11.   And New York City is still suffering from the combined effects of an economic downturn and the terrorist attacks.

12.   But the combined effects of the Holocaust, the diffusion and assimilation of American Jews and the aging of the immigrant population gnawed away at audience numbers.

13.   Certainly the combined effects of antagonizing the police and the Catholic church earned Bruce no good will from those who could break him.

14.   Everyone else in the business is reeling from the combined effects of sagging demand and the scorched-earth price war Dell began this spring.

15.   He says that this combined effect of degrading collagen more rapidly and producing less new collagen is probably what causes premature skin aging in smokers.

16.   Hildegard Jorgensen, clinical research coordinator, said some of the individual herbs have known effects, but there is no consensus on the combined effect.

17.   If this were happening in late August, when ozone levels are at their highest, the combined effects of smoke and ozone could make the air very toxic.

18.   It is the combined effect of American dismissal of its most reliable allies.

19.   Moreover, once older people become infected with HIV, they tend to deteriorate more rapidly because of the combined effects of other ailments that often come with age.

20.   Since then, the combined effects of running time and subject matter have conspired to keep these grand behemoths from finding American theatrical release.