text:
Personal Narrative: My Identity In Hamilton
As people always recognize kids for their strength, I've been put a writer card in my wallet of identity since I was young (according to my mum, I wrote earlier than anybody in Kindergarten, although she forgot I was also older than anybody). To be honest, while sometimes I'm proud of it, sometimes this "Write and Wrong" identity really creates pressure and constriction. I surprisingly found out Hamilton is really where I'm looking for. The open curriculum with a stress on writing and speaking can let students truly explore the liberal arts while building a solid communication capability base. I'll be able to meet more possibilities and potentials with the guide of "The Quill Pen" that has been leading this college for years. The next time
Reflection On Autoethnography
Autoethnography means a way for me to provide meaning of my experiences at a in-depth level and "opportunities to cast a critical eye on aspects of own practice" (Lambrek, 2005, p. 230). As I looked into the research paper which used autoethnography as method people expressed that it offered them a way to expand their knowledge, to achieve reflective insights that would not have happened through other methods of research. During (2009) L. Alwin stated that autoethnography enabled him to "get at another
Strategic Management and Michael Porter: a Postmodern Reading
exploration and play (Bauman 1992; Rorty 1989). I do not attempt to deconstruct (Linstead 1995; Cooper 1989; Derrida 1978), but merely to explore the possiblilty of a radical new reading of Michael E Porter. Is Porter postmodern? The project originated in my need to 'make sense' of the strategic management literature, and specifically the place of Michael E Porter within it. The question, what is strategic management?, often leads to the work of Porter.
Voice Recorders Are Not Standard For African American Language
about them and gave them shoes in the winter etc and repeatedly outright said so. Ms Hamlin also probably had a preconceived notion about how this ex-slave would act because she repeatedly verified her name against one very similar one (Hamlin not Hamilton), showing she had already known a good deal about her. Conversely, Mrs Hamlin gives a different interview about slavery to a one Augustus Laudson. Here, she does not hold anything back and allows all of her opinions to flourish in the open. Instead
Analysis Of The Book ' The '
Dielle Ghislaine Ochotorena American Studies 1/2 Destructiveness of Obedience Alot of people like to believe that the world is generally all good or all evil; however, in reality they are the yin and yang of the human condition, and they are the labels we put on things that either appeal to us or don't. The biblical story of Lucifer, who before he was banished from Heaven, was God's favorite angel. Lucifer in the story, defied God which was the ultimate disobedience to authority in everyone's
Sports Therapy And Rehabilitation Services
Introduction Sports Therapy and Rehabilitation Services (STARS) at its location in East Meadow, New York, is addressing the problem of spinal cord injuries. These injuries are not as well known as one may think. Warren, Hamilton, and Roden-Foreman state that the "incidence of traumatic spinal cord injury (SCI) is estimated to occur in the United States at a rate of 40 cases per million" (pp. 303, 2013). This is a low incidence, especially in a country of approximately one-third of a billion of people
The Roosevelt During The Great Depression
what you want to hear." Interviewers' questions, though unconsciously, "constantly communicated with their subjects the kind of evidence they want, the length of answers and even the manner in which answers ought to be offered" (Davidson 181). The personal relationships also created an interesting dynamic during an interview. Interviewees often knew interviewers personally and said, "I don't want to tell you nothin' but what to please you" (Davidson 183). The author again points out that the manner
Positive And Negative Aspects Of The Lgbt Community
capabilities, social standing to many more. Regardless of the reasons for boxing people into a specific category, the dominant signifiers seem to greatly influence the trajectory of one's identifiable categories. When humans are forming their self-identity they tend to place themselves in a box that society has deemed as
Essay on Black Artists in Country Music
15 Works Cited
Charlie Pride did it in 1971. Darius Rucker did it in 2009. That's it. Two black men, spanning thirty-eight years, are the only black artists to win a Country Music Association Award. With country music rooted in bluegrass and rhythm and blues, why aren't there more black country music stars? When considering the roots of country music, and how closely related country is to blues, bluegrass and honky tonk music, an examination of what happened to all the black musicians seems warranted, no? This
The Death of the 'Authorlessness Theory'? Essay
The Death of the 'Authorlessness Theory'? Let's face it. Can one fully buy into Roland Barthes' claim that "The birth of the reader must be at the cost of the death of the Author"? (172). Even if "it is language which speaks, not the author" (168), an author is responsible for the creation of a unique sequence of words in a novel, a poem or an article. The canvas on which freeplaying signifiers paint themselves seems so vast to Barthes that "the writer can only imitate a gesture
A Rebuttal to E. R. Dodds' On Misunderstanding the Oedipus Rex
However, the driving force of Oedipus' fact-finding mission is an attempt to end the plague which racks his city. He does not realize the personal consequences his hunt will have for him, and his "loyalty to the truth" (23) is based on his ignorance of it. In fact, if we examine the events leading up to Oedipus' revelation, the incidental nature of his "quest for identity" becomes apparent. First, he summons Tiresias to name the killer, whom Oedipus does not at the time believe to be himself. Then a messenger
Percy Jackson And The Olympian's Heroes Of Olympus
Savannah, Georgia Case Study
Olympic Games Sponsors
Common Good Approach
Therapist-Personal Narrative
The Government Lie: A Case Study


yup. Thursday at Erie International, which they should just give up and rename Regional. who are we trying to kid, Detroit's hardly international. the Toronto dream died so long ago.
question: do you like Kathy Dahlkemper? her hand was so cold.
One foot in the grave.


text:
CV🦠News – Week of April 6, 2020
by The Village Doctor
Greetings Friends of TVD!
We hope this note finds you all well, staying home these past cozy, rainy days, not spending too much time on social media nor the news, and now that the sun is out, getting outside for a breath of fresh air. As many of you know, we've been working hard at keeping our website up to date with coronavirus and COVID-19 information. We have been fortunate to leverage the fact that The Village Doctor has FIVE physicians working together to keep your family safe, healthy, and informed. The physician team "Zooms" daily to share knowledge and experience gained in the past 24 hours so we can serve you, and our community better. In the spirit of keeping YOU up to date, we've decided to launch this weekly newsletter devoted to coronavirus topics, including a section we call Hope & Grace. Let us recognize the beauty in the human experience, even in this painful time we are experiencing.
Until then, it is on to "Plan Be"… where we can focus less on "waiting" for things to get better, and more on "being". Being healthy, being with each other, being supportive, being loving. Being human.
Cautious good news! Or as Dr. Sara Cody said on Monday, "We're not out of the woods, but there are a few little sparkles of optimism." Coronavirus cases continue to expand in the Bay Area, but the sheltering in place is reducing the rate of expansion. The volume of hospitalized people in Northern California is gradually increasing (approximately doubling every week, see graphs below), however the volumes are currently manageable. It is expected that the number of people will increase and peak hospital utilization will occur in late April or early May. We may be sheltering in place until June. Overall, our local hospital, Stanford, appears to be well prepared. Note this does NOT mean we can let down our guard… please continue to stay home!
The Santa Clara County Dashboard has been updated and also provides helpful data about current hospital and lab testing statistics.
On April 9th, the NIH announced a clinical trial to evaluate the safety and effectiveness of hydroxychloroquine for the treatment of adults hospitalized with coronavirus disease 2019 (COVID-19) starting at Vanderbilt University Medical Center, Nashville. Participants will be randomly assigned to receive hydroxychloroquine 400 mg twice daily for two doses (day one), then 200 mg twice daily for the subsequent eight doses (days two to five) or a placebo twice daily for five days. "Hydroxychloroquine has showed promise in a lab setting against SARS-CoV-2, the virus that causes COVID-19 and preliminary reports suggest potential efficacy in small studies with patients. However, we really need clinical trial data to determine whether hydroxychloroquine is effective and safe in treating COVID-19", said James P. Kiley, director, Division of Lung Diseases, NHLBI
PUBLIC HEALTH ADVISORIES
We continue to #stayhomesavelives! As of March 31, Health officers in seven Bay Area jurisdictions are extending a previous stay-at-home order through May 3, 2020 in order to preserve critical hospital capacity across the region. The health officers have determined that more and stricter social distancing is needed to slow the rate of spread, prevent deaths, and stop the health care system from becoming overwhelmed. The new order adds some clarifying language around essential business and activities, as well as some new directives, including:
* Use of playgrounds, dog parks, public picnic areas, and similar recreational areas is prohibited. These areas must be closed to public use.
* Use of shared public recreational facilities such as golf courses, tennis and basketball courts, pools, and rock walls is prohibited. These facilities must be closed for recreational use.
*Sports requiring people to share a ball or other equipment must be limited to people in the same household.
* Requires essential businesses to develop a social distancing protocol before April 3rd.
* Most construction—residential and commercial—is prohibited.
* Funerals limited to no more than 10 people attending.
* Essential businesses expanded to include service providers that enable residential transactions (notaries, title companies, realtors, etc.); funeral homes and cemeteries; moving companies, rental car companies and rideshare services that specifically enable essential activities.
* Essential businesses that continue to operate facilities must scale down operations to their essential component only.
Home delivery of testing kits is temporarily delayed because of concerns by the FDA regarding quality of testing. Hopefully this can be resolved within the next week. Note there are two types of tests: one uses PCR (polymerase chain reaction) to look for actual coronavirus RNA to determine if you have COVID-19 at the time of testing while the other looks at antibodies in blood to determine if you had COVID-19 in the past.
Note also that there were some earlier questions about how accurate the testing was at Stanford (accuracy is measured by a test's sensitivity and specificity). It appears that some of the early tests' weakness had to do with how the samples were being collected rather than the test itself. More recently, samples being collected at Stanford have both outstanding sensitivity (96%) and specificity (nearly 100%), which means the test is quite good at determining whether or not you have COVID.
Lastly, here are some updates from the news this past week:
(3/27/20) Abbott launches a new test that can detect COVID-19 in as little as 5 minutes.
(3/26/20) Curative Inc labs racing to deliver 10,000 saliva tests / day to LA County.
(03/22/20) Everlywell offers COVID-19 test kit, but limiting it to frontline medical facilities.
HYDROXYCHLOROQUINE FOR COVID TREATMENT? A small trial published in China revealed that hydroxychloroquine may be helpful for mild or moderate disease. It was a small study of only 60 people and some American scientists question the validity of the study. That said, much of the very early excitement has now been tampered down, but this hasn't stopped the political pressure. Some claim that even our FDA put politics over science when it issued an emergency use authorization for chloroquine and hydroxychloroquine on March 29, 2020. On March 30 the University of Minnesota started a trial looking at hydroxychloroquine used as prophylaxis against COVID-19. So all to say, there is a lot to learn, a lot of political pressure and a tremendous amount of clinical need. The coming few weeks should be very interesting!
STILL NOT SURE ABOUT THE NEED FOR PHYSICAL DISTANCING? Please read this piece from Jonathan Smith at Yale University.
Hey everybody, as an infectious disease epidemiologist, at this point I feel morally obligated to provide some information about what we are seeing from a transmission dynamic perspective, and how it applies to social distancing measures.
Like any good scientist I have noticed two things that are either not articulated or not present in the "literature" of social media.
Specifically, I want to make two aspects of these measures very clear and unambiguous.
First, we are in the very infancy of this epidemic's trajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks.
Our hospitals will be overwhelmed; people will die that didn't have to. This may lead some people to think that the social distancing measures are not working. They are.
They may feel futile. They aren't.
You will feel discouraged. You should. This is normal in chaos. But this is also the nature of a normal epidemic trajectory.
Stay calm.
The enemy we are facing is very good at what it does; yet we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse.
This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception.
We know what will happen; I want to help the community brace for this impact.
Stay strong, and with solidarity know with absolute certainty that what you are doing is saving lives, even as many people get sick and others die.
You may feel like giving in. Don't.
Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (e.g., families) in transmission dynamics.
While social distancing decreases contact with members of society, it of course increases your contact with group (family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics.
Study after study demonstrates that even if there is only a little bit of connection between groups (e.g., social dinners, playdates, playgrounds, etc.), the epidemic trajectory isn't much different than if there was no measure in place.
The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit.
You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk.
Seemingly small social chains get large and complex with alarming speed.
If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son's girlfriend's mother shook hands with.
This sounds silly, it's not.
This is not a joke or a hypothesis. We as epidemiologists see it borne out
in the data time and time again and no one listens.
Conversely, any break in that chain breaks disease transmission along that chain.
In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison.
The results from these measures also take a long time to develop.
It is hard (even for me) to conceptualize how 'one quick little get- together' can undermine the entire framework of a public health intervention, but it does.
I promise you, it does. I promise. I promise. I promise.
You can't cheat it. People are already itching to cheat on the social distancing precautions just a "little" – a playdate, a haircut, picking up a needless item at the store, etc.
From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that nullifies all the work the community has done to that point.
Until we get a viable vaccine, this unprecedented outbreak will not be overcome in a grand, sweeping gesture. Rather, only by the collection of individual choices our community makes in the coming months.
This virus is unforgiving to unwise choices.
My goal in writing this is to prevent communities from getting 'sucker- punched' by what the epidemiological community knows will happen in the coming weeks.
It will be easy to be drawn to the idea that what we are doing isn't working and become paralyzed by fear, or to 'cheat' a little bit in the coming weeks.
By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of great danger and uncertainty.
Link to this publication in the press can be found here.
CAN OUR KIDS GO ON PLAYDATES WITH OTHER CHILDREN? No, not now. While social distancing by staying home is hard, it is very important – for both adults and children, since both can act as carriers for the disease as well as experience the illness directly. Note that as parents, if we don't take this seriously and curb face-to-face interaction, we also defeat the purpose of closing schools and workplaces.
Note there are some terrific resources out there for you parents challenged with a "shelter in place" order, and kids home from school. Thank you to TVD Pediatrics for putting this list together!
FAQs and Answers: COVID-19 & Children — CDC
COVID-19: What Parents Need To Know — Stanford Children's
How to Talk to your Kids About Coronavirus — NY Times
Talking to Teens and Tweens About Coronavirus — NY Times
9 Questions Parents May Have About Coronavirus — NY Times
UC Davis Kids Considered Podcast for Parents
How do you manage fighting kids during a lockdown? | CNN
HOPE AND GRACE
If you have made it this far, time for a reward, something to lighten your day, and acknowledge the human spirit. Let us recognize the beauty in the human experience, even in this painful time we are experiencing. Find some escape, or perhaps even inspiration, in this collection of works and perspectives gathered from around the world. Maybe even joy. Please contact me directly at [email protected] if you have come across something that has lifted your heart today.
NOTE for this week's Good Friday services, there are multiple Bay Area churches offering online services.
Please enjoy David Mathews' new song, "Singing From The Window". Turn up the volume.
And before we go… Please take a contemplative few minutes to both read, and reflect on, this thoughtful piece by Lynn Ungar:
Pandemic, by Lynn Ungar (with permission)
What if you thought of it
as the Jews consider the Sabbath—
the most sacred of times?
Cease from travel.
Cease from buying and selling.
Give up, just for now,
on trying to make the world
different than it is.
Sing. Pray. Touch only those
to whom you commit your life.
Center down.
And when your body has become still,
reach out with your heart.
Know that we are connected
in ways that are terrifying and beautiful.
(You could hardly deny it now.)
Know that our lives
are in one another's hands.
(Surely, that has come clear.)
Do not reach out your hands.
Reach out your heart.
Reach out your words.
Reach out all the tendrils
of compassion that move, invisibly,
where we cannot touch.
Promise this world your love–
for better or for worse,
in sickness and in health,
so long as we all shall live.
Yours, in health and resilience,
Eric, Jenn, Prerana, Sky and Jackie

redpajama_set_name: RedPajamaCommonCrawl


There are many individuals that are planning to apply for a loan. However, the real issue is that they are not planning to leave a collateral because either they do not have any property or they cannot afford to lose the one they have. In this situation, the best solution would be getting the unsecured loan.
Most people have the misconception that getting the unsecured loan is very easy. Here we have everything you need to know about unsecured loans.
The first thing you should know is that unsecured loans have the fixed interest rates and other policies. There is no chance that the lender will change the policies for you. Assure that you properly read the policies so you know what you are getting yourself into.
The best thing about unsecured loans is that they are easy to pay off. There are many services and payment techniques that you can select.
There are different payment methods available. You can select the one that is most preferable to you.
Despite having the fixed interest rates, it has been noticed that interest rates are lower, which means you can easily manage the loan within a limited time.
If you are planning to apply for the unsecured loan, one of the most important things that you have to consider is your credit score. As there is no collateral in the system, you have to assure that you maintain your good credit score; otherwise, you will not get the approval for the loan. In all situations, even after getting the loan you have to maintain your credit score.
Remember when you make payments on time, you get the chance to improve your credit score.
Make sure that you get the unsecured loan only when you need it. Because it can improve your credit score and at the same time, delayed payment can negatively affect your credit score. Assure that you get the unsecured loan from a reliable lender because that is the only way you will get the best services.
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Make the right decision when looking for a loan under $5000 with bad credit – small-unsecured loan from Loan Away will help you to handle increasing interests and to solve current difficulties.


text:
Three Butterflies
CC0 Public Domain Designation
James McNeill Whistler
American, 1834-1903
Digital Publication
Whistler Paintings and Drawings at the Art Institute of Chicago
An in-depth exploration of the Art Institute's important collection of James McNeill Whistler's work, tracing the artist's dramatic reception in Chicago.
Graphite on cream wove card
Inscribed, verso, bottom left, in graphite: "R1375t"
Gift of Walter S. Brewster
The International Image Interoperability Framework (IIIF) represents a set of open standards that enables rich access to digital media from libraries, archives, museums, and other cultural institutions around the world.
https://api.artic.edu/api/v1/artworks/113073/manifest.json
James McNeill Whistler, The Gentle Art of Making Enemies (London, 1890), pp. 221, 248.
Margaret F. MacDonald, James McNeill Whistler: Drawings, Pastels, and Watercolours: A Catalogue Raisonné (New Haven, 1995), p. 456, no. 1259 (ill.).
Col. R. Goff, from 1903 [MacDonald 1995]. Sold by Albert Roullier Art Galleries, Chicago, to Walter S. Brewster (1872-1954), Chicago, November 1924 [MacDonald 1995; stamp (Lugt 2651 a-b), recto, upper left, in blue]; given to the Art Institute, 1933.
Soldier with Lance, 1854/55
Old Woman in Shawl and Cap, 1887
Sketch of the Peacock Room, 1898
Study for Portrait of Thomas Way, 1896
Butterfly, c. 1890
Whistler inscription and butterfly formerly on mat of Rembrandt's Clement de Jonghe, n.d.
Sketches of Biblical Scenes, Town by Lake, Mountain Village, Warrior, n.d.
Rodolphe Bresdin
Young Woman Playing a Mandolin, Study for Portrait of Mlle. Fiocre in the Ballet "La Source", 1866/68
Hilaire Germain Edgar Degas
Kneeling Draped Figure, c. 1865–70
Sir Edward Burne-Jones
The Beach at Royan, n.d.
Maxime Lalanne
Portrait of a Man Writing, 1855
Anton Mauve


text:
Guinea nahm mit acht Sportlern an den Sommer-Paralympics 2008 im chinesischen Peking teil.

Es gab keinen Fahnenträger beim Einmarsch der Mannschaften, da das Team erst am 7. September 2008 in Peking eintreffen sollte. Es sind keine Ergebnisse in den offiziellen Listen für die Sportler vorhanden.

Teilnehmer nach Sportart

Leichtathletik
Männer
 Ahmed Lailli Barry
 Mohamed Camara

Powerlifting (Bankdrücken)
Männer
 Emile Lama
 Sekou Toure
 Adama Bah

Frauen
 Safi Youla

Schwimmen
 Ousmane Bah
 Seydou Doumbouya

Einzelnachweise

Guinea
Paralympics (Guinea)

redpajama_set_name: RedPajamaWikipedia


TRENTON -- Prosecutors do not have to present live witnesses when trying to convince a judge to throw someone in jail under New Jersey's new criminal justice system, the state's highest court ruled on Tuesday.
The New Jersey Supreme Court unanimously rejected arguments from public defenders and civil liberties advocates that the constitution guaranteed criminal defendants the right to confront witnesses at hearings that determine whether they should be held until trial.
The case was the latest to tackle a technical but high-stakes issue raised by New Jersey's massive criminal justice system overhaul, which eliminated cash bail for most defendants.
It involved an arrest in Camden just over an hour after the new system took effect.
According to court records, police saw Amed Ingram wielding a .45 caliber handgun at 1:08 a.m. that day and arrested him on weapons charges including possession of a handgun by a convicted felon.
In court documents, police provided few details about the circumstances of the arrest other than to say they saw Ingram holding the gun.
In a section meant to describe how police became aware of the underlying facts of the arrest, a police officer wrote simply "officer observations." In another document, the officer wrote that he had recovered shell casings from the scene and a second officer also saw the incident.
Ingram also had a lengthy criminal record and received the highest possible score on a public safety assessment, a tool used by the courts to gauge a defendant's potential risk of flight and danger to the community.
Under the new system, if prosecutors want a judge to lock someone up until trial, they have to hold a detention hearing within 48 hours. At that hearing, public defenders argued Ingram had a right to confront the witnesses testifying against him, which in this case were the police officers themselves.
A trial judge said it was not necessary for the police officers themselves to show up in court, and public defenders appealed, but an appellate panel also sided with prosecutors.
While the right to confront witnesses at trial is well-established in constitutional law, the question is less clear at a detention hearing, where the burden of proof is lower because the judge is deciding only whether to lock someone up until trial.
"We think the decision to lock someone up is a critical one, especially before they've been convicted of anything," said Alexander Shalom, senior staff attorney at the state chapter of the American Civil Liberties Union, which joined public defenders in their appeal.
In court papers, state prosecutors argued the tight timeline of the pretrial hearings would mean live witnesses -- including, in some cases, victims of crimes -- would have to make court appearances in short order in nearly every case, creating "an extraordinary burden on the criminal justice system."
Chief Justice Stuart Rabner, writing for the court, held that the underlying documents supporting the state's case was enough for a pretrial hearing, citing case law in the federal courts to support the justices' decision.
Rabner wrote that law enforcement should provide more details in their filings to support having a defendant jailed, but that police don't have to follow "a mathematical formula" in writing their reports.
The justices also held that individual judges can order witnesses be called if they aren't convinced by the state's case.
State Attorney General Christopher Porrino praised the ruling, saying it prevented the "harassment and intimidation of victims and witnesses who would otherwise have to come to court to testify and be cross-examined within days of the crime."
Joseph Krakora, the state public defender, said he was "disappointed" with the decision but "heartened" that the justices provided new guidelines for police so their court filings "comport with basic principles of due process."


Meader American persimmon is a native tree, often known as common persimmon. It is often found in abandoned places like fields and yards. There are orange valleys between the distinctly blocky bark. Nice red fall color. It is adaptable to urban environment but has fruit litter problems. Cold hardy and drought tolerant. It is a self-fertile cultivar and female plant needs a male for pollination.
The tree is dioecious which male and female flower blooms on different trees from May to June. The flower is cream in color and not showy.
Full-sun. Well drained, moist soil. It also adapts to various soil types. Drought tolerant.
Medium to large sized, showy deep orange fruit in the fall, usually will hang on the tree through into winter. Early ripening.


It is essentially universally accepted that imaging studies are not always used appropriately. Although overuse generates the greatest concern, both inappropriate overuse and underuse occur. Underuse may compromise patient care directly. Overuse adds unjustified cost to the healthcare system, at a time when it is obvious that the system is not functioning as efficiently or effectively as it should. It may lead to detection of incidental findings which then must be evaluated, often adding additional cost and anxiety, and often without real benefit. Further, if the inappropriate imaging involves ionizing radiation, this poses unjustified theoretical and likely actual long-term risk to patients and the population.
The use of imaging studies overall is clearly of great value in improving healthcare. When used appropriately, the risk-benefit ratio of imaging unquestionably favors using these capabilities. If imaging studies are used inappropriately, however, the possible risks of radiation (and the risks associated with elucidating unexpected findings) alter this balance. There is widespread concern about the effect on individual patients of repeated exposures, as well as concerns about the costs that may be unnecessarily added to our healthcare system. For these reasons, there is increasing interest in providing accurate guidance for the use of imaging procedures. This optimally means use of valid, methodologically sound clinical imaging guidelines.
Much of the focus on using clinical imaging guidelines to improve the appropriate use of imaging arose from a general interest in improving healthcare and, more recently, from requirements for prior certification as a means to control use and thereby costs. Prior certification, however, does not specifically require valid guidelines and does not necessarily lead to more appropriate use of imaging. It also adds a layer of administration, with attendant costs and difficulties for those ordering exams. Interest in clinical imaging guidelines has increased significantly with the CMS mandate to consult specified appropriate use criteria through an approved clinical decision support mechanism when ordering advanced diagnostic imaging services for Medicare patients.
There is, then, a major nationwide interest in and commitment to the use of clinical imaging guidelines. It is now feasible to incorporate them into electronic health records, to provide an effective clinical decision support tool for imaging. The major concerns are that not all available guidelines are actually evidence based; that they may not cover all situations; and that consequently, they are not necessarily clinically relevant to all for whom imaging is or should be considered. To be both valid and effective, clinical imaging guidelines must fulfill certain fairly well-defined criteria: they must be created using a widely-accepted and well-defined methodology; they must be based on peer-reviewed, high quality published studies; all relevant stakeholders must be involved in a well-defined way in creating the guidelines; there must be disclosure of all potential conflicts of interest; and the guidelines must be regularly updated.
The American College of Radiology Appropriateness Criteria® (ACR AC) provide such a tool. They fulfill all the requirements for valid and effective clinical imaging guidelines, and are specified 'appropriate use criteria' (AUC) as defined by CMS. These clinical guidelines for the use of imaging are available on the ACR website and are easily searchable. Other such guidelines exist, both in this country and elsewhere, but the ACR AC have several important characteristics that support their broad use. Currently, ACR AC cover most common clinical settings and include nearly 140 major clinical concerns with 688 variants that are currently available. The ACR AC have been supplemented by empirically-developed clinical indications, to offer over 2500 distinct clinical variants and to form ACR SelectTM, a widely available electronic clinical decision support tool.
The ACR AC are developed as follows: there are 22 expert panels, with one or two for each specific anatomical area of interest (e.g., neuroradiology, cardiac, breast, musculoskeletal). Each panel has a chair, most have a vice-chair and each has 10-20 members. Each member is assigned one-to-three topics each year to prepare or to revise. One or more representatives from 26 non-radiology clinical specialty societies also participate on each topic.
The process starts with a systematic literature search, which identifies all available peer-reviewed articles relevant to that topic. The primary author reviews these articles and rates and selects those that are most relevant and valid, based on well-defined, reproducible and transparent criteria. The selected articles are summarized in an evidence table for the topic and are used to create a narrative. The articles are used to rate the strength of evidence for the recommendations that are promulgated.
The panel chair and vice-chair review the narrative and evidence table and make suggestions before circulating the draft to the other panelists. The ACR AC variant table consisting of all relevant imaging tests is then constructed, and each panelist rates each test on a standardized scale of 1 to 9, based on the relevant included publications, and considering the overall value, including risks and benefits, of each imaging study for the specific clinical condition. Ratings of 1-3 indicate a test is not usually appropriate; ratings of 4-6 mean a test may or may not be appropriate; and ratings of 7-9 mean a test is usually appropriate. The Rand UCLA appropriateness Delphi method is used, with up to three voting rounds, each followed as needed by a conference call, to reach consensus on ratings. After each topic is finalized, it is reviewed by the Panel chair and vice-chair and by staff. It is then published to the ACR AC website and submitted to the National Guidelines Clearinghouse (NGC), a database of evidence-based clinical practice guidelines and related documents maintained as a public resource by the Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services. Each topic is then formally reviewed and revised yearly, as needed.
Radiation exposure is addressed using a similarly well-defined, uniform, and transparent methodology to create a relative radiation level (RRL) for each exam listed in the ACR AC. A radiation subcommittee has established guidelines for defining the radiation dose, as a relative risk based on population exposure For each specific exam (e.g., CT abdomen, CTA lower extremities, chest x-ray, MRI head, pelvic ultrasound) a RRL of from 0 to 5 radiation symbols (☢)is applied. No radiation symbols (or O) corresponds to no radiation (e.g., an ultrasound or MR exam) and 5 (☢☢☢☢☢) corresponds to an effective adult dose estimate of 30-100 mSv. These dose estimates are based on the available published literature, supplemented as needed by the expert opinion of the medical physicists and the clinical expertise of the radiologists on the subcommittee. Relative radiation level ratings are reviewed annually or whenever a new procedure is added.
Further information on the ACR AC methodology can be found at www.acr.org/ac.
The votes of the panelists are based as much as possible on published, peer-reviewed studies supplemented as needed by expert opinion (since evidence is essentially never completely conclusive) and must balance clinical utility as defined in high quality studies, likely availability of equipment and expertise, and possible radiation and other risk. Thus it would be expected that in children an exam that uses ionizing radiation would be downgraded in cases where an exam that does not use ionizing radiation is also available and provides nearly equivalent information. For example, in the setting of suspected appendicitis, if the referring physician deems an imaging study to be necessary, an ultrasound exam would be rated higher (more appropriate) than CT for children and pregnant women, while the reverse would be true for most adults.
There is a clear need to improve the use of imaging in medical care. The role of imaging has grown dramatically over the last few decades. With the improvement in healthcare that his has engendered, there are, however, concerns about overuse, inappropriate use, and radiation exposure to individuals and the population. It is difficult to define optimal imaging due the many relevant variables, including patient characteristics, expertise, and the lack of sufficient high-quality studies to define the best use in all clinical settings. It is apparent, however, that clinical imaging guidelines are needed, and the ACR Appropriateness Criteria provide the best guidelines currently available, and are the only US guidelines that take into full account relative radiation exposure (RRL, or relative radiation level). The availability of ACR SelectTM, an enhanced and expanded platform based on ACR AC, as an electronic clinical decision support tool is a major advance in improving the risk-benefit ratio that must always be considered with the use of imaging, and in improving healthcare.


text:
Q: Embed images in the body of an automated email - Apps Script Issue I am trying to create an automated email with an embedded image. It works on Apps Scripts but when I send the email, I receive the code of my function. So far, I have created an HTML file with  the base64 image code (it works), the file with the function and the main code, with the spreadsheets and everything. Does anyone know how to fix it?
Main code:
function inlineImages() {
  var sheet = SpreadsheetApp.getActiveSpreadsheet().getSheetByName("EAD");
  var range = sheet.getDataRange();
  var values = range.getValues();
  var rows = range.getNumRows();

  for (var row = 1; row < rows; row++) {
    var email = values[row][5];
    var name = values[row][4];
    MailApp.sendEmail(email, "This is a test", doGet);
  }
}

Function HtmlService:
function doGet() {
  return HtmlService.createHtmlOutputFromFile('imagem');
}

Here is the HTML code:
<!DOCTYPE html>
<html>
  <head>
    <base target="_top">
  </head>
  <body>
     <img src="data:image/png;base64, /codeHere" alt="Red dot"/>
  </body>
</html>

redpajama_set_name: RedPajamaStackExchange


text:
The examples and perspective in this article deal primarily with the United Kingdom and the United States and do not represent a worldwide view of the subject. You may improve this article, discuss the issue on the talk page, or create a new article, as appropriate. (August 2019) (Learn how and when to remove this template message)
Look up obstetrics or gynaecology in Wiktionary, the free dictionary.
Leopold's maneuvers
Obstetrics and Gynaecology (also spelled as Obstetrics and Gynecology; abbreviated as Obs and Gynae, O&G, OB-GYN and OB/GYN[a]) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and the postpartum period) and gynecology (covering the health of the female reproductive system – vagina, uterus, ovaries, and breasts).
Postgraduate training programs for both fields are usually combined, preparing the practising obstetrician-gynecologist to be adept both at the care of female reproductive organs' health and at the management of pregnancy, although many doctors go on to develop subspecialty interests in one field or the other.
According to the American Board of Obstetrics and Gynecology (ABOG), which is responsible for issuing OB-GYN certifications in the United States, the first step to OB-GYN certification is completing medical school to receive an MD or DO degree.[2] From there doctors must complete a four-year OB-GYN residency program approved by the Accreditation Council for Graduate Medical Education (ACGME).[2][3] For the 2021 Electronic Residency Application Service (ERAS) match, there were 277 OB-GYN residency programs accepting applicants.[4]
In their fourth year of residency, with an affidavit from their director to confirm program completion, OB-GYN residents can choose whether to begin the board certification process by applying to take the ABOG Qualifying Exam, which is a written test.[5] If residents pass the Qualifying Exam, demonstrating they possess the knowledge and skills to potentially become certified OB-GYNs, they are then eligible to sit for the oral Certification Exam.[5] Prior to the Certification Exam, residents must also gather a list of patient cases they've worked on throughout their residency in order to demonstrate their competence and experience in OB-GYN patient care.[2]
Residents then sit for the three-hour oral exam at ABOG's test center, and if they pass the exam they become "board certified" OB-GYNs.[3] Since 2013 at least 82% of all Certifying Exam examinees have passed.[6]
This adds up to 11–14 years of education and practical experience. The first 7–9 years are general medical training.
Experienced OB-GYN professionals can seek certifications in sub-specialty areas, including maternal and fetal medicine. See Fellowship (medicine).
All doctors must first complete medical school and obtain a MBBS or equivalent certification.[7] This portion typically takes five years. Following this, they are eligible for provisional registration with the General Medical Council. They then must complete a two years of foundation training.[7][8] After the first year of training is complete, trainees are eligible for full registration with the General Medical Council.[7] After the foundation training is complete applicants take the Part 1 MRCOG examination[9] administered by the Royal College of Obstetricians and Gynaecologists. There are an additional seven years of training after this, and two more exams (Part 2 and Part 3 MRCOG exams) which adds up to nine years total minimum in training, although some trainees may take longer.[10]
Examples of subspecialty training available to physicians in the US are:
Maternal-fetal medicine: an obstetrical subspecialty, sometimes referred to as perinatology, that focuses on the medical and surgical management of high-risk pregnancies and surgery on the fetus with the goal of reducing morbidity and mortality.
Reproductive endocrinology and infertility: a subspecialty that focuses on the biological causes and interventional treatment of infertility
Gynecological oncology: a gynaecologic subspecialty focusing on the medical and surgical treatment of women with cancers of the reproductive organs
Female pelvic medicine and reconstructive surgery: a gynaecologic subspecialty focusing on the diagnosis and surgical treatment of women with urinary incontinence and prolapse of the pelvic organs. Sometimes referred to by laypersons as "female urology"
Advanced laparoscopic surgery
Family planning: a gynaecologic subspecialty offering training in contraception and pregnancy termination (abortion)
Pediatric and adolescent gynaecology
Menopausal and geriatric gynaecology
Of these, only the first four are truly recognized sub-specialties by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Obstetrics and Gynecology (ABOG). The other subspecialties are recognized as informal concentrations of practice. To be recognized as a board-certified subspecialist by the American Board of Obstetrics and Gynecology or the American Osteopathic Board of Obstetrics and Gynecology, a practitioner must have completed an ACGME or AOA-accredited residency and obtained a Certificate of Added Qualifications (CAQ) which requires an additional standardized examination.[11][12]
Additionally, physicians of other specialties may become trained in Advanced Life Support in Obstetrics (ALSO), a short certification that equips them to better manage emergent OB/GYN situations.
Common procedures
There are many procedures that can be provided to people by OB/GYN's. Some procedures may include:[13]
Colposcopy: If the results of a cervical cancer screening test, such as Pap smear or HPV test, are abnormal this more thorough examination of the cervix and vaginal tissues may be needed.
Loop electrical excision procedure (LEEP): a procedure to quickly remove abnormal vaginal tissue within the cervix. A local anesthetic and a solution to enhance the points of removal visually is administered during the process. There is a chance of experiencing watery, pinkish discharge, brownish discharge, and mild cramping.
Endometrial biopsy: a procedure that collects a tissue sample from the endometrium lining of the uterus. The sample is tested and checked under a microscope for abnormals cells or indicators of cancer.
IUD insertion: an intrauterine device that is T-shaped and is placed in the uterus through the cervix. It is a reversible contraceptive that can be done in a doctor's office.
Nexplanon: is about a 4 cm implant that goes into the upper forearm. This implant releases birth control hormones into the body and can last up to three years. This type of birth control has a 99% success rate for pregnancy prevention.
Dilation and curettage (D&C): an out-patient procedure to open (dilate) the cervix to collect samples of endometrial tissue with a curette. A D&C can also be done to remove a fetus that was not passed naturally after a miscarriage or to induce an abortion.
Tubal ligation: a surgery to close the fallopian tubes for the prevention of pregnancy. It is also known as "tying the tubes".
Ovarian cystectomy: the removal of a cyst that either has a solid appearance, larger than three inches in diameter, has the possibility to become cancerous, or causes a constant pain. Cysts can be removed without removing an ovary. Women who do not take birth control produce small cysts every other month but they can disappear on their own.
Inclusive approaches to care
There is no global standard, or national U.S. standard, for OB-GYN curricula, during or after residency. Hospitals and universities implement their care and provider education with different priorities in mind, some institutions focusing on following the requirements from their governing body while others go beyond the set standards to set a precedent with the care they offer.
However, the American College of Obstetrics and Gynecology (ACOG) encourages OB-GYN care providers to offer care that is inclusive to all individuals, in the context of providing a safe space for lesbian and bisexual women, and transgender and gender diverse individuals.[14][15] ACOG shares this recommendation through a series of Committee Opinions, the latest of which are #525 and #823, published 2012 and 2021 respectively. ACOG's first comment on the need for LGBTQ+ inclusive care from OB-GYNs came in 2011 through Committee Opinion #512, "Healthcare for Transgender Individuals", which has since been withdrawn and replaced by 2021 opinion #823.
ACOG recommends that OB-GYNs should:[14][15]
Be a resource for both patients and families with health-oriented information on sexual orientation and gender issues
Provide gender-affirming surgeries if possible, and treat these procedures as medically necessary for patients with gender dysphoria
In the process of gender transition, fertility and parenting desires should be discussed early on, and patients should be offered all available information
Preventative screening procedures should be offered based on anatomical structures present, not gender identity
Create a structurally inclusive environment by making their offices "inviting to all individuals who need obstetric or gynecologic health care"
Educate all care providers and office personnel about LGBTQ+ health, including the use of inclusive language and the unique needs of LGBTQ+ patients
Post a nondiscrimination policy for the office in the reception area
Offer comprehensive patient education specific to LGBTQ+ individuals, like clarifying that gender hormone therapy is not a form of birth control
The need for LGBTQ+ affirming OB-GYNs
Transgender, nonbinary people, and lesbian or bisexual women frequently face additional challenges—including structural and overt discrimination, accessing insurance coverage stigma, and cisnormativity—when attempting to access gynecologic and reproductive healthcare services and providers.[16] Obstetrics and gynecology is a field thought of as traditionally serving women because of its focus on the female reproductive system, leading care providers to make assumptions about patients' gender identity and expression in "women's health clinics" when many transgender or nonbinary patients may also seek care from OB-GYNs.[16] Additionally, LGBTQ+ patients are at risk for and experience unique health conditions which care providers may not be prepared to address—i.e. the providers lack cultural competence—without LGBTQ+ specific healthcare training.[16]
Interactions with care providers who are not prepared or knowledgeable enough to offer comprehensive and effective care can compound the "negative and traumatic experiences that many nonbinary and transgender people have had when accessing care", and drive them away from seeking necessary healthcare in the future.[16][17] Even if transgender or nonbinary patients have not had a personally negative of traumatic experience, collective trauma can also play into a fear of medical settings and providers.[16] This results in nearly 25% of transgender or nonbinary people reporting avoidance of healthcare services out of fear of being mistreated for their gender.[17] Care typically offered by OB-GYNs, like pelvic exams and procedures, can be "particularly difficult or traumatic" for transgender and nonbinary patients, which the provider can offset by engaging a trauma-informed care approach to exams.[16]
More research is gradually being done to establish the need for an LGBTQ+ healthcare curriculum for all medical students, residents, and doctors. Multiple researchers have also suggested that obstetrics & gynecology is the ideal field for this education to initially be implemented, since the nature of OB-GYN work ties it more directly to gender than other medical specialties.[16][18] OB-GYNs also historically have more cultural competency training around gender based issues.
Some common services LGBTQ+ folks may seek from OB-GYNs include:[19]
Preventive services such as PAP smears
Contraceptive counseling[16]
Treatment for gynecologic conditions
Support for family planning
Risk/harm reduction
Gender affirming surgeries like hysterectomies and oophorectomies[16]
If providers are not educated on LGBTQ+ healthcare they will not be aware of some of the health risks LGBTQ+ patients may be more vulnerable too, placing their patients at greater risk. Common chronic diseases the LGBTQ+ population is at risk for:[18]
Chronic anovulation and polycystic ovarian syndrome
Sexually transmitted infections including human papilloma virus (HPV) and human immunodeficiency virus (HIV) infections
Cancer (anal, breast, cervical, colon, endometrial and oropharyngeal)
Teaching LGBTQ+ healthcare
Most OB-GYN programs have a flexible curriculum that offers learning in a variety of contexts, including small group discussions, case study discussions, and structured patient exams.[18] The multifaceted nature of this teaching structure makes it easier for programs to begin initiating LGBTQ+ healthcare instruction in informal voluntary contexts, while simultaneously advocating for long-term structural change that would incorporate LGBTQ+ healthcare into all OB-GYN and medical school curricula.[18]
When initially instituting a LGBTQ+ healthcare curricula for OB-GYN residents or professionals, the Association of Professors of Gynecology and Obstetrics' (APGO) Undergraduate Medical Education Committee (UMEC) recommends that topics like patient education, screening standards, and common chronic diseases in the LGBTQ+ population are prioritized to ensure comprehensive and effective care for LGBTQ+ patients.[18]
In residency
APGO's UMCE poses that academic health centers are in an ideal position to drive the "curricular change that is needed to remove health disparities" for all patient populations in the LGBTQ+ community.[16]
Although not a requirement within the ACGME's standards for American OB-GYN residency programs curriculum, LGBTQ+ healthcare education is established in some OB-GYN residency programs throughout America. A web-based survey of approximately 100 Illinois OB-GYN residents a survey study found that 62% of their programs had spent 1-5 hours in the past year educating residents about lesbian and bisexual health, and 63% of the their programs had spent 1-5 hours in the past year educating residents about transgender health.[20]
APGO's UMEC identifies the third year of residency or "clerkship" as an ideal time to institute education if it hasn't already occurred, and ideally to reinforce competencies with LGBTQ+ patients through clinical experiences.[18]
Established OB-GYNs
In addition to instituting new educational policies for current and future OB-GYN residents, many programs are also looking to educate OB-GYNs that are already certified.[15]
For example, the University of Michigan OB-GYN program utilizes what they name "Continuing Medical Education" to instruct their OB-GYN care providers on the nuances of caring for transgender patients. Daphna Strousma, MD, MPH, is responsible for instituting and developing UM's transgender healthcare curriculum—"Improving Care for Transgender & Non-Binary Individuals"—in coordination with Michigan Medicine and the Council on Resident Education in Obstetrics and Gynecology (CREOG). The curriculum is offered to UM's OB-GYNs through a series of video modules covering the following topics:[21]
Gender Identity and Care of Transgender and Gender Non-Conforming Patients
Preventative Care for Transgender and Gender Non-Conforming Patients
Gender Affirming Treatment & Transition Related Care
Addressing Common Gynecologic Issues Among Transgender Patients
Health Records, Billing, Insurance, and Legal Documents in Transgender Medicine
Challenges to instituting inclusive care
Although the ACOG has called upon OB-GYN care providers to provide gender-affirming and inclusive care for all individuals, that doesn't mean there hasn't been resistance, particularly because there is no formal legislation mandating the inclusion of LGBTQ+ healthcare in OB-GYN curricula.
Many OB-GYN providers do not currently feel comfortable offering care to LGBTQ+ patients, either because of their personal beliefs or due to a lack of education on LGBTQ+ healthcare. One study of approximately 100 Illinois OB-GYN residents found that 50% of residents felt unprepared to care for lesbian or bisexual patients, and 76% of residents felt unprepared to offer care to transgender patients. The two main areas the residents identified as preventing the implementation of LGBTQ+ healthcare training were curricular crowding, 85%, and lack of experienced faculty, 91%. However, 92% of residents wanted to receive more education on how to offer care to LGBTQ+ patients.[20]
^ "OB-GYN" (or "OB/GYN") is most commonly treated as an initialism and pronounced as five individual letters, even though it only represents two different words.[1]
^ "Ob-gyn". Merriam-Webster.com Dictionary. Merriam-Webster. Retrieved December 4, 2022.
^ a b c "Overview for Specialty Certification". American Board of Obstetrics and Gynecology. Retrieved 2021-12-08. ((cite web)): CS1 maint: url-status (link)
^ a b "Education, Training, and Certification for OBGYN". The University of Illinois College of Medicine. Retrieved 2021-12-08.
^ "ERAS 2021 Participating Specialties & Programs". Electronic Residency Application Service. 2021-01-11. Archived from the original on 2021-01-11. Retrieved 2021-12-09.
^ a b "Speciality Certification Requirements". American Board of Obstetrics and Gynecology. Retrieved 2021-12-08. ((cite web)): CS1 maint: url-status (link)
^ "Specialty Certifying Exam Pass Rates". American Board of Obstetrics and Gynecology. Retrieved 2021-12-08. ((cite web)): CS1 maint: url-status (link)
^ a b c "Entry requirements, skills and interest (obstetrics and gynaecology)". Health Careers. 2015-05-27. Retrieved 2019-04-11.
^ "UK Foundation Programme". www.foundationprogramme.nhs.uk. Retrieved 2019-04-11.
^ "Part 1 MRCOG exam". Royal College of Obstetricians & Gynaecologists. Retrieved 2019-04-11.
^ "Training and development (obstetrics and gynaecology)". Health Careers. 2015-05-27. Retrieved 2019-04-11.
^ Welcome to the American Board of Obstetrics and Gynecology Web Site: Certification of Obstetricians and Gynecologists
^ "Eligibility/Board Eligibility". American Osteopathic Board of Obstetrics and Gynecology. 2012. Retrieved 19 September 2012.
^ "Common GYN Procedures | Obstetrics & Gynecology | Springfield Clinic". www.springfieldclinic.com. Retrieved 2019-03-13.
^ a b "Health Care for Lesbians and Bisexual Women". www.acog.org. Retrieved 2021-12-10.
^ a b c "Health Care for Transgender and Gender Diverse Individuals". www.acog.org. Retrieved 2021-12-10.
^ a b c d e f g h i j Crissman H, Stroumsa D (2020-08-05). "Gynecologic care considerations for transmasculine people". Contemporary Ob/Gyn Journal. Vol 65 No 08. 64 (8).
^ a b James S, Herman J, Rankin S, Keisling M, Mottet L, Anafi MA (2016). The Report of the 2015 U.S. Transgender Survey (PDF) (Report). Washington, DC: National Center for Transgender Equality.
^ a b c d e f McKenzie ML, Forstein DA, Abbott JF, Buery-Joyner SD, Craig LB, Dalrymple JL, et al. (March 2020). "Fostering Inclusive Approaches to Lesbian, Gay, Bisexual, and Transgender (LGBT) Healthcare on the Obstetrics and Gynecology Clerkship". Medical Science Educator. 30 (1): 523–527. doi:10.1007/s40670-019-00886-z. PMC 8368615. PMID 34457696.
^ "OB/GYN Care for LGBTQ People". Temple Health. Retrieved 2021-12-10.
^ a b Guerrero-Hall KD, Muscanell R, Garg N, Romero IL, Chor J (April 2021). "Obstetrics and Gynecology Resident Physician Experiences with Lesbian, Gay, Bisexual, Transgender and Queer Healthcare Training". Medical Science Educator. 31 (2): 599–606. doi:10.1007/s40670-021-01227-9. PMC 8368479. PMID 34457914.
^ "Transgender Healthcare Curriculum | Obstetrics and Gynecology | Michigan Medicine". Obstetrics and Gynecology. 2020-09-29. Retrieved 2021-12-10.
Llewellyn-Jones D, Abraham S, Oats J (1999). Fundamentals of Obstetrics and Gynecology (7th ed.). Mosby. ISBN 978-0-7234-3150-3.
Lane J (July 1987). "A provincial surgeon and his obstetric practice: Thomas W. Jones of Henley-in-Arden, 1764-1846". Medical History. 31 (3): 333–348. doi:10.1017/s0025727300046895. PMC 1139744. PMID 3306222.
Stockham AB (1891) [1886]. Tokology. A Book for Every Woman (Reprint of Revised Edition Chicago ed.). Kessinger Publishing. ISBN 978-1-4179-4001-1.
www.figo.org International Federation of Gynaecology and Obstetrics (FIGO)
BJOG: An International Journal of Obstetricians and Gynecologists
World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI)
Digestive system surgery
Allergy / Immunology
Angiology
Obstetrics and
Maternal–fetal medicine
Reproductive endocrinology and infertility
Diving medicine
Mass gathering medicine
Family medicine / General practice
Oral medicine
Physical medicine and rehabilitation (PM&R)
Addiction psychiatry
Bachelor of Medical Sciences
Master of Medicine
MD–PhD
Chief physician
Tests and procedures relating to pregnancy and childbirth
Maternal tests
Fetal tests
Obstetric ultrasonography
Nuchal scan
Anomaly scan
Fetal movement counting
Contraction stress test
Nonstress test
Vibroacoustic stimulation
Biophysical profile
Amniotic fluid index
Umbilical artery doppler
Chorionic villus sampling
Triple test
Quad test
Fetoscopy
Fetal scalp blood testing
Fetal scalp stimulation test
Percutaneous umbilical cord blood sampling
Apt test
Kleihauer–Betke test
Lung maturity
Lecithin–sphingomyelin ratio
Lamellar body count
Fetal fibronectin test
Cardiotocography
Fetendo
Podalic version
External cephalic version
Amnioinfusion
Vaginal delivery
Artificial rupture of membranes
Symphysiotomy
Forceps in childbirth
Ventouse in childbirth
Odon device
Dystocia management
McRoberts maneuver
Wood's screw maneuver
Zavanelli maneuver
Third stage of labor
Manual placenta removal
On maternal request
Resuscitative hysterotomy
B-Lynch suture


We will talk to Carlos Brooks, DB. We will ask him some questions about playing college at Bowling Green State University and with the Arizona Cardinals (1995). We will find out what he's been doing since. We will also find out Carlos' thoughts on the first three weeks of the NFL season. We will talk some broad topics.
Carlos Brooks played at Bowling Green State University from 1989 - 1992. He was a defensive back with 12 interceptions and 1 touch down. He then played in the Arena League in 1994. He played in the NFL for the Arizona Cardinals in 1995. In 1997, he played in the European league. He played in the Arena League in 1998. One more stint in the NFL European League in 1998. He played for the Arena League from 1999 - 2002.


text:
#include <axutil_utils_defines.h>
#include <axis2_defines.h>
#include <axutil_param.h>
#ifndef RAMPART_CALLBACK_H
#define RAMPART_CALLBACK_H

/**
* @file rampart_callback.h
* @brief The callback module for a password
*/

#ifdef __cplusplus
extern "C"
{
#endif

    /**
     * Struct to get password using callbacks
     * @defgroup rampart_callback Rampart Callback Module
     * @{
     */

    typedef struct rampart_callback_ops rampart_callback_ops_t;
    typedef struct rampart_callback rampart_callback_t;

    struct rampart_callback_ops
    {
        /**
         * Retuens a password for the given username.
         * By providing a function to this function pointer
         * user can write custom password callback module
         * @param callback rampart callback pointer
         * @param env environment must not be null
         * @param username The username of the password expected.
         * @param param any parameter that is to be passed to the callback function.
         * @return returns password if any. Otherwise NULL returns
         */
        axis2_char_t *(AXIS2_CALL*
                       callback_password)(rampart_callback_t *callback,
                                          const axutil_env_t *env,
                                          const axis2_char_t *username,
                                          void *param);
		/**
		 * Returns a password for PKCS12 key store
		 * By providing a function to this pointer user can write
		 * cutom password callback module to support PKCS12
		 * key store usage.
		 * @param callback rampart callback pointer
		 * @param env pointer to environment struct, must not be null
		 * @param username The username of the owner of the key store
		 * @param any parameter that is to be passed to the callback function.
		 * @returns returns password if any. Otherwise NULL
		 */
		axis2_char_t *(AXIS2_CALL*
					   callback_pkcs12_password)(rampart_callback_t *callback,
							   					const axutil_env_t *env,
												const axis2_char_t *username,
												void *param);
		/**
         * Free function of the rampart callback
         * @param callback rampart callback pointer
         * @param env environment must not be null
         * @return AXIS2_SUCCESS on success AXIS2_FAILURE otherwise
         */
        axis2_status_t (AXIS2_CALL*
                        free)(rampart_callback_t *rcb,
                              const axutil_env_t* env);

    };

    struct rampart_callback
    {
        rampart_callback_ops_t *ops;
        axutil_param_t *param;
    };

    /*************************** Function macros **********************************/
#define RAMPART_CALLBACK_FREE(callback, env) \
      ((callback)->ops->free (callback, env))

#define RAMPART_CALLBACK_CALLBACK_PASSWORD(callback, env, username, param) \
      ((callback)->ops->callback_password(callback, env, username, param))

#define RAMPART_CALLBACK_CALLBACK_PKCS12_PASSWORD(callback, env, username, param) \
	  ((callback)->ops->callback_pkcs12_password(callback, env, username, param))

    /** @} */
#ifdef __cplusplus
}
#endif

#endif /* RAMPART_CALLBACK_H */

redpajama_set_name: RedPajamaGithub


text:
36 Brygada Okrętów Rakietowych (36 BOR) – morski związek taktyczny Sił Zbrojnych Federacji Rosyjskiej w strukturach Floty Bałtyckiej.

Struktura i okręty

Przypisy

Bibliografia

Związki taktyczne i oddziały Marynarki Wojennej Federacji Rosyjskiej
Flota Bałtycka
Brygady okrętów Sił Zbrojnych Federacji Rosyjskiej
Wojsko w Bałtyjsku


9/02/2014 · I would like to add some shadow to my background image which I add to the promoted links tiles, but the promote links tiles itself has a background, which stops the shadow from doing what it …... The difference between a promoted tweet and a regular tweet is the ability to resonate with Twitter users. If a brand sends out a promoted tweet and it is not shared organically, Twitter will discontinue the use of the promoted tweet.
Info; Code; History; Feedback (0) Stats; Twitter - Remove Promoted Tweets. Remove promoted tweets from Twitter... Now under each tweet you will see something written like this 'promoted in 1 campaign. Just click on this and a pop up will open up. You can pick the campaign to remove the ad from the campaign.
Hide promoted tweets, accounts and trends on Twitter FREE Get Deal Remove Promotions for Twitter is a Google Chrome extension that removes promoted accounts, tweets and trends on the site as well.... 26/10/2011 · I didn't really want it there, though – I don't really want to see any Promoted Tweets, if I'm being absolutely honest – so I quickly looked for a way to get rid of it.
27/01/2018 · Because promoted posts cannot be blocked in the Twitter app, you'll need to use an app like Opera. Opera is a free browser with built-in ad blocking. Because of this feature, it works to block promoted tweets on Twitter.
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BATERÍA DE 12V 55mA, ALCALINA. PARA CONTROLES REMOTOS DE AUTOS Y PORTONES ELÉCTRICOS, JUGUETES Y APARATOS BIOMEDICOS.
This is a very small, extremely light weight battery based on the new Polymer Lithium Ion chemistry. This is the highest energy density currently in production. Each cells outputs a nominal 3.7V at 500mAh! Comes terminated with a standard 2-pin JST-PH connector - 2mm spacing between pins. These batteries require special charging. Do not attempt to charge these with anything but a specialized Lithium Polymer charger. Battery includes built-in protection against over voltage, over current, and minimum voltage. Note: Be careful with the JST connectors. They can stick in pretty good and tugging on them can damage the connector. Check this tutorial for an easy way to remove them safely. CARACTERISTICAS: •Bateria: LiPo. •Voltaje de carga: 3.7V. •Celdas: 1S. •Capacidad de descarga: 30 a 60C •Descarga continua: 25C Aplicación •Dimensiones (mm) : Largo 58(±3) * Alto 18.5(±1) * Ancho 6.5(±1) • Peso de la batería (g): 15(±4).
BATERIA LiPo 3.7V 850mAh RECOMENDADO PARA DRONES CUADROPTEROS (for Syma X5C X5C X5SC X5SW Drone BC713) MEDIDAS: Aprox. 45 x 25 x 10mm / 1.77" x 0.98" x 0.39"
If you need to charge LiPo batteries, this simple charger will do just that, and do it fast! The Lithium Battery Charger can charge 3.7V LiPo battery at a rate of 500mA per hour. It is designed to charge single-cell Li-Ion or Li-Polymer batteries. Check the datasheet below to see if it will work with your battery. The board incorporates a charging circuit, status LED, connector for your battery (JST-type used in the batteries we carry), and a micro-USB connector. Four small mounting holes allows this charger to be easily embedded into a project.


text:
use strict;
use Apache::Cookie ();
use Apache::Request ();

use vars qw(@ANIMALS);

unless (@ANIMALS) {
    @ANIMALS = sort qw{
	lion tiger bear pig porcupine ferret zebra gnu ostrich
        emu moa goat weasel yak chicken sheep hyena dodo lounge-lizard
        squirrel rat mouse hedgehog racoon baboon kangaroo hippopotamus
	};
}

my $r = shift;
my $apr = Apache::Request->new($r);
my $cookies = Apache::Cookie->new($r)->parse;
my $c = $cookies->{'animals'};
my %zoo = ();
%zoo = $c->value if $c;

# Recover the new animal(s) from the parameter 'new_animal'
my @new = $apr->param('new_animals');

# If the action is 'add', then add new animals to the zoo.  Otherwise
# delete them.
foreach (@new) {
    if ($apr->param('action') eq 'Add') {
	$zoo{$_}++;
    }
    elsif ($apr->param('action') eq 'Delete') {
	$zoo{$_}-- if $zoo{$_};
	delete $zoo{$_} unless $zoo{$_};
    }
}

# Add new animals to old, and put them in a cookie
my $cookie = Apache::Cookie->new($r,
				 -name => 'animals',
				 -value => \%zoo,
				 -expires => '+1h');

$cookie->bake;
$apr->send_http_header('text/html');
my $title = 'Animal crackers';

print <<EOF;

<TITLE>$title</TITLE>

$title

Choose the animals you want to add to the zoo, and click "add".

Add/DeleteCurrent Contents

<FORM METHOD="POST">
<SELECT NAME="new_animals" SIZE=10 MULTIPLE>
EOF

for (@ANIMALS) {
    print qq{<OPTION  VALUE="$_">$_\n}
}

print <<EOF;
</SELECT>

<INPUT TYPE="submit" NAME="action" VALUE="Delete">
<INPUT TYPE="submit" NAME="action" VALUE="Add">
</FORM>

EOF

if (%zoo) {
    print "
\n";
    foreach (sort keys %zoo) {
        print "
$zoo{$_} $_\n";
    }
    print "
\n";
}
else {
    print "The zoo is empty.\n";
}

print <<EOF;

EOF


text:
erik prince hot scoops jared kushner jared kushner secret back channel communications to russia jared kushner secret meeting with russian bank jill abramson journamalism maggie haberman mark mazzetti matt apuzzo maxwell smart shoe phone media circus mike flynn new york times pt all the news donald trump says we can print Sergey Kislyak syria trump transition Vnesheconombank (VEB)
New York Times Has VERY GOOD REASON For Jared Kushner's Russian Spy Phone. It Is 'Reason'!
Rebecca Schoenkopf
Last night, the entire nation's jaws fell off their heads and onto the floor after the Washington Post produced a wee scoopty about how Jared Kushner, First Son-In-Law, asked the Russian ambassador to let him (and disgraced then-future/now-former National Security Adviser Mike Flynn) use secure communications channels in the Russian embassy to secretly call Vladimir Putin.
Every person who has ever worked in the Intelligence community or the government hit the teevee or the Twitter to say, no, hiding your calls to Russia from US intelligence by using Russian spy phones is really just as bad as it could possibly be -- with the exception of three Trump administration officials, who instead got on the horn to the New York Times. They didn't deny it at all; they explained instead that it was totally innocent! Mike Flynn just wanted to discuss military strategy in Syria with his Russian counterparts! And he needed to use a secret Russian spy phone to do it, because "reason."
Actually, the New York Times never followed up with the question of "why would you need to use a secret Russian spy phone to talk to Russia instead of regular channels," so they never even had to say, "because 'reason,'" because the New York Times was too busy presenting the administration's claim as unquestioned fact.
What say you, Maggie Haberman, Mark Mazzetti and Matt Apuzzo? That this is all but nothing, because it was the Washington Post that got the scoop?
Jared Kushner, President Trump's son-in-law and senior adviser, spoke last December with Russia's ambassador to the United States about establishing a secret communications channel between the Trump transition team and Moscow to discuss strategy in Syria and other policy issues, according to three people with knowledge of the discussion.
Sure, they attribute it to "three people with knowledge" -- whom they never, ever seem to question.
It is unclear who first proposed the communications channel, but the people familiar with the meeting said that the idea was to have Mr. Flynn speak directly with a senior military official in Moscow to discuss Syria and other security issues. The communications channel was never set up, the people said. [...]
The idea behind the secret communications channel, the three people said, was for Russian military officials to brief Mr. Flynn about the Syrian war and to discuss ways to cooperate there. Less than two weeks later, Mr. Kushner backed off the idea of the communications channel when Mr. Trump announced Rex W. Tillerson, a former chief executive of Exxon Mobil who had worked closely with Russian officials on energy deals, as his choice to become secretary of state.
They never ask why the secure communications would need to be kept secret from the US government (these meetings occurred during the transition), or why (as the Post reported), Flynn and Kushner in that same meeting would set up a secret rendezvous in the Seychelles between a Russian emissary and creepy mercenary Erik Prince.
They do have one nice, tiny aside:
Current and former American officials said that Mr. Kushner's activities, like those of many others around Mr. Trump, are under scrutiny as part of the investigation. But Mr. Kushner is not currently the subject of a criminal investigation.
In the days after the meeting with Mr. Kislyak, Mr. Kushner had a separate meeting with Sergey Gorkov, a Russian banker with close links to President Vladimir V. Putin of Russia.
But then they just leave it there, without even linking back to their own previous good work on Jared Kushner's "foundering" 666 Fifth Avenue building and how he really needs cash, or mentioning their own story on Jared Kushner whoops accidentally leaving these meetings with Kislyak off his security clearance forms. We guess the Times whoops accidentally forgot too! And literally no one is buying it.
FBI Sure Managed To Light A Fire Under Its Ass To Clear Donald Trump Of All Crimes Past, Present And Future
New York Times for the assist!
The New York Times famously rubbished David Corn's reporting on John Christopher Steele's "dossier," as well as Franklin Foer's reporting on the mysterious server activity between the Trump Organization and Alfa Bank.
Intelligence officials have said in interviews over the last six weeks that apparent connections between some of Mr. Trump's aides and Moscow originally compelled them to open a broad investigation into possible links between the Russian government and the Republican presidential candidate. Still, they have said that Mr. Trump himself has not become a target. And no evidence has emerged that would link him or anyone else in his business or political circle directly to Russia's election operations.
NONE! None evidence! That story, coming just days before the election, has not aged well.
New York Times May Have Cleared Trump Of Russian Collusion A *Tad* Prematurely
This never would have happened under Jill Abramson.
In March, CNN confirmed that the FBI was still investigating the mysterious server activity. And now-fired FBI director James Comey himself confirmed in open hearings in March that the FBI was investigating Trump's associates and had been as early as last spring.
The New York Times played this:
Why did The Times report extensively on the hacking of the Democratic Party, but not this?
The Times did report before the election that the F.B.I. was investigating claims about Mr. Trump's ties to Russia — an article that resulted from an extensive reporting effort. The Democratic National Committee and Podesta emails were public, their authenticity was not in doubt, and they contained newsworthy information.
Yes, and that "report" specifically said that there was nothing to see here, move along.
Has Donald Trump Landed Yet?
Would the people writing this reality at least try to come up with something plausible, please?
While the Times and the Washington Post were making out with each other last week, trading scoops back and forth and generally being the horniest teens at the prom (IN A GOOD WAY) ...
On Internet, A Shrieking Sh*tpile Of Emotional Feminist Hysteria At Totally Non-Sexist New York Times
... that seems to be over, and the New York Times is doing what it's been best at ever since it canned Jill Abramson for being loud and shrill and abrasive like a common Hillary Clinton: pandering to the Right and coming up with any excuse it can to Say Something Nice About Donald Trump.
While we don't think that misbegotten column ever appeared, the news pages are doing what they can to help poor innocent naive Jared Kushner as he runs the entire government from inside Russia's shoe phone.
[The real story / the bullshit story]
Wonkette is ad-free and totally taking the weekend off after this, because you helped us hire Robyn for weekends! KEEP HELPING PLS!
Rebecca Schoenkopf is the owner, publisher, and editrix of Wonkette. She is a nice lady, SHUT UP YUH HUH. She is very tired with this fucking nonsense all of the time, and it would be terrific if you sent money to keep this bitch afloat. She is on maternity leave until 2033.


text:
The Midnight Venus () is a 1951 West German comedy film directed by Ferdinand Dörfler and starring Theo Lingen, Paul Kemp and Maria Andergast.

Cast
 Theo Lingen as Meister Anton
 Paul Kemp as Hansl
 Maria Andergast as Frau Anna
 Hans Schwarz Jr. as Reitersepp
 Hubert von Meyerinck as Director Meyer
 Fita Benkhoff as Madame Lavable
 Hella Lexington as Miss Spleen
 Guenther R. Ewers as von Kitschampur
 Lotte Stein as van der Gould
 Lotte Lang as Marei

References

Bibliography
 Hans-Michael Bock and Tim Bergfelder. The Concise Cinegraph: An Encyclopedia of German Cinema. Berghahn Books, 2009.

External links

1951 films
German comedy films
1951 comedy films
West German films
1950s German-language films
Films directed by Ferdinand Dörfler
Films about fashion designers
German black-and-white films
1950s German films


text:
<?php
return include $modx->getOption('core_path').'components/migx/model/imageupload/imageupload.php';


Description Red and yellow apples in a basket at harvest with a painterly feel.
Buy high quality art prints of my photographs here. Click on a gallery to the right to get started.
I have lived in Mexico for many years. Mexico is a beautiful country with many natural resources. I'll be taking photographs when I visit a new place with my friends and share them with you here.
If you are looking for high quality art prints, then you are at the right place. All of my photos are available here in a variety of quality papers and custom framing delivered to your door with a 30-day-guarantee!
What do I take photos of? I love to take photos of nature including plants, flowers, trees, mountains, caves, etc. I also like to take photographs of culture including archaeological zones, architecture, towns, cities, old churches and cathedrals.


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