Beware the Travel Syndromes: Just How Many Symptoms Can Come About from Going Places?

January 15, 2018 § Leave a comment

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Have you every heard of “travel syndrome”? Me neither, until I saw a video circulated recently by Newsfare showing a distraught traveler in Qingdao, China. The man rushed off his train, which was stopped at a station, and tried to throw himself over a guardrail to the underpass below. He was spared injury when a policeman and two passengers caught him. The story accompanying the video says that the man had spent 40 hours on the train and was suffering from “travel syndrome,” defined as “a short-time psychotic disorder.” The man reportedly became calm after ten minutes.

I’m still not sure if travel syndrome is a real thing. Maybe there’s something going on with the translation. And maybe there was more to the man’s situation than just a long train ride. A more detailed video and story at CCTV+ doesn’t mention a syndrome but rather says that medical workers think that the man “might have had a hallucination which caused his physical disorders.”

(China.Recorder, “Police Grabs Man Jumping off Guardrails at Train Station,” January 1, 2018; “Police Officer Stops Hallucinated Passenger from Jumping off Railway Platform,” CCTV+, January 1, 2018)

But regardless of the accuracy, or lack thereof, of this gentleman’s diagnosis, there are such things as syndromes associated with travel. And I’m talking not just about made-up maladies, like “rude-tourist syndrome” or “lost-luggage syndrome.” No, these syndromes are real enough to garner serious discussion.

Economy-class syndrome
“Economy-class syndrome,” “second-class-travel syndrome,” and “cheap-airfare syndrome” are all names for deep vein thrombosis, or the formation of blood clots, in the legs, caused by lack of movement by passengers during long flights. Deep vein thrombosis is a real concern, especially if a clot detaches and gets lodged in the lungs (pulmonary embolism), a potentially fatal condition. But in an article at WebMD, the American College of Chest Physicians says that the risks are low for healthy travelers and that sitting in coach does not make the risks higher. Rather, it’s long stretches of immobility that cause the most problems, regardless of where your seat is located—though being trapped in a window seat can limit opportunities to move around.

(Salynn Boyles, “New Guidelines Debunk ‘Economy Class Syndrome,'” WebMD, February 7, 2012)

High-altitude syndrome
A brochure published by the Port Health Travel Centre of Hong Kong’s Department of Health says that high-altitude syndrome is caused by ascending to altitudes above 8,000 feet more rapidly than your body can acclimate. Symptoms begin with a mild headache and can progress to Acute Mountain Sickness—including a headache “similar to a bad hangover” plus nausea, fatigue, dizziness, or difficulty sleeping—High Altitude Cerebral Edema (fluid accumulating in the brain), and High Altitude Pulmonary Edema (fluid accumulating in the lungs). Without treatment, these last two conditions can result in death.

(“High Altitude Syndrome,” Port health Travel Centre, Department of Health, Hong Kong, 2005)

Culture-shock syndrome
You probably know what culture shock is, but adding syndrome after it sounds much more significant, especially with this definition from the Handbook of Psychiatric Education and Faculty Development:

a protean psychodynamic manifestation including mourning of the lost culture, severe anxiety in adapting to the new and consequent identity disturbances.

(Jerald Kay, et al., Handbook of Psychiatric Education and Faculty Development, American Psychiatric, 1999)

Time-zone-change syndrome
Likewise, jet lag has its own “syndrome” name, too. And here’s how time-zone-change (jet-lag) syndrome is described in the  International Classification of Sleep Disorders: Diagnostic and Coding Manual:

varying degrees of difficulties in initiating or maintaining sleep, excessive sleepiness, decrements in subjective daytime alertness and performance, and somatic symptoms (largely related to gastrointestinal function) following rapid travel across multiple time zones.

(American Academy of Sleep Medicine, International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual, American Academy of Sleep Medicine, 2001)

Chinese-restaurant syndrome
So with “gastrointestinal function” as a segue. . . . Not a few people complain of adverse physical reactions after eating food with monosodium glutamate (MSG), which is often used as a flavor enhancer in Chinese cuisine. I don’t think the label “Chinese-restaurant syndrome” is fair, not because I don’t believe in the negative effects of MSG (I’m not going to enter that debate), but rather because Chinese cuisine is far from the only food containing the additive. First introduced in Japan in 1908, MSG has since spread across Asia. But you don’t need to go overseas or even to an Asian restaurant to get your fill. MSG is found naturally in foods such as tomatoes and parmesan cheese; it’s added for flavor to products such as Doritos and Campbell’s Chicken Noodle Soup; and it’s in the recipes at KFC and Chick-fil-A.

Toxic-airline syndrome
“Toxic-airline syndrome” and “aerotoxic syndrome” are names given to symptoms that some believe are caused by breathing airliner cabin air that is contaminated with engine lubricants or noxious fumes. There is disagreement as to the potential dangers:. On the one hand is the UK’s Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT), which states that a valid explanation for the illnesses is that they are manifested in people who perceive cabin air to be hazardous. This is called the “nocebo effect,” as opposed to the “placebo effect.” But on the other hand are those who believe long exposure, such as by flight crew or frequent fliers, has led even to the deaths of their loved ones. Regardless, most agree that the issue is serious enough to warrant further investigation.

(Kate Leahy, “There Are Hundreds of Sick Crew’: Is Toxic Air on Planes Making Frequent Flyers Ill?” The Guardian, August 19, 2017; “Position Paper on Cabin Air,” Committee on Toxicity, 2013)

Airport-assault syndrome
A 1982 issue of The BMJ (formerly British Medical Journal), contains a short article on “airport-assault syndrome.” Those were simpler times, and the assault referenced there isn’t concerning terrorism. Instead it’s the “plague” of luggage trolleys running into the Achilles tendons of innocent passersby. The authors suggest developing shorter, more easily maneuverable trolleys or pulling, rather than pushing, them as ways to “prevent many travelers from grievous bodily harm at the hands of unsuspecting charioteers.”

(Michael Heim, et al., “The Airport Assault Syndrome on the Increase,” The BMJ, December 23, 1989)

Airport syndrome
Sometimes the syndromes are not a result of travel, but traveling, or attempting to travel, is a manifestation of previous disorders. “Airport syndrome,” as referenced in the BJPsych Bulletin, is characterized by “airport wandering,” when “travel to the airport [is] in some way a product of [psychotic] illness.”

Jet-set Munchausen syndrome
The same BJPsych Bulletin article also cites a case of Munchausen syndrome that took place on a plane, causing the flight to be diverted. Munchausen syndrome is a mental disorder in which a person repeatedly pretends to be sick even though the illness is not real. In this “jet-set” case, it happened to occur on a plane.

(Harvey Gordon, et al., Air Travel by Passengers with Mental Disorder,” BJPsych Bulletin, July 30, 2004)

Florence Syndrome, et al.
And then there is a small atlas of syndromes named after travel destinations that overwhelm visitors, with symptoms including anxiety, disorientation, dizziness, fainting, and even convulsions and hallucinations—sometimes leading to hospitalization.

Florence syndrome is also called Stendhal syndrome—after the French author who reported his reaction to visiting Florence in 1817—and can apply to visiting any destination with cultural and artistic significance.

Paris syndrome, most often experienced by Japanese tourists, comes about when the reality of Paris does not meet the romanticized expectations of the visitors. Jerusalem syndrome involves religious delusions or obsessions caused by travel to the city. And India syndrome is a set of psychotic symptoms experienced by outsiders coming to the country on spiritual journeys.

In his book A Death on Diamond Mountain, Scott Carney includes a simple cure for India syndrome, given by Kalyan Sachdev, the medical director of New Delhi’s Privat Hospital: a trip home. “[Y]ou put them on the plane,” Sachdev says, “and they are completely all right.”

(Scott Carney, A Death on Diamond Mountain: A True Story of Obsession, Madness, and the Path to Enlightenment, Penguin, 2015)

Post-travel syndrome
But is going home the answer to travel woes? Though it’s not officially recognized, I’ll include “post-travel syndrome” here because so many people talk about it and claim to experience it. Also called “post-travel depression,” it’s the emotional low one gets after returning from a trip. But as Dr. Sebastian Filep of the University of Otago’s Department of Tourism tells NBC News, “The idea of post-travel depression is largely a myth.” In the same report, Jeroen Nawijn, of the Centre for Sustainable Tourism and Transport, who has studied vacationing’s effect on mood, says he’s “found no proof of post-travel depression,” and labels it “not a legitimate mental health issue.”

And yet it can feel so real.

(Dana McMahan, “Do Well-needed Vacations Actually Bum Us Out?NBC News, May 9, 2013)

So, in light of all this, should we just stay home and never venture beyond the confines of our immediate locales? I guess that’s one solution, but be warned. That would mean giving up on all that can be gained from seeing the world and expanding our horizons. And if you let your concerns about travel consume you, you run the risk of suffering the incapacitating effects of treksyndraphobia syndrome—the fear-of-travel-syndromes syndrome.

Yeah, I made that one up.

(Mike Robinson and David Picard, eds., Emotion in Motion: Tourism, Affect and Transformation, Routledge, 2012)

[photo: “Stranded in Madrid,” by Daniel Gasienica, used under a Creative Commons license]

33 Clickbait Headlines for Expats—Number 12 Will Make You Gasp [—at A Life Overseas]

December 27, 2017 § Leave a comment

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Normally, clickbait headlines are created simply to grab clicks—and clicks and clicks and more clicks. But you can’t click on the titles below, since there aren’t any stories linked to them. Instead, if being an expat is in your past, present, or future, the stories are up to you, to write or live out yourselves.

So here’s to the new year . . . and all the stories ahead!

  1. They had no idea why all the nationals were staring at them
  2. She said the same thing to her neighbor every morning for a month—until her language teacher explained to her what it meant
  3. Only 1 in 1000 people can identify these countries by their shapes—can you?
  4. He thought his carryon would fit in the overhead bin, then this happened
  5. 5 things visa officers don’t want you to know

See the rest of the list at A Life Overseas

[photo: “Giorgi – Shocked,” by japrea, used under a Creative Commons licesnse]

What Did I Do Today? I Made a Copy. Woohoo! [—at A Life Overseas]

October 28, 2017 § Leave a comment

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An imagined but quite possible day in a life overseas . . .

This morning I woke up with my to-do list waiting for me on the nightstand. Item number one was Get out of bed (I’d written that one down so I could start the day by crossing it off). Number two said Copy document. That’s because yesterday at the county government office, when I went to get my resident permit renewed, the lady behind the desk told me I needed to bring a copy of my registration letter to leave with them.

I was more than ready to get that taken care of and move on to the other, bigger, better, more important things on my list. It was an impressive list. I had quite the day planned.

After a quick shower and a slice of toast for breakfast, I grabbed my permit documents and walked the four blocks to the bus stop and took the bus to the copy shop, about 15 minutes away. But when I stepped off the bus I saw that the copy shop wasn’t a copy shop anymore. Instead,  sometime over the weekend, it had been turned into a KFG Chicken restaurant. (That’s right, a KFG not a KFC. This one had a big green smiling rooster on its sign.) I called my teammate to get her advice, and she said I could get a copy at a bank. There was a bank down the street, and after going there and standing in line, I asked the teller if she could help me make a copy. She said that was impossible.

On the way back to the bus stop, I called another teammate, and he told me to try the photo shop next to the new high school. I decided to take a taxi there to save time, but the only cash I had was a large bill and I figured the driver wouldn’t have change for it, so I walked back to the bank to withdraw some money from the ATM. But then the ATM ate my card and wouldn’t spit it out no matter how many buttons I pushed. I went back into the bank to retrieve it, but they said that was impossible—at least until after two business days.

You can read the rest at A Life Overseas. . . .

[photo: “Braden’s Woohoo!,” by Laura Molnar, used under a Creative Commons license]

Pre-Tripisms

December 8, 2016 § 1 Comment

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First expatisms, then airportisms, and now . . . pre-tripisms. Because we simply don’t have enough ways to talk about things.

metapacking
Carrying a suitcase in a suitcase so that you can bring back more stuff than you take. This can be as simple as a duffle bag inside another piece of luggage, but in its purest form, it is a checked bag precisely fitting inside another checked bag. The term metapacking can be extended also to encompass using a cheap or broken suitcase to transport items one way and then disposing of that suitcase after you arrive. Seasoned travelers always keep a broken suitcase lying around.

eurekathing
Something you find inside your luggage when you start packing—something you haven’t seen since your last trip. Discovering it brings out such responses as “Oh, that’s where that is,” or “I do have one of those.” A wad of ten-dollar bills is eurekaching, a piece of jewelry, eurekabling.

flotsam and jetsam and thensam
The abundance of things that people give you and your children right before you leave for the airport or get on the plane. This includes gifts, souvenirs, snacks, word-find and sudoku books, coloring books with a four-pack of crayons, and those faces with metal shavings that you form into a beard with a magnet.

tetrisness
The feeling of accomplishment one feels after packing every necessary item just right in a suitcase. A landmark study out of the University of Gatwick-Hempstead shows that tetrisness activates the same portion of the brain as when one successfully folds a fitted sheet.

bait and glitch
You find a cheap plane ticket online and go through all the steps to buy it, double and triple checking all the details, and then when you select “confirm,” you get that encouraging message that says, “The fare you’ve selected is no longer available.” Maybe it’s because the search site wasn’t up to date or because someone else recklessly grabbed the last seat while you were prudently making up your mind. If it’s the latter, it just proves the old standard, “Time flies when you’re choosing flight times” (or something like that).

vontrappish
How you feel when you’re ready for bed the night before a morning flight, with all your luggage placed neatly (more or less) next to the door—lined up like the von Trapp family ready to sing “So Long, Farewell.” You may have mixed feelings, and you may or may not sleep. In extreme cases, you hear yourself humming the tune.

So long, farewell, auf Wiedersehen, good night
I hate to go and leave this pretty sight

I’m glad to go,
I cannot tell a lie
I flit, I float
I fleetly flee, I fly

So long, farewell, auf Wiedersehen, goodbye
I leave and heave a sigh and say goodbye—Goodbye!

fortnightlies
Countless requests for coffee, a get-together, or a meal made by friends who have just realized that your departure for a long or permanent stay is only. two. weeks. away.

direct flight to the dog house
This is what you receive after you proudly show the money-saving itinerary—that you just booked—to your spouse, and said spouse points out that it includes a 14-hour layover (also known as a “wayover”) and that you and your four children will need to collect all checked baggage between each of the five connecting flights. Travel to the doghouse does accumulate frequent-flyer miles, but they can only be redeemed for undesirable trips, such as to overnight stays on the living-room couch.

disafearance
Leaving your tightly locked up (?) house thinking you might have left the iron on (even though you don’t remember having done any ironing) is one thing, but watching your hand zip your passport into the front pocket of your backpack and then just two minutes later checking to see if it’s actually there because you’re afraid that you didn’t in fact zip your passport into the front pocket of your backpack but instead, due to a muscle spasm, may have opened the car window and tossed your passport onto the shoulder of the highway—or what if it just spontaneously combusted, leaving no smoke or ashes?—that’s disaffearance.

TSAT
The TSAT (pronounced Tee Ess Ay Tee or Tee-Sat) is an oral exam in which family members yell questions and answers from room to room concerning Transportation Security Administration regulations:

Is it the 3-1-1 rule or 1-1-3 . . . or 3-2-1 or 9-1-1? Does deodorant count as a liquid? What about wet wipes? Or snow globes? Or chocolate-covered cherries? Can I take nail clippers in my carry-on? What about tweezers? Duct tape? Scotch tape? Chopsticks? Toothpicks? Javelins?

[photo: “We live in a wonderful world,” by Kate Ter Haar, used under a Creative Commons license]

Air China Back-Back-Backtracks from Inflight Article on London

September 9, 2016 § Leave a comment

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The Interwebs have been in an uproar the last few days over an article in Air China’s inflight magazine Wings of China. As reported by journalist Haze Fan for CNBC, the latest issue of the magazine touts London as a top destination but includes the following “safety” advice in a section called “Tips from Air China”:

London is generally a safe place to travel, however precautions are needed when entering areas mainly populated by Indians, Pakistanis and black people. We advise tourists not to go out alone at night, and females always to be accompanied by another person when travelling.

Fan notes that the capital city is currently being led by a mayor, Sadiq Khan, who was born in London to Pakistani parents.

After Fan’s reporting, Air China North America issued the following apology via Twitter:

We at Air China Limited do not condone discrimination in any shape or form. We regret and apologize for the offensive language. . . .

But Air China was not done reversing its engines. The company also pulled the magazine from their planes and even deleted the above Tweet. Wings of China is now offline, as well.

So . . . I can’t send you to the Wings of China to read the article yourself, but I will remind you that if you’d like to see some other airline mags from around the world, go to my list of over 100 links at “Inflight Magazines: My Virtual Seat-Back Pocket Runneth Over.” Maybe you’ll be the one to scoop the next big piece of travel news.

(Haze Fan, “Air China Magazine Warns London Visitors to Avoid Ethnic Minority Areas,” CNBC, Sept. 7, 2016; Haze Fan, “Air China’s Magazine Says Media, Readers Misinterpreted London Travel Advice,” CNBC, Sept. 8, 2016)

[photo: “B-5178 | Air China | Boeing 737-86N | Grey Peony Livery | PEK,” by Byeangel, used under a Creative Commons license]

US Passports: Things to Know So You’ll Stay Ahead of the Game

May 4, 2016 § Leave a comment

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Your passport is easy to take for granted . . . unless you need it and you can’t find it, or it’s stolen, or it’s expired. But the US Department of State doesn’t take it for granted. Here are some ways that they’re working on improving your passport, as well as tips on how to keep your travel headaches to a minimum.

No more adding pages
As of this January, passport holders are no longer able to add pages to an existing passport so that it can hold more entry and exit stamps. Travelers previously could add 24 pages to a full passport, but now, with that no longer an option, passport applicants outside the US are issued a 52 page book, while those in the US can choose between 23 and 52 pages.

(U.S. Department of State, “Extra Visa Pages No Longer Issued Effective January 1, 2016,” November 19, 2015)

Why carrying copies is a good idea
 At “Lost or Stolen Passports Abroad,” the Department of State advises travelers overseas to take along a photocopy of their passport ID page. I recently had the chance to ask a foreign service officer what purpose that serves and here’s what he said: While US embassies and consulates have the ability to replace a lost or stolen passport without you providing any documents or ID, there are other reasons for having copies. The passport copies are most helpful to carry with you while you leave the real thing in a safe location. If someone asks to see your passport while you’re out, you can show your copy; or if a place such as a hotel asks to hold your passport, you can offer your copy instead. He suggested carrying two color copies for this purpose. While officers can give you a new passport without presenting any documents or identification,  it’s better, according to the Department website, if you have a photo ID, a police report (or, says the officer, the ability to say that you tried to get one), your passport copy, and your travel itinerary (to document that you need the new passport quickly.)

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Click to see larger image

What about a passport card?
 Whenever I see a passport application, I wonder about the advantages of getting a passport card. Now I know why I probably don’t need one. A passport card is not a replacement for a passport book for general international travel. Instead, the card can be used only for land and sea travel between the US and Canada, Mexico, Bermuda, and the Caribbean. The card could be useful in any country in place of a color photocopy for getting a replacement passport (see above), but it won’t work for air travel, regardless of your destination. Even in the countries where the card can be used, without your passport book you’ll be in trouble if an emergency occurs and you need to fly back to the US. Also, if you’re on a cruise and for some reason miss the boat (literally), you won’t be able to use your card to fly—to catch up with the ship or to go back home.

(Ned Levi, “Passport Card: Does It Make Sense to Purchase One?” May 10, 2010)

Don’t get below 6 months
While many countries require you to have at least 6 months left on your passport before they’ll let you enter, the Department of State suggests you replace your passport when you cross the one-year-left mark. Not only will this keep you from being caught unprepared, but if you enter a country with only six months left on your passport, stay for a while and then decide to go to another country with the six-month restriction, you’ll be denied entry.

Expect more changes
US passports are scheduled for a big design update this year. The security updates will include an information page with a polycarbonate coating and containing an embedded data chip, the number laser-cut through pages, raised designs, and ink that shows multiple colors when viewed from different angles.

(Katherine LaGrave, “U.S. Passports to Get a Makeover in 2016,” Condé Nast Traveler, February 22, 2016)

Registering is easy
 This one isn’t directly related to passports, but it does apply to international travel. (Consider it a bonus.) The Department of State encourages citizens to register with them when traveling abroad, but what does that entail? It’s as easy as going to step.state.gov and signing up for the Smart Traveler Enrollment Program (STEP). You can also enroll to receive advisories and alerts, even when you’re not the one traveling, so that you can keep up to date while others are outside the country.

[photo: “Let’s Go! – Passport,” by Lucas, used under a Creative Commons license]

To Augustine the World Is a Book, but Is It a Travel Book?

April 13, 2016 § 2 Comments

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One of my father’s favorite jokes was to say a phrase of dubious meaning, and often questionable grammar, and tag William Shakespeare as the source. It went something like this:

No matter where you go, there you are . . . Shakespeare.

Seems that Dad was ahead of his time. All over the Interwebs, there are oft-used quotations attributed to oft-quoted people—Mark Twain, Martin Luther, Martin Luther King, Jr., Winston Churchill, Erma Bombeck . . . and Shakespeare. The trouble is, the pairings are oft-wrong.

Take, for instance, this popular quotation:

The world is a book and those who do not travel read only one page.

Nearly every online citation says it comes from the pen of St. Augustine, but as far as I can tell, no one has been able to find it in his writings.

The closest I’ve seen is in his Letter 43, written circa 397. While discussing schisms in the church in Africa and recounting some church history, he refers to the world as a book. But rather than using that as a metaphor to promote travel, he is proclaiming that the world shows the working out of biblical principles. Translated from Latin, he writes,

If, after all that you have read, you are still in doubt, be convinced by what you see. By all means let us give up arguing from ancient manuscripts, public archives, or the act of courts, civil or ecclesiastical. We have a greater book—the world itself. In it I read the accomplishment of that of which I read the promise in the Book of God: “The Lord hath said unto Me, and I shall give Thee the heathen for Thine inheritance, and the uttermost parts of the earth for Thy possession.

Jump ahead to 1750, and Louis-Charles Fougeret de Monbron writes Le Cosmopolite ou le Citoyen du Monde (The Cosmopolitan or the Citizen of the World), which opens with the following paragraph (as translated into English):

The universe is a sort of book, whose first page one has read when one has seen only one’s own country. I have leafed through a great many that I have found equally bad. This inquiry has not been at all unfruitful. I hated my country. All the oddities of the different people among whom I have lived have reconciled me to it. Should I gain no other benefit from my travels than this, I will have regretted neither the pains nor the fatigues.

British travel writer John Feltham joins our discussion with his publication of English Enchiridion in 1700. His collection of “apothegms, moral maxims. &c” includes one that seems to tie together Augustine and the thoughts of Fougeret de Monbron (it is not a direct quotation of either), and attempts to bring the early church father into the travel-writing fold:

St. Augustine, when he speaks of the great advantages of travelling, says, that the world is a great book, and none study this book so much as a traveller. They that never stir from their home read only one page of this book.

A few years later, Le Cosmopolite caught the attention of the young poet Lord Byron. In a letter to R. C. Dallas in 1811, he writes, “I send you a motto” and quotes the work’s opening paragraph. He tells Dallas, “If not too long, I think it will suit the book.” The book turned out to be his Childe Harold’s Pilgrimage, published in installments from 1812 to 1818, and the passage, still in French, became the work’s epigraph.

And finally, in 1824, Thomas Fielding gave us a more familiar rendering of the phrase in his Selected Proverbs of All Nations, crediting it to Augustine:

“The world is a great book, of which they that never stir from home read only a page.”

Simplify the language and you have “The world is a book and those who do not travel read only one page.” Oversimplify the authorship and you have Augustine.

Bring on the inspirational photos.

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[photos: “Atlas,” by Ian Carroll, used under a Creative Commons license; “Dyrhólaey Arc,” by Andrés Nieto Porras, used under a Creative Commons license]

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