title: John William Friso

text: Before 9 April 1939 King Zog I of Albania makes the position of MRCA unknown, since his ancestry is itself almost entirely unknown and he has no traceable connection to other European royalty except through his wife Geraldine.


title: John William Friso

text: Since the death of Elizabeth II on 8 September 2022 the MRCA of hereditary European monarchs is John Frederick's great-grandson Louis IX, Landgrave of Hesse-Darmstadt (1719 – 1790) and his wife Caroline of Zweibrücken (1721 – 1774), who were formerly common ancestors to all reigning European monarchs except Elizabeth II. This is because Charles III is descended through his paternal grandmother from Louis IX's grandson Louis II, Grand Duke of Hesse via both her parents. Despite this, John William Friso and Marie Louise remain to be the most recent common ancestor of all "current" and "former" European monarchs.


The Hong Kong Special Administrative Region passport is a passport issued only to permanent residents of Hong Kong who also hold Chinese citizenship. In accordance with the Basic Law of the Hong Kong Special Administrative Region, since the transfer of sovereignty on 1 July 1997, the passport has been issued by the Immigration Department of the Government of Hong Kong under the authorisation of the Central People's Government of the People's Republic of China. As the official languages of Hong Kong are Chinese and English, the passport is printed bilingually in both Chinese (traditional characters) and English.


In English, the passport is sometimes referred to by its long-form name which appears on the cover (i.e. the Hong Kong Special Administrative Region People's Republic of China passport – a literal translation of the Chinese title ). Alternatively, the passport is commonly referred to as the Hong Kong Special Administrative Region passport () (the Hong Kong legislative ordinance concerning the passport is titled the "Hong Kong Special Administrative Region Passports Ordinance (Chapter 539)", the Hong Kong SAR passport, the HKSAR passport or the Hong Kong passport.


title: Hong Kong Special Administrative Region passport

text: The authorities of the Republic of China (commonly known as "Taiwan") refer to the Hong Kong SAR passport as the "Hong Kong passport" because the ROC government tries to avoid references to the political status of Hong Kong as a SAR of the People's Republic of China. Meanwhile, the Brazilian Consulate-General in Hong Kong uses the term "Hong Kong passport" in reference to both the Hong Kong SAR and British National (Overseas) passports.


text: Hong Kong official travel documents prior to 1997 included the Hong Kong Certificate of Identity (CI), British Dependent Territories Citizen (BDTC), British National (Overseas) (BN(O)) and British Citizen (BC) passports. After 1997, BN(O) and BC passports are still valid but CIs and BDTC passports are no longer in use.


text: The issuing of Hong Kong SAR passports began on 1 July 1997, following the transfer of sovereignty over Hong Kong from the United Kingdom to the People's Republic of China. PRC citizens who have right of abode in the HKSAR and who hold Hong Kong permanent resident identity cards, whether or not they are holders of British National (Overseas) passport or Hong Kong Certificate of Identity or other travel documents, are eligible to apply for the Hong Kong SAR passport.


text: Note that acquisition of British citizenship in the British Nationality Selection Scheme itself does not affect the eligibility for a HKSAR passport. Nor does the holding of any foreign passport itself affect the eligibility for a HKSAR passport, provided that one remains a PRC citizen.


text: Under Hong Kong Basic Law, the Government of Hong Kong is responsible for immigration control in the territory. The Hong Kong SAR passport is issued by the Immigration Department of Hong Kong under the authorisation of the Central People's Government (or the State Council). Its design is distinct from other types of People's Republic of China passports and the holders enjoy visa-free entry to more countries than other PRC passports.


text: Starting from 1 January 2003, the second version of the passport was introduced with enhanced security features. The passport was machine readable, designed for immigration control points equipped with passport scanners. The passport size was . The second version of the Hong Kong SAR passport was available either as a 32-page ordinary-size passport or as a 48-page passport.


text: The cover of the passport was dark blue with wording and the national emblem of the People's Republic of China in gold. The word "Passport" in Chinese and English is found below the crest. Above are the words "Hong Kong Special Administrative Region People's Republic of China", also in Chinese and English. It is worth noting that the characters 中華人民共和國 (People's Republic of China) are bigger than the characters 香港特別行政區 (Hong Kong Special Administrative Region) on the passport cover. In English, however, "HONG KONG" is bigger than the phrase "SPECIAL ADMINISTRATIVE REGION PEOPLE'S REPUBLIC OF CHINA" for easy distinction by foreign immigration officials.


text: The passport's explanatory notes were on page 1 in Chinese, and on page 2 in English. They consisted of the following words:


text: Personal data was recorded on the inner rear cover of the passport, which was covered with a security laminate. Details included were:


text: Changes from the first version included optically variable ink used to print the letters "HKSAR" along the left hand side of the photo and the words "IMMIGRATION DEPARTMENT, HONG KONG SPECIAL ADMINISTRATIVE REGION" in the "Issuing authority" section of the personal data page.


text: Since the issuing of the Hong Kong Special Administrative Region passport commenced on 1 July 1997 following the transfer of sovereignty of Hong Kong, the passport has undergone three different changes, each with security enhancements. In February 2007, the first ePassport was introduced. The design conforms with the document design recommendations of the International Civil Aviation Organization. The new ePassport featured in the 2008 Stockholm Challenge Event and was a finalist for the Stockholm Challenge Award in the Public Administration category. The Hong Kong SAR ePassport design was praised on account of the "multiple state-of-the-art technologies [which] are seamlessly integrated in the sophisticated Electronic Passport System (e-Passport System)".[20] The cover of the new biometric passport remains essentially the same as that of previous versions, with the addition of the biometric passport logo at the bottom.[21]


text: In 2006, the Immigration Department announced that Unihub Limited (a PCCW subsidiary company heading a consortium of suppliers, including Keycorp) had won the tender to provide the technology to produce biometric passports.[22] In February 2007, the first ePassport was introduced. The cover of the new biometric passport remains essentially the same as that of previous versions. The biometric passport symbol appears at the bottom under the word "PASSPORT". However, the design of the inner pages has changed substantially.


text: On the inner front cover of the passport, below the crest of the People's Republic of China and above a picture of the Great Wall of China are the following words:中華人民共和國外交部請各國軍政機關對持照人予以通行的便利和必要的協助


text: The Ministry of Foreign Affairs of the People's Republic of China requests all civil and military authorities of foreign countries to allow the bearer of this passport to pass freely and afford assistance in case of need.On the reverse of the polycarbonate identification page insert is a blue image with the Hong Kong Special Administrative Region emblem in the centre. At the top is a pattern of the words "中華人民共和國香港特別行政區 HONG KONG SPECIAL ADMINISTRATIVE REGION PEOPLE'S REPUBLIC OF CHINA". At the bottom is a picture of Victoria Harbour behind an outline of the Great Wall of China.


text: The identification page appears on a polycarbonate insert between the front cover and the first page. Using laser engraving technology, the holder's photograph is printed in black and white, with the holder's Hong Kong Permanent Identity Card number printed vertically on the right-hand side of the portrait photograph. The passport is also machine readable, designed for immigration control points equipped with passport scanners. Details which are printed include:[21]


text: The code "CHN" (China) is used for both issuing state and nationality. This is the same as PRC passport and Macau SAR passport. (During the British colonial era, a Hong Kong British Dependent Territories Citizen passport used "HKG" as the code of the issuing state and "GBD" as the nationality code.)


text: Instead of printing the holder's signature on the identification/observation pages, space is reserved on the last page of the passport below the emergency contact information for the holder to complete his/her signature.


text: Enveloping the top right hand corner of the portrait photograph, and the surname, given names and nationality data sections is a kinegram, consisting of an amalgamation of the Chinese and Hong Kong flags, and the letters "HK香港". In the middle of the identification page is a multiple laser image consisting of two circles: in the left hand circle is another image of the holder's portrait photograph, at the bottom of which is the passport number; in the right hand circle is the Hong Kong regional flag (the red and white reverse gradually as the viewing angle is changed).[21]


text: The Hong Kong permanent identity card number is printed at the bottom right hand side of the portrait photograph as a trapezium shape which gradually widens towards the bottom. The three waves at the bottom of the portrait photograph, as well as the straight line separating the machine readable zone from the rest of the data page and the vertical straight line of the right hand column of Tsing Ma Bridge, contains micro-lettering of the holder's English name, Hong Kong permanent identity card number and date of birth.[21]


text: The background of the identification page changes under ultraviolet light, when a scene of the Tsing Ma Bridge with nighttime fireworks becomes visible. The identification page also contains an engraving of a bauhinia, but with certain lines replaced by microlettering consisting of "HKSAR".[21]


text: All the inner pages have seasonal flowers at the side, and different "華" characters in the centre (in English this means "Chinese"). As well as being printed in red at the bottom of each page, the passport number is perforated through the top section of all the odd-numbered pages. At the bottom of each page is a gold outline of the Great Wall of China. The seasonal flower is printed across the middle of even-numbered and odd-numbered pages. When two pages are rolled up such that they meet each other, the seasonal flower on the right margin of odd-numbered page matches up with the flower on the left margin of the even-numbered page (e.g. pages 11 and 14), forming a complete bunch of flowers.


text: The observations page, located on page 1, contains a photograph of the holder. If the passport is issued through a Chinese foreign mission, the embassy/consulate will make an endorsement in the observations stating so.


text: The explanatory notes on the passport are placed on the second last page of the passport, and read as follows-


text: The last page of the passport has a section to be filled in by the holder with contact information in the event of an emergency, as well as a space for the holder to complete his/her signature.


text: The explanation from back cover for the chip is as follows:本護照含敏感的電子部件，為保持護照的最佳效能，請勿彎曲護照或在本頁打孔；切勿讓本護照接觸高低溫或受潮。


text: This passport contains sensitive electronics. For the best performance please do not bend, perforate this page or expose this passport to extreme temperatures or excess moisture.


text: In comparison with the British National (Overseas) passport, the Hong Kong SAR passport's application fees are lower. When applying in Hong Kong, a British National (Overseas) passport costs £83 (32 pages), and £53 (child) from April 2014. In comparison with other Chinese passports, when applying from Hong Kong, the People's Republic of China passport costs HK$250, whilst the Macao SAR passport costs MOP$370/HK$359.


text: Hong Kong permanent residents without Chinese citizenship cannot be issued HKSAR passports and must obtain passports from their country of origin, or they may obtain a Hong Kong Document of Identity for Visa Purposes if they are stateless.


text: Chinese citizens residing Hong Kong who are not yet Hong Kong permanent residents are not eligible for this passport but may also obtain Hong Kong Document of Identity in lieu of HKSAR passports.


text: The Ministry of Public Security does not allow Hong Kong permanent residents to travel to the mainland with SAR passports, since both mainland and Hong Kong authorities have agreed that using passport is 'unnecessary and inappropriate' for 'domestic' travel. Instead, those who are eligible for a Hong Kong SAR passport are also eligible to apply for a Home Return Permit via the Bureau of Exit and Entry Administration of the Ministry of Public Security (represented in Hong Kong by the China Travel Service). The possession of a Hong Kong SAR passport does not guarantee the issuing of a Home Return Permit; several pro-democracy advocates, for example, have been refused Home Return Permits or had their permits confiscated.


text: Hong Kong residents who do not have a Home Return Permit or who want to travel to the mainland from a third country must obtain a Chinese Travel Document prior to travel.


text: Regardless of their citizenship status, Hong Kong permanent residents do not need passports to travel to Macau. However, those residents must bring their Hong Kong permanent identity cards which grant a one-year visa-free entry.


text: When Hong Kong residents travel abroad via Macau, such residents can use their HKSAR passports to enter Macau and stay 7 days visa-free.


text: Hong Kong SAR passport holders who have either visited Taiwan previously or who were born in Hong Kong or Macau are able to obtain a 30-day entry permit online at the website of the National Immigration Agency which can be used for a single entry to Taiwan within three months of the application date. Once the permit has been granted online, the applicant must print it out to be presented at the border checkpoint with a Hong Kong SAR passport with at least 6 months' validity and a return flight/ferry ticket.


text: Hong Kong SAR passport holders can also obtain a 30-day entry permit upon arrival in Taiwan at the border checkpoint on presentation of their Hong Kong Permanent Identity Card as well as their Hong Kong SAR or British National (Overseas) passport, as long as they were born in Hong Kong. A fee of NT$300 is incurred for each application.


text: Alternatively, they can apply for an entry permit in advance through Taipei Economic and Cultural Office in Hong Kong at a cost of HK$75, which is valid for 3 months from the date of issuance, permitting the holder to enter Taiwan twice, each time for a maximum stay of 30 days.


text: According to the Hong Kong Immigration Department, as of 28 March 2018, 163 countries and territories grant Hong Kong SAR passport holders either visa-free or visa-on-arrival access (Note: this figure excludes countries and territories not officially recognised by the People's Republic of China, e.g. Kosovo and Taiwan), including all member states of the European Union, Brazil, Canada, Chile, Japan, Malaysia, New Zealand, Russia, Singapore, South Africa and South Korea. According to the Henley Passport Index, in 2019 the Hong Kong SAR passport was ranked as the 19th most powerful passport worldwide, tied with Bulgaria; in contrast, the Macau SAR passport was ranked 36th, while the PRC passport was ranked 74th.


text: With regards to Schengen Agreement signatory states, Hong Kong SAR passport holders are also permitted to take up a paid activity (e.g. work) visa-free for a maximum of 90 days within a 180-day period in Belgium, Denmark, Iceland, Lithuania, Luxembourg, the Netherlands, Norway, Slovenia and Sweden. In Switzerland, another Schengen signatory state, Hong Kong SAR passport holders are able to exercise a "gainful occupation" for a maximum of 8 days during their 90 days visa-exempt stay without the need to apply for a special work visa. However, this 8-day visa exemption excludes gainful occupation in the primary or secondary construction industry, civil engineering, catering and hotel services, industrial and private cleaning industry, surveillance and security services and sex industry. Alternatively, if in possession of a long term residence permit issued by any other Schengen member state, the Hong Kong SAR passport holder can exercise a gainful occupation for up to 3 months visa-free in Switzerland (without the industry-specific restrictions listed in the 8-day visa exemption).


text: As Chinese citizens, those travelling on Hong Kong SAR passports are entitled to the consular protection offered by the People's Republic of China government while overseas. However, it is not uncommon for PRC authorities overseas to offer consular assistance to PRC citizens of Hong Kong origin travelling on their British National (Overseas) passports, as their British nationality is not recognised by the Chinese government. See also British consular protection enjoyed by BN(O) passport holders outside the PRC and the UK.


text: Hong Kong SAR passport holders are also able to enjoy travel convenience under some bilateral agreements concluded between the PRC and other countries (on PRC passports in general). For example, holders of PRC passport and that of HKSAR passport are exempt from the fee for Nepalese tourist visas.


text: On 10 April 2013, the Prime Minister of Australia, Julia Gillard, announced that, starting from 2015, holders of Hong Kong SAR e-passports would be able to use SmartGates in Australia on a trial basis. The trial period started in September 2015. Since June 2016, Hong Kong e-passport holders are eligible to use smartgates in Australia.


text: In some cases, Hong Kong SAR passport holders are subject to visa requirements to countries whose nationals can enter Hong Kong visa-free. For example, American and Indian nationals can enter Hong Kong visa-free for a maximum period of 90 and 14 days respectively, though Hong Kong SAR passport holders are required to apply for a visa for any visit to the United States or India. Other countries such as Paraguay and Costa Rica also require visas for any visits, despite nationals from these countries entering Hong Kong visa free.


text: Also, Hong Kong SAR passport holders may be given less favourable visa-free conditions by certain countries, compared to the conditions offered by Hong Kong to those countries' nationals


text: Conversely, in some situations, Hong Kong SAR passport holders enjoy better visa waiver conditions to countries whose nationals are subject to stricter conditions entering Hong Kong. Hong Kong SAR passport holders enjoy a visa-free stay of up to 90 days to Bosnia and Herzegovina, Macedonia and Rwanda, although nationals of these countries are only granted a maximum visa-free stay of 14 days in Hong Kong.


text: In some cases, Hong Kong SAR passport holders are offered visa-free access to countries whose nationals are unable to travel to Hong Kong visa-free for any length of time. An example is Nicaragua, to which Hong Kong SAR passport holders can travel visa-free for a maximum period of 90 days. However, Nicaraguans must apply for a visa to travel to Hong Kong.


text: The Hong Kong Immigration Department cites the number of countries and territories offering visa-free access for Hong Kong SAR passport holders as 158 (this figure excludes countries and territories not officially recognised by the People's Republic of China, e.g. Kosovo and Taiwan). The British Consulate-General in Hong Kong states 119 as the number of countries and territories providing visa-free access to British National (Overseas) passport holders.


text: Hong Kong residents staying in the United Kingdom for 6 months or more and entering on a British National (Overseas) passport are exempt from having to register with the police, whilst entry on a Hong Kong SAR passport does not exempt them from this administrative procedure, with a police registration fee of £34 payable. In this sense, Hong Kong SAR passports are treated in the same way as ordinary Chinese passports. For travel to Dominica, Grenada and Morocco, entry on a British National (Overseas) passport permits a longer visa-free stay than on a HKSAR passport – 6 months compared to 21 days, 6 months compared to 3 months, and 3 months compared to 30 days respectively. Whilst entry on a HKSAR passport to Nauru requires a visa to be obtained in advance, a BN(O) passport holder can obtain a 30-day visa on arrival free of charge.


text: However, Hong Kong SAR passport holders enjoy better visa-free access to Australia than British National (Overseas) passports. Whilst both passports are eligible for the Electronic Travel Authority scheme, BN(O) passport holders can only apply for an ETA in person at an Australian visa office or through a travel agent/airline, whilst Hong Kong SAR passport holders can apply online at the ETA official website. Entry to Indonesia on a HKSAR passport permits a visa-free stay of 30 days whilst on a BN(O) passport a 30-day visa must be purchased on arrival at a cost of US$25. Similarly, HKSAR passport holders are eligible to obtain a visa on arrival in Lebanon and the United Arab Emirates, whilst BN(O) passport holders are ineligible.


text: Due to the international status of Hong Kong and British National (Overseas), both HKSAR passports and BN(O) passports are ineligible for Visa Waiver Program of the United States, and required to obtain a visa prior to travelling to the United States. However, HKSAR passport holders may travel to Guam and Northern Mariana Islands visa-free for 45 days.


text: In comparison with other Chinese passports, the Hong Kong SAR passport provides considerably more visa-free access than the ordinary People's Republic of China passport, the Macao Special Administrative Region passport, and the Republic of China (Taiwan) passport.


text: As a result of bilateral working holiday visa agreements made between the Government of Hong Kong and a number of other countries, Hong Kong SAR passport holders aged between 18 and 30 are eligible to apply for working holiday visas to Australia, Canada, France, Germany, Ireland, Japan, New Zealand and South Korea. These visas allow their holders to spend a maximum of 12 months in the foreign country with the primary purpose of travelling, but also permitting supplementary short-term employment (and for some countries (e.g. South Korea), short-term study may in addition be allowed). On the basis of reciprocity, Australian, Canadian, French, German, Irish, Japanese, New Zealand and South Korean nationals are also able to apply for working holiday visas in Hong Kong under similar conditions.


text: HKSAR passport holders have been eligible for UK working holiday visas, subject to Certificate of Sponsorship and annual maximum of 1000 placements since January 2014. However, holders of a British National (Overseas) passport are not subject to any quotas nor Certificate of Sponsorship under the same Scheme and are able to work or study in the UK for 5 years as holders are granted limited leave to remain.


text: Lai Changxing, the suspect of a large smuggling and corruption scandal in Mainland China, used a HKSAR passport to enter Canada as a tourist in 1999. His HKSAR passport and Hong Kong permanent residency were revoked by the Hong Kong Government in 2002 on the grounds that he had obtained the residency by dishonest means.


text: On 16 April 2008, the Court of First Instance of the High Court of the Hong Kong Special Administrative Region decided in open court to publicize the case of "Aziz Akbar Butt v Director of Immigration" (HCAL32-2007). Aziz Akbar Butt, born in Pakistan and a Hong Kong permanent resident who became a naturalised Chinese citizen of Hong Kong on 8 January 2007, argued that for HKSAR passport holders such as himself born outside the Mainland China, Hong Kong or Macao, it was not necessary for the Director of Immigration to label their "place of birth" as stated in the HKSAR passport to be the country/state of birth specifically, with the city or province of birth sufficing. He further claimed to have problems travelling to several countries because his HKSAR passport stated "Pakistan" (i.e. his country of birth) instead of "Karachi" or "Sindh" (i.e. his specific place of birth within Pakistan) as his "place of birth". The Director of Immigration asserted that it was in accordance with HKSAR law and ICAO standards that one's "country of birth" should be specified for holders of the HKSAR passport born outside the Mainland China, Hong Kong and Macao.


text: The Court of First Instance of the High Court decided that the Director of Immigration was wrong in using a policy to insert the country of birth as the "place of birth" in the applicant's passport in this instance, given a passport's nature as a document ensuring freedom of travel and the lack of a specific requirement within ICAO standards for machine-readable passports to state one's country of birth specifically. As a result of this court decision, the Director of Immigration cancelled the passport previously issued to Butt, and replaced it with a new passport at no cost, with his place of birth stated as "Sindh".


title: Cygnus (spacecraft)

text: Cygnus is an expendable American cargo spacecraft developed by Orbital Sciences Corporation and now manufactured and launched by Northrop Grumman Space Systems as part of NASA's Commercial Resupply Services (CRS) program. It is launched by Northrop Grumman's Antares rocket or ULA's Atlas V and is designed to transport supplies to the International Space Station (ISS) following the retirement of the American Space Shuttle. Since August 2000, ISS resupply missions have been regularly flown by the Russian Progress spacecraft, as well as by the European Automated Transfer Vehicle, and the Japanese H-II Transfer Vehicle. With the Cygnus spacecraft and the SpaceX Dragon, NASA seeks to increase its partnerships with domestic commercial aviation and aeronautics industry.


title: Cygnus (spacecraft)

text: With Rocketplane Kistler unable to meet funding obligations for its K-1 launch vehicle under the terms of the COTS agreement, NASA decided on 18 October 2007 to terminate its contract with Rocketplane Kistler and re-award its contract after a competition. On 19 February 2008, NASA announced that it had chosen Orbital Sciences as the new winner. On 23 December 2008, NASA awarded Orbital Sciences a $1.9 billion contract under the Commercial Resupply Services (CRS) program. Under this contract, Orbital Sciences agreed to deliver up to 20 tons of cargo to the ISS through 2016 in eight Cygnus spacecraft flights.


title: Cygnus (spacecraft)

text: By April 2010, Orbital had displayed a full-scale model of the Cygnus cargo delivery spacecraft at the National Space Symposium (NSS) in Colorado Springs, CO.


title: Cygnus (spacecraft)

text: Launched on an Antares (renamed from Taurus II) medium-class launch vehicle or Atlas V, the first Cygnus flight was originally planned to occur in December 2010.· The Cygnus demonstration mission was successfully launched on 18 September 2013. On 12 January 2014, the first scheduled Cygnus resupply mission arrived at the space station; the capsule carried Christmas presents and fresh fruit for the astronauts. Its arrival was delayed, first by the need to repair the station, and then by frigid weather at the launch site and solar flares that forced postponements.·


title: Cygnus (spacecraft)

text: With the December 2015 launch of Orb CRS-4 on Atlas V, the enhanced version of Cygnus made its debut. While it was planned from the beginning to fly on the fifth mission, the Orb CRS-3 failure and subsequent move to Atlas V meant a delay. However, lessons learned on packing and the extra capabilities of the Atlas allowed payload to be increased to .


title: Cygnus (spacecraft)

text: The Cygnus spacecraft consists of two basic components: the Pressurized Cargo Module (PCM) and the Service Module (SM). The PCM is manufactured by Thales Alenia Space in Turin, (Italy). The initial PCMs have an empty mass of 1,500 kg and a volume of 18 m·. The service module is built by Orbital ATK and is based on their GEOStar and LEOStar spacecraft buses as well as components from the development of the Dawn spacecraft. It has a gross mass of 1,800 kg with propulsion provided by thrusters using the hypergolic propellants hydrazine and nitrogen tetroxide (the propellant mass is 800 kg ). The service module is capable of producing up to 4 kW of electrical power via two gallium arsenide solar arrays. On 12 November 2009, Dutch Space announced it will provide the solar arrays for the initial Cygnus spacecraft.


title: Cygnus (spacecraft)

text: The fourth and all subsequent Cygnus spacecraft are planned to be of the "Enhanced" variant, as the standard variant has been retired. These will use a stretched 1,800-kilogram (empty weight) PCM which increases the interior volume to 27 m and the service module will use Orbital ATK Ultraflex solar arrays which will provide the same amount of power as the previous solar arrays but at a lower mass.· A new upper stage built by Orbital ATK, the Castor 30XL, will be used in conjunction with the enhanced Cygnus; because of the more powerful upper stage and the lighter solar arrays, the payload that Cygnus can deliver to the ISS will be increased by 700 kg.


title: Cygnus (spacecraft)

text: During nominal CRS missions, Cygnus maneuvers close to the International Space Station, where the Canadarm2 robotic arm grapples the spacecraft and berths it to a Common Berthing Mechanism on the Harmony module in a similar fashion to the Japanese H-II Transfer Vehicle and the retired SpaceX Dragon, but not the other active American CRS Dragon 2 vehicle, which docks autonomously. For typical missions, Cygnus is planned to remain berthed for about 30 days.· Unlike Dragon 2 and the earlier Dragon, Cygnus does not provide cargo return capability. However, it can be loaded with obsolete equipment and trash for destructive reentry similar to the Russian Progress vehicles.


title: Cygnus (spacecraft)

text: A formerly planned variant of Cygnus would have replaced the PCM with the Unpressurized Cargo Module (UCM), based on NASA's ExPRESS Logistics Carrier, and would have been used to transport unpressurized cargo, such as ISS Orbital Replacement Units.· Another proposed variant would have replaced the PCM with the Return Cargo Module (RCM), which would have allowed Cygnus to return cargo to Earth.·


title: Cygnus (spacecraft)

text: In August 2019, NASA decided to sole source its design for the Minimal Habitation Module (now known as the Habitation and Logistics Outpost, or HALO) of the Lunar Gateway to Northrop Grumman Innovation Systems, which offered a minimalist 6.1-meter (20 feet) by 3-meter (9.8 feet) design based directly on the Enhanced Cygnus, as well as a larger 7-meter (22.9 feet) by 4.4-meter (14.4 feet) design also based on the Cygnus, to the outside of which radial docking ports, body-mounted radiators (BMRs), batteries and communications antennae will be added. Northrop Grumman Innovation Systems opted to build the minimalist design, which offered the advantage of component compatibility and expedited testing of life support systems on existing Cygnus spacecraft. On 5 June 2020, NASA awarded Northrop Grumman Innovation Systems a $187 million contract to complete the preliminary design of HALO. NASA will sign a separate contract with Northrop for the fabrication of the HALO, and for integration with the Power and Propulsion Element (PPE), being built by Maxar.


title: Cygnus (spacecraft)

text: "List includes only missions that have flown and five planned missions. one mission is currently planned to be launched from Mid-Atlantic Regional Spaceport Launch Pad 0A on the one remaining Antares 230+ rocket, three are to be launched on the Falcon 9 rocket from Cape Canaveral SLC-40, and one from Wallops on an Antares 330".


title: Cygnus (spacecraft)

text: In March 2022, NASA ordered six additional flights, Cygnus NG-20 to NG-25, to resupply the ISS through 2026.


title: Winnetou

text: Winnetou is a fictional Native American hero of several novels written in German by Karl May (1842–1912), one of the best-selling German writers of all time with about 200 million copies worldwide, including the "Winnetou" trilogy. The character made his debut in the novel "Old Firehand" (1875).


title: Winnetou

text: According to Karl May's story, first-person narrator Old Shatterhand encounters the Apache Winnetou, and after initial dramatic events, a true friendship arises between them; on many occasions, they give proof of great fighting skill, but also of compassion for other human beings. It portrays a belief in an innate "goodness" of mankind, albeit constantly threatened by ill-intentioned enemies.


title: Winnetou

text: Nondogmatic Christian feelings and values play an important role, and May's heroes are often described as German Americans.


title: Winnetou

text: Winnetou became the chief of the tribe of the Mescalero Apaches (and of the Apaches in general, with the Navajo included) after his father Intschu-tschuna and his sister Nscho-tschi were slain by the white bandit Santer. He rode a horse called Iltschi ("Wind") and had a famous rifle called Silberbüchse (The Silver Gun, a double-barrelled rifle whose stock and butt were decorated with silver studs). Old Shatterhand became the blood brother of Winnetou and rode the brother of Iltschi, called Hatatitla (Lightning). In a number of adaptations, Winnetou referred to himself in the third person.


title: Winnetou

text: Karl May's "Winnetou" novels symbolize, to some extent, a romantic desire for a simpler life in close contact with nature. The popularity of the series is due in large part to the ability of the stories to tantalize fantasies many Europeans had and have for this more untamed environment. The sequel has become the origin of festivals, and the first regular Karl-May-Spiele were staged 1938 till 1941 in Rathen, Saxony. East Germany restarted those open-air theater plays in 1984. In West Germany, the Karl-May-Festspiele in Bad Segeberg were started as early as 1950 and then expanded to further places like Lennestadt-Elspe in honor of Karl May's Apache hero, Winnetou.


title: Winnetou

text: The stories were so popular that Nazi Germany did not ban them despite the heroic treatment of people of color; instead, the argument was made that the stories demonstrated the fall of the American aboriginal peoples was caused by a lack of racial consciousness.


title: Winnetou

text: May's heroes drew on archetypes of Germanic culture and had little to do with actual Native American cultures. "Winnetou is noble because he combines the highest aspects of otherwise 'decadent' Indian cultures with the natural adoption of the romantic and Christian traits of Karl May's own vision of German civilization. As he is dying, the Apache Winnetou asks some settlers to sing an Ave Maria for him, and his death is sanctified by his quiet conversion to Christianity."


title: Winnetou

text: In the 1960s, French nobleman and actor Pierre Brice played Winnetou in several movies coproduced by German–Yugoslav producers. At first, Brice was not very excited about the role beside Lex Barker, but his very reduced text and stage play brought Winnetou to real life in Germany. Brice not only became a star in Germany, but a significant contributor to German–French reconciliation, as well.


title: Winnetou

text: In the 1950s Croatian comic book artist Walter Neugebauer finished his 1930s comic book adaptation of Karl May's stories. Serbian artist Aleksandar Hecl also drew one. Belgian comics artist Willy Vandersteen created a whole series of comics based on May's stories, simply titled "Karl May" (1962–1977). More notable Winnetou comic strip adaptations were done by Spanish writer and artist Juan Arranz for the Dutch comic strip weekly Sjors between 1963 and 1970. Most of these stories were also published in comic strip albums and were syndicated to other European countries. Two Hungarian authors named Horváth Tibor and Zórád Ernö collaborated on yet another comic version in 1957. In Germany, Helmut Nickel also adapted the source material, published bi-weekly from 1962 to 1966.


title: Winnetou

text: In all these movies, Winnetou was played by French actor Pierre Brice, who was usually teamed with Lex Barker as Old Shatterhand. The music for all Winnetou movies (with its famous title melody played on the harmonica by Johnny Müller) was composed by German composer Martin Böttcher, except "Old Shatterhand", composed by Italian composer Riz Ortolani, and "Winnetou und sein Freund Old Firehand", composed by German composer Peter Thomas. The films were so successful in Germany, their budgets could be increased almost every time. Principal shooting usually took place in Paklenica karst river canyon national park, Croatia. The early films preceded the Spaghetti Western.


title: Winnetou

text: All of the Winnetou movies are available on VHS tape in PAL format – some also dubbed in English under the above-mentioned English titles. "Winnetou I–III", "Der Schatz im Silbersee", "Old Shatterhand", and "Winnetou und Shatterhand im Tal der Toten" are also available on DVD (region-code 2), but all in German only. In 2004–2005, the missing movies were also to reappear on DVD. In 2016 a bluray box with all Winnetou movies was released, they also were made available as part of the Karl May bluray box.


title: Winnetou

text: In April 2009, DVDs of the cleared remastered movies were issued in the Czech Republic, selling as an add-on to the Metro newspaper for 50 Czech crowns. All movies are dubbed into Czech and German, with subtitles in Czech and Slovak.


title: Winnetou

text: In 2016, Winnetou (2016 film) was published, a modernized version of the classic movies in three parts directed by Philipp Stölzl. starring Nik Xhelilaj as Winnetou.


title: Geneva, New York

text: Geneva is a city in Ontario and Seneca counties in the U.S. state of New York. It is at the northern end of Seneca Lake; all land portions of the city are within Ontario County; the water portions are in Seneca County. The population was 13,261 at the 2010 census. The city is supposedly named after the city and canton of Geneva in Switzerland. The main settlement of the Seneca was spelled Zoneshio by early white settlers, and was described as being two miles north of Seneca Lake.


title: Geneva, New York

text: The city borders and was once (the portion in Ontario County) part of the Town of Geneva. The city identifies as the "Lake Trout Capital of the World."


title: Geneva, New York

text: The area was long occupied by the Seneca tribe, which had established a major village of "Kanadaseaga" here by 1687. The British helped fortify the village against the French of Canada during the Seven Years' War (locally known as the French and Indian War); later they added defensive fortifications against the Americans during the Revolutionary War. During the latter warfare, the punitive Sullivan Expedition of 1779 mounted by rebel forces destroyed many of the dwellings, as well as the winter stores of the people, and they abandoned the ruins. Following the war and the forced removal of the Seneca from their native land, European-Americans settled here about 1793. They developed a town encouraged by the Pulteney Association, which owned the land and was selling plots.


title: Geneva, New York

text: At the end of the Revolutionary War, Lt. Col. Seth Reed (né Read), who had fought at Bunker Hill, was one of many pioneers who moved from Massachusetts into Ontario County. By trade with the Seneca, he bought a tract of land eighteen miles in extent. (This was illegal, as only the US government was authorized to make land deals with the Native Americans.) This occurred in 1787, while his wife Hannah stayed in Uxbridge, Massachusetts with their family. "Seth Read moved his wife Hannah and their family to Geneva, Ontario County, New York in the winter of 1790".


title: Geneva, New York

text: The settlement at Geneva was not yet permanent; the European Americans continued to harass the Seneca on the frontier. In 1795 Read and his family removed to Erie, Pennsylvania, where they became the earliest European-American settlers.


title: Geneva, New York

text: The "Village of Geneva" was incorporated in 1806, formally separating it from the surrounding area of Geneva Town. Later the village became a city through a 1871 charter.


title: Geneva, New York

text: In the 1830s, a government surveyor named John Brink named both Geneva Lake and Lake Geneva in Wisconsin after Geneva, New York. Geneva, Nebraska, founded in 1871, is considered to have been named after the one in New York, rather than directly for the Swiss city.


title: Geneva, New York

text: The town is at the two-mile wide northern outlet of Seneca Lake, a lake that spans 34 miles south to Watkins Glen. Geneva is in the Finger Lakes region, the largest wine-producing area in New York State. The Cayuga-Seneca Canal is part of the watershed of Keuka Lake. It flows north through Geneva, connecting to the Erie Canal, which was completed in 1825, giving access for the region to the Great Lakes and midwestern markets for their produce, as well as to buy natural resource commodities.


title: Geneva, New York

text: According to the United States Census Bureau, the city has a total area of 5.8 square miles (15.2 km). 4.3 square miles (11.0 km) of it is land and 1.6 square miles (4.1 km) of it (27.18%) is water.


title: Geneva, New York

text: Geneva is connected via the east–west US 20, concurrent with NY 5. NY 14 is a north–south highway through the city. It is approximately equidistant from Rochester and Syracuse, each being about 45 miles away.


title: Geneva, New York

text: Geneva uses a mayor-council form of government. The mayor is elected at large. The council consists of eight members. Six are elected from one of six wards. The other two are elected at large. Former Ward 3 councilor Steve Valentino is the Mayor of the City of Geneva and Amie Hendrix serves as the City Manager. The current mayoral and council term runs from January 1, 2020, through December 31, 2024.


title: Geneva, New York

text: The Geneva City School District operates the local public primary and secondary schools. The district has two elementary schools, North Street School (3rd-5th) and West Street School (K-2). The district's secondary schools are Geneva Middle School and Geneva High School.


title: Geneva, New York

text: As of the census of 2000, there were 13,617 people, 5,014 households, and 2,933 families residing in the city. The population density was 3,199.5 inhabitants per square mile (1,234.2/km). There were 5,564 housing units at an average density of 1,307.4 per square mile (504.3/km). The racial makeup of the city was 81.52% White, 10.22% African American, 0.25% Native American, 1.23% Asian, 0.05% Pacific Islander, 3.39% from other races, and 3.34% from two or more races. Hispanic or Latino of any race were 8.50% of the population.


title: Geneva, New York

text: There were 5,014 households, out of which 29.5% had children under the age of 18 living with them, 38.6% were married couples living together, 15.9% had a female householder with no husband present, and 41.5% were non-families. 34.1% of all households were made up of individuals, and 14.8% had someone living alone who was 65 years of age or older. The average household size was 2.35 and the average family size was 3.03.


title: Geneva, New York

text: In the city, the population was spread out, with 23.2% under the age of 18, 18.9% from 18 to 24, 24.3% from 25 to 44, 18.1% from 45 to 64, and 15.5% who were 65 years of age or older. The median age was 32 years. For every 100 females, there were 87.4 males. For every 100 females age 18 and over, there were 84.5 males.


title: Geneva, New York

text: The median income for a household in the city was $31,600, and the median income for a family was $41,224. Males had a median income of $31,315 versus $23,054 for females. The per capita income for the city was $15,609. About 13.7% of families and 17.5% of the population were below the poverty line, including 27.2% of those under age 18 and 7.8% of those age 65 or over.


title: Geneva, New York

text: One of the major industries in and around Geneva is winemaking. The area is becoming increasingly popular for agritourism: there are over 100 wineries in the Finger Lakes Region, and the Seneca Lake wine trail provides easy access to many of these from Geneva. As Geneva grows as a tourist destination, so does the number of rooms available. Along with this growth, FLX Table opened in 2016 under the vision of a master sommelier, soon after winning the "USA Today" recognition of best new restaurant in the country.


title: Geneva, New York

text: In 2015, the National Civic League chose Geneva as one of ten cities from across the country to receive its annual All-America City Award. In June 2017, it was announced Geneva would receive $10 million from New York (state) as part of a downtown revitalization initiative as well as an additional $5 million for a welcome center.


title: Psychedelic therapy

text: Psychedelic therapy (or psychedelic-assisted therapy) refers to the proposed use of psychedelic drugs, such as psilocybin, MDMA, LSD, and ayahuasca, to treat mental disorders. As of 2021, psychedelic drugs are controlled substances in most countries and psychedelic therapy is not legally available outside clinical trials, with some exceptions.


title: Psychedelic therapy

text: The procedure for psychedelic therapy differs from that of therapies using conventional psychiatric medications. While conventional medications are usually taken without supervision at least once daily, in contemporary psychedelic therapy the drug is administered in a single session (or sometimes up to three sessions) in a therapeutic context. The therapeutic team prepares the patient for the experience beforehand and helps them integrate insights from the drug experience afterwards. After ingesting the drug, the patient normally wears eyeshades and listens to music to facilitate focus on the psychedelic experience, with the therapeutic team interrupting only to provide reassurance if adverse effects such as anxiety or disorientation arise.


title: Psychedelic therapy

text: As of 2022, the body of high-quality evidence on psychedelic therapy remains relatively small and more, larger studies are needed to reliably show the effectiveness and safety of psychedelic therapy's various forms and applications. On the basis of favorable early results, ongoing research is examining proposed psychedelic therapies for conditions including major depressive disorder, anxiety and depression linked to terminal illness, and post-traumatic stress disorder. The United States Food and Drug Administration has granted "breakthrough therapy" status, which expedites the assessment of promising drug therapies for potential approval, to psychedelic therapies using psilocybin (for treatment-resistant depression and major depressive disorder) and MDMA (for post-traumatic stress disorder). Breakthrough status is given to treatments that are either used alone or with other drugs for the treatment of a serious disease or condition and that show promise of improving existing therapies.


title: Psychedelic therapy

text: Humans have long consumed psychedelic substances derived from cacti, seeds, bark, and roots of various plants and fungi. Since ancient times, shamans and medicine men have used psychedelics as a way to gain access to the spirit world. Though western culture usually views the practice of shamans and medicine men as predominantly spiritual in nature, elements of psychotherapeutic practice can be read into the entheogenic or shamanic rituals of many cultures.


title: Psychedelic therapy

text: Shortly after Albert Hofmann discovered the psychoactive properties of LSD in 1943, Sandoz Laboratories began widespread distribution of LSD to researchers in 1949. Throughout the 1950s and 1960s, scientists in several countries conducted extensive research into experimental chemotherapeutic, and psychotherapeutic uses of psychedelic drugs. In addition to spawning six international conferences and the release of dozens of books, over 1,000 peer-reviewed clinical papers detailing the use of psychedelic compounds (administered to approximately 40,000 patients) were published by the mid-1960s. Proponents believed that psychedelic drugs facilitated psychoanalytic processes, making them particularly useful for patients with conditions such as alcoholism that are otherwise difficult to treat. However, many of these trials did not meet the methodological standards that are required today.


title: Psychedelic therapy

text: Researchers like Timothy Leary felt psychedelics could alter the fundamental personality structure or subjective value-system of an individual to great potential benefit. Beginning in 1961, he conducted experiments with prison inmates in an attempt to reduce recidivism with short, intense psychotherapy sessions. Participants were administered psilocybin during these sessions weeks apart with regular group therapy sessions in between. Psychedelic therapy was also applied in a number of other specific patient populations including alcoholism, children with autism, and persons with terminal illness.


title: Psychedelic therapy

text: Throughout the 1960s, concerns raised about the proliferation of unauthorized use of psychedelic drugs by the general public (and, most notably, the counterculture) resulted in the imposition of increasingly severe restrictions on medical and psychiatric research conducted with psychedelic substances. Many countries either banned LSD outright or made it extremely scarce, and, bowing to governmental concerns, Sandoz halted production of LSD in 1965. During a congressional hearing in 1966, Senator Robert F. Kennedy questioned the shift of opinion, stating, "Perhaps to some extent we have lost sight of the fact that (LSD) can be very, very helpful in our society if used properly." In 1968, Dahlberg and colleagues published an article in the "American Journal of Psychiatry" detailing various forces that had successfully discredited legitimate LSD research. The essay argues that individuals in government and the pharmaceutical industry sabotaged the psychedelic research community by canceling ongoing studies and analysis while labeling genuine scientists as charlatans.


title: Psychedelic therapy

text: Studies on medicinal applications of psychedelics ceased entirely in the United States when the Controlled Substances Act was passed in 1970. LSD and many other psychedelics were placed into the most restrictive "Schedule I" category by the United States Drug Enforcement Administration. Schedule I compounds are claimed to possess "significant potential for abuse and dependence" and have "no recognized medicinal value", effectively rendering them illegal to use in the United States for all purposes. Despite objections from the scientific community, authorized research into therapeutic applications of psychedelic drugs had been discontinued worldwide by the 1980s.


title: Psychedelic therapy

text: Despite broad prohibition, unofficial psychedelic research and therapeutic sessions continued nevertheless in the following decades. Some therapists exploited windows of opportunity preceding scheduling of particular psychedelic drugs. Informal psychedelic therapy was conducted clandestinely in underground networks consisting of sessions carried out both by licensed therapists and autodidacts within the community. Due to the largely illegal nature of psychedelic therapy in this period, little information is available concerning the methods that were used. Individuals having published information between 1980 and 2000 regarding psychedelic psychotherapy include George Greer, Ann and Alexander Shulgin ("PiHKAL" and "TiHKAL"), Myron Stolaroff ("The Secret Chief", regarding the underground therapy done by Leo Zeff), and Athanasios Kafkalides.


title: Psychedelic therapy

text: In the early 2000s, a renewal of interest in the psychiatric use of psychedelics contributed to an increase in clinical research centering on the psychopharmacological effects of these drugs and their subsequent applications. Advances in science and technology allowed researchers to collect and interpret extensive data from animal studies, and the advent of new technologies such as PET and MRI scanning made it possible to examine the sites of action of hallucinogens in the brain. Furthermore, retrospective studies involving users of illicit drugs as voluntary subjects were conducted, allowing data to be collected on how psychedelics affect the human brain while simultaneously sidestepping bureaucratic difficulties associated with providing illegal substances to subjects. The new century also ushered in a broader change in political attitude towards psychedelic medicine—specifically within the Food and Drug Administration. Curtis Wright, then deputy director of the FDA Division of Anesthetic, Critical Care and Addiction Drugs explained a motivation for this change: "the agency was challenged legally in a number of cases and also underwent a process of introspection, asking 'Is it proper to treat this class of drugs differently?'"


title: Psychedelic therapy

text: As of 2014, global treaties listing LSD and psilocybin as "Schedule I" controlled substances continues to inhibit a better understanding of these drugs. Much of the renewed clinical research has been conducted with psilocybin and MDMA in the United States with special permission and breakthrough therapy designations by the FDA, while other studies have investigated the mechanisms and effects of ayahuasca and LSD. MDMA-assisted psychotherapy is being actively researched by MAPS. Only six formal studies on the applications of LSD occurred between 1990 and 2017. No complications of LSD administration were observed.


title: Psychedelic therapy

text: As of 2021, many new centers for psychedelics research have been launched, including the Centre for Psychedelic Research at Imperial College London, the UC Berkeley Center for the Science of Psychedelics, the Center for Psychedelic and Consciousness Research at Johns Hopkins University, the Center for Psychedelic Research and Therapy at Dell Medical School at the University of Texas at Austin, the Center for Psychedelic Psychotherapy and Trauma Research at the Icahn School of Medicine at Mount Sinai, and the Psychae Institute in Melbourne.


title: Psychedelic therapy

text: Psychedelic substances which may have therapeutic uses include psilocybin (the main active compound found in magic mushrooms), LSD, and mescaline (the main active compound in the peyote cactus). Although the history behind these substances has hindered research into their potential medicinal value, scientists are now able to conduct studies and renew research that was halted in the 1970s. Some research has shown that these substances have helped people with such mental disorders as obsessive-compulsive disorder, post-traumatic stress disorder, alcoholism, depression, and cluster headaches. Some of the well known particular psychedelic substances that have been used to this day are: LSD, DMT, psilocybin, mescaline, 2C-B, 2C-I, 5-MeO-DMT, AMT, ibogaine and DOM. In general, however, the drugs remain poorly understood. Their effects are strongly dependent on the environment in which they are given and on the recipient's state of mind (set and setting).


title: Psychedelic therapy

text: Studies by Humphry Osmond, Betty Eisner, and others examined the possibility that psychedelic therapy could treat alcoholism (or, less commonly, other addictions). A 1998 review of the effectiveness of psychedelic therapy for treating alcoholism concluded that due to methodological difficulties in the research prior to that time, it was not possible to state whether it was effective. A 2012 meta-analysis found that "In a pooled analysis of six randomized controlled clinical trials, a single dose of LSD had a significant beneficial effect on alcohol misuse at the first reported follow-up assessment, which ranged from 1 to 12 months after discharge from each treatment program. This treatment effect from LSD on alcohol misuse was also seen at 2 to 3 months and at 6 months, but was not statistically significant at 12 months post-treatment. Among the three trials that reported total abstinence from alcohol use, there was also a significant beneficial effect of LSD at the first reported follow-up, which ranged from 1 to 3 months after discharge from each treatment program."


title: Psychedelic therapy

text: During the early 1950s and 1960s the National Institute of Mental Health sponsored the study of psychedelic drugs such as psilocybin and LSD to alleviate the debilitating anxiety and depression patients with terminal diagnoses may feel. While these early studies are hard to find, the resurgence of interest in psychedelic drugs to treat humans end of life mindset has led to some small studies in the 21st Century. The more recently published research strengthens the findings from the 1950s and 1960s showing the drug is extremely effective in reducing anxiety and depression in this patient population once carefully screened and has few adverse effects when administered in a psychotherapy setting and under medical supervision. The psychologists leading psychedelic drug therapy trials found that end of life patients often experience the emotional turmoil of dying more than the physical aspects. This mindset makes it difficult for patients to find meaning and enjoyment in life during their last few months or years. While all patients have completely different experiences on these mind altering drugs the research subjects interviewed all expressed they had, "heightened clarity and confidence about their personal values and priorities, and a renewed or enhanced recognition of intrinsic meaning and value of life." More recently, researchers have argued that psychedelic therapy is beneficial for these patients because it may specifically reduce their fear of dying.


title: Psychedelic therapy

text: As of 2016, Johns Hopkins University and New York University have conducted large randomized, placebo-controlled studies. These two studies are some of the first large controlled studies measuring the effects of psychedelic therapy on depression and anxiety in cancer patients. Across clinician-ratings and self-ratings, the psychedelic treatment produced statistically significant lowered anxiety and depression, with sustenance for at least 6 months. The studies monitored for adverse effects from the drugs but no serious adverse effects were observed. Both studies also attributed the efficacy in part to patients experiencing a "mystical experience". A mystical experience is a very personal introspective experience where some sort of unity or transcendence of time and space is described. More research is necessary to expand generalizability of the conclusions. Also, more research is necessary to understand the biological properties of a mystical experience.


title: Psychedelic therapy

text: The Multidisciplinary Association for Psychedelic Studies (MAPS) is conducting studies seeking to understand how MDMA could be helpful in the treatment of post-traumatic stress disorder. The Phase 2 trials of these studies, conducted in the U.S., Canada, and Israel, consisted of 107 participants who had chronic, treatment-resistant PTSD, and had had PTSD for an average of 17.8 years. Out of the 107 participants, 61% no longer qualified for PTSD after three sessions of MDMA-assisted psychotherapy two months after the treatment. At the 12-month follow-up session, 68% no longer had PTSD. Phase 2 trials conducted between 2004 and 2010 reported an overall remission rate of 66.2% and low rates of adverse effects for subjects with chronic PTSD. In 2017, MAPS and the FDA reached an agreement on the special protocol for phase 3 trails.


title: Psychedelic therapy

text: It is important to note that given the difficulties with appropriate blinding in trials of MDMA- and psychedelic-assisted psychotherapy the results are likely overestimated. Furthermore, there are no superiority or non-inferiority clinical trials comparing MDMA-assisted psychotherapy to already existent evidence-based treatments for PTSD, but given the effects reported in clinical trials of MDMA-assisted psychotherapy for PTSD there is no reason to believe that this treatment modality is more effective than existent trauma-focused psychological treatments.


title: Psychedelic therapy

text: In 2019, the FDA approved the use of esketamine for intranasal use for major depressive disorder (MDD), and treatment-resistant depression (TRD), in conjunction with an oral antidepressant.


title: Psychedelic therapy

text: Also in 2019, the FDA granted "breakthrough therapy" status to psilocybin for treatment-resistant depression and major depressive disorder in order to hasten the process for potential regulatory approval. The designation of "breakthrough therapy" fast-tracks the study of drugs where preliminary clinical evidence shows that they could be substantially more effective than therapies that are already available.


title: Psychedelic therapy

text: Studies on the clinical effects of ayahuasca have found significant antidepressant and anxiolytic effects, leading to calls for further research to overcome methodological limitations in the existing studies.


title: Psychedelic therapy

text: The main approach used in the contemporary resurgence of research, often simply called "psychedelic therapy", involves the use of moderate-to-high doses of psychedelic drugs. The psychedelic therapy method was initiated by Humphry Osmond and Abram Hoffer (with some influence from Al Hubbard) and replicated by Keith Ditman, and is more closely aligned to transpersonal psychology than to traditional psychoanalysis. Most recent research on psychedelic therapy has used psilocybin or ayahuasca.


title: Psychedelic therapy

text: Patients spend most of the acute period of the drug's activity lying down with eyeshades listening to music selected beforehand and exploring their inner experience. Dialogue with the therapists the drug session(s) but essential during the preparation session before and the integration session afterwards. The therapeutic team normally consists of a man and a woman, who are both present throughout the psychedelic experience. One aspect that occurs in most participants undergoing psychedelic therapy with moderate-to-high doses is transcendental, mystical, or peak experiences. Research has suggested that the strength of these experiences, together with discussion of them soon after in a therapeutic session, could be a major determinant of how great the longer-term effects on symptoms will be.


title: Psychedelic therapy

text: Some studies of psychedelic therapy have incorporated cognitive behavioral therapy (CBT) or motivational enhancement therapy (MET). Within a structured CBT intervention and a dose of psilocybin, patients are given the opportunity to experience cognitive and emotional states that are altered. With these psychedelic effects, cognitive reframing of detrimental schemas and self-identity can be modified positively. In a MET environment, patients are able to reflect on their own behaviors to make changes in problematic manners, such as alcohol use disorder. Additionally, it could potentially enhance motivation to change and decrease possible ambivalence about behavioral changes. Within psychedelic drug sessions, through a reevaluation of the concept of self and reconnecting with core beliefs and values, this can be achieved.


title: Psychedelic therapy

text: It is thought that there will eventually be 10,000 clinics for entactogen and psychedelic therapy established in the US. To meet this demand, a huge workforce of therapists is needed. There are many courses which train healthcare professionals however, price has proven to be the main barrier to entry. As such in 2022 a new trend emerged, open source psychedelic therapy which offers the free training of clinicians in psychedelic therapy Best Practice.


title: Psychedelic therapy

text: Psycholytic therapy involves the use of low-to-medium doses of psychedelic drugs, repeatedly at intervals of 1–2 weeks. The therapist is present during the peak of the experience to assist the patient in processing material that arises and to offer support. This general form of therapy was mostly used to treat patients with neurotic and psychosomatic disorders. The name psycholytic therapy was coined by Ronald A. Sandison, literally meaning "soul-dissolving", refers to the belief that the therapy can dissolve conflicts in the mind. Psycholytic therapy was historically an important approach to psychedelic psychotherapy in Europe, and was also practiced in the United States by some psychotherapists, including Betty Eisner. In the time since the 1970s, psycholytic therapy has not been a focus of research.


title: Psychedelic therapy

text: Psychedelic drugs are useful for exploring the subconscious because a conscious sliver of the adult ego usually remains active during the experience. Patients remain intellectually alert throughout the process and remember their experiences vividly afterward. In this highly introspective state, patients are actively aware of ego defenses such as projection, denial, and displacement as they react to themselves and their choices.


title: Psychedelic therapy

text: The ultimate goal of the therapy is to provide a safe, mutually compassionate context through which the profound and intense reliving of memories can be filtered through the principles of genuine psychotherapy. Aided by the deeply introspective state attained by the patient, the therapist assists him/her in developing a new life framework or personal philosophy that recognizes individual responsibility for change.


title: Psychedelic therapy

text: In Germany, designed a form of psycholytic therapy, which was developed officially but was also used by some socio-politically motivated underground therapists in the 1970s.


title: Psychedelic therapy

text: The Chilean therapist Claudio Naranjo developed a branch of psychedelic therapy that utilized drugs like MDA, MDMA, harmaline and ibogaine.


title: Psychedelic therapy

text: The term "anaclitic" (from the Ancient Greek "ἀνάκλιτος", "anaklitos" – "for reclining") refers to primitive, infantile needs and tendencies directed toward a pre-genital love object. Developed by two London psychoanalysts, Joyce Martin and Pauline McCririck, this form of treatment is similar to psycholytic approaches as it is based largely on a psychoanalytic interpretation of abreactions produced by the treatment, but it tends to focus on those experiences in which the patient re-encounters carnal feelings of emotional deprivation and frustration stemming from the infantile needs of their early childhood. As a result, the treatment was developed with the aim to directly fulfill or satisfy those repressed, agonizing cravings for love, physical contact, and other instinctual needs re-lived by the patient. Therefore, the therapist is completely engaged with the subject, as opposed to the traditional detached attitude of the psychoanalyst. With the intense emotional episodes that came with the psychedelic experience, Martin and McCririck aimed to sit in as the "mother" role who would enter into close physical contact with the patients by rocking them, giving them milk from a bottle, etc.


title: Psychedelic therapy

text: Hypnodelic therapy, as the name suggests, was developed with the goal to maximize the power of hypnotic suggestion by combining it with the psychedelic experience. After training the patient to respond to hypnosis, LSD would be administered, and during the onset phase of the drug the patient would be placed into a state of trance. Levine and Ludwig found the combination of these techniques to be more effective than the use of either of these two components separately.


title: Psychedelic therapy

text: A resurgence of public interest in psychedelic drug therapy in the 21st century has been driven in part by articles in "The New Yorker", "The New York Times" and "The Wall Street Journal". Articles on psychedelic therapy in "The New York Times" have included "How Psychedelic Drugs Can Help Patients Face Death" (April 20, 2012) and "My Adventures With the Trip Doctors" (May 15, 2018).


title: Psychedelic therapy

text: The first article to bring attention to the uses of psychedelic drugs for mental health was titled, "Seeking the Magic Mushroom," written by Robert Gordon Wasson and published in 1957 by "TIME" magazine. It detailed his experience traveling to Oaxaca, Mexico and taking "magic mushrooms" (psilocybin) within the cultural practices that started the "trip" experience. Since that time there has been growing interest within the United States to travel for these unique psychedelic experiences. The market for psychedelic tourism is currently growing rapidly. While typically the vacation destinations for psychedelics are based in Central and South America there is a rise in western culture taking over their traditional practices. In the Netherlands there are psychedelic society retreats that range from $500–1200 that center on a ceremony in which tourists take magic mushrooms and trip together for around six hours. There are also underground psychedelic "guides" popping up around the United States that include leaders who claim to assist people through their trip similar to shamans in other cultures. An article in "The Guardian" entitled "Welcome to the trip of your life: the rise of underground LSD guides" details various styles of guides that can be found within the United States.


title: New Objectivity

text: The New Objectivity (in ) was a movement in German art that arose during the 1920s as a reaction against expressionism. The term was coined by Gustav Friedrich Hartlaub, the director of the "Kunsthalle" in Mannheim, who used it as the title of an art exhibition staged in 1925 to showcase artists who were working in a post-expressionist spirit.


title: New Objectivity

text: As these artists—who included Max Beckmann, Otto Dix, George Grosz, Christian Schad, Rudolf Schlichter and Jeanne Mammen—rejected the self-involvement and romantic longings of the expressionists, Weimar intellectuals in general made a call to arms for public collaboration, engagement, and rejection of romantic idealism.


title: New Objectivity

text: Although principally describing a tendency in German painting, the term took a life of its own and came to characterize the attitude of public life in Weimar Germany as well as the art, literature, music, and architecture created to adapt to it. Rather than some goal of philosophical objectivity, it was meant to imply a turn towards practical engagement with the world—an all-business attitude, understood by Germans as intrinsically American.


title: New Objectivity

text: The movement essentially ended in 1933 with the end of the Weimar Republic and the beginning of the Nazi dictatorship.


title: New Objectivity

text: Although "New Objectivity" has been the most common translation of "Neue Sachlichkeit", other translations have included "New Matter-of-factness", "New Resignation", "New Sobriety", and "New Dispassion". The art historian Dennis Crockett says there is no direct English translation, and breaks down the meaning in the original German:


title: New Objectivity

text: In particular, Crockett argues against the view implied by the translation of "New Resignation", which he says is a popular misunderstanding of the attitude it describes. The idea that it conveys resignation comes from the notion that the age of great socialist revolutions was over and that the left-leaning intellectuals who were living in Germany at the time wanted to adapt themselves to the social order represented in the Weimar Republic. Crockett says the art of the "Neue Sachlichkeit" was meant to be more forward in political action than the modes of Expressionism it was turning against: "The "Neue Sachlichkeit" is Americanism, cult of the objective, the hard fact, the predilection for functional work, professional conscientiousness, and usefulness."


title: New Objectivity

text: Leading up to World War I, much of the art world was under the influence of Futurism and Expressionism, both of which abandoned any sense of order or commitment to objectivity or tradition. Expressionism was in particular the dominant form of art in Germany, and it was represented in many different facets of public life—in dance, in theater, in painting, in architecture, in poetry, and in literature.


title: New Objectivity

text: Expressionists abandoned nature and sought to express emotional experience, often centering their art around inner turmoil (angst), whether in reaction to the modern world, to alienation from society, or in the creation of personal identity. In concert with this evocation of angst and unease with bourgeois life, expressionists also echoed some of the same feelings of revolution as did Futurists. This is evidenced by a 1919 anthology of expressionist poetry titled "Menschheitsdämmerung", which translates to “Twilight of Humanity”—meant to suggest that humanity was in a twilight; that there was an imminent demise of some old way of being and beneath it the urgings of a new dawning.


title: New Objectivity

text: Critics of expressionism came from many circles. From the left, a strong critique began with Dadaism. The early exponents of Dada had been drawn together in Switzerland, a neutral country in the war, and seeing their common cause, wanted to use their art as a form of moral and cultural protest—they saw shaking off the constraints of artistic language in the same way they saw their refusal of national boundaries. They wanted to use their art in order to express political outrage and encourage political action. Expressionism, to Dadaists, expressed all of the angst and anxieties of society, but was helpless to do anything about it.


title: New Objectivity

text: Bertolt Brecht, a German dramatist, launched another early critique of expressionism, referring to it as constrained and superficial. Just as in politics Germany had a new parliament but lacked parliamentarians, he argued, in literature there was an expression of delight in ideas, but no new ideas, and in theater a "will to drama", but no real drama. His early plays, "Baal" and "Trommeln in der Nacht" (Drums in the Night) express repudiations of fashionable interest in Expressionism.


title: New Objectivity

text: After the destruction of the war, more conservative critics gained force particularly in their critique of the style of expressionism. Throughout Europe a return to order in the arts resulted in neoclassical works by modernists such as Picasso and Stravinsky, and a turn away from abstraction by many artists, for example Matisse and Metzinger. The return to order was especially pervasive in Italy.


title: New Objectivity

text: Because of travel restrictions, German artists in 1919–1922 had little knowledge of contemporary trends in French art; Henri Rousseau, who died in 1910, was the French painter whose influence was most apparent in the works of the New Objectivity. However, some of the Germans found important inspiration in the pages of the Italian magazine "Valori plastici", which featured photographs of recent paintings by Italian classical realists.


title: New Objectivity

text: Hartlaub first used the term in 1923 in a letter he sent to colleagues describing an exhibition he was planning. In his subsequent article, "Introduction to 'New Objectivity': German Painting since Expressionism", Hartlaub explained,


title: New Objectivity

text: The New Objectivity was composed of two tendencies which Hartlaub characterized in terms of a left and right wing: on the left were the "verists", who "tear the objective form of the world of contemporary facts and represent current experience in its tempo and fevered temperature"; and on the right the "classicists", who "search more for the object of timeless ability to embody the external laws of existence in the artistic sphere".


title: New Objectivity

text: The verists' vehement form of realism emphasized the ugly and sordid. Their art was raw, provocative, and harshly satirical. George Grosz and Otto Dix are considered the most important of the verists. The verists developed Dada's abandonment of any pictorial rules or artistic language into a “satirical hyperrealism”, as termed by Raoul Hausmann, and of which the best known examples are the graphical works and photo-montages of John Heartfield. Use of collage in these works became a "compositional" principle to blend reality and art, as if to suggest that to record the facts of reality was to go beyond the most simple appearances of things. Artists such as Grosz, Dix, Georg Scholz, and Rudolf Schlichter painted satirical scenes that often depicted a madness behind what was happening, depicting the participants as cartoon-like. When painting portraits, they gave emphasis to particular features or objects that were seen as distinctive aspects of the person depicted.


title: New Objectivity

text: Other verists, like Christian Schad, depicted reality with a clinical precision, which suggested both an empirical detachment and intimate knowledge of the subject. Schad's paintings are characterized by "an artistic perception so sharp that it seems to cut beneath the skin", according to the art critic Wieland Schmied. Often, psychological elements were introduced in his work, which suggested an underlying unconscious reality.


title: New Objectivity

text: Max Beckmann, who is sometimes called an expressionist although he never considered himself part of any movement, was considered by Hartlaub to be a verist and the most important artist of "Neue Sachlichkeit".


title: New Objectivity

text: Compared to the verists, the classicists more clearly exemplify the "return to order" that arose in the arts throughout Europe. The classicists included Georg Schrimpf, Alexander Kanoldt, Carlo Mense, Heinrich Maria Davringhausen, and Wilhelm Heise. The sources of their inspiration included 19th-century art, the Italian metaphysical painters, the artists of Novecento Italiano, and Henri Rousseau.


title: New Objectivity

text: The classicists are best understood by Franz Roh's term Magic Realism, though Roh originally intended "magical realism" to be synonymous with the "Neue Sachlichkeit" as a whole. For Roh, as a reaction to expressionism, the idea was to declare "[that] the autonomy of the objective world around us was once more to be enjoyed; the wonder of matter that could crystallize into objects was to be seen anew." With the term, he was emphasizing the "magic" of the normal world as it presents itself to us—how, when we really look at everyday objects, they can appear strange and fantastic.


title: New Objectivity

text: Most of the artists of the New Objectivity did not travel widely, and stylistic tendencies were related to geography. While the classicists were based mostly in Munich, the verists worked mainly in Berlin (Grosz, Dix, Schlichter, and Schad); Dresden (Dix, Hans Grundig, Wilhelm Lachnit and others); and Karlsruhe (Karl Hubbuch, Georg Scholz, and Wilhelm Schnarrenberger). The works of the Karlsruhe artists emphasize a hard, precise style of drawing, as in Hubbuch's watercolor "The Cologne Swimmer" (1923).


title: New Objectivity

text: In Cologne, a constructivist group led by Franz Wilhelm Seiwert and Heinrich Hoerle also included Gerd Arntz. Also from Cologne was Anton Räderscheidt, who after a brief constructivist phase became influenced by Antonio Donghi and the metaphysical artists.


title: New Objectivity

text: Artists active in Hanover, such as Grethe Jürgens, Hans Mertens, Ernst Thoms, and Erich Wegner, depicted provincial subject matter with an often lyrical style.


title: New Objectivity

text: Franz Radziwill, who painted ominous landscapes, lived in relative isolation in , a small coastal town. Carl Grossberg became a painter after studying architecture in Aachen and Darmstadt and is noted for his clinical rendering of industrial technology.


title: New Objectivity

text: Albert Renger-Patzsch and August Sander are leading representatives of the "New Photography" movement, which brought a sharply focused, documentary quality to the photographic art where previously the self-consciously poetic had held sway. Some other related projects as "Neues Sehen", coexisted at the same moment. Karl Blossfeldt's botanical photography is also often described as being a variation on New Objectivity.


title: New Objectivity

text: New Objectivity in architecture, as in painting and literature, describes German work of the transitional years of the early 1920s in the Weimar culture, as a direct reaction to the stylistic excesses of Expressionist architecture and the change in the national mood. Architects such as Bruno Taut, Erich Mendelsohn and Hans Poelzig turned to New Objectivity's straightforward, functionally minded, matter-of-fact approach to construction, which became known in Germany as ("New Building"). The movement, flourishing in the brief period between the adoption of the Dawes plan and the rise of the Nazis, encompassed public exhibitions like the Weissenhof Estate, the massive urban planning and public housing projects of Taut and Ernst May, and the influential experiments at the Bauhaus.


title: New Objectivity

text: In film, New Objectivity reached its high point around 1929. As a cinematic style, it translated into realistic settings, straightforward camerawork and editing, a tendency to examine inanimate objects as a way to interpret characters and events, a lack of overt emotionalism, and social themes.


title: New Objectivity

text: The director most associated with the movement is Georg Wilhelm Pabst. Pabst's films of the 1920s concentrate on social issues such as abortion, prostitution, labor disputes, homosexuality, and addiction. His cool and critical 1925 "Joyless Street" is a landmark of the objective style. Other directors included Ernő Metzner, Berthold Viertel, and Gerhard Lamprecht.


title: New Objectivity

text: The primary characteristic of New Objective literature was its political perspective on reality. It renders anti-utopias, in a non-sentimental, emotionless reportage style, with precision of detail and veneration for "the fact". The works were seen to provide a rejection to humanism, a refusal to play the game of art as utopia, a negation of art as escapism, and a palpable cynicism about humanity. Authors associated with New Objectivity literature included Alfred Döblin, Hans Fallada and Erich Kästner.


title: New Objectivity

text: Bertolt Brecht, from his opposition to the focus on the individual in expressionist art, began a collaborative method to play production, starting with his Man Equals Man project. This approach to theater-craft began to be known as "Brechtian" and the collective of writers and actors who he worked with are known as the "Brechtian collective".


title: New Objectivity

text: New Objectivity in music, as in the visual arts, rejected the sentimentality of late Romanticism and the emotional agitation of expressionism. Composer Paul Hindemith may be considered both a New Objectivist and an expressionist, depending on the composition, throughout the 1920s; for example, his wind quintet ' Op. 24 No. 2 (1922) was designed as '; one may compare his operas "Sancta Susanna" (part of an expressionist trilogy) and "" (a parody of modern life). His music typically harkens back to baroque models and makes use of traditional forms and stable polyphonic structures, together with modern dissonance and jazz-inflected rhythms. Ernst Toch and Kurt Weill also composed New Objectivist music during the 1920s. Though known late in life for his austere interpretations of the classics, in earlier years, conductor Otto Klemperer was the most prominent to ally himself with this movement.


title: New Objectivity

text: The New Objectivity movement is usually considered to have ended with the Weimar Republic when the National Socialists under Adolf Hitler seized power in January 1933. The Nazi authorities condemned much of the work of the New Objectivity as "degenerate art", so that works were seized and destroyed and many artists were forbidden to exhibit. A few, including Karl Hubbuch, Adolf Uzarski, and Otto Nagel, were among the artists entirely forbidden to paint. While some of the major figures of the movement went into exile, they did not carry on painting in the same manner. George Grosz emigrated to America and adopted a romantic style, and Max Beckmann's work by the time he left Germany in 1937 was, by Franz Roh's definitions, expressionism.


title: New Objectivity

text: The influence of New Objectivity outside of Germany can be seen in the work of artists like Balthus, Salvador Dalí (in such early works as his "Portrait of Luis Buñuel" of 1924), Auguste Herbin, Maruja Mallo, Cagnaccio di San Pietro, Grant Wood, Adamson-Eric, and Juhan Muks.


title: Dilation and evacuation

text: Dilation and evacuation (D&E) is the dilation of the cervix and surgical evacuation of the uterus (potentially including the fetus, placenta and other tissue) after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to remove all pregnancy tissue.


title: Dilation and evacuation

text: D&E normally refers to a specific second trimester procedure. However, some sources use the term D&E to refer more generally to any procedure that involves the processes of dilation and evacuation, which includes the first trimester procedures of manual and electric vacuum aspiration. Intact Dilation and Extraction (D&X) is a different procedural variation on D&E.


title: Dilation and evacuation

text: Dilation and evacuation (D&E) is one of the methods available to completely remove the fetus and all of the placental tissue in the uterus after the first trimester of pregnancy. A D&E may be performed for a surgical abortion, or for surgical management of a miscarriage.


title: Dilation and evacuation

text: Induced abortion after the first trimester of pregnancy is rare. Approximately 630,000 abortions were performed in the US in 2015, the most recent year for which data are available. Fewer than 10% of all abortions in the United States are performed after 13 weeks of gestation, and just over 1% are performed after 21 weeks gestation. In the United States, 95–99% of abortions after the first trimester of pregnancy are performed by surgical abortion via dilation and evacuation.


title: Dilation and evacuation

text: People who do not have access to affordable abortion care in their area or who face legal restrictions to obtaining a wanted abortion may wait longer to get an abortion after they make the decision to terminate their pregnancy. When an abortion is delayed, a D&E may be necessary.


title: Dilation and evacuation

text: Dilation and evacuation can be offered for management of second trimester miscarriage if skilled providers are available. Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery. Both methods offer the option of fetal and placental testing. Although pregnancy loss is emotionally distressing, there are rarely medical complications associated with a short (<1 week) delay to management.


title: Dilation and evacuation

text: Prior to the procedure, cervical preparation with osmotic dilators or medications is recommended in order to reduce risk of complications such as cervical laceration and to facilitate cervical dilation during the procedure. Although there is no consensus as to which method of cervical preparation is superior in terms of safety and technical ease of the procedure, one particular concern is reducing the risk of preterm birth. Concerns within the medical community have advised against or at least asked for further research concerning the safety of performing the dilation of the cervix on the same day as the surgery for some or all second trimester pregnancies. The concern is that performing the dilation too soon before the surgery could increase the risk of preterm birth should the woman ever carry a subsequent pregnancy to term.


title: Dilation and evacuation

text: Most patients will be provided NSAIDs for pain management. Local anesthetics, such as lidocaine, are frequently injected by the cervix to reduce pain during the procedure. IV sedation may also be used. General anesthesia may be used depending on individual circumstances, however it is not preferred as it adds significant anesthesia risks to the procedure.


title: Dilation and evacuation

text: A speculum is placed in the vagina to allow visualization of the cervix. If osmotic dilators were placed prior to the procedure, these are removed.


title: Dilation and evacuation

text: The cervix may be further dilated with rigid dilator instruments (as opposed to osmotic dilators). Sufficient cervical dilation decreases the risk of morbidity, including cervical injury and uterine perforation. Uterine contents are removed using a cannula to apply aspiration, followed by forceps. Tissue inspection ensures removal of the fetus in its entirety. The procedure may be performed under ultrasound guidance to aid in visualizing uterine anatomy and to assess if all tissue has been removed at the completion of the procedure.


title: Dilation and evacuation

text: D&E is usually performed in the outpatient setting, and the patient can be safely sent home the same day after a period of observed recovery, ranging from 45 minutes to several hours. Generally, the woman may return to work the following day. The type of anesthesia given also influences the appropriate amount of recovery time before discharge. There is rarely a need for narcotic pain medications afterwards, and NSAIDs are recommended for home pain management. Recovery from the procedure is typically fast and uncomplicated.


title: Dilation and evacuation

text: Some women may experience lactation after a second-trimester loss or termination of pregnancy. At this time, medications to suppress lactation are not proven to be effective.


title: Dilation and evacuation

text: If the fetus is removed intact, the procedure is referred to as intact dilation and extraction by the American Medical Association, and referred to as "intact dilation and evacuation" by the American Congress of Obstetricians and Gynecologists (ACOG).


title: Dilation and evacuation

text: D&E is a safe procedure when performed by experienced practitioners. The rate of mortality following legal procedures in the US is 0.62 legal induced abortion-related deaths per 100,000 reported legal abortions. The strongest risk factor for mortality following abortion is increasing gestational age.


title: Dilation and evacuation

text: Risks of D&E include bleeding, infection, uterine perforation, and damage to surrounding organs or tissues . Hemorrhage occurs following less than 1% of all surgical abortions. Infection rates following second trimester abortion have been reported to be 0.1–4%. The risk of infection is decreased by the use of antibiotics. Rare risks of D&E include uterine perforation, retained products of conception, and rare risk of hysterectomy.


title: Dilation and evacuation

text: There is no evidence that surgical abortion causes an increase in infertility or adverse outcomes in subsequent pregnancies.


title: Dilation and evacuation

text: Complication rates after D&E are similar to or lower than those of labor induction (medical abortion) after 13 weeks, though few studies exist comparing the two approaches. In certain clinical scenarios--severe anemia, for example-- D&E may be preferred over labor induction.


title: Dilation and evacuation

text: Proposals to limit abortion access sometimes target specific procedures such as D&E, though this also restricts access for non-abortion patients, such as those with pregnancy loss. Kansas was the first state to ban D&E in 2015, later it was struck down in 2016. Currently three US states (Mississippi, Nebraska, and West Virginia) have specifically banned D&E.


title: Tsarina

text: Tsarina or tsaritsa (also spelled csarina or csaricsa, tzarina or tzaritza, or czarina or czaricza; ; ; ) is the title of a female autocratic ruler (monarch) of Bulgaria, Serbia or Russia, or the title of a tsar's wife. The English spelling is derived from the German "czarin" or "zarin", in the same way as the French "tsarine"/"czarine", and the Spanish and Italian "czarina"/"zarina".


title: Tsarina

text: Since 1721, the official titles of the Russian male and female monarchs were emperor () and empress () or empress consort, respectively. Officially the last Russian tsarina was Eudoxia Lopukhina, Peter the Great's first wife. Alexandra Feodorovna (Alix of Hesse), the wife of Nicholas II of Russia, was the last Russian empress.


title: Tsarina

text: Eudoxia Lopukhina was sent to a monastery in 1698 (which was the usual way the emperor "divorced" his wife), and she died in 1731. In 1712 Peter married in church Catherine I of Russia. The Russian Empire was officially proclaimed in 1721, and Catherine became empress by marriage. After Peter's death she became ruling empress by her own right. In following centuries, the title "tsarina" was in unofficial informal use – a kind of "pet name" for empresses, whether ruling queens or queen consorts. ("Mother dear-tsaritsa" () was used only for Catherine the Great, the most popular empress.) For a list of Russian empresses in the 18th and 19th centuries, see empress of Russia.


title: Tsarina

text: "De jure" tsarinas in Russia existed from 1547 until 1721. Among the most famous tsarinas of this period were six or seven wives of Ivan the Terrible, who were poisoned by his enemies, killed or imprisoned by him in monasteries. However, only the first four of them were crowned tsarinas, as the later marriages were not blessed by the Orthodox Church and were considered as cohabitation. Polish noblewoman Marina Mnishek also became tsarina of Russia by her marriage to the impostor False Dmitry I and later to False Dmitry II.


title: Tsarina

text: Many wives were chosen by bride-show (the custom of beauty pageant, borrowed from the Byzantine Empire), when hundreds of poor but handsome noblewomen gathered in Moscow from all the regions of Russia and the tsar chose the most beautiful. This deprived Russia of the benefits of royal intermarriage with European monarchs, but protected from inbreeding, as well as from the political influence of foreign princesses (Catholic or Protestant). The only foreign wife of a Russian tsar in this early era (except Mnishek) was Maria Temryukovna, a Circassian princess, who converted to Orthodoxy.


title: Tsarina

text: The first Bulgarian ruler to use the title tsar was Simeon I of Bulgaria, and his consort (her name is uncertain, reportedly Maria Sursuvul) used the title tsarina. The title was used by subsequent Bulgarian consorts until the end of the First Bulgarian Empire in 1018. The last royal spouse to use the title was Maria, the wife of Ivan Vladislav of Bulgaria.


title: Tsarina

text: When the Second Bulgarian Empire was created in 1185 the rulers again adopted the title tsar and their consorts were therefore called tsarinas.


title: Tsarina

text: In the Third Bulgarian State, Ferdinand I of Bulgaria adopted the title tsar after he proclaimed Bulgaria's Independence in 1908, and his wife, Eleonore Reuss of Köstritz, previously "knyaginya", became "tsaritsa". The last Bulgarian tsaritsa was Giovanna of Italy, the wife of Tsar Boris III of Bulgaria. Margarita Gómez-Acebo y Cejuela, the wife of Simeon II of Bulgaria, is also sometimes referred as a tsaritsa.


title: Tsarina

text: The first Serbian tsarina was Helena of Bulgaria, sister of Bulgarian Tsar Ivan Alexander and wife of Tsar Stephen Uroš IV Dušan of Serbia. She was the empress consort of Serbia from 1346 until Dušan's sudden death in 1355. The second (and the last) Serbian tsarina was Anna, Empress of Serbia, from the Wallachian noble house of Basarab. She married Dušan's son, Tsar Stephen Uroš V of Serbia, sometime in the 1350s, and ruled until the Serbian empire's demise in 1371.


title: Shoshannah Stern

text: She was born in Walnut Creek, California, into an observant Jewish and fourth-generation Deaf family, the daughter of Ron Stern and Hedy Marilyn Stern (née Udkovich), and the sister of writer and artist Louise Stern and former Gallaudet Men's Basketball Coach and current political scientist Brendan Stern. Both of her grandmothers are Holocaust survivors. Her hometown is Fremont, California, where she attended the California School for the Deaf, Fremont.


title: Shoshannah Stern

text: Stern's first language is American Sign Language. She is also able to read lips and speak English without an interpreter. She attended Gallaudet University, the only liberal arts college for the Deaf in the world.


title: Shoshannah Stern

text: She married her husband, Ricky Mitchell, on June 3, 2012, in Santa Fe, New Mexico. Their daughter was born in February 2015. She currently resides with him in Hollywood, California.


title: Shoshannah Stern

text: Stern got her first regular series role as Holly Brodeen, a member of an elite government anti-terrorist task force in ABC's "Threat Matrix". The role was created for her by the show's producers after a director who had worked with her on "The Division" recommended her. She had a recurring role in Showtime's "Weeds" (as Megan Beals-Botwin) and was also on "ER", "Providence" and "Cold Case". She played Bonnie Richmond in the CBS post-apocalyptic drama "Jericho". She had a recurring role in Season 3 of Fox's "Lie to Me".


title: Shoshannah Stern

text: Stern appeared with Matthew Broderick in the film "The Last Shot" and starred in the film "Adventures of Power". She also appeared in the popular music video "Yes We Can", written by will.i.am for the Barack Obama campaign.