41.   He fell asleep in committee meetings, the cumulative effect of night after night of restless sleeping.

42.   He added, however, that he thought some of the new enthusiasm was the cumulative effect of years of government effort.

43.   He sat out the remainder of the season, struggling to shake the cumulative effects of his fourth concussion.

44.   Her death was almost certainly a coincidence, but the cumulative effect of such accounts was devastating to the immunization program.

45.   It became a cumulative effect.

46.   It averages the sound level over eight hours because of the cumulative effect of successive peaks.

47.   Instead, the label is looking more for a cumulative effect.

48.   It might instead simply be the cumulative effect of a renewed commitment to therapy.

49.   It is occurring in the context of a larger debate about air pollution and the cumulative effects of toxins.

50.   It is, perhaps, too much to believe, that the cumulative effect of individual decisions to buy and sell would create such hidden patterns.