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Seven hills rise from the Ohio River in this city of 309,000, where Appalachian foothills create neighborhoods with distinct elevation and character. Four seasons arrive with Midwest intensity—winter lows around 24°F with occasional heavy snow, humid summers climbing into the mid-80s—and 44 inches of annual precipitation. River valley position creates temperature inversions and humid conditions, while surrounding hills funnel storm systems through the region. German heritage remains visible in architecture and culture despite ongoing demographic shifts in this regional center for healthcare, finance, and consumer goods.
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