30, the studio announced the film would be skipping theaters and going to be available to buy via video on demand on October 13, before being made available to rent on October 27. The following day, the studio announced the film had its U.S. pay TV and streaming rights sold to HBO for $20–30 million, who will release it in early 2021 and have it stream on HBO Max and Amazon Prime for the United Kingdom, Canada, and Australia releases. It was later reported the VOD release date had been pushed to December 18. The studio spent an estimated $10 million promoting the film domestically.


title: Greenland (film)

text: "Greenland" was first released in Belgium, making $73,112 from 55 theaters on its opening weekend. On its first day of release in France, the film made $255,000 with 31,000 tickets sold, 61% ahead of Butler's "Olympus Has Fallen" (2013) despite fewer theaters and tight COVID-19 restrictions. Overall, it debuted to $1.09 million in the country, with a 10-day international total of $1.3 million. In its third weekend of international release, the film finished first in nine countries and made a total of $2.82 million. In November the film opened in China and Mexico, debuting to $3.4 million and $882,000, respectively; the running global total was $43.1 million.


title: Greenland (film)

text: Upon the film's VOD release in the United States, it was the second-most rented on FandangoNow, and third on Apple TV and Google Play. The film remained near the top of rental charts into February, finishing first at both Google Play and Apple TV. In February 24, IndieWire estimated the film had already netted STX Films $60–80 million in profit, including around $32 million from two million PVOD rentals.


title: Greenland (film)

text: On review aggregator Rotten Tomatoes, the film has an approval rating of based on reviews, with an average rating of . The website's critics consensus reads: "Beware, comets of "Greenland": Gerard Butler is here to protect Earth – and show audiences an improbably entertaining time." On Metacritic, it has a weighted average score of 64 out of 100 based on 25 critics, indicating "generally favorable reviews".


title: Greenland (film)

text: Writing for the "Chicago Sun-Times", Richard Roeper gave the film three out of four stars, saying, "Unlike the typical, effects-laden, comet-threatens-the-planet B-movie, "Greenland" is more in the vein of Steven Spielberg's "War of the Worlds", with the scenes of chaos and destruction serving as the backdrop for the story of one family's desperate quest for survival — even when circumstances have ripped them apart." Writing for IndieWire, David Ehrlich gave the film a grade of B and said, "By eschewing spectacle and focusing on the human scale of a crisis, "Greenland" becomes the rare disaster movie that feels realistic."


title: Greenland (film)

text: Katie Walsh of the "Los Angeles Times" wrote that "[the film is not just plausible but recognizable. There's very little otherworldly about this cinematic apocalypse. These are the people, places and, yes, behaviors we know all too well".


title: Greenland (film)

text: Jordan Mintzer of "The Hollywood Reporter" said "The gritty verisimilitude that the star and director Ric Roman Waugh bring to the table goes a long way in making this B-level blockbuster a timely and guilty pleasure". Chris Hewitt of the "Star Tribune" called it a "capably done [film]".


title: Greenland (film)

text: According to Matthew Monagle of "The Austin Chronicle", ""Greenland" might be a B-movie at heart, but in keeping at least one toe on the ground at all times, the filmmakers craft something that punches well above its weight class".


title: Greenland (film)

text: The criticism of the film, just like its praise, was abundant as well. Ignatiy Vishnevetsky of "The A.V. Club" compared "Greenland" to Roland Emmerich's films, while Owen Gleiberman of "Variety" wrote "A thriller isn't supposed to be a cakewalk; if it were, it wouldn't thrill".


title: Greenland (film)

text: In June 2021, it was announced a sequel titled "Greenland: Migration" was in development, and will reportedly center on the Garritys' journey across a frozen European wasteland to find a new home. The following month, STX acquired the worldwide distribution rights for the film at 2021 Cannes Film Festival for $75 million, and agreed to give the sequel a $65 million budget.


title: Madhouse (company)

text: Madhouse has created and helped to produce many well-known shows, OVAs and films, starting with TV anime series "Ace o Nerae!" (produced by Tokyo Movie Shinsha) in 1973, and including "Wicked City", "Ninja Scroll", "Perfect Blue", "", "Trigun", "Di Gi Charat", "Black Lagoon", "Death Note", "Paprika", "Wolf Children, Parasyte: The Maxim" and the first season of "One-Punch Man". Unlike other studios founded at this time such as AIC and J.C.Staff, their strength was and is primarily in TV shows and theatrical features. Expanding from the initial Mushi Pro staff, Madhouse recruited important directors such as Morio Asaka, Masayuki Kojima, and Satoshi Kon during the 1990s. Their staff roster expanded in the 2000s to include Mamoru Hosoda, Takeshi Koike, and Mitsuo Iso, as well as many younger television directors. The studio was also responsible for the first "Beyblade" anime series as well as the "Dragon Drive" anime and the 2011 anime adaptation of "Hunter × Hunter".


title: Madhouse (company)

text: The studio often collaborates with known manga artists, including Naoki Urasawa and Clamp. Madhouse produced adaptations of Urasawa's "Yawara!", "Master Keaton" and "Monster", with Masayuki Kojima helming the later two. The company has animated a number of CLAMP's titles, including "Tokyo Babylon", two versions of "X" (a theatrical movie and a TV series), "Cardcaptor Sakura" and its sequel "", and "Chobits".


title: Madhouse (company)

text: Madhouse was established in 1972 by ex–Mushi Production animators, including Masao Maruyama, Osamu Dezaki, and Yoshiaki Kawajiri, with funding from Yutaka Fujioka, the founder of Tokyo Movie, and co-produced its earliest series with Tokyo Movie. In February 2004, Madhouse became a subsidiary of Index Corporation. On February 8, 2011, Nippon TV became Madhouse's primary stockholder (replacing Index Corporation), via a third-party allocation of new shares. NTV bought 128,667 new shares (each ¥7,772) issued by Madhouse for ¥999,999,924 total (about $12.4 million), raising its stake in the company from 10.4% to 84.5%. Index Corporation's stake in Madhouse fell from 60.91% to 10.54%. In January 2012, Madhouse announced their acquisition of the animation rights to the "Peanuts" comic strip. In March 2014, NTV bought all the shares belonging to Index Corporation, increasing its stake in Madhouse to 95%.


title: Madhouse (company)

text: The studio employs approximately 70 employees, with employment levels varying depending on the number of productions currently underway. Additionally, the company has invested in the animation studio DR Movie. Madhouse has a subsidiary, Madbox Co., Ltd., that mainly focuses on computer graphics.


title: Madhouse (company)

text: Madhouse's early theatrical work included assistance on the "Barefoot Gen" films, and "", an anime movie based on the space opera series by pulp science fiction author E.E. "Doc" Smith.


title: Madhouse (company)

text: In the late 1980s and early 1990s, director Yoshiaki Kawajiri produced a string of action films including "Wicked City", "Demon City Shinjuku", and "Ninja Scroll".


title: Madhouse (company)

text: In the late 1990s, the studio aimed at a younger female audience with Morio Asaka's two "Cardcaptor Sakura" films, based on the popular television series.


title: Madhouse (company)

text: In the early 2000s, an ambitious collaboration with Tezuka Productions resulted in "Metropolis", directed by Rintaro and adapted from the manga by Osamu Tezuka. Earlier collaborations with Tezuka productions included two feature-length films made for Sanrio starring Tezuka's unicorn character Unico.


title: Madhouse (company)

text: Director Satoshi Kon produced all four of his films with the studio: "Perfect Blue", "Millennium Actress", "Tokyo Godfathers", and "Paprika", as well as his TV series "Paranoia Agent". Kon was also making his fifth film the "Dreaming Machine" with Madhouse, although it was left incomplete at his death in 2010.


title: Madhouse (company)

text: In 2003, Madhouse produced "", which was adapted from the seinen manga "Nasu" by Iou Kuroda and directed by Studio Ghibli veteran Kitarō Kōsaka. "Nasu" was the first Japanese animated film ever selected for screening at the renowned Cannes Film Festival. Kōsaka followed up his film with an OVA sequel in 2007.


title: Madhouse (company)

text: In 2006, director Mamoru Hosoda began his career with the studio by directing "The Girl Who Leapt Through Time".


title: Madhouse (company)

text: Recent productions included Masayuki Kojima's theatrical debut "Forest of Piano" (2007), Hosoda's acclaimed "Summer Wars" (2009), Sunao Katabuchi's "Mai Mai Miracle" (2009), the company's first CG animated film, "Yona Yona Penguin" (2009), Takeshi Koike's feature film debut "Redline" (2009), a theatrical version of the "Trigun" series, "" (2010), and "The Tibetan Dog", a co-production with China (2011).


title: Madhouse (company)

text: Collectively, Madhouse films have won a total of two Japan Academy Prizes, four Grand Prizes in the Animation Division at Japan Media Arts Festival, two Gertie Awards, six Mainichi Film Awards (three Ōfuji Noburō Awards, and three Animation Grand Awards), two Tokyo Anime Awards for Animation of the Year, and five Animation Kobe Feature Film Awards.


title: Madhouse (company)

text: Madhouse designed the characters for Hudson Soft's game "Virus" (the first installment of the "Virus Buster Serge" franchise). Madhouse worked with Square Enix on the OVA "" as well as Capcom for the mini series of "".


title: Madhouse (company)

text: They collaborated with Studio Ghibli by contributing animation to Hayao Miyazaki's "My Neighbor Totoro" (1988), "Spirited Away" (2001), and "Howl's Moving Castle" (2004), as well as Tomomi Mochizuki's "I Can Hear the Sea" (1993) and Goro Miyazaki's "Tales from Earthsea" (2006).


title: Madhouse (company)

text: Madhouse collaborated with professional rapper Snoop Dogg in the 2006 horror-comedy movie "Hood of Horror", in which they assisted in the animated sections of the movie.


title: Madhouse (company)

text: Madhouse also collaborated with Disney for the anime "Stitch!" for its first and second arcs (equal to 56 episodes total), between 2008 and 2010. They also animated the intro cutscene to PlayStation video game "Wild Arms" and the opening movie to PlayStation Vita video game "Persona 4 Golden" ("Persona 4: The Golden" in Japan), along with opening to the PSP remake of "".


title: Madhouse (company)

text: They worked with Marvel Entertainment to create adaptations of "Blade", "Iron Man", "Wolverine" and "X-Men".


title: Madhouse (company)

text: 2010 also saw the publication of "Devil", a manga intended specifically for the American market; the property is a collaboration with Dark Horse Comics, and is written and drawn by Torajiro Kishi.


title: Madhouse (company)

text: Madhouse also participated in animating the "Wakfu" TV special "Ogrest, la légende" in collaboration with Ankama Japan.


title: Carpal tunnel syndrome

text: Carpal tunnel syndrome (CTS) is the collection of symptoms and signs associated with median neuropathy at the carpal tunnel. Most CTS is related to idiopathic compression of the median nerve as it travels through the wrist at the carpal tunnel (IMNCT). Idiopathic means that there is no other disease process contributing to pressure on the nerve. As with most structural issues, it occurs in both hands, and the strongest risk factor is genetics.


title: Carpal tunnel syndrome

text: Other conditions can cause CTS such as wrist fracture or rheumatoid arthritis. After fracture, swelling, bleeding, and deformity compress the median nerve. With rheumatoid arthritis, the enlarged synovial lining of the tendons causes compression.


title: Carpal tunnel syndrome

text: The main symptoms are numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. People often report pain, but pain without tingling is not characteristic of IMNCT. Rather, the numbness can be so intense that it is described as painful.


title: Carpal tunnel syndrome

text: Symptoms are typically most troublesome at night. Untreated, and over years to decades, IMNCT causes loss of sensibility and weakness and shrinkage (atrophy) of the muscles at the base of the thumb.


title: Carpal tunnel syndrome

text: Work-related factors such as vibration, wrist extension or flexion, hand force, and repetition increase the risk of developing CTS. The only certain risk factor for IMNCT is genetics. All other risk factors are open to debate. It is important to consider IMNCT separately from CTS in diseases such as rheumatoid arthritis.


title: Carpal tunnel syndrome

text: Diagnosis of IMNCT can be made with a high probability based on characteristic symptoms and signs. IMNCT can be measured with electrodiagnostic tests.


title: Carpal tunnel syndrome

text: People wake less often at night if they wear a wrist splint. Injection of corticosteroids may or may not alleviate better than simulated (placebo) injections. There is no evidence that corticosteroid injection alters the natural history of the disease, which seems to be a gradual progression of neuropathy.


title: Carpal tunnel syndrome

text: The carpal tunnel is an anatomical compartment located at the base of the palm. Nine flexor tendons and the median nerve pass through the carpal tunnel that is surrounded on three sides by the carpal bones that form an arch. The median nerve provides feeling or sensation to the thumb, index finger, long finger, and half of the ring finger. At the level of the wrist, the median nerve supplies the muscles at the base of the thumb that allow it to abduct, move away from the other four fingers, as well as move out of the plane of the palm. The carpal tunnel is located at the middle third of the base of the palm, bounded by the bony prominence of the scaphoid tubercle and trapezium at the base of the thumb, and the hamate hook that can be palpated along the axis of the ring finger. From the anatomical position, the carpal tunnel is bordered on the anterior surface by the transverse carpal ligament, also known as the flexor retinaculum. The flexor retinaculum is a strong, fibrous band that attaches to the pisiform and the hamulus of the hamate. The proximal boundary is the distal wrist skin crease, and the distal boundary is approximated by a line known as Kaplan's cardinal line. This line uses surface landmarks, and is drawn between the apex of the skin fold between the thumb and index finger to the palpated hamate hook.


title: Carpal tunnel syndrome

text: The median nerve can be compressed by a decrease in the size of the canal, an increase in the size of the contents (such as the swelling of tissue around the flexor tendons), or both. When the pressure builds up inside the tunnel, it damages the median nerve (median neuropathy).


title: Carpal tunnel syndrome

text: As the median neuropathy gets worse, there is loss of sensibility in the thumb, index, middle, and thumb side of the ring finger. As the neuropathy progresses, there may be first weakness, then to atrophy of the muscles of thenar eminence (the flexor pollicis brevis, opponens pollicis, and abductor pollicis brevis). The sensibility of the palm remains normal because the superficial sensory branch of the median nerve branches proximal to the TCL and travels superficial to it.


title: Carpal tunnel syndrome

text: IMNCT is estimated to affect one out of ten people during their lifetime and is the most common nerve compression syndrome. There is notable variation in such estimates based on how one defines the problem, in particular whether one studies people presenting with symptoms vs. measurable median neuropathy (IMNCT) whether or not people are seeking care. It accounts for about 90% of all nerve compression syndromes. The best data regarding IMNCT and CTS comes from population-based studies, which demonstrate no relationship to gender, and increasing prevalence (accumulation) with age.


title: Carpal tunnel syndrome

text: The characteristic symptom of CTS is numbness, tingling, or burning sensations in the thumb, index, middle, and radial half of the ring finger. These areas process sensation through the median nerve. Numbness or tingling is usually worse with sleep. People tend to sleep with their wrists flexed, which increases pressure on the nerve. Ache and discomfort may be reported in the forearm or even the upper arm, but its relationship to IMNCT is uncertain. Symptoms that are not characteristic of CTS include pain in the wrists or hands, loss of grip strength, minor loss of sleep, and loss of manual dexterity.


title: Carpal tunnel syndrome

text: Median nerve symptoms may arise from compression at the level of the thoracic outlet or the area where the median nerve passes between the two heads of the pronator teres in the forearm, although this is debated.


title: Carpal tunnel syndrome

text: Severe IMNCT is associated with measurable loss of sensibility. Diminished threshold sensibility (the ability to distinguish different amounts of pressure) can be measured using Semmes-Weinstein monofilament testing. Diminished discriminant sensibility can be measured by testing two-point discrimination: the number of millimeters two points of contact need to be separated before you can distinguish them.


title: Carpal tunnel syndrome

text: A person with idiopathic median neuropathy at the carpal tunnel will not have any sensory loss over the thenar eminence (bulge of muscles in the palm of hand and at the base of the thumb). This is because the palmar branch of the median nerve, which innervates that area of the palm, separates from the median nerve and passes over the carpal tunnel.


title: Carpal tunnel syndrome

text: Severe IMNCT is also associated with weakness and atrophy of the muscles at the base of the thumb. People may lose the ability to palmarly abduct the thumb. IMNCT can be detected on examination using one of several maneuvers to provoke paresthesia (a sensation of tingling or "pins and needles" in the median nerve distribution). These so-called provocative signs include:


title: Carpal tunnel syndrome

text: Diagnostic performance characteristics such as sensitivity and specificity are reported, but difficult to interpret because of the lack of a consensus reference standard for CTS or IMNCT.


title: Carpal tunnel syndrome

text: Genetic factors are believed to be the most important determinants of who develops carpal tunnel syndrome due to IMNCT. In other words, your wrist structure seems programmed at birth to develop IMNCT later in life. A genome-wide association study (GWAS) of carpal tunnel syndrome identified 16 genomic loci significantly associated with the disease, including several loci previously known to be associated with human height.


title: Carpal tunnel syndrome

text: Factors that may contribute to symptoms, but have not been experimentally associated with neuropathy include obesity, and Diabetes mellitus . One case-control study noted that individuals classified as obese (BMI > 29) are 2.5 times more likely than slender individuals (BMI < 20) to be diagnosed with CTS." "It's not clear whether this association is due to an alteration of pathophysiology, a variation in symptoms, or a variation in care-seeking.


title: Carpal tunnel syndrome

text: Hereditary neuropathy with susceptibility to pressure palsies is a genetic condition that appears to increase the probability of developing MNCT. Heterozygous mutations in the gene SH3TC2, associated with Charcot-Marie-Tooth, may confer susceptibility to neuropathy, including CTS.


title: Carpal tunnel syndrome

text: Association between common benign tumors such as lipomas, ganglion, and vascular malformation should be handled with care. Such tumors are very common and overlap with IMNCT is more likely than pressure on the median nerve. Similarly, the degree to which transthyretin amyloidosis-associated polyneuropathy and carpal tunnel syndrome is under investigation. Prior carpal tunnel release is often noted in individuals who later present with transthyretin amyloid-associated cardiomyopathy. There is consideration that bilateral carpal tunnel syndrome could be a reason to consider amyloidosis, timely diagnosis of which could improve heart health. Amyloidosis is rare, even among people with carpal tunnel syndrome (0.55% incidence within 10 years of carpal tunnel release). In the absence of other factors associated with a notable probability of amyloidosis, it's not clear that biopsy at the time of carpal tunnel release has a suitable balance between potential harms and potential benefits.


title: Carpal tunnel syndrome

text: Work-related factors that increase risk of CTS include vibration (5.4 effect ratio), hand force (4.2), and repetition (2.3). Exposure to wrist extension or flexion at work increases the risk of CTS by two times. The balance of evidence suggests that keyboard and computer use does not cause CTS.


title: Carpal tunnel syndrome

text: The international debate regarding the relationship between CTS and repetitive hand use (at work in particular) is ongoing. The Occupational Safety and Health Administration (OSHA) has adopted rules and regulations regarding so-called "cumulative trauma disorders" based concerns regarding potential harm from exposure to repetitive tasks, force, posture, and vibration.


title: Carpal tunnel syndrome

text: A review of available scientific data by the National Institute for Occupational Safety and Health (NIOSH) indicated that job tasks that involve highly repetitive manual acts or specific wrist postures were associated with symptoms of CTS, but there was not a clear distinction of paresthesia (appropriate) from pain (inappropriate) and causation was not established. The distinction from work-related arm pains that are not carpal tunnel syndrome was unclear. It is proposed that repetitive use of the arm can affect the biomechanics of the upper limb or cause damage to tissues. It is proposed that postural and spinal assessment along with ergonomic assessments should be considered, based on observation that addressing these factors has been found to improve comfort in some studies although experimental data are lacking and the perceived benefits may not be specific to those interventions. A 2010 survey by NIOSH showed that 2/3 of the 5 million carpal tunnel diagnosed in the US that year were related to work. Women are more likely to be diagnosed with work-related carpal tunnel syndrome than men.


title: Carpal tunnel syndrome

text: A variety of patient factors can lead to CTS, including heredity, size of the carpal tunnel, associated local and systematic diseases, and certain habits. Non-traumatic causes generally happen over a period of time, and are not triggered by one certain event. Many of these factors are manifestations of physiologic aging.


title: Carpal tunnel syndrome

text: There is no consensus reference standard for the diagnosis of carpal tunnel syndrome. A combination of characteristic symptoms (how it feels) and signs (what the clinician finds on exam) are associated with a high probability of IMNCT without electrophysiological testing.


title: Carpal tunnel syndrome

text: Electrodiagnostic testing (electromyography and nerve conduction velocity) can objectively measure and verify median neuropathy.


title: Carpal tunnel syndrome

text: Ultrasound can image and measure the cross sectional diameter of the median nerve, which has some correlation with idiopathic median neuropathy at the carpal tunnel (IMNCT). The role of ultrasound in diagnosis--just as for electrodiagnostic testing--is a matter of debate. EDX cannot fully exclude the diagnosis of CTS due to the lack of sensitivity. A joint report published by the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), the American Academy of Physical Medicine and Rehabilitation (AAPM&R), and the American Academy of Neurology defines practice parameters, standards, and guidelines for EDX studies of CTS based on an extensive critical literature review. This joint review concluded median and sensory nerve conduction studies are valid and reproducible in a clinical laboratory setting and a clinical diagnosis of CTS can be made with a sensitivity greater than 85% and specificity greater than 95%. Given the key role of electrodiagnostic testing in the diagnosis of CTS, The AANEM has issued evidence-based practice guidelines, both for the diagnosis of carpal tunnel syndrome.


title: Carpal tunnel syndrome

text: Electrodiagnostic testing (electromyography and nerve conduction velocity) can objectively verify the median nerve dysfunction. Normal nerve conduction studies, however, do not exclude the diagnosis of CTS. Clinical assessment by history taking and physical examination can support a diagnosis of CTS. If clinical suspicion of CTS is high, treatment should be initiated despite normal electrodiagnostic testing.


title: Carpal tunnel syndrome

text: The role of confirmatory electrodiagnostic testing is debated. The goal of electrodiagnostic testing is to compare the speed of conduction in the median nerve with conduction in other nerves supplying the hand. When the median nerve is compressed, as in IMNCT, it will conduct more slowly than normal and more slowly than other nerves. Compression results in damage to the myelin sheath and manifests as delayed latencies and slowed conduction velocities. There are many electrodiagnostic tests used to make a diagnosis of CTS, but the most sensitive, specific, and reliable test is the Combined Sensory Index (also known as the Robinson index). Electrodiagnosis rests upon demonstrating impaired median nerve conduction across the carpal tunnel in context of normal conduction elsewhere. It is often stated that normal electrodiagnostic studies do not preclude the diagnosis of carpal tunnel syndrome. The rational for this is that a threshold of neuropathy must be reached before study results become abnormal and also that threshold values for abnormality vary. Others contend that idiopathic median neuropathy at the carpal tunnel with normal electrodiagnostic tests would represent very, very mild neuropathy that would be best managed as a normal median nerve. Even more important, notable symptoms with mild disease is strongly associated with unhelpful thoughts and symptoms of worry and despair. Notable CTS with unmeasurable IMNCT should remind clinicians to always consider the whole person, including their mindset and circumstances, in strategies to help people get and stay healthy.


title: Carpal tunnel syndrome

text: The role of MRI or ultrasound imaging in the diagnosis of idiopathic median neuropathy at the carpal tunnel (IMNCT) is unclear. Their routine use is not recommended. MRI has high sensitivity but low specificity for IMNCT. High signal intensity may suggest accumulation of axonal transportation, myelin sheath degeneration or oedema.


title: Carpal tunnel syndrome

text: There are few disorders on the differential diagnosis for carpal tunnel syndrome. Cervical radiculopathy can also cause paresthesia abnormal sensibility in the hands and wrist. The distribution usually follows the nerve root, and the paresthesia may be provoked by neck movement. Electromyography and imaging of the cervical spine can help to differentiate cervical radiculopathy from carpal tunnel syndrome if the diagnosis is unclear. Carpal tunnel syndrome is sometimes applied as a label to anyone with pain, numbness, swelling, or burning in the radial side of the hands or wrists. When pain is the primary symptom, carpal tunnel syndrome is unlikely to be the source of the symptoms.


title: Carpal tunnel syndrome

text: When the symptoms and signs point to atrophy and muscle weakness more than numbness, consider neurodegenerative disorders such as Amyotrophic Lateral Sclerosis or Charcot-Marie Tooth.


title: Carpal tunnel syndrome

text: There is little or no data to support the concept that activity adjustment prevents carpal tunnel syndrome. The evidence for wrist rest is debated. There is also little research supporting that ergonomics is related to carpal tunnel syndrome. Due to risk factors for hand and wrist dysfunction being multifactorial and very complex it is difficult to assess the true physical factors of carpal tunnel syndrome.


title: Carpal tunnel syndrome

text: Biological factors such as genetic predisposition and anthropometric features are more strongly associated with idiopathic carpal tunnel syndrome than occupational/environmental factors such as hand use.


title: Carpal tunnel syndrome

text: CTS related to another pathophysiology is addressed by treating that pathology. For instance, disease-modifying medications for rheumatoid arthritis or surgery for traumatic acute carpal tunnel syndrome.


title: Carpal tunnel syndrome

text: Generally accepted treatments include: physiotherapy, steroids either orally or injected locally, splinting, and surgical release of the transverse carpal ligament. Limited evidence suggests that gabapentin is no more effective than placebo for CTS treatment. There is insufficient evidence to recommend therapeutic ultrasound, yoga, acupuncture, low level laser therapy, vitamin B6, myofascial release, and any form of stretch or exercise. Change in activity may include avoiding activities that worsen symptoms.


title: Carpal tunnel syndrome

text: The American Academy of Orthopedic Surgeons recommends proceeding conservatively with a course of nonsurgical therapies tried before release surgery is considered. A different treatment should be tried if the current treatment fails to resolve the symptoms within 2 to 7 weeks. Early surgery with carpal tunnel release is indicated where there is evidence of median nerve denervation or a person elects to proceed directly to surgical treatment. Recommendations may differ when carpal tunnel syndrome is found in association with the following conditions: diabetes mellitus, coexistent cervical radiculopathy, hypothyroidism, polyneuropathy, pregnancy, rheumatoid arthritis, and carpal tunnel syndrome in the workplace.


title: Carpal tunnel syndrome

text: The importance of wrist braces and splints in the carpal tunnel syndrome therapy is known, but many people are unwilling to use braces. In 1993, The American Academy of Neurology recommended a non-invasive treatment for the CTS at the beginning (except for sensitive or motor deficit or grave report at EMG/ENG): a therapy using splints was indicated for light and moderate pathology. Current recommendations generally don't suggest immobilizing braces, but instead activity modification and non-steroidal anti-inflammatory drugs as initial therapy, followed by more aggressive options or specialist referral if symptoms do not improve.


title: Carpal tunnel syndrome

text: Many health professionals suggest that, for the best results, one should wear braces at night. When possible, braces can be worn during the activity primarily causing stress on the wrists. The brace should not generally be used during the day as wrist activity is needed to keep the wrist from becoming stiff and to prevent muscles from weakening.


title: Carpal tunnel syndrome

text: Corticosteroid injections may provide temporary alleviation of symptoms although they are not clearly better than placebo. This form of treatment is thought to reduce discomfort in those with CTS due to its ability to decrease median nerve swelling. The use of ultrasound while performing the injection is more expensive but leads to faster resolution of CTS symptoms. The injections are done under local anesthesia. This treatment is not appropriate for extended periods, however. In general, local steroid injections are only used until more definitive treatment options can be used. Corticosteroid injections do not appear to slow disease progression.


title: Carpal tunnel syndrome

text: Release of the transverse carpal ligament is known as "carpal tunnel release" surgery. It is recommended when there is static (constant, not just intermittent) numbness, muscle weakness, or atrophy, and when night-splinting or other palliative interventions no longer alleviate intermittent symptoms. The surgery may be done with local or regional anesthesia with or without sedation, or under general anesthesia. In general, milder cases can be controlled for months to years, but severe cases are unrelenting symptomatically and are likely to result in surgical treatment.


title: Carpal tunnel syndrome

text: Surgery is more beneficial in the short term to alleviate symptoms (up to six months) than wearing an orthosis for a minimum of six weeks. However, surgery and wearing a brace resulted in similar symptom relief in the long term (12–18 month outcomes).


title: Carpal tunnel syndrome

text: An evidence-based guideline produced by the American Academy of Orthopedic Surgeons assigned various grades of recommendation to physical therapy and other nonsurgical treatments. One of the primary issues with physiotherapy is that it attempts to reverse (often) years of pathology inside the carpal tunnel. Self-myofascial ligament stretching can be an easy, do-at-home, treatment to help alleviate symptoms. Self-myofascial stretching involves stretching the carpal ligament for 30 seconds, 6 times a day for about 6 weeks. Many patients report improvements in symptoms such as pain, function, and nerve conduction. Practitioners caution that any physiotherapy such as myofascial release may take weeks of persistent application to effectively manage carpal tunnel syndrome.


title: Carpal tunnel syndrome

text: Again, some claim that pro-active ways to reduce stress on the wrists, which alleviates wrist pain and strain, involve adopting a more ergonomic work and life environment. For example, some have claimed that switching from a QWERTY computer keyboard layout to a more optimised ergonomic layout such as Dvorak was commonly cited as beneficial in early CTS studies; however, some meta-analyses of these studies claim that the evidence that they present is limited.


title: Carpal tunnel syndrome

text: A randomized control trial published in 2017 sought to examine the efficacy of manual therapy techniques for the treatment of carpal tunnel syndrome. The study included a total of 140 individuals diagnosed with carpal tunnel syndrome and the patients were divided into two groups. One group received treatment that consisted of manual therapy. Manual therapy included the incorporation of specified neurodynamic techniques, functional massage, and carpal bone mobilizations. Another group only received treatment through electrophysical modalities. The duration of the study was over the course of 20 physical therapy sessions for both groups. Results of this study showed that the group being treated through manual techniques and mobilizations yielded a 290% reduction in overall pain when compared to reports of pain prior to conducting the study. Total function improved by 47%. Conversely, the group being treated with electrophysical modalities reported a 47% reduction in overall pain with a 9% increase in function.


title: Carpal tunnel syndrome

text: A 2018 Cochrane review on acupuncture and related interventions for the treatment of carpal tunnel syndrome concluded that, "Acupuncture and laser acupuncture may have little or no effect in the short term on symptoms of carpal tunnel syndrome (CTS) in comparison with placebo or sham acupuncture." It was also noted that all studies had an unclear or high overall risk of bias and that all evidence was of low or very low quality.


title: Carpal tunnel syndrome

text: Most people relieved of their carpal tunnel symptoms with conservative or surgical management find minimal residual or "nerve damage". Long-term chronic carpal tunnel syndrome (typically seen in the elderly) can result in permanent "nerve damage", i.e. irreversible numbness, muscle wasting, and weakness. Those that undergo a carpal tunnel release are nearly twice as likely as those not having surgery to develop trigger thumb in the months following the procedure.


title: Carpal tunnel syndrome

text: While outcomes are generally good, certain factors can contribute to poorer results that have little to do with nerves, anatomy, or surgery type. One study showed that mental status parameters or alcohol use yields much poorer overall results of treatment.


title: Carpal tunnel syndrome

text: The condition known as carpal tunnel syndrome had major appearances throughout the years but it was most commonly heard of in the years following World War II. Individuals who had had this condition have been depicted in surgical literature for the mid-19th century. In 1854, Sir James Paget was the first to report median nerve compression at the wrist in two cases.


title: Carpal tunnel syndrome

text: The first to notice the association between the carpal ligament pathology and median nerve compression appear to have been Pierre Marie and Charles Foix in 1913. They described the results of a postmortem of an 80-year-old man with bilateral carpal tunnel syndrome. They suggested that division of the carpal ligament would be curative in such cases. Putman had previously described a series of 37 patients and suggested a vasomotor origin. The association between the thenar muscle atrophy and compression was noted in 1914. The name "carpal tunnel syndrome" appears to have been coined by Moersch in 1938.


title: Carpal tunnel syndrome

text: In the early 20th century there were various cases of median nerve compression underneath the transverse carpal ligament. Physician George S. Phalen of the Cleveland Clinic identified the pathology after working with a group of patients in the 1950s and 1960s.


title: Carpal tunnel syndrome

text: Paget described two cases of carpal tunnel syndrome. The first was due to an injury where a cord had been wrapped around a man's wrist. The second was due to a distal radial fracture. For the first case, Paget performed an amputation of the hand. For the second case Paget recommended a wrist splint – a treatment that is still in use today. Surgery for this condition initially involved the removal of cervical ribs despite Marie and Foix's suggested treatment. In 1933 Sir James Learmonth outlined a method of decompression of the nerve at the wrist. This procedure appears to have been pioneered by the Canadian surgeons Herbert Galloway and Andrew MacKinnon in 1924 in Winnipeg but was not published. Endoscopic release was described in 1988.


title: Survivorship bias

text: Survivorship bias or survival bias is the logical error of concentrating on entities that passed a selection process while overlooking those that did not. This can lead to incorrect conclusions because of incomplete data.


title: Survivorship bias

text: Survivorship bias is a form of selection bias that can lead to overly optimistic beliefs because multiple failures are overlooked, such as when companies that no longer exist are excluded from analyses of financial performance. It can also lead to the false belief that the successes in a group have some special property, rather than just coincidence as in correlation "proves" causality.


title: Survivorship bias

text: Another kind of survivorship bias would involve thinking that an incident was not all that dangerous because the only people who were involved in the incident who can speak about it are those who survived it. Even if one knew that some people are dead, they would not have their voice to add to the conversation, leading to bias in the conversation.


title: Survivorship bias

text: The parapsychology researcher Joseph Banks Rhine believed he had identified the few individuals from hundreds of potential subjects who had powers of extra-sensory perception (ESP). His calculations were based on the improbability of these few subjects guessing the Zener cards shown to a partner by chance. A major criticism that surfaced against his calculations was the possibility of unconscious survivorship bias in subject selections. He was accused of failing to take into account the large effective size of his sample (all the people he rejected as not being "strong telepaths" because they failed at an earlier testing stage). Had he done this he might have seen that, from the large sample, one or two individuals would probably achieve the track record of success he had found purely by chance.


title: Survivorship bias

text: Writing about the Rhine case in "Fads and Fallacies in the Name of Science", Martin Gardner explained that he did not think the experimenters had made such obvious mistakes out of statistical naivety, but as a result of subtly disregarding some poor subjects. He said that, without trickery of any kind, there would always be some people who had improbable success, if a large enough sample were taken. To illustrate this, he speculates about what would happen if one hundred professors of psychology read Rhine's work and decided to make their own tests; he said that survivor bias would winnow out the typically failed experiments, but encourage the lucky successes to continue testing. He thought that the common null hypothesis (of no result) would not be reported, but "[e]ventually, one experimenter remains whose subject has made high scores for six or seven successive sessions. Neither experimenter nor subject is aware of the other ninety-nine projects, and so both have a strong delusion that ESP is operating." He concludes: "The experimenter writes an enthusiastic paper, sends it to Rhine who publishes it in his magazine, and the readers are greatly impressed."


title: Survivorship bias

text: If sufficiently many scientists study a phenomenon, some will find statistically significant results by chance, and these are the experiments submitted for publication. Additionally, papers showing positive results may be more appealing to editors. This problem is known as "positive results bias", a type of publication bias. To combat this, some editors now call for the submission of "negative" scientific findings, where "nothing happened".


title: Survivorship bias

text: Survivorship bias is one of the research issues brought up in the provocative 2005 paper "Why Most Published Research Findings Are False", which shows that a large number of published medical research papers contain results that cannot be replicated.


title: Survivorship bias

text: One famous example of immortal time bias was discovered in a study by Redelmeier and Singh in the "Annals of Internal Medicine" that reported that Academy Award-winning actors and actresses lived almost four years longer than their less successful peers. The statistical method used to derive this statistically significant difference gave winners an unfair advantage, however, because it credited an Academy Award winner's years of life before winning toward survival subsequent to winning. When the data was reanalyzed using methods that avoided this "immortal time" bias, the survival advantage was closer to one year and was not statistically significant.


title: Survivorship bias

text: In finance, survivorship bias is the tendency for failed companies to be excluded from performance studies because they no longer exist. It often causes the results of studies to skew higher because only companies that were successful enough to survive until the end of the period are included. For example, a mutual fund company's selection of funds today will include only those that are successful now. Many losing funds are closed and merged into other funds to hide poor performance. In theory, 70% of extant funds could truthfully claim to have performance in the first quartile of their peers, if the peer group includes funds that have closed.


title: Survivorship bias

text: In 1996, Elton, Gruber, and Blake showed that survivorship bias is larger in the small-fund sector than in large mutual funds (presumably because small funds have a high probability of folding). They estimate the size of the bias across the U.S. mutual fund industry as 0.9% per annum, where the bias is defined and measured as:


title: Survivorship bias

text: Additionally, in quantitative backtesting of market performance or other characteristics, survivorship bias is the use of a current index membership set rather than using the actual constituent changes over time. Consider a backtest to 1990 to find the average performance (total return) of S&P 500 members who have paid dividends within the previous year. To use the current 500 members only and create a historical equity line of the total return of the companies that met the criteria would be adding survivorship bias to the results. S&P maintains an index of healthy companies, removing companies that no longer meet their criteria as a representative of the large-cap U.S. stock market. Companies that had healthy growth on their way to inclusion in the S&P 500 would be counted as if they were in the index during that growth period, which they were not. Instead there may have been another company in the index that was losing market capitalization and was destined for the S&P 600 Small-cap Index that was later removed and would not be counted in the results. Using the actual membership of the index and applying entry and exit dates to gain the appropriate return during inclusion in the index would allow for a bias-free output.


title: Survivorship bias

text: Michael Shermer in "Scientific American" and Larry Smith of the University of Waterloo have described how advice about commercial success distorts perceptions of it by ignoring all of the businesses and college dropouts that failed. Journalist and author David McRaney observes that the "advice business is a monopoly run by survivors. When something becomes a non-survivor, it is either completely eliminated, or whatever voice it has is muted to zero".


title: Survivorship bias

text: In his book "The Black Swan", financial writer Nassim Taleb called the data obscured by survivorship bias "silent evidence".


title: Survivorship bias

text: Diagoras of Melos was asked concerning paintings of those who had escaped shipwreck: "Look, you who think the gods have no care of human things, what do you say to so many persons preserved from death by their especial favour?", to which Diagoras replied: "Why, I say that their pictures are not here who were cast away, who are by much the greater number."


title: Survivorship bias

text: Susan Mumm has described how survival bias leads historians to study organisations that are still in existence more than those that have closed. This means large, successful organisations such as the Women's Institute, which were well organised and still have accessible archives for historians to work from, are studied more than smaller charitable organisations, even though these may have done a great deal of work.


title: Survivorship bias

text: Just as new buildings are being built every day and older structures are constantly torn down, the story of most civil and urban architecture involves a process of constant renewal, renovation, and revolution. Only the most (subjectively, but popularly determined) beautiful, most useful, and most structurally sound buildings survive from one generation to the next. This creates another selection effect where the ugliest and weakest buildings of history have long been eradicated from existence and thus the public view, and so it leaves the visible impression, seemingly correct but factually flawed, that all buildings in the past were both more beautiful and better built.


title: Survivorship bias

text: Whether it be movie stars, athletes, musicians, or CEOs of multibillion-dollar corporations who dropped out of school, popular media often tells the story of the determined individual who pursues their dreams and beats the odds. There is much less focus on the many people that may be similarly skilled and determined but fail to ever find success because of factors beyond their control or other (seemingly) random events. This creates a false public perception that anyone can achieve great things if they have the ability and make the effort. The overwhelming majority of failures are not visible to the public eye, and only those who survive the selective pressures of their competitive environment are seen regularly.


title: Survivorship bias

text: During World War II, the statistician Abraham Wald took survivorship bias into his calculations when considering how to minimize bomber losses to enemy fire. The Statistical Research Group (SRG) at Columbia University, which Wald was a part of, examined the damage done to aircraft that had returned from missions and recommended adding armor to the areas that showed the least damage. The bullet holes in the returning aircraft represented areas where a bomber could take damage and still fly well enough to return safely to base. Therefore, Wald proposed that the Navy reinforce areas where the returning aircraft were unscathed, inferring that planes hit in those areas were the ones most likely to be lost. His work is considered seminal in the then-nascent discipline of operational research.


title: Survivorship bias

text: In a study performed in 1987, it was reported that cats who fall from less than six stories, and are still alive, have greater injuries than cats who fall from higher than six stories. It has been proposed that this might happen because cats reach terminal velocity after righting themselves at about five stories, and after this point they relax, leading to less severe injuries in cats who have fallen from six or more stories. In 1996, "The Straight Dope" newspaper column proposed that another possible explanation for this phenomenon would be survivorship bias. Cats that die in falls are less likely to be brought to a veterinarian than injured cats, and thus many of the cats killed in falls from higher buildings are not reported in studies of the subject.


title: Survivorship bias

text: Tropical vines and lianas are often viewed as macro-parasites of trees that reduce host tree survival. The proportion of trees infested with lianas was observed to be much greater in shade-tolerant, heavy wooded, slow-growing tree species while light-demanding, lighter wooded and fast-growing species are often liana free. Such observations led to the expectation that lianas have stronger negative effects on shade-tolerant species. Further investigations, however, revealed that liana infestation is far more harmful to light-demanding fast-growing tree species where liana infestation greatly decreases survival such that the observable sample is biased towards those that survived and are liana-free. Hence, the observable sample of trees with lianas in their crown is skewed due to survivorship bias.


title: Survivorship bias

text: Large groups of organisms called clades that survive a long time are subject to various survivorship biases such as the "push of the past", generating the illusion that clades in "general" tend to originate with a high rate of diversification that then slows through time.


title: Survivorship bias

text: Certain portrayals of disability, such as inspiration porn (where disabled people are able to do ordinary things) and supercrip stereotype (where disabled people do extraordinary things) could be inferred to mean barriers don't exist or that there are no special needs. Many disabled people remain unemployed or unsupported. Employment discrimination is reported to play a significant part in the high rate of unemployment among those with a diagnosis of mental illness. The media portrayal of successful examples may be cherry picking; many of other people with similar conditions who do not get suitable employment, remain unnoticed.


title: Survivorship bias

text: Survivorship bias can raise truth-in-advertising problems when the success rate advertised for a product or service is measured with respect to a population whose makeup differs from that of the target audience whom the company offering that product or service targets with advertising claiming that success rate. These problems become especially significant when


title: Survivorship bias

text: For example, the advertisements of online dating service eHarmony.com pass this test because they fail the first two prongs but not the third: They claim a success rate significantly higher than that of competing services while generally not disclosing that the rate is calculated with respect to a viewership subset of individuals who possess traits that increase their likelihood of finding and maintaining relationships and lack traits that pose obstacles to their doing so (1), and the company deliberately selects for these traits by administering a lengthy pre-screening process designed to reject prospective customers who lack the former traits or possess the latter ones (2), but the company does not charge a fee for administration of its pre-screening test, with the effect that its prospective customers face no "downside risk" other than losing the time and expending the effort involved in completing the pre-screening process (negating 3).


title: Dubai International Airport

text: Dubai International Airport () is the primary international airport serving Dubai, United Arab Emirates, and is the world's busiest airport by international passenger traffic. It is also the nineteenth-busiest airport in the world by passenger traffic, one of the busiest cargo airports in the world, the busiest airport for Airbus A380 and Boeing 777 movements, and the airport with the highest average number of passengers per flight. In 2017, the airport handled 88 million passengers and 2.65 million tonnes of cargo and registered 409,493 aircraft movements.


title: Dubai International Airport

text: Dubai International Airport is situated in the Al Garhoud district, east of Dubai and spread over an area of of land. Terminal 3 is the second-largest building in the world by floor space and the largest airport terminal in the world. In July 2019, Dubai International airport installed the largest solar energy system in the region's airports as part of Dubai's goal to reduce 30 percent of the city energy consumption by 2030.


title: Dubai International Airport

text: Emirates Airline has its hub airport in Dubai International (DXB) and has their own terminal 3 with 3 concourses that they share with Flydubai. The Emirates hub is the largest airline hub in the Middle East; Emirates handles 51% of all passenger traffic and accounts for approximately 42% of all aircraft movements at the airport. Dubai Airport is also the base for low-cost carrier flydubai which handles 13% of passenger traffic and 25% of aircraft movements at DXB. The airport has a total capacity of 90 million passengers annually. As of January 2016, there are over 7,700 weekly flights operated by 140 airlines to over 270 destinations across all inhabited continents. Over 63% of travelers using the airport in 2018 were connecting passengers.