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The largest problem is the dangerous amount of nitrogen oxide (which mixes with vehicle-exhaust gas to create ozone, and then smog) coughed out by the state's industrial plants.
ECONOMIST: The Lone Smog State
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It wheezed and coughed and then eventually lay on its side and surrendered, blinking at me.
NEWYORKER: Naima
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We waited through the long silences and then nodded when he coughed, in collegial approval.
NEWYORKER: Midnight in Dostoevsky