![]() ![]() ![]() 1 However, federal health programs allow patients to participate in disease-specific independent charity patient assistance programs based on the assumption that these programs do not violate anti-kickback laws. Federal health programs, including Medicare, prohibit the use of manufacturer-sponsored drug-specific patient assistance programs due to the federal Anti-Kickback Statute that forbids manufacturers from offering any remuneration for a federally reimbursable item. Patient assistance programs help patients afford prescription drugs by subsidizing their out-of-pocket costs. Medications that were covered by the patient assistance programs were generally more expensive than those that were not covered. Off-patent brand-name drugs (cost: >$10 000) were covered by a mean of 3.1 (SD, 2.0) patient assistance programs, whereas their generic equivalents were covered by a mean of 1.2 (SD, 1.0) patient assistance programs.Ĭonclusions and Relevance In 2018, among 274 patient assistance programs operated by the 6 independent charity foundations, the majority did not provide coverage for uninsured patients. The median annual cost of the drugs per beneficiary covered by the programs was $1157 (interquartile range, $247-$5609) compared with $367 (interquartile range, $100-$1500) for the noncovered drugs. The most common income eligibility limit was 500% of the federal poverty level. A total of 267 programs (97%) required insurance coverage as an eligibility criterion (ie, excluded uninsured patients). Of the 274 patient assistance programs offered by these organizations, 168 (61%) provided only co-payment assistance, and the most common therapeutic area covered was cancer or cancer treatment–related symptoms (113 patient assistance programs 41%). Results Among the 6 independent charity foundations included in the analysis, their total revenue in 2017 ranged from $24 million to $532 million, and expenditures on patient assistance programs ranged from $24 million to $353 million, representing on average, 86% of their revenue. ![]() The secondary outcomes were the cost of the drugs covered by the patient assistance programs and the coverage of expensive off-patent brand-name drugs vs substitutable generic drugs. Main Outcomes and Measures The primary outcomes were the characteristics of patient assistance programs, including assistance type, insurance coverage (vs uninsured), and income eligibility. Drugs were identified for subgroup analysis that had any use reported on the Medicare Part D spending dashboard and any off-patent brand-name drugs that incurred more than $10 000 in Medicare spending per beneficiary in 2016.Įxposures Support by independent charity patient assistance programs. These charities offered 274 different disease-specific patient assistance programs. Objective To examine the eligibility criteria of the independent charity patient assistance programs and the drugs covered by them.ĭesign, Setting, and Participants Descriptive cross-sectional study of the 6 largest independent charities offering patient assistance programs for patients including, but not limited to, Medicare beneficiaries in 2018. Little is known about the design of the programs, patient eligibility, or drug coverage. Importance Although independent charity patient assistance programs improve patient access to costly prescription drugs, recent federal investigations have raised questions about their potential to increase pharmaceutical spending and to violate the federal Anti-Kickback Statute. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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![]() Withdrawal from some recreational drugs can produce hallucinations, including withdrawal from alcohol, sedatives, hypnotics, or anxiolytics.Use of certain recreational drugs may induce hallucinations, including amphetamines and cocaine, hallucinogens (such as lysergic acid diethylamide or LSD), phencyclidine (PCP), and cannabis or marijuana.Auditory hallucinations, in particular, are common in psychotic disorders such as schizophrenia. includes schizophrenia, schizoaffective disorder, schizophreniform disorder, shared psychotic disorder, brief psychotic disorder, substance-induced psychotic disorder, bipolar disorder, major depression with psychotic features, delirium, or dementia.Delusion of guilt or sin (or delusion of self-accusation).Delusional jealousy (or delusion of infidelity).In contrast, it is quite rare for two people to share a hallucination. In fact, some atheists believe that all organized religion and faith in God is a delusion. People in cults may all believe that their leader is a messiah or that the end of the world is nigh. It is common for many people to hold a shared delusion that stems from their paranoia or belief system. A hallucination may be hearing "voices" or seeing ghosts. For example, a delusion may be a belief that the government is controlled by reptilian men who are poisoning the water supply to enslave the masses. Individuals with delusional disorder suffer from long-term, complex delusions that fall into one of six categories: persecutory, grandiose, jealousy, erotomanic, somatic, or mixed.ĭelusions are erroneous beliefs and hallucinations are perceptions of stimuli that don't actually exist. They are also the major feature of delusional disorder. ![]() They can appear in the form of visions, voices or sounds, tactile feelings (known as haptic hallucinations), smells, or tastes.ĭelusions are a common symptom of several mood and personality-related mental illnesses, including schizoaffective disorder, schizophrenia, shared psychotic disorder, major depressive disorder, and bipolar disorder. As a result, hallucinations occur during periods of consciousness. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith).Ī hallucination occurs when environmental, emotional, or physical factors such as stress, medication, extreme fatigue, or mental illness cause the mechanism within the brain that helps to distinguish conscious perceptions from internal, memory-based perceptions to misfire. These sensory impressions are generated by the mind rather than by any external stimuli, and may be seen, heard, felt, and even smelled or tasted.Ī delusion is a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. Hallucinations are false or distorted sensory experiences that appear to be veridical perceptions. ![]() ![]() ![]() You also might not be using the correct communication tools to be able to bring repair into the broken relationship in order to take your terrible tango and synchronize into the harmonious dance with your partner you’ve always longed for.The coupling of nicotinamide adenine dinucleotide (NAD +) breakdown and protein deacylation is a unique feature of the family of proteins called ‘sirtuins.’ This intimate connection between NAD + and sirtuins has an ancient origin and provides a mechanistic foundation that translates the regulation of energy metabolism into aging and longevity control in diverse organisms. The challenge is that both your styles of arguing might be unhealthy in trying to fix the misunderstandings between the two of you. The other style is called “The Runner.” This is the spouse who just can’t deal with the situation right now and just wants to leave the situation to deal with another day. Needles to say the fighter ends up chasing the runner and depending who is fastest, will generally lead to yet again another terrible tango built for two.īy looking more closely at your arguments it may be that your partner is really trying to make things work out. The first confrontational style is I like to call “The fighter.” This is the spouse who just has to deal with the situation right now. When you think of your disagreement what confrontational style do you have? I find often in working with couples and families someone tends to fall in one of 2 very general categories. When you argue between each other, think back to the most common issues that are driving you crazy. It’s those differences that we need to learn to embrace and sometimes learn to be patient with because chances are you have some differences that your loved one has been working through in embracing and learning to be patient with you. ![]() There’s an old cliché statement that goes ‘opposites attract’ and even with online matching to find that perfect match I’ve yet to find a couple who have at some point in their relationship have found differences in personality that appear to sometimes clash with each other. The problem of course is that how your communicating with each other is not being successful and you need to find a better and calmer way to communicate in order to feel heard and loved. It’s very possible that each of you is trying to communicate how you are really feeling in order to feel heard and safe with each other. Look at it another way what’s the point of being with each other and wasting your valuable time arguing, unless the reality is that you both want to actually make this thing called love somehow work out. If so, then it’s possible that both of you care deeply for each other without knowing how to resolve your differences. Do you find the argument ends up into another ongoing dance where you end up not even remembering what the initial argument was about. Do you not feel heard or maybe you recognize that it’s your partner who’s not feeling heard. ![]() Look more closely at what is happening when you argue.Īsk yourself what is happening when you argue. ![]() I know at first glance this might sound totally crazy, however, if we take a closer look at what might be happening during that re-occurring argument that keeps happening, we might find some possible clues to look at improving your relationship towards each other. Believe it or not, the fights and disagreements that are happening between you and your loved one might actually be a sign that there is still hope, life and potential for your relationship to grow into a healthy and thriving relationship of love and security. ![]() ![]() ![]() Insert your key and turn it until the plunger pops out. The error codes trigger your error lights, such as you check engine light, to come. Whether you are protecting your items from theft or damage, a safe gets the job done. To reprogram the user code, press the program (p) button. It's always a good idea to change your combination . Always keep your safe locked when not in use. Digital Fire Water Safe Sfw082et Sentrysafe Sentrysafe Pistol Safes Program User Codes Youtube from i. Please enjoy this guide to replace your sentry safe key. To reset the combination on a sentry safe, open the door of the safe, delete the existing codes, press the prog or p key and enter the factory code. Changing the master code Īlways keep your safe locked when not in use. Sentry Safe Lost Combination Outlet 50 Off Www Ingeniovirtual Com Sentrysafe Pistol Safes Program User Codes Youtube from i. Step by step instructions for how to program and delete codes on a sentry®safe fire safe that uses a basic electronic keypad. enter: Always keep your safe locked when not in use.Turn the dial to the left (counterclockwise) three times to the first number of . It's important to reset your electronic digital safe combination on a regular basis to prevent people from cracking the code. How To Program Codes On Your Sentry Safe Electronic Lock Fire Safe Youtube How To Open A Sentrysafe Electonic Lock And Dual Key Fire Safe Otosection from i0.wp.com Then, input the factory code on your electronic keypad. ![]() Enter your model number below to locate and download a copy of your product manual.Īt this point, a green light . ![]() Sentry Safe Change Combination Without Factory Code Middot Pdf Filesentry Safe Change Combination Without Factory Code Once Your Notary Form Has Been Received It Can Take Up To 3 5 How To Program Codes On Your Sentry Safe Electronic Lock Fire Safe Youtube from i. enter: Insert your key and turn it until the plunger pops out.Begin the code reprogramming process by pushing the pound sign (#), on the keypad, then enter the factory master code, followed by the pound sign for the second .īegin the code reprogramming process by pushing the pound sign (#), on the keypad, then enter the factory master code, followed by the pound sign for the second . ![]() 9+ Easy Ways How To Reset Sentry Safe Code. ![]() ![]() ![]() Chickoo/Sapodilla/Supporta, a common fruit available in India very cheap and you get it round the year. I have always felt it is a kind of ignored fruit when it comes to dessert, people either eat it as such or prepare chickoo shake. I used to adore Chickoo shake(during college days either chickoo shake or sharjah shake was the most commonly ordered drink by me from the juice corner ) so much that I have done quite a few recipes with this fruit, most of it turning out to be good. ![]() If using coconut milk use a mixture of light and full-fat. I have prepared Chickoo pudding umpteen times and was relished by many. You can replace all of the dairy in this recipe and use coconut milk instead. I have always prepared this using chickoo pulp without any lumps. But when you prepare the same thing again and again you tend to become more casual, Right? Atleast in my case it happens and recently when I prepared it instead of grinding to a pulp, I just mashed the fruit leaving some chunks of it, the result was amazing. The chunks of chickoo settled at the bottom rendering a kind of double layered look. ![]() Add the chikoo pulp and using a mixer, whisk it for 1 minute until all the ingredients are incorporated. Take a big steel vessel, add the cooking cream, milk powder, sugar & milk, using a hand whisk well till no lumps remain. Chikoo puddingSapodilla pudding recipe in Malayalameasyrecipe chikoomalayalam puddingrecipe easyrecipe dessert dessertoftheday dessertlove muhsiyun. Blend the fruit to make a smooth pulp with a hand blender or a mixer grinder and keep aside. I can assure you that you will love this pudding Chickoo/ Sapota Coconut Milk Pudding Easy Sapodilla Pudding - Chikoo milkshake recipe sapodilla milkshake recipe - Chickoo or Sapota Milkshake with. (If you grind to a paste, well and good-You still get a tasty pudding) Unpeel and Deseed chickoo and mash it nicely to get a two layer kinda pudding. Soak gelatin in quarter cup of cold water and reserve. Boil milk, condensed milk and sugar continuously stirring it. I, the copyright holder of this work, hereby publish it under the following license. Date: 29 January 2021: Source: Own work: Author: MeghaJainSrivastava: Licensing. Description: English: Chikoo kiwi pudding with some dry fruits and sprinkles on it. Now add in soaked gelatin, keep stirring until gelatin is fully melted in. Chikoo kiwi pudding with some dry fruits and sprinkles on it. Remove from heat, stir for a minute, and add chickoo pulp and stir well.įinally fold in fresh cream and pour it in to pudding dish or jelly mould. ![]() We encourage all food lovers to post their own recipes, as well as discover those made by other home chefs.If jelly mould is used demould it after setting. Our community is primarily driven by home cooks across the country who share their recipes from traditional family classics to their very own inventions. Our mission is keeping families at home and around the dining table. But deciding what to cook and what to eat everyday is definitely not easy. Our advanced search functionality, multilingual app and website (in English, Hindi, Marathi, Bengali, Tamil, Telegu & Gujarati) and well explained step by step recipes makes the process of discovery even easier.ĭespite some great eating out options today, nothing beats the pleasure of a good home cooked meal 'Ghar ka khana'. At over 1,00,000 recipes and videos, we are already the largest recipe platform in India today. Our platform promotes discovery of the incredible variety of food made in homes today, from the most basic recipe to undiscovered regional and world cuisines. BETTERBUTTER is a cooking platform for the Indian cook. ![]() ![]() ![]() When seeking visibility, bisexual people are accused of taking up too much queer space. Bisexual identities, as well as trans identities, threaten what is accepted as legitimate or appropriate queerness. LGBTQ+ discourse in the mainstream forces the larger community into the narrative of a sexual binary: homosexual or heterosexual orientation. Working towards bi-visibility within mainstream society is an arduous journey, and at the individual level, it comes with its own unique set of baggage. ![]() In combating bi-erasure, bisexual political activism has come a long way in not only promoting the LGBTQ+ movement as a whole, but also making headway on legislative positions and focused support systems for the community. Moreover, bi-erasure threatens the livelihoods of bi people when they are excluded from policies that are meant to protect people on the basis of their sexual identity. It is a key factor in the higher rates of anxiety and depression present in bi people as compared to gay and lesbian people due to isolation from the community at large. This normalized tendency is perpetuated by people within and outside of the LGBTQ+ community, and its impact has led to detrimental effects for individuals who are bisexual. In addition to providing an opportunity to uplift and recognize members of the bi community, this day of pride is particularly important because of bi-erasure, the questioning and invalidating of one’s bisexuality to the point of de-legitimizing their existence. The first tri-colored post appeared on my Twitter feed as I was getting ready to go to bed, and I couldn’t help but feel a sense of loss in letting Bi Visibility Day slip away from me.īi Visibility Day was founded by activists Wendy Curry, Michael Page and Gigi Raven Wilbur to address marginalization faced by the bisexual community and to celebrate bi experiences. Nevertheless, this past Thursday felt eerily quiet. That and the rampant commercialization of Pride deepened my hesitation in participating in any form of liberating celebration. The month of June never really held any specific importance to me apart from exercising my eager allyship to the larger LGBTQ+ community because I didn’t quite know where I fit in. 23 concludes a week of pride and awareness for those of us who, you know, see on both sides as Frank Ocean put it in his groundbreaking track “Chanel.” But to be honest, this year’s Bisexual Visibility Day passed by quite ordinarily - in fact, I may have completely missed it. 30, 2022, the author decided to update the article with the author’s name under the approval of the 2022 Editor-in-Chief and Managing Editors of Michigan in Color. 28, 2021 for fear of professional retaliation and to resist the heteronormative culture of ‘coming-out.’ In accordance with our ethics policy (which can be found in full in our bylaws ), the 2021 Editor-in-Chief and Managing Editors of Michigan in Color are aware of the author’s identity. Editor’s Note : A previous version of this article was published anonymously on Sept. ![]() ![]() ![]() ![]() Test the ins and outs of dodging, jumping, and invincibility frames. While there are many abilities you can get that will power up your weaponry, such as Charged Shots for Nero's Blue Rose or Dante's Ebony and Ivory pistols, put your focus first on grabbing the abilities that will give you new options for engaging in combat. Aside from some mainstay moves like Streak for Nero and Stinger for Dante-both moves that help them bridge the gap between enemies-they'll also go a long way in giving you the chance to vary up your combos and set up enemies for longer strings of attacks, thereby giving you the ability to get better level rankings and more Red Orbs. How do you get them, you ask? From all those Red Orbs that you've been grabbing by slaying enemies, smash objects, finding them in the environment, and working your way towards getting those SSStylish combo rankings.ĭante, Nero, and V each have a wide range of new abilities that they'll be able to gain throughout DMC5, but if I have to make a recommendation for which ones to get first, I'd say that you should start out by trying to get abilities that will either give you new moves or extend the combos of moves you already have. Over the course of your playthrough in Devil May Cry 5, each of the three characters that you play as will get the opportunity to gain new abilities by purchasing them from Nico in the DMC van. Given how different each one is from one another, there are a ton of different options to explore throughout the storyline of DMC5, and it's worth getting to know what makes Dante, Nero, and V tick.įocus on grabbing new abilities that will extend your combos. That all being said, as you play Devil May Cry 5, take some time with lower-powered enemies to experiment with each of the three characters to get a feel for their playstyles. The panther-like Shadow hits enemies up close with its melee attacks, Griffon flies up in the air and targets enemies with electric blasts, and when V builds up his Devil Trigger, he summons the ultra-powerful Nightmare to deal heavy damage to anything in its sight. Instead of fighting directly like Dante and Nero, V stands back and lets his trio of shadowy Familiars do the dirty work. The final character of the three, V, is by far the most eccentric and different playable character from a combat standpoint. Mainly, Devil Breaker can either grab enemies and pull them in closer to Nero (or he can grapple over to them and bridge the gap quickly), while in DMC5, the Devil Breaker also has a wide range of attachments that can be used to give Nero new abilities compared to his Devil Bringer arm in DMC4. ![]() Namely, he has his trusty sword Red Queen to attack enemies up close and his Blue Rose revolver to blast enemies from afar, but what really sets Nero apart is his robotic Devil Breaker arm. For Dante, juggling enemies in the air and keeping things varied between your styles and weapons is crucial to landing those SSStylish combos.įor Nero, the up-and-coming Demon Hunter introduced in Devil May Cry 4, his fighting style slightly resembles Dante's, but with a few key differences. Dante has four different fighting styles he can switch between-Trickster, Swordmaster, Gunslinger, and Royalguard-that each give him varying abilities, and a wide range of melee and ranged weapons to employ, all of which he can juggle on the fly. The series' iconic, wise-cracking Demon Hunter Dante of course makes his return in DMC5, and of the three characters, Dante is probably the most complex. Between Dante, Nero, and the mysterious new character "V," there are a range of combat styles between the three characters that can be dug into, so we'll break them down into their basics. ![]() However, one of the most notable elements-especially for newcomers to the series-is the fact that Devil May Cry 5's three playable characters each have very different combat styles worth exploring. DMC5 very much plays like the classic original games but with the refinements of modern technology and gameplay design behind it. Take some time to learn how each character plays.įor fans that have played the previous games, Devil May Cry 5 will feel like putting on a pair of familiar gloves. ![]() ![]() ![]() The second issue is the rising fear that Igbo votes might be suppressed by the rhetoric on election boycott, which, he stated, emanated from a disaffected high-ranking member of IPOB based overseas. “We simply took our time to study major candidates before we decided that Obi is topnotch, and should be supported without equivocation.” He said: “The truth is that Igbo elder statesmen did not wish to be seen as jumping out to support Obi just because he is Igbo. Reacting to innuendoes from familiar quarters that ranking Igbo elder statesmen such as himself are not behind Obi, Obioha, who was late Chief Moshood Abiola’s political ally, described this notion as far from the truth. Obioha stated that his statement was necessitated by major issues he considered critical and germane to the 2023 general elections, and what the conduct or outcome of the election portends for the corporate existence of Nigeria.Īccording to him, the first issue is the epochal candidacy of Obi, which, he said, has taken the entire nation by storm, adding: “The Obi phenomenon is so revolutionary and swift that in just few months, he has come to be seen by many as the candidate to beat.” He also called on those pushing for the self-destructive election boycott to retrace their steps.ĭisclosing why Igbo elder statesmen are solidly behind the presidential bid of Peter Obi, Obioha, a former member of the House of Representatives and one time presidential aspirant, stated: “It is not merely because Obi is Igbo, but because he possesses the character and fitness to be president.” Obioha, in a statement, yesterday, said that it was for this reason that he called on Ndigbo to ignore calls for boycott of the general elections and prepare to vote despite hindrances. Igbo elder statesman and former Chairman of Ohanaeze Ndigbo Caretaker Committee, Chief Ralph Obioha, has stated that the Indigenous People of Biafra (IPOB), led by the detained Nnamdi Kanu, is against boycott of the 2023 general elections. ![]() ![]() ![]() In addition, NetLogo print commands are redirected to the R console. If silent is set to FALSE, a message with the current random seed and siminputrow is printed to the console after successful execution of each simulation run. The run_nl_all(), run_nl_one() and run_nl_dyn() functions provide a “silent” parameter that allows to capture progress of running simulations. The function will report detailed warnings or error messages, if definitions of variables or constants are invalid. After attaching an experiment to an nl object, validity of defined experiment variables and constants can be checked by commiting the nl object to the function eval_variables_constants(). This function reads all GUI elements of the NetLogo model that can be set by nlrx. If your model does not have any globals (GUI and code), please create a dummy global (either create a global widget on the GUI or add a dummy variable to the globals code section) for your model and put it in the constants list with an appropriate value.Ī complete list of all valid NetLogo parameters can be loaded by commiting a nl object with a valid modelpath to the function report_model_parameters(). simdesign_simple() requires at least one defined constant within the constants list.NetLogo model parameters that are not listed in any of these two lists will be set with their default value from the NetLogo model interface.It is not allowed to list the same variable in the variables and constants list.Variable values that should be recognized by NetLogo as logical need to be entered as strings (e.g.Variable values that should be recognized by NetLogo as strings need to be nested inside escaped quotes (e.g. ![]() Categorical variable values are currently only allowed for simdesign_simple, simdesign_distinct and simdesign_ff.Values, or min, max, step (values is prioritized)Īdditionally, please note the following restrictions in order to define variables and constants correctly: The implemented simdesigns have different requirements for variable definitions: Simdesign Correctly defining variables within the experiment class object is crucial for creating simdesigns. ![]() ![]() ![]() Such companies currently hold leases across some 37,500 square miles (97,000 square kilometers) of bureau land. ![]() Joe Manchin’s support for last year’s climate law.īiden remains under intense pressure from Manchin and many Republicans to allow more drilling. Biden later revived the deals to win West Virginia Democratic Sen. While the bureau previously issued leases for conservation in limited cases, it has never had a dedicated program for it.įormer President Donald Trump tried to ramp up fossil fuel development on bureau lands, but President Joe Biden suspended new oil and gas leasing when he entered office. Catherine Cortez Masto of Nevada - where the federal land bureau controls about two thirds of the land - urged the administration to work with ranchers and farmers before finalizing the proposal, which the National Cattlemen’s Beef Association said would “upend” land management in the West. There have not been rules around how we deliver on the portions of (federal law) that say, ‘Manage for fish and wildlife habitat, manage for clean water.’”ĭemocratic U.S. ![]() There are rules around how we do oil and gas. “There are rules around how we do solar development. ![]() “It makes conservation an equal among the multiple uses that we manage for,” Stone-Manning said. And people could still hunt on the leased property or use it for recreation, she said. If grazing is now permitted on a parcel, it could continue. Stone-Manning told the AP that critics were misreading the rule, and that conservation leases would not usurp existing ones. “The secretary wants to make non-use a use,” said Barrasso, the ranking Republican on the committee. John Barrasso, a Wyoming Republican who tried to block Stone-Manning’s 2021 Senate confirmation, says the proposed rule is illegal.Įarlier this month he berated Interior Secretary Deb Haaland over it during an Energy and Natural Resources Committee hearing, saying she was “giving radicals a new tool to shut out the public.” “It would have a term, and when that restoration goal is met, the term would lapse,” he said. George, acting assistant director for the bureau, said the conservation leases would not “lock up land in perpetuity.” But officials acknowledged receiving numerous queries about grazing and drilling potentially being excluded.īrian St. There was no opportunity for public comment, and questions for officials were screened by the agency. Senior bureau officials on Monday night hosted the first virtual public meeting about the conservation proposal. Those holdings put the agency at the center of arguments over how much development should be allowed. It also regulates publicly owned underground minerals, including oil, coal and lithium for renewable energy across more than 1 million square miles (2.5 million square kilometers). The bureau has a history of industry-friendly policies for the 380,000 square miles (990,000 square kilometers) it oversees, an area more than twice the size of California. She said it would make conservation an “equal” to grazing, drilling and other uses while not interfering with them. Tracy Stone-Manning, director of the Bureau of Land Management, told The Associated the proposed changes address rising pressure from climate change and development. ![]() |
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