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13: Appendices


13: Appendices

Appendices

Fundamental activities that involve working with a patient who has been diagnosed with an infectious disease to identify and provide support to people (contacts) who may have been infected through exposure to the patient. This process prevents further transmission of disease by separating people who have (or may have) an infectious disease from people who do not.

Close Contact

Someone who has been within 6 feet of an infected person (laboratory-confirmed or a clinically compatible illness) for a cumulative total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes in one day). An infected person can spread SARS-CoV-2 starting from 2 days before they have any symptoms (or, for asymptomatic patients, 2 days before the positive specimen collection date), until they meet criteria for discontinuing home isolation.

Public Health Recommendations:

Except in certain circumstances, people who have been in close contact with someone who has COVID-19 should quarantine. However, the following people with recent exposure may NOT need to quarantine:

Additional Information:

A number of factors can influence COVID-19 exposure risk, including type, proximity, and duration of exposure, environmental factors (for example, crowding), vaccination status, prior COVID-19 infection, and mask use.

Correct and consistent mask use is a critical step that people can take to protect themselves and others from COVID-19. However, the type of masks used, and whether or not they are used consistently and correctly varies throughout the general population. Therefore, mask use is not considered when determining COVID-19 exposure and the definition of a close contact during case investigation and contact tracing, regardless of whether the person diagnosed with and/or the person exposed to COVID-19 was wearing a mask. (Note: Exposure risk in the healthcare setting is determined separately and outlined in CDC guidance).

Confirmed COVID-19 Case

Report of person with COVID-19 and meeting confirmatory laboratory evidence.

Contact Elicitation Window

The timeframe when the case was likely infectious and not under isolation. This is the time period for which possible contacts should be elicited.

Critical Infrastructure Worker

Having come into contact with a cause of, or possessing a characteristic that is a determinant of, a particular health problem. Principles of Epidemiology in Public Health Practice.

First-responder

Law enforcement, fire services, emergency medical services, and emergency management officials. EMS Guidance.

Healthcare personnel

All paid and unpaid people serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances contaminated medical supplies, devices, and equipment contaminated environmental surfaces or contaminated air. Potential Exposure at Work.

Incubation period

Period of time between exposure to an infection and onset of symptoms

The separation of a person or group of people known or reasonably believed to be infected with a communicable disease and potentially infectious from those who are not infected to prevent spread of the communicable disease. Isolation for public health purposes may be voluntary or compelled by federal, state, or local public health order.

Multigenerational Household

Households that consist of more than two generations living under the same roof external icon . Many researchers also include households with a grandparent and at least one other generation.

Probable COVID-19 Case

Report of person meeting clinical AND epidemiologic evidence of COVID-19 but without confirmatory laboratory evidence. More about Probable COVID-19 Case pdf icon [252 KB, 10 Pages] external icon .

The separation of a person or group of people reasonably believed to have been exposed to a communicable disease but not yet symptomatic from others who have not been so exposed to prevent the possible spread of the communicable disease. Quarantine may be voluntary or compelled by federal, state, or local public health order.

When the locating information provided for a patient or close contact is insufficient, case investigation and contact tracing may come to an abrupt halt. The following list includes additional resources that may be used to obtain missing locating information and keep the investigation moving forward.

  • State DMV records
  • Online people search engines (may incur additional costs)
  • Health department records
  • Following up with the index case to ask for additional locating information on a contact
  • Jail and other correctional facility records
  • Property tax records
  • Frequent shopper cards
  • Women Infants and Children Program, Food Stamps and other social services records
  • Online white pages
  • Google maps
  • Employment records
Case Investigation
Data Element Type Codes Notes
Locating Information
Investigator Open Text Name of investigator
Investigator ID Numeric
Date Assigned for Investigation Date
Index patient ID Numeric Autogenerated
Lot Number (to link related cases and contacts) Numeric To track clusters
Patient Last Name Open Text
Patient First Name Open Text
Patient Preferred Name Open Text
DOB Date
Gender Categorical M/F/Other/Unk
Primary Language Open Text/Categorical
Interpreter used Categorical Y/N/U/R
Residential Street Address Open Text
City of Residence Open Text
County of Residence Open Text
State of Residence Open Text
Zip code Numeric
Tribal Affiliation Open Text
Born in the United States Categorical Y/N/U/R
Phone Number 1 Numeric
Phone Number 2 Numeric
Email 1 Open Text
Email 2 Open Text
Ok to Text Categorical Yes, No, Partial, Refused
Ok to Email Categorical Yes, No, Partial, Refused
Race Categorical Check all apply Use Census pdf icon [454 KB, 4 Pages] external icon or HHS external icon categories
Ethnicity Categorical Check box Use Census pdf icon [454 KB, 4 Pages] external icon or HHS external icon categories
Date of interview Attempt 1 Date
Interview 1 occurred Categorical Yes, No, Partial, Refused
Date of interview Attempt 2 Date
Interview 2 occurred Categorical Yes, No, Partial, Refused
Date of interview Attempt 3 Date
Interview 3 occurred Categorical Yes, No, Partial, Refused
Symptoms and Clinical Course
Fever Categorical Check Box (Y/N/U/R)
Cough Categorical Check Box (Y/N/U/R)
Shortness of Breath Categorical Check Box (Y/N/U/R)
Diarrhea/GI Categorical Check Box (Y/N/U/R)
Headache Categorical Check Box (Y/N/U/R)
Muscle ache Categorical Check Box (Y/N/U/R)
Chills Categorical Check Box (Y/N/U/R)
Sore throat Categorical Check Box (Y/N/U/R)
Vomiting Categorical Check Box (Y/N/U/R)
Abdominal Pain Categorical Check Box (Y/N/U/R)
Nasal congestion Categorical Check Box (Y/N/U/R)
Loss of sense of smell Categorical Check Box (Y/N/U/R)
Loss of sense of taste Categorical Check Box (Y/N/U/R)
Malaise Categorical Check Box (Y/N/U/R)
Fatigue Categorical Check Box (Y/N/U/R)
Other symptom Categorical
Other symptom description Open Text
Date of symptom onset Date
SARS-CoV-2 testing Categorical Check Box (Y/N/U/R)
Date of first SARS-CoV-2 test Date
Results of first SARS-CoV-2 test Categorical Pos/Neg/Equi/Unk
Date of last SARS-CoV-2 test Date
Results of last SARS-CoV-2 test Categorical Pos/Neg/Equi/Unk
Hospitalized Categorical Yes, No, Partial, Refused
Pneumonia Categorical Yes, No, Partial, Refused
ECMO
ICU Categorical Yes, No, Partial, Refused
Death Categorical Yes, No, Partial, Refused
Stroke Categorical Yes, No, Partial, Refused
MI Categorical Yes, No, Partial, Refused
Pre-existing conditions
Chronic lung disease Categorical Yes, No, Partial, Refused
Diabetes Categorical Yes, No, Partial, Refused
Severe Obesity (BMI>=40) Categorical Yes, No, Partial, Refused
CVD Categorical Yes, No, Partial, Refused
Chronic renal disease Categorical Yes, No, Partial, Refused
Chronic liver disease Categorical Yes, No, Partial, Refused
Immunocompromised Categorical Yes, No, Partial, Refused
Pregnant (if Female) Categorical Yes, No, Partial, Refused
Risk Factors
Contact with confirmed COVID case Categorical Y/N/U/R
Employed Categorical Yes/No-unemployed/No-retired/No-unable to work/No-student
If employed, what occupation Open text
If employed, what kind of workplace Open text
HCP Categorical Y/N/U/R Work or volunteer in a healthcare setting
If HCP, what kind of setting
Hospital Categorical Check box
Ambulatory care Categorical Check box
EMS/Fire/Law Enforcement/1st responder Categorical Check box
Urgent care Categorical Check box
Long term care Categorical Check box
Hospice Categorical Check box
Name of HCP setting Open Text
Address of HCP setting Open Text
Congregate setting Categorical Y/N/U/R Do you live or work in congregate setting
If Congregate, what kind
Corrections Categorical Check box
Dorm Categorical Check box
Group home Categorical Check box
Multi-family household Categorical Check box
Multi-generational household Categorical Check box
Name of congregate setting Open Text
Address of congregate setting Open Text
Contact Tracing (during contact elicitation window)
Any household contact Categorical Y/N/U/R
Total Number of household contacts Numeric
Can you self-isolate Categorical Y/N/U/R Add in script what this means (use of bedroom and bathroom away from others)
Do you need assistance to self-isolate Categorical Y/N/U/R
Any intimate partners Categorical Y/N/U/R Partners you do not reside with
Total Number of Intimate Partners Numeric
Any other people in close-contact with, including coworkers Categorical Y/N/U/R
Contact Elicitation Investigation
Data Element Type Codes Notes
Index Information Collected on the index
Investigator Open Text Name of investigator
Investigator ID Numeric
Date Assigned for Investigation Date
Index patient ID Numeric Autogenerated
Lot Number Numeric To track clusters
Date of contact elicitation Date
Start date of Contact Elicitation Window Date
End date of Contact Elicitation Window Date
Information about contacts Ask for each identified contact
Contact Last Name Open Text
Contact First Name Open Text
Contact AKA Open Text
Contact Phone 1 Open Text
Contact Phone 2 Open Text
Contact email 1 Open Text
Contact email 2 Open Text
Contact social media handle 1 Open Text Twitter, Grindr, etc.
Contact social media handle 2 Open Text
Contact Address Open Text
Contact setting Check all that apply
Home Check box
School Check box
Day Care Check box
Workplace Check box includes customers/clients/patients and coworkers
Place of Worship Check box
Shelter Check box
Hospital/Medical Care Check box
Travel or Transit Check box
Retail setting Check box includes, supermarkets, gas stations, farmers markets, etc.
Duration of Exposure (minutes) Numeric
Pre-existing conditions If known
Chronic lung disease Categorical Y/N/U/R
Diabetes Categorical Y/N/U/R
Severe Obesity (BMI>=40) Categorical Y/N/U/R
CVD Categorical Y/N/U/R
Chronic renal disease Categorical Y/N/U/R
Chronic liver disease Categorical Y/N/U/R
Immunocompromised Categorical Y/N/U/R
Pregnant (if Female) Categorical Y/N/U/R
Risk Factors If known
HCP Categorical Y/N/U/R Work or volunteer in a healthcare setting
If HCP, what kind of setting
Hospital Categorical Check box
Ambulatory care Categorical Check box
EMT/Fire/1st responder Categorical Check box
Urgent care Categorical Check box
Long term care Categorical Check box
Hospice Categorical Check box
Congregate setting Categorical Y/N/U/R Do you live or work in congregate setting
If Congregate, what kind
Corrections Categorical Check box
Dorm Categorical Check box
Group home Categorical Check box
Multi-family household Categorical Check box
Multi-generational household Categorical Check box
Community Settings
Travel risk Categorical Y/N/U/R Train, plane, public transit
Specify travel Open Text List specific flights, routes, etc.
Workplace Categorical Y/N/U/R
Specify workplace Open Text Specific work locations
Retail Categorical Y/N/U/R
Specify retail Open Text
Large community social event Categorical Y/N/U/R
Specify Open Text
Recreational activity Categorical Y/N/U/R
Specify Open Text
Places of Worship Categorical Y/N/U/R
Specify Open Text
Contact Investigation
Data Element Type Codes Notes
Locating Information
Investigator Open Text Name of investigator
Investigator ID Numeric
Date Assigned for Investigation Date
Index patient ID Numeric Autogenerated
Lot Number Numeric To track clusters
Contact patient ID Numeric
Contact Last Name Open Text
Contact First Name Open Text
Contact Preferred Name Open Text
DOB Date
Gender Categorical M/F/Other/Unk
Primary Language Open Text/Categorical
Interpreter used Categorical Y/N/U/R
Residential Street Address Open
City of Residence Open Text
County of Residence Open Text
State of Residence Open Text
Zip code Numeric
Tribal Affiliation Open Text
Born in the United States Categorical Y/N/U/R
Phone Number 1 Numeric
Phone Number 2 Numeric
Email 1 Open Text
Email 2 Open Text
Ok to Text Categorical Yes, No, Partial, Refused
Ok to Email Categorical Yes, No, Partial, Refused
Race Categorical Check all apply Use Census pdf icon [454 KB, 4 Pages] external icon or HHS external icon categories
Ethnicity Categorical Check box Use Census pdf icon [454 KB, 4 Pages] external icon or HHS external icon categories
Date of interview Attempt 1 Date
Interview 1 occurred Categorical Yes, No, Partial, Refused
Date of interview Attempt 2 Date
Interview 2 occurred Categorical Yes, No, Partial, Refused
Date of interview Attempt 3 Date
Interview 3 occurred Categorical Yes, No, Partial, Refused
Any household contact Categorical Y/N/U/R
Total Number of household contacts Numeric
Can you self-isolate Categorical Y/N/U/R Add in script what this means (use of bedroom and bathroom away from others)
Do you need assistance to self-isolate Categorical Y/N/U/R
Symptoms and Clinical Course
Fever Categorical Check Box (Y/N/U/R)
Cough Categorical Check Box (Y/N/U/R)
Shortness of Breath Categorical Check Box (Y/N/U/R)
Diarrhea/GI Categorical Check Box (Y/N/U/R)
Headache Categorical Check Box (Y/N/U/R)
Muscle ache Categorical Check Box (Y/N/U/R)
Chills Categorical Check Box (Y/N/U/R)
Sore throat Categorical Check Box (Y/N/U/R)
Vomiting Categorical Check Box (Y/N/U/R)
Abdominal Pain Categorical Check Box (Y/N/U/R)
Nasal congestion Categorical Check Box (Y/N/U/R)
Loss of sense of smell Categorical Check Box (Y/N/U/R)
Loss of sense of taste Categorical Check Box (Y/N/U/R)
Other symptom Categorical
Other symptom description
Date of symptom onset Date
SARS-CoV-2 testing Categorical Check Box (Y/N/U/R)
Date of first SARS-CoV-2 test Date
Results of first SARS-CoV-2 test Categorical Pos/Neg/Equi/Unk
Date of last SARS-CoV-2 test Date
Results of last SARS-CoV-2 test Categorical Pos/Neg/Equi/Unk
Pre-existing conditions
Chronic lung disease Categorical Yes, No, Partial, Refused
Diabetes Categorical Yes, No, Partial, Refused
Severe Obesity (BMI>=40) Categorical Yes, No, Partial, Refused
CVD Categorical Yes, No, Partial, Refused
Chronic renal disease Categorical Yes, No, Partial, Refused
Chronic liver disease Categorical Yes, No, Partial, Refused
Immunocompromised Categorical Yes, No, Partial, Refused
Pregnant (if Female) Categorical Yes, No, Partial, Refused
Risk Factors
Contact with confirmed COVID case Categorical Y/N/U/R
Employed Categorical Yes/No-unemployed/No-retired/No-unable to work/No-student
If employed, what occupation Open text
If employed, what kind of workplace Open text
HCP Categorical Y/N/U/R Work or volunteer in a healthcare setting
If HCP, what kind of setting
Hospital Categorical Check box
Ambulatory care Categorical Check box
EMS/Fire/Law Enforcement/1st responder Categorical Check box
Urgent care Categorical Check box
Long term care Categorical Check box
Hospice Categorical Check box
Name of HCP setting Open Text
Address of HCP setting Open Text
Congregate setting Categorical Y/N/U/R Do you live or work in congregate setting
If Congregate, what kind
Corrections Categorical Check box
Dorm Categorical Check box
Group home Categorical Check box
Multi-family household Categorical Check box
Multi-generational household Categorical Check box
Name of congregate setting Open Text
Address of congregate setting Open Text

Once states have lower COVID-19 case rates for at least 14 days, widely available testing, and adequate medical/hospital resources, contact tracing becomes an important strategy to eliminate transmission of SARS-CoV-2, the virus that causes COVID-19. Contact tracing involves multiple steps, including case investigation of COVID-19 clients, notification of close contacts, and daily monitoring of close contacts. This process can be labor-intensive, and communities have different circumstances that affect contact tracing activities. These factors include the number of persons diagnosed with COVID-19 each day, number of contacts per patient, and the amount of time and resources needed to reach and follow the clients and contacts. The number of contact tracers needed is large and will vary by community. Each community will need to examine local case load and other factors to estimate how many contact tracers will be needed.

Mathematical modeling tools can be used to help estimate the number of contact tracers needed. These models require data to quantify each part of the process. The data used may differ among communities and over the course of the pandemic, which may lead to large differences in estimates from different models &ndash or from the same model if using different values. Each community will need to determine some key parameters to be in the model. Local tuberculosis / sexually transmitted disease contact tracers are likely familiar with community-specific &ldquoinputs&rdquo regarding the average number of contacts per case and how difficult contacts are to find.

CDC does not endorse the use of a specific model however, these tools may be used to guide planning and calculate resources needed under different scenarios. Each community should carefully incorporate as much knowledge about its situation as possible to estimate the number of contact tracers needed.

Content describing non-CDC tools in this document is provided for informational purposes only and is not intended to indicate endorsement, actual or implied, of the tools. Additionally, information on this site is provided &ldquoas is,&rdquo for users to evaluate and make their own determination as to their effectiveness.

This model is built into an Excel workbook and requires input on the following values:

  • # new COVID-19 clients / day
  • # close contacts / COVID-19 patient
  • Proportion of clients who are easy / hard / hardest to reach (and never reached). The amount of time needed to arrange and conduct the initial interview with the index patient can vary.
    • Average time needed for patient investigation for each patient category
    • Average time spent on contact notification for each contact category
    • Average amount of time spent on contacts for each day in each category
    • Hours of daily productive work per contact tracer
    • Number of workdays per week per contact tracer
    • Number of contact tracers per manager

    Changing the parameters in the model will change the estimated total staffing needed, even when keeping the number of daily new COVID-19 patients constant. (Note that this model does not specify overall population size. The total amount of work is proportional to the number of COVID-19 clients and contacts identified in each community rather than the total number of people living in the community.)

    Estimates of contact tracers needed based on different assumptions in the model
    Model developed by Resolve to Save Lives Assumed daily COVID-19 Incidence/ 100,000 persons Contact tracing staff needed / 100,000 persons Notes or assumptions
    Contact Tracing Staffing Calculator -Lower estimate (See below) 9* 33 5 contacts per patient contact tracers work 8 hours/day contacts easy-to-reach many contacts use app/email to report daily.
    Contact Tracing Staffing Calculator &ndash Higher estimate (See below) 136** 3,739 20 contacts per patient contact tracers work 7-hour days contacts harder to reach, take longer to interview, most require calls each day.

    *Between April 15-23, 2020, the daily incidence of COVID-19 in the United States ranged between approximately 8 and 9 per 100,000 (between 25,858 and 29,916 new COVID-19 patients per day assume US population of 328M).

    **Approximate peak daily incidence of COVID-19 in New York City (approx. 11,400 incident new patients on 4/15/2020, assume NYC population of 8.4M).


    BSA/AML Manual

    The following information is provided as guidance. Refer to FinCEN's Suspicious Activity Report (FinCEN SAR) Electronic Filing Requirements, Release Date October 2012, Version 1.2. 306 Refer to the FinCEN's SAR Electronic Filing Instructions. FinCEN's instructions contain a checklist as a guide for preparing the narrative. FinCEN has requested banks include certain key terms in the narrative section of the SAR. A consolidated listing of SAR narrative key terms and a link to the related advisories and guidance can be found on FinCEN's website. 307 Refer to the FinCEN's SAR Advisory Key Terms. Banks also should consult Suggestions for Addressing Common Errors Noted in Suspicious Activity Reporting (October 10, 2007). 308 Refer to Suggestions for Addressing Common Errors Noted in Suspicious Activity Reporting (October 10, 2007).

    Often SARs have been instrumental in enabling law enforcement to initiate or supplement major money laundering or terrorist financing investigations and other criminal cases. Information provided in SARs also allow FinCEN and the federal banking agencies to identify emerging trends and patterns associated with financial crimes. The information about those trends and patterns is vital to law enforcement agencies and provides valuable feedback to financial institutions.

    Banks must file SARs that are complete, sufficient, and timely. Unfortunately, some banks file SARs that contain incomplete, incorrect, or disorganized narratives, making further analysis difficult, if not impossible. Because the SAR narrative serves as the only free text area for summarizing suspicious activity, the narrative section is "critical." The care with which the narrative is written may make the difference in whether or not the described conduct and its possible criminal nature are clearly understood by law enforcement, and thus a failure to adequately describe the factors making a transaction or activity suspicious undermines the purpose of the SAR.

    The SARs should include any information readily available to the filing bank obtained through the account opening process and due diligence efforts. In general, a SAR narrative should identify the five essential elements of information (who? what? when? where? and why?) for the suspicious activity being reported. The method of operation (or how?) is also important and should be included in the narrative.

    Who is conducting the suspicious activity?

    While one section of the SAR calls for specific suspect information, the narrative should be used to further describe the suspect or suspects, including occupation, position or title within the suspect's business, the nature of the suspect's business (or businesses), and any other information and identification numbers associated with the suspects.

    What instruments or mechanisms are being used to facilitate the suspect transactions?

    A list of instruments or mechanisms that may be used in suspicious activity includes, but is not limited to, funds transfers, letters of credit and other trade instruments, correspondent accounts, casinos, structuring, shell companies, bonds or notes, stocks, mutual funds, insurance policies, traveler's checks, bank drafts, money orders, credit or debit cards, prepaid cards, and digital currency business services. The SAR includes a number of check boxes to record the instrument type(s)/payment mechanism(s) involved in the suspicious activity and type(s) of suspicious activity being reported. FinCEN requests that banks check the appropriate box(es) in the Suspicious Activity Information section and include certain key terms in the narrative section of the SAR. If necessary, the instrument and type of suspicious activity can be described in further detail in the narrative. If a SAR narrative summarizes the flow of funds, the narrative should always include the source of the funds (origination) and the use, destination, or beneficiary of the funds.

    When did the suspicious activity take place?

    If the activity takes place over a period of time, indicate the date when the suspicious activity was first noticed and describe the duration of the activity. When possible, in order to better track the flow of funds, individual dates and amounts of transactions should be included in the narrative rather than only the aggregated amount.

    Where did the suspicious activity take place?

    The narrative should indicate where the suspicious activity took place. . The narrative should also specify if the suspected activity or transactions involves a foreign jurisdiction.

    Why does the filer think the activity is suspicious?

    The SAR should describe, as fully as possible, why the activity or transaction is unusual for the customer, considering the types of products and services offered by the filing bank&rsquos industry, and drawing any applicable contrasts with the nature and normally expected activities of similar customers.

    How did the suspicious activity occur?

    The narrative should describe the &ldquomodus operandi&rdquo or the method of operation of the subject conducting the suspicious activity. In a concise, accurate, and logical manner, the narrative should describe how the suspect transaction or pattern of transactions was committed. For example, if what appears to be structuring of currency deposits is matched with outgoing funds transfers from the accounts, the SAR narrative should include information about both the structuring and outbound transfers (including dates, destinations, amounts, accounts, frequency, and beneficiaries of the funds transfers).

    Supporting Documentation

    Filers can include a single, Microsoft Excel file with no more than one megabyte of data as an attachment to the SAR. This file would be most suitable for documenting transaction records that are too numerous to record in Part V. Do not include any other supporting documentation with the SAR. Instead, describe in Part V other supporting documentation not included in the spreadsheet. Filers must retain all supporting documentation or a business record equivalent for five (5) years from the date of the report. All supporting documentation must be made available to appropriate authorities upon request.


    What Appendicitis Really Feels Like, From 13 People Who Have Been There

    Having a horrible stomachache or mysterious abdominal pain is never fun. And it’s even less fun when you’re sitting there curled up in a ball mildly panicking and googling your symptoms, unsure if it’s just horrible gas, nasty period cramps, a bout of food poisoning, or something more severe—like appendicitis.

    Appendicitis just means inflammation of the appendix, which is “a vestigial, meaning not useful, cone-shaped organ that we have hanging off the right side of the colon,” Kyle Staller, M.D., M.P.H., a gastroenterologist at Massachusetts General Hospital, tells SELF. The cause of appendicitis isn't always clear. In many cases, the appendix gets clogged up, like with a fecalith (a hard mass of poop), causing it to become swollen and infected, Dr. Staller explains.

    The telltale symptoms of appendicitis include pain on the right side of the lower abdomen (that typically feels worse if you move around), nausea, bloating, and possibly a fever and/or vomiting, according to the Mayo Clinic.

    You may not have that textbook, localized pain off the bat, however. “The gut nerves really only tell you a general area of where something is wrong,” Dr. Staller explains. “When something’s angry in that area where your appendix is, people actually feel discomfort around their belly button.”

    Generally, a person will first feel sick and notice that pain near the belly button—but these initial symptoms may be tough to distinguish from a typical stomachache, so people often wait it out, Dr. Staller says. Then, as the appendix continues to swell, it will start to irritate the wall of the abdomen, which is when the pain will usually migrate down to the lower part of the abdomen where the appendix is located, and your body will pretty much start telling you, “S.O.S.!”

    If your appendix ruptures, you might actually feel a sensation of relief. “Once in a while we see this in the emergency room. A patient will come to us in excruciating pain, and all of a sudden out of nowhere, the symptoms go away,” Michael Klein, M.D., trauma surgeon and assistant professor of surgery at NYU Langone Health, tells SELF. “Usually this is an indication to the care team that your appendix has ruptured. So although a patient with a ruptured appendix might feel relief and think, ‘Oh, maybe this was a bad cramp,’ the physician will still want to confirm you don’t have untreated appendicitis.”

    A ruptured appendix is a potentially life-threatening complication of appendicitis—which is why you want to rule out appendicitis as quickly as possible, before this happens. “When it ruptures it can cause very serious infections,” Dr. Klein says. “You never can predict when an infected appendix is going to rupture, so surgically removing the appendix before it ruptures is the best form of treatment.” (Patients do respond to antibiotics in many appendicitis cases, Dr. Staller notes, but there’s always the chance of recurrence and potential complications down the line if you do delay surgery.)

    The truth is, if you are dealing with appendicitis, you will most likely know. Just ask these 13 people, many of whom went through a bit of hesitation and confusion about their symptoms, but eventually hit a point where they knew they were not dealing with run-of-the-mill stomach pains.

    “A few months ago, I came home from work on a Friday with plans to meet up with friends that evening, and the pain came out of nowhere. It hit me like a ton of bricks. I had to cancel my plans because I was curled up in a ball on my bed in the fetal position trying to find an angle to position my body that would give me a moment of reprieve. Nothing worked.

    “I had always heard that lower right abdominal pain was the classic sign of an appendicitis, but my pain was a sharp and persistent stabbing below my belly button, before moving to the right. Having suffered ovarian cysts in the past, I also considered that possibility, but again, the placement seemed off. The pain never let up or dulled in the slightest. It felt like knives mercilessly carving up my insides. I couldn't believe how fast I went from feeling absolutely fine to writhing in agonizing pain and crying. I was worried that I was overreacting and being a baby about it. I thought, What if my pain threshold was just low, and this was nothing more than a bad stomachache?

    “So after a good four or so hours of nonstop pain, to the point of tears, I bit the bullet and went to the ER. The last place I wanted to spend my Friday night was in the hospital, especially if it was for nothing, but I couldn’t take it anymore. I was seen within 10 minutes of arriving. Sure enough, they told me I had appendicitis and needed surgery. I had a laparoscopic appendectomy the next morning that took less than an hour to complete. I was released the same day, a few hours later. The whole ordeal took less than 24 hours.”

    “I was having breakfast with a friend and had what seemed like a nagging stomachache. I was 23 at the time. I was never prone to digestive problems, or any health problems at that point, so I figured it would go away. As the day progressed, it got worse. I went to the theater to see a show in the evening with some friends. I was in a lot of pain and mused about going to the hospital until someone suggested it could be gas. By intermission, I simply couldn't sit in a chair anymore with the pain so I went home and straight to bed. I still thought it would pass.

    “This sounds ridiculous, but around midnight, my roommate came home and I was lying in my robe on the linoleum kitchen floor to keep cool, because I was sweating with pain, and still I refused his offer to take me to the hospital. Finally, by about 2 A.M., I drove myself to the hospital. I didn't want to wake my roommate to take me or call an ambulance, and I couldn't bear to wait any longer than necessary. I hobbled into the ER and said, ‘I'll be embarrassed if this is gas, but I think something is really wrong.’

    “I was so doubled over in stabbing pain that it took a couple of staff in the ER to ‘uncurl’ me so they could examine me. They did an ultrasound and ran some other tests and informed me that I was going in for emergency surgery to remove my appendix. I had just started dating someone new who I really liked at that time. My very naive 23-year-old self said to the surgeon, ‘Can we do it later this week? I have a date tomorrow.’ He laughed out loud and said, ‘You have a date with me!’

    “The surgery and the whole experience really pulled the rug out from under me. I had never experienced pain like that. Up until that point, I thought I was in relative control of my body. It was a shock to discover that sometimes, when I least expect it, my body has other plans. I had never been intubated or under general anesthesia, and the pain coming out of major abdominal surgery took my breath away. Even now, 20 years later, I haven't forgotten the experience of becoming a total passenger to my body's limits, and also to modern medicine. It prepared me well for when I gave birth by c-sections though years later.”

    “I was 18 and going on college trips, deciding which school I wanted to go to. While visiting one of the schools, I came down with a [high] fever and started to feel lightheaded. Later in the night, I started to feel a sharp pain coming from what seemed like my lower stomach. At first it would come in waves, then at some point the pain intensified and didn't leave.


    Appendix XIV, SAVERR/TIERS Type Program Chart

    Revision 17-1 Effective March 15, 2017

    The following chart may be used for the determination of financial eligibility based on automated records. It indicates the type of programs registered on the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR) and the Texas Integrated Eligibility Redesign System (TIERS), and how existing coverage affects eligibility for Community Care Services Eligibility (CCSE) services.

    Temporary Assistance for Needy Families (TANF) and Medicaid (three prescriptions, or unlimited if covered by HMO)

    Check SAVERR individual screen to determine if applicant is receiving Regular Medicaid – if so, categorically eligible for Title XIX.

    Medicaid for the Elderly and People with Disabilities (MEPD) Medicaid (three prescriptions)

    Title XIX categorical eligibility

    Medicaid only, for 12 months after TANF eligibility ends (three prescriptions, or unlimited if covered by managed care organization (MCO))

    Title XIX categorical eligibility

    Child Protective Services (CPS) Foster Care Medicaid (unlimited prescriptions)

    Title XIX categorical eligibility

    TP 70
    TP 87
    TP 88
    TP 93
    TP 94
    TP 97
    TP 99

    CPS Foster Care Medicaid (unlimited prescriptions)

    Title XIX categorical eligibility

    TP 52
    TP 53
    TP 54
    TP 57
    TP 58
    TP 59
    TP 70

    TANF foster care (unlimited prescriptions)

    Title XIX categorical eligibility

    Prior Medicaid for an individual applying for institutional or waiver Medicaid

    Categorically eligible for Title XIX during the months in which individual has active coverage.

    MEPD three-months-prior Medicaid (three prescriptions)

    Categorically eligible for Title XIX during the months in which individual has active coverage.

    Historical prior medical – MEPD or Texas Works (TW)

    Categorically eligible for Title XIX during the months in which individual has active coverage.

    Manual Supplemental Security Income (SSI) Medicaid for nursing facility resident

    Not eligible for Community Care Services Eligibility (CCSE) under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a Community Attendant Services (CAS) referral.

    Manual SSI recipient waivers

    Already covered under a Medicaid Waiver, so may or may not be eligible for CCSE. Community Living Assistance and Support Services (CLASS) cannot receive any CCSE service, except Title XX Day Activity and Health Services (DAHS). See Appendix XX, Mutually Exclusive Services.

    Title XIX categorically eligible

    Manual SSI recipient, non-state community based group homes

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact Social Security Administration (SSA) (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Medicaid for state hospital resident

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Medicaid for state supported living center resident

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Manual SSI recipient, state community based group homes

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Title XIX categorically eligible

    Institutional SSI Medicaid coverage for individuals in nursing facilities (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Categorically eligible for Title XIX CCSE services during active months.

    Already covered under a Medicaid Waiver, so may or may not be eligible for CCSE. CLASS cannot receive any CCSE service, except Title XX DAHS. See Appendix XX.

    SSI Medicaid for individuals living in the community (three prescriptions)

    Title XIX categorical eligibility

    Institutional SSI Medicaid coverage for individuals in ICF/IID facilities (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Institutional SSI Medicaid coverage for individuals in state supported living centers (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    SSI recipient, state community-based group home

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    SSI Medicaid for recipients in chest hospitals

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then have the individual or authorized representative contact SSA (at the local office or at 1-800-772-1213) to correct the eligibility record.

    Categorically eligible for Title XIX CCSE services during active months.

    Institutional Medical Assistance Only (MAO) Medicaid coverage for individuals in nursing facilities (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Medicaid waivers – Home and Community-based Services (HCS), CLASS, Deaf Blind with Multiple Disabilities (DBMD) (unlimited prescriptions)

    Already covered under a Medicaid waiver, so may or may not be eligible for CCSE. CLASS cannot receive any CCSE service, except Title XX DAHS. See Appendix XX.

    Already covered under a Medicaid waiver, so may or may not be eligible for CCSE. CLASS cannot receive any CCSE service, except Title XX DAHS. See Appendix XX.

    Institutional MAO Medicaid coverage for individuals in Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID) (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Medicaid for state hospital residents

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Institutional MAO Medicaid coverage for individuals in state supported living centers (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Medicaid for ICF/IID resident

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    CAS (no prescription coverage)

    The CAS program provides PHC, funded through §1929(b)(2)(B) of the Social Security Act.

    Historical institutional waivers

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Medicaid for disabled adult children (three prescriptions)

    Title XIX categorical eligibility

    SSI transitional Medicaid for children (three prescriptions)
    Interim SSI denied child (three prescriptions)

    Title XIX categorical eligibility – will be denied or transferred to other coverage at age 18.

    Additional four months of Medicaid for the child following denial due to receipt of child support (three prescriptions)

    Title XIX categorical eligibility for the child during eligible months

    Not categorically eligible

    Disabled widow/widowers – Medicaid (three prescriptions)

    Title XIX categorical eligibility

    Early Aged widow/widowers – Medicaid (three prescriptions)

    Title XIX categorical eligibility

    Temporary widow/widowers – Medicaid (three prescriptions)

    Title XIX categorical eligibility during eligible months

    Specified Low-Income Medicare Beneficiary (SLMB) – Pays Part B premium, but no Medicaid (no prescription coverage)

    Title XX categorical eligibility

    Qualifying Individual (QI)-1 – Pays Part B premium, but no Medicaid (no prescription coverage)

    Title XX categorical eligibility

    Title XX categorical eligibility

    Qualified Medicare Beneficiary (QMB). Pays Part B premium, deductibles, co-insurance, but no Medicaid (no prescription coverage)

    Title XX categorical eligibility

    Qualified disabled and working individuals

    Title XX categorical eligibility

    Medicaid for 12-18 months after TANF for certain caretakers (three prescriptions, or unlimited if covered by MCO)

    Title XIX categorical eligibility during eligible months

    Aid and Attendance emergency Medicaid for aliens (three prescriptions)

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition with spend-down

    Categorically eligible for Title XIX services for the coverage period if an effective date appears on the SAVERR record. The case worker will be required to confirm continued eligibility on a monthly basis. Failure to confirm eligibility could result in an invalid finding if the case is pulled for casereading and the individual is no longer Title XIX eligible.

    If the individual name, but no effective date, appears in the SAVERR record, resource eligibility for Title XX already determined by TANF. Test for income eligibility only for Title XX.

    Medicaid for an emergency condition for children 1-5

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition – for children 6-18

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition – for children under 1

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition for pregnant women

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition (historical Family Medical Assistance (FMA))

    Title XIX categorical eligibility during eligible months

    Medicaid for an emergency condition for TF-level families

    Title XIX categorical eligibility during eligible months

    Medicaid for 12-18 months after TANF eligibility (three prescriptions, or unlimited if covered by MCO)

    Title XIX categorical eligibility during eligible months

    Medicaid for pregnant women – coverage ends two full months after birth of child (three prescriptions, or unlimited if covered by MCO)

    Title XIX categorical eligibility during eligible months

    Presumptive Medicaid for pregnant women – converted to TP-40 if ongoing coverage is granted (three prescriptions, or unlimited if covered by MCO)

    Very short-term Title XIX categorical eligibility during eligibility period – check SAVERR for ongoing TP 40 coverage.

    Medicaid for children under age 12 months – coverage may convert to another TP at end of eligibility period

    Title XIX categorical eligibility for the child

    Medicaid for children age 6-18 – coverage ends at 19th birthday

    Title XIX categorical eligibility for the child

    Medicaid for newborns – coverage opened by TMHP when mother is covered by Medicaid in birth month. Coverage under this program ends at end of 12th month, although may convert to another TP

    Title XIX categorical eligibility

    Medicaid for children ineligible for TANF based on stepparent or grandparent income

    Title XIX categorical eligibility for child

    Medicaid for children at least 13 months, but under 6 – may convert to another TP at end of eligibility period

    Title XIX categorical eligibility for child

    Grandfathered institutional MAO Medicaid coverage for individuals in nursing facilities (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Grandfathered Medicaid individuals in the community who were discharged from an institution setting when the ICF II level was phased out (three prescriptions)

    Title XIX categorical eligibility

    Grandfathered Medicaid individuals eligible under Rider 51J

    Title XIX categorical eligibility

    Rider 51 waiver recipients

    Already covered under a Medicaid waiver during covered months, so may or may not be eligible for CCSE. CLASS cannot receive any CCSE service, except Title XX DAHS. See Appendix XX.

    Title XIX categorically eligible during eligible months unless receiving waiver services. If so, not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Grandfathered institutional MAO Medicaid coverage for individuals in ICF/IID facilities (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Grandfathered institutional MAO Medicaid coverage for individuals in state hospitals (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Grandfathered institutional MAO Medicaid coverage for individuals in state supported living centers (unlimited prescriptions)

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Rider 51 ICF/IID state community-based homes

    Not eligible for CCSE under this TP/BP. Confirm living arrangement, then check with MEPD staff to determine if they are aware the individual has moved from the facility. They will test for community programs inform MEPD if this will be a CAS referral.

    Categorically eligible for Title XIX during eligible months

    Medicaid for the medically needy

    Categorically eligible for Title XIX during eligible months

    Medicaid spend-down program – eligibility for CCSE services depends on eligibility status on the SAVERR record.

    Categorically eligible for Title XIX services for the coverage period if an effective date appears on the SAVERR record. The case worker will be required to confirm continued eligibility on a monthly basis. Failure to confirm eligibility could result in an invalid finding if the case is pulled for casereading and the individual is no longer Title XIX eligible.

    If the individual name, but no effective date, appears in the SAVERR record, resource eligibility for Title XX already determined by TANF. Test for income eligibility only for Title XX.

    TANF and Medicaid for two-parent households (three prescriptions, or unlimited if covered by MCO)

    Title XIX categorical eligibility

    Medicaid for two-parent households (three prescriptions, or unlimited if covered by MCO)

    Title XIX categorical eligibility

    One-time TANF – no Medicaid coverage (one adult)

    Not categorically eligible

    One-time TANF – no Medicaid coverage (two parents)

    Not categorically eligible

    Categorically eligible for all Title XX programs, DAHS XIX, PHC and Texas Home Living waiver

    Individuals with an active Supplemental Nutrition Assistance Program case are also categorically eligible for Title XX benefits.


    13: Appendices

    (1) Airframe major alterations. Alterations of the following parts and alterations of the following types, when not listed in the aircraft specifications issued by the FAA, are airframe major alterations:

    (viii) Elements of an airframe including spars, ribs, fittings, shock absorbers, bracing, cowling, fairings, and balance weights.

    (ix) Hydraulic and electrical actuating system of components.

    (xi) Changes to the empty weight or empty balance which result in an increase in the maximum certificated weight or center of gravity limits of the aircraft.

    (xii) Changes to the basic design of the fuel, oil, cooling, heating, cabin pressurization, electrical, hydraulic, de-icing, or exhaust systems.

    (xiii) Changes to the wing or to fixed or movable control surfaces which affect flutter and vibration characteristics.

    (2) Powerplant major alterations. The following alterations of a powerplant when not listed in the engine specifications issued by the FAA, are powerplant major alterations.

    (i) Conversion of an aircraft engine from one approved model to another, involving any changes in compression ratio, propeller reduction gear, impeller gear ratios or the substitution of major engine parts which requires extensive rework and testing of the engine.

    (ii) Changes to the engine by replacing aircraft engine structural parts with parts not supplied by the original manufacturer or parts not specifically approved by the Administrator.

    (iii) Installation of an accessory which is not approved for the engine.

    (iv) Removal of accessories that are listed as required equipment on the aircraft or engine specification.

    (v) Installation of structural parts other than the type of parts approved for the installation.

    (vi) Conversions of any sort for the purpose of using fuel of a rating or grade other than that listed in the engine specifications.

    (3) Propeller major alterations. The following alterations of a propeller when not authorized in the propeller specifications issued by the FAA are propeller major alterations:

    (i) Changes in blade design.

    (iii) Changes in the governor or control design.

    (iv) Installation of a propeller governor or feathering system.

    (v) Installation of propeller de-icing system.

    (vi) Installation of parts not approved for the propeller.

    (4) Appliance major alterations. Alterations of the basic design not made in accordance with recommendations of the appliance manufacturer or in accordance with an FAA Airworthiness Directive are appliance major alterations. In addition, changes in the basic design of radio communication and navigation equipment approved under type certification or a Technical Standard Order that have an effect on frequency stability, noise level, sensitivity, selectivity, distortion, spurious radiation, AVC characteristics, or ability to meet environmental test conditions and other changes that have an effect on the performance of the equipment are also major alterations.

    (1) Airframe major repairs. Repairs to the following parts of an airframe and repairs of the following types, involving the strengthening, reinforcing, splicing, and manufacturing of primary structural members or their replacement, when replacement is by fabrication such as riveting or welding, are airframe major repairs.

    (ii) Monocoque or semimonocoque wings or control surfaces.

    (iii) Wing stringers or chord members.

    (vi) Members of truss-type beams.

    (vii) Thin sheet webs of beams.

    (viii) Keel and chine members of boat hulls or floats.

    (ix) Corrugated sheet compression members which act as flange material of wings or tail surfaces.

    (x) Wing main ribs and compression members.

    (xi) Wing or tail surface brace struts.

    (xiv) Members of the side truss, horizontal truss, or bulkheads.

    (xv) Main seat support braces and brackets.

    (xvi) Landing gear brace struts.

    (xix) Skis, and ski pedestals.

    (xx) Parts of the control system such as control columns, pedals, shafts, brackets, or horns.

    (xxi) Repairs involving the substitution of material.

    (xxii) The repair of damaged areas in metal or plywood stressed covering exceeding six inches in any direction.

    (xxiii) The repair of portions of skin sheets by making additional seams.

    (xxiv) The splicing of skin sheets.

    (xxv) The repair of three or more adjacent wing or control surface ribs or the leading edge of wings and control surfaces, between such adjacent ribs.

    (xxvi) Repair of fabric covering involving an area greater than that required to repair two adjacent ribs.

    (xxvii) Replacement of fabric on fabric covered parts such as wings, fuselages, stabilizers, and control surfaces.

    (xxviii) Repairing, including rebottoming, of removable or integral fuel tanks and oil tanks.

    (2) Powerplant major repairs. Repairs of the following parts of an engine and repairs of the following types, are powerplant major repairs:

    (i) Separation or disassembly of a crankcase or crankshaft of a reciprocating engine equipped with an integral supercharger.

    (ii) Separation or disassembly of a crankcase or crankshaft of a reciprocating engine equipped with other than spur-type propeller reduction gearing.

    (iii) Special repairs to structural engine parts by welding, plating, metalizing, or other methods.

    (3) Propeller major repairs. Repairs of the following types to a propeller are propeller major repairs:

    (i) Any repairs to, or straightening of steel blades.

    (ii) Repairing or machining of steel hubs.

    (iv) Retipping of wood propellers.

    (v) Replacement of outer laminations on fixed pitch wood propellers.

    (vi) Repairing elongated bolt holes in the hub of fixed pitch wood propellers.

    (vii) Inlay work on wood blades.

    (viii) Repairs to composition blades.

    (ix) Replacement of tip fabric.

    (x) Replacement of plastic covering.

    (xi) Repair of propeller governors.

    (xii) Overhaul of controllable pitch propellers.

    (xiii) Repairs to deep dents, cuts, scars, nicks, etc., and straightening of aluminum blades.

    (xiv) The repair or replacement of internal elements of blades.

    (4) Appliance major repairs. Repairs of the following types to appliances are appliance major repairs:

    (i) Calibration and repair of instruments.

    (ii) Calibration of radio equipment.

    (iii) Rewinding the field coil of an electrical accessory.

    (iv) Complete disassembly of complex hydraulic power valves.

    (v) Overhaul of pressure type carburetors, and pressure type fuel, oil and hydraulic pumps.

    (c) Preventive maintenance

    Preventive maintenance is limited to the following work, provided it does not involve complex assembly operations:

    (1) Removal, installation, and repair of landing gear tires.

    (2) Replacing elastic shock absorber cords on landing gear.

    (3) Servicing landing gear shock struts by adding oil, air, or both.

    (4) Servicing landing gear wheel bearings, such as cleaning and greasing.

    (5) Replacing defective safety wiring or cotter keys.

    (6) Lubrication not requiring disassembly other than removal of nonstructural items such as cover plates, cowlings, and fairings.

    (7) Making simple fabric patches not requiring rib stitching or the removal of structural parts or control surfaces. In the case of balloons, the making of small fabric repairs to envelopes (as defined in, and in accordance with, the balloon manufacturers' instructions) not requiring load tape repair or replacement.

    (8) Replenishing hydraulic fluid in the hydraulic reservoir.

    (9) Refinishing decorative coating of fuselage, balloon baskets, wings tail group surfaces (excluding balanced control surfaces), fairings, cowlings, landing gear, cabin, or cockpit interior when removal or disassembly of any primary structure or operating system is not required.

    (10) Applying preservative or protective material to components where no disassembly of any primary structure or operating system is involved and where such coating is not prohibited or is not contrary to good practices.

    (11) Repairing upholstery and decorative furnishings of the cabin, cockpit, or balloon basket interior when the repairing does not require disassembly of any primary structure or operating system or interfere with an operating system or affect the primary structure of the aircraft.

    (12) Making small simple repairs to fairings, nonstructural cover plates, cowlings, and small patches and reinforcements not changing the contour so as to interfere with proper air flow.

    (13) Replacing side windows where that work does not interfere with the structure or any operating system such as controls, electrical equipment, etc.

    (14) Replacing safety belts.

    (15) Replacing seats or seat parts with replacement parts approved for the aircraft, not involving disassembly of any primary structure or operating system.

    (16) Trouble shooting and repairing broken circuits in landing light wiring circuits.

    (17) Replacing bulbs, reflectors, and lenses of position and landing lights.

    (18) Replacing wheels and skis where no weight and balance computation is involved.

    (19) Replacing any cowling not requiring removal of the propeller or disconnection of flight controls.

    (20) Replacing or cleaning spark plugs and setting of spark plug gap clearance.

    (21) Replacing any hose connection except hydraulic connections.

    (22) Replacing prefabricated fuel lines.

    (23) Cleaning or replacing fuel and oil strainers or filter elements.

    (24) Replacing and servicing batteries.

    (25) Cleaning of balloon burner pilot and main nozzles in accordance with the balloon manufacturer's instructions.

    (26) Replacement or adjustment of nonstructural standard fasteners incidental to operations.

    (27) The interchange of balloon baskets and burners on envelopes when the basket or burner is designated as interchangeable in the balloon type certificate data and the baskets and burners are specifically designed for quick removal and installation.

    (28) The installations of anti-misfueling devices to reduce the diameter of fuel tank filler openings provided the specific device has been made a part of the aircraft type certificiate data by the aircraft manufacturer, the aircraft manufacturer has provided FAA-approved instructions for installation of the specific device, and installation does not involve the disassembly of the existing tank filler opening.

    (29) Removing, checking, and replacing magnetic chip detectors.

    (30) The inspection and maintenance tasks prescribed and specifically identified as preventive maintenance in a primary category aircraft type certificate or supplemental type certificate holder's approved special inspection and preventive maintenance program when accomplished on a primary category aircraft provided:

    (i) They are performed by the holder of at least a private pilot certificate issued under part 61 who is the registered owner (including co-owners) of the affected aircraft and who holds a certificate of competency for the affected aircraft (1) issued by a school approved under §147.21(e) of this chapter (2) issued by the holder of the production certificate for that primary category aircraft that has a special training program approved under §21.24 of this subchapter or (3) issued by another entity that has a course approved by the Administrator and

    (ii) The inspections and maintenance tasks are performed in accordance with instructions contained by the special inspection and preventive maintenance program approved as part of the aircraft's type design or supplemental type design.

    (31) Removing and replacing self-contained, front instrument panel-mounted navigation and communication devices that employ tray-mounted connectors that connect the unit when the unit is installed into the instrument panel, (excluding automatic flight control systems, transponders, and microwave frequency distance measuring equipment (DME)). The approved unit must be designed to be readily and repeatedly removed and replaced, and pertinent instructions must be provided. Prior to the unit's intended use, and operational check must be performed in accordance with the applicable sections of part 91 of this chapter.

    (32) Updating self-contained, front instrument panel-mounted Air Traffic Control (ATC) navigational software data bases (excluding those of automatic flight control systems, transponders, and microwave frequency distance measuring equipment (DME)) provided no disassembly of the unit is required and pertinent instructions are provided. Prior to the unit's intended use, an operational check must be performed in accordance with applicable sections of part 91 of this chapter.

    (Secs. 313, 601 through 610, and 1102, Federal Aviation Act of 1958 as amended (49 U.S.C. 1354, 1421 through 1430 and 1502) (49 U.S.C. 106(g) (Revised Pub. L. 97–449, Jan. 21, 1983) and 14 CFR 11.45)

    [Doc. No. 1993, 29 FR 5451, Apr. 23, 1964, as amended by Amdt. 43–14, 37 FR 14291, June 19, 1972 Amdt. 43–23, 47 FR 41086, Sept. 16, 1982 Amdt. 43–24, 49 FR 44602, Nov. 7, 1984 Amdt. 43–25, 51 FR 40703, Nov. 7, 1986 Amdt. 43–27, 52 FR 17277, May 6, 1987 Amdt. 43–34, 57 FR 41369, Sept. 9, 1992 Amdt. 43–36, 61 FR 19501, May 1, 1996]


    13-year-old had appendix and part of bowel removed after participating in ‘tongue piercing’ TikTok trend

    A 13-year-old from England underwent surgery to remove her appendix and a section of her bowel following a failed attempt to recreate a “tongue piercing” TikTok trend.

    According to the Liverpool Echo, TikTokers participating in the trend place magnetic ball bearings on the top and bottom of their tongue to look like a tongue piercing.

    Faye Elizabeth told the paper that her daughter began vomiting and complained of stomach pains, most likely occurring after accidentally swallowing the ball bearings.

    Elizabeth, who lives in Rainhill, England, said she took her daughter to the hospital when her pains worsened.

    Doctors first thought it was appendicitis but after completing a scan, discovered ten magnetic balls lodged inside the daughter’s bowel and appendix. The girl was rushed to another hospital for emergency surgery.

    “They had to take part of her bowel away and re-stitch it. There was [a bead] stuck in her appendix, so they had to remove that,” Elizabeth said. Per the Echo, “surgeons removed 15 magnetic beads from the young girl’s internal organs.”

    The girl is recovering, though she will have a scar reminding her of the catastrophe.

    “I don’t know when she swallowed them because she didn’t admit at first to doing it,” Elizabeth said. “I think she was a bit scared of admitting what she’d done … Apparently, she watched a TikTok video where there’s a trend that all the kids are doing at the minute.”


    13: Appendices

    INVESTIGATING
    INVESTIGATIONS

    to advance the
    State-of-the-Art of
    investigations, through
    investigation process
    research.

    International Investigation Standards

    Extracts for Experimental On-line Investigation Research Project
    Document available from ICAO at http://www.icao.org/icao/en/cat.htm

    INTERNATIONAL STANDARDS AND RECOMMENDED PRACTICES

    AIRCRAFT ACCIDENT AND INCIDENT INVESTIGATION

    TO THE CONVENTION ON INTERNATIONAL CIVIL AVIATION

    When the following terms are used in the Standards and Recommended practices for Aircraft Accident and Incident Investigation they have the following meaning:

    Accident. An occurrence associated with the operation of an aircraft which takes place between the time any person boards the aircraft with the intention of flight until such time as all such persons have disembarked, in which:

    a) a person is fatally or seriously injured as a result of

    - direct contact with any part of the aircraft, including parts which have become detached from the aircraft, or

    - direct exposure to jet blast,

    except when the injuries are from natural causes, self inflicted or inflicted by other persons, or when the injuries are to stowaways hiding outside the areas normally available to the passengers and crew: or

    b) the aircraft sustains damage or structural failure which:

    - adversely affects the structural strength, performance or flight characteristics of the aircraft, and

    - would normally require major repair or replacement of the affected component,

    except for engine failure or damage. when the damage is limited to the engine, its cowlings or accessories: or for damage limited to propellers, wing tips, antennas, tires, brakes, fairings, small dents or puncture holes in the aircraft skin: or

    c) the aircraft is missing or is completely inaccessible.

    Note I.-- For statistical uniformity only, an injury resulting in death within thirty days of the date of the accident is classified as a fatal injury by ICAO.

    Note 2.-- An aircraft is considered to be missing when the official search has been terminated and the wreckage has not been located.

    Accredited representative. A person designated by a State, on the basis of his or her qualifications, for the purpose of participating in an investigation conducted by another State.

    Adviser. A person appointed by a State, on the basis of his or her qualifications, for the purpose of assisting its accredited representative in an investigation.

    Aircraft. Any machine that can derive support in the atmosphere from the reactions of the air other than the reactions of the air against the earth's surface.

    Causes. Actions, omissions, events, conditions, or a combination thereof, which led to the accident or incident.

    Flight recorder. Any type of recorder installed in the aircraft for the purpose of complementing accident/incident Investigation.

    Note.-- See Annex 6, Parts I, II and III, for specifications relating to flight recorders.

    Incident. An occurrence, other than an accident, associated with the operation of an aircraft which affects or could affect the safety of operation.

    Note.-- The type of incidents which are of main interest to the International Civil Aviation Organization for accident prevention studies are listed in the ICAO Accident/lncident Reporting Manual (Doe 9156).

    Investigation. A process conducted for the purpose of accident prevention which includes the gathering and analysis of information, the drawing of conclusions, including the determination of causes and, when appropriate, the making of safety recommendations.

    Investigator-in-charge. A person charged, on the basis of his or her qualifications, with the responsibility for the organization. conduct and control of an investigation.

    Note.-- Nothing in the above definition is intended to preclude the functions of an investigator-in-charge being assigned to a commission or other body.

    Maximum mass. Maximum certificated take-off mass.

    Operator. A person. organization or enterprise engaged in or offering to engage in aircraft operation.

    Preliminary Report. The communication used for the prompt dissemination of data obtained during the early stages of the investigation.

    Safety recommendation. A proposal of the accident investigation authority of the State conducting the investigation, based on information derived from the investigation, made with the intention of preventing accidents or incidents.

    Serious incident. An incident involving circumstances indicating that an accident nearly occurred.

    Note 1.-- The difference between an accident and a serious incident lies only in the result.

    Note 2.-- Examples of serious incidents can be found in Attachment D of Annex 13 and in the ICAO Accident/Incident Reporting Manual (Dot 9156)

    Serious injury. An injury which is sustained by a person in an accident and which:

    a) requires hospitalization for more than 48 hours, commencing within seven days from the date the injury was received: or

    b) results in a fracture of any bone (except simple fractures of fingers. toes, or nose): or

    c) involves lacerations which cause severe hemorrhage. nerve, muscle or tendon damage: or

    d) involves injury to any internal organ: or

    e) involves second or third degree burns, or any burns affecting more than 5 per cent of the body surface: or

    f) involves verified exposure to infectious substances or injurious radiation.

    State of Design. The State having jurisdiction over the organization responsible for the type design.

    State of Manufacture. The State having jurisdiction over the organization responsible for the final assembly of the aircraft.

    State of Occurrence.The State in the territory of which an accident or incident occurs.

    State of the Operator. The State in which the operator's principal place of business is located or, if there is no such place of business, the operators permanent residence.

    State of Registry. The State on whose register the aircraft is entered.

    Note.-- In the case of the registration of aircraft of an international operating agency

    n other than a national basis, the States constituting the agency are jointly and severally bound to assume the obligations which, under the Chicago Convention, attach to) a State of Registry. See, in this regard, the Council Resolution of 14 December 1967 on Nationality and Registration of Aircraft Operated by International Operating Agencies (Doc 8722).

    OBJECTIVE OF THE INVESTIGATION

    3.1 The sole objective of the investigation of an accident or incident shall be the prevention of accidents and incidents. It is not the purpose of this activity to apportion blame or liability.
    . . . . .

    APPENDIX. FORMAT OF THE FINAL REPORT

    The purpose of this format is to present the Final Report in a convenient and uniform manner.

    Detailed guidance for completing each section of the Final Report is found in the ICAO Manual of Aircraft Accident Investigation (Doc 6920).

    Title.The Final Report begins with a title comprising:

    name of the operator: manufacturer. model. nationality and registration marks of the aircraft: place and date of the accident or incident.

    Synopsis.Following the title is a synopsis describing briefly all relevant information regarding:

    notification of accident to national and foreign authorities:

    identification of the accident investigation authority and accredited representation: organization of the investigation:

    authority releasing the report and date of publication:

    and concluding with a brief resume of the circumstances leading to the accident.

    Body.The body of the Final Report comprises the following main headings:

    each heading consisting of a number of sub-headings as outlined in the following.

    Appendices.Include as appropriate.

    Note.- In preparing a Final Report, using this format. ensure that:

    a) all information relevant to an understanding of the factual information analysis and conclusions is included under each appropriate heading:

    b) where information in respect of any of the items in I.-Factual information is not available, or is irrelevant to the circumstances leading to the accident, a note to this effect is included under the appropriate sub-headings.

    1. FACTUAL INFORMATION

    1.1 History of the flight.A brief narrative giving the following information:

    - Flight number, type of operation, last point of departure, time of departure (local time or UTC), point of intended landing.

    - Flight preparation, description of the flight and events leading to the accident, including reconstruction of the significant portion of the flight path, if appropriate.

    - location (latitude, longitude, elevation), time of the accident (local time or UTC whether day or night.

    1.2 Injuries to persons.Completion of the following (in numbers):

    Injuries Crew Passengers Others

    Note.- Fatal injuries include all deaths determined to be a direct result of injuries sustained in the accident. Serious injury is defined in Chapter 1 of the Annex.

    1.3 Damage toaircraft. Brief statement of the damage sustained by aircraft in the accident (destroyed, substantially damaged, slightly damaged, no damage).

    1.4 Other damage.Brief description of damage sustained by objects other than the aircraft.

    1.5 Personnel information:

    a) Pertinent information concerning each of the flight crew members including: age, validity of licences, ratings, mandatory checks, flying experience (total and on type) and relevant information on duty time.

    b) Brief statement of qualifications and experience of other crew members.

    c) Pertinent information regarding other personnel, such as air traffic services, maintenance. etc., when relevant.

    1.6 Aircraft information:

    a) Brief statement on airworthiness and maintenance of the aircraft (indication of deficiencies known prior to and during the flight to be included. if having any bearing on the accident).

    b) Brief statement on performance, if relevant, and whether the mass and centre of gravity were within the prescribed limits during the phase of operation related to the accident. (If not and if of any bearing on the accident give details.)

    1.7 Meteorological information:

    a) Brief statement on the meteorological conditions appropriate to the circumstances including both forecast and actual conditions, and the availability of meteorological information to the crew.

    b) Natural light conditions at the time of the accident (sunlight, moonlight, twilight, etc.).

    1.8 Aids to navigation.Pertinent information on navigation aids available, including landing aids such as ILS, MLS, NDB, PAR. VOR, visual ground aids, etc., and their effectiveness at the time.

    1.9 Communications.Pertinent information on aeronautical mobile and fixed service communications and their effectiveness.

    1.10 Aerodrome information.Pertinent information associated with the aerodrome, its facilities and condition, or with the take-off or landing area if other than an aerodrome.

    1.11 Flight recorders.Location of the flight recorder installations in the aircraft, their condition on recovery and pertinent data available therefrom.

    1 f 12 Wreckage and impact information.General information on the site of the accident and the distribution pattern of the wreckage detected material failures or component malfunctions. Details concerning the location and state of the different pieces of the wreckage are not normally

    required unless it is necessary to indicate a break-up of the aircraft prior to impact. Diagrams, charts and photographs may be included in this section or attached in the Appendices.

    1.13 Medical and pathological information.Brief description of the results of the investigation undertaken and pertinent data available therefrom.

    Note.- Medical information related to flight crew licences should be included in 1.5 - Personnel information.

    1.14 Fire.If fire occurred, information on the nature of the occurrence, and of the fire fighting equipment used and its effectiveness.

    1.15 Survival aspects.Brief description of search, evacuation and rescue, location of crew and passengers in relation to injuries sustained, failure of structures such as seats and seat-belt attachments.

    1.16 Tests and research.Brief statements regarding the results of tests and research.

    1.17 Organizational and management information.

    Pertinent information concerning the organizations and their management involved in influencing the operation of the aircraft. The organizations include, for example, the operator. the air traffic services, airway. aerodrome and weather service agencies: and the regulatory authority. The information could include, but not be limited to, organizational structure and functions, resources, economic status, management policies and practices. and regulatory framework.

    1.18 Additional information.Relevant information not already included in 1.1 to 1.17 above.

    1.19 Useful or effective investigation techniques.When useful or effective investigation techniques have been used during the investigation, briefly indicate the reason for using these techniques and refer here to the main features as well as describing the results under the appropriate sub-headings 1.1 to 1.18.

    Analyse, as appropriate, only the information documented in I. - Factual information and which is relevant to the determination of conclusions and causes.

    List the findings and causes established in the investigation. The list of causes should include both the immediate and the deeper systemic causes.

    4. SAFETY RECOMMENDATIONS

    As appropriate, briefly state any recommendations made for the purpose of accident prevention and any resultant corrective action.

    Include, as appropriate, any other pertinent information considered necessary for the understanding of the report.


    13: Appendices

    Table C.1 lists all tokens that are key words in the SQL standard and in PostgreSQL 13.3. Background information can be found in Section 4.1.1. (For space reasons, only the latest two versions of the SQL standard, and SQL-92 for historical comparison, are included. The differences between those and the other intermediate standard versions are small.)

    SQL distinguishes between reserved and non-reserved key words. According to the standard, reserved key words are the only real key words they are never allowed as identifiers. Non-reserved key words only have a special meaning in particular contexts and can be used as identifiers in other contexts. Most non-reserved key words are actually the names of built-in tables and functions specified by SQL. The concept of non-reserved key words essentially only exists to declare that some predefined meaning is attached to a word in some contexts.

    In the PostgreSQL parser life is a bit more complicated. There are several different classes of tokens ranging from those that can never be used as an identifier to those that have absolutely no special status in the parser as compared to an ordinary identifier. (The latter is usually the case for functions specified by SQL.) Even reserved key words are not completely reserved in PostgreSQL , but can be used as column labels (for example, SELECT 55 AS CHECK , even though CHECK is a reserved key word).

    In Table C.1 in the column for PostgreSQL we classify as “ non-reserved ” those key words that are explicitly known to the parser but are allowed as column or table names. Some key words that are otherwise non-reserved cannot be used as function or data type names and are marked accordingly. (Most of these words represent built-in functions or data types with special syntax. The function or type is still available but it cannot be redefined by the user.) Labeled “ reserved ” are those tokens that are not allowed as column or table names. Some reserved key words are allowable as names for functions or data types this is also shown in the table. If not so marked, a reserved key word is only allowed as an “ AS ” column label name.

    As a general rule, if you get spurious parser errors for commands that contain any of the listed key words as an identifier you should try to quote the identifier to see if the problem goes away.

    It is important to understand before studying Table C.1 that the fact that a key word is not reserved in PostgreSQL does not mean that the feature related to the word is not implemented. Conversely, the presence of a key word does not indicate the existence of a feature.

    Key Word PostgreSQL SQL:2016 SQL:2011 SQL-92
    A non-reserved non-reserved
    ABORT non-reserved
    ABS reserved reserved
    ABSENT non-reserved non-reserved
    ABSOLUTE non-reserved non-reserved non-reserved reserved
    ACCESS non-reserved
    ACCORDING non-reserved non-reserved
    ACOS reserved
    ACTION non-reserved non-reserved non-reserved reserved
    ADA non-reserved non-reserved non-reserved
    ADD non-reserved non-reserved non-reserved reserved
    ADMIN non-reserved non-reserved non-reserved
    AFTER non-reserved non-reserved non-reserved
    AGGREGATE non-reserved
    ALL reserved reserved reserved reserved
    ALLOCATE reserved reserved reserved
    ALSO non-reserved
    ALTER non-reserved reserved reserved reserved
    ALWAYS non-reserved non-reserved non-reserved
    ANALYSE reserved
    ANALYZE reserved
    AND reserved reserved reserved reserved
    ANY reserved reserved reserved reserved
    ARE reserved reserved reserved
    ARRAY reserved reserved reserved
    ARRAY_AGG reserved reserved
    ARRAY_​MAX_​CARDINALITY reserved reserved
    AS reserved reserved reserved reserved
    ASC reserved non-reserved non-reserved reserved
    ASENSITIVE reserved reserved
    ASIN reserved
    ASSERTION non-reserved non-reserved non-reserved reserved
    ASSIGNMENT non-reserved non-reserved non-reserved
    ASYMMETRIC reserved reserved reserved
    AT non-reserved reserved reserved reserved
    ATAN reserved
    ATOMIC reserved reserved
    ATTACH non-reserved
    ATTRIBUTE non-reserved non-reserved non-reserved
    ATTRIBUTES non-reserved non-reserved
    AUTHORIZATION reserved (can be function or type) reserved reserved reserved
    AVG reserved reserved reserved
    BACKWARD non-reserved
    BASE64 non-reserved non-reserved
    BEFORE non-reserved non-reserved non-reserved
    BEGIN non-reserved reserved reserved reserved
    BEGIN_FRAME reserved reserved
    BEGIN_PARTITION reserved reserved
    BERNOULLI non-reserved non-reserved
    BETWEEN non-reserved (cannot be function or type) reserved reserved reserved
    BIGINT non-reserved (cannot be function or type) reserved reserved
    BINARY reserved (can be function or type) reserved reserved
    BIT non-reserved (cannot be function or type) reserved
    BIT_LENGTH reserved
    BLOB reserved reserved
    BLOCKED non-reserved non-reserved
    BOM non-reserved non-reserved
    BOOLEAN non-reserved (cannot be function or type) reserved reserved
    BOTH reserved reserved reserved reserved
    BREADTH non-reserved non-reserved
    BY non-reserved reserved reserved reserved
    C non-reserved non-reserved non-reserved
    CACHE non-reserved
    CALL non-reserved reserved reserved
    CALLED non-reserved reserved reserved
    CARDINALITY reserved reserved
    CASCADE non-reserved non-reserved non-reserved reserved
    CASCADED non-reserved reserved reserved reserved
    CASE reserved reserved reserved reserved
    CAST reserved reserved reserved reserved
    CATALOG non-reserved non-reserved non-reserved reserved
    CATALOG_NAME non-reserved non-reserved non-reserved
    CEIL reserved reserved
    CEILING reserved reserved
    CHAIN non-reserved non-reserved non-reserved
    CHAINING non-reserved
    CHAR non-reserved (cannot be function or type) reserved reserved reserved
    CHARACTER non-reserved (cannot be function or type) reserved reserved reserved
    CHARACTERISTICS non-reserved non-reserved non-reserved
    CHARACTERS non-reserved non-reserved
    CHARACTER_LENGTH reserved reserved reserved
    CHARACTER_​SET_​CATALOG non-reserved non-reserved non-reserved
    CHARACTER_SET_NAME non-reserved non-reserved non-reserved
    CHARACTER_SET_SCHEMA non-reserved non-reserved non-reserved
    CHAR_LENGTH reserved reserved reserved
    CHECK reserved reserved reserved reserved
    CHECKPOINT non-reserved
    CLASS non-reserved
    CLASSIFIER reserved
    CLASS_ORIGIN non-reserved non-reserved non-reserved
    CLOB reserved reserved
    CLOSE non-reserved reserved reserved reserved
    CLUSTER non-reserved
    COALESCE non-reserved (cannot be function or type) reserved reserved reserved
    COBOL non-reserved non-reserved non-reserved
    COLLATE reserved reserved reserved reserved
    COLLATION reserved (can be function or type) non-reserved non-reserved reserved
    COLLATION_CATALOG non-reserved non-reserved non-reserved
    COLLATION_NAME non-reserved non-reserved non-reserved
    COLLATION_SCHEMA non-reserved non-reserved non-reserved
    COLLECT reserved reserved
    COLUMN reserved reserved reserved reserved
    COLUMNS non-reserved non-reserved non-reserved
    COLUMN_NAME non-reserved non-reserved non-reserved
    COMMAND_FUNCTION non-reserved non-reserved non-reserved
    COMMAND_​FUNCTION_​CODE non-reserved non-reserved
    COMMENT non-reserved
    COMMENTS non-reserved
    COMMIT non-reserved reserved reserved reserved
    COMMITTED non-reserved non-reserved non-reserved non-reserved
    CONCURRENTLY reserved (can be function or type)
    CONDITION reserved reserved
    CONDITIONAL non-reserved
    CONDITION_NUMBER non-reserved non-reserved non-reserved
    CONFIGURATION non-reserved
    CONFLICT non-reserved
    CONNECT reserved reserved reserved
    CONNECTION non-reserved non-reserved non-reserved reserved
    CONNECTION_NAME non-reserved non-reserved non-reserved
    CONSTRAINT reserved reserved reserved reserved
    CONSTRAINTS non-reserved non-reserved non-reserved reserved
    CONSTRAINT_CATALOG non-reserved non-reserved non-reserved
    CONSTRAINT_NAME non-reserved non-reserved non-reserved
    CONSTRAINT_SCHEMA non-reserved non-reserved non-reserved
    CONSTRUCTOR non-reserved non-reserved
    CONTAINS reserved reserved
    CONTENT non-reserved non-reserved non-reserved
    CONTINUE non-reserved non-reserved non-reserved reserved
    CONTROL non-reserved non-reserved
    CONVERSION non-reserved
    CONVERT reserved reserved reserved
    COPY non-reserved reserved
    CORR reserved reserved
    CORRESPONDING reserved reserved reserved
    COS reserved
    COSH reserved
    COST non-reserved
    COUNT reserved reserved reserved
    COVAR_POP reserved reserved
    COVAR_SAMP reserved reserved
    CREATE reserved reserved reserved reserved
    CROSS reserved (can be function or type) reserved reserved reserved
    CSV non-reserved
    CUBE non-reserved reserved reserved
    CUME_DIST reserved reserved
    CURRENT non-reserved reserved reserved reserved
    CURRENT_CATALOG reserved reserved reserved
    CURRENT_DATE reserved reserved reserved reserved
    CURRENT_​DEFAULT_​TRANSFORM_​GROUP reserved reserved
    CURRENT_PATH reserved reserved
    CURRENT_ROLE reserved reserved reserved
    CURRENT_ROW reserved reserved
    CURRENT_SCHEMA reserved (can be function or type) reserved reserved
    CURRENT_TIME reserved reserved reserved reserved
    CURRENT_TIMESTAMP reserved reserved reserved reserved
    CURRENT_​TRANSFORM_​GROUP_​FOR_​TYPE reserved reserved
    CURRENT_USER reserved reserved reserved reserved
    CURSOR non-reserved reserved reserved reserved
    CURSOR_NAME non-reserved non-reserved non-reserved
    CYCLE non-reserved reserved reserved
    DATA non-reserved non-reserved non-reserved non-reserved
    DATABASE non-reserved
    DATALINK reserved reserved
    DATE reserved reserved reserved
    DATETIME_​INTERVAL_​CODE non-reserved non-reserved non-reserved
    DATETIME_​INTERVAL_​PRECISION non-reserved non-reserved non-reserved
    DAY non-reserved reserved reserved reserved
    DB non-reserved non-reserved
    DEALLOCATE non-reserved reserved reserved reserved
    DEC non-reserved (cannot be function or type) reserved reserved reserved
    DECFLOAT reserved
    DECIMAL non-reserved (cannot be function or type) reserved reserved reserved
    DECLARE non-reserved reserved reserved reserved
    DEFAULT reserved reserved reserved reserved
    DEFAULTS non-reserved non-reserved non-reserved
    DEFERRABLE reserved non-reserved non-reserved reserved
    DEFERRED non-reserved non-reserved non-reserved reserved
    DEFINE reserved
    DEFINED non-reserved non-reserved
    DEFINER non-reserved non-reserved non-reserved
    DEGREE non-reserved non-reserved
    DELETE non-reserved reserved reserved reserved
    DELIMITER non-reserved
    DELIMITERS non-reserved
    DENSE_RANK reserved reserved
    DEPENDS non-reserved
    DEPTH non-reserved non-reserved
    DEREF reserved reserved
    DERIVED non-reserved non-reserved
    DESC reserved non-reserved non-reserved reserved
    DESCRIBE reserved reserved reserved
    DESCRIPTOR non-reserved non-reserved reserved
    DETACH non-reserved
    DETERMINISTIC reserved reserved
    DIAGNOSTICS non-reserved non-reserved reserved
    DICTIONARY non-reserved
    DISABLE non-reserved
    DISCARD non-reserved
    DISCONNECT reserved reserved reserved
    DISPATCH non-reserved non-reserved
    DISTINCT reserved reserved reserved reserved
    DLNEWCOPY reserved reserved
    DLPREVIOUSCOPY reserved reserved
    DLURLCOMPLETE reserved reserved
    DLURLCOMPLETEONLY reserved reserved
    DLURLCOMPLETEWRITE reserved reserved
    DLURLPATH reserved reserved
    DLURLPATHONLY reserved reserved
    DLURLPATHWRITE reserved reserved
    DLURLSCHEME reserved reserved
    DLURLSERVER reserved reserved
    DLVALUE reserved reserved
    DO reserved
    DOCUMENT non-reserved non-reserved non-reserved
    DOMAIN non-reserved non-reserved non-reserved reserved
    DOUBLE non-reserved reserved reserved reserved
    DROP non-reserved reserved reserved reserved
    DYNAMIC reserved reserved
    DYNAMIC_FUNCTION non-reserved non-reserved non-reserved
    DYNAMIC_​FUNCTION_​CODE non-reserved non-reserved
    EACH non-reserved reserved reserved
    ELEMENT reserved reserved
    ELSE reserved reserved reserved reserved
    EMPTY reserved non-reserved
    ENABLE non-reserved
    ENCODING non-reserved non-reserved non-reserved
    ENCRYPTED non-reserved
    END reserved reserved reserved reserved
    END-EXEC reserved reserved reserved
    END_FRAME reserved reserved
    END_PARTITION reserved reserved
    ENFORCED non-reserved non-reserved
    ENUM non-reserved
    EQUALS reserved reserved
    ERROR non-reserved
    ESCAPE non-reserved reserved reserved reserved
    EVENT non-reserved
    EVERY reserved reserved
    EXCEPT reserved reserved reserved reserved
    EXCEPTION reserved
    EXCLUDE non-reserved non-reserved non-reserved
    EXCLUDING non-reserved non-reserved non-reserved
    EXCLUSIVE non-reserved
    EXEC reserved reserved reserved
    EXECUTE non-reserved reserved reserved reserved
    EXISTS non-reserved (cannot be function or type) reserved reserved reserved
    EXP reserved reserved
    EXPLAIN non-reserved
    EXPRESSION non-reserved non-reserved non-reserved
    EXTENSION non-reserved
    EXTERNAL non-reserved reserved reserved reserved
    EXTRACT non-reserved (cannot be function or type) reserved reserved reserved
    FALSE reserved reserved reserved reserved
    FAMILY non-reserved
    FETCH reserved reserved reserved reserved
    FILE non-reserved non-reserved
    FILTER non-reserved reserved reserved
    FINAL non-reserved non-reserved
    FINISH non-reserved
    FIRST non-reserved non-reserved non-reserved reserved
    FIRST_VALUE reserved reserved
    FLAG non-reserved non-reserved
    FLOAT non-reserved (cannot be function or type) reserved reserved reserved
    FLOOR reserved reserved
    FOLLOWING non-reserved non-reserved non-reserved
    FOR reserved reserved reserved reserved
    FORCE non-reserved
    FOREIGN reserved reserved reserved reserved
    FORMAT non-reserved
    FORTRAN non-reserved non-reserved non-reserved
    FORWARD non-reserved
    FOUND non-reserved non-reserved reserved
    FRAME_ROW reserved reserved
    FREE reserved reserved
    FREEZE reserved (can be function or type)
    FROM reserved reserved reserved reserved
    FS non-reserved non-reserved
    FULFILL non-reserved
    FULL reserved (can be function or type) reserved reserved reserved
    FUNCTION non-reserved reserved reserved
    FUNCTIONS non-reserved
    FUSION reserved reserved
    G non-reserved non-reserved
    GENERAL non-reserved non-reserved
    GENERATED non-reserved non-reserved non-reserved
    GET reserved reserved reserved
    GLOBAL non-reserved reserved reserved reserved
    GO non-reserved non-reserved reserved
    GOTO non-reserved non-reserved reserved
    GRANT reserved reserved reserved reserved
    GRANTED non-reserved non-reserved non-reserved
    GREATEST non-reserved (cannot be function or type)
    GROUP reserved reserved reserved reserved
    GROUPING non-reserved (cannot be function or type) reserved reserved
    GROUPS non-reserved reserved reserved
    HANDLER non-reserved
    HAVING reserved reserved reserved reserved
    HEADER non-reserved
    HEX non-reserved non-reserved
    HIERARCHY non-reserved non-reserved
    HOLD non-reserved reserved reserved
    HOUR non-reserved reserved reserved reserved
    ID non-reserved non-reserved
    IDENTITY non-reserved reserved reserved reserved
    IF non-reserved
    IGNORE non-reserved non-reserved
    ILIKE reserved (can be function or type)
    IMMEDIATE non-reserved non-reserved non-reserved reserved
    IMMEDIATELY non-reserved non-reserved
    IMMUTABLE non-reserved
    IMPLEMENTATION non-reserved non-reserved
    IMPLICIT non-reserved
    IMPORT non-reserved reserved reserved
    IN reserved reserved reserved reserved
    INCLUDE non-reserved
    INCLUDING non-reserved non-reserved non-reserved
    INCREMENT non-reserved non-reserved non-reserved
    INDENT non-reserved non-reserved
    INDEX non-reserved
    INDEXES non-reserved
    INDICATOR reserved reserved reserved
    INHERIT non-reserved
    INHERITS non-reserved
    INITIAL reserved
    INITIALLY reserved non-reserved non-reserved reserved
    INLINE non-reserved
    INNER reserved (can be function or type) reserved reserved reserved
    INOUT non-reserved (cannot be function or type) reserved reserved
    INPUT non-reserved non-reserved non-reserved reserved
    INSENSITIVE non-reserved reserved reserved reserved
    INSERT non-reserved reserved reserved reserved
    INSTANCE non-reserved non-reserved
    INSTANTIABLE non-reserved non-reserved
    INSTEAD non-reserved non-reserved non-reserved
    INT non-reserved (cannot be function or type) reserved reserved reserved
    INTEGER non-reserved (cannot be function or type) reserved reserved reserved
    INTEGRITY non-reserved non-reserved
    INTERSECT reserved reserved reserved reserved
    INTERSECTION reserved reserved
    INTERVAL non-reserved (cannot be function or type) reserved reserved reserved
    INTO reserved reserved reserved reserved
    INVOKER non-reserved non-reserved non-reserved
    IS reserved (can be function or type) reserved reserved reserved
    ISNULL reserved (can be function or type)
    ISOLATION non-reserved non-reserved non-reserved reserved
    JOIN reserved (can be function or type) reserved reserved reserved
    JSON non-reserved
    JSON_ARRAY reserved
    JSON_ARRAYAGG reserved
    JSON_EXISTS reserved
    JSON_OBJECT reserved
    JSON_OBJECTAGG reserved
    JSON_QUERY reserved
    JSON_TABLE reserved
    JSON_TABLE_PRIMITIVE reserved
    JSON_VALUE reserved
    K non-reserved non-reserved
    KEEP non-reserved
    KEY non-reserved non-reserved non-reserved reserved
    KEYS non-reserved
    KEY_MEMBER non-reserved non-reserved
    KEY_TYPE non-reserved non-reserved
    LABEL non-reserved
    LAG reserved reserved
    LANGUAGE non-reserved reserved reserved reserved
    LARGE non-reserved reserved reserved
    LAST non-reserved non-reserved non-reserved reserved
    LAST_VALUE reserved reserved
    LATERAL reserved reserved reserved
    LEAD reserved reserved
    LEADING reserved reserved reserved reserved
    LEAKPROOF non-reserved
    LEAST non-reserved (cannot be function or type)
    LEFT reserved (can be function or type) reserved reserved reserved
    LENGTH non-reserved non-reserved non-reserved
    LEVEL non-reserved non-reserved non-reserved reserved
    LIBRARY non-reserved non-reserved
    LIKE reserved (can be function or type) reserved reserved reserved
    LIKE_REGEX reserved reserved
    LIMIT reserved non-reserved non-reserved
    LINK non-reserved non-reserved
    LISTAGG reserved
    LISTEN non-reserved
    LN reserved reserved
    LOAD non-reserved
    LOCAL non-reserved reserved reserved reserved
    LOCALTIME reserved reserved reserved
    LOCALTIMESTAMP reserved reserved reserved
    LOCATION non-reserved non-reserved non-reserved
    LOCATOR non-reserved non-reserved
    LOCK non-reserved
    LOCKED non-reserved
    LOG reserved
    LOG10 reserved
    LOGGED non-reserved
    LOWER reserved reserved reserved
    M non-reserved non-reserved
    MAP non-reserved non-reserved
    MAPPING non-reserved non-reserved non-reserved
    MATCH non-reserved reserved reserved reserved
    MATCHED non-reserved non-reserved
    MATCHES reserved
    MATCH_NUMBER reserved
    MATCH_RECOGNIZE reserved
    MATERIALIZED non-reserved
    MAX reserved reserved reserved
    MAXVALUE non-reserved non-reserved non-reserved
    MEASURES reserved
    MEMBER reserved reserved
    MERGE reserved reserved
    MESSAGE_LENGTH non-reserved non-reserved non-reserved
    MESSAGE_OCTET_LENGTH non-reserved non-reserved non-reserved
    MESSAGE_TEXT non-reserved non-reserved non-reserved
    METHOD non-reserved reserved reserved
    MIN reserved reserved reserved
    MINUTE non-reserved reserved reserved reserved
    MINVALUE non-reserved non-reserved non-reserved
    MOD reserved reserved
    MODE non-reserved
    MODIFIES reserved reserved
    MODULE reserved reserved reserved
    MONTH non-reserved reserved reserved reserved
    MORE non-reserved non-reserved non-reserved
    MOVE non-reserved
    MULTISET reserved reserved
    MUMPS non-reserved non-reserved non-reserved
    NAME non-reserved non-reserved non-reserved non-reserved
    NAMES non-reserved non-reserved non-reserved reserved
    NAMESPACE non-reserved non-reserved
    NATIONAL non-reserved (cannot be function or type) reserved reserved reserved
    NATURAL reserved (can be function or type) reserved reserved reserved
    NCHAR non-reserved (cannot be function or type) reserved reserved reserved
    NCLOB reserved reserved
    NESTED non-reserved
    NESTING non-reserved non-reserved
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    Girl, 13, has appendix removed after vomiting ‘black stuff’ from dangerous TikTok trend

    A 13-year-old girl who copied a dangerous TikTok trend was raced to hospital for emergency surgery after she had bad stomach pains and started vomiting “black stuff”.

    The Liverpudlian ended up having her appendix and part of her bowel removed.

    A scary viral video shows users how to create the appearance of a tongue piercing by placing magnetic ball bearings underneath and on top of the tongue, Liverpool ECHO reports.

    Faye Elizabeth’s daughter, who didn’t want her name to be public, had 15 magnetic beads mashed amongst her internal organs.

    Faye, from Rainhill, said : "The pains got worse so I took her to Whiston Hospital.

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    “They thought it might have been her appendix at first.

    "Then they ruled that out and thought it might have been gastroenteritis until she started vomiting black stuff.

    "They did a scan and found 10 of the ball bearings."

    Magnetic balls were lodged in her bowel and appendix, Faye added.

    The young girl was rushed emergency surgery at Alder Hey Children’s hospital.

    Faye said: "They had to take part of her bowel away and re-stitch it. There was one stuck in her appendix so they had to remove that."

    By the end of surgery, medics had taken a whopping 15 magnetic beads out of the girl’s organs.

    She’s been left with a scar over six inches long and is still in hospital trying to recover.

    The mum added: "I don&apost know when she swallowed them because she didn&apost admit at first to doing it. I think she was a bit scared of admitting what she&aposd done.

    "Apparently she watched a TikTok video where there&aposs a trend that all the kids are doing at the minute.

    "I haven&apost actually seen it but she told me about it and a lot of other children her age have seen it.

    "They put one of the beads on top of their tongue and one underneath and it makes it look like their tongue is pierced.

    "And then she saw one where they put a big bead in the side of your cheek and put little beads on top of your cheek and you move it with your tongue so they move on your face.

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    "They&aposre magnets but because they&aposre so small they&aposre easy to swallow."

    Tragically, it isn’t an isolated incident.

    On Sunday an 11-year-old boy was left on his death bed after copying the same tongue piercing game.

    He swallowed five small magnetic balls and was left in a “critical” position after infections spread from two major surgeries, The Daily Mail reports.

    Faye said her daughter is still recovering and won’t be able to go home for another week or two.

    She said: "She&aposs in bed and the nurses are being wonderful and looking after her.

    "She&aposs feeding through tubes at the minute and she&aposs got all drips and stuff.

    "I&aposve never seen her in so much pain in her life."

    She added: "I think parents need to be made aware of these magnetic beads as they&aposre very dangerous."


    Watch the video: Adding an Appendix to Your Research Paper (October 2021).