title: Roméo Dallaire

text: In 2004, PBS "Frontline" featured a documentary named "The Ghosts of Rwanda". In an interview conducted for the documentary and recorded over the course of four days in October 2003, Dallaire said: "Rwanda will never ever leave me. It's in the pores of my body. My soul is in those hills, my spirit is with the spirits of all those people who were slaughtered and killed that I know of, and many that I didn't know ..."


title: Roméo Dallaire

text: A Canadian dramatic feature film "Shake Hands with the Devil" adapted from Roméo Dallaire's 2003 book and starring Roy Dupuis as Lieutenant-General Dallaire, started production in mid-June 2006, and was released on September 28, 2007. Dallaire participated in a press conference about the film held on June 2, 2006, in Montreal, a film for which he was being consulted. The film earned 12 Genie Award nominations and won one in the category Best Achievement in Music – Original Song for the song "Kaya" by Valanga Khoza and David Hirschfelder.


title: Roméo Dallaire

text: In 1996, Dallaire was made an officer of the Legion of Merit of the United States for his service in Rwanda. Dallaire was also awarded the inaugural Aegis Trust Award in 2002, and on October 10 of the same year, he was inducted as an Officer in the Order of Canada. Dallaire was named a Grand Officer of the National Order of Quebec in 2005. He was granted the inaugural Aegis Award for Genocide Prevention from the Aegis Trust (United Kingdom). On March 9, 2005, Dallaire was awarded the 25th Pearson Medal of Peace.


title: Roméo Dallaire

text: In 2019 (the 25th anniversary of the Genocide in Rwanda), the Government of Canada announced the establishment of the Dallaire Centre for Peace and Security. That same year, Dallaire was awarded the Nelson Mandela Award for Human Rights, the University of Victoria's Huminatis Award, and was also awarded the Adrienne Clarkson Prize for Global Citizenship.


title: Roméo Dallaire

text: Dallaire has received honorary doctorates from a large number of Canadian and American universities. He received doctor of laws degrees from the University of Guelph, University of Saskatchewan, St. Thomas University, Boston College, the University of Calgary, Memorial University of Newfoundland, Athabasca University, Trent University, the University of Victoria, the University of Western Ontario, Concordia University, and Simon Fraser University, an honorary doctor of humanities degree from the University of Lethbridge and honorary degrees from the University of Northern British Columbia and the University of York. On June 1, 2006, Dallaire was awarded a doctorate of humane letters by the Queens College of the City University of New York (CUNY) in recognition of his efforts in Rwanda and afterwards to speak out against genocide. He received an ovation from the crowd for his comment that "no human is more human than any other". Dallaire received the Loyola Medal from Concordia University in 2006. Dallaire was named a fellow of the Ryerson University, and an honorary fellow of the Royal College of Physicians and Surgeons of Canada. On October 11, 2006, the Center for Unconventional Security Affairs at the University of California, Irvine awarded Dallaire with the 2006 Human Security Award.


title: Roméo Dallaire

text: In 2002, Dallaire was given Canada's World Peace Award, in recognition of his peacekeeping experience and study of children in conflict, by the World Federalist Movement-Canada Dallaire planted a tree at the Kofi Annan International Peacekeeping Training Centre, Accra, Ghana in 2007 at the invitation of the commandant, Major-General John Attipoe. Dallaire was a recipient of the Vimy Award.


title: Roméo Dallaire

text: As part of the 50th Anniversary commemoration of the founding of the Pugwash Peace Exchange, in 2007 Dallaire accepted Sir Joseph Rotblat's Nobel Peace Prize.


title: Roméo Dallaire

text: Dallaire was one of the eight Olympic Flag bearers at the opening ceremony for the 2010 Olympic Winter Games, in Vancouver.


title: Roméo Dallaire

text: The CBC's "The Greatest Canadian" program saw Dallaire voted, in 16th place, as the highest rated military figure.


title: Roméo Dallaire

text: There are elementary schools named after Dallaire in Winnipeg, Manitoba, Ajax, Ontario, and a French-immersion elementary school in Maple, Ontario. There is also a French high school in Barrie, Ontario. that is named for Dallaire. Also, a street is named after him in the Lincoln Park neighbourhood of Calgary, Alberta.


title: Batteries Not Included

text: Batteries Not Included (stylized as *batteries not included) is a 1987 American science fiction comedy film directed by Matthew Robbins about small extraterrestrial living spaceships that save an apartment block under threat from property development. The story was originally intended to be featured in the television series "Amazing Stories", but executive producer Steven Spielberg liked the idea so much that he decided to adapt it into a film. It was the feature film screenwriting debut of Brad Bird.


title: Batteries Not Included

text: Frank and Faye Riley, an elderly couple who manage an apartment building and café in the East Village, come under threat by a nearby property development. The development manager, Lacey, sends a hoodlum named Carlos and his gang of thugs to bribe the couple and their tenants to move out. When the tenants resist, Carlos and his thugs punch through artist Mason Baylor's door, intimidate pregnant single mother Marisa Esteval, and break retired boxer Harry Noble's jar of tiles. After Frank Riley refuses to move, Carlos vandalizes the café.


title: Batteries Not Included

text: This assault convinces three of the tenants to move out. Mason's girlfriend, Pamela is tired of living in an old, depressing building with a guy whose art career is going nowhere. She dumps Mason, packs up and before leaving, advises Mason to quit being an artist and get a steady job. The Rileys' friends, Muriel and Sid Hogensin, take Lacey's bribe and decide to move to a retirement home in New Jersey. Frank feels a little betrayed by the Hogensins for taking Lacey's money but they explain that the building doesn't feel like home anymore. They advise Frank that maybe he and Faye should come live with them at the retirement home. With the assault and Faye's dementia growing, Frank contemplates giving in.


title: Batteries Not Included

text: Things look bleak until a pair of small living spaceships appear in the Rileys' apartment that evening and start repairing many of the items that were broken. They also repair the vandalized cafe, putting Frank and Faye back in business. The two aliens take up residence in the shed at the top of the apartment building and are dubbed "The Fix-Its" by the residents. Carlos comes back to threaten the tenants once again, but the Fix-Its lure him to the top of the building and into the shed where they scare him away.


title: Batteries Not Included

text: Faye and Marisa learn that the "female" Fix-It is pregnant. After consuming plenty of metal and electrical objects, it gives birth to three baby Fix-Its, although one of them is stillborn. Faye buries the stillborn in a flowerbox the next day, but then Harry digs it up, takes it back to his apartment, and succeeds in reviving it by taking apart his precious television set. Frank and Faye see a boost of business in the café from the demolition crew, while the Fix-Its help in the kitchen.


title: Batteries Not Included

text: Mason and Marisa grow closer. Marisa finds Mason's paintings very nice, which makes Mason feel better about his art and not to give up on it. Marisa's baby is due in 2 to 3 months. Her boyfriend, Hector, who is a musician and the father of her baby, comes over. Mason leaves Marisa and Hector alone, but when Mason returns, Hector is gone. Marisa explains that Hector and his band have found a steady gig in Chicago with good pay. Mason wonders why Hector would leave without her. Marisa confesses that she told Hector to go without her because their relationship just wasn't working out. But it also appears she has developed feelings for Mason. Mason has developed feelings for her as well.


title: Batteries Not Included

text: With Carlos unable to prove the existence of the Fix-Its that had been foiling their plans, Lacey is furious with the delays in evicting the tenants and moves to replace him. Desperate to see the job done and growing more unstable, Carlos breaks into the building's basement to sabotage the building's pipework and electricity, and badly damages the "father" machine in the process. After Harry throws him out, the tenants discover the Fix-It children are missing and go searching for them in the city while Faye stays behind with the "mother" machine as it fixes the "father". When the "father" machine is repaired, the now-wary Fix-It parents leave to seek out their offspring. After finding them with Harry, the machine family departs from the planet.


title: Batteries Not Included

text: Tired of the delays, Lacey hires an arsonist. The arsonist attempts to burn down the building in a staged "accidental fire". Carlos discovers the plan and, in a rage, sabotages the arson to make the entire building explode, only to then discover that Faye is still in the building. While the arsonist flees, Carlos unsuccessfully attempts to pose as her late son Bobby to get her to leave, but succeeds in rescuing her as the fire spreads. The tenants then return to find the blazing apartment block collapsing, and Faye being loaded into an ambulance.


title: Batteries Not Included

text: By the next morning, the apartment block has been reduced to a smoldering wreck. To Kovacs' fury the construction crew, out of respect for Harry, refuse to continue as he is sitting dejected on the steps. Harry is greeted by the mechanical family later that night, who have recruited countless other Fix-Its for repairs. By the next morning, the entire building has been seamlessly restored to brand new condition, ending Lacey's demolition plans and resulting in him terminating Kovacs. Mason and Marisa settle into a relationship while Carlos tries to start a friendship with the Rileys, with Faye finally having come to accept her real son's passing.


title: Batteries Not Included

text: Some years later, the developments have been built, but this time flanking either side of the tiny apartment building, with Frank's café now doing a roaring trade as a result of the new employment brought into the area.


title: Batteries Not Included

text: Principal photography started in New York in August 1986, but location scouting began almost a year before. "Since the story called for a solitary building amidst rubble," explained producer Ronald Schwary, "we had to find a vacant lot with burned-out buildings all around it. We finally settled on an actual building on 8th Street between Avenues C and D on New York's Lower East Side (the building no longer stands, and was probably located on the site of the current Housing Bureau substation, or the building to the east. ). Production designer Ted Haworth designed a three-sided, four-story tenement facade and oversaw its construction on a location that covered most of a city block. In the name of authenticity, he brought 50 to 60 truckloads of rubble to cover the one vacant lot. It was so remarkably realistic that the Sanitation Department came by and took away prop garbage one morning, potential customers stopped by to eat in the diner, and the business agent for the Plumber's Local of New York visited, demanding to know why there wasn't a permit down at City Hall for the construction."


title: Batteries Not Included

text: The movie gained a mostly mixed reception but debuted at #4 at the box office. It has a rating of 67% on Rotten Tomatoes based on 18 reviews. Gene Siskel described it as "a comic book with the best pages torn out" and accused the film of having "forced warmth." Roger Ebert defended the film, saying it "had a lot of good feeling in it, it had a few nice laughs, it had a few interesting special effects, and...it's better than most of the stuff out there."


title: Patellofemoral pain syndrome

text: Patellofemoral pain syndrome (PFPS; not to be confused with jumper's knee) is knee pain as a result of problems between the kneecap and the femur. The pain is generally in the front of the knee and comes on gradually. Pain may worsen with sitting, excessive use, or climbing and descending stairs.


title: Patellofemoral pain syndrome

text: While the exact cause is unclear, it is believed to be due to overuse. Risk factors include trauma, increased training, and a weak quadriceps muscle. It is particularly common among runners. The diagnosis is generally based on the symptoms and examination. If pushing the kneecap into the femur increases the pain, the diagnosis is more likely.


title: Patellofemoral pain syndrome

text: Treatment typically involves rest and rehabilitation with a Physical Therapist. Runners may need to switch to activities such as cycling or swimming. Insoles may help some people. Symptoms may last for years despite treatment. Patellofemoral pain syndrome is the most common cause of knee pain, affecting more than 20% of young adults. It occurs about 2.5 times more often in females than males.


title: Patellofemoral pain syndrome

text: The onset of the condition is usually gradual, although some cases may appear suddenly following trauma. The most common symptom is diffuse vague pain around the kneecap (peripatellar) and localized pain focused behind the kneecap (retropatellar). Affected individuals typically have difficulty describing the location of the pain. They may place their hands over the anterior patella or describe a circle around the patella. This is often called the "circle sign". Pain is usually initiated when weight is put on the knee extensor mechanism, such as when ascending or descending stairs or slopes, squatting, kneeling, cycling, or running. Pain during prolonged sitting is sometimes termed the "movie sign" or "theatre sign" because individuals might experience pain while sitting to watch a film or similar activity. The pain is typically aching and occasionally sharp. Pain may be exacerbated by activities. The knee joint may exhibit noises such as clicking. However, this has no relation to pain and function. Giving-way of the knee may be reported. Reduced knee flexion may be experienced during activities.


title: Patellofemoral pain syndrome

text: In most patients with PFPS an examination of their history will highlight a precipitating event that caused the injury. Changes in activity patterns such as excessive increases in running mileage, repetitions such as running up steps and the addition of strength exercises that affect the patellofemoral joint are commonly associated with symptom onset. Excessively worn or poorly fitted footwear may be a contributing factor. To prevent recurrence the causal behaviour should be identified and managed correctly.


title: Patellofemoral pain syndrome

text: The medical cause of PFPS is thought to be increased pressure on the patellofemoral joint. There are several theorized mechanisms relating to how this increased pressure occurs:


title: Patellofemoral pain syndrome

text: Causes can also be a result of excessive genu valgum and the above-mentioned repetitive motions leading to abnormal lateral patellar tracking. Individuals with genu valgum have larger than normal Q-angles causing the weight-bearing line to fall lateral to the centre of the knee causing overstretching of the MCL and stressing the lateral meniscus and cartilages.


title: Patellofemoral pain syndrome

text: The cause of pain and dysfunction often results from either abnormal forces (e.g. increased pull of the lateral quadriceps retinaculum with acute or chronic lateral PF subluxation/dislocation) or prolonged repetitive compressive or shearing forces (running or jumping) on the PF joint. The result is synovial irritation and inflammation and subchondral bony changes in the distal femur or patella known as "bone bruises". Secondary causes of PF Syndrome are fractures, internal knee derangement, osteoarthritis of the knee and bony tumors in or around the knee.


title: Patellofemoral pain syndrome

text: People can be observed standing and walking to determine patellar alignment. The Q-angle, lateral hypermobility, and J-sign are commonly used determined to determine patellar maltracking. The patellofemoral glide, tilt, and grind tests (Clarke's sign), when performed, can provide strong evidence for PFPS. Lastly, lateral instability can be assessed via the patellar apprehension test, which is deemed positive when there is pain or discomfort associated with lateral translation of the patella. Various clinical tests have been investigated for diagnostic accuracy. The Active Instability Test, knee pain during stair climbing, Clarke's test, pain with prolonged sitting, patellar inferior pole tilt, and pain during squatting have demonstrated the best accuracy. However, careful consideration is still needed when using these tests to make a differential diagnosis of PFPS.


title: Patellofemoral pain syndrome

text: Magnetic resonance imaging rarely can give useful information for managing patellofemoral pain syndrome and treatment should focus on an appropriate rehabilitation program including correcting strength and flexibility concerns. In the uncommon cases where a patient has mechanical symptoms like a locked knee, knee effusion, or failure to improve following physical therapy, then an MRI may give more insight into diagnosis and treatment.


title: Patellofemoral pain syndrome

text: PFPS is one of a handful of conditions sometimes referred to as runner's knee; the other conditions being chondromalacia patellae, iliotibial band syndrome, and plica syndrome.


title: Patellofemoral pain syndrome

text: Chondromalacia patellae is a term sometimes used synonymously with PFPS. However, there is general consensus that PFPS applies only to individuals without cartilage damage, thereby distinguishing it from chondromalacia patellae, a condition with softening of the patellar articular cartilage. Despite this distinction, the diagnosis of PFPS is typically made based only on the history and physical examination rather than on the results of any medical imaging. Therefore, it is unknown whether most persons with a diagnosis of PFPS have cartilage damage or not, making the difference between PFPS and chondromalacia theoretical rather than practical. It is thought that only some individuals with anterior knee pain will have true chondromalacia patellae.


title: Patellofemoral pain syndrome

text: The diagnosis of patellofemoral pain syndrome is made by ruling out patellar tendinitis, prepatellar bursitis, plica syndrome, Sinding-Larsen and Johansson syndrome, and Osgood–Schlatter disease. Currently, there is not a gold standard assessment to diagnose PFPS.


title: Patellofemoral pain syndrome

text: A variety of treatments for patellofemoral pain syndrome are available. Most people respond well to conservative therapy.


title: Patellofemoral pain syndrome

text: Patellofemoral pain syndrome may also result from overuse or overload of the PF joint. For this reason, knee activity should be reduced until the pain is resolved.


title: Patellofemoral pain syndrome

text: There is consistent but low quality evidence that exercise therapy for PFPS reduces pain, improves function and aids long-term recovery. However, there is insufficient evidence to compare the effectiveness of different types of exercises with each other, and exercises with other forms of treatment.


title: Patellofemoral pain syndrome

text: Exercise therapy is the recommended first line treatment of PFPS. Various exercises have been studied and recommended. Exercises are described according to 3 parameters:


title: Patellofemoral pain syndrome

text: The majority of exercise programs intended to treat PFPS are designed to strengthen the quadriceps muscles. Quadriceps strengthening is considered to be the "gold" standard treatment for PFPS. Quadriceps strengthening is commonly suggested because the quadriceps muscles help to stabilize the patella. Quadriceps weakness and muscle imbalance may contribute to abnormal patellar tracking.


title: Patellofemoral pain syndrome

text: If the strength of the vastus medialis muscle is inadequate, the usually larger and stronger vastus lateralis muscle will pull sideways (laterally) on the kneecap. Strengthening the vastus medialis to prevent or counter the lateral force of the vastus lateralis is one way of relieving PFPS. However, there is growing evidence that shows proximal factors play a much larger role than vastus medialis (VMO) strength deficits or quadriceps imbalance. Hip abductor, extensor, and external rotator strengthening may help.


title: Patellofemoral pain syndrome

text: Emphasis during exercise may be placed on coordinated contraction of the medial and lateral parts of the quadriceps as well as of the hip adductor, hip abductor and gluteal muscles. Many exercise programs include stretches designed to improve lower limb flexibility. Electromyographic biofeedback allows visualization of specific muscle contractions and may help individuals performing the exercises to target the intended muscles during the exercise. Neuromuscular electrical stimulation to strengthen quadracep muscles is sometimes suggested, however the effectiveness of this treatment is not certain.


title: Patellofemoral pain syndrome

text: Inflexibility has often been cited as a source of patellofemoral pain syndrome. Stretching of the lateral knee has been suggested to help.


title: Patellofemoral pain syndrome

text: Knee and lumbar joint mobilization are not recommended as primary interventions for PFPS. It can be used as combination intervention, but as we continue to promote use of active and physical interventions for PFPS, passive interventions such as joint mobilizations are not recommended.


title: Patellofemoral pain syndrome

text: Manual therapy in addition to exercises helps in reducing pain, improving function, and knee range of motion in patients with PFPS. Manual therapy such as patellar joint mobilization, manipulation and soft tissue mobilization along with Physical therapy exercises is found to be effective in treating PFPS. However, there is no enough evidence that supports lumbopelvic spine manipulation has any effect on the quadriceps muscle activation to improve function & reduce pain.


title: Patellofemoral pain syndrome

text: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to treat PFPS; however, there is only very limited evidence that they are effective. NSAIDs may reduce pain in the short term; overall, however, after three months pain is not improved. There is no evidence that one type of NSAID is superior to another in PFPS, and therefore some authors have recommended that the NSAID with fewest side effects and which is cheapest should be used.


title: Patellofemoral pain syndrome

text: Glycosaminoglycan polysulfate (GAGPS) inhibits proteolytic enzymes and increases synthesis and degree of polymerization of hyaluronic acid in synovial fluid. There is contradictory evidence that it is effective in PFPS.


title: Patellofemoral pain syndrome

text: There is no difference in pain symptoms between taping and non-taping in individuals with PFPS. Although taping alone is not shown to reduce pain, studies show that taping in conjunction with therapeutic exercise can have a significant effect on pain reduction.


title: Patellofemoral pain syndrome

text: Knee braces are ineffective in treating PFPS. The technique of McConnell taping involves pulling the patella medially with tape (medial glide). Findings from some studies suggest that there is limited benefit with patella taping or bracing when compared to quadriceps exercises alone. There is a lack of evidence to show that knee braces, sleeves, or straps are effective.


title: Patellofemoral pain syndrome

text: Low arches can cause overpronation or the feet to roll inward too much increasing load on the patellofemoral joint. Poor lower extremity biomechanics may cause stress on the knees and can be related to the development of patellofemoral pain syndrome, although the exact mechanism linking joint loading to the development of the condition is not clear. Foot orthoses can help to improve lower extremity biomechanics and may be used as a component of overall treatment. Foot orthoses may be useful for reducing knee pain in the short term, and may be combined with exercise programs or physical therapy. However, there is no evidence supporting use of combined exercise with foot orthoses as intervention beyond 12 months for adults. Evidence for long term use of foot orthoses for adolescents is uncertain. No evidence supports use of custom made foot orthoses.


title: Patellofemoral pain syndrome

text: The scientific consensus is that surgery should be avoided except in very severe cases in which conservative treatments fail. The majority of individuals with PFPS receive nonsurgical treatment.


title: Patellofemoral pain syndrome

text: The use of electrophysical agents and therapeutic modalities are not recommended as passive treatments should not be the focus of the plan of care. There is no evidence to support the use of acupuncture or low-level laser therapy. Most studies claiming benefits of alternative therapies for PFPS were conducted with flawed experimental design, and therefore did not produce reliable results.


title: Patellofemoral pain syndrome

text: Patellarfemoral pain syndrome can become a chronic injury, with an estimated 50% of people reporting persistent patellar-femoral pain after a year. Risk factors for a prolonged recovery (or persistent condition) include age (older athletes), females, increased body weight, a reduction in muscle strength, time to seek care, and in those who experience symptoms for more than two months.


title: Patellofemoral pain syndrome

text: Patellofemoral pain syndrome is the most common cause of anterior knee pain in the outpatient. Specific populations at high risk of primary PFPS include runners, bicyclists, basketball players, young athletes and females.


title: Patellofemoral pain syndrome

text: BMI did not significantly increase risk of developing PFPS in adolescents. However, adults with PFPS have higher BMI than those without. It is suggested that higher BMI is associated with limited physical activity in people with PFPS as physical activity levels decrease as a result of pain associated with the condition. However, no longitudinal studies are able to show that BMI can be a predictor of development or progression of the condition.


title: Cagayan

text: Cagayan ( ), officially the Province of Cagayan (; ; ; ), is a province in the Philippines located in the Cagayan Valley region, covering the northeastern tip of Luzon. Its capital is the city of Tuguegarao. It is about northwest of Manila, and includes the Babuyan Islands to the north. The province borders Ilocos Norte and Apayao to the west, and Kalinga and Isabela to the south.


title: Cagayan

text: Cagayan was one of the early provinces that existed during the Spanish colonial period. Called "La Provincia de Cagayan", its borders essentially covered the entire Cagayan Valley, which included the present provinces of Isabela, Quirino, Nueva Vizcaya, Batanes and portions of Kalinga and Apayao. The former capital was Nueva Segovia, which also served as the seat of the Diocese of Nueva Segovia. Today, only remain of the former vastness of the province. The entire region, however, is still referred to as Cagayan Valley.


title: Cagayan

text: A folk legend holds that the name was originally derived from the "tagay", a plant that grows abundantly in the northern part of the province. The term "Catagayan", "the place where the "tagay" grows" was shortened to "Cagayan". Linguists, however, hold that "cagayan" comes from an ancient, lost word that means "river". Variations of this word—"karayan", "kayan", "kayayan", and "kalayan"—all mean "river".


title: Cagayan

text: Cagayan has a prehistoric civilization with rich and diverse culture. According to archaeologists, the earliest man in the Philippines probably lived in Cagayan thousands of years ago. Pieces of evidence


title: Cagayan

text: In the classical era, Gattaran and Lal-lo used to be the home of hunter-gatherers who specialized in hunting mollusks. These hunter-gatherers have stockpiled their leftover mollusk shells in numerous sites in Gattaran and Lal-lo, until eventually, the shells formed into the largest stock of shell-midden sites in the entire Philippines.


title: Cagayan

text: From available evidence, the "Atta" or Negritos - short dark-skinned nomads - were the first people in Cagayan. They were later moved to the uplands by the Austronesians who eventually became the Ibanags, Itawes, Yogads, Gaddangs, Irayas and Malawegs - the natives of Cagayan - who actually came from one ethnicity. These are the people found by the Spaniards in the different villages along the rivers all over Cagayan. The Spaniards rightly judged that these various villagers came from a single racial stock and decided to make the Ibanag language the "lingua franca", both civilly and ecclesiastically for the entire people of Cagayan which they called collectively as the "Cagayanes" which later was transliterated to become "Cagayanos".


title: Cagayan

text: Cagayan was a major site for the Maritime Jade Road, one of the most extensive sea-based trade networks of a single geological material in the prehistoric world, operating for 3,000 years from 2000 BCE to 1000 CE.


title: Cagayan

text: Even before the Spaniards came to Cagayan, the Cagayanos have already made contact with various civilizations like the Chinese, Japanese and even Indians, as evidenced by various artifacts and even the presence of minor to moderate foreign linguistic elements in the languages of the natives.


title: Cagayan

text: Various other racial strains, mainly the Ilocanos, Pangasinenses, Kapampangans and Tagalogs, as well as Visayans, Moros and even foreigners like the Chinese, Indians, Arabs, Spaniards and others were further infused to the native Cagayanes to become the modern "Cagayano" that we know today.


title: Cagayan

text: Cagayan is also the site of a Wokou state when the Japanese pirate-lord Tay Fusa, set up his Japanese pirate kingdom in Cagayan before it was destroyed during the 1582 Cagayan battles.


title: Cagayan

text: In 1581, Captain Ivan Sabala arrived in Cagayan with a hundred fully equipped soldiers and their families by order of Gonzalo Ronquillo de Peñaloza, the fourth Spanish Governor-General of the Philippines. The expeditionary force was sent to explore the Cagayan Valley, to convert the natives to Catholicism, and to establish ecclesiastical missions and towns throughout the valley.


title: Cagayan

text: On June 29, 1583, Spanish "conquistador" Juan de Salcedo traced the northern coastline of Luzon and set foot on the Massi (Pamplona), Tular, and Aparri areas.


title: Cagayan

text: In 1583, through a Spanish Royal Decree, the entire northeastern portion of Luzon (specifically, all territories east of the Cordillera mountains and those north of the Caraballo mountains) including the islands in the Balintang Channel were organized into one large political unit called the "La Provincia de Cagayan". The "provincia"'s territorial delineation encompassed the present provinces of Batanes, Isabela, Quirino, Nueva Vizcaya, including portions of Kalinga and Apayao. Its capital was "Nueva Segovia" (the present municipality of Lal-lo).


title: Cagayan

text: The Spanish friars soon established mission posts in Camalaniugan and Lal-lo ("Nueva Segovia"), which became the seat of the Diocese established by Pope Clement VIII on August 14, 1595.


title: Cagayan

text: A founding population of 200 Spanish citizens from Europe accompanied by 100 Spanish soldiers set up settlements across Cagayan Valley. These people were in turn supplemented by 155 Latin American soldiers recruited from Mexico.


title: Cagayan

text: The see was moved in 1758 to Vigan because of its relative distance. The Spanish influence can still be seen in the massive churches and other buildings that the Spaniards built for the spiritual and social welfare of the people.


title: Cagayan

text: In 1839, Nueva Vizcaya was established as a politico-military province and was separated from Cagayan. Later, Isabela was founded as a separate province on May 1, 1856, its areas carved from southern Cagayan and eastern Nueva Vizcaya territories.


title: Cagayan

text: During the late 18th century, the New Spain government encouraged the expansion of trade and development of commodity crops. Among these was tobacco, and lands in Cagayan became the center of a vertically integrated monopoly: tobacco was grown there and shipped to Manila, where it was processed and made into cigarettes and cigars. The development of the related bureaucracy and accounting systems was done under the leadership of José de Gálvez, who as visitor-general to Mexico from 1765 to 1772 developed the monopoly there and increased revenues to the Crown. He worked in the Philippines as Minister of the Indies from 1776 to 1787, constructing a similar monopoly there under Governor-General Basco y Vargas (1778–1787). The Spanish development of this industry affected all their economic gains in the Philippines.


title: Cagayan

text: The establishment of the civil government of Cagayan through the 1583 Spanish Royal Decree is commemorated in the annual Aggao Nac Cagayan celebrations of the Provincial Government of Cagayan and its people.


title: Cagayan

text: When the Treaty of Paris was signed in 1898, ending the Spanish–American War, the United States took over the Philippines. It influenced the culture, most notably in agriculture and education, as well as in public works and communications. A naval base also increased interaction between local Filipinos and American sailors and administrators. At the close of the 18th century, there were 29 municipalities in the province of Cagayan. After the Philippines came under American sovereignty in 1902, more municipalities were founded. Since then, due to centralization and shifting of populations, the number of municipalities is back to 29. A new wave of immigration began in the late 19th and 20th centuries with the arrival of another group of the Ilocano settlers who came in large numbers. They now constitute the largest group in the province, and it was only in this large-scale Ilocano immigration & settlement that made Ilocano language replaced Ibanag as the "lingua franca" of the province.


title: Cagayan

text: During the Second World War, with air raids by Japanese fighters and bombers, the province of Cagayan suffered much destruction by bombing and later invasion. Japanese Imperial forces entered Cagayan in 1942. While under the Japanese Occupation, several pre-war infantry divisions and regular units of the Philippine Commonwealth Army were re-established during the period on January 3, 1942, to June 30, 1946. They established general headquarters, camps and garrisoned troops in the province of Cagayan, and began operations against the Japanese Occupation forces in the Cagayan Valley. This included sending troops to the provinces of Cagayan and Isabela, and helping the local soldiers of the 11th and 14th Infantry Regiment of the USAFIP-NL, the local guerrilla fighters and the U.S. liberation forces. They fought against the Japanese Imperial forces from 1942 to 1945.


title: Cagayan

text: The Battle off Cape Engaño on October 26, 1944, was held off Cape Engaño. At that time American carrier forces attacked the Japanese Northern Force. This became the concluding action of the Battle of Leyte Gulf. The Japanese lost 4 carriers, 3 light cruisers and 9 destroyers.


title: Cagayan

text: In 1945, the combined United States and Philippine Commonwealth ground troops, together with the recognized guerrillas, took Cagayan. Part of the action were the Filipino soldiers of the 1st, 2nd, 12th, 13th, 15th and 16th Infantry Division of the Philippine Commonwealth Army, 1st Constabulary Regiment of the Philippine Constabulary and the 11th and 14th Infantry Regiment of the United States Armed Forces in the Philippines – Northern Luzon or USAFIP-NL from the Battle of Cagayan Valley during the Second World War.


title: Cagayan

text: During the 1970s and 1980s, Cagayan became known as a bailiwick of Juan Ponce Enrile of Gonzaga, who as Secretary and later Minister of National Defense became one of the most powerful figures during the Martial Law period under President Ferdinand Marcos. His influence enabled the construction of Port Irene, a modernized international harbor facility in Santa Ana that was named after Marcos' daughter Irene, which later formed the basis for the creation of the Cagayan Special Economic Zone and Freeport, whose enabling law was authored by Enrile as a Senator in 1995 and now includes Santa Ana and parts of Aparri. Despite Enrile's defection in the 1986 EDSA People Power Revolution, Cagayan remained as one of the few bastions of Marcos supporters in the so-called "Solid North" region of northern Luzon. However, this did not prevent the province from being one of the hotbeds of the NPA rebellion starting in the 1970s. During that time, logging concessions were awarded in the province by the Marcoses to Enrile and other cronies, leading to the severe degradation of forest cover in the province that contributed to widespread flooding and other environmental issues that persist today.


title: Cagayan

text: Cagayan was also the site of the Hotel Delfino Siege in Tuguegarao, which took place on March 4, 1990, when efforts to arrest suspended governor Rodolfo Aguinaldo for supporting rebellions against the government of President Corazon Aquino led to him storming the provincial capital and taking hostages including his would-be arresting officer, Brigadier General Oscar Florendo of the Armed Forces of the Philippines Civil Relations Service. The stand-off deteriorated into a series of gun-battles throughout the town, with Florendo being killed presumably in a crossfire inside the hotel and Aguinaldo managing to escape and go into hiding before later surrendering and being cleared of legal charges by winning reelection in 1992.


title: Cagayan

text: Situated within the Cagayan Valley region, the province is bounded by the Philippine Sea on the east; on the south by Isabela province; on the west by the Cordillera Mountains; and on the north by the Balintang Channel and the Babuyan Group of Islands. About from the northeastern tip of the province is the island of Palaui; a few kilometers to the west is Fuga Island. The Babuyan Group of Islands, which includes Calayan, Dalupiri, Camiguin, and Babuyan Claro, is about north of Luzon mainland.


title: Cagayan

text: The eastern coast forms the northern portion of the Sierra Madre mountain range, while the western limits are generally hilly to low in elevation. The central area, dominated by a large valley, forms the lower basin of the country's longest river, the Cagayan. The mouth is located at the northern town of Aparri.


title: Cagayan

text: The province of Cagayan comprises an aggregate land area of which constitutes approximately three percent of the total land area of the country, making it the second largest province in the region.


title: Cagayan

text: Cagayan comprises 28 municipalities and one city divided into three congressional districts. It has 820 barangays. Tuguegarao City (as of December 18, 1999) is the provincial capital, regional seat, and center of business, trade, and education and the only city in the province.


title: Cagayan

text: The 28 municipalities and 1 city of the province comprise a total of 820 barangays, with "Ugac Sur" in Tuguegarao City as the most populous in 2010, and "Centro 15 (Poblacion)" in Aparri as the least. If cities are excluded, "Maura" in Aparri has the highest population.


title: Cagayan

text: The majority of people living in Cagayan are of Ilocano descent, mostly from migrants coming from the Ilocos Region. Originally, the more numerous groups were the Ibanags, who were first sighted by the Spanish explorers and converted to Christianity by missionaries, the reason why the Ibanag language had spread throughout the valley region prior to the arrival of the migrating Ilocanos. Cagayan is predominantly Roman Catholic with 85% of the population affiliated and the Aglipayan Church has a very strong minority in the province.


title: Cagayan

text: Aside from Ilocanos and Ibanags, Malawegs, Itawits, Gaddangs, groups of nomadic Aetas, as well as families of Ibatans who have assimilated into the Ibanag-Ilocano culture make Cagayan their home. More recently, a new group from the south, the Muslim Filipinos, have migrated to this province and have made a community for themselves. In addition to this, Tagalog-speaking peoples from Central Luzon and Southern Luzon have also settled in the area, as well as a few Pangasinans and Kapampangans from the central plains.


title: Cagayan

text: Major languages spoken are Ilocano followed by Ibanag, Yogad and Gaddang. Ilocanos and Ibanags speak Ilocano with an Ibanag accent, as descendants of Ilocanos from first generation in Cagayan who lived within Ibanag population learned Ibanag; same situation with Ilocano tinged by Gaddang, Paranan, Yogad, and Itawis accents when descendants of Ilocanos from first generation in Cagayan who lived within Gaddang, Paranan, Yogad, and Itawis populations learned their languages. People especially in the capital and commercial centers speak and understand English and Tagalog/Filipino. Tagalogs, Ilocanos, and Ibanags speak Tagalog with an Ibanag accent, as descendants of Tagalogs from first generation in Cagayan who lived within Ibanag population learned Ibanag.


title: Cagayan

text: There are two endangered indigenous languages in Cagayan. These are the "Dupaninan Agta" language (with fewer than 1400 remaining speakers) and the "Central Cagayan Agta" language (with fewer than 799 remaining speakers); both of these are listed as "Vulnerable" according to the UNESCO "Atlas of the World's Endangered Languages". All remaining speakers of the languages are among the community's elders. Without a municipality-wide teaching mechanism of the two endangered languages for the youth where the languages are present, the languages may be extinct within 3-5 decades, making them languages in grave peril unless a teaching-mechanism is established by either the government or an educational institution in the municipalities of Gattaran and Baggao.


title: Cagayan

text: Agricultural products are rice, corn, peanut, beans, and fruits. Livestock products include cattle, hogs, carabaos, and poultry. Fishing various species of fish from the coastal towns is also undertaken. Woodcraft furniture made of hardwood, rattan, bamboo, and other indigenous materials are also available in the province.


title: Cagayan

text: The Northern Cagayan International Airport is a planned airport in Lal-lo. The airport will be built to support the Cagayan Special Economic Zone in northern Cagayan, which also serves seaborne traffic through Port Irene. The airport project will involve the construction of a 2,200-meter runway, with a width of 45 meters, following the standards of the International Civil Aviation Organization. Once completed, the planned international airport can accommodate large aircraft such as the Airbus A319-100 and Boeing regional jets of comparable size.


title: Cagayan

text: Since Cagayan faces the Philippine Sea, an extensive shoreline sprawls along the northern coastal towns of Sanchez Mira, Pamplona, Santa Praxedes, Claveria, Buguey, Aparri, Ballesteros, Abulug, and the islands of Palaui, Fuga, and island municipality of Calayan. Sanchez Mira, Claveria, and Santa Praxedes have facilities for excursion stays while Fuga Island is being developed as a world-class recreation and tourism center. Activities include whale watching at the Calayan Islands, and scuba diving, snorkeling and fishing in Palaui Island of Santa Ana. The airstrip at Claveria could be used as a jump-off point to Fuga Island.


title: Cagayan

text: The Sambali Festival is celebrated throughout the province in commemoration of its founding. Hotels include the Governors Garden Hotel, Hotel Candice, Hotel Roma and Hotel Kimikarlai all in Tuguegarao City.


title: Cagayan

text: Claveria is host to several scenic attractions which include: the "Lakay-Lakay Lagoon", the rocky formation along the "Camalaggaon Caves", the "Roadside Park" overlooking the Claveria Bay, "Macatel Falls" with its clear waters that run in abundance throughout the year, the "Pata Lighthouse", and the Claveria Beach Resort along the white sand coasts.


title: Jack Keane

text: John M. "Jack" Keane (born February 1, 1943) is a retired American four-star general, a former Vice Chief of Staff of the United States Army, and a recipient of the Presidential Medal of Freedom. He is a national security analyst, primarily on Fox News, and serves as chairman of the Institute for the Study of War and as chairman of AM General.


title: Jack Keane

text: Keane was born in Manhattan, New York, the son of Elizabeth (Davis) and John Keane. He has a brother, Ronald.


title: Jack Keane

text: Keane attended Bishop Dubois High School and Fordham University, where he participated in the Pershing Rifles. He graduated with a B.S. degree in accounting in 1966. He then attended Western Kentucky University and graduated with an M.A. degree in philosophy. He later graduated from the US Army Command and General Staff College and the US Army War College.


title: Jack Keane

text: Keane served in the Vietnam War as a Ranger paratrooper, leading in combat as a platoon leader and company commander. He obtained the Combat Infantry Badge and the Master Parachutist Badge. He later served in U.S. engagements in Somalia, Haiti, Bosnia, and Kosovo. His commands include the 1st Brigade, 10th Mountain Division, 101st Airborne Division, and the XVIII Airborne Corps.


title: Jack Keane

text: In 1991 Keane saved the life of David Petraeus during a live-fire exercise. According to Keane, Petraeus was shot "accidentally, standing right next to me, and I had to fight to save his life. He had a hole about the size of a quarter in his back and is gushing with blood, and we stopped the bleeding and got him on a helicopter and got him to a surgeon and so we were sort of bonded ever since that time."


title: Jack Keane

text: After his retirement, he has served as an informal advisor to presidents and other senior officials. He served an advisory role in the management of the US occupation of Iraq, as a member of the Defense Policy Board Advisory Committee. In January 2007, Keane and the scholar Frederick W. Kagan released a policy paper, "Choosing Victory: A Plan for Success in Iraq," through the American Enterprise Institute that called for bringing security by putting 30,000 additional American troops there for at least 18 months. In part convinced by this paper, President George W. Bush ordered on January 10, 2007, the deployment of 21,500 additional troops to Iraq, most of whom would be deployed to Baghdad. The deployment has been nicknamed the 2007 "surge."


title: Jack Keane

text: Of his initial meeting with President Bush regarding the surge, Keane said thar he made a phone call to Newt Gingrich to ask his advice prior to the meeting. As Keane said in 2014,


title: Jack Keane

text: Keane was asked by Vice President Cheney to go back on active duty and to lead the surge in the field. When Keane declined, Cheney pressed him to come work in the White House and oversee both the wars in Afghanistan and Iraq; Keane again declined. Keane ended up briefly working at the White House and then later traveled to Iraq several times to advise General Petraeus.


title: Jack Keane

text: Keane is a regular contributor to Fox News and is involved in a variety of business, think tank and charitable activities. He serves as chairman of AM General, the firm that produces the Humvee. In June 2016, Keane co-founded IP3 International (IP3), a nuclear energy consulting firm.


title: Jack Keane

text: Keane is an advisor to the Spirit of America, a 501(c)(3) organization. He formerly served as a strategic advisor for Academi and is a former director of defense giant General Dynamics.


title: Jack Keane

text: In November 2016, shortly after Stanley A. McChrystal declined the post of Secretary of Defense, Keane was offered an appointment to the post, but he declined, citing the death of his wife several months earlier. After Defense Secretary Jim Mattis resigned in December 2018, Trump again offered the job to Keane, who again declined.


title: Jack Keane

text: Keane is considered an influential voice to leaders from both major political parties, including Donald Trump, particularly on foreign policy issues related to the Middle East.


title: Jack Keane

text: According to a staff report to the chairman of the House Oversight Committee, during the 2016 US presidential campaign of Donald Trump and subsequently, Trump aides such as Jared Kushner and others have been engaged in promoting IP3's plan to transfer nuclear technology from the US to Saudi Arabia. According to the report, IP3 founders and others have been seeking to broker a deal with Riyadh without the "gold standard," a provision—tied to Section 123 of the 1954 Atomic Energy Act, which establishes conditions for nuclear cooperation between the US and its allies, that seeks to limit weaponizing of nuclear energy.


title: Jack Keane

text: In July 2019, the committee chairman released a second staff report that detailed various activities and contacts between IP3 and the Trump administration.


title: Jack Keane

text: Keane married his first wife, Theresa Doyle, in 1965, and has two sons. She died in 2016 after having Parkinson's disease for 14 years. He is married to Angela McGlowan.


title: Jack Keane

text: Military awards that Keane has received include two Defense Distinguished Service Medals, two Army Distinguished Service Medals, the Silver Star, five Legion of Merits, the Bronze Star Medal, three Meritorious Service Medals, one Army Commendation Medal, the Joint Chiefs Service Badge, the Humanitarian Service Medal, Ranger Tab, the Combat Infantryman Badge, the Master Parachutist Badge, and the Air Assault Badge.


title: Jack Keane

text: Keane's civilian awards include the Fordham University Distinguished Alumni Award, the USO 2002 Man of the Year award, and the Association of the United States Army 2001 Man of the Year award. Keane was furthermore awarded an honorary Ph.D. degree in Law from Fordham University and an honorary Ph.D. degree in Public Service from Eastern Kentucky University.


title: San Onofre Nuclear Generating Station

text: The San Onofre Nuclear Generating Station (SONGS) is a permanently closed nuclear power plant located south of San Clemente, California, on the Pacific coast, in Nuclear Regulatory Commission Region IV. The plant was shut down in 2013 after replacement steam generators failed; it is currently in the process of decommissioning. The 2.2 GW of electricity supply lost when the plant shut down was replaced with 1.8 GW of new natural-gas fired power plants and 250 MW of energy storage projects.


title: San Onofre Nuclear Generating Station

text: The plant is owned by Southern California Edison. Edison International, parent of SCE, holds 78.2% ownership in the plant; San Diego Gas & Electric Company, 20%; and the City of Riverside Utilities Department, 1.8%. When fully functional, it employed over 2,200 people. Located between the ocean and Interstate 5, the station is a prominent landmark because of its twin hemispherical containment buildings, which were designed to contain any unexpected releases of radioactive material from the power generators.


title: San Onofre Nuclear Generating Station

text: The plant's first unit, Unit 1, operated from 1968 to 1992. Unit 2 was started in 1983 and Unit 3 started in 1984. Upgrades designed to last 20 years were made to the reactor units in 2009 and 2010; however, both reactors were shut down in January 2012 after premature wear was found on more than 3,000 tubes in replacement steam generators that had been installed in 2010 and 2011. The Nuclear Regulatory Commission investigated the events that led to the closure. In May 2013, Senator Barbara Boxer, the then-chairman of the Senate Environment and Public Works Committee, said the modifications had proved to be "unsafe and posed a danger to the eight million people living within 50 miles of the plant," and she called for a criminal investigation.


title: San Onofre Nuclear Generating Station

text: In June 2013, Southern California Edison announced the permanent retirement of Unit 2 and Unit 3, citing "continuing uncertainty about when or if SONGS might return to service" and noting that ongoing regulatory and "administrative processes and appeals" would likely cause any tentative restart plans to be delayed for "more than a year". The company stated that "Full retirement of the units prior to decommissioning will take some years in accordance with customary practices. Actual decommissioning will take many years until completion." Controversy continues over Edison's plans for on-site dry cask storage of the considerable amount of nuclear waste created during the facility's decades of operation.


title: San Onofre Nuclear Generating Station

text: Unit 1, a first-generation Westinghouse pressurized water reactor that operated for 25 years, closed permanently in 1992; it has been dismantled and is used as a storage site for spent fuel. It had a spherical containment of concrete and steel; the smallest wall was thick. It generated 456 MWe gross, and 436 MWe net, when operating at 100% capacity.


title: San Onofre Nuclear Generating Station

text: Units 2 and 3, Combustion Engineering two-loop pressurized water reactors, generated 1,127 MWe gross, and 1,070 MWe and 1,080 MWe net respectively, when operating at 100% capacity.


title: San Onofre Nuclear Generating Station

text: In a ten-year project completed in 2011 and costing $671 million, Edison replaced the steam generators in both reactors with Mitsubishi steam generators of modified design. Because of the reactors' two-loop design, uncommon for such large reactors of that era, the steam generators were among the largest in the industry. A common shortcoming of these large steam generators was tube wear, requiring replacement earlier than their 40-year design life. The steam generators being the largest components in the reactor required a temporary hole through the concrete containment shell. The Unit 2 replacement was completed in 2009 and Unit 3 in 2011. Edison estimated that the modernization would save customers $1 billion during the plant's license period, which at the time ran until 2022.


title: San Onofre Nuclear Generating Station

text: During its operation until 2012, SONGS provided about 20% of the power to large portions of Southern California.


title: San Onofre Nuclear Generating Station

text: The San Onofre Nuclear Generating Station (SONGS), operated by Southern California Edison (SCE) is approximately 100 km (60 mi) south of Los Angeles, 6.5 km (4 mi) south of San Clemente, CA. It is located between I-5 and the Pacific Ocean, within the boundary of the Camp Pendleton military reserve. The site originally comprised three nuclear power plants. Unit 1 commenced operation in 1968, and shut down in 1992. Units 2 and 3 permanently ceased operations in June 2013. Dismantlement of Unit 1 is essentially complete. The turbine building was removed and the licensee completed reactor pressure vessel internal segmentation and cutup; however, the licensee was unable to make arrangements for shipping the reactor pressure vessel to a disposal facility because of the size and weight of the vessel and shipping package. The licensee is making plans to ship the vessel offsite during the decommissioning activities for Units 2 and 3 because the radioactivity has decayed to a level that allows it to be treated as low level waste.


title: San Onofre Nuclear Generating Station

text: SONGS-1 was a Westinghouse 3-loop pressurized water reactor constructed by Bechtel and rated at 1347 MWthermal . It began commercial operation on January 1, 1968, and ceased operation on November 30, 1992. Defueling was completed on March 6, 1993. On December 28, 1993, NRC approved the Permanently Defueled Technical Specifications. On November 3, 1994, SCE submitted a Proposed Decommissioning Plan to place SONGS-1 in SAFSTOR until the shutdown of Units 2 and 3. On December 15, 1998, following a change in NRC decommissioning regulations, SCE submitted a post shutdown decommissioning activities report (PSDAR) for SONGS-1, to commence DECON in 2000. SCE actively decommissioned the facility, and most of the structures and equipment have been removed and sent to a disposal facility. The NRC issued a license amendment in February 2010 releasing the off-shore portions of the Unit 1 cooling intake and outlet pipes in place, under the Pacific Ocean seabed, for unrestricted use. The fuel from Unit 1 was transferred to Phase 1 of the independent spent fuel storage installation (ISFSI). In 2015, the ISFSI was expanded onto the area previously occupied by Unit 1 in order to store all Unit 2 and Unit 3 spent fuel. SCE completed transferring all of the nuclear fuel to dry storage in 2020.


title: San Onofre Nuclear Generating Station

text: The Unit 1 Reactor Pressure Vessel was transported via rail and then highway to the Energy Solutions disposal facility in Clive, Utah. The shipment left May 24, 2020 from San Onofre and arrived at the disposal facility on July 14, 2020.


title: San Onofre Nuclear Generating Station

text: The San Onofre station had technical problems over the years. In July 1982, Time wrote, "The firm Bechtel was ... embarrassed in 1977, when it installed a 420-ton nuclear-reactor vessel backwards" at San Onofre. In 2008, the San Onofre plant received multiple citations over issues such as failed emergency generators, improperly wired batteries and falsified fire safety data. In its annual review of 2011, the Nuclear Regulatory Commission (NRC) identified improvements but noted that in the area of human performance, "corrective actions to date have not resulted in sustained and measurable improvement".


title: San Onofre Nuclear Generating Station

text: According to the NRC, workers at San Onofre were "afraid they will be retaliated against if they bring up safety problems, something that's against the rules". As of 2011, according to the NRC, there had been progress on the issue and the problems were not considered a threat to the safety of plant workers or the public. In November 2011, there was an ammonia leak, and as a precaution company employees were evacuated from the leak area, while the units continued normal operation.


title: San Onofre Nuclear Generating Station

text: A mid-cycle inspection report spanning July 2011 to June 2012 revealed three incidents relating to human performance. An additional issue concerned a failure to develop procedures for a "cyber security analysis of electronic devices" that was later corrected.


title: San Onofre Nuclear Generating Station

text: In 2012, coolant fluid was found in the oil system of a backup diesel generator, which would have caused the generator to fail if needed. An internal investigation found "evidence of potential tampering", making sabotage by staff a possible cause.


title: San Onofre Nuclear Generating Station

text: Southern California Edison stated after the Fukushima disaster in 2011 that the station was "built to withstand a 7.0 magnitude earthquake directly under the plant". Additionally, there was a 25-foot wall to protect the plant from a tsunami which could be potentially generated by the active fault 5 miles offshore. The closest tectonic fault line is the Christianitos fault, less than a mile away, which is considered inactive or "dead", but other active faults in the vicinity might pose some threat.


title: San Onofre Nuclear Generating Station

text: The NRC's estimate of the yearly risk of an earthquake intense enough to cause core damage to the reactor at San Onofre was 1 in 58,824, according to a study it had published in August 2010.


title: San Onofre Nuclear Generating Station

text: In June 2012 S. David Freeman, the former head of the Southern California Public Power Authority and "a longtime anti-nuclear voice", described San Onofre and Diablo Canyon as "disasters waiting to happen: aging, unreliable reactors sitting near earthquake fault zones on the fragile Pacific Coast, with millions of Californians living nearby".


title: San Onofre Nuclear Generating Station

text: The San Onofre plant used seawater for cooling, like some other seaside facilities in Southern California, lacking the large cooling towers typically associated with nuclear generating stations. Limited available land next to SONGS would likely have required towers to be built on the opposite side of Interstate 5.


title: San Onofre Nuclear Generating Station

text: The NRC defines two emergency planning zones around nuclear power plants: 1) a plume exposure pathway zone with a radius of , concerned primarily with exposure to, and inhalation of, airborne radioactive contamination, and 2) an ingestion pathway zone of about , concerned primarily with ingestion of food and liquid contaminated by radioactivity. The average prevailing westerly wind direction at San Onofre blows inland 9 months of the year.


title: San Onofre Nuclear Generating Station

text: The 2010 U.S. population within of San Onofre was 92,687, an increase of 50.0 percent in a decade, according to an analysis of U.S. Census data for msnbc.com. The 2010 U.S. population within was 8,460,508, an increase of 14.9 percent since 2000. Three of the cities within 20 miles of the facility are San Clemente and Laguna Beach in Orange County and Oceanside in San Diego County. San Diego is 45 miles south of the facility, and Los Angeles is 60 miles north of the facility.


title: San Onofre Nuclear Generating Station

text: On August 6, 1977, about a thousand anti-nuclear protesters marched outside the nuclear generation station, while units 2 & 3 were under construction.


title: San Onofre Nuclear Generating Station

text: On June 22, 1980, in the wake of the Three Mile Island accident, about 15,000 people attended a protest rally against the San Onofre nuclear plant that was organized by the Southern California Alliance For Survival. Among the speakers was physicist Michio Kaku, who noted that one of the reactor pressure vessels had been installed backwards and called on California governor Jerry Brown (then considered an environmentalist) to shut them down.


title: San Onofre Nuclear Generating Station

text: On March 11, 2012, more than 200 activists protested at the San Onofre Nuclear Generating Station to mark the one-year anniversary of the Fukushima Daiichi nuclear disaster. Two Japanese residents who lived through the Fukushima meltdowns and congressman Raymond Lutz, spoke. They said the generators which had been offline since January 2012, should remain off.


title: San Onofre Nuclear Generating Station

text: In May 2012, environmental and anti-nuclear activists gathered at Southern California Edison's Irvine headquarters calling for the San Onofre plant to be decommissioned.


title: San Onofre Nuclear Generating Station

text: Unit 2 was shut down in early January 2012 for routine refueling and replacement of the reactor vessel head. On January 31, 2012, Unit 3 suffered a radioactive leak largely inside the containment shell, with a release to the environment below allowable limits, and the reactor was shut down per standard procedure. On investigation, the replacement steam generators from 2011 in both units were found to show premature wear on over 3,000 tubes, in 15,000 places. Plant officials pledged not to restart until the causes of the tube leak and tube degradation were understood. Neither unit was ever restarted. There were no blackouts due to the lack of SONGS electricity; more pollution was caused by the use of natural gas plants to make up for the lost power generation, and additional cost led to higher utility bills.


title: San Onofre Nuclear Generating Station

text: In March 2012, the NRC forbade the plant to be reopened until the causes of its equipment problems were thoroughly understood and fixed. At the same time, Irvine Councilman Larry Agran called for the plant to be decommissioned safely and as soon as possible. Concerns included "nuclear waste stored at the plant, health hazards from radioactive material, and inadequate evacuation plans". Resolutions passed in neighboring cities Laguna Beach and San Clemente called for safer and more secure nuclear waste storage. San Clemente voted to request public information about radiation levels near the plant. The spokesman for Edison International said "the company will work to prepare detailed responses to council and community member questions and concerns".


title: San Onofre Nuclear Generating Station

text: In June 2012 the environmental group Friends of the Earth filed a legal petition with the NRC, asking that any decision to restart SONGS be considered a de facto NRC license amendment which required a public hearing, rather than a decision by the NRC commissioners. Friends of the Earth submitted evidence and sworn statements of John Large of the London-based nuclear consulting engineers Large & Associates, demonstrating that the steam generating tube degradation was a generic fault of the Mitsubishi design and that Edison's power derating of the two nuclear units would not lower the rate of wear or the risk of catastrophic tube failure. SCE and NRC staff filed statements opposing the petition.


title: San Onofre Nuclear Generating Station

text: In July 2012, the NRC's final report identified ten issues that needed followup and stated "the plant will not be permitted to restart until the licensee has developed a plan to prevent further steam generator tube degradation and the NRC independently verifies that it can be operated safely."


title: San Onofre Nuclear Generating Station

text: , the cost related to the shutdown had reached $165 million, with $117 million of that being the purchasing of power from other sources to replace the output of the plant. The Chairman of Edison International Ted Craver stated the possibility that reactor 3 might be scrapped as "It is not clear at this time whether Unit 3 will be able to restart without extensive additional repairs".


title: San Onofre Nuclear Generating Station

text: In August 2012, Southern California Edison announced plans to lay off one-third, or 730, of the plants employees; the company said that the downsizing had been planned more than two years before. Rochelle Becker of the Alliance for Nuclear Responsibility said the layoffs showed that the company was not honest about their plans for the power plant.


title: San Onofre Nuclear Generating Station

text: In September 2012, Allison Macfarlane, the NRC Chairwoman, said that the plant would be down for a prolonged period, and that Unit 3 would be defueled in September 2012 because the unit had been significantly damaged. Due to the shutdown, the NRC ended requirements to monitor non-operating systems.


title: San Onofre Nuclear Generating Station

text: In October 2012, SCE submitted a "Unit 2 Return to Service Report" about corrective actions, such as plugging worn tubes and preventively plugged additional tubes. It proposed a restart limiting Unit 2 to 70% power, to prevent excessive tube vibration, until an inspection within 150 days of operation. SCE reported that most of the excessive wear had been in limited areas, due to higher speed and drier steam than computer modeling had predicted, and inadequate tube support at the U-bend. Analysis had concluded operating at 70% power would eliminate the conditions that caused excessive wear.


title: San Onofre Nuclear Generating Station

text: In November 2012, the NRC decided to refer the Friends of the Earth hearing request to the Atomic Safety and Licensing Board. By November 2012, the cost of the outage was over $300 million, and discussion of restarting Unit 2 had been postponed.


title: San Onofre Nuclear Generating Station

text: In December 2012, the last of the four old steam generators was transported to Clive, Utah for disposal.


title: San Onofre Nuclear Generating Station

text: In February 2013, the NRC asked the steam generator manufacturer Mitsubishi Heavy Industries to provide a redacted version of a report on the plant's steam generators for publication. The report described the changes made in the replacement steam generator including the removal of a support cylinder, changes to the tube support plates and anti-vibration bars, and addition of about 400 tubes.


title: San Onofre Nuclear Generating Station

text: In December 2013, the NRC cited SONGS for failing to properly check the steam generator design, which had caused the plant shutdown. The finding did not carry any fine or penalty but complicated SCE's legal position that they did nothing wrong. The California Public Utilities Commission was considering whether to order a multimillion-dollar refund to SCE customers.


title: San Onofre Nuclear Generating Station

text: On May 13, 2013, the Atomic Safety and Licensing Board issued its decision on the Friends of the Earth hearing request filed in June 2012. It determined the current NRC process on this issue constituted a de facto license amendment requiring an adjudicatory public hearing, for three independent reasons:


title: San Onofre Nuclear Generating Station

text: In May 2013, Senator Barbara Boxer asked that the United States Justice Department investigate possible malfeasance by Edison officials, and released a 2004 letter by an Edison executive that expressed worries that the new steam generators, though similar, would not be "like for like" replacements and could lead to the same kind of potential "disastrous" issues that in fact led to the plant's shutdown in 2012. In making the request for a possible criminal investigation, Boxer stated "This correspondence leads me to believe that Edison intentionally misled the public and regulators in order to avoid a full safety review and public hearing in connection with its redesign of the plant." Edison denied any wrongdoing. but reportedly signaled it might shut the plant down for good should the company not be allowed to restart one of the reactors at 70% of capacity.


title: San Onofre Nuclear Generating Station

text: On June 7, 2013, Southern California Edison announced it would "permanently retire" Unit 2 and Unit 3, ending their attempt to restart the plant at a reduced capacity. The utility said it would cut the SONGS workforce from about 1,500 to some 400 employees, with most reductions "expected to occur in 2013". The company also said it would "pursue recovery of damages from Mitsubishi Heavy Industries, the supplier of the replacement steam generators", although the contract limited liability to $138 million and excluded consequential damages. The chief executive of Edison International explained that the current licenses expire in 2022, and with post-Fukushima requirements, which include re-evaluating earthquake vulnerability, it was uncertain renewal would be economic, so it made little sense making costly and politically difficult repairs now that would not make a return on investment before 2022.


title: San Onofre Nuclear Generating Station

text: California Senator Dianne Feinstein signaled approval of the decision to permanently close the plant, stating "I firmly believe this is the right thing to do for the more than 7 million Californians who live within 50 miles of San Onofre." However, Representative Darrell Issa, whose voting district includes the nuclear station, was more downbeat, saying "our communities now face the loss of employment for more than a thousand highly skilled workers and an essential local source of low-cost, clean energy." Issa also pledged to work to improve the prospects for nuclear power nationwide. In contrast, Sierra Club Director Kathryn Phillips applauded the move, saying in a statement that "We hope, especially, that the utilities will take this opportunity to help get more locally generated renewable energy, such as rooftop solar, into their portfolios."


title: San Onofre Nuclear Generating Station

text: In 2015, State Attorney General Kamala Harris opened an investigation of the Office of Ratepayer Advocates, San Diego Gas and Electric, and Southern California Edison. California state investigators searched the home of California utility regulator Michael Peevey and found hand written notes, which showed that Peevey had met with an Edison executive in Poland, where the two had negotiated the terms of the San Onofre settlement leaving San Diego taxpayers with a $3.3 billion bill to pay for the closure of the plant. The investigation was closed amidst Harris' 2016 run for the US Senate position, which opened when Barbara Boxer retired.


title: San Onofre Nuclear Generating Station

text: Total greenhouse gas emissions from power plants in California increased by 35% from 2011 to 2012, according to figures from the California Air Resources Board, which per the World Nuclear News is partly due to the early closure of San Onofre.


title: San Onofre Nuclear Generating Station

text: Decommissioning San Onofre will take numerous years until the process is complete. In February 2014 SCE announced that it would be auctioning off non-radioactive equipment from the former nuclear plant March 2015. In August 2014, SCE announced decommissioning would take 20 years, cost $4.4 billion and spent fuel would be held on-site in dry casks indefinitely, while Low Level Radioactive Waste would be disposed in Texas and Utah.


title: San Onofre Nuclear Generating Station

text: On December 20, 2016, SCE announced it had selected a joint venture of AECOM and EnergySolutions as decommissioning general contractor for SONGS.


title: San Onofre Nuclear Generating Station

text: Since the Yucca Mountain nuclear waste repository plan was terminated in 2008, nuclear waste will have to be stored on site in San Onofre until Congress finds another location for a nuclear waste repository.


title: San Onofre Nuclear Generating Station

text: SONG's nuclear waste is in steel-lined concrete pools known as wet storage. According to the NRC, nuclear waste must sit in these pools for about 5 years in order to cool. It then must be transferred into a more permanent, dry storage, consisting of 80 underground steel lined concrete monoliths.


title: San Onofre Nuclear Generating Station

text: SCE decided on Holtec International to design the dry storage canisters. The canisters will be thick compared to the thickness used for most other canisters in the US. These steel-lined concrete monoliths right next to the Pacific Ocean exceed California's earthquake requirements and Edison says they are designed to withstand fire and tsunamis.


title: San Onofre Nuclear Generating Station

text: The canisters are prone to cracking mainly because of chloride-induced stress corrosion from being close to the ocean. The canisters cannot be inspected for cracks. Kris Singh, president and CEO of Holtec, says that they are working on developing inspection methods, but that even if cracks could be detected, there is no way to repair them.


title: San Onofre Nuclear Generating Station

text: As an added safety measure, Holtec is providing an extra canister on site. The Electric Power Research Institute (EPRI) will be using new technologies in order to detect and protect these canisters from cracking. EPRI believes the best method for chloride-induced stress-corrosion cracking is to apply proactive practices, which include using standard methods to classify the corrosivity of the site environment, monitoring the site-specific absolute humidity, and planning for visual inspection of the canister surface in a timeframe based on the results.


title: San Onofre Nuclear Generating Station

text: In April 2017 Southern California Edison agreed to move spent nuclear fuel off the site, following legal action by San Diego environmental group Citizens Oversight.


title: San Onofre Nuclear Generating Station

text: In July 2020, the California Coastal Commission approved an inspection and maintenance program that will allow Southern California Edison to continue to store spent nuclear fuel in a storage site at San Onofre.


title: San Onofre Nuclear Generating Station

text: In July 2013 SCE started a 90-day dispute resolution process with Mitsubishi Heavy Industries. The dispute resolution was unsuccessful, so a binding arbitration process run by the International Chamber of Commerce commenced in October 2013. SCE claimed $7.57 billion (930 billion yen), but MHI argues that compensation is limited to $137 million by their contract.


title: San Onofre Nuclear Generating Station

text: In October 2015 the owners reached a $400 million settlement with their insurers for outages caused by the failure. SCE received $312.8 million, SDG&E $80 million, and the city of Riverside $7.16 million. The arbitration claim against MHI continued to be pursued through the International Chamber of Commerce.


title: San Onofre Nuclear Generating Station

text: In March 2017 the International Chamber of Commerce ordered MHI to pay $125 million compensation, the liability limit contained in the contract. The tribunal rejected claims of fraud and gross negligence against Mitsubishi, and ordered the claimants to pay MHI $58 million in legal fees and costs.


title: San Onofre Nuclear Generating Station

text: The San Onofre Nuclear Generating Station is shown in the 1987 film "Made in U.S.A." directed by Ken Friedman and starring Adrian Pasdar, Chris Penn and Lori Singer. SONGS was also featured in Godfrey Reggio's 1982 experimental film Koyaanisqatsi, where sunbathers are shown on San Onofre State Beach in front of the station. Passing reference is made to the design of the containment shields (which resemble breasts) in the lyrics of the Descendents song "Kids" from their 1986 album "Enjoy!", and in the cult comedy "The Naked Gun" (1987).


title: San Onofre Nuclear Generating Station

text: The nuclear generating station was also used as a backdrop for the nondescript Californian nuclear reactor in the film "Cloud Atlas" (2012).


title: Causes of autism

text: Many causes of autism have been proposed, but understanding of the theory of causation of autism and the other autism spectrum disorders (ASD) is incomplete. Attempts have been made to incorporate the known genetic and environmental causes into a comprehensive causative framework. ASD is a complex developmental condition marked by persistent challenges to social interaction, speech and nonverbal communication, and restricted/repetitive behaviors and its phenotypes vary significantly.


title: Causes of autism

text: Research indicates that genetic factors predominate. The heritability of autism, however, is complex, and it is typically unclear which genes are involved. In rare cases, autism is associated with agents that cause birth defects. Many other causes have been proposed.


title: Causes of autism

text: Numerous epidemiological studies have shown no scientific evidence supporting any link between vaccinations and autism.


title: Causes of autism

text: Autism involves atypical brain development which often becomes apparent in behavior and social development before a child is three years old. It can be characterized by impairments in social interaction and communication, as well as restricted interests and stereotyped behavior, and the characterization is independent of any underlying neurological defects. Other characteristics include repetitive-like tasks seen in behavior and sensory interests. This article uses the terms "autism" and "ASD" to denote classical autism and the wider dispersion of symptoms and manifestations of autism, respectively.


title: Causes of autism

text: Autism's theory of causation is incomplete. It has long been presumed that there is a common cause at the genetic, cognitive, and neural levels for autism's characteristic triad of symptoms. However, there is increasing suspicion among researchers that autism does not have a single cause, but is instead a complex disorder with a set of core aspects that have distinct causes, where the interactions between these core aspects determine whether or not autism develops. Different underlying brain dysfunctions have been hypothesized to result in the common symptoms of autism, just as completely different brain types result in intellectual disability. The terms "autism" or "ASDs" capture the wide range of its processes at work. Although these distinct causes have been hypothesized to often co-occur, it has also been suggested that the correlation between the causes has been exaggerated. The number of people known to have autism has increased dramatically since the 1980s, at least partly due to changes in diagnostic practice. It is unknown whether prevalence has increased as well.


title: Causes of autism

text: The consensus among mainstream autism researchers is that genetic factors predominate. Environmental factors that have been claimed to contribute to autism or exacerbate its symptoms, or that may be important to consider in future research, include certain foods, infectious disease, heavy metals, solvents, diesel exhaust, PCBs, phthalates and phenols used in plastic products, pesticides, brominated flame retardants, alcohol, smoking, and illicit drugs. Among these factors, vaccines have attracted much attention, as parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and parental concern about vaccines has led to a decreasing uptake of childhood immunizations and an increasing likelihood of measles outbreaks. However, there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella (MMR) vaccine and autism, and there is no scientific evidence that the vaccine preservative thiomersal causes autism.


title: Causes of autism

text: Genetic factors may be the most significant cause for autism spectrum disorders. Early studies of twins had estimated heritability to be over 90%, meaning that genetics explains over 90% of whether a child will develop autism. This may be an overestimation, as later twin studies estimate the heritability at between 60 and 90%. Evidence so far still suggests a strong genetic component, with one of the largest and most recent studies estimating the heritability at 83%. Many of the non-autistic co-twins had learning or social disabilities. For adult siblings the risk for having one or more features of the broader autism phenotype might be as high as 30%.


title: Causes of autism

text: In spite of the strong heritability, most cases of ASD occur sporadically with no recent evidence of family history. It has been hypothesized that spontaneous "de novo" mutations in the father's sperm or mother's egg contribute to the likelihood of developing autism. There are two lines of evidence that support this hypothesis. First, individuals with autism have significantly reduced fecundity, they are 20 times less likely to have children than average, thus curtailing the persistence of mutations in ASD genes over multiple generations in a family. Second, the likelihood of having a child develop autism increases with advancing paternal age, and mutations in sperm gradually accumulate throughout a man's life.


title: Causes of autism

text: The first genes to be definitively shown to contribute to risk for autism were found in the early 1990s by researchers looking at gender-specific forms of autism caused by mutations on the X chromosome.


title: Causes of autism

text: An expansion of the CGG trinucleotide repeat in the promoter of the gene "FMR1" in boys causes fragile X syndrome, and at least 20% of boys with this mutation have behaviors consistent with autism spectrum disorder. Mutations that inactivate the gene "MECP2" cause Rett syndrome, which is associated with autistic behaviors in girls, and in boys the mutation is embryonic lethal.


title: Causes of autism

text: Besides these early examples, the role of "de novo" mutations in ASD first became evident when DNA microarray technologies reached sufficient resolution to allow the detection of copy number variation (CNV) in the human genome. CNVs are the most common type of structural variation in the genome, consisting of deletions and duplications of DNA that range in size from a kilobase to a few megabases. Microarray analysis has shown that "de novo" CNVs occur at a significantly higher rate in sporadic cases of autism as compared to the rate in their typically developing siblings and unrelated controls. A series of studies have shown that gene disrupting "de novo" CNVs occur approximately four times more frequently in ASD than in controls and contribute to approximately 5–10% of cases. Based on these studies, there are predicted to be 130–234 ASD-related CNV loci. The first whole genome sequencing study to comprehensively catalog "de novo" structural variation at a much higher resolution than DNA microarray studies has shown that the mutation rate is approximately 20% and not elevated in autism compared to sibling controls. However, structural variants in individuals with autism are much larger and four times more likely to disrupt genes, mirroring findings from CNV studies.


title: Causes of autism

text: CNV studies were closely followed by exome sequencing studies, which sequence the 1–2% of the genome that codes for proteins (the "exome"). These studies found that "de novo" gene inactivating mutations were observed in approximately 20% of individuals with autism, compared to 10% of unaffected siblings, suggesting the etiology of ASD is driven by these mutations in around 10% of cases. There are predicted to be 350-450 genes that significantly increase susceptibility to ASDs when impacted by inactivating "de novo" mutations. A further 12% of cases are predicted to be caused by protein altering missense mutations that change an amino acid but do not inactivate a gene. Therefore, approximately 30% of individuals with autism have a spontaneous "de novo" large CNV that deletes or duplicates genes, or mutation that changes the amino acid code of an individual gene. A further 5–10% of cases have inherited structural variation at loci known to be associated with autism, and these known structural variants may arise "de novo" in the parents of affected children.


title: Causes of autism

text: Tens of genes and CNVs have been definitively identified based on the observation of recurrent mutations in different individuals, and suggestive evidence has been found for over 100 others. The Simons Foundation Autism Research Initiative (SFARI) details the evidence for each genetic locus associated with autism.


title: Causes of autism

text: These early gene and CNV findings have shown that the cognitive and behavioral features associated with each of the underlying mutations is variable. Each mutation is itself associated with a variety of clinical diagnoses, and can also be found in a small percentage of individuals with no clinical diagnosis. Thus the genetic disorders that comprise autism are not autism-specific. The mutations themselves are characterized by considerable variability in clinical outcome and typically only a subset of mutation carriers meet criteria for autism. This variable expressivity results in different individuals with the same mutation varying considerably in the severity of their observed particular trait.


title: Causes of autism

text: The conclusion of these recent studies of "de novo" mutation is that the spectrum of autism is breaking up into quanta of individual disorders defined by genetics.


title: Causes of autism

text: One gene that has been linked to autism is SHANK2. Mutations in this gene act in a dominant fashion. Mutations in this gene appear to cause hyperconnectivity between the neurons.


title: Causes of autism

text: A study conducted on 42,607 autism cases has identified 60 new genes, five of which had a more moderate impact on autistic symptoms. The related gene variants were often inherited from the participant’s parents.


title: Causes of autism

text: Epigenetic mechanisms may increase the risk of autism. Epigenetic changes occur as a result not of DNA sequence changes but of chromosomal histone modification or modification of the DNA bases. Such modifications are known to be affected by environmental factors, including nutrition, drugs, and mental stress. Interest has been expressed in imprinted regions on chromosomes 15q and 7q.


title: Causes of autism

text: Most data supports a polygenic, epistatic model, meaning that the disorder is caused by two or more genes and that those genes are interacting in a complex manner. Several genes, between two and fifteen in number, have been identified and could potentially contribute to disease susceptibility. However, an exact determination of the cause of ASD has yet to be discovered and there probably is not one single genetic cause of any particular set of disorders, leading many researchers to believe that epigenetic mechanisms, such as genomic imprinting or epimutations, may play a major role.


title: Causes of autism

text: Epigenetic mechanisms can contribute to disease phenotypes. Epigenetic modifications include DNA cytosine methylation and post-translational modifications to histones. These mechanisms contribute to regulating gene expression without changing the sequence of the DNA and may be influenced by exposure to environmental factors and may be heritable from parents. Rett syndrome and Fragile X syndrome (FXS) are single gene disorders related to ASD with overlapping symptoms that include deficient neurological development, impaired language and communication, difficulties in social interactions, and stereotyped hand gestures. It is not uncommon for a patient to be diagnosed with both ASD and Rett syndrome and/or FXS. Epigenetic regulatory mechanisms play the central role in pathogenesis of these two disorders. Rett syndrome is caused by a mutation in the gene that encodes methyl-CpG-binding protein (MECP2), one of the key epigenetic regulators of gene expression. MeCP2 binds methylated cytosine residues in DNA and interacts with complexes that remodel chromatin into repressive structures. On the other hand, FXS is caused by mutations that are both genetic and epigenetic. Expansion of the CGG repeat in the 5'-untranslated region of the FMR1 genes leads to susceptibility of epigenetic silencing, leading to loss of gene expression.


title: Causes of autism

text: Genomic imprinting may also contribute to ASD. Genomic imprinting is another example of epigenetic regulation of gene expression. In this instance, the epigenetic modification(s) causes the offspring to express the maternal copy of a gene or the paternal copy of a gene, but not both. The imprinted gene is silenced through epigenetic mechanisms. Candidate genes and susceptibility alleles for autism are identified using a combination of techniques, including genome-wide and targeted analyses of allele sharing in sib-pairs, using association studies and transmission disequilibrium testing (TDT) of functional and/or positional candidate genes and examination of novel and recurrent cytogenetic aberrations. Results from numerous studies have identified several genomic regions known to be subject to imprinting, candidate genes, and gene-environment interactions. Particularly, chromosomes 15q and 7q appear to be epigenetic hotspots in contributing to ASD. Also, genes on the X chromosome may play an important role, as in Rett Syndrome.


title: Causes of autism

text: An important basis for ASD causation is also the over- or underproduction of brain permanent cells (neurons, oligodendrocytes, and astrocytes) by the neural precursor cells during fetal development.


title: Causes of autism

text: The risk of autism is associated with several prenatal risk factors, including advanced age in either parent, diabetes, bleeding, and use of psychiatric drugs in the mother during pregnancy. Autism has been linked to birth defect agents acting during the first eight weeks from conception, though these cases are rare. If the mother of the child is dealing with autoimmune conditions or disorders while pregnant, it may affect if the child developed autism. All of these factors can cause inflammation or impair immune signaling in one way or another.


title: Causes of autism

text: Sleep apnea can result in intermittent hypoxia and has been increasing in prevalence due in part to the obesity epidemic. The known maternal risk factors for autism diagnosis in her offspring are similar to the risk factors for sleep apnea. For example, advanced maternal age, maternal obesity, maternal type 2 diabetes and maternal hypertension all increase the risk of autism in her offspring. Likewise, these are all known risk factors for sleep apnea.


title: Causes of autism

text: One animal study found behaviour of offspring exhibited autism-like traits when rats were subjected to intermittent hypoxia during gestation, replicating the oxygen drops seen in sleep apnea. A human study found that gestational sleep apnea was associated with low reading test scores in children and that this effect may be mediated by an increased risk of the child having sleep apnea themselves. Another study reported low social development scores in 64% of infants born to mothers with sleep apnea compared to 25% of infants born to controls, suggesting sleep apnea in pregnancy may have an effect on offspring neurodevelopment. There was also an increase in the amount of snoring the mothers with sleep apnea reported in their infants when compared to controls. Children with sleep apnea have "hyperactivity, attention problems, aggressivity, lower social competency, poorer communication, and/or diminished adaptive skills". One study found significant improvements in ADHD-like symptoms, aggression, social problems and thought problems in autistic children who underwent adentonsillectomy for sleep apnea. Sleep problems in autism have been linked in a study to brain changes, particularly in the hippocampus, though this study does not prove causation. A common presentation of sleep apnea in children with autism is insomnia.


title: Causes of autism

text: Prenatal viral infection has been called the principal non-genetic cause of autism. Prenatal exposure to rubella or cytomegalovirus activates the mother's immune response and may greatly increase the risk for autism in mice. Congenital rubella syndrome is the most convincing environmental cause of autism. Infection-associated immunological events in early pregnancy may affect neural development more than infections in late pregnancy, not only for autism, but also for psychiatric disorders of presumed neurodevelopmental origin, notably schizophrenia.


title: Causes of autism

text: Teratogens are environmental agents that cause birth defects. Some agents that are theorized to cause birth defects have also been suggested as potential autism risk factors, although there is little to no scientific evidence to back such claims. These include exposure of the embryo to valproic acid, paracetamol, thalidomide or misoprostol. These cases are rare. Questions have also been raised whether ethanol (grain alcohol) increases autism risk, as part of fetal alcohol syndrome or alcohol-related birth defects. All known teratogens appear to act during the first eight weeks from conception, and though this does not exclude the possibility that autism can be initiated or affected later, it is strong evidence that autism arises very early in development.


title: Causes of autism

text: Maternal inflammatory and autoimmune diseases can damage embryonic and fetal tissues, aggravating a genetic problem or damaging the nervous system.


title: Causes of autism

text: Thyroid problems that lead to thyroxine deficiency in the mother in weeks 8–12 of pregnancy have been postulated to produce changes in the fetal brain leading to autism. Thyroxine deficiencies can be caused by inadequate iodine in the diet, and by environmental agents that interfere with iodine uptake or act against thyroid hormones. Possible environmental agents include flavonoids in food, tobacco smoke, and most herbicides. This hypothesis has not been tested.


title: Causes of autism

text: Diabetes in the mother during pregnancy is a significant risk factor for autism; a 2009 meta-analysis found that gestational diabetes was associated with a twofold increased risk. A 2014 review also found that maternal diabetes was significantly associated with an increased risk of ASD. Although diabetes causes metabolic and hormonal abnormalities and oxidative stress, no biological mechanism is known for the association between gestational diabetes and autism risk.


title: Causes of autism

text: Maternal obesity during pregnancy may also increase the risk of autism, although further study is needed.


title: Causes of autism

text: Maternal malnutrition during preconception and pregnancy influences fetal neurodevelopment. Intrauterine growth restriction is associated with ASD, in both term and preterm infants.


title: Causes of autism

text: It has been hypothesized that folic acid taken during pregnancy could play a role in reducing cases of autism by modulating gene expression through an epigenetic mechanism. This hypothesis is supported by multiple studies.


title: Causes of autism

text: Prenatal stress, consisting of exposure to life events or environmental factors that distress an expectant mother, has been hypothesized to contribute to autism, possibly as part of a gene-environment interaction. Autism has been reported to be associated with prenatal stress both with retrospective studies that examined stressors such as job loss and family discord, and with natural experiments involving prenatal exposure to storms; animal studies have reported that prenatal stress can disrupt brain development and produce behaviors resembling symptoms of autism. However, other studies have cast doubts on this association, notably population based studies in England and Sweden finding no link between stressful life events and ASD.