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Journal Article — "Engaged Buddhism in Retreat" Revisited: A Reply to Barbara Newell's Response — by Lisa Kemmerer
Journal Article — "Engaged Buddhism in Retreat" Revisited: A Reply to Barbara Newell's Response — by Lisa Kemmerer quantity
This is a reply by Lisa Kemmerer to a response provided by Bhikshuni Chan Tung Nghiem (Barbara Newell) (titled "Peace in Oneself, Peace in the World: The Real Heart of Engaged Buddhism–A Response to Lisa Kemmerer," pp. 145-147) to Kemmerer's original commentary (titled "Engaged Buddhism in Retreat," pp. 135-143) published in the Summer 2008 issue of Human Architecture: Journal of the Sociology of Self-Knowledge (volume VI, issue 3). The journal issue was dedicated to the exploration of the engaged buddhism of Thich Nhat Hanh, the Vietnamese buddhist and Zen master.
Kemmerer, Lisa. 2009. ""Engaged Buddhism in Retreat" Revisited: A Reply to Barbara Newell's Response." Pp. 221-228 in Sociological Re-Imaginations in & of Universities (Human Architecture: Journal of the Sociology of Self-Knowledge: Volume VII, Issue 3, 2009.) Belmont, MA: Okcir Press (an imprint of Ahead Publishing House).
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H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE , VII, 3, S UMMER 2009, 221-228 221 H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE ISSN: 1540-5699. © Copyright by Ahead Publishing House (imprint: Okcir Press) and authors. All Rights Reserved. HUMAN ARCHITECTURE Journal of the Sociology of Self- A Publication of OKCIR: The Omar Khayyam Center for Integrative Research in Utopia, Mysticism, and Science (Utopystics) This is a reply to Ms. Newell's com- ment on my article published in the Sum- mer 2008 special issue on Thich Nhat Hanh. Ms. Newell responded to me as if I were a pilgrim looking for Zen solutions, instead of a scholar well versed in Bud- dhism calling attention to some rather grievous inconsistencies between Thich Nhat Hanh's teachings and certain prac- tices which I observed at the Colorado re- treat. Zen silence would have been much preferred to the various replies that I re- ceived, none of which addressed the issues at hand: What of the many sentient crea- tures who suffered and died unnecessarily in the prime of their lives because those running Thay's retreat choose to serve dairy products and eggs? Ms. Newell dismisses my inquiries as "mere intellectual" pursuits, but my com- ments concern core Thich Nhat Hanh teachings, and practices that I observed at the Estes Park retreat, more specifically, contradictions between teaching and prac- tice which I observed. I accept that the sex- ism and elitism which I observed may have been merely situational, since I base my comments on just one retreat. This still leaves the problem regarding food offered in the dining hall, which cannot be brushed off as mere coincidences, and which fails fundamentally to speak for compassion or peace for all beings. To respond appropriately to any given situation, an individual must have some understanding of that situation. For exam- Lisa Kemmerer (Montana State University) is the author of In Search of Consistency: Ethics and Animals (Brill, 2006), which won the "International Critical Animal Studies Book Award" in 2006, as well as a poetry chapbook, Curly Tails and Cloven Hooves (Finishing Line Press, 2008). She is the author/editor of several upcoming books including Religion and Animals: Rightful Relations, Women and Social Justice: Animals and Activism, Call to Compas- sion: Reflections on Animal Advocacy from the World's Religions, and The Bible and the Beasts. She has published numerous articles, including "Broilers" which tied for 3rd place in the 2005 Lantern Books Essay Contest (Reprinted in Satya, June/July 2006). She has written, directed, and produced two documentaries on Buddhism. Lisa is an artist, activist, and adventurer who has hiked, biked, kayaked, and traveled widely. "Engaged Buddhism in Retreat" Revisited A Reply to Barbara Newell's Response Lisa Kemmerer Montana State University –––––––––––––––––––––––––––––––––––––– [email protected] Abstract: This is a reply by Lisa Kemmerer to a response provided by Bhikshuni Chan Tung Nghiem (Barbara Newell) (titled "Peace in Oneself, Peace in the World: The Real Heart of Engaged Buddhism—A Response to Lisa Kemmerer," pp. 145-147) to Kemmerer's original commentary (titled "Engaged Buddhism in Retreat," pp. 135-143) published in the Summer 2008 issue of Human Architecture: Journal of the Sociology of Self-Knowledge (volume VI, issue 3). The journal issue was dedicated to the exploration of the engaged buddhism of Thich Nhat Hanh, the Vietnamese buddhist and Zen master. 222 L ISA K EMMERER H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE , VII, 3, S UMMER 2009 ple, we must be aware of sweatshops— what they mean and how they operate—to respond in any meaningful way to sweat- shops. Once we are aware that a particular practice causes suffering, we can decide whether or not to support or protest that practice or industry. Because of Thich Nhat Hanh's focus on compassion, the Colorado retreat purpose- fully offered only vegetarian foods, and ab- solutely no alcohol. Yet in response to my encouraging a vegan selection, Ms. Newell indicates that offering only vegan foods in the dining hall would be controlling, and much too strict to impose on "a broad spec- trum of people who are not yet ready to, for example, go totally vegan or even be full- time vegetarians," and Thich Nhat Hanh retreats do not intend to "force" 800 partic- ipants to be vegan. But the retreat did "force" 800 adults to be vegetarian, and to abstain from alcohol. Why, then, does offer- ing a vegan diet for the sake of compassion seem controlling when offering a vegetar- ian diet does not? Based on her responses, I assume that Ms. Newell does not understand the dairy and egg industries—more specifically the suffering and mass deaths caused by these industries. Alternatively, she believes that human preferences, tastes, and habits are more important than the life and sufferings of other sentient creatures, and that this at- titude is consistent with the teachings of Thich Nhat Hanh. I turn to these industries so that Ms. Newell and other readers will understand how central the matter of a ve- gan diet is to compassion and peace for all beings. E GG AND D AIRY INDUSTRIES "Dairy" Cattle 1 Cows, like humans and other mam- mals, only lactate after they give birth, at which time they produce milk for their off- spring for roughly ten months. To produce milk, cows are artificially impregnated ev- ery year. They carry their young for ten months, but their calves are taken shortly after birth, though the mother—like most mothers—tries desperately to protect and keep her offspring. Her calf gone, the cow's nursing milk is then extracted and sold. What happens to her calves? The veal industry exists because of the dairy industry, and was created to take ad- vantage of an abundant supply of un- wanted male calves. Male calves are either killed shortly after birth and sold as 'bob' veal for low-quality meals (such as frozen TV dinners), or they are chained by the neck in a two-by-five foot wooden crate, where they are unable to turn, stretch, or lie down comfortably. These calves are fed a liquid milk substitute that is deficient in iron and fiber, designed to create an ane- mic, light-colored flesh that is prized as veal. Veal calves are usually slaughtered when they are just four months old. Genetic manipulation and dietary con- trols cause extraordinary and unnatural milk output in "diary" cows. Cows are so exhausted by the dairy process that they are often "spent" after four or five years of repeated impregnation, birth, calf-robbing, and constant milking machines. "Spent" 1 To understand the moral and spiritual im- portance of this topic, one must know what hap- pens behind the scenes. Such information can be found on many websites, including VIVA! USA (http://www.vivausa.org/visualmedia/in- dex.html), PETA (http://www.petatv.com/), HSUS (http://video.hsus.org/), PCRM (http:/ /www.pcrm.org/resources/), Farm Sanctuary (http://www.farmsanctuary.org/mediacenter/ videos.html), and Vegan Outreach (http:// www.veganoutreach.org/whyvegan/ani- mals.html). Information on dairy cattle and lay- ing hens was taken from the following sites: HSUS Factory Farming Campaign (http:// www.hsus.org/farm/resources/research/wel- fare/welfare_overview.html#76), farmsanctu- ary's FactoryFarming.com (http:// www.farmsanctuary.org/issues/factoryfarm- ing/), and VIVA!USA Guides (http:// www.vivausa.org/activistresources/guides/ murdershewrote1.htm#). "E NGAGED B UDDHISM IN R ETREAT " R EVISITED 223 H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE , VII, 3, S UMMER 2009 cows—whose milk production has dropped—are sent to slaughter; most cows are pregnant when they are slaughtered, and their bodies are used for soup, burgers, or processed foods. "Dairy" cows end up in the flesh industry—both calves and their mothers are destined to slaughter for hu- man consumption. Slaughter Legislation offers minimal protection (at least on paper) for mammals during slaughter: They are supposed to be "stunned" (rendered unconscious) before they are killed (federal Humane Slaughter Act, 1958). But slaughter, like almost all businesses, is driven by economic regula- tors such as efficiency and profit and loss. In the slaughterhouse, the quicker each farmed animal is killed, the higher the profit margin. Workers must be paid for their time, and while one animal's body is on the dismemberment line, no other body can be processed. Consequently, the eco- nomic necessity for speed often makes ef- fective stunning impossible. A USDA survey concluded that stunning was either "unacceptable" or a "serious problem" in 36 percent of slaughter houses for sheep and pigs, and 64 percent of those for cattle. Even more remarkable, chickens, turkeys, ducks—every species of poultry—is ex- empt from the federal Humane Slaughter Act. Ninety percent of those killed for food in the U.S. are birds. There are several slaughterhouses stunning methods: captive bolt pistol (cat- tle, most calves, and some sheep); electric stunner (pigs, most sheep, and some calves); and though not required, an electri- fied water basin for birds. Electric Stunner There is, as yet, no way to determine exactly how much electric current is re- quired to properly stun a large or medium sized pig or sheep. Insufficient current will paralyze the victim but not prevent sensa- tion. Too much current will result in 'blown loins': bruising caused by capillaries that have burst, which reduces the value of the flesh; managers often lower the electric cur- rent to prevent this bruising. When an animal enters the slaughter- house, a worker clamps the electric stunner (imagine ear phones on an insulated han- dle) onto the victim's head, then triggers an electric shock. As with all high-speed as- sembly-line operations, human and me- chanical errors are common. Consequently, many pigs, calves, and sheep emerge fully sentient and conscious. Captive Bolt Pistol A captive bolt pistol is placed against a cow or calf's forehead, then fired, driving a rod through the skull and into the brain. If done properly, the animal will immediately lose consciousness. Poor aim, a hurried shot, or a sudden movement from the cow generally results in tremendous pain and damage to the victim, but not stunning. Be- cause the assembly line keeps moving, and workers are pressured to process animals as quickly as possible, improperly stunned animals are pushed forward. Conscious an- imals bellow and struggle as they travel down the line to be disassembled. Downers Transporting animals to slaughter is a rough business. The meat industry calls an- imals who arrive at slaughter too sick or in- jured to stand or walk, "downers." Undercover investigators have repeatedly documented downed animals being kicked, beaten, pushed with bulldozers, and dragged from transport trucks with ropes or chain, often bellowing. 224 L ISA K EMMERER H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE , VII, 3, S UMMER 2009 "Laying" Hens Shortly after hatching, without anes- thesia, chicks are "de-beaked" to reduce in- juries caused by stressed birds in overcrowded conditions—the tips of their sensitive beaks are sliced off with a hot blade, cutting through bone, cartilage, and soft tissue. Some chicks bleed to death, or die of shock, as a result of debeaking. It is difficult for hens to peck food, in their nor- mal fashion, with cut beaks. When hens reach eighteen weeks of age, they are put into 1.5 square foot cages (slightly bigger than your average micro- wave oven). Although the average hen's wing span is 2.5 feet, four or more birds are stuffed into each of these small cages. Needless to say, the birds cannot stretch their wings, and their bodies constantly rub against wire, causing featherless sore spots. Hens remain in these tiny cells, laying eggs, until they are shipped to slaughter, usually at about a year and a half old, though hens can live to upwards of fifteen years. When a hen's egg cycle begins to de- cline, if they are not old enough for slaugh- ter, they are put through "forced-molt," in which they are starved and kept in total darkness for as long as eighteen days. This shocks their exhausted bodies into another egg-cycle, but also causes some hens to lose more than 25% of their body weight. Forced molt claims the lives of 5-10% of the "lay- ing" hen population. Hens in the wild lay roughly twenty eggs per year, but factory farmed hens yield 250 eggs (or more) annually. Hens some- times suffer from "cage layer fatigue," a condition in which they become "egg bound," and die because they are too weak to expel even one more egg. Though these birds have a strong urge to create a nest and sit on their eggs, factory farmed hens can- not do either. Each egg rolls onto a con- veyor belt and is taken away to be boxed. Hens lay eggs (and cow's produce milk) as part of their basic biological func- tioning—not because they are well cared for or contented. Factory farms are not con- ducive to hen health. Factory farmed hens suffer from prolapses (the uterus is ex- pelled along with the egg), egg peritonitis, cancers, infectious bronchitis, and severe liver and kidney disease. Because egg shells require a tremendous amount of cal- cium, they also suffer from calcium defi- ciencies resulting in broken bones, paralysis, and premature death. Because egg-laying chickens have been bred for maximum egg production, they don't grow fast or large enough to be rou- tinely killed for meat. Many spent hens are thrown into a wood chipper in order to avoid the cost of transport and slaughter. Undercover investigators documented Ward Egg Ranch (California) throwing more than 15,000 spent laying hens into a wood-chipping machine, alive. Despite tre- mendous outcry from a newly informed and horrified public, the district attorney declined to prosecute, noting that dispos- ing of hens in a wood-chipper is legal and is a "common industry practice." Male chicks are of no economic value, and are literally discarded the day they hatch. Each year billions of male chicks are gassed, crushed, or thrown into garbage bins to die of dehydration or asphyxiation; their bodies are used as fertilizer or as feed for farmed animals. As with spent hens, an- other common method to eliminate male chicks is to toss them into a grinder. Eyewit- ness accounts describe struggling, peeping chicks being dismembered by metal blades. After just one year of egg production, hens are "spent," and some hens are sent to slaughter for soups, baby food, stock cubes, school dinners, pot pies, the restaurant trade, animal food, or other low-grade products (for which their "spent" bodies are shredded). Their brittle, calcium-de- pleted bones often shatter during trans- port, or when they are handled at the slaughterhouse. They are transported in "E NGAGED B UDDHISM IN R ETREAT " R EVISITED 225 H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE , VII, 3, S UMMER 2009 open cages, or crates stacked on open trucks, without food, water, or protection from rain, snow, or sun, though they travel as much as eighty miles per hour in all weather conditions for many hours. Some birds inevitably freeze to death, while oth- ers die of heat stress or suffocation. It is cheaper to absorb high transportation mor- tality rates than pay for enclosed trucks. There are no United States laws regu- lating the slaughter of fowl, yet 90 percent of those killed for food in the United States are birds. At the slaughterhouse, they are dumped onto a conveyor belt, but some flapping and frightened birds inevitably miss the belt and fall onto the ground, where they are either crushed by machin- ery, or die of starvation or exposure. Birds who land on the belt are hung up- side down by their legs, in metal shackles. For the sake of efficiency, most slaughter- houses attempt to stun the birds—it is much easier to kill a bird who is not strug- gling for her life. As the birds move along the assembly line, hanging upside down, turning their heads to see what might befall them, their heads are supposed to be dragged through an electrified basin of wa- ter. Some birds, particularly smaller ones, raise their heads to avoid the water, and continue along the line fully conscious. As with electric tongs, the amount of current needed to properly stun birds is uncertain; too much power damages the flesh, reduc- ing profits, so that managers tend to err on the side of lower electric current. As a re- sult, birds are usually immobilized by the electric basin, but remain fully capable of feeling pain. After the electric water basin, the hen's throats are cut either by hand or by a me- chanical blade. With slaughter lines run- ning up to 8,400 chickens per hour , accuracy is the exception rather than the rule. The birds are then submerged in scalding water (with intent to loosen their feathers), and those still conscious—millions annually— are boiled alive. A DDITIONAL S TATISTICS FROM THE U.S. ANIMAL INDUSTRIES Chickens • Nearly ten billion chickens are hatched annually. • 300 million "laying hens" are factory farmed for eggs each year. • Because of the factory farming egg in- dustry, 200 million male chicks are killed annually soon after they hatch. • More than 95% of hens are factory farmed in giant warehouses, and must live out their life in less than two square feet of space. • One million factory farmed "broiler" chickens are killed each hour. • "Broiler" chickens reach market weight just 45 days after hatching, and are sent to slaughter, though hens can live up- wards of fifteen years. Cattle • Every year thirty-five million cattle are exploited for beef, nine million cows for milk, and one million calves for veal. • Cows exploited for dairy are subjected to a dehorner that scoops, gouges, or cuts horns from a cow's head. • "Dairy" cows are often killed at four to seven years of age, despite a life expect- ancy of more than twenty years. • To produce veal, one million calves are confined in crates measuring 2-5 feet. • Cows naturally produce just over two tons of milk per year, but Bovine Growth Hormone (BGH/BST) has in- creased milk output so that cows now provide as much as thirty tons of milk annually, enough for ten calves. • One-in-five factory farmed "dairy" cows secretes pus from her udders, which invariably mixes with her milk. • "Dairy" cows endure mechanized 226 L ISA K EMMERER H UMAN A RCHITECTURE : J OURNAL OF THE S OCIOLOGY OF S ELF -K NOWLEDGE , VII, 3, S UMMER 2009 milking for ten out of twelve months per year (including seven months of their nine-month pregnancies). • Thousands of factory farmed cattle ar- rive at slaughter injured, or too dispir- ited to walk, and are kicked, beaten, or forcibly dragged from transport trucks. An informed individual is unlikely to consider concern for hens and cows in the dairy and egg industries "merely intellec- tual." Such knowledge is critical to choos- ing and offering a compassionate diet. R EGARDING M S . N EWELL ' S R ESPONSE Some people fool themselves into be- lieving that they must eat meat. A balanced vegan diet is nutritionally complete (http:/ /www.veganhealth.org/). (Of course a ve- gan diet, like any diet, is likely to be un- healthy, if it is not balanced.) There is no biological need to eat flesh, dairy, or eggs— especially if one lives where food choices abound. While there are societies in remote corners of the world that require animal products to achieve a balanced diet, Estes Colorado is not one of them. In light of what we know about the egg and dairy industries, let us reflect on Ms. Newell's quote from Sister Chan Khong: Thay Nhat Hanh asks us to prac- tice mindfulness deeply every time we eat or drink. If we do so, we may find that our appetite for meat and fish begins to diminish. The important thing is to be aware of what we consume. I have met peo- ple who cannot be vegetarian be- cause of medical reasons, but who respect life more than many vege- tarians. Some vegetarians are too extreme, and are unkind to those who cannot give up meat-eating. I am more comfortable with a meat- eater than an extremist vegetarian who is filled with self-righteous- ness. In this quote, Khong (and Newell) sug- gest that mindfulness can include choices that cause extreme suffering and premature death, but we "may" tend away from these practices. What matters is not the suffering, according to Khong (and Newell), but that we be aware that we are consuming flesh, dairy, and eggs. Furthermore, she notes that some one can be too extreme in their compassionate actions, and that advocat- ing for the downtrodden can be "unkind" to those committed to exploitation, espe- cially those who believe they cannot re- main healthy without that exploitation. Khong (and Newell) also indicate, I suspect unknowingly, that violence to the point of death is better than nonviolence with an at- titude. Are Newell and Khong really "more comfortable" with causing tremendous suf- fering and mass premature death to other sentient creatures than they are with a com- mitment to compassion that some may per- ceive to be self-righteous? Do Newell and Khong prefer people who trade in slaves, or sell girls, or willingly invest in and profit from sweatshops, over those who staunchly reject such exploitation, but do so with an attitude? Would Thich Nhat Hanh's retreat have invested money in any of these forms of exploitation? Of course a vegan diet cannot be equated with self- righteousness, whereas the consumption of factory farmed dairy and eggs is always di- rectly linked with suffering and slaughter. While self-righteousness is unattractive, painful exploitation culminating in the pre- mature death of billions of sentient crea- tures is downright ugly. A glass of alcohol is unlikely to cause anywhere near the amount of suffering that is inherent in every slab of cheese served at the Estes Park retreat. Alcohol was not served, dairy and eggs were. Those in "ENGAGED BUDDHISM IN RETREAT" REVISITED 227 HUMAN ARCHITECTURE: JOURNAL OF THE SOCIOLOGY OF SELF-KNOWLEDGE, VII, 3, SUMMER 2009 charge of Thich Nhat Hanh retreats seem unaware of what dairy and eggs cost in real pain and loss of life. Factory farming, like sweatshops and selling girls into prostitu- tion, are extremely harmful even in minis- cule doses. When one has a choice—and Thich Nhat Hanh's retreat organizers in Es- tes Park did have a choice—neither a little enslavement, nor a little factory farmed cheese, are consistent with compassion and peace for all beings. Just as surely as a veg- etarian diet was offered, a vegan diet might have been offered. An extreme stand against cruel exploi- tation and unnecessary slaughter is not a character flaw. I suspect that both Ms. Newell and Sister Khong find even a little torture and a little murder unacceptable; factory farmed dairy and egg products are bought at the price of prolonged misery and premature death for billions, not to mention extensive environmental degrada- tion. Those in charge of Thich Nhat Hanh's retreat in Estes Park chose to buy suffering and death—a choice that is not consistent with Thich Nhat Hanh's core teachings of compassion and peace for all beings. My hope is that this will not always be the case.


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Rev. Soc. Bras. Med. Trop. vol.52 Uberaba 2019 Epub 16-Maio-2019
Chronic Cystoisospora belli infection in an HIV/AIDS patient treated at the specialized assistance service in Porto Velho County - Rondônia.
Flávia Serrano Batista1 2 3
Laís de Souza Miranda1
Márcia Benedita de Oliveira Silva4
Roger Lafontaine Mesquita Taborda1
Maiara Cristina Ferreira Soares5
Najla Benevides Matos6
1Laboratório de Microbiologia, Centro de Pesquisa em Medicina Tropical, Porto Velho, RO, Brasil.
2Curso de Biomedicina, Centro Universitário São Lucas, Porto Velho, RO, Brasil.
3Universidade Federal de Rondônia, Porto Velho, RO, Brasil.
4Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
5Centro de Medicina Tropical, Porto Velho, RO, Brasil.
6Fundação Oswaldo Cruz, Porto Velho, RO, Brasil.
Cystoisospora belli infection manifests as diarrhea, and can potentially progress to malabsorption in HIV patients. Here, we report a case of C. belli infection in an HIV/AIDS patient with chronic diarrhea symptoms for at least 2 years. Coproscopic analyses based on direct technique and modified Ziehl-Neelsen technique without a commercial kit were performed. The current case report highlights the protocol to be adopted in coproscopic analyses applied to HIV patients. The importance of including the appropriate parasitological testing of patients with chronic intestinal isosporiasis in parasitological test routines must be considered.
Keywords: Cystoisospora belli; HIV/AIDS; Laboratory Diagnosis
Gastrointestinal symptoms are commonly observed among HIV/AIDS patients, even after HAART (Highly active antiretroviral therapy) administration. These symptoms cause intense discomfort and reduce the patients' quality of life because most of these infections tend to become chronic. This occurs mainly because the gastrointestinal tract is a lymphoid organ highly affected by HIV infection1. Changes in immune function are the determining factors for worsening of the infection. The depletion of T helper 17 cells, which protect the intestinal mucosa, results in impaired mucosal integrity and favors microorganism translocation2. Gastric acid barrier decrease is another concerning factor that favors infections caused by opportunistic microorganisms such as viruses, bacteria, fungi, and protozoa3.
Coccidia such as Cryptosporidium spp. and Cystoisospora belli are the main protozoan classes responsible for gastrointestinal infections in HIV/AIDS patients3. Symptoms in immunocompetent patients may be self-limiting; however, HIV/AIDS patients present with chronic diarrhea symptoms such as watery diarrhea, fever, myalgia, and weight loss, which may progress to chronic infection4.
C. belli oocysts measure approximately 30 × 12 μm and can be identified through direct visualization or staining. However, lack of experience in microscopic visualization can influence the results, leading to underdiagnosis, and consequently, compromising the patients' therapy.
This case report is about a 31 years old female patient, who has been HIV positive since 2011. She was treated with non-regular antiretroviral therapy (ART) based on Biovir and Kaletra regimens since the diagnosis. The patient was asymptomatic with a CD4 of 510 cells/mm3. However, she started experiencing continuous watery diarrhea after discontinuation of the treatment in 2012. She reported 10 diarrhea episodes/ day when she sought for health care in the Specialized Assistance Service (SAS) of Porto Velho County - RO. In 2014, she resumed the non-regular ART based on Biovir and Efavirez regimens, according to her medical records. Although medication was reintroduced, she continued to experience diarrhea, significant weight loss, pale skin, but no fever. She was hospitalized for ten days in October 2015, when she was subjected to colonoscopy (normal results), coproculture (negative results) and abdominal tomography (normal results). During this period, the medical microbiology laboratory of CEPEM and FIOCRUZ/RO received the patient's samples, which were subjected to laboratory techniques in the following order: direct technique and modified Ziehl-Neelsen staining technique. The direct technique identified smooth- and hyaline-walled C. belli oocysts in the patient's diarrheal samples (Figure 1A). The modified Ziehl-Neelsen staining technique identified large non-sporulated oocysts presenting color characteristics of acid alcohol-resistant coccidian protozoa (Figure 1B).
FIGURE 1: Cystoisosopora belli identified using (A) direct technique and (B) Ziehl Neelsen technique.
More than one oocyst per field was observed when analyzed under 40 X objective lens in the first sample. The CD4+ T lymphocyte count in the biological sample analysis was 972 cells/mm3, whereas the viral load was <40.000, according to results from May 2015. When delivering the patient's result to her home, the research team collected drinking water samples for analysis purposes. Results showed that the water was consumed without undergoing any previous treatment. Water collection (multiple tubes) and analysis were based on parameters set by the National Health Foundation5. The water consumed by the patient presented high contamination levels (MLN/100 mL >16).
Results were disclosed to the Specialized Assistance Service (SAS) and the patient was subjected to oral therapy with 800/160 mg sulfamethoxazole + trimethoprim every 6 hours, for 10 days. Two sample collection sessions were performed after the treatment was over. Results revealed no evidence of oocysts in any of these samples, suggesting decreased parasitemia.
Cystoisosporiasis is an opportunistic infection, which causes persistent or chronic diarrhea in immunosuppressed patients, particularly in those with HIV/AIDS. The infection results from the ingestion of sporulated contaminated oocysts, which invade the enterocytes and undergo asexual and sexual cycles6. In addition, it mainly spreads through the intake of water contaminated with human fecal matter, besides being often associated with precarious sanitary conditions and low personal hygiene levels in the population. The prevalence of C. belli infection in Brazilian HIV/AIDS patients assessed in two different studies was 6.7% in Minas Gerais and 6.9% in Rio Grande do Norte7,8.
Results of the case report presented herein recorded a C. belli count of higher than 200 cells/mm3 in an HIV/AIDS patient, thus suggesting chronic diarrhea for more than two years. Some studies indicate that cystoisosporiasis occurs in patients presenting CD4+ T lymphocyte counts higher than 200 cells/mm3.8. The count of CD4+ cells recorded in the assessed patient ranged from 510 to 972 cells/mm3 between 2012 and 2015. TCD4+ cell depletion involves the entire intestine and happens in the acute infection phase. TCD4+ cell decrease does not reflect on the peripheral blood, as it does at the gastrointestinal level. The mechanisms comprising the attack on gastrointestinal cells are not yet fully understood, despite being an important area of research9.
Studies conducted in Ethiopia showed high cryptosporidiosis and cystoisosporiasis rates in HIV population and have raised much public health concern10. Studies conducted in Uberaba County, MG (Brazil), found a high prevalence (16.9%) of enteric coccidia related to diarrhea, CD4+ T cell reduction, and to low CD4+ T lymphocyte count, which is a predisposing factor for protozoal infections. According to the aforementioned study, low CD4+ T lymphocyte count is a predisposing factor for protozoal infections. Studies found cryptosporidiosis prevalence after ART introduction, since this therapy suppresses HIV replication, leads to increase in circulating CD4+ T lymphocyte count, enables intestinal repopulation and, subsequently, reestablishes mucosal immunity4.
Sanitation conditions are determinant factors for the incidence and permanence of cystoisosporiasis. According to the National Sanitation Information System (NSIS), only 41.01% of the population living in Rondônia State had access to water, 3.53% had access to sanitary sewage and only 4.54% of the generated sewage was treated in 201411. This result has direct impact on public health and on the quality of life, especially on the quality of life of HIV patients.
ART administration and, more recently, the introduction of combined ART (cART), significantly reduced the onset of many infectious diseases. However, patients do not always adhere to effective treatments, which reduces the effectiveness of the treatments; consequently, these patients become more susceptible to infectious diseases. Studies indicate that, unlike microsporidiosis and cryptosporidiosis, Cystoisospora prevalence increased from 0.4 per 1,000 patients in the pre-HAART era to 4.4 per 1000 patients in the HAART era12.
C. belli recurrence has already been described in the literature. It is related to the parasite development when patients do not properly respond to the treatment. A study conducted with 1,600 HIV patients treated in the Infectious and Tropical Disease Service of Mayo National Hospital, in Peru, recorded six patients who reported recurrent chronic diarrhea due to treatment-resistant C. belli6.
This report addresses the ideal diagnostic methods that should be adopted by laboratories to analyze coproscopic samples from HIV patients. The laboratories should perform techniques other than the usual ones, thus increasing the likelihood of identifying other parasites, mainly coccidians. Furthermore, C. belli, which causes chronic intestinal infection, besides decreasing the quality of life of HIV patients, should be highlighted as a major public health concern.
We are very grateful to Albenita de Jesus Nogueira Dias, Coordinator of the Specialized Assistance Service (SAS) of Porto Velho County, for her intense support; to Dr. Stella Angela T. Zummuli and Dr. Sérgio Basano, for their constant encouragement and support as SAS doctors and CEMETRON directors; as well as to all collaborating physicians.
1. Leite CAC, Succi RCDM, Patrício FRDS, Fagundes-Neto U. Aspectos funcionais, microbiológicos e morfológicos intestinais em crianças infectadas pelo vírus da imunodeficiência humana. Arq Gastroenterol 2006;43(4):310-5. [ Links ]
2. Logan C, Beadsworth MBJ, Beeching NJ. HIV and diarrhoea: what is new? Curr Opin Infect Dis 2016;29(5):486-94. [ Links ]
3. Feasey NA, Healey P, Gordon MA. Review article: the aetiology, investigation and management of diarrhoea in the HIV-positive patient. Aliment Pharmacol Ther 2011;34(6):587-603. [ Links ]
4. Assis DC, Resende DV, Cabrine-Santos M, Correia D, Oliveira-Silva MB. Prevalence and genetic characterization of Cryptosporidium spp. and Cystoisospora belli in HIV-infected patients. Rev Inst Med Trop Sao Paulo. 2013;55(3):111-20. [ Links ]
5. Brasil. Fundação Nacional de Saúde. Manual Prático de Análise de Água. 4. ed. Brasília: 2013. [ Links ]
6. Montalvo R, Ticona E, Navincopa M, Garcia Y, Chavez G, Chavez V, et al. [Recurrent diarrhea due to Cystoisopora belli in HIV/AIDS patients receiving HAART]. Rev Peru Med Exp Salud Publica 2013;30(2):326-30. [ Links ]
7. Casmo V, Lebboad M, Maugate S, Lindh J. Ocurrence of Cryptosporidium spp and Cystoisospora belli among adult patients with diarrhoea in Maputo, Mozambique. Heliyon. 2018. Sep 7; 4(9): e00769. [ Links ]
8. de Oliveira-Silva MB, de Oliveira LR, Resende JCP, Peghini BC, Ramirez LE, Lages-Silva E, et al. Seasonal profile and level of CD4+ lymphocytes in the occurrence of cryptosporidiosis and cystoisosporidiosis in HIV/AIDS patients in the Triângulo Mineiro region, Brazil. Rev Soc Bras Med Trop. 2007;40(5):512-5. [ Links ]
9. Brenchley JM, Douek DC. The mucosal barrier and immune activation in HIV pathogenesis. Curr Opin HIV AIDS. 2008;3(3):356-61. [ Links ]
10. Adamu H, Petros B, Zhang G, Kassa H, Amer S, Ye J, et al. Distribution and Clinical Manifestations of Cryptosporidium Species and Subtypes in HIV/AIDS Patients in Ethiopia. PLoS Negl Trop Dis. 2014;8(4):e2831. [ Links ]
11. Trata-Brasil. Benefícios econômicos da expansão do saneamento básico no Estado de Rondônia. 2014. [ Links ]
12. Lagrange-Xélot M, Porcher R, Sarfati C, Castro N de, Carel O, Magnier J-D, Delcey V, Molina JM. Isosporiasis in patients with HIV infection in the highly active antiretroviral Therapy era in France. HIV Med. 2008;9(2):126-30. [ Links ]
Financial Support: National Council for Scientific and Technological Development (CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico) - PIBIC - FIOCRUZ-RO - CEPEM - Rondônia State Foundation for the Development of Scientific and Technological Actions and Research - FUNDAÇÃO RONDÔNIA - FAPERO - State Secretariat of Health (SESAU - Secretaria de Estado da Saúde) - Ministry of Health (MS - Ministério da Saúde).
Recebido: 28 de Maio de 2018; Aceito: 26 de Março de 2019
Corresponding author: Dra. Najla Benevides Matos. e-mail:najlamatos@fiocruz.br
Conflicts of interest: The authors declare that there is no conflict of interest.

redpajama_set_name: RedPajamaCommonCrawl


Vintage Gasoline Sign PDS Pack - Free Photoshop Brushes at Brusheezy!
More interested in the vector version? Check out the Vintage Gasoline Sign Vector Pack over on Vecteezy!


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Q: Microsoft Edge "Access Denied" when using firebase.auth().SignInWithEmailAndPassword This code on MS Edge returns a "SCRIPT7002: XMLHttpRequest: Network Error 0x80070005, Access denied." error:
firebase.auth().signInWithEmailAndPassword(email, password).then(function(user) {

},
function(error) {
    // this is executed with auth/network-request-failed error code
});

It works on Chrome and Firefox and it's intended to be embedded in a WebView of an UWP app, so it's running locally.

A: Please ensure you have checked the Private Networks (Client & Server) capability in UWP app's Package.appxmanifest file. Ref: Enable device capabilities
This is also been mentioned in here: WinJS.xhr: Network Error 0x2efd, Could not complete the operation due to error 00002efd

And there may be SSL certificate valdiation issue, please check out this answer: https://stackoverflow.com/a/33095348/5254458
---Update(03/24/2017)---
We created a firebase web application and found the same exception in IE Edge on Windows 10 Build 14393. There are lots of feedbacks on this in here.
Based on internal message, this issue has been fixed from OS build 14951(Or earlier). We confirmed that this has been resolve on Windows Insider Preview Build 15058.0, see screenshot:

Welcome to join Windows insider and try the latest insider preview SDK.

redpajama_set_name: RedPajamaStackExchange


Hexagon has introduced the Leica Rugby CLH and Leica Rugby CLA lasers. This next generation of lasers offer the unique capability to adapt to user application needs through software upgrades – an industry first, according to the company.
Excavators equipped with 2D or 3D excavator guidance solutions from Leica Geosystems and tilt rotators supported by SVAB Quantum can now use a new functionality, iXE CoPilot, that enables the tilt function on a tilt rotator to be handled automatically. The tilt will automatically be adjusted so it is held parallel to the surface as the operator pulls in the excavator arm.
Heavy construction has come a long way when it comes to grade control and measurement. Gone are the days when ensuring an excavation was progressing correctly involved a surveyor with a grade rod manually checking slopes throughout the project.


Law Office of Carlos G. Galliani, P.C. is a DFW based personal injury & bankruptcy law firm. Starting his law practice in 2009, Carlos Galliani has expanded his firm and now has two separate locations in the DFW metroplex. We have a location based in Fort Worth as well as one located in downtown Dallas.
Carlos G. Galliani is an experienced Dallas/Fort Worth personal injury and bankruptcy attorney. Carlos graduated from Washington University School of Law in 2009. In 2016, the Law Office of Carlos G. Galliani was selected as a "Rising Star" by Super Lawyers.


Facebook recently changed its terms of service again, and — as with previous alterations — has weighted those changes heavily in favor of Facebook's own corporate aims. To the extent that privacy of user data was ever a concern at Facebook, the erosion of those interests over time has been steady and premeditated.
Documenting Facebook's abuses is more than I care to do. If you're a Facebook fan, good luck to you. If you're a staunch Facebook defender, I'm not interested in debating your bullet points. The bottom line for me is that Facebook has tipped its hand more than once, and I'm at the point where I feel like a fool for believing anything Facebook says. I don't consider the site benign, I don't consider the site's corporate aims benevolent, and I don't believe that Facebook will honor any current legal obligation if they believe they can make more money by voiding that obligation.
Welcome to the independent writer's life. Put up your short story collection at the beginning of the week, get pounded by malicious code injections the rest of the week.
To help keep your own chin high and lip stiff, I offer herewith a helping of distractions and items of interest that could very well make or break your ability to ever again confront the horrifying solitude of the keyboard. Drink up.
Found this via a tweet by Levi Montgomery. Easily one of the Top 5 most useful bits of information ever posted on Twitter.
You laugh. I'm serious. Who can keep these things straight?
On the platform subject, does it help or hurt an author to have an indecipherable name? Does it make people less likely to reference you, or does it make them more likely to talk about you, if only relative to the difficulty of pronunciation?
I recently published a collection of twelve short stories on Smashwords. [Book removed 01/03/17].
The first three stories can be viewed free. The entire collection is $4.99, and available in a variety of formats.
I am making three stories available for three reasons. First, I like the idea that a prospective online customer can peruse part of a work as they might in a bookstore. Second, I believe self-published authors have an obligation to demonstrate that they can carry a tune before asking someone to pay for their work. Third, I intendThe Year of the Elm to create an overall effect, and I feel an obligation to make the structure clear to the prospective buyer. Reading the first three stories should do that.
The next step for TYOTE is to put together a print-on-demand (POD) version, probably through Lightning Source. I'll have more to say about TYOTE, and about the process of publishing it myself, in subsequent posts.
On the horizon, my next project involves a novel I'm revising, and what may or may not be an innovative attempt to meld the strengths of the internet as a medium with the craft aims of traditional storytelling. I believe that all mediums are eventually turned to fiction, and my hope would be to show how that might be better done with the internet itself.
I don't believe in writer's block. I know full well there are days when the writing comes easy and days when the writing won't come at all, but I don't ascribe the difference to any unseen or mystical force. Rather, I ascribe the difference to the fact that writing is damned hard all the time, and any day when it's going great is a miracle.
I was reminded of my feelings about writer's block by a post from Stephanella Walsh, in which she herself talked about coming to terms with the myth of writer's block. It's a good post, and particularly so because it admits to change, which is something too few people are confident enough to do.
Stephanella does a solid job of listing reasons why people reach for the "I'm blocked!" excuse, and I don't disagree with any of them. People have been using the excuse of writer's block — and the premise: that writing necessarily flows from some hidden spring of inspiration — since the first caveman struggled with the first cave painting.
I would like to propose, however, that there is a basic choice that every storyteller needs to make when approaching their work, and that in making this choice a writer necessarily allows or precludes writer's block as an aspect of the storytelling process. The choice I speak of is whether or not writing is viewed first and foremost as a craft.
If you view storytelling as a craft — as a mix of techniques and channeled authorial gifts (the stuff you just happen to be good at) — I don't see how writer's block pertains. When you write from craft you can say you're stuck, or you're tired, or you hate your life, but the idea that your muse is playing coy, or that something that happened in your childhood is getting in the way of your ability to bash the holy hell out of your keyboard is absurd on the face of it — as it would be if you were a ditch digger and complained of ditch-digger's block.
On the other hand, if you view storytelling as art — as a nebulous, ill-defined process of introspection and pure expression devoid of any compelling need to communicate with the reader, or even to be intelligible — then I suspect that writer's block is useful in an endless variety of ways. Including, perhaps most importantly, by connecting you in spirit to all the other great writers who sat back in a sunny cafe chair and bemoaned the lonely fate of the truly and tragically gifted.
It's your call, of course. But if you're thinking that what you'd like to do is tell stories, you might want to take a long hard look at what your storytelling is in service of. Giving your authorial fate over to the unseen or mystical strikes me as a both a considerable statement of intent and a mistake. Unless, of course, what you're really interested in is the drama of being a storyteller as opposed to the end product.


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When Jamaal Lemon and Shep Jenkins return from a trip, their debriefing always includes an inventory of what they've lost. "In San Francisco, I had a South American bracelet I lost and Shep lost one shoe," Lemon says.
The taco-eating challenge at The Palms in Las Vegas this year was chronic, if not pretty. The legendary eater and reigning champ Takeru Kobayashi gobbled down 137 chicken soft tacos in 10 minutes to claim the $5,000 cash prize and the flowered skull trophy of the 6th Annual Gringo Bandito Chronic Tacos Challenge.
If the 600 young women lined up in front of the soon-to open Coyote Ugly bar in Wales were taking the name literally, they might not be so keen on being a Coyote. After all, the origin of the name is taken from one-night stand lore, where a man wakes up in the morning, sees the grossly unattractive woman he brought home from the bar sleeping on his outstretched arm and would rather gnaw off his arm to escape than wake her up.
After 15 years in Africa, the HealthStore Foundation is changing its stripes, going from a non-profit platform for its franchised health clinics to a for-profit franchisor.
When it's third-and-one at 10 a.m., it's not time to punt, declares former Colts great Donnell Thompson, today a Denny's operator. We asked him to share his playbook.
Shouts, cheers, clapping, honest-to-goodness screams—that's business as usual when Drew Brees makes an appearance in Walk-On's, the brand he has just thrown his considerable celebrity behind. Here's a look at where the New Orleans Saints superstar is going after he throws his last professional pass down the field.
Robots in retail may seem like a gimmick today, and a fun one at that. But tech watchers believe current experiments, at places like Domino's and Lowe's, may turn into tomorrow's innovations. Which retailers are out front in AI?
1. The KASE The concept: With more than 150 stores in nearly 30 countries including France, Germany, India and Singapore, The KASE has established itself as a formidable player globally where it sells custom-made cases and accessories for smartphones, laptops and tablets. Now, the company launched in France in 2012 wants to expand its U.S. footprint by selling franchises, said co-founder Steve Rosenblum.
When cars don't need drivers, who will need repair shops?
Take a nap while your car drives itself? That future is coming, trend-watchers say, and along with it a sea change for franchises that exist to fix all those autos. The key will be shifting to large-scale fleet customers.
September 12 marks the second annual celebration of Franchising Gives Back, the International Franchise Association's recognition of franchise companies' contributions to the well-being of their communities through monetary and in-kind donations and volunteer hours. One winner in each of five categories will receive the gold distinction from the stage prior to the IFA's Franchise Action Network initiative, where members visit their congressional leaders. Two other franchises will bring home the silver in each category (the Spirit of Franchising has three silver winners).
Calling New Orleans' comeback 'a great win for human beings,' Smoothie King's CEO details his brand's role in the recovery. From Antoine's, the oldest restaurant in the U.S., to VooDoo BBQ, a young franchise, our reporter walks the streets to tell the story.
Past the receptionist (ahem, the director of first impressions as is her official title), it's an enviable view from the 27th floor conference room of Sentinel Capital Partners in Manhattan.
Shadowy entities that control billions of dollars are among us. No, this isn't some tinfoil hat-Illuminati madness, but family offices are all across the franchising industry and few people—if anyone—has a complete picture of what they're doing.
When you are trying to sell franchises, do you show your unit sales results to prospective franchisees? If not, why not? If the reason is that someone told you not to show this information, it is time to rethink that advice.
ITEM 1 In most FDDs, Item 1 is a quick read. Midas Inc.'s is so complicated it requires a flow chart. Midas began selling franchises in 1956. A subsidiary, SpeeDee Worldwide, sells quick-oil-change franchises through its own FDD. Tire and auto parts distributor TBC Corp. has owned Midas since 2012, and TBC is owned in turn by the Sumitomo Corp. of Japan. TBC is the "indirect parent corporation" that sells Big O Tire franchises, and operates 763 other non-Big O tire stores. Midas has four more subsidiaries including Progressive Automotive Systems (PAS), point of sale software designed for use in Midas shops, a point we'll take up in Item 8, below.
Is your HQ mindset so old it's mossy?
Isn't it great when juicy rumors turn out to be true? While walking around Detroit and conducting interviews along the way this spring, there was no denying change was afoot in the gritty Motor City.
Apair of damning reports predicted some dark times for the industry ahead.
One CEO is '100 percent data.' Another learned the hard way to emphasize only a handful of metrics. But all three bosses of our Living Large franchisors believe doing the math is part of building a brand.
Later this month, CEO Bruce Rosenthal believes Houston-based Submarina's three-year ordeal in bankruptcy court will at last come to an end. He expects to receive a judgment to collect at least $1.7 million from a group of franchisees in California who stopped paying royalties in 2012. Rosenthal plans to use that recouped money to repay creditors and exit Chapter 11.
When we examine the laws that will apply to the relationship between a franchisor and a franchisee in a cross-border context, we are accustomed to asking the usual questions: Will it be governed by the law of the franchisor's home country? The franchisee's? Or, in unusual circumstances, the law of a third country?
If you'll forgive me, I'm going to blatantly misquote one of our most storied presidents, Abraham Lincoln, for the sake of this column.
Slow unit growth is the intelligent strategy these days, isn't it? You open, say, one or maybe two franchise restaurants annually — and, well, Bob's your uncle. Just to make sure, I posed the question to franchise consultant Andy Simpson of Results Thru Strategy. "The franchisee who's thinking smarter has a development deal that calls for one a year. That's a strong deal," he affirmed.
Twenty-three-year old son Sam had a friend, Dylan, with a job I thought sounded like a scream: driving the Mr. Peanut truck around the country for one year, and wearing the Mr. Peanut suit at functions along the way. This was affectionately named "The 2015 Nutmobile Tour," and concluded with a professional YouTube video of Dylan dancing with the Louisiana Dance Collective (ala Mr. Peanut). C'mon. You're 22 with no ties? One year on the road with a bunch of other millennials in a big nutmobile? Freakishly fun.


Learn about the different locations for static webapp resources and when to use which location.
In the site webapp in src/main/webapp.
In the content repository as Web Files (bootstrapped from the repository-data-webfiles module).
Typically both locations are used in a single project. The nature of each static resource as well as specific project requirements determine where it is located. This page provides some guidelines for best practices.
Note that files stored as assets in the content repository are user-managed and therefore considered dynamic, rather than static, resources.
The table below provides an overview of the characteristics of the two different locations, some guidance for suitables uses, and typical examples.


The third week of Knockagh View's Dressage League had a lovely warm day with judges Ivor Harper and Sally Hodgkinson judging some very competitive classes.
The next week of the summer Dressage league takes place on Sunday 12th August.
Entries can be texted to Ruth on 07732809188.
Class 7- Elementary 49: 1st, Nicky Nesbitt, Ringfort India.
Knockagh View Equestrian Centre is holding their Summer show this Sunday 22nd July starting at 11am.
There are a full range of ridden and in hand Horse and pony classes, with rosettes and prizes in all classes and sashes for each section champion and overall supreme championship at end of day.
For full schedule visit the website www.knockaghviewec.com.


Convertible notched collar with hook-and-eye closure.
London 'Esters' Trench Short Dress Black priced $118.37 won't disappoint you with reliable quality.Take your right size now.
The iconic trench inspires a short-sleeve dress tailored from cotton twill and fastened with gleaming oversized snaps. Heritage details include epaulets, signature woven checks under the collar and a trapunto-stitched belt with a covered leather buckle and D-ring detail.


text:
Kristen Stewart claims she was advised to hide her sexuality
The "Charlie's Angels" actress told Harper's Bazaar the advice was intended to "preserve" her film career.
Kristen Stewart at the Venice Film Festival in Italy on Aug. 30, 2019.Vittorio Zunino Celotto / Getty Images
By Brooke Sopelsa
Actress Kristen Stewart, who skyrocketed to fame over a decade ago with a starring role in the blockbuster "Twilight" franchise, said she had been advised to stay in the proverbial closet to "preserve" her career.
"I have fully been told, 'If you just like do yourself a favor, and don't go out holding your girlfriend's hand in public, you might get a Marvel movie,'" Stewart, 29, told Harper's Bazaar in an interview published Monday.
Sarah Kate Ellis, president and CEO of the LGBTQ media advocacy group GLAAD, said Stewart's "experience in the entertainment industry isn't unique."
NBC OUTConversion therapy crusader has something to say: He's gay
"For decades, LGBTQ actors have been told that in order to secure roles in Hollywood, they have to hide their authentic selves and stay closeted," Ellis told NBC News in an email.
She added, however, that things are getting better for lesbian, gay, bisexual, transgender and queer entertainers.
"While many actors in Hollywood still face bias in casting offices, this year's Emmy nominees — including 'Pose,' Billy Porter, Laverne Cox, Hannah Gadsby, Ryan O'Connell and several others — give us hope that LGBTQ actors are not only becoming accepted, but also celebrated, by audiences everywhere."
News'So much black pain': Mj Rodriguez of 'Pose' works to bring hope despite trans violence
The once publicity-shy Stewart, who dates women but reportedly identifies as neither a lesbian nor bisexual, is now open about her sexuality — and her dislike of labels.
"I just think we're all kind of getting to a place where — I don't know, evolution's a weird thing — we're all becoming incredibly ambiguous," she told Harper's Bazaar. "And it's this really gorgeous thing."
Stewart is set to star in the upcoming "Charlie's Angels" reboot, which will hit theaters in November.
Follow NBC Out on Twitter, Facebook & Instagram
Brooke Sopelsa
Brooke Sopelsa is the editorial director of NBC Out, NBC News' LGBTQ digital destination.


At which stage of Mac OS X 10.6 Snow Leopard installation would a faulty installation DVD be detected?
This means the folder's permissions have been set to ________.
To use "Wake on Demand," both the computer requesting the Bonjour network service and the computer providing it must be using Mac OS X v10.6 Snow Leopard.
You go on site and find a customer's Mac Pro is hanging at loading the desktop. His external firewire backup drive is not bootable, and he has misplaced his Snow Leopard Install DVD. The customer has a spare MacBook Pro available, how can you use it to resolve this issue?
A. Restart the Mac Pro into Target Disk Mode, connect it to the MacBook Pro and open Console.
B. Restart the Mac Pro into Target Disk Mode, connect it to the MacBook Pro and use the Disk Utility.
C. Restart the Mac Pro into Target Disk Mode, connect it to the MacBook Pro and open System Profiler.
D. Restart the MacBook Pro into Target Disk Mode, connect it to the Mac Pro then attempt to boot from it.
Your customer would like to create a back up his iMac's hard drive as a compressed and encrypted disk image to an external hard drive. How can you accomplish this task when started from the Snow Leopard Install DVD?
A. Open Restore from Backup and select the backup to disk image option.
B. Open Disk Utility, select the hard drive, then click the New Image button.
C. Open Disk Utility, select the hard drive, click the Restore tab, then select restore to disk image.
Jill uses her MacBook late at night and occasionally has to restart. Despite having muted the speaker volume the MacBook always boot chimes loudly after restart. What step should you try first to resolve this issue?
Scott's Mac mini is hanging during startup at a blue screen. What built-in startup mode might resolve this issue?
From the list below, select the new feature of the Security Pane in Snow Leopard.
A. The ability to use secure virtual memory.
B. The Firewall tab has been moved from Sharing preferences.
C. A setting to require a password to unlock each System Preferences pane.
D. The ability to add a delay to the required password after sleep or screensaver begins.
A customer with Snow Leopard finds that her MacBook Pro (13-inch Mid 2009) no longer asks what to do with blank DVD-Rs. Which troubleshooting steps should you try first?
A. Start from the Snow Leopard install DVD, then run System Profiler.
B. Start from an external USB or FireWire hard drive, then test for the issue.
C. Open System Preferences CDs & DVDs pane, then check for incorrect settings.
D. Try a known good blank DVD-R, if the issue persists then replace the SuperDrive.


I'm hoping to find someone who is like minded and wants to collaborate/bounce ideas around. Preferably with more of a mixing/production background and is genuinly interested in creating something a little different. My music is an eclectic mix of ambient, vintage electronics mixed with melodic acoustics.
I also have an eclectic range of influences including Bonobo, Blue States, Daft Punk, Zero Seven, Flaming Lips, Kasabian, The Polyphonic Spree etc.


text:
Mountain Biking In Blue Hills
Collect your good friends, connect to the identical Wifi and discover the mountains together. Compete in races or attempt out the new battle mode where you throw snowballs and plant rails to send your good friends off the course. You can commence the hike from Amisan Mountain and get to Dabulsan and then Mongsan. Because see it here all three mountains aren't quite higher, you can finish the hike in half a day, even if you take sufficient breaks through the hike. The ride was comfortable, the staff knowledgeable, and scenery sublime!
None of the 80 mammal species identified in the Alps are "strictly" endemic, which means they happen in the Alps and nowhere else in the planet. Some of the larger carnivore species found in the Alps contain the Alpine ibex, the chamois, the Eurasian lynx, the wolf, and the brown bear. These populations have been lowered in size or fragmented into tiny groups. There are also numerous rodent species found in the Alps, such as voles and marmots. Witnessing the myriad wildlife in the Land Down Beneath is a uncommon treat the continent is property to some of the most exotic species…
For majority of tours that head outside Lhasa to the western regions of Shigatse Prefecture, Mount Everest Base Camp is the major attraction, and thousands of tourists travel the route to the mountain every single year. Grand Teton is positioned in Wyoming, U.S.A. The mountain stands at 13,775 feet and is a well-known climbing location. At Grand Teton National Park there are over 200 miles of trails to explore, considerably wildlife to observe, and pristine lakes to admire. Each mountain ranges lie to the north and north-east of the State and separate it from Russian Turkistan and Tibet.
The Apennines are characterised by snow-capped mountains but also mountain plains with wealthy vegetation. Bears and wolves are amongst the wildlife that call the area dwelling although not to be missed are the dozens of hilltop villages with their spectacular scenery. Other times, a special type of mountain is created when one plate is pushed beneath the other, pushing magma to the surface. Volcanic activity under Earth's surfacecan also outcome in new mountains when magma is pushed up toward the surface. Maybe a single of the most beautiful sights on Earth, even though, is a majestic mountain variety. From the Himalayas to the Rocky Mountains, there's just one thing about those tall, craggy peaks that stirs the soul.
By doing many drives via the passes into the interior such as the Montagu Pass outdoors of George which wends its way via the valleys and then back on high ground via the Outeniqua Pass. For decades of the 19th and 20th centuries these imposing fortresses have been a big hindrance to transport and communication between the coast and its hinterland. Ox wagons laboured in treacherous situations for days over the challenging terrain.
Among the two plates, sediments are compressed, accumulated, and uplifted as the plates collide. This video shows a model of an avalanche is developed using flour and sugar layers to represent the distinct sorts of snow fall for the duration of a season. In 2014 we started to calculate weather models with historical information from 1985 onwards and generated a continuous 30-year global history with hourly weather information.
The quirky Slovenian wine named Cviček is produced around the town of situlae. In Ljubljana and Central Slovenia you can experience every little thing – from the vivacious cultural vibe to the peaceful moments in nature. Novo mesto is the centre of Dolenjska, and it has an archaeological heritage of world value. The town of situlae is surrounded by gentle wine-developing hills, exactly where the common Cviček wine is produced, and the mysterious Gorjanci Hills. Otočec Castle, the only "water castle" in Slovenia, is located on a smaller island in the River Krka.
Powered by machine learning and a wealth of present and historical information, EpicMix Time lets you choose the finest times for your favourite lifts all day lengthy. There are no charges necessary to access Pilot Mountain State Park for day use, except for the shuttle service tickets to the summit area on weekends and holidays for the duration of peak season. Costs are charged for camping, group climbing, certain occasion permits, and facility reservations. Nestled in 3200 acres of natural beauty, Stone Mountain Park characteristics family-friendly attractions, outdoor recreational activities and a range of on-web site lodging alternatives so you can keep exactly where you play! Discover our breathtaking natural areas, expertise our family members-friendly park attractions and appreciate our seasonal festivals and unique events. Mountain Collective Passholders WILL be essential to make reservations at Huge Sky Resort.
Nonetheless, more than the years DoBIH evolved into one thing substantially larger with six editors and many hillwalkers supplying information. Climbing to the highest point of every single county is a form of peak bagging, dating back to the 1920s when John Rooke Corbett was attempting to stop by all British County Tops. An arrow pointing towards the major of the Malminkartanonhuippu hill in Helsinki, Finland.
The significant centers, with their longer life spans, develop diverse magmatic systems whose eruptive goods can span the complete compositional range from basalt to andesite, dacite, and rhyolite. The hot subterranean environment for the long-lived centers is believed to host the important element of Cascade-connected geothermal sources. I formulated the rules by comparing which capabilities are normally located in mountain belts.
Founded on November 4th, 1954 by none other than Pandit Jawaharlal Nehru, the initial Prime Minister of India, to commemorate the initially productive ascent of Mount Everest by late Tenzing Norgay Sherpa & Sir Edmund Hillary. Getting the premier mountaineering institute of South-east Asia, HMI is also referred to as the Mecca of Indian Mountaineering. The Institute has an international reputation and has educated thousands of individuals from across the globe in mountaineering and allied adventure activities. Pumori expedition from the South East Ridge presents climbers with some of the most effective views of Lhotse and Mount Everest. Mt. Pumori is the most well-known 7000m+ mountain in Nepal and the starting point to other high altitude mountains. Just 8 km west of Mt. Everest, the pyramid-shaped Pumori is referred to 'Everest's Daughter' by some climbers.
The weather phenomenon named Jet Stream impacts our image of the highest peaks on earth. The sturdy stream of winds from the west, passes by means of Everest, building a familiar plume of snow blowing from the summit that is visible from a terrific distance. The western rivers combine into the Indus Basin, of which the Indus Riveris the biggest. The Indus starts in Tibet at the confluence of Sengge and Gar rivers and flows southwest by way of Pakistan to the Arabian Sea.
As one particular of Canada's best universities, we're identified for excellence across the humanities, sciences, inventive arts, business, engineering and overall health sciences. I am a writer, editor, teacher, and mother to two gorgeous children. I came to Korea to teach English for one year but now it has been over 11 years. This stunning nation is captivating and exceptional, but at the very same time hurting and wanting to be heard.
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Creekview Family Dentistry wants you to feel comfortable, confident, and informed when you're in our office, so we're prepared to answer any questions you may have. If you don't see the answer to your question, please fill out our easy online form or call our Lewisville, TX location today at 972-505-3423!
What Are My Orthodontic Options?
What If I Need To Replace All Of My Teeth?
What If I Have A Dental Emergency?
What Kind Of Care Can You Provide For My Entire Family?
Do You Offer Same-Day Crowns?
Q: Can You Help Me Be Less Nervous During My Appointment?
We're proud to offer a variety of patient-friendly, aesthetically pleasing braces that are comfortable and work great. We provide clear or virtually invisible orthodontic treatments from Invisalign, Six Month Smiles, and Cfast braces – all of which are designed to make you smile without a care while wearing them. We also offer traditional braces.
If you need a whole new set of pearly whites, we can help you with a full-mouth reconstruction! We can custom make both traditional dentures and implant-supported dentures to restore your oral function and your confidence!
If you are dealing with a dental emergency, we will do everything in our power to get you a same-day visit. We offer extended morning, evening, and Saturday hours, and we even set aside appointment times during the day to make it possible to see you immediately. Once you're here, we'll provide instant pain relief and get to work saving your smile.
In short, the works! We offer general, cosmetic and restorative dentistry solutions for you and each family member, and we proudly provide excellent pediatric dentistry care for younger patients. Through regular cleanings and exams, we can make sure everyone in the house is always happy with their smile.
Yes, we do! We have invested in CEREC technology, which allows us to repair damaged and decayed teeth in just one visit. Your Lewisville, TX dentist will take digital impressions to create your dental crown. While you wait, we'll design it and make it right here. Then we'll place it over your tooth, check the fit and appearance – and that's it. You're free to smile as soon as you leave our office!
Yes, we can. Dental anxiety, or being scared at the dentist or even about the idea of seeing the dentist, is a very real and common thing. You'll enjoy our soothing atmosphere and warm, understanding staff. For those who need it, we're happy to provide two levels of dental sedation so that you can relax during your appointment.
Comfortable, personalized dental care is one phone call away. We can't wait to see you!
No More Crooked Teeth! Fix crooked teeth and enjoy a healthier, beautiful smile. See how orthodontics can help you in our FREE e-book.


text:
First Green Condo Loan proves green buildings are profitable
May 28, 2014 by TAF
Unique loan from Toronto Atmospheric Fund yields impressive financial and environmental results
Toronto, ON – Nearly two years ahead of schedule, the condominium corporation for the Nuvo II building in Etobicoke recently paid off its $500,000 Green Condo Loan, an innovative financial arrangement developed through a unique collaboration between Toronto Atmospheric Fund (TAF) and Tridel, one of Canada's leading high rise residential developers, to advance improvements in energy efficiency.
Thanks to the energy efficient measures installed during construction and paid for through the Green Condo Loan, the 29-story condominium achieved a 41% reduction in energy use compared to its conventionally built sister building and saves $125,000 a year in energy costs – 30% more than the annual Green Condo Loan payments. The tower became one of Toronto's first LEED Silver condominiums and the drop in its energy consumption translates to a 550-tonne reduction in yearly greenhouse gas emissions.
The first Green Condo Loan was entered into between Tridel and TAF in 2008 when the two condominium towers were being built. One of the towers was constructed and financed in a conventional manner while the other incorporated energy efficient improvements. By taking on the loan, Tridel was able to pay for the incremental costs of the improvements – such as better insulation and high efficiency boilers – over and above building code requirements at the time without raising the price of its residential units.
"After helping to create the financing model with TAF's team, Tridel entered into the loan agreement on behalf of the future condominium corporation so that we could build a high performance building and introduce a new standard of efficient construction at competitive prices in a crowded market," said Jamie James, a partner with GreenSoil Investments, who was Tridel's sustainability advisor at the time. "The results affirm the value of investing in efficiency. Now that the loan is paid off, all of the savings accrue to the homeowners. A significant monthly charge has just come off the books, which should result in higher condo valuations."
The Green Condo Loan bridges the divide between builders focused on cost control and condominium corporations who pay the utility bills. It provides developers with financing to build energy efficient structures that exceed the minimum energy code requirements by at least 25%. However, payments on the loan are actually made by the condominium corporation, which benefits from the lower utility costs.
"Our Green Condo Loan shows that green buildings are profitable," said Tim Stoate, TAF's Vice President Impact Investing. "The Tridel building proves the viability and benefits of this financing program. Owners meet their bottom line, people get to live in energy efficient buildings, and everyone benefits from a cleaner environment."
TAF has committed to advancing five other Green Condo Loans, and Tridel has used the Green Condo Loan model in 16 additional buildings.
Nearly half of the City of Toronto's greenhouse gas emissions are generated by buildings. Finding ways to reduce energy consumption in this sector is the single most effective means of reducing emissions that cause climate change.
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text:
Q: Use text variable in rmarkdown I want to use a text variable for a html, pdf, and word output with knitr.
This is the code I currently have in markdown
I want to set a variable

var <- "just some text"

so that I don't need to write the text 3 different times
(please apologize the bad code, I am very new to this)

For HTML Only
```{asis, echo=is_html_output()}
  <p>just some text</p>
```
For PDF Only
\color{ecbblue}{\scriptsize{just some text}}

For DOCX Only
```{asis, echo=is_word_output()}
just some text

A: If you want to work in LaTex you can use this code :
\usepackage{xspace}
newcommand{\VarName}{text to insert\xspace}

Then whenever you want

text to insert

So as an example you could do :
\color{blue}{\scriptsize{\VarName}}

would return text to insert in blue just like you want. This will indeed only work for text variable.

Edit : while the other answer is good, if you want to do it the R way I suggest to instead use the pander package which does a really good job and is even simpler.
install.packages("pander")
library("pander")

For LaTeX(PDF) in your R chunks simply do :
pander(cat("\\textcolor{red}{", var ,"}"))

For HTML in your R chunks simply do :
pander(cat("<span style=color:red>", var, "</span>"))

A: You can define your variable in an invisible code chunk and output it in an inline expression. That way you don't need to handle <p> etc.:
---
output:
  pdf_document: default
  word_document: default
  html_document: default
---

```{r, include=FALSE}
var <- "just some text"
h2 <- "Text2"
```

## `r h2`

`r if(knitr::is_latex_output()) paste("\\textcolor{blue}{\\scriptsize", var, "}") else var`

Note that I am using \textcolor instead of \color, since the latter does not take an argument and will make all following text also blue.


text:
» Transplant Recipients
Last Updated on Wed, 06 Apr 2016 | Transplant Recipients
severe liver disease. Intrinsic pulmonary dysfunction in patients with severe liver disease, such as emphysema or asthma has the same incidence as in patients without liver disease. The severity of these irreversible diseases should be considered when accepting a patient for transplantation. However, some lung dysfunction is the direct result of liver disease. Restrictive pulmonary disease can be the result of tense ascites or pleural effusion, which is especially common on the right side.
Hepatopulmonary syndrome is a condition that is unique to severe liver disease: it is the result of abnormally dilated precapillaries and capillaries in the pulmonary circulation, leading to significant ventilation/perfusion mismatch and hypoxia. Dilated capillaries are more common in the bases of the lungs, leading to orthodeoxia (lower arterial pO2 in the upright position). Oxygen administration improves oxygenation, which should not occur in situations with right-to-left shunting. However, injection of agitated saline (echogenic contrast) during echocardiography shows the contrast in the left atrium and ventricle about 3-4 cardiac cycles after their presence in the right atrium or ventricle, suggesting the presence of an intrapulmonary right-to-left shunt. This combination is unique to hepatopulmonary syndrome. Thus, the condition is confirmed by contrast-enhanced echocardiography, and pulmonary angiography or radionuclide scanning is rarely necessary to confirm the diagnosis. The presence of the hepatopulmonary syndrome is not a contraindication to liver transplantation, because the syndrome is reversible after successful transplantation, although many have a prolonged recovery in the intensive care unit.
Cerebral function can be affected because of an excess of metabolites that are normally metabolized by the liver or because of abnormal metabolites. Hepatic encephalopathy, common in acute fulminant failure, has been attributed to abnormal ammonia metabolites. However, other factors contribute to hepatic encephalopathy: cerebral edema, changes in neurotransmitter concentrations and blood-brain barrier function, decreased cerebral metabolic rate, uncoupling of cerebral blood flow, and increased intracranial pressure. By itself, encephalopathy is not a contraindication to liver transplantation, but if severe it may require tracheal intubation for airway protection. Seizures and subarachnoidal bleeding also can affect consciousness. Evaluation includes the use of computed tomography scans of the head, electroencephalography, transcranial Doppler blood flow determination, and epidural intracranial pressure determination.
Renal System
Renal dysfunction may be the result of hypovolemia, acute tubular necrosis, terminal renal disease, or hepatorenal syndrome. The hepatorenal syndrome is caused by abnormal distribution of renal blood flow, due to hormonal imbalances, resulting in low urine output, a low urinary sodium concentration (< 5 mmol/L) and a high urine/plasma creatinine ratio. The hepatorenal syndrome is reversible after successful transplantation. Patients with non-reversible renal failure should be considered for combined liver-kidney transplantation.
The Best Ways to Treat Kidney Damage
Instant Remedies for Asthma
Speed Up Your Metabolism Naturally
How to Cope with Acute Renal Failure Naturally, Metabolic rate: sports training has a significant effect, Kidney Transplantation


It actually makes sense why asking for wisdom is #1. We probably make decisions every second of our life.
What to do next? What to eat? Where to go? Should I say yes or no?
In order to have a better life, we need to make sound decision. We have to be wise to choose what is right for us. We need to ask the Lord for wisdom. And everything else will follow - better marriage, the right parenting skills, people skills, productive day at work, the right priorities, more savings.
Desire wisdom - We have to want it!
Pray for wisdom - Ask God for it.
Seek wisdom - You will find insights on wisdom in the book of Proverbs.
Grow in wisdom - It doesn't stop after receiving wisdom, we have to keep living and growing in it.
As my task for the day, I had to pick a verse from a chapter in Proverbs, write it down and carry it with me throughout the day.
and be at ease, without fear of harm."


text:
Affordable Housing Trust Contributes To Rental Assistance Program July 8, 2020
By: William F. Galvin
HARWICH — The affordable housing trust will contribute $37,800 to the housing authority's rental assistance program to ensure funding is available as the new fiscal year begins. The housing authority is seeking $200,000 in Community Preservation Act funds for the program in the annual town meeting. Because the session was put off until Sept. 28 due to the COVID-19 pandemic, the funds won't be available until t...
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Voter Turnout Low In Harwich Annual Election July 8, 2020
By: Staff Reports
HARWICH – Voters cast ballots in very low numbers in Tuesday's annual town election due both to the absence of any elective races and the COVID-19 pandemic. Only 807 voters, about 5 percent of those registered, cast ballots during limited polling hours. Town Clerk Anita Doucette said 346 ballots were cast by mail. Most, 327, were absentee ballots, and another 19 were early voting ballot requests. She said voti...
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Baseball Is Back! July 8, 2020
By: Kat Szmit
With The Help Of Monomoy Players, Centerville Coyotes Play To First 2020 Win COTUIT – If you thought you heard the crack of a bat and the slap of a ball against a glove in Cotuit on Monday evening, you weren't dreaming. Baseball is back, and with it came the Centerville Coyotes' first victory of 2020, a come-from-behind 4-2 win against the New Bedford Whalers. The game marked the first for the Coyotes,...
Read more from Baseball Is Back!
Garden Club Of Harwich Persists Through Pandemic July 8, 2020
HARWICH – We've all been spending quite a lot more time indoors than was once normal. It's only natural that when we venture out of our homes for necessary errands, we tend to see the once familiar world around us with fresh eyes. Take a look at those flowers! Wow, those planted containers are just stunning. I wonder who has been taking care of these garden b eds during the quarantine? If you are asking ...
Read more from Garden Club Of Harwich Persists Through Pandemic
Cape Cod Community College Could Be Alternative For Some July 8, 2020
Institution Poised To Adapt To Pandemic Changes WEST BARNSTABLE — It was eerily quiet at the Cape Cod Community College campus on a recent visit. The parking lot was empty, concourses vacant. While summer traditionally is the season of fewer enrollments at the college, the COVID-19 pandemic has had a major impact and will change the way students will be educated. "This is part of life, learning how we na...
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Nature Connection: Reconnecting July 8, 2020
By: Mary Richmond
It's been a long few months of being more or less housebound, alone or together. For some it has been a nightmare, but for others it's been a blessing of sorts. As things ease up a bit, it is easy to tell the most social amongst us, as they were out and about and eagerly seeking company for drinks, dinners and group activities as quickly as they could. The rest of us may feel a bit of regret as life resume...
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Our View: Fish Pier Fiasco July 8, 2020
By: Cape Cod Chronicle
The newly rebuilt observation deck at the Chatham Fish Pier is certainly an improvement over its predecessor. Solidly built, spacious, attractive and made of more durable material than the previous wooden deck (situated in one of the harshest environments one can imagine), it will no doubt weather storms, sun and salt spray for years, hopefully decades, to come. But getting to the point of opening the deck to ...
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Letters to the Editor: July 9, 2020 July 8, 2020
By: Cape Cod Chronicle Readers
Chatham Selectmen Fail Voters Editor: If you have ever thought about serving as a volunteer on a Chatham board, think twice. Your efforts will not be appreciated unless you cede your right to speak freely and express an honest opinion. Don't ever criticize the board of selectmen or you'll not be re-appointed. Despite entreaties from friends, colleagues, and concerned citizens, I was not re-appointed to t...
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Donna Tavano: Bring Fourth Illumination July 8, 2020
By: Donna Tavano
If you've lost track of time and space, stumbling about in a calendar-less COVID-19 coma, the recent explosion of fireworks, sending shuddering dogs into under-the-bed mode, might have alerted you to the sudden appearance of the Fourth of July. As so many traditional Independence Day activities and formal fireworks displays have been canceled due to the virus, let us be illuminated by some little-known July Fo...
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Author, Diplomat, Nickerson Descendant, William Walker Is Glad To Be On The Cape July 8, 2020
By: Debra Lawless
William Nickerson Walker's third spy novel, "Target Switzerland," will be released later this month. In retirement, Walker, 82, is a prolific writer, an indefatigable golfer and an energetic vice president of the Nickerson Family Association, Inc. (NFA). In the past he was an international businessman and financier, diplomat, government official and partner in a large Wall Street law firm. Two years ago, Wa...
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Red Tide Cysts Not A Red Light For Estuary Dredge Disposal July 8, 2020
ORLEANS — The Nauset Estuary Stakeholder Group will meet via Zoom tonight (July 9) at 5 to hear some good news regarding the long-sought and oft-delayed effort to dredge the estuary and restore its utility for commercial and recreational boaters. The likely presence of red tide cysts in some of the material to be dredged presented concerns about their possible spread when the materials were relocated. A pilo...
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Work Sessions To Prepare Ship Of State For Rough Financial Seas July 8, 2020
Fiscal stability involves not only planning to pay for needed services years into the future but also being prepared for unexpected circumstances. That's why the work sessions will also look at ways to protect the town's AAA bond rating, to reduce reliance on free cash to offset the operating budget, and to preserve financial reserves including stabilization funds. According to the DOR, towns can recover 100 p...
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Perseverance Pays Off For Quahog Dragger Chris Viprino July 8, 2020
By: Doreen Leggett
Not too long ago the Orleans harbormaster, a bit worried, asked a longtime fisherman to keep watch on a young guy who had started bullraking in Cape Cod Bay with no more experience than watching a few videos on YouTube. "In two days I made about $28," said Chris Viprino, the young guy in question, on a recent overcast day at Rock Harbor. "I spent a winter doing it. Too stubborn to do anything else." Viprino...
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No Major Injuries After Boat Capsizes July 3, 2020
CHATHAM — Four young men were apparently spared any serious injury after their boat capsized in Chatham's North Cut Friday afternoon. At about 2:50 p.m., officials received a 911 call from one of the men, who indicated that they were in the vicinity of Outermost Harbor before the call was disconnected. Dispatchers retrieved the phone's location and plotted it to a location several miles away near the north inlet....
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The Long Wait Is Over: Rebuilt Fish Pier Deck Opens July 2, 2020
CHATHAM – Nearly 18 months after construction started, the new fish pier observation deck finally opened to the public Thursday. A few visitors were watching fishing boats unload and seals swimming in Aunt Lydia's Cove from the new, spacious deck. A board of health order mandates that face masks be worn on the observation deck from 9 a.m. to 9 p.m. Construction of the $1.7 million deck began in January 2019...
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Voter Turnout Low In Harwich Election July 1, 2020
HARWICH – Voters cast ballots in very low numbers in Tuesday's annual town election due both to the absence of any elective races and the COVID-19 pandemic. Only 805 voters cast ballots during limited polling hours. Incumbent selectmen Donald Howell and Larry Ballantine were returned to office with 602 and 593 votes, respectively. Incumbent Monomoy Regional School Committee members Meredith Henderson, 633 vote...
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text:
Cancer & Blood Disorders >
Innovative Programs & Services >
Innovative Programs & Services
Benign Blood Disorders
Center for Comprehensive Wellness
Center for Histiocytic Disorders
Center for Survivor Wellness
Child and Adolescent Rare Skin Cancer Program
Leukemia Care
Lymphoma Care
Pediatric Cancer Foundation Developmental Therapeutics Program
Pediatric Cellular Therapy Program
Pediatric Liver Cancer Program
Precision in Pediatric Sequencing (PIPseq) Program
Stem Cell Transplantation Program
Our team of dedicated access representatives are here to help you make an appointment with the specialists that you need.
What Makes Our Program Different
We care for a large population of patients with sickle cell disease, affording us with exceptional experience managing this disease. In 1983, Hematology, Oncology, and Stem Cell Transplantation within the Department of Pediatrics at Columbia became home to one of only ten National Heart, Lung and Blood Institute Comprehensive Sickle Cell Centers in the United States.
The New York State Department of Health has also accredited the Division as a Hemoglobinopathy Specialty Center.
Our Approach to Care
Specialized services that we offer our patients include:
A Center for Regular, Routine Care
A comprehensive care program to ensure that children have annual clinical, laboratory, radiologic, and psychosocial evaluations in accordance with national guidelines.
Management of Pain and Treatment Without a Hospital Stay
Outpatient management and preventive care of vaso-occlusive pain, fever, blood transfusions, and hydroxyurea therapy, which can reduce the frequency of pain and blood transfusions for patients with sickle cell disease.
Rapid Response to Pain Crises
A special "Pain Pathway" in the Emergency Department and outpatient clinic to ensure the rapid evaluation and treatment of sickle cell patients with vaso-occlusive crisis.
Access to an Array of Specialists and Clinical Trials
Our patients have access to all of the physicians throughout Columbia University Medical Center who specialize in pediatric conditions and who can help treat complications of sickle cell disease and other conditions.
For patients who may benefit from stem cell transplantation, we have access to one of the country's largest Stem Cell Transplantation programs.
Our patients also have the opportunity to enter into many clinical trials, including stroke prevention trials, which would allow them access to new treatments.