how many villages are there in phek district

As of  2011[update] the 2011 census the district holds two towns, Phek and Pfutsero, and 117 villages, divided into fourteen admin circles as follows:

Phek district

Phek (pron:/ˈfɛk/) is a district of Nagaland state in India, It was established in 1973. The district headquarter is in the town of Phek.[2]

Phek district is a mountainous region, of which 70% is evergreen forest. The highest mountain is Zanibu, whose summit is over 2,400 m (7,900 ft) above mean sea level (AMSL). The district HQ town of Phek lies at the lowest altitude of the district at 1,524m above sea level, with the village of Pfutsero at the highest point 2,136m above.[3][4]

The largest rivers of the district are the Tizu, Lanyi, Arachu, and three most important lakes are the Shilloi, Chida and Dzudu.[2]
As of  2002[update], of its 89 recognized villages, twelve were not accessible by road at all, and of the rest only 24 were accessible by "all-weather roads". Only 9 of the 89 villages were still to be connected to the water supply.[3]

Avakhung International Border Checkpost, also known as Avankhu in Phek district of Nagaland, is an International Border Checkpost on India–Myanmar barrier and a highway is being developed as part of the Bharatmala project (2017-2022).[5]

The summers are moderately warm with the average temperature being 27 °C without exceeding 32 °C. Monsoon starts towards the end of May, and is over by the end of September. Winters are cold, in comparison to the nearby plains of Assam, with the temperature dropping to 0 °C in the coldest months of January and February.[6]

The average annual rainfall is 1,527mm.[6]

The name Phek comes from the word Phekrekedze, meaning watch tower.[2]

Phek district was established in 1973 when it was  by Nagaland state notification notification no. APA.15/12/71 dated 19 December 73

The Deputy Commissioner's office is located in Phek.
The district is split into 14 administrative circles, which are Pfutsero, Phek Sadar, Chetheba, Chozuba, Meluri, Sekruzu, Chizami, Sakraba, Razieba, Zuketsa, Phor, Khuza, Khezhakeno, and Phokhungri.[7]

Additional Deputy Commissioner (ADC) offices are located in Pfutsero, Meluri and Chozuba. A Sub-Divisional Officer is located in Chizami, and Extra Assistant Commissioner EAC headquarters are located in Sakraba, Sekruzu, Phokhungri, Khezhakeno, Chetheba, Khuza, Zuketsa, and Phor.[4]

As of  2011[update] the 2011 census Phek district has a population of 163,294,[8] roughly equal to the nation of Saint Lucia.[9]  This gives it a ranking of 596th in India (out of a total of 640).[8] Phek has a sex ratio of 951 females for every 1000 males,[8] and a literacy rate of 79.13%.[8]

85% of the population lives in rural areas of the district.[10]

The district is the home of the Chakhesang and Pochury tribes.[2]

The following Angami–Pochuri languages are spoken in Phek district.

Christianity is the religion of 97% of the inhabitants. Other religions followed are Hinduism by 2% of the population, Islam by 0.6%, Buddhism by 0.2%, and a few Jains and Sikhs.[10]

Agriculture is the main occupation with Terrace Rice Cultivation (TRC) as the most predominant.[2] Jhum cultivation is also a common practice.[25]

Important crops produced in the district include Rice, Maize and Millet.[4]

Manufacturing here includes production of salt in Meluri, fruit juice production, weaving, bamboo and wood carving.[2]

The healthcare sector comprises one hospital, two community health centres and eight primary health centres.[3]

The education sector comprises 116 primary schools, 46 middle schools, 18 high schools plus one higher secondary school, and three colleges.[3]

The festivals of Shükhrünyie, Yemshe, Tsükhrünyie, and Nazhü are celebrated in Phek district.[4]


who did liverpool beat in 1981 european cup final

The 1981 European Cup Final was an association football match between Liverpool of England and Real Madrid of Spain on 27 May 1981 at the Parc des Princes, Paris, France. It was the final match of the 1980–81 season of Europe's premier cup competition, the European Cup. Liverpool were appearing in their third final, after two appearances in 1977 and 1978. Real Madrid were appearing in their ninth final, they had previously won the competition six times and lost twice.

1981 European Cup Final

Each club needed to progress through four rounds to reach the final. Matches were contested over two legs, with a match at each team's home ground. All but one of Liverpool's ties were comfortable victories, they beat Bayern Munich on the away goals rule, while they won all their other ties by at least five goals. Real Madrid's matches ranged from close affairs to comfortable victories. In the first round they beat Limerick 7â€“2 on aggregate, but their final two ties were won by at least two goals.

Watched by a crowd of 48,360, the first half was goalless. Liverpool took the lead in the second half when Alan Kennedy scored. They held this lead to win the match 1â€“0, securing Liverpool's third European Cup and a fifth consecutive victory by an English team. Liverpool manager Bob Paisley became the first manager to win the competition three times.

The two teams would meet once again in the 2018 Champions League Final.

Liverpool gained entry to the competition by winning the 1979–80 Football League, entering as English champions.[1] Their opponents in the first round were Finnish champions Oulun Palloseura. The first leg in Finland at the Raatti Stadion was drawn 1–1. The second leg at Liverpool's home ground Anfield resulted in a comprehensive 10–1 victory for Liverpool. Two of their players, Graeme Souness and Terry McDermott, scored a hat-trick. Liverpool won the tie 11–2 on aggregate.[2]

In the second round Liverpool were drawn against Scottish champions Aberdeen, managed by Alex Ferguson. The first leg was at Aberdeen's home ground, Pittodrie, a McDermott goal in the fifth minute ensured a 1–0 victory for Liverpool. The second leg at Anfield was won 4–0 by Liverpool, thus they won the tie 5–0 on aggregate.[3] Liverpool's opponents in the quarter-finals were Bulgarian champions CSKA Sofia. The first leg was held in England, another hat-trick from Souness and goals from McDermott and Sammy Lee gave Liverpool a 5–1 victory. They won the second leg at the Vasil Levski National Stadium 1–0 to progress to the semi-finals courtesy of a 6–1 aggregate victory.[4]

They faced German champions Bayern Munich in the semi-finals. The first leg in England ended in a 0–0 draw. Liverpool needed to score in the second leg to advance to the final. Their cause was not helped when striker Kenny Dalglish had to be replaced in the early minutes of the match by the inexperienced Howard Gayle. However, Gayle rose to the occasion, unsettling the Bayern defence with his attacking threat.[5] With seven minutes of normal time left, Ray Kennedy scored to give Liverpool a 1–0 lead. Bayern responded soon afterwards when Karl-Heinz Rummenigge scored, however they needed to score another goal due to the away goals rule. They were unable to do so and Liverpool progressed to their third final in five seasons.[6]

Real Madrid gained entry to the competition as Spanish champions, after they won the 1979–80 La Liga. Their opponents in the first round were Irish champions Limerick. Limerick took the lead in the first leg at Lansdowne Road, but Real scored twice to win the first leg 2–1.[7] The second leg at Real's home ground, the Santiago Bernabéu Stadium, ended in a 5–1 victory for Real, they won the tie 7–2 on aggregate.[8]

Their opponents in the second round were Hungarian champions Honvéd. A goal from Santillana ensured Real won the first leg 1–0 in Spain. Two goals from Laurie Cunningham and Francisco García Hernández secured a 2–0 victory in the second leg at Honvéd's home ground the Bozsik Stadion, thus, winning the tie 3–0 on aggregate.[8]

In the quarter-finals Real faced Soviet champions Spartak Moscow. A 0–0 at the Dynamo Lenin Stadium in the Soviet Union left the tie finely balanced heading into the second leg in Spain. Two goals from Isidro in the second half secured a 2–0 victory in the match and over aggregate.[8]

Real's opponents in the semi-finals were Italian champions Internazionale. Real won the first leg 2–0 in Spain after goals from Santillana and Juanito. Internazionale needed to score twice to force the tie into extra-time, however they were only able to score once. They won the second leg 1–0, but Real won the tie 2–1 on aggregate to progress to their ninth final.[8]

Liverpool were appearing in their third European Cup Final. They had won their two previous appearances in 1977 and 1978. Real Madrid were appearing in their ninth final, they had won the competition six times,[9] including a record five successive victories from 1956 to 1960. Their sixth victory was in 1966, while their two losses were in 1962 and 1964.[10]

Liverpool had finished fifth during the 1980–81 Football League, thus they needed to win the final to ensure that they would compete in the European Cup the following season. Despite this, Liverpool had won the Football League Cup for the first time earlier in the season, defeating West Ham United 2–1 in a replay after the final finished 1–1.[11] Real Madrid had finished second in the 1980–81 La Liga, they had qualified for the UEFA Cup as a result, but victory would enable them to compete in the European Cup the following season.[12]

Both sides had injury concerns before the match. Liverpool had doubts over a number of players. Kenny Dalglish had not trained for several weeks,[3] while Alan Kennedy had been sidelined for six weeks with a broken wrist.[13] Real had concerns over striker Laurie Cunningham who had been sidelined since November.[3]

Liverpool controlled the opening passages of the game. Their first goalscoring chance came in the 11th minute when Alan Kennedy's 30 yard shot was saved by Real goalkeeper Agustín Rodríguez.[13] Further chances were created, but neither Terry McDermott or Dalglish were able to score. Real started to exert more of an influence after this, midfielder Juanito started to cause Liverpool problems with his passing. One pass found José Antonio Camacho who beat Liverpool defender Alan Hansen but put his shot wide of the Liverpool goal.[14] Despite their scoring opportunity, one problem Real had was to get the best out of their winger Cunningham. Not fully fit, he was tightly marked and made little impact in the match.[3]

Liverpool had a chance to take the lead before half-time. Phil Neal advanced down the right hand side of the pitch and found Dalglish who passed to Graeme Souness, who ran late through the Real defence. His subsequent shot was not held by Agustín Rodríguez, but Souness was unable to get to the rebounded ball. Real had the first chance of the second half. Liverpool's defence had stopped as they thought Cunningham was offside, however he was not and Camacho advanced towards Ray Clemence in the Liverpool goal. Clemence came off his line and ran towards the Real midfielder, Camacho attempted to lob the ball over the keeper, but his shot went over the goal.[14]

The tactical approaches of the two sides were cancelling each other out. Real's slow pace interspersed with high speed bursts,[13] while Liverpool preferred a more deliberate approach, keeping possession and making use of their wingers.[14] Their various forms of marking also negated each other, Real man marked Liverpool's best players such as Dalglish and Souness, while Liverpool were content for the nearest defender to mark the man on the ball.[13]

Despite the tactical battle Liverpool were able to score in the 81st minute. A throw-in from Ray Kennedy found Alan Kennedy, whose run up the left hand side of the pitch caught Real off-guard. Kennedy went past Real defender Rafael García Cortés into the Real box, his subsequent shot beat the Real goalkeeper to give Liverpool the lead. Soon afterwards Liverpool replaced Dalglish with midfielder Jimmy Case in an attempt to see out the match.[13] Although Liverpool had chances to extend their lead as Real went all out to score, Real keeper Agustín Rodríguez made a number of saves to keep his team in the game.[14] The score remained 1–0 and Liverpool won their third European Cup, the first British club to do so.[14] Liverpool's victory meant that Bob Paisley became the first manager to win the European Cup three times.[15]


who was in charge of building the eiffel tower

Alexandre Gustave Eiffel (born Bönickhausen;[4] /ˈaɪfəl/; French pronunciation: [ɛfɛl]; 15 December 1832 – 27 December 1923) was a French civil engineer. A graduate of École Centrale Paris, he made his name with various bridges for the French railway network, most famously the Garabit viaduct. He is best known for the world-famous Eiffel Tower, built for the 1889 Universal Exposition in Paris, and his contribution to building the Statue of Liberty in New York. After his retirement from engineering, Eiffel focused on research into meteorology and aerodynamics, making significant contributions in both fields.

Gustave Eiffel

Gustave Eiffel was born in Burgundy, France, in the city of Dijon, Côte-d'Or, the first child of Catherine-Mélanie (née Moneuse) and Alexandre Bönickhausen (French pronunciation: [bɔnikozɑ̃]).[5] He was a descendant of Jean-René Bönickhausen, who had emigrated from the German town of Marmagen and settled in Paris at the beginning of the 18th century.[6] The family adopted the name Eiffel as a reference to the Eifel mountains in the region from which they had come. Although the family always used the name Eiffel, Gustave's name was registered at birth as Bönickhausen,[1] and was not officially changed to Eiffel until 1880.[2][4]

At the time of Gustave's birth his father, an ex-soldier, was working as an administrator for the French Army; but shortly after his birth, his mother expanded a charcoal business, and soon afterwards his father gave up his job to assist her. Due to his mother's business commitments, Gustave spent his childhood living with his grandmother, but nevertheless remained close to his mother, who was to remain an influential figure until her death in 1878. His father, however, did not play a big part in young Eiffel's early life. The business was successful enough for Catherine Eiffel to sell it in 1843 and retire on the proceeds.[7] Eiffel was not a studious child, and thought his classes at the Lycée Royal in Dijon boring and a waste of time, although in his last two years, influenced by his teachers for history and literature, he began to study seriously, and he gained his baccalauréats in humanities and science.[8] An important part in his education was played by his uncle, Jean-Baptiste Mollerat, who had invented a process for distilling vinegar and had a large chemical works near Dijon, and one of his uncle's friends, the chemist Michel Perret. Both men spent a lot of time with the young Eiffel, teaching him about everything from chemistry and mining to theology and philosophy.

Eiffel went on to attend the Collège Sainte-Barbe in Paris, to prepare for the difficult entrance exams set by engineering colleges in France, and qualified for entry to two of the most prestigious schools – École polytechnique and École Centrale des Arts et Manufactures – and ultimately entered the latter.[9] During his second year he chose to specialize in chemistry, and graduated ranking at 13th place out of 80 candidates in 1855. This is what is thought to be one of the things that led young Eiffel into his career of engineering. This was the year that Paris hosted the second World's Fair, and Eiffel was bought a season ticket by his mother.[10]

After graduation, Eiffel had hoped to find work in his uncle's workshop in Dijon, but a family dispute made this impossible. After a few months working as an unpaid assistant to his brother-in-law, who managed a foundry, Eiffel approached the railway engineer Charles Nepveu, who gave Eiffel his first paid job as his private secretary.[11] However, shortly afterwards Nepveu's company went bankrupt, but Nepveu found Eiffel a job designing a 22 m (72 ft) sheet iron bridge for the Saint Germaine railway. Some of Nepveu's businesses were then acquired by the Compagnie Belge de Matériels de Chemin de Fer: Nepveu was appointed the managing director of the two factories in Paris, and offered Eiffel a job as head of the research department. In 1857 Nepveu negotiated a contract to build a railway bridge over the river Garonne at Bordeaux, connecting the Paris-Bordeaux line to the lines running to Sète and Bayonne, which involved the construction of a 500 m (1,600 ft) iron girder bridge supported by six pairs of masonry piers on the river bed. These were constructed with the aid of compressed air caissons and hydraulic rams, both innovative techniques at the time. Eiffel was initially given the responsibility of assembling the metalwork and eventually took over the management of the entire project from Nepveu, who resigned in March 1860.[12]

Following the completion of the project on schedule Eiffel was appointed as the principal engineer of the Compagnie Belge. His work had also gained the attention of several people who were later to give him work, including Stanislas de la Roche Toulay, who had prepared the design for the metalwork of the Bordeaux bridge, Jean Baptiste Krantz and Wilhelm Nordling. Further promotion within the company followed, but the business began to decline, and in 1865 Eiffel, seeing no future there, resigned and set up as an independent consulting engineer. He was already working independently on the construction of two railway stations, at Toulouse and Agen, and in 1866 he was given a contract to oversee the construction of 33 locomotives for the Egyptian government, a profitable but undemanding job in the course of which he visited Egypt, where he visited the Suez Canal which was being constructed by Ferdinand de Lesseps. At the same time he was employed by Jean-Baptiste Kranz to assist him in the design of the exhibition hall for the Exposition Universelle which was to be held in 1867. Eiffel's principal job was to draw up the arch girders of the Galerie des Machines. In order to carry out this work, Eiffel and Henri Treca, the director of the Conservatoire des Arts et Metiers,[13] conducted valuable research on the structural properties of cast iron, definitively establishing the modulus of elasticity applicable to compound castings.

At the end of 1866 Eiffel managed to borrow enough money to set up his own workshops at 48 Rue Fouquet in Levallois-Perret.[14] His first important commission was for two viaducts for the railway line between Lyon and Bordeaux, and the company also began to undertake work in other countries, including the church of San Marcos in Arica, Chile, which was an all-metal prefabricated building, manufactured in France and shipped to South America in pieces to be assembled on site.

On 6 October 1868 he entered into partnership with Théophile Seyrig, like Eiffel a graduate of the École Centrale, forming the company Eiffel et Cie ("Eiffel and Company"). In 1875, Eiffel et Cie were given two important contracts, one for a new terminus for the line from Vienna to Budapest and the other for a bridge over the river Douro in Portugal.[15] The station in Budapest was an innovative design. The usual pattern for building a railway terminus was to conceal the metal structure behind an elaborate facade: Eiffel's design for Budapest used the metal structure as the centerpiece of the building, flanked on either side by conventional stone and brick-clad structures housing administrative offices.

The bridge over the Douro came about as the result of a competition held by the Royal Portuguese Railroad Company. The task was a demanding one: the river was fast-flowing, up to 20 m (66 ft) deep, and had a bed formed of a deep layer of gravel which made the construction of piers on the river bed impossible, and so the bridge had to have a central span of 160 m (520 ft). This was greater than the longest arch span which had been built at the time.[16] Eiffel's proposal was for a bridge whose deck was supported by five iron piers, with the abutments of the pair on the river bank also bearing a central supporting arch. The price quoted by Eiffel was FF.965,000, far below the nearest competitor and so he was given the job, although since his company was less experienced than his rivals the Portuguese authorities appointed a committee to report on Eiffel et Cie's suitability. The members included Jean-Baptiste Krantz, Henri Dion and Léon Molinos, both of whom had known Eiffel for a long time: their report was favorable, and Eiffel got the job. On-site work began in January 1876 and was complete by the end of October 1877: the bridge was ceremonially opened by King Luis I and Queen Maria Pia, after whom the bridge was named, on 4 November.

The Exposition Universelle in 1878 firmly established his reputation as one of the leading engineers of the time. As well as exhibiting models and drawings of work undertaken by the company, Eiffel was also responsible for the construction of several of the exhibition buildings.[17] One of these, a pavilion for the Paris Gas Company, was Eiffel's first collaboration with Stephen Sauvestre, who was later to become the head of the company's architectural office.

In 1879 the partnership with Seyrig was dissolved, and the company was renamed the Compagnie des Établissements Eiffel.[18] The same year the company was given the contract for the Garabit viaduct, a railway bridge near Ruynes en Margeride in the Cantal département. Like the Douro bridge, the project involved a lengthy viaduct crossing the river valley as well as the river itself, and Eiffel was given the job without any process of competitive tendering due to his success with the bridge over the Douro.[19] To assist him in the work he took on several people who were to play important roles in the design and construction of the Eiffel Tower, including Maurice Koechlin, a young graduate of the Zurich Polytechnikum, who was engaged to undertake calculations and make drawings, and Émile Nouguier, who had previously worked for Eiffel on the construction of the Douro bridge.

The same year Eiffel started work on a system of standardised prefabricated bridges, an idea that was the result of a conversation with the governor of Cochin-China. These used a small number of standard components, all small enough to be readily transportable in areas with poor or non-existent roads, and were joined together using bolts rather than rivets, reducing the need for skilled labour on site. A number of different types were produced, ranging from footbridges to standard-gauge railway bridges.[20]

In 1881 Eiffel was contacted by Auguste Bartholdi who was in need of an engineer to help him to realise the Statue of Liberty. Some work had already been carried out by Eugène Viollet-Le-Duc, but he had died in 1879. Eiffel was selected because of his experience with wind stresses. Eiffel devised a structure consisting of a four-legged pylon to support the copper sheeting which made up the body of the statue. The entire statue was erected at the Eiffel works in Paris before being dismantled and shipped to the United States.[21]

In 1886 Eiffel also designed the dome for the Astronomical Observatory in Nice. This was the most important building in a complex designed by Charles Garnier, later among the most prominent critics of the Tower. The dome, with a diameter of 22.4 m (73 ft), was the largest in the world when built and used an ingenious bearing device: rather than running on wheels or rollers, it was supported by a ring-shaped hollow girder floating in a circular trough containing a solution of magnesium chloride in water. This had been patented by Eiffel in 1881.

The design of the Eiffel Tower was originated by Maurice Koechlin and Emile Nouguier, who had discussed ideas for a centrepiece for the 1889 Exposition Universelle. In May 1884 Koechlin, working at his home, made an outline drawing of their scheme, described by him as "a great pylon, consisting of four lattice girders standing apart at the base and coming together at the top, joined together by metal trusses at regular intervals".[22] Initially Eiffel showed little enthusiasm, although he did sanction further study of the project, and the two engineers then asked Stephen Sauvestre to add architectural embellishments. Sauvestre added the decorative arches to the base, a glass pavilion to the first level and the cupola at the top. The enhanced idea gained Eiffel's support for the project, and he bought the rights to the patent on the design which Koechlin, Nougier, and Sauvestre had taken out. The design was exhibited at the Exhibition of Decorative Arts in the autumn of 1884, and on 30 March 1885 Eiffel read a paper on the project to the Société des Ingénieurs Civils. After discussing the technical problems and emphasising the practical uses of the tower, he finished his talk by saying that the tower would symbolise[23]

"not only the art of the modern engineer, but also the century of Industry and Science in which we are living, and for which the way was prepared by the great scientific movement of the eighteenth century and by the Revolution of 1789, to which this monument will be built as an expression of France's gratitude."

Little happened until the beginning of 1886, but with the re-election of Jules Grévy as President and his appointment of Edouard Lockroy as Minister for Trade decisions began to be made. A budget for the Exposition was passed and on 1 May Lockroy announced an alteration to the terms of the open competition which was being held for a centerpiece for the exposition, which effectively made the choice of Eiffel's design a foregone conclusion: all entries had to include a study for a 300 m (980 ft) four-sided metal tower on the Champ de Mars. On 12 May a commission was set up to examine Eiffel's scheme and its rivals and on 12 June it presented its decision, which was that only Eiffel's proposal met their requirements. After some debate about the exact site for the tower, a contract was signed on 8 January 1887. This was signed by Eiffel acting in his own capacity rather than as the representative of his company, and granted him one and a half million francs toward the construction costs. This was less than a quarter of the estimated cost of six and a half million francs. Eiffel was to receive all income from the commercial exploitation during the exhibition and for the following twenty years.[24] Eiffel later established a separate company to manage the tower.

The tower had been a subject of some controversy, attracting criticism both from those who did not believe it feasible and from those who objected on artistic grounds. Just as work began at the Champ de Mars, the "Committee of Three Hundred" (one member for each metre of the tower's height) was formed, led by Charles Garnier and including some of the most important figures of the French arts establishment, including Adolphe Bouguereau, Guy de Maupassant, Charles Gounod and Jules Massenet: a petition was sent to Jean-Charles Alphand, the Minister of Works, and was published by Le Temps.[25]

"To bring our arguments home, imagine for a moment a giddy, ridiculous tower dominating Paris like a gigantic black smokestack, crushing under its barbaric bulk Notre Dame, the Tour de Saint-Jacques, the Louvre, the Dome of les Invalides, the Arc de Triomphe, all of our humiliated monuments will disappear in this ghastly dream. And for twenty years... we shall see stretching like a blot of ink the hateful shadow of the hateful column of bolted sheet metal"

18 July 1887

7 December 1887

20 March 1888

15 May 1888

21 August 1888

26 December 1888

Work on the foundations started on 28 January 1887. Those for the east and south legs were straightforward, each leg resting on four 2 m (6.6 ft) concrete slabs, one for each of the principal girders of each leg but the other two, being closer to the river Seine were more complicated: each slab needed two piles installed by using compressed-air caissons 15 m (49 ft) long and 6 m (20 ft) in diameter driven to a depth of 22 m (72 ft)[26] to support the concrete slabs, which were 6 m (20 ft) thick. Each of these slabs supported a limestone block, each with an inclined top to bear the supporting shoe for the ironwork. These shoes were anchored by bolts 10 cm (4 in) in diameter and 7.5 m (25 ft) long. Work on the foundations was complete by 30 June and the erection of the iron work was started. Although no more than 250 men were employed on the site, a prodigious amount of exacting preparatory work was entailed: the drawing office produced 1,700 general drawings and 3,629 detail drawings of the 18,038 different parts needed.[27] The task of drawing the components was complicated by the complex angles involved in the design and the degree of precision required: the positions of rivet holes were specified to within 0.1 mm (0.04 in) and angles worked out to one second of arc. The components, some already riveted together into sub-assemblies, were first bolted together, the bolts being replaced by rivets as construction progressed. No drilling or shaping was done on site: if any part did not fit it was sent back to the factory for alteration. The four legs, each at an angle of 54° to the ground, were initially constructed as cantilevers, relying on the anchoring bolts in the masonry foundation blocks. Eiffel had calculated that this would be satisfactory until they approached halfway to the first level: accordingly work was stopped for the purpose of erecting a wooden supporting scaffold. This gave ammunition to his critics, and lurid headlines including "Eiffel Suicide!" and "Gustave Eiffel has gone mad: he has been confined in an Asylum" appeared in the popular press.[28] At this stage a small "creeper" crane was installed in each leg, designed to move up the tower as construction progressed and making use of the guides for the elevators which were to be fitted in each leg. After this brief pause erection of the metalwork continued, and the critical operation of linking the four legs was successfully completed by March 1888. In order to precisely align the legs so that the connecting girders could be put into place, a provision had been made to enable precise adjustments by placing hydraulic jacks in the footings for each of the girders making up the legs.

The main structural work was completed at the end of March, and on the 31st Eiffel celebrated this by leading a group of government officials, accompanied by representatives of the press, to the top of the tower. Since the lifts were not yet in operation, the ascent was made by foot, and took over an hour, Eiffel frequently stopping to make explanations of various features. Most of the party chose to stop at the lower levels, but a few, including Nouguier, Compagnon, the President of the City Council and reporters from Le Figaro and Le Monde Illustré completed the climb. At 2.35 Eiffel hoisted a large tricolour, to the accompaniment of a 25-gun salute fired from the lower level.[29]

By June construction had reached the second level platform, and on Bastille Day this was used for a fireworks display, and Eiffel held a celebratory banquet for the press on the first level platform.

In 1887, Eiffel became involved with the French effort to construct a canal across the Panama Isthmus. The French Panama Canal Company, headed by Ferdinand de Lesseps, had been attempting to build a sea-level canal, but came to the realization that this was impractical. The plan was changed to one using locks, which Eiffel was contracted to design and build. The locks were on a large scale, most having a change of level of 11 m (36 ft).[30] Eiffel had been working on the project for little more than a year when the company suspended payments of interest on 14 December 1888,[31] and shortly afterwards was put into liquidation. Eiffel's reputation was badly damaged when he was implicated in the financial and political scandal which followed. Although he was simply a contractor, he was charged along with the directors of the project with raising money under false pretenses and misappropriation of funds. On 9 February 1893 Eiffel was found guilty on the charge of misuse of funds, and was fined 20,000 francs and sentenced to two years in prison,[32] although he was acquitted on appeal.[33] The later American-built canal used new lock designs (see History of the Panama Canal).

Shortly after the trial Eiffel had announced his intention to resign from the Board of Directors of the Compagnie des Etablissements Eiffel, and did so at a General Meeting held on 14 February, saying "I have absolutely decided to abstain from any participation in any manufacturing business from now on, and so that no one can be misled and to make it most evident that I intend to remain absolutely uninvolved with the management of the establishments which bear my name, I insist that my name should disappear from the name of the company."[34] The company changed its name to La Société Constructions Levallois-Perret, with Maurice Koechlin as managing director. The name was changed to the Anciens Etablissements Eiffel in 1937.[35]

About six months after his retirement from the Compagnie des Etablissements Eiffel, Eiffel was approached by Felix-Max Richard, owner of the Comptoir General de Photographie. Felix-Max Richard had just lost a lawsuit against him by his brother to enforce a noncompetition agreement. Felix-Max Richard appealed the decision but felt he needed a back-up plan if his appeal was denied. On May 28, 1895, the court denied the appeal and Gustave Eiffel bought the Comptoir with three other men: Joseph Vallot, Alfred Besnier, and Leon Gaumont, who was thirty years his junior.[36] The company was renamed L. Gaumont et Cie after its youngest partner because Eiffel did not want his name on the company. Leon Gaumont was manager and Eiffel was president from 1895 through 1906. The company went public in January 1907 and is one of the oldest motion picture companies in the world.

During those years, Eiffel guided the company, contributed to its capital investments and inventions, and was absorbed by the new technologies and decisions the company made in its first eleven years. In 1897, he collaborated with Louis-Paul Cailletet and Leon Gaumont on a motion picture camera that was installed in a hot-air balloon. According to the correspondence between Gaumont and Eiffel, Eiffel had dark rooms at his Beauleau-Sur-Mer and Vevey vacation homes where he experimented with chemical developers. He patented a photographic heliograph in 1907.[37][38]

He went on to do important work in meteorology and aerodynamics.[39] Eiffel's interest in these areas was a consequence of the problems he had encountered with the effects of wind forces on the structures he had built.

His first aerodynamic experiments, an investigation of the air resistance of surfaces, was carried out by dropping the surface to be investigated together with a measuring apparatus down a vertical cable stretched between the second level of the Eiffel Tower and the ground. Using this Eiffel definitely established that the air resistance of a body was very closely related to the square of the airspeed. He then built a laboratory on the Champ de Mars at the foot of the tower in 1905, building his first wind tunnel there in 1909. The wind tunnel was used to investigate the characteristics of the airfoil sections used by the early pioneers of aviation such as the Wright Brothers, Gabriel Voisin and Louis Blériot. Eiffel established that the lift produced by an airfoil was the result of a reduction of air pressure above the wing rather than an increase of pressure acting on the under surface. Following complaints about noise from people living nearby, he moved his experiments to a new establishment at Auteuil in 1912. Here it was possible to build a larger wind tunnel, and Eiffel began to make tests using scale models of aircraft designs.[40]

In 1913 Eiffel was awarded the Samuel P. Langley Medal for Aerodromics by the Smithsonian Institution. In his speech at the presentation of the medal, Alexander Graham Bell said:[41]

...his writings upon the resistance of the air have already become classical. His researches, published in 1907 and 1911, on the resistance of the air in connection with aviation, are especially valuable. They have given engineers the data for designing and constructing flying machines upon sound, scientific principles

Eiffel had meteorological measuring equipment placed on the tower in 1889, and also built a weather station at his house in Sèvres. Between 1891 and 1892 he compiled a complete set of meteorological readings, and later extended his record-taking to include measurements from 25 different locations across France.

Eiffel died on 27 December 1923, while listening to Beethoven's 5th Symphony, Second movement Andante, in his mansion on Rue Rabelais in Paris, France. He was buried in the family tomb in Levallois-Perret Cemetery.

Gustave Eiffel's career was facilitated by the Industrial Revolution. For a variety of economic and political reasons, this had been slow to make an impact in France,[42] and Eiffel had the good fortune to be working at a time of rapid industrial development in France. Eiffel's importance as an engineer was twofold. Firstly he was ready to adopt innovative techniques first used by others, such as his use of compressed-air caissons and hollow cast-iron piers, and secondly he was a pioneer in his insistence on basing all engineering decisions on thorough calculation of the forces involved, combining this analytical approach with an insistence on a high standard of accuracy in drawing and manufacture.

The growth of the railway network had an immense effect on people's lives, but although the enormous number of bridges and other work undertaken by Eiffel were an important part of this, the two works that did most to make him famous are the Statue of Liberty and the Eiffel Tower, both projects of immense symbolic importance and today internationally recognized landmarks. The Tower is also important because of its role in establishing the aesthetic potential of structures whose appearance is largely dictated by practical considerations.

His contribution to the science of aerodynamics is probably of equal importance to his work as an engineer.[39]

A number of works of Gustave Eiffel are in danger today. Some have already been destroyed, as in Vietnam. A proposal to demolish the railway bridge of Bordeaux (also known as the "passerelle St Jean"), the first major work of Gustave Eiffel, resulted in a large response from the public. Actions to protect the bridge were taken as early as 2002 by the "Association of the Descendants of Gustave Eiffel",[43] joined from 2005 onwards by the Association "Sauvons la Passerelle Eiffel" ("Save the Eiffel Bridge"). They led, in 2010, to the decision to list Eiffel's Bordeaux bridge as a French Historical Monument.[44]


who won dancing with the stars season 22

On May 24, 2016, Nyle DiMarco and his partner Peta Murgatroyd were crowned champions; this was Murgatroyd's second win on the show, as she also won season 14 with Donald Driver. DiMarco is also the first deaf contestant to win the show. Paige VanZant and Mark Ballas finished second, while Ginger Zee and Valentin Chmerkovskiy placed third.

Dancing with the Stars (U.S. season 22)

Season twenty-two of Dancing with the Stars premiered March 21, 2016, on the ABC network.[1] Hosts Tom Bergeron and Erin Andrews returned, as did judges Carrie Ann Inaba and Bruno Tonioli. Len Goodman returned as head judge, after being absent for the previous season.

The cast was revealed on March 8, 2016 on Good Morning America.[2] Edyta Śliwińska returned as a professional dancer this season after an eleven-season hiatus.[3] Also returning to the pro roster are Artem Chigvintsev and Peta Murgatroyd, both of whom did not appear last season as professional dancers, as well as Sasha Farber, who is once again promoted from troupe member to pro dancer. Last season's champion Derek Hough is not returning for this season.[4] Also not returning are Allison Holker, Emma Slater, Anna Trebunskaya, and Louis van Amstel.

Actress Jodie Sweetin was the first celebrity revealed on Good Morning America on March 2, 2016, while TV meteorologist Ginger Zee was also revealed on that show two days later, March 4.[5][6] The remaining celebrities and professionals dancers were later revealed, also on Good Morning America, on March 8.[2]

talk show host

Tom Bergeron and Erin Andrews returned as hosts, while judges Carrie Ann Inaba and Bruno Tonioli returned this season. Head judge Len Goodman has returned after missing last season, while Julianne Hough, who served as a judge during the previous three seasons, did not return.[16]

This table only counts dances scored on a 30-point scale (scores by guest judges are excluded).

The best and worst performances in each dance according to the judges' 30-point scale are as follows (scores by guest judges are excluded):

Scores are based upon a potential 30-point maximum (scores by guest judges are excluded).

Individual judges' scores in the charts below (given in parentheses) are listed in this order from left to right: Carrie Ann Inaba, Len Goodman, Bruno Tonioli.

The couples danced the cha-cha-cha, foxtrot, jive, quickstep, or tango.

The couples danced a Latin-inspired routine; Argentine tango, paso doble, rumba, salsa, and samba are introduced.

Due to a back injury, Mark Ballas was unable to dance with Paige VanZant; troupe member Alan Bersten performed in his place.[8]

The couples performed one unlearned dance to celebrate the most memorable year of their lives; contemporary and waltz are introduced.

Individual judges scores in the chart below (given in parentheses) are listed in this order from left to right: Carrie Ann Inaba, Len Goodman, Zendaya, Bruno Tonioli.

The couples performed one unlearned dance to a song from a Disney film; jazz and Viennese Waltz are introduced.

Individual judges scores in the chart below (given in parentheses) are listed in this order from left to right: Carrie Ann Inaba, Len Goodman, Maksim Chmerkovskiy, Bruno Tonioli.

The celebrities performed one unlearned dance with a different partner selected by the general public; due to the nature of the week, no elimination took place.

The couples performed one unlearned dance that paid tribute to iconic dance performances from films, music videos, or live performances; Bollywood is introduced.

The couples performed one unlearned dance and a team dance to songs from popular musical icons.

Individual judges scores in the chart below (given in parentheses) are listed in this order from left to right: Carrie Ann Inaba, Len Goodman, Bruno Tonioli, America's Score.

The couples performed one unlearned dance and a team-up dance with another couple that was designed and coached by one of the three judges.

To avoid favoritism, the judges did not score their own teams. Instead, the general public was able to score the team-up dances on a scale from 1 to 10, with an averaged score counting alongside the remaining judges.[13]

The couples performed a trio dance involving an eliminated pro or a member of the troupe and an unlearned dance; Charleston is introduced.

On the first night, the couples performed a redemption dance and a freestyle.

On the second night, the couples danced a fusion dance that fused two dance styles.

Running order (Night 1)

Running order (Night 2)

The celebrities and professional partners will dance one of these routines for each corresponding week:

Beginning in week four of the live shows, a celebrity guest judge was present at the judges table to comment on and score the dance routines. Season 16 runner-up Zendaya was the first celebrity guest judge on April 11.[20]


who played hugh on star trek the next generation

Jonathan Del Arco (born March 7, 1966) is a Uruguayan American actor and gay rights and political activist. He is best known for his role as Hugh the Borg on Star Trek: The Next Generation and for his starring role as medical examiner Dr. Morales on The Closer and Major Crimes. He was awarded the 2013 Visibility Award from Human Rights Campaign and is a guest speaker for the organization.

Jonathan Del Arco

As a teenager, Del Arco became interested in acting and the theater.  He often traveled by commuter train to New York City, where he attended plays. He eventually enrolled in acting classes there;[1] and, after graduating from high school, he moved to New York City permanently.[2] Shortly after, Del Arco won a role in the road company of Torch Song Trilogy.[1]

Del Arco partnered with another gay man while living in New York City. This partner died of AIDS in the late 1980s while Del Arco resided in the city.[2]

In 1990, with a role on the Miami Vice television show and a role in the independent film Lost Angeles under his belt, Del Arco moved to Los Angeles, California. Guest starring roles on the television series True Colors, Sisters, The Wonder Years, and Blossom as well as a small role in the film The Mambo Kings followed. His most notable role during this period was as the Borg drone, Hugh, on Star Trek: The Next Generation in 1992, which he reprised in 1993.[3]

Del Arco turned to waiting tables in 1995 for an income. Instead, through a friend, he found paid work on an environmental campaign being led by actor/director Rob Reiner. Over the next decade, Del Arco worked on five political campaigns.  Del Arco credits the political activism with allowing him to find a new passion and expansiveness as an actor, which led to new acting roles.[2]

Del Arco's breakout role came in 2003 when he landed a recurring guest star role on FX Networks' highly popular series Nip/Tuck, where he played a transgender woman named Sofia Lopez. Roles on other highly rated shows such as 24, The Sopranos, and Dollhouse followed.[2] Beginning in 2007, Del Arco had a recurring role on TNT cable network's The Closer as the openly gay medical examiner, Dr. Morales.[4] He continued in the role in the series' spin-off, Major Crimes.[1] In 2014, he appeared in the episode "Love Sucks" of The Crazy Ones as Timothy, the previously unseen husband of Brad Garrett's character.

Del Arco has appeared in a wide range of live theatrical plays.  His Broadway theatre debut came in 1987 in Milcha Sanchez-Scott's Roosters at the INTAR Theatre. Theater critic Mel Gussow called his a "most sensitive performance", and said his debut was "auspicious".[5] His second Broadway role followed in 1988, when he played Martin in Michael Weller's play Spoils of War at the Music Box Theatre (taking over from Christopher Collet).[6] This was followed in 1990 by a role in John Jesurun's Everything That Rises Must Converge at the Kitchen Theatre Company.[7]

Del Arco's numerous other stage performances include (in alphabetical order):[8]

In 1996, Del Arco began participating in the Hispanic Playwrights Project at the South Coast Repertory, and spent six seasons there. He also spent the summer of 1998 and 1999 at the Institute on the Arts and Civic Dialogue at Harvard University, working under Anna Deveare Smith.[8]

Del Arco is a member of Actors' Equity Association.[8]

In addition to acting, Del Arco is a political, environmental, and gay rights activist.

Del Arco  volunteered for Barack Obama.[12] and has worked for three presidential campaigns and he served as an Obama Celebrity Surrogate for the 2012 Presidential Campaign.[13]

He works raising awareness for the Gay, Lesbian and Straight Education Network (GLSEN), which works to improve the educational environment for LGBT elementary and secondary students in the United States.[4][14] Del Arco says his work with GLSEN has been life-changing.

"Never did I imagine that working for a nonprofit organization would have such a great effect on me personally. It's changed the structure of how I use my career as an actor because now I have a reason beyond entertainment to promote something other than me."[2]

In 2013, Del Arco was awarded the 2013 Visibility Award from the Human Rights Campaign and now work with the campaign  as a guest speaker.


why does liver failure lead to kidney failure

HRS can affect individuals with cirrhosis, severe alcoholic hepatitis, or liver failure, and usually occurs when liver function deteriorates rapidly because of a sudden insult such as an infection, bleeding in the gastrointestinal tract, or overuse of diuretic medications. HRS is a relatively common complication of cirrhosis, occurring in 18% of people within one year of their diagnosis, and in 39% within five years of their diagnosis. Deteriorating liver function is believed to cause changes in the circulation that supplies the intestines, altering blood flow and blood vessel tone in the kidneys. The kidney failure of HRS is a consequence of these changes in blood flow, rather than direct damage to the kidney. The diagnosis of hepatorenal syndrome is based on laboratory tests of individuals susceptible to the condition. Two forms of hepatorenal syndrome have been defined: Type 1 HRS entails a rapidly progressive decline in kidney function, while type 2 HRS is associated with ascites (fluid accumulation in the abdomen) that does not improve with standard diuretic medications.

Hepatorenal syndrome

Hepatorenal syndrome (often abbreviated HRS) is a life-threatening medical condition that consists of rapid deterioration in kidney function in individuals with cirrhosis or fulminant liver failure. HRS is usually fatal unless a liver transplant is performed, although various treatments, such as dialysis, can prevent advancement of the condition.

The risk of death in hepatorenal syndrome is very high; the mortality of individuals with type 1 HRS is over 50% over the short term, as determined by historical case series. The only long-term treatment option for the condition is liver transplantation. While awaiting transplantation, people with HRS often receive other treatments that improve the abnormalities in blood vessel tone, including supportive care with medications, or the insertion of a transjugular intrahepatic portosystemic shunt (TIPS), which is a small shunt placed to reduce blood pressure in the portal vein. Some patients may require hemodialysis to support kidney function, or a newer technique called liver dialysis which uses a dialysis circuit with albumin-bound membranes to bind and remove toxins normally cleared by the liver, providing a means of extracorporeal liver support until transplantation can be performed.

Hepatorenal syndrome is a particular and common type of kidney failure that affects individuals with liver cirrhosis or, less commonly, with fulminant liver failure.[1] The syndrome involves constriction of the blood vessels of the kidneys and dilation of blood vessels in the splanchnic circulation, which supplies the intestines.[2] The classification of hepatorenal syndrome identifies two categories of kidney failure, termed type 1 and type 2 HRS, which both occur in individuals with either cirrhosis or fulminant liver failure. In both categories, the deterioration in kidney function is quantified either by an elevation in creatinine level in the blood, or by decreased clearance of creatinine in the urine.[3]

Type 1 HRS is characterized by rapidly progressive kidney failure, with a doubling of serum creatinine to a level greater than 221 μmol/L (2.5 mg/dL) or a halving of the creatinine clearance to less than 20 mL/min over a period of less than two weeks. The prognosis of individuals with type 1 HRS is particularly grim, with a mortality rate exceeding 50% after one month.[4] Patients with type 1 HRS are usually ill, may have low blood pressure, and may require therapy with drugs to improve the strength of heart muscle contraction (inotropes) or other drugs to maintain blood pressure (vasopressors).[5]

In contrast, type 2 HRS is slower in onset and progression. It is defined by an increase in serum creatinine level to >133 μmol/L (1.5 mg/dL) or a creatinine clearance of less than 40 mL/min, and a urine sodium < 10 μmol/L.[6] It also carries a poor outlook, with a median survival of approximately six months unless the affected individual undergoes liver transplantation. Type 2 HRS is thought to be part of a spectrum of illness associated with increased pressures in the portal vein circulation, which begins with the development of fluid in the abdomen (ascites). The spectrum continues with diuretic-resistant ascites, where the kidneys are unable to excrete sufficient sodium to clear the fluid even with the use of diuretic medications. Most individuals with type 2 HRS have diuretic-resistant ascites before they develop deterioration in kidney function.[7]

Both types of hepatorenal syndrome share three major components: altered liver function, abnormalities in circulation, and kidney failure. As these phenomena may not necessarily produce symptoms until late in their course, individuals with hepatorenal syndrome are typically diagnosed with the condition on the basis of altered laboratory tests. Most people who develop HRS have cirrhosis, and may have signs and symptoms of the same, which can include jaundice, altered mental status, evidence of decreased nutrition, and the presence of ascites.[2] Specifically, the production of ascites that is resistant to the use of diuretic medications is characteristic of type 2 HRS. Oliguria, which is a decrease in urine volume, may occur as a consequence of kidney failure; however, some individuals with HRS continue to produce a normal amount of urine.[3] As these signs and symptoms may not necessarily occur in HRS, they are not included in the major and minor criteria for making a diagnosis of this condition; instead HRS is diagnosed in an individual at risk for the condition on the basis of the results of laboratory tests, and the exclusion of other causes.[3]

Hepatorenal syndrome usually affects individuals with cirrhosis and elevated pressures in the portal vein system (termed portal hypertension). While HRS may develop in any type of cirrhosis, it is most common in individuals with alcoholic cirrhosis, particularly if there is concomitant alcoholic hepatitis identifiable on liver biopsies.[8] HRS can also occur in individuals without cirrhosis, but with acute onset of liver failure, termed fulminant liver failure.[3][8]

Certain precipitants of HRS have been identified in vulnerable individuals with cirrhosis or fulminant liver failure. These include bacterial infection, acute alcoholic hepatitis, or bleeding in the upper gastrointestinal tract. Spontaneous bacterial peritonitis, which is the infection of ascites fluid, is the most common precipitant of HRS in cirrhotic individuals. HRS can sometimes be triggered by treatments for complications of liver disease: iatrogenic precipitants of HRS include the aggressive use of diuretic medications or the removal of large volumes of ascitic fluid by paracentesis from the abdominal cavity without compensating for fluid losses by intravenous replacement.[8]

There can be many causes of kidney failure in individuals with cirrhosis or fulminant liver failure. Consequently, it is a challenge to distinguish hepatorenal syndrome from other entities that cause kidney failure in the setting of advanced liver disease. As a result, additional major and minor criteria have been developed to assist in the diagnosis of hepatorenal syndrome.[3]

The major criteria include liver disease with portal hypertension; kidney failure; the absence of shock, infection, recent treatment with medications that affect the function of the kidney (nephrotoxins), and fluid losses; the absence of sustained improvement in kidney function despite treatment with 1.5 litres of intravenous normal saline; the absence of proteinuria (protein in the urine); and, the absence of kidney disease or obstruction of kidney outflow as seen on ultrasound.[3]

The minor criteria are the following: a low urine volume (less than 500 mL (18 imp fl oz; 17 US fl oz) per day), low sodium concentration in the urine, a urine osmolality that is greater than that in the blood, the absence of red blood cells in the urine, and a serum sodium concentration of less than 130 mmol/L.[3]

Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. Individuals with pre-renal kidney failure do not have damage to the kidneys, but as in individuals with HRS, have kidney dysfunction due to decreased blood flow to the kidneys. Also, similarly to HRS, pre-renal kidney failure causes the formation of urine that has a very low sodium concentration. In contrast to HRS, however, pre-renal kidney failure usually responds to treatment with intravenous fluids, resulting in reduction in serum creatinine and increased excretion of sodium.[3] Acute tubular necrosis (ATN) involves damage to the tubules of the kidney, and can be a complication in individuals with cirrhosis, because of exposure to toxic medications or the development of decreased blood pressure. Because of the damage to the tubules, ATN affected kidneys usually are unable to maximally resorb sodium from the urine. As a result, ATN can be distinguished from HRS on the basis of laboratory testing, as individuals with ATN will have urine sodium measurements that are much higher than in HRS; however, this may not always be the case in cirrhotics.[5] Individuals with ATN also may have evidence of hyaline casts or muddy-brown casts in the urine on microscopy, whereas the urine of individuals with HRS is typically devoid of cellular material, as the kidneys have not been directly injured.[3] Some viral infections of the liver, including hepatitis B and hepatitis C can also lead to inflammation of the glomerulus of the kidney.[9][10] Other causes of kidney failure in individuals with liver disease include drug toxicity (notably, the antibiotic gentamicin) or contrast nephropathy, caused by intravenous administration of contrast agents used for medical imaging tests.[3]

The kidney failure in hepatorenal syndrome is believed to arise from abnormalities in blood vessel tone in the kidneys.[2] The predominant theory (termed the underfill theory) is that blood vessels in the kidney circulation are constricted because of the dilation of blood vessels in the splanchnic circulation (which supplies the intestines), which is mediated by factors released by liver disease.[4][11] Nitric oxide,[12] prostaglandins,[2][13] and other vasoactive substances[2] have been hypothesized as powerful mediators of splanchnic vasodilation in cirrhosis.[2] The consequence of this phenomenon is a decrease in the "effective" volume of blood sensed by the juxtaglomerular apparatus, leading to the secretion of renin and the activation of the renin–angiotensin system, which results in the vasoconstriction of vessels systemically and in the kidney specifically.[2] However, the effect of this is insufficient to counteract the mediators of vasodilation in the splanchnic circulation, leading to persistent "underfilling" of the kidney circulation and worsening kidney vasoconstriction, leading to kidney failure.[11]

Studies to quantify this theory have shown that there is an overall decreased systemic vascular resistance in hepatorenal syndrome, but that the measured femoral and kidney fractions of cardiac output are respectively increased and reduced, suggesting that splanchnic vasodilation is implicated in the kidney failure.[14] Many vasoactive chemicals have been hypothesized as being involved in mediating the systemic hemodynamic changes, including atrial natriuretic factor,[15] prostacyclin, thromboxane A2,[16] and endotoxin.[4] In addition to this, it has been observed that the administration of medications to counteract splanchnic vasodilation (such as ornipressin,[15] terlipressin,[17] and octreotide)[18] leads to improvement in glomerular filtration rate (which is a quantitative measure of kidney function) in patients with hepatorenal syndrome, providing further evidence that splanchnic vasodilation is a key feature of its pathogenesis.

The underfill theory involves activation of the renin–angiotensin–aldosterone system, which leads to an increase in absorption of sodium from the kidney tubule (termed renal sodium avidity) mediated by aldosterone, which acts on mineralocorticoid receptors in the distal convoluted tubule.[7][11] This is believed to be a key step in the pathogenesis of ascites in cirrhotics as well. It has been hypothesized that the progression from ascites to hepatorenal syndrome is a spectrum where splanchnic vasodilation defines both resistance to diuretic medications in ascites (which is commonly seen in type 2 HRS) and the onset of kidney vasoconstriction (as described above) leading to hepatorenal syndrome.[7]

The risk of death in hepatorenal syndrome is very high; consequently, there is a significant emphasis on the identification of patients who are at risk for HRS, and prevention of triggers for onset of HRS. As infection (specifically spontaneous bacterial peritonitis) and gastrointestinal hemorrhage are both complications in individuals with cirrhosis, and are common triggers for HRS, specific care is made in early identification and treatment of cirrhotics with these complications to prevent HRS.[5] Some of the triggers for HRS are induced by treatment of ascites and can be preventable. The aggressive use of diuretic medications should be avoided. In addition, many medications that are either used to treat cirrhotic complications (such as some antibiotics) or other conditions may cause sufficient impairment in kidney function in the cirrhotic to lead to HRS.[4][5] Also, large volume paracentesis—which is the removal of ascites fluid from the abdomen using a needle or catheter in order to relieve discomfort—may cause enough alteration in hemodynamics to precipitate HRS, and should be avoided in individuals at risk. The concomitant infusion of albumin can avert the circulatory dysfunction that occurs after large-volume paracentesis and may prevent HRS.[19] Conversely, in individuals with very tense ascites, it has been hypothesized that removal of ascitic fluid may improve kidney function if it decreases the pressure on the renal veins.[20]

Individuals with ascites that have become infected spontaneously (termed spontaneous bacterial peritonitis or SBP) are at an especially high risk for the development of HRS.[2] In individuals with SBP, one randomized controlled trial found that the administration of intravenous albumin on the day of admission and on the third day in hospital reduced both the rate of kidney insufficiency and the mortality rate.[21]

The definitive treatment for hepatorenal syndrome is liver transplantation, and all other therapies can best be described as bridges to transplantation.[1][22] While liver transplantation is by far the best available management option for HRS, the mortality of individuals with HRS has been shown to be as high as 25% within the first month after transplantation.[23] Individuals with HRS and evidence of greater hepatic dysfunction (quantified as MELD scores above 36) have been found to be at greatest risk of early mortality after liver transplantation.[23] A further deterioration of kidney function even after liver transplantation in individuals with HRS has been demonstrated in several studies; however, this is transient and thought to be due to the use of medications with toxicity to the kidneys, and specifically the introduction of immunosuppressants such as tacrolimus and cyclosporine that are known to worsen kidney function.[2] Over the long-term, however, individuals with HRS who are the recipients of liver transplants almost universally recover kidney function, and studies show that their survival rates at three years are similar to those who have received liver transplants for reasons other than HRS.[1][2]

In anticipation of liver transplantation (which may be associated with considerable in-hospital delay), several other strategies have been found to be beneficial in preserving kidney function. These include the use of intravenous albumin infusion, medications (for which the best evidence is for analogues of vasopressin, which causes splanchnic vasoconstriction), radiological shunts to decrease pressure in the portal vein, dialysis, and a specialized albumin-bound membrane dialysis system termed molecular adsorbents recirculation system (MARS) or liver dialysis.[2]

Many major studies showing improvement in kidney function in patients with hepatorenal syndrome have involved expansion of the volume of the plasma with albumin given intravenously.[2][24][25] The quantity of albumin administered intravenously varies: one cited regimen is 1 gram of albumin per kilogram of body weight intravenously on the first day, followed by 20 to 40 grams daily.[26] Notably, studies have shown that treatment with albumin alone is inferior to treatment with other medications in conjunction with albumin; most studies evaluating pre-transplant therapies for HRS involve the use of albumin in conjunction with other medical or procedural treatment.[2][27]

Midodrine is an alpha-agonist and octreotide is an analogue of somatostatin, a hormone involved in regulation of blood vessel tone in the gastrointestinal tract. The medications are respectively systemic vasoconstrictors and inhibitors of splanchnic vasodilation, and were not found to be useful when used individually in treatment of hepatorenal syndrome.[1][2][28] However, one study of 13 patients with hepatorenal syndrome showed significant improvement in kidney function when the two were used together (with midodrine given orally, octreotide given subcutaneously and both dosed according to blood pressure), with three patients surviving to discharge.[29] Another nonrandomized, observational study of individuals with HRS treated with subcutaneous octreotide and oral midodrine showed that there was increased survival at 30 days.[1][30]

The vasopressin analogue ornipressin was found in a number of studies to be useful in improvement of kidney function in patients with hepatorenal syndrome,[1][24][31] but has been limited in its use, as it can cause severe ischemia to major organs.[1][24] Terlipressin is a vasopressin analogue that has been found in one large study to be useful for improving kidney function in patients with hepatorenal syndrome with a lesser incidence of ischemia but is not available in the United States.[1][25] A key criticism of all of these medical therapies has been heterogeneity in the populations investigated and the use of kidney function, instead of mortality, as an outcome measure.[32]

Other agents that have been investigated for use in treatment of HRS include pentoxifylline,[33] acetylcysteine,[34] and misoprostol.[1][35] The evidence for all of these therapies is based on either case series, or in the case of pentoxifylline, extrapolated from a subset of patients treated for alcoholic hepatitis.[1]

A transjugular intrahepatic portosystemic shunt (TIPS) involves the decompression of the high pressures in the portal circulation by placing a small stent between a portal and hepatic vein. This is done through radiologically guided catheters which are passed into the hepatic vein either through the internal jugular vein or the femoral vein. Theoretically, a decrease in portal pressures is thought to reverse the hemodynamic phenomena that ultimately lead to the development of hepatorenal syndrome. TIPS has been shown to improve kidney function in patients with hepatorenal syndrome.[7][36][37] Complications of TIPS for treatment of HRS include the worsening of hepatic encephalopathy (as the procedure involves the forced creation of a porto-systemic shunt, effectively bypassing the ability of the liver to clear toxins), inability to achieve adequate reduction in portal pressure, and bleeding.[7][36]

Liver dialysis involves extracorporeal dialysis to remove toxins from the circulation, usually through the addition of a second dialysis circuit that contains an albumin-bound membrane. The molecular adsorbents recirculation system (MARS) has shown some utility as a bridge to transplantation in patients with hepatorenal syndrome, yet the technique is still nascent.[7][38]

Renal replacement therapy may be required to bridge individuals with hepatorenal syndrome to liver transplantation, although the condition of the patient may dictate the modality used.[39] The use of dialysis, however, does not lead to recuperation or preservation of kidney function in patients with HRS, and is essentially only used to avoid complications of kidney failure until transplantation can take place. In patients who undergo hemodialysis, there may even be an increased risk of mortality due to low blood pressure in patients with HRS, although appropriate studies have yet to be performed. As a result, the role of renal replacement therapy in patients with HRS remains unclear.[2]

As the majority of individuals with hepatorenal syndrome have cirrhosis, much of the epidemiological data on HRS comes from the cirrhotic population. The condition is quite common: approximately 10% of individuals admitted to hospital with ascites have HRS.[8] A retrospective case series of cirrhotic patients treated with terlipressin suggested that 20.0% of acute kidney failure in cirrhotics was due to type 1 HRS, and 6.6% was due to type 2 HRS.[17] It is estimated that 18% of individuals with cirrhosis and ascites will develop HRS within one year of their diagnosis with cirrhosis, and 39% of these individuals will develop HRS within five years of diagnosis.[8] Three independent risk factors for the development of HRS in cirrhotics have been identified: liver size, plasma renin activity, and serum sodium concentration.[8]

The prognosis of these patients is grim with untreated patients having an extremely short survival.[4][8][22] The severity of liver disease (as evidenced by the MELD score) has been shown to be a determinant of outcome.[23][40] Some patients without cirrhosis develop HRS, with an incidence of about 20% seen in one study of ill patients with alcoholic hepatitis.[33]

The first reports of kidney failure occurring in individuals with chronic liver diseases were from the late 19th century by Frerichs and Flint.[8] However, the hepatorenal syndrome was first defined as acute kidney failure that occurred in the setting of biliary surgery.[1][41] The syndrome was soon re-associated with advanced liver disease,[22] and, in the 1950s, was clinically defined by Sherlock, Hecker, Papper and Vessin as being associated with systemic hemodynamic abnormalities and high mortality.[8][42] Hecker and Sherlock specifically identified that individuals with HRS had low urinary output, very low sodium in the urine, and no protein in the urine.[1] Murray Epstein was the first to characterize splanchnic vasodilation and kidney vasoconstriction as the key alterations in hemodynamics in patients with the syndrome.[43] The functional nature of the kidney impairment in HRS was crystallized by studies demonstrating that kidneys transplanted from patients with hepatorenal syndrome returned to function in the new host,[44] leading to the hypothesis that hepatorenal syndrome was a systemic condition and not a kidney disease. The first systematic attempt to define hepatorenal syndrome was made in 1994 by the International Ascites Club, a group of liver specialists. The more recent history of HRS has involved elucidation of the various vasoactive mediators that cause the splanchnic and kidney blood flow abnormalities of the condition.[8]


what is the system of government in indonesia

The Politics of Indonesia take place in a framework of a presidential representative democratic republic, whereby the President of Indonesia is both head of state and head of government, and of a multi-party system. Executive power is exercised by the government. Legislative power is vested in both the government and the two People's Representative Councils. The judiciary is independent of the executive and the legislature.[1]

Politics of Indonesia

The 1945 constitution provided for a limited separation of executive, legislative and judicial power. The governmental system has been described as "presidential with parliamentary characteristics."[2] Following the Indonesian riots of May 1998 and the resignation of President Suharto, several political reforms were set in motion via amendments to the Constitution of Indonesia, which resulted in changes to all branches of government. The Economist Intelligence Unit has rated Indonesia as "flawed democracy" in 2016.[3]

An era of Liberal Democracy (Indonesian: Demokrasi Liberal) in Indonesia began on August 17, 1950 following the dissolution of the federal United States of Indonesia less than a year after its formation, and ended with the imposition of martial law and President Sukarno's decree regarding the introduction of Guided Democracy on July 5, 1959. It saw a number of important events, including the 1955 Bandung Conference, Indonesia's first general and Constitutional Assembly elections, and an extended period of political instability, with no cabinet lasting as long as two years.

Guided Democracy (Indonesian: Demokrasi Terpimpin) was the political system in place in Indonesia from 1957 until the New Order began in 1966. It was the brainchild of President Sukarno, and was an attempt to bring about political stability. Sukarno believed that Western-style democracy was inappropriate for Indonesia's situation. Instead, he sought a system based on the traditional village system of discussion and consensus, which occurred under the guidance of village elders.

Indonesia's transition to the "New Order" in the mid-1960s, ousted the country's first president, Sukarno, after 22 years in the position. One of the most tumultuous periods in the country's modern history, it was the commencement of Suharto's 31-year presidency.

Described as the great dhalang ("puppet master"), Sukarno drew power from balancing the opposing and increasingly antagonistic forces of the army and Indonesian Communist Party (PKI). By 1965, the PKI extensively penetrated all levels of government and gained influence at the expense of the army.[4]

On 30 September 1965, six of the military's most senior officers were killed in an action (generally labelled an "attempted coup") by the so-called 30 September Movement, a group from within the armed forces. Within a few hours, Major General Suharto mobilised forces under his command and took control of Jakarta. Anti-communists, initially following the army's lead, went on a violent purge of communists throughout the country, killing an estimated half million people and destroying the PKI, which was officially blamed for the crisis.[5][6]

The politically weakened Sukarno was forced to transfer key political and military powers to General Suharto, who had become head of the armed forces. In March 1967, the Indonesian parliament (MPRS) named General Suharto acting president. He was formally appointed president one year later. Sukarno lived under virtual house arrest until his death in 1970. In contrast to the stormy nationalism, revolutionary rhetoric, and economic failure that characterised the early 1960s under the left-leaning Sukarno, Suharto's pro-Western "New Order" stabilized the economy but continued the policies of Pancasila.

The New Order (Indonesian: Orde Baru) is the term coined by the second Indonesian President Suharto to characterise his regime as he came to power in 1966. Suharto used this term to contrast his rule with that of his predecessor, Sukarno (dubbed the "Old Order," or Orde Lama). The term "New Order" in more recent times has become synonymous with the Suharto years (1966â€“1998).

Immediately following the attempted coup in 1965, the political situation was uncertain, but the Suharto's New Order found much popular support from groups wanting a separation from Indonesia's problems since its independence. The 'generation of 66' (Angkatan 66) epitomised talk of a new group of young leaders and new intellectual thought. Following Indonesia's communal and political conflicts, and its economic collapse and social breakdown of the late 1950s through to the mid-1960s, the "New Order" was committed to achieving and maintaining political order, economic development, and the removal of mass participation in the political process. The features of the "New Order" established from the late 1960s were thus a strong political role for the military, the bureaucratisation and corporatisation of political and societal organisations, and selective but effective repression of opponents. Strident anti-communism remained a hallmark of the regime for its subsequent 32 years.

Within a few years, however, many of its original allies had become indifferent or averse to the New Order, which comprised a military faction supported by a narrow civilian group. Among much of the pro-democracy movement which forced Suharto to resign in the 1998 Indonesian Revolution and then gained power, the term "New Order" has come to be used pejoratively. It is frequently employed to describe figures who were either tied to the Suharto period, or who upheld the practises of his authoritarian regime, such as corruption, collusion and nepotism (widely known by the acronym KKN: korupsi, kolusi, nepotisme).[7]

The Post-Suharto era in Indonesia began with the fall of Suharto in 1998 during which Indonesia has been in a period of transition, an era known in Indonesia as Reformasi (English: Reform[8][9][10]). A more open and liberal political-social environment ensued following the resignation of authoritarian President Suharto, ending the three decades of the New Order period.

A constitutional reform process lasted from 1999 to 2002, with four constitutional amendments producing important changes.[11]

Among these are term limits of up to 2 five-year terms for the President and Vice-President, and measures to institute checks and balances. The highest state institution is the People's Consultative Assembly (MPR), whose functions previously included electing the president and vice-president (since 2004 the president has been elected directly by the people), establishing broad guidelines of state policy, and amending the constitution. The 695-member MPR includes all 550 members of the People's Representative Council (DPR) (the House of Representatives) plus 130 "regional representatives" elected by the twenty-six provincial parliaments and sixty-five appointed members from societal groups[12]

The DPR, which is the premier legislative institution, originally included 462 members elected through a mixed proportional/district representational system and thirty-eight appointed members of the armed forces (TNI) and police (POLRI). TNI/POLRI representation in the DPR and MPR ended in 2004. Societal group representation in the MPR was eliminated in 2004 through further constitutional change.[13][14]

Having served as rubberstamp bodies in the past, the DPR and MPR have gained considerable power and are increasingly assertive in oversight of the executive branch. Under constitutional changes in 2004, the MPR became a bicameral legislature, with the creation of the Dewan Perwakilan Daerah (DPD), in which each province is represented by four members, although its legislative powers are more limited than those of the DPR. Through his appointed cabinet, the president retains the authority to conduct the administration of the government.[15]

A general election in June 1999 produced the first freely elected national, provincial and regional parliaments in over forty years. In October 1999 the MPR elected a compromise candidate, Abdurrahman Wahid, as the country's fourth president, and Megawati Sukarnoputri — a daughter of Sukarno, the country's first president — as the vice-president. Megawati's PDI-P party had won the largest share of the vote (34%) in the general election, while Golkar, the dominant party during the Soeharto era, came in second (22%). Several other, mostly Islamic parties won shares large enough to be seated in the DPR. Further democratic elections took place in 2004 and 2009.

The president and vice-president are selected by vote of the citizens for five-year terms. Prior to 2004, they were chosen by People's Consultative Assembly. The last election was held 9 July 2014. The president heads the Kabinet Kerja which means the cabinet of work. The President of Indonesia is directly elected for a maximum of two five-year terms, and is the head of state, commander-in-chief of Indonesian armed forces and responsible for domestic governance and policy-making and foreign affairs. The president appoints a cabinet, who do not have to be elected members of the legislature.[16]

The People's Consultative Assembly (Indonesian: Majelis Permusyawaratan Rakyat, MPR) is the legislative branch in Indonesia's political system. Following elections in 2004, the MPR became a bicameral parliament, with the creation of the DPD as its second chamber in an effort to increase regional representation.[17]

The Regional Representatives Council (Indonesian: Dewan Perwakilan Daerah, DPD) is the upper house of The People's Consultative Assembly. The lower house is The People's Representative Council (Indonesian: Dewan Perwakilan Rakyat, DPR), sometimes referred to as the House of Representatives, which has 560 members, elected for a five-year term by proportional representation in multi-member constituencies.

The General Elections Commission (Indonesian: Komisi Pemilihan Umum, KPU ) is the body responsible for running both parliamentary and presidential elections in Indonesia. Article 22E(5) of the Constitution rules that the Commission is national, permanent, and independent. Prior to the General Election of 2004, KPU was made up of members who were also members of political parties. However, members of KPU must now be non-partisan.

Note: 1. Results are pending to appeals made in the Constitutional Court.
2. Aceh local parties only contested for the regional legislative assemblies, not the DPR. Results are included here for completeness. The remainder of the votes were won by national parties.

The Indonesian Supreme Court (Indonesian: Mahkamah Agung) is the highest level of the judicial branch. Its judges are appointed by the president. The Constitutional Court (Indonesian: Mahkamah Konstitusi) rules on constitutional and political matters, while a Judicial Commission (Indonesian: Komisi Yudisial) oversees the judges.[24]

During the regime of president Suharto, Indonesia built strong relations with the United States and had difficult relations with the People's Republic of China owing to Indonesia's anti-communist policies and domestic tensions with the Chinese community. It received international denunciation for its annexation of East Timor in 1978. Indonesia is a founding member of the Association of South East Asian Nations, and thereby a member of both ASEAN+3 and the East Asia Summit.

Since the 1980s, Indonesia has worked to develop close political and economic ties between South East Asian nations, and is also influential in the Organisation of Islamic Cooperation. Indonesia was heavily criticised between 1975 and 1999 for allegedly suppressing human rights in East Timor, and for supporting violence against the East Timorese following the latter's secession and independence in 1999. Since 2001, the government of Indonesia has co-operated with the US in cracking down on Islamic fundamentalism and terrorist groups.