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In June 2024, the Government of Canada introduced Bill C-721 (Box 1) requiring that health information technology (IT) be interoperable. (2) This is a key step toward patients easily accessing [...]

THERE'S NOT MUCH in New York that has staying power. Every other day, a new scandal outscandals whatever we were just scandalized by; every few years, a hotter, scarier downtown [...]

In December 2020, Rusty Bowers's modest suburban home in the Phoenix suburbs became the site of virulent MAGA protests. Bowers, the Republican Speaker of Arizona's House of Representatives, had come [...]

Background: In an evolving landscape of practices and policies, reviewing and incorporating the latest scientific evidence is necessary to ensure optimal clinical management for people with opioid use disorder. We provide a synopsis of the 2024 update of the 2018 National Guideline for the Clinical Management of Opioid Use Disorder, from the Canadian Research Initiative in Substance Matters. Methods: For this update, we followed the United States Institute of Medicine's Standards for Developing Trustworthy Clinical Practice Guidelines and used the Appraisal of Guidelines Research and Evaluation--Recommendation Excellence tool to ensure guideline quality. We carried out a comprehensive systematic literature review, capturing the relevant literature from Jan. 1, 2017, to Sept. 14, 2023. We drafted and graded recommendations according to the Grading of Recommendations, Assessments, Development and Evaluation approach. A multidisciplinary external national committee, which included people with living or lived experience of opioid use disorder, provided input that was incorporated into the guideline. Recommendations: From the initial 11 recommendations in the 2018 guideline, 3 remained unchanged, and 8 were updated. Specifically, 4 recommendations were consolidated into a single revised recommendation; 1 recommendation was split into 2; another recommendation was moved to become a special consideration; and 2 recommendations were revised. Key changes have arisen from substantial evidence supporting that methadone and buprenorphine are similarly effective, particularly in reducing opioid use and adverse events, and both are now considered preferred first-line treatment options. Slow-release oral morphine is recommended as a second-line option. Psychosocial interventions can be offered as adjunctive treatment but should not be mandatory. The guideline reaffirms the importance of avoiding withdrawal management as a standalone intervention and of incorporating evidence-based harm reduction services along the continuum of care. Interpretation: This guideline update presents new recommendations based on the latest literature for standardized management of opioid use disorder. The aim is to establish a robust foundation upon which provincial and territorial bodies can develop guidance for optimal care., Opioid use disorder is characterized by a problematic pattern of opioid use occurring within a 12-month period, which leads to clinically significant impairment or distress; the disorder is categorized from [...]

CASE AT A GLANCE Under Medicare Part A, the Department of Health and Human Services (HHS) pays hospitals a fixed rate for services for elderly and disabled individuals who are enrolled in the program. The Social Security Act requires HHS to increase the fixed rate when hospitals serve patients who 'were entitled to supplemental security income benefits.' The act provides this upward adjustment to account for the fact that, on average, hospital care for low-income individuals costs more., Introduction Supplemental Security Income (SSI) provides cash payments and other benefits for qualifying low-income individuals. Individuals qualify for SSI cash payments based on their income and resources, reassessed on a [...]

Cross-border movements are surging as U.S.-based companies seek to shorten supply chains exposed for over-reliance on Far East manufacturing during and after the pandemic. Shippers are advised to plan early [...]

These are challenging times in the truckload (TL) market, as top carrier executives are predicting it will be the second half of 2025 before a rate recovery occurs in the [...]

It's now a race between environmentalists and government regulators on which technology to mandate on the ground freight transportation community to lower carbon emissions. But whatever happens, who occupies the [...]

Product Support Managers (PSMs) manage the package of support functions required to field and maintain the readiness and operational capability of weapon systems, subsystems, and components. As the life cycle [...]

The components that make something a luxury item -leather seats, granite countertops, fine wood paneling, diamonds, a million-dollar view--almost invariably are not man-made. There's a whole theology that explores the [...]

ONE TRAGEDY OF LIFE is when children make promises they never fulfill as adults. We're all guilty. As a youngster in the late 1990s, my aspirations were simple. In order [...]

Pretending to be a gentleman of wealth, a man misses out on an opportunity for love and prosperity. Characters TOWERS CHANDLER FRANK BARNES MISS MARIAN WINDSOR DOROTHY WINDSOR TIME: New [...]

This adaptation of Aunt Susanna's Thanksiving Dinner is protected by U.S. copyright law. It is unlawful to use this play in any way unless you are a current subscriber to [...]

Background: Standard pharmacotherapy for patients with heart failure with reduced ejection fraction (HFrEF) comprises 'quadruple therapy' with a reninangiotensin system inhibitor, a 3-blocker, a mineralocorticoid receptor antagonist, and a sodium-glucose cotransporter-2 inhibitor. Randomized controlled trials evaluating different sequencing strategies for initiating and titrating these medications are lacking. We sought to compare costs for various HFrEF quadruple therapy sequencing strategies. Methods: We used an individual-based state-transition microsimulation model to compare cost utility for 12 sequencing strategies with either weekly or biweekly medication adjustments for treatment-naive patients with HFrEF. We conducted a probabilistic analysis with a lifetime horizon from the public-payer perspective, along with a deterministic sensitivity analysis and 2 scenario analyses. We estimated costs, quality-adjusted life years (QALYs), incremental net monetary benefit (NMB) at a willingness-to-pay threshold of $50 000/QALY, and incremental cost-effectiveness ratios (ICERs) of each strategy versus the conventional approach. Results: Over a lifetime, the 12 strategies resulted in costs ranging from $76 440 to $79 338, QALYs ranging from 9.55 to 9.72, and incremental NMB ranging from $2233 to $6529. Compared with the conventional sequencing strategy of starting and titrating biweekly 1 medication at a time, other strategies had ICERs ranging from $11 175 to $22 492. The simultaneous initiation of all 4 medications with subsequent biweekly adjustment had the highest probability of being the most cost-effective strategy at the specified willingness-to-pay threshold. Interpretation: Simultaneous initiation of the 4 standard HFrEF medications with biweekly adjustment provided the highest cost utility compared with other strategies. Systems of care are needed to enable rapid initiation and sustained use of HFrEF medications., Heart failure causes substantial morbidity and mortality and consumes considerable health care resources. (1-4) Heart failure is the third most common reason for hospital admission in Canada, (2) with a [...]

CASE AT A GLANCE The Environmental Protection Agency (EPA) issued a permit to San Francisco that allowed the city to discharge combined sewage and stormwater into the Pacific Ocean. The permit contained effluent limitations on the discharge; it also contained limitations based on the water quality of the 'receiving waters.' San Francisco challenged the latter limitations, arguing that they exceeded EPA's authority under the Clean Water Act (CWA)., Introduction Section 301(b)(1) of the Clean Water Act (CWA) authorizes Environmental Protection Agency (EPA) to impose effluent limitations on dischargers and, in a separate subsection, 'any more stringent limitation, including [...]

CASE AT A GLANCE The Gun Control Act of 1968 requires any manufacturer or dealer of 'firearms' to obtain a federal license, to maintain records related to the acquisition and transfer of firearms, and to conduct a background check before transferring a firearm to a nonlicensee. The act also requires importers and manufacturers to mark firearms with a serial number. The Bureau of Alcohol, Tobacco, Firearms and Explosives, which enforces the Gun Control Act, issued a rule that applies these requirements to manufacturers and dealers of kits that contain easy-to-assemble firearm components, but which are not (yet) operational firearms., Introduction The lower courts ruled that the definitions of 'firearm' and 'frame or receiver' in the Gun Control Act did not encompass gun kits, and that the Bureau of Alcohol, [...]

CASE AT A GLANCE A group of plaintiffs sued the commissioner of the Virginia Department of Motor Vehicles to halt enforcement of a state law that provided for the automatic suspension of a resident's driver's license if they failed to pay certain court fines and fees. The district court issued a preliminary injunction halting enforcement of the state law. Before the case went to trial, the Virginia General Assembly repealed the law. The plaintiffs then asked for attorney's fees under federal law., Introduction 42 U.S.C. [section] 1988 authorizes a court to award attorney's fees to a 'prevailing party' in a civil rights case. The parties wrangle over whether the plaintiffs 'prevailed' only [...]

Objective. This scoping review synthesizes and summarizes the evidence on racial and ethnic disparities in outcomes after physical therapist treatment. Methods. Four databases from 2001 through 2021 were searched for articles reporting physical therapy outcomes across racial and ethnic groups. The Arksey and O'Malley methodological framework was adapted for this scoping review. Two reviewers screened the abstracts, and 5 reviewers screened full texts for inclusion. Five reviewers extracted information including study design, diagnoses, setting, outcomes reported, the domains the outcomes measured, and racial and ethnic groups included. To identify disparities, summarized differences in outcomes (better, worse, no difference) for each racial and ethnic group compared to White patients were calculated. Results. Of 1511 abstracts screened, 65 met inclusion criteria, 57 of which were observational designs. All 65 articles included non-Hispanic White patients as the reference group. A majority of the physical therapy outcomes reported by race were for Black patients and/or Hispanic or Latino patients, whereas outcomes for Asian, American Indian, Alaskan Native, and/or Native Hawaiians or Pacific Islander patients were reported infrequently. Most articles reported disparities in health outcomes for patients in the inpatient rehabilitation setting (n = 48) and for adults (n = 59) with neurologic diagnoses (n = 36). Compared to White patients, worse outcomes were reported more frequently for all marginalized racial and ethnic groups after physical therapy, with the exception of marginalized groups having the same or better outcomes for successful post-rehabilitation community discharge. Conclusion. Gaps remain in understanding outcome disparities beyond older adult and neurologic populations as well as for musculoskeletal diagnoses frequently treated by physical therapists. Impact. The presence of racial and ethnic disparities in physical therapy outcomes should motivate physical therapists to understand the mechanisms underlying disparities and focus on social and structural drivers of health inequity in their clinical decision-making. Keywords: Bias (Epidemiology), Decision Making, Effect Modifiers (Epidemiology), Epidemiologic Factors, Patient Care, Public Health, Rehabilitation, Search Strategies, Social Responsibility, Introduction Dr Camara Jones, former president of the American Public Health Association (APHA), stated that 'racism saps the strength of our entire society through the waste of human resources.' (1) [...]

Objective. The aims of this scoping review were to summarize the evidence regarding sex, racial, ethnic, geographic, and socioeconomic disparities in post-acute rehabilitation following total hip arthroplasty (THA) and knee arthroplasty (TKA). Methods. Literature searches were conducted in Ovid MEDLINE, EMBASE, CINAHL, Web of Science, and PEDro. Studies were included if they were original research articles published 1993 or later; used data from the US; included patients after THA and/or TKA; presented results according to relevant sociodemographic variables, including sex, race, ethnicity, geography, or socioeconomic status; and studied the utilization of post-acute rehabilitation as an outcome. Results. Twelve studies met the inclusion criteria. Five examined disparities in inpatient rehabilitation and found that Black patients and women experience longer lengths of stay after arthroplasty, and women are less likely than men to be discharged home after inpatient THA rehabilitation. Four studies examined data from skilled nursing facilities and found that insurance type and dual eligibility impact length of stay and rates of community discharge but found conflicting results regarding racial disparities in skilled nursing facility utilization after TKA. Five studies examined home health data and noted that rural agencies provide less care after TKA. Results regarding racial disparities in home health utilization after arthroplasty were conflicting. Six studies of outpatient rehabilitation noted geographic differences in timing of outpatient rehabilitation but mixed results regarding race differences in outpatient rehabilitation. Conclusion. Current evidence indicates that sex, race, ethnicity, geography, and socioeconomic status are associated with disparities in postacute rehabilitation use after arthroplasty. Impact. Rehabilitation providers across the postacute continuum should be aware of disparities in the population of patients after arthroplasty and regularly assess social determinants of health and other factors that may contribute to disparities. Customized care plans should ensure optimal timing and amount of rehabilitation is provided, and advocate for patients who need additional care to achieve the desired functional outcome. Keywords: Arthroplasty, Orthopedics, Rehabilitation, Introduction Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most common surgeries in the US, with more than one million performed annually. (1) THA and TKA [...]

Objective. Discussions of the root causes of health disparities and educational inequities often neglect to identify racism as a primary factor. Researchers must take a systems perspective to identify the effects of racism and other forms of systemic oppression on health. It is unclear to what extent this perspective exists in the physical therapy research literature. We conducted a scoping review to quantify and describe the volume of research in physical therapy pertaining to diversity, equity, and inclusion specifically examining race and/or ethnicity and references racism or antiracism. Methods. A systematic search of PubMed and Scopus databases for articles published between 1997 and 2021 was conducted. Articles were screened to ensure they were focused exclusively or primarily on physical therapy and used diversity, equity, and inclusion terms in the context of personal identity factors. This resulted in 158 relevant articles. Each was tagged with an article type and personal identity factor focus. Results. A majority of the included articles were descriptive/observational in nature. The included articles explored various personal identity factors, with race and ethnicity being the most common focus followed by culture, disability, and socioeconomic status. A small proportion of articles explicitly discussed racism or antiracism. Conclusion. These findings highlight the need in physical therapy research for greater attention to racism as a fundamental cause of health disparities and educational inequities. Addressing this gap is crucial for promoting diversity, equity, and inclusion within the field and ultimately achieving optimal health outcomes for marginalized populations. Impact. Including consideration of racism and otherforms of systemic oppression in the motivation, design, and interpretation of research in physical therapy will help to make more visible the root causes of inequity and improve our ability to develop effective, multi-level interventions. Keywords: Culture, Ethnic Groups, Health Services Accessibility, Peer Review: Research, Physical Therapists, Professional Issues, Public Health, Social Responsibility, Socioeconomic Factors, Introduction Inequity in physical therapy takes many forms, from disparities in health care access, quality, and outcomes to unequal access to professional education programs to limited diversity of program directors, [...]

The Tax Cuts and Jobs Act (TCJA), P.L. 115-97, limited itemizers' state and local tax (SALT) deductions to $10,000 for tax years 2018 through 2025 (the SALT cap). However, federal [...]

It is said the warrior's is the twofold Way of pen and sword, and he should have a taste for both Ways. Even if a man has no natural ability, [...]

In the dental hygiene discipline, evidence-based practice serves as a cornerstone for delivering high quality patient care and moving professional standards forward. As practitioners delve deeper into research to inform clinical decision making, the integration of robust survey methodologies becomes imperative. However, the complexities of survey design, implementation, and analysis pose notable challenges, particularly in ensuring the reliability and validity of research outcomes. This short report provides brief practical guidance about the basics of survey research methodologies for dental hygiene professionals. Keywords survey methods, survey methodology, survey design, questionnaire, dental health surveys NDHRA priority area, Professional development: Education (evaluation). Submitted for publication: 4/4/2024; accepted: 7/10/2024, INTRODUCTION Survey research is a strategy to gather information from a sample by asking a series of questions or items that may be used to make inferences more broadly in [...]

The contents of this article are for educational and informational purposes only. They are not a substitute for professional medical advice, diagnosis, or treatment. Readers are encouraged to seek the [...]

Supply chain control towers (SCCTs) are emerging as vital components of modern supply chain management (SCM). However, research on SCCTs is limited and disjointed. This paper explores critical success factors (CSFs) necessary for high-performing SCCTs and examines their impact on supply chain resilience (SCRES). Through a comprehensive systematic literature review, this research inductively identifies and classifies 14 CSFs into a framework consisting of organizational, process, and technological dimensions. We further map complex relationships among these CSFs, revealing how SCCT performance relies on CSFs interacting synergistically as dynamic capabilities. Moreover, this study extends the theory related to SCRES under dynamic and disruptive market conditions by discretely connecting SCCT outcomes to supply chain readiness, responsiveness, recovery, and renewal. By integrating both theoretical and practical perspectives, this study contributes to existing SCM knowledge by providing both a structured approach to identifying and implementing CSFs for SCCTs and explaining the role of SCCTs in advancing SCRES. This paper, therefore, serves as a valuable resource for both researchers and industry practitioners in understanding SCCT operations and outcomes in achieving efficient, robust, and resilient supply chains. Keywords: control tower, critical success, logistics, resilience, supply chain factors, 1. INTRODUCTION As global supply chains continue to evolve, the deployment of supply chain control towers (SCCTs) is increasingly necessary for maintaining firm competitiveness and resilience. SCCTs are centralized platforms [...]

Mountainous terrain has proven to be the ultimate combat and sustainment equalizer, but the U.S. Army's 10th Mountain Division has been 'flattening' mountainous and alpine terrain for the U.S. military's [...]

Dwight D. Eisenhower rose from obscurity soon after the United States entered World War II in 1941 to achieve dizzying heights, first, as Supreme Allied Commander of the Allied Expeditionary [...]

Within two years of the September 11 attacks, the United States found itself with substantial military forces in Afghanistan and Iraq. An enormous amount of foreign ideas and resources flowed [...]

Since its establishment in 1901, the US Army War College (USAWC) has adapted to meet the needs of the Army and a nation during episodic changes in the security environment. [...]

Behavioral correlates to happiness (i.e., indices of happiness) have been used as means of measuring happiness in individuals with developmental disabilities. However, research has not yet evaluated the possibility that indices of happiness/unhappiness (IHUs) may signal the presence of a setting event that could affect other behaviors. The purpose of this study was to assess the relation between indices of happiness/unhappiness (IHUs) and challenging behavior with a 14-year-old boy diagnosed with autism spectrum disorder. A conditional probability calculation was used to evaluate the relation between IHUs, demand type, and challenging behavior. Results indicated that different IHUs predicted specific topographies of challenging behavior given demands to transition or engage in academic tasks., Author(s): Jacqueline D. Wilson [sup.1] [sup.2], Caitlyn A. Federico [sup.1] [sup.2], Jesse Perrin [sup.1] [sup.2], Cody Morris [sup.1] Author Affiliations: (1) https://ror.org/004qfsw40, grid.430064.5, 0000 0000 9900 6074, Department of Psychology, [...]

ABSTRACT Background: Indwelling double-J-stent (DJ stent) kept post-urological procedures may cause urinary tract infections (UTIs) due to polymicrobial biofilm formation and colonisation. Aims: To determine the incidence and microbiological characteristics of DJ stent related UTIs in a paediatric population. Methods and Material: Patients under the age of 18 admitted for DJ stent removal following pediatric urological procedures were enrolled into the study. Prior to surgical removal of the DJ stent, a urine sample was collected and the stent was cystoscopically removed under anesthesia. The ends of the stent were inoculated into culture media and incubated up to 48 hours. When growth was observed, an antibiogram was obtained using a panel of anti-microbial agents. Results: The study group consisted of 27 patients (M:F = 23:4) with a mean age of 4.3 years (1 month - 13 years). The commonest indication for stent placement was Pyeloplasty, 19 (70). Stent colonisation was found in 8 out of 27 patients (29.6; CI 12-51) and E.Coli (33) was the commonest organism. Polymicrobial growth was noted in 4 patients. Organisms were sensitive to Cephaerazone/ Sulbactam and Amikacin, and resistant to other Cephalosporins. All 8 culture positive patients were asymptomatic and a repeat urine culture revealed no growth. Colonisation did not lead to active UTI and post stent removal the urine became sterile. Conclusions: Microbial colonisation was noted in 30 of patients with indwelling DJ stents. Prior knowledge of culture sensitivity pattern helps to cover the patients with appropriate antibiotic on the day of stent removal. Keywords: Antibiotic prophylaxis, bacterial colonization, pyeloplasty, urinary tract infection, Author(s): Sandeep Nishanth (corresponding author) [1]; Ramesh Babu [1]; Sathyamurthy Arunaa [1]; D. Arun Prasad [1]; M. Shanthi [2]; Uma Sekar [2] INTRODUCTION Urinary tract infections (UTIs) can vary from [...]

The Fraser River Delta (FRD) is a large sedimentary system and home to Metro Vancouver, situated within the unceded territories of several First Nations. This review provides an overview of the geological evolution of the FRD, connecting hydrodynamic processes with sedimentary deposits across its diverse environments, from the river to the delta slope. The study emphasizes the implications of sedimentation and delta evolution for natural hazards and coastal/delta management, pinpointing knowledge gaps. Comprising four main zones--river, delta plain, tidal flats, and delta slope--the FRD is subject to several natural hazards, including subsidence, flooding, earthquakes, liquefaction, and tsunamis. The delta plain, bordering the Fraser River's distributary channels, hosts tidal marshes and flats, including both active and abandoned areas. Active tidal flats like Roberts Bank and Sturgeon Bank receive sediment directly from the Fraser River, while abandoned tidal flats, like those at Boundary Bay and Mud Bay, no longer receive sediment. The tidal flats transition into the delta slope, characterized by sand in the south and mud in the north of the Main Channel. The FRD's susceptibility to hazards necessitates protective measures, with approximately 250 km of dykes shielding the delta plain from river floods and storm surges. Subsidence amplifies the impact of rising sea levels. Earthquakes in the region can induce tsunamis, submarine slope failures, and liquefaction of delta sediments, emphasizing the importance of incorporating sedimentation patterns and delta evolution into management strategies for sustainable urban development, habitat restoration, and coastal defence initiatives. Key words: sedimentology, stratigraphy, deltas, tidal flats, coastal management, natural hazards, 1. Introduction Deltas sit at the nexus of fluvial and marine environments and are a storage place and staging ground for sediment, pollutants, and organic carbon that are transported from [...]

We review currently available Canadian and international lithostratigraphic and lithodemic schemes and find most of them inadequate for classifying intrusive and strongly metamorphosed rocks of Canada and beyond. A new system is proposed, one that unifies, complements, and extends components of the revised North American Stratigraphic Code, the British Geological Survey Rock Unit Classification System of 2021, and the International Stratigraphic Guide of 1999. This new Cooperative Lithodemic and Stratigraphic System (CLASS) is intended to serve as a practical guide to geoscientists who need to classify and report on lithodemic units in North America and has broad applicability to other jurisdictions. It is built with database management practices in mind and employs the concept of inheritance of root characteristics between seven formal rock unit ranks, which will allow incorporation of the scheme into compact object-oriented and relational databases designed for purpose. Broad application of CLASS, especially to historically problematic lithodemic units, should help to foster jurisdictional interoperability, data sharing, global compilations, and thematic studies. At the heart of this proposed system is a subdivision and accompanying nomenclature that allows classification of rocks into seven formal ranks. Following the well-established lithostratigraphic supergroup, group, subgroup, formation, member, submember, and bed approach, CLASS proposes three classes of lithodemic subdivisions for formally naming lithodemic rock units. Key words: nomenclature, North American Stratigraphic Code, International Stratigraphic Guide, lithodeme, lithotectonic assemblage, suite, 1. Introduction As outlined by the North American Commission on Stratigraphic Nomenclature (NACSN 1983, 2021), a stratigraphic code is 'a formulation of current views on stratigraphic principles [...] that [...] [...]

CASES BOUNDARY DISPUTES: One-year statute of limitations on claims challenging a trustee's conveyance does not apply to adverse possession or boundary by acquiescence. The Vaudts purchased their home in 1991 [...]

Florida recently modernized its laws related to the administration of estates and trusts by enacting the Florida Uniform Fiduciary Income and Principal Act (the act or FIPA). (1) The act, [...]

Football in Mississippi isn't just for sport; it's as deeply rooted in the culture as magnolias, good manners, and the blues, turning Saturdays into a celebration of team spirit, rivalry, [...]

The Third Circuit has decided a case involving computing the tolling period within Code Sec. 6330(e)(1) for appeals from Collection Due Process (CDP) determinations, including the period of time following [...]

Purpose: To ascertain current nutritional knowledge and training needs of community-based nurses caring for older adults in the United Kingdom. Method: A descriptive cross-sectional, anonymized, online survey of nurses' knowledge, attitudes, and practices related to older adults' nutrition was developed. Community-based nurses working with older adults in the United Kingdom were recruited via social media and convenience sampling. Results: Responses were received from 194 community-based nurses. Nutritional care was seen as a multidisciplinary responsibility by 62% of participants. Most undertook nutrition screening (93%), were confident in providing nutritional advice (83%), and ease of identifying those in need (88%) was high. However, some aspects of nutritional knowledge were less complete, including recommended daily intakes of protein (60% unsure) and fiber (52% unsure). Conclusion: High confidence in delivering nutritional advice contrasted with uncertainty around some aspects of nutritional knowledge, suggesting opportunities to improve training on the nutritional needs of older adults. [Journal of Gerontological Nursing, xx(xx), xx–xx.], Nutrition is a modifiable lifestyle factor that impacts all aspects of health. Older adults may be at greater risk of poor nutrition due to aging-related changes in physiology and comorbidities [...]

The Supreme Court this term issued two hotly controversial and deeply impactful rulings that cut to the heart of our constitutional system. In the first, Trump v. Anderson, the Court ruled that Colorado lacked authority to disqualify former President Donald J. Trump from the 2024 presidential ballot on the ground that he supported an insurrection. In the second, Trump v. United States, the Court held that Trump, as a former president, enjoyed extensive immunity from criminal prosecution for his behavior while in office., If you feel a little unbalanced after reading those brief descriptions, that's understandable: it's the lurching of the tectonic plates in our separation-of-powers system. In terms of Court rulings on [...]

A half-naked woman was lying on the table, and guests were invited to drip hot wax onto her body. Nearby, waiters passed tuna-tartare cones as a pair of burlesque dancers [...]

His text said, 'I'm dying,' and he was and we both knew it. We'd known it since the last October when his doctor gave him 48 hours to live. God, [...]

Cooling systems are vital to remove heat from equipment or process. The function of a cooling system is to transfer the heat from one medium to another. Heat transfer from [...]

Background: Esophageal cancer (EC) is an extremely aggressive tumor with one of the highest geographic, ethnic, and gender variations. Various factors including tobacco consumption, unhealthy diet, and socioeconomic status have been implicated in the etiology of EC. Despite the advent of modern treatments, the prognosis of EC is dismal. This study has been undertaken to review the clinical and pathologic profiles, treatment approach, and survival pattern in patients with EC in a tertiary care hospital in northeast India. Materials and Methods: A retrospective descriptive study was done with 179 EC patients presented to our department between January 2013 and December 2020. Statistical analysis was done by using IBM Statistical Package for the Social Sciences version 21. P- value Results: The majority of the patients presented in the sixth decade of life from rural areas with male to female ratio of 3.7:1. Dysphagia was the most common presenting feature. High incidence of tobacco and alcohol use was found. Mid-esophagus is the most common site and squamous cell carcinoma is the most common type. Fifty-two (29.1) and 71 (39.6) patients presented in stages III and IV, respectively. Twenty-four (13.4) patients presented with metastatic disease, the lung being the most common site. Patients were treated with surgery, chemotherapy, radiotherapy, or combination of any of these. Overall median survival for the EC patients was 6 months. Patients treated with concurrent chemoradiation had better survival. Conclusion: EC is a serious malignancy with a dismal prognosis due to the advanced stage at presentation. Larger clinical trials using new therapeutic strategies are the need of the hour. Keywords: Chemotherapy, dysphagia, EC, metastasis, radiotherapy, squamous cell carcinoma, Author(s): Kishalay Baidya [1]; Yumkhaibam Sobita Devi (corresponding author) [1]; Hari K. Rai [2]; Ningthoujam D. Devi [1]; Neeta Sinam [1]; Gowtham L. T. Kilari [1] INTRODUCTION Esophageal cancer (EC) [...]

As the COVID-19 pandemic reached its second year, and vaccine mandates to return to work or school became a contested debate among leaders in health care organizations and universities, nursing academic and hospital leadership had to consider which health and safety requirements, including COVID-19 vaccines, were needed to return students, nurses, and nurse faculty to more typical clinical and classroom activities. In this context, this mixed-methods study surveyed and analyzed data from a large national sample of students, nurses, and faculty about their vaccine status, and reasons for their decisions to be vaccinated or not. Study findings point clearly to the need for better messaging in all public health campaigns, emphasizing the protection of others as the strongest predictor for vaccine uptake. Keywords: Vaccine mandates, COVID-19 vaccine uptake, public health messaging, early adopters of vaccine acceptance, nurses vaccine hesitancy, pandemic, COVID-19., COVID-19 continues to be a highly researched topic. Of particular interest is the subject of vaccination, especially in states where the vaccine was mandated for certain populations following U.S. Federal [...]

In 'Balancing Nonresident Joint Professional Military Education With Military Life,' Commander Doug Morea makes the salient point that the current joint professional military education (JPME) process fails the individual joint [...]

Logistics professionals are receiving praise for navigating waters during a period when 'no tide table seems reliable,' the 35th Annual State of Logistics (SoL) Report concludes. 'Logistics executives and policymakers [...]