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Shortly after coming to the outside world, Diana interrupted a terrorist attack and was named "Wonder Woman" by the press.[5] She continued to use her gifts to fight for peace and justice in Man's World.[6] She later fought who she thought to be Ares, though in truth it was Phobos and Deimos who were disguised as their father. Fearing that she would eventually discover the truth and free Ares from his prison beneath Themyscira, the Gods of Olympus sent Phobos and Deimos to erase all memory of Themyscira from Diana's mind. The twin gods were unable to erase the memory, so instead they later implanted false memories regarding her home to deceive Diana, leading to a completely separate origin story and causing her to hallucinate new adventures. Diana was unaware that her memories had been tampered with, and believed the falsifications until her search for the truth led her to Ares himself years later.[7][8]
Later, in London, Diana talked with Hessia about what being Queen really meant. Hessia told her the changes she was trying to impose were hard, and it might take a long time for the Amazons to accept them. Wonder Woman was called by the Justice League to look for the survivors of another missing village. As part of the operation, Superman explored the interior of a volcano until he was attacked by insects and lost contact with the League.[52] Wonder Woman and Batman were next to enter the volcano and found Superman safe and sound. Exploring the volcano further, the heroes found the missing villagers dead and their remains encased in cocoons by one of the volcano's insectoid denizens. Wonder Woman almost killed one of these creatures, until the League intervened and took the creature to the Watchtower for medical attention. Upon returning to Paradise Island, Diana spoke to the spirit of Hippolyta. Comforting her daughter, Hippolyta motivated Diana into accepting her duty as God of War. Diana also learnt that relations between Amazons and the Sons of Themyscira had gone sour and the Amazons had created Donna Troy from magical clay, an Amazon who sought to replace Diana as Queen.[53]
Wonder Woman is the most popular female comic-book superhero of all time. Aside from Superman and Batman, no other comic-book character has lasted as long. Generations of girls have carried their sandwiches to school in Wonder Woman lunchboxes. Like every other superhero, Wonder Woman has a secret identity. Unlike every other superhero, she also has a secret history.
At the time of her debut, Wonder Woman sported a red top with a golden eagle emblem, a white belt, blue star-spangled culottes, and red and golden go-go boots. She originally wore a skirt; however according to Elizabeth Martson, "It was too hard to draw and would have been over her head most of the time."[189] This outfit was entirely based on the American flag, because Wonder Woman was purely an American icon as she debuted during World War II.[194] Later in 1942, Wonder Woman's outfit received a slight change – the culottes were converted entirely into skin-tight shorts and she wore sandals.[194] While earlier most of her back was exposed, during the imposition of the Comics Code Authority in the mid-1950s, Wonder Woman's outfit was rectified to make her back substantially covered, in order to comply with the Authority's rule of minimum exposure.[194] During Mike Sekowsky's run in the late 1960s, Diana surrendered her powers and started using her own skills to fight crime. She wore a series of jumpsuits as her attire; the most popular of these was a white one.[194]
With a new decade arriving, DC president Jenette Kahn ordered a revamp in Wonder Woman's appearance. Artist Milton Glaser, who also designed the "bullet" logo adopted by DC in 1977, created a stylized "WW" emblem that evoked and replaced the eagle in her bodice and debuted in 1982.[39] The emblem in turn was incorporated by studio letterer Todd Klein onto the monthly title's logo, which lasted for a year and a half before being replaced by a version from Glaser's studio.[40] With sales of the title continuing to decline in 1985 (despite an unpublished revamp that was solicited), the series was canceled and ended in issue #329 (February 1986) written by Gerry Conway, depicting Steve Trevor's marriage to Wonder Woman.
Her tiara's signature star symbol is now an eight pointed starburst. According to designer Lindy Hemming and director Patty Jenkins, every design decision made for Themyscira came down to the same question: "How would I want to live that's badass?"[197] "To me, they shouldn't be dressed in armor like men. It should be different. It should be authentic and real ... and appealing to women." When asked about the decision to give the Amazons heeled sandals, Jenkins explained that they also have flats for fighting, adding "It's total wish-fulfillment ... I, as a woman, want Wonder Woman to be sexy, hot as hell, fight badass, and look great at the same time ... the same way men want Superman to have ridiculously huge pecs and an impractically big body. That makes them feel like the hero they want to be. And my hero, in my head, has really long legs."[198] This corresponds to the original intent by William Moulton Marston, who wanted his character to be alluringly feminine.
Categories: 2017 filmsEnglish-language filmsSuperheroine films2017 3D films2010s action films2010s fantasy films2010s superhero films2010s war filmsAmerican war filmsAmerican 3D filmsAmerican action filmsAmerican fantasy adventure filmsAmerican superhero filmsAmerican science fantasy filmsAmerican science fiction action filmsAtlas Entertainment filmsDC Extended Universe filmsDeicide in fictionFantasy war filmsFilms about chemical war and weaponsFilms scored by Rupert Gregson-WilliamsFilms based on Greco-Roman mythologyFilms directed by Patty JenkinsFilms produced by Zack SnyderFilms set in 1918Films set in 2016Films set in BelgiumFilms set in FranceFilms set in GermanyFilms set in LondonFilms set in the Mediterranean SeaFilms set in the Ottoman EmpireFilms set on islandsFilms shot in LondonFilms shot in MateraFilms using computer-generated imageryFratricide in fictionIMAX filmsPrequel filmsTencent Pictures filmsWar adventure filmsWarner Bros. filmsWestern Front films (World War I)Wonder Woman filmsHugo Award for Best Dramatic Presentation, Long Form winning worksCultural depictions of Erich Ludendorff
After the disappointing downward trend of quality for this series, this volume was a somewhat refreshing addition. Though the plot was rather basic and a bit nonsensical at times, overall it was a decent enough addition to the series. The artwork is solid and makes the story more engaging. This volume also includes Wonder Woman Annual #2, which as a fan of the Star Sapphires I enjoyed. However, the ending to this arc was incredibly rushed and told in a way that completely removed any sense of su ...more
As Zola defeated Poseidon, the First Born returned to Olympus and ordered the Minotaur to attack Wonder Woman. The Minotaur, however, refused to kill her and the First Born killed him instead. Upon seeing the unmasked Minotaur, Diana discovered her foe was the creature she had spared in the labyrinth.[48] Wonder Woman furiously threw the First Born into the abyss he was originally trapped in while Zola placed Zeke on the throne. Zola revealed herself to be Athena and Zeke to be another iteration of Zeus himself. Both had planned for Wonder Woman to fight the First Born and accept her destiny as a goddess. With the conflict ended, Athena planned to put an end to her human identity and become a goddess once more, but Wonder Woman convinced her to allow Zola and Zeke to live without godly interference.[49]
Gaines was troubled. Roubicek, who worked on Superman, too, had invented kryptonite. She believed superheroes ought to have vulnerabilities. She told Gaines she thought Wonder Woman ought to be more like Superman and, just as Superman couldn't go back to the planet Krypton, Wonder Woman ought not to be able to go back to Paradise Island, where the kinkiest stuff tended to happen. Gaines then sent Roubicek to Bellevue Hospital to interview Bender. In a memo to Gaines, Roubicek reported that Bender "does not believe that Wonder Woman tends to masochism or sadism." She also liked the way Marston was playing with feminism, Roubicek reported: "She believes that Dr. Marston is handling very cleverly this whole 'experiment' as she calls it. She feels that perhaps he is bringing to the public the real issue at stake in the world (and one which she feels may possibly be a direct cause of the present conflict) and that is that the difference between the sexes is not a sex problem, nor a struggle for superiority, but rather a problem of the relation of one sex to the other." Roubicek summed up: "Dr. Bender believes that this strip should be left alone."
The success of the superhero television series Supergirl informed the marketing and promotion strategy used for Wonder Woman.[155] According to Time Warner chief marketing officer Kristen O'Hara, they wanted to approach the Wonder Woman marketing campaign in a light manner, similar to how they did with Supergirl. O'Hara elaborated that the modest campaign route they took for Supergirl aided in establishing a large central fanbase among women well in advance of the series, which reportedly generated 5 million female superhero fans in one week.[155] They were then able to model over time, and grow that audience leading up to the 15-months-later release of Wonder Woman.[155] Though neither the film nor the series are aimed exclusively at women, the latter's campaign gave them their first opportunity to begin collecting data about female superhero fans.[155] In May 2017, a promo for Wonder Woman was released during the season finale of Supergirl, featuring a remix of the song "These Boots Are Made for Walkin'" and Supergirl (Melissa Benoist) wearing Wonder Woman's boots.[156] The promo included an appearance by Lynda Carter, star of the 1970s Wonder Woman, who plays the American president on Supergirl.[156]
Wonder Woman is a 2017 American superhero film based on the DC Comics character of the same name, produced by DC Entertainment in association with RatPac Entertainment and Chinese company Tencent Pictures, and distributed by Warner Bros. Pictures. It is the fourth installment in the DC Extended Universe (DCEU).[6] Directed by Patty Jenkins from a screenplay by Allan Heinberg and a story by Heinberg, Zack Snyder, and Jason Fuchs, Wonder Woman stars Gal Gadot in the title role, alongside Chris Pine, Robin Wright, Danny Huston, David Thewlis, Connie Nielsen, and Elena Anaya. It is the second live action theatrical film featuring Wonder Woman following her debut in 2016's Batman v Superman: Dawn of Justice.[7] In Wonder Woman, the Amazon princess Diana sets out to stop World War I, believing the conflict was started by the longtime enemy of the Amazons, Ares, after American pilot and spy Steve Trevor crash-lands on their island Themyscira and informs her about it.
Gaines forwarded Jacobs' letter to Marston, with a note: "This is one of the things I've been afraid of." Something had to be done. He therefore enclosed, for Marston's use, a memo written by Roubicek containing a "list of methods which can be used to keep women confined or enclosed without the use of chains. Each one of these can be varied in many ways—enabling us, as I told you in our conference last week, to cut down the use of chains by at least 50 to 75% without at all interfering with the excitement of the story or the sales of the books."
When she is preparing for the final game (Teaming up with Supergirl, Starfire, Bumblebee and Batgirl against Lobo, Maxima, Bleez, Mongal and Blackfire), the competition is interrupted by Lena Luthor. Wonder Woman starts putting civilians safe, including the Embassador, who, out of fear, orders her to star with him to protect him. She refuses and returns to the batlle, angering the Embassador. She fight Lena and then Brainiac. Upon their defeat, Wonder Woman rejoins with her mother, thinking she dissapointed her by no following the Embassador orders, but Hippolyta is proud instead, stating that Wonder Woman will be an amazing Queen.
Siracca tells Diana how she and her mother were killed by the hands of the jealous goddess Hera. Although she was torn to shreds by Hera's fury, Zeus took pity on her and turned her into wind. The very same wind that spills secrets to Lennox. Wonder Woman share her encounter with Hera and how she so desperately needs to find Zola's child, stolen due to Hermes. Siracca attempts to help Diana in finding Hermes and the baby. She suggests meeting Milan, once again, another child of Zeus for advice. Diana treks off to New York to find him.
I am sooooo happy to hear you say this! YES! I was worried about saying Jason wasn't part of Wilson's run. I'm a very anti-spoiler guy so I typed and deleted that point a few times. BUT ultimately I thought I didn't know how or why he wasn't there so I couldn't spoil his arc for you AND if there was a character who frustrated me as much as he frustrates you, I'd like to know there was relief coming. So, whew! Foot-in-mouth mistake averted :).
Additional music featured in the film are: "Another Little Drink Wouldn't Do Us Any Harm" by Clifford Grey and Nat Ayer and performed by Edgar Trevor and Cecil Cooper; "Molly O'Morgan" written by Fred Godfrey and Will Letters and performed by Ella Retford; "It's a Long Way to Tipperary" written by Jack Judge and Harry Williams; "Sous les ponts de Paris" written by Jean Rodor and Vincent Scotto and performed by Lucienne Delyle; "I'll Walk Beside You" written by Edward Lockton and Alan Murray and performed by Ewen Bremner; "Green Grow the Rushes, O" written by Robert Burns and performed by Ewen Bremner; and "Schatzwalzer Op. 4" written by Johann Strauss II and performed by the Berlin String Quartet.[145]
Dear Justice League, dear justice league comic, Justice League, Michael Northrop, gustavo duarte, middle grade, middle grade comics, middle grade graphic novels, comics for kids, good comics for kids, graphic novels for kids, good graphic novels for kids, young readers, all ages comics, good all ages comics, Batman, Superman, wonder woman, The Flash, Green Lantern, hawkgirl, cyborg, Aquaman, dc zoom, dc kids, ashley v. robinson
Superhuman Strength: Diana possesses far greater strength than the finest human athletes. She kept an A.R.G.U.S aircraft from crashing by holding it up. She dispatched numerous Parademons during Darkseid's invasion and broke the Fortress of Solitude's doors down when H'el locked Superman out and took control of it. She has also managed to briefly overpower both Green Lantern and Aquaman, as well as Supergirl. She managed to defeat the goddess Artemis, as well as draw blood from The First Born.[citation needed]
Diana confronts Steppenwolf, before Cyborg attacks him, which leads to Wonder Woman fighting Steppenwolf. As Flash helped Cyborg get to the Mother Boxes, he takes care of the Parademons. While Cyborg tries to separate the Mother Boxes, Batman saves Flash by grappling his legs from stopping him from falling: Batman takes one of the Parademons' guns and fires at them. Steppenwolf finds out that Cyborg is trying to separate the Mother Boxes, which he grabs him before Wonder Woman saves him.
Flash and Cyborg save all the hostage, which Silas Stone tells Victor that Steppenwolf can not get the final Mother Box. Batman then jumps down into the Knightcrawler and saves Wonder Woman after a Parademon manages to briefly knock her out. The Knightcrawler gets attacked by Steppenwolf, and Barry helps Wonder Woman get her sword so she can help Batman.
In 1911, when Marston was a freshman at Harvard, the British suffragist Emmeline Pankhurst, who'd chained herself to the gates outside 10 Downing Street, came to speak on campus. When Sanger faced charges of obscenity for explaining birth control in a magazine she founded called the Woman Rebel, a petition sent to President Woodrow Wilson on her behalf read, "While men stand proudly and face the sun, boasting that they have quenched the wickedness of slavery, what chains of slavery are, have been or ever could be so intimate a horror as the shackles on every limb—on every thought—on the very soul of an unwilling pregnant woman?" American suffragists threatened to chain themselves to the gates outside the White House. In 1916, in Chicago, women representing the states where women had still not gained the right to vote marched in chains.
She asked him who he was, but before he could answer, the two noticed several boats coming through the island's forcefield. Steve noted that he was one of the good guys and the people on the boats—Germans—were bad guys. Having noticed the invading ships, the Amazons quickly gathered on the cliffs above the beach. Hippolyta ordered Trevor to move away from Diana, but forgot about him as the German soldiers began to come closer to shore. She took command of her army, ordering the archers to fire on the boats. Diana and Trevor took cover behind boulders on the beach.
On May 31, Wonder Woman was banned in Lebanon after the Campaign to Boycott Supporters of Israel asked the Lebanese government's Ministry of Economy and Trade to block the film because its star, Gal Gadot, is Israeli.[163] The Lebanese government did not ban Gadot's Fast & Furious films which did screen in Lebanon.[164][165] On June 7, Variety reported that a Tunisian court suspended the theatrical release of Wonder Woman after a lawsuit brought by the Al-Chaab party and the Tunisian Association of Young Lawyers to have the film blocked due to Gadot's Israeli citizenship, military service, and public comments in support of the Israeli military during the 2014 war in Gaza.[166] Jordan was reportedly also considering a ban of the film and suspended screenings pending a decision,[167] but on June 11, it was reported that the government decided not to do so, as there was no legal precedent for it.[168]
If you're looking for a certified God of War on a personal vendetta against a pantheon of gods, Wonder Woman has you covered. The current version of Diana hacking and slashing her way through the DC Universe, anyway. After unintentionally bringing a new collection of "Dark Gods" into the comic book universe, it falls to the daughter of Zeus to save Earth from their malice.
Storylines	The 18th Letter • A League of One • A Piece of You • Amazons Attack! • Beauty and the Beasts • Birds of Paradise • Bitter Rivals • Blood • Bones • The Bronze Doors • The Challenge of Artemis • Challenge of the Gods • Champion • The Circle • The Contest • Counting Coup • Depths • Destiny Calling • Devastation • Devastation Returns • Down to Earth • Ends of the Earth • Expatriate • Flesh • The Game of the Gods • God Complex • Gods and Mortals • Gods of Gotham • Godwar • Guts • Iron • Judgment in Infinity • Land of the Lost • Levels • Love and Murder • Lifelines • Marathon • The Men Who Moved the Earth • A Murder of Crows • Odyssey • The Pandora Virus • Paradise Island Lost • Revenge of the Cheetah • Rise of the Olympian • Sacrifice • Second Genesis • Stoned • Three Hearts • Trinity 98 • The Twelve Labors • War • Warkiller • War-Torn • Who is Donna Troy? • Who is Troia? • Who Is Wonder Woman? • The Witch and the Warrior • Wrath of the Silver Serpent
Following the 1985 Crisis on Infinite Earths series, George Pérez, Len Wein, and Greg Potter rewrote the character's origin story, depicting Wonder Woman as an emissary and ambassador from Themyscira to Patriarch's World, charged with the mission of bringing peace to the outside world. Pérez incorporated a variety of deities and concepts from Greek mythology in Wonder Woman's stories and origin. His rendition of the character acted as the foundation for the modern Wonder Woman stories, as he expanded upon the widely accepted origin of Diana being birthed out of clay. The relaunch was a critical and commercial success.[41]
On occasions Wonder Woman has employed a magical sword of unknown (though presumably Amazon) origin. This sword has been used most specifically against those with the power of invulnerability as invulnerability generally does not work against magical items. It is generally represented as a short sword. In Wonder Woman (vol. 4) #15, Hephaestus modifies Diana's bracelets so that she can manifest two short swords from them during battle.
As a result of the New 52 in 2011, the entire line of DC characters was relaunched, incorporating properties belonging to the company's imprints: Wildstorm, Milestone, and Vertigo. As such, elements of this character's history have been altered in some way from the previous incarnation's. For a complete list of all versions of this character, see our disambiguation page.
The princess of the Amazons, armed with superpowers of a god, Wonder Woman is one of Earth's most powerful defenders of peace, justice, and equality and a member of the Justice League. She is often considered an archetype for many non-comicbook heroines. She stands for Love and peace. Her original origin allegorically depicted her as a clay figure brought to life by the gods, but in recent years she has been depicted more literally as the daughter of Zeus and the Amazon queen Hippolyta.
The series has been one of the most altered of the New 52 event. Joey Esposito and Erik Norris of IGN noted that the new creative team provided "a creative well that appears bottomless."[78] Timothy Callahan of Comic Book Resources called the title "the best of the New 52" and described the work of Brian Azzarello and Cliff Chiang as "a clean, poetic story with a strong mythological pull."[79]
Granted by Hermes (God of Messengers), her top speed has never been well documented, but she has entered the speed force under her own power, implying she can accelerate to at least light speed. The Flash has said that Wonder Woman can easily keep up with him and she has been seen keeping up with Flash going faster than hypersonic speed. She has been shown to be on par with some of the fastest characters in the DC Universe such as Jesse Quick. She can disarm human opponents of their weapons instantly and she can immobilize her opponents in the blink of an eye, as she showed when she speedblitzed White Martian and Genocide into space in no time and was able to take down Amazo before he could finish a word. She is such a well trained athlete that in combat, her reflexes even surprise the likes of Superman.


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Chicago Med Recap 10/19/22: Season 8 Episode 5 "Yup, This is The World We Live In"
BY Kristine Francis on October 19, 2022 | Comments: Leave Comments
Related : Recap, Television, TV
Tonight on NBC their medical drama Chicago Med airs with an all-new Wednesday, October 19, 2022, episode, and we have your Chicago Med recap below. In tonight's Chicago Med season 8 episode 5 called, "The effects of the supply chain shortages continue to impact the E.D. when Vanessa's drug dealer reappears.
One of the victims of the recent train crash needs a transplant, forcing Crockett to improvise. Charles and Nellie help a patient with amnesia."
So make sure to bookmark this spot and come back between 8 PM – 9 PM ET for our Chicago Med recap. While you wait for our recap make sure to check our Chicago Med recap, spoilers, news & more, right here!
Tonight's Chicago Med recap starts now – Refresh Page often to get the most current updates!
In tonight's Chicago Med episode, the psych ward was full. The ED was full of psych patients that needed beds and the ward just didn't have it all. The other hospital also didn't have it. Everyone was full. The pandemic has left behind a legacy of a mental health crisis and no authority was willing to deal with it. After Dr. Nellie Cuevas couldn't find beds for their patients, Dr. Charles told her to check with clinics. They couldn't treat everyone and yet everyone deserved treatment. It was tough. Even Dr. Choi felt the pinch. Choi came in to work like it was any other day and he noticed that Maggie was trying to keep from handing over a patient's file. He soon managed to sneak it away from her. And that's when he noticed who the new patient came in with.
The patient came with April. April was at the hospital. She escorted her patient there because Brock's condition was serious and contradictory. He presented with symptoms of gastritis. Only he wasn't vomiting. He would have been sick if he actual had the condition and so something else was wrong with him. His physicians just didn't know what that could be and that's why they took him to the hospital. April could have taken him to another hospital, but she trusts Chicago Med. She told Maggie that she didn't want to run into Choi. That's why Maggie was trying to keep him away from Brock's patient file, but Choi saw April and there was no way he was walking away from this one.
Choi tested Brock. He couldn't find anything that stood out and so he ordered a couple of tests. He was waiting on the results, April was with her patient, and that's when they both heard the commotion. Someone began attacking the doctors. He was a new patient. He showed signs of being confused before he became violent. He began pushing people before escalating into flat-out assault. He beat up Dr. Archer really badly. He punched him several times. He also hit with him with an oxygen tank and several of those blows was to the head. Choi stepped in to keep the guy from killing his friend. They tussled for a bit until security finally showed.
The security team wanted to go straight for the tasers. It was April who stopped them because she reminded them that they could have hit Choi and that's when the intern stepped in. Dr. Zach Hudgins saved the day. He gave the patient an injection that quickly sedated him. With the guy finally down, the doctors were able to treat him. The patient's name is Devon. He was high on cocaine laced with PCP. He probably didn't even know about the PCP. He simply took the cocaine and he didn't know about the rest until he began having side-effects. And Devon was known to Dr. Taylor because they both went to medical school together.
Devon was also a drug dealer now. He was the one that got Taylor the medication she needed to give to her patients. But now she was worried. Taylor had to call the cops because Devon was on dangerous drugs and so her worry was more about a possible retaliation. She didn't want Devon to rat her out. If he told anyone that he gave her illegal prescription drugs, she might get into legal trouble. Taylor was worried if she told the cops about Devon's drugs that he would try to tell on her to get out of trouble himself only Dr. Halstead thought that was a risk worth taking. He reminded her that the dealer that sold Devon the cocaine could potentially kill someone with a bad batch. They had to consider the safety of the public.
Halstead was in just as much trouble as Taylor. He was in on the decision to give the patient illegal drugs. He didn't administer the drugs. He simply left out so that the patient's husband could give it to her. But Halstead and Taylor chose to play it safe. They alerted the detectives and they also mentioned what they did. They were in trouble with the cops as well as with Sharon Goodwin. She hated that they went rouge. She told them that they put the hospital at risk. She had thought that Halstead was over such risky behavior and yet here he was doing it all over again. It's like he never learned from his mistakes.
Speaking of mistakes, Dr. Archer had Dr. Asher treat him. The ED was full. He didn't want the intern doctor treating him and so he demanded that Asher treat him and that was a mistake. She was brusque with him. She also undermedicated him. He had to get snappy with her and demand medications. Archer had to be his own advocate. He wasn't the only one. There was a nice elderly woman who has been waiting for medical transport since the night before. No one showed to pick her up. She had to stay on top of the doctors and nurses to make sure that she got a ride. But the ride came too late. Eleanor was too sick to take the ride when it came.
Eleanor missed most of her daily medications. She also hadn't had anything to eat or drink in hours. She was dehydrated and in pain because her arthritis was acting up. When medical transport arrived, Eleanor said she just wanted it all to be over. Cuevas had to ask Charles if she was simply venting or did she just confess to wanting to self-harm. Either way, they still admitted her. They even had a fresh bed in the psych department because Charles tried to get treatment for someone struggling with the depression and that guy left before he could be treated. And Cuevas thought it was irony that Eleanor came because she fell and couldn't get up and ended up staying because she got sick at the hospital.
Choi meanwhile figured out what was wrong with Brock. Brock was struggling with a disease called MIS and it was a something he got after he had covid. But Choi also figured out that Brock was AWOL. He also chose not to call the MPs about it. He showed April that he changed and that was enough to reignite a spark. They went dancing out to a club afterwards. And they really reconnected.
As for two troublemakers, Halstead and Taylor aren't getting in trouble over what they did. The board decided to let it slide. Sharon warned him not to do it again. And Maggie told Halstead not to drag her daughter into his mess.
Dr. Marcel also pulled off a miracle rescue and he was able to salvage a pair of lugs for a patient of his and so he made history.
And Charles's patient did come back and now they were out of beds again.
THE END!
Chicago Med Premiere Recap 09/21/22: Season 8 Episode 1 "How Do You Begin To Count The Losses"
Chicago Med Recap 09/28/22: Season 8 Episode 2 "(Caught Between) The Wrecking Ball And The Butterfly"
Chicago Med Recap 10/05/22: Season 8 Episode 3 "Winning the Battle, but Still Loosing the War"
Chicago Med Recap 10/12/22: Season 8 Episode 4 "The Apple Doesn't Fall Far From the Teacher"
Chicago Med Recap 4/13/17: Season 2 Episode 20 "Generation Gap"
Chicago Med Recap 02/12/20: Season 5 Episode 14 "It May Not Be Forever"
Chicago Med Recap 03/18/20: Season 5 Episode 17 "The Ghost Of The Past"
Chicago Med Recap 04/13/22: Season 7 Episode 18 "Judge Not, For You Will Be Judged"

redpajama_set_name: RedPajamaCommonCrawl


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Chibchella är ett släkte av insekter. Chibchella ingår i familjen vårtbitare.

Kladogram enligt Catalogue of Life:

Källor

Vårtbitare
Chibchella

redpajama_set_name: RedPajamaWikipedia


Sized perfectly for kids up to 110 pounds.
The EVO S Junior is the next evolution in junior slalom ski performance.
Featuring quicker, more complete turns, this junior ski is a completely new shape designed specifically for our "up and coming" skiers.
The JR EVO is smooth and predictable with no surprises. While stability is the key ingredient in junior ski design, this ski also delivers top slalom course performance just like the adult version of the EVO. The JR EVO ski follows D3's most successful junior designs in history like the JR Nomad, JR Fusion and JR Quest.
Regardless of boat speed or line length, the JR EVO is designed to transport junior skiers to a whole new level of performance.
The 62.5" JR EVO features D3 standard insert pattern and does not require a special plate for the front binding.
Fast, stable, effortless and intuitive… that's the 62.5" JR EVO!
Balance rocker profile - The turns on both sides are quicker and more complete. Flat spot position allows skier to easily stay in the sweet spot.
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Accuset Fin Block - Accurate, three point set screw for easy fin adjustments and laser aligned fin position.
Machined screw inserts - To accommodate D3, HO, Reflex and most current binding hole patterns. NO special junior front binding plate required. All inserts are set in hard PVC anchor blocks for trouble free screw retention.


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A systematic review of epinephrine stability and sterility with storage in a syringe
Hannah G. Parish1,
Jacquelyn R. Morton1 and
Julie C. Brown1, 2Email author
Allergy, Asthma & Clinical Immunology201915:7
Epinephrine is a lifesaving medication in the treatment of anaphylaxis. Epinephrine auto-injectors are the preferred method of epinephrine administration, but are not universally available or affordable. Little is known about the effects on epinephrine when it is drawn up in advance and stored as prefilled syringes.
To study the stability and sterility of epinephrine when stored in syringes.
We searched Embase, Medline, and Web of Science in June 2016 for all studies of epinephrine stored in syringes in concentrations between 0.1 and 1 mg/mL that measured epinephrine stability and/or sterility over time, regardless of date published or language.
Three studies were included, one testing two concentrations of epinephrine. Only one study tested epinephrine 1 mg/mL, the concentration clinically relevant for intramuscular use during anaphylaxis. Neither this study nor the one study testing 0.7 mg/mL epinephrine found significant degradation after 56 and 90 days, respectively. One of the two studies testing epinephrine at a concentration of 0.1 mg/mL found significant degradation by 14 days; the other found no degradation up to 168 days. Two studies tested for bacterial growth, with none detected after 28 and 90 days, respectively. One study tested for fungal growth, with none detected after 90 days.
Limited evidence suggests that syringes filled with 1 mg/mL epinephrine are stable and sterile for 90 days. More research is needed testing the duration of stability and sterility of prefilled syringes with the 1 mg/mL concentration most commonly used in anaphylaxis, testing more extensively in different storage conditions and across a wider range of marketed syringe brands.
Prefilled
Sterility
Epinephrine is the only first-line therapy for anaphylaxis. Guidelines recommend that individuals with life-threatening allergies carry one or more epinephrine auto-injectors (EAIs) in case of contact with their allergen [1, 2]. However, in many parts of the world EAIs are unavailable or not readily accessible [3], and rising costs of EAIs, particularly in the United States, are creating a financial barrier for both private consumers and health care systems [4–7]. Patients may seek alternatives to the EAIs they need but cannot access or afford [4–7]. In some countries, insurance plans cover epinephrine in vials provided with syringes for self-preparation, but not auto-injector devices [8]. In pre-hospital and hospital settings, the high costs of EAIs has resulted in increased use of epinephrine in vials and ampules, drawn up into a syringe either in advance or at the time of use [9–11].
Parents and caregivers have difficulty drawing up epinephrine from a vial into a syringe accurately or reliably [12], as may patients themselves. Preparing and storing epinephrine in syringes in advance may decrease errors as well as ensure timely administration, compared with drawing up epinephrine at the time of need. This systematic review was performed to identify and evaluate all published studies on the stability and sterility of epinephrine when drawn up and stored in prefilled syringes.
The databases Embase.com, Medline in Ovid, and Web of Science were searched in June 2016 for relevant studies. This literature search was conducted following PRISMA guidelines [13]. No limits were applied to the searches except for the time constraints of the databases themselves. Medline contains literature from 1946 to the present, Embase.com from 1974 on, and Web of Science from 1985 on. In Medline and Embase, appropriate Medical Subject Headings (MeSH) or Emtree headings were used, respectively, in addition to keywords and text words. Medline and Embase were searched by our experienced librarian (J.R.M.) for the keywords epinephrine or adrenalin in combination with syringe, "pre-filled", or prefilled. Web of Science was searched for the keyword syringe* in combination with epinephrin* or adrenalin* in the title. All studies captured in the search were imported into an electronic reference manager for management and review. Duplicates were removed using the "Find Close Duplicates" function in the reference manager, which was checked manually to ensure that no studies were incorrectly removed. Duplicates that were not identified electronically due to slight formatting differences between databases were manually removed during first review and accounted for in the total number of duplicates. Potentially relevant articles in other languages were translated into English using Google Translate. All potentially relevant English language studies were searched forward in Web of Science in order to find newer sources in which the original ones were cited. The references of all potentially relevant English language studies were reviewed to search for additional relevant studies.
Included studies assessed epinephrine in clinically relevant concentrations between 0.1 and 1 mg/mL that had been drawn up into prefilled syringes. In the United States and Canada, epinephrine as an anaphylaxis drug is commercially available in EAIs in two concentrations, 1 mg/mL and 0.5 mg/mL [14, 15]. When epinephrine is administered intramuscularly during anaphylaxis using a needle and syringe, as is often done in the hospital setting, it is typically drawn up from a vial or ampule with a 1 mg/mL concentration. Epinephrine at a concentration of 0.1 mg/mL was also considered clinically relevant due to its use as a cardiac resuscitation drug. Included studies reported epinephrine concentration at each time point as any of: (a) the percent of the labeled dose, based on manufacturer's standards, (b) the relative percent of the initial dose measured at the start of the study, or (c) the relative percent of a control dose. Included studies described storage of epinephrine in accordance with commercial manufacturer guidelines, which recommend 1 mg/mL epinephrine ampules, vials, and auto-injectors be stored at controlled room temperature (defined as 20 °C to 25 °C, with a mean kinetic temperature not more than 25 °C and excursions permitted between 15 and 30 °C) and protected from light [14–21]. Included studies contained epinephrine as the only active ingredient in the syringe (other than drug stabilizers, such as sodium bisulfite or sodium metabisulfite; simple buffers, such as hydrochloric acid; and salts such as sodium chloride); therefore, studies that tested a mixed solution of epinephrine and another active ingredient (e.g. lidocaine with epinephrine) were excluded. Studies were excluded if the epinephrine tested exceeded the expiration date prior to or during the course of the study.
One investigator (H.G.P.) reviewed all study titles and abstracts to identify potentially relevant studies. These resulting studies were reviewed by two investigators (H.G.P. and J.C.B.), who each read the full text independently to determine eligibility. The rationale for excluding each potentially relevant study was discussed to confirm consistent reasoning. Any discrepancies in inclusion were resolved through discussion. Data including measured epinephrine concentrations at each time point, results of statistical tests, notes on other degradation tests or solution appearance, results of sterility testing, sample sizes for each test, timing of each test, and characteristics of the epinephrine source, syringe and needle, syringe preparation conditions, and storage conditions were collected from each included study independently by two investigators (H.G.P and J.C.B.). Any discrepancies in data collection were resolved through discussion and re-examination of the study. When relevant study details were missing from an included study, attempts were made to contact the corresponding author of the study to obtain these details. The concentration of epinephrine remaining at each time point was recorded for all studies as either the percentage of labeled dose of the test sample or the mean percentage relative to an initial dose, based on which information was available.
Literature searches resulted in 209 studies from Medline, 396 studies from Embase, and 17 studies from Web of Science. Of these, 156 studies were duplicates between the databases, yielding 466 unique studies. There were 454 studies excluded on first review based on titles, abstracts, or articles that clearly indicated non-relevance, leaving six potentially relevant studies published in English [11, 22–26] and six published in other languages. The six English language studies were then searched forward in Web of Science, yielding nine new studies. All nine were excluded on first review. The references of the six English language studies were then reviewed, yielding no additional relevant studies. The six potentially relevant English articles underwent further review, and three of these studies were determined to be eligible for inclusion (Fig. 1) [11, 22, 24]. Of the three studies excluded at this stage, one was excluded because the epinephrine was stored in a continuously infusing syringe pump system rather than a simple syringe, which was excluded due to the mobile nature of that system [23]. Another study was excluded because the syringes were stored in incubators at 38 °C, which is well above the recommended storage range for epinephrine [25]. The third excluded study diluted the 1 mg/mL epinephrine to a 1 in 100 solution before storage in sterile plastic syringes, making the concentration of epinephrine stored too low for inclusion [26]. The six studies published in a different language (three in French [27–29], one in Dutch [30], one in Spanish [31], and one in Danish [32]) were translated from their respective languages into English using Google Translate and reviewed by two authors. None of these six studies were determined to be eligible for inclusion.
Flowchart of study selection
Ultimately, three studies were included in this review (Fig. 1) [11, 22, 24]. There were no differences to resolve regarding study eligibility or data abstraction. The characteristics of the included studies are shown in Table 1.
Characteristics of included studies
Epinephrine source concentration (mg/mL)
Epinephrine source container
Epinephrine source manufacturer and location
Storage syringe and needle type
Syringe manufacturer and location
Preparation/transfer conditions
Varying conditions studied
Donnelly [22]
Parke-Davis Limited; Scarborough, Ontario, Canada
10 mL sealed glass vial, or 10 mL plastic syringe with 18G needle attached and capped
Glass vials: Miles Incorporated; Spokane, Washington, United States
Plastic syringes: Becton, Dickinson and Company (BD); Franklin Lakes, New Jersey, United States
Epinephrine diluted with sterile water to 0.1 mg/mL or 0.7 mg/mL before transfer to syringe or vial
Stored protected from light and at room temperature
Storage container: sealed glass vial vs plastic syringe with needle attached
Kerddonfak [24]
Government Pharmaceutical Organization; Bangkok, Thailand
Disposable plastic 1 mL syringe with 23G needle attached and recapped
Nipro; Osaka, Japan
1 mL of epinephrine transferred into syringe under either laminar flow hood or open air, then air bubbles removed from syringe
Stored in pencil box to protect from light, storage at ambient room temperature (26 ± 3 °C, measured at 8–9 a.m.)
Transfer conditions: laminar flow vs open air
Zenoni [11]
Monico; Venice, Italy
1 mL Luer-lock polycarbonate latex-free syringe with no needle attached, sealed with a plastic cap
BD; Republic of Singapore
Epinephrine diluted with pyrogen-free water to 0.1 mg/mL and transferred into syringe in contamination controlled environment
Stored in heat-sealed light-proof plastic pocket, at room temperature (20–24 °C) or 2–8 °C
Storage temperature: 20–24 °C vs 2–8 °C
vs versus
The three included studies tested the epinephrine samples for degradation after different storage times, as shown in Table 2. In all three studies, there were multiple study arms being compared. In two cases, one arm of the study met inclusion criteria but the other did not. When this occurred, the study was included and the excluded arm was presented in Table 2 in italics, for comparison purposes.
Stability of epinephrine in prefilled syringes
Concentration of epinephrine (mg/mL)
Variable conditions
# of samples in study arm
Time period of storage (24 h days)
Mean percent of initial (or labeleda) dose remaining (%)
Significance test used
Significant degradation of epinephrine concentration? (yes/no)
Stored in plastic syringe
96.0 ± 1.01
Clinical significance: < 90% of mean initial dose remaining
No other signs of degradation noted; all solutions remained clear and colorless; needles capped
Stored in glass vial
Prepared under laminar flow hood
Clinical significance: < 90% or > 110% of labelled dose remaining
No other signs of degradation noted in samples; norepinephrine not detected in any sample; brown particles found at needle cap in some syringes; solutions were pink-brown at 4 months
Prepared in open air
Storage at room temperature (20–24 °C)
90 ± 1.2
Statistical significance: one-way ANOVA; Clinical significance: < 90% of labelled dose remaining
Statistically yes (compared to refrigerated storage, p < 0.002); clinically no
No other signs of degradation noted: no degradation products detected, no changes in color or clarity visualized
Storage at 2–8 °C
104 ± 0.1
aStudy measured percent of manufacturer's labeled dose
b4 samples were obtained from 2 syringes or vials tested in duplicate
c2 samples were obtained from 1 syringe tested in duplicate
Only one study evaluated 1 mg/mL epinephrine, as would typically be used to treat anaphylaxis [24]. No significant epinephrine degradation was found in prefilled syringes at any time point up to the 3 months of storage studied.
One included study compared the stability of epinephrine stored in prefilled syringes between two different concentrations of epinephrine [22]. This study found that 0.7 mg/mL epinephrine remained stable for the 8-week duration of the study, whereas 0.1 mg/mL epinephrine showed clinically significant degradation by 14 days. The syringes were stored with 18G needles attached, which exposed the epinephrine in the needle to air during storage. Another included study evaluated 0.1 mg/mL epinephrine and found no clinically significant degradation at any point over the 24-week duration of the study [11]. In the latter study, the syringes were stored without needles, tightly sealed with a plastic cap, and protected inside a heat-sealed light-proof plastic pocket.
Two of the three included studies performed tests to determine the sterility of the prefilled syringe samples during the study period (Table 3) [11, 24]. Kerddonfak tested for gram-negative bacteria, gram-positive bacteria, and fungal cultures after 1, 2, and 3 months of storage and detected no growth in any sample, regardless of whether the samples were prepared under a sterile laminar flow hood or in open air. In a few syringes, some brown particles were found at the needle cap after storage. These particles were cultured and found to be neither bacterial nor fungal, and were hypothesized to be from a reaction between epinephrine and the air at the needle cap. Zenoni performed particulate testing, limulus amebocyte lysate (LAL) testing for the presence of endotoxin, and visual inspection of the solutions at time zero and after 4 weeks (timing and methods verified by personal communication) and all tests were negative.
Sterility of epinephrine in prefilled syringes
Type of epinephrine container used
Total # of samples tested
Sterility tests performed
Time at which sterility tested
Plastic syringe
Glass vial
1-mL disposable syringe, prepared under laminar flow hood
6 syringes (2 per time point)
Tests for gram-negative bacteria, gram-positive bacteria, and fungal cultures
Syringes (1 mL each) tested for bacteria on blood agar incubated at 35 °C in air and for fungal cultures on brain heart blood agar incubated at 37 °C and sabouraud dextrose agar incubated at 37 °C
At each time point (after 1, 2, and 3 months of storage) for both conditions
No aerobic bacterial or fungal growths in any sample
1-mL disposable syringe, prepared in open air
1-mL polycarbonate syringes
6 syringes (2 at time zero, 2 stored at room temperature, and 2 stored at 2–8 °C)
Tests for sterility, absence of bacterial endotoxin, and the rate of particle contamination
Particulate test according to European Pharmacopeia, limulus amebocyte lysate (LAL) test for the presence of endotoxin, visual examination of the solution
At time zero and after 4 weeks
All tests negative: bacterial contamination absent, endotoxin levels < 0.125 EU/mL, no visually detectable changes in color or clarity of solution, invisible particle count (< 10 μm and < 25 μm) below detectable limits
The incidence of allergies and anaphylaxis continues to increase worldwide, especially among children [33]. Epinephrine is a critical life-saving therapy for anaphylaxis and must be readily available to those at risk in order to reduce morbidity and mortality [1]. EAIs are the preferred administration method for epinephrine due to their relative ease of use and proven stability [1, 34]. EAIs contain epinephrine in a sealed container that protects the drug from exposure to oxygen and light, allowing the epinephrine to remain pharmacologically stable for at least 1 year after the device is produced. Some studies have indicated that epinephrine stored in EAIs may remain stable and clinically usable for much longer than 1 year, although results vary by device and between studies [35–37]. Auto-injector devices reduce errors by eliminating some of the variables of administering the drug, such as determining the correct dose [12, 38]. The EAI user does not have to see the needle prior to use, or be experienced in how to self-administer a medication using a needle and syringe, potentially reducing barriers to use [39].
The prospect of administering epinephrine safely without an EAI raises concerns among doctors and patient advocates, who believe it is more complicated to administer the correct dose safely using a syringe and needle [5]. However, patients and providers have had to consider this alternative in many parts of the world where EAIs are unavailable or cost-prohibitive. As of 2007, auto-injectors containing 0.3 mg of epinephrine were officially available in only 39 countries worldwide (20% of the 195 countries) [3]. EAIs with doses appropriate for infants were not available in any country at that time, although a 0.1 mg EAI with a shorter needle was recently marketed in the United States [40]. Even in areas where auto-injectors are distributed, they may not be accessible to all patients at risk of anaphylaxis. EAIs are potentially cost-prohibitive, particularly in the United States, where escalating EAI costs, rising insurance deductibles for many patients, and varying coverage of EAIs makes for a complicated system for consumers to navigate successfully [41]. The use of a syringe and needle to deliver epinephrine is an inexpensive alternative in these cases [7] and also allows for customizable doses and needle lengths, which may benefit patients for whom the standard needle length of an auto-injector is too short (resulting in subcutaneous injection) or too long (resulting in injection into bone) [42]. However, a patient or caregiver may be unable to quickly and correctly draw up a dose of epinephrine during the stress and time constraints of an anaphylactic reaction [12, 43].
Prefilled syringes can be prepared in advance, either in clinic or in a pharmacy, for the patient to take home. Transferring epinephrine from an ampule or vial into the syringe potentially exposes the epinephrine to oxygen, which could accelerate degradation. The medication also potentially risks contamination during transfer. Although evidence is limited, the results of this systematic review suggest that epinephrine prefilled syringes, in concentrations typically used in anaphylaxis, appear to be a viable alternative to EAIs. Under recommended storage conditions, 1 mg/mL epinephrine is stable in a syringe for at least 3 months [24] and 0.7 mg/mL epinephrine is stable in a syringe for at least 8 weeks [22]. An additional study by Rawas-Qalaji et al., excluded from this review based on prolonged high heat exposure, showed similar stability of epinephrine. In this study, syringes containing 1 mg/mL epinephrine and stored at 38 °C still delivered at least 90% of the label dose after 2 months of storage in low humidity or 3 months in high humidity [25]. These results are especially notable because high storage temperatures are expected to accelerate degradation of epinephrine compared to room temperature storage [44].
Donnelly's study was the only one which compared the stability between two different concentrations of epinephrine stored in prefilled syringes [22]. This study found that 0.7 mg/mL epinephrine remained stable for the full 8 weeks of the study, while 0.1 mg/mL epinephrine showed clinically significant degradation by 14 days. These results suggest that higher concentrations of epinephrine are more stable in syringes over time. The stability of 1 mg/mL epinephrine in Kerddonfak's study further supports this idea [24]. However, another study did not find any clinically significant degradation of 0.1 mg/mL epinephrine in prefilled syringes over 24 weeks [11], indicating that different storage conditions may have an impact on stability of epinephrine regardless of concentration.
Each study stored the epinephrine-filled syringes in a slightly different way, which may have contributed to the variation seen in the results. In Donnelly's study, in which the 0.1 mg/mL epinephrine samples demonstrated significant degradation past 7 days of storage, capped needles were attached to the epinephrine prefilled syringes during storage. The needle allowed air exposure during storage that may have contributed to the degradation of epinephrine seen in this study [22]. In Zenoni's study, which also tested 0.1 mg/mL epinephrine, the syringes were stored without needles attached, sealed with a plastic cap, and kept inside a sealed, light-proof plastic container. In this study, no significant degradation of epinephrine was detected over 24 weeks of storage [11]. This more rigorous storage process may have reduced air exposure and minimized the impacts of light, moisture, and oxygen on the degradation of epinephrine.
Zenoni additionally compared storage of 0.1 mg/mL epinephrine at room temperature to storage in a refrigerator (2–8 °C) [11]. Storing epinephrine prefilled syringes at 2–8 °C resulted in significantly higher concentrations of epinephrine compared to the syringes stored at room temperature over the course of the 24-week study, although neither group showed clinically significant degradation (epinephrine concentration below 90%) by 24 weeks. Although epinephrine is recommended for storage at room temperature in the United States, studies on epinephrine stored in cold temperatures, including freezing, have found no significant degradation, even up to a full year of storage [44].
Neither of the two studies testing for bacterial growth [11, 24] nor the one study testing for fungal growth [24] identified any contamination. In addition, another study demonstrated that prefilled syringes containing 1 mg/mL epinephrine remained sterile after storage in contaminated soil, whereas epinephrine ampules, needles, and syringes stored separately in the same contaminated soil before combining them for use resulted in contamination of six out of 10 solutions [45]. Prefilled syringes may offer a more sterile solution in the community than providing an ampule, needle, and syringe. However, the testing performed in these studies was on a very limited number of samples (Table 3) and only up to 3 months of storage, and therefore cannot be extrapolated to the long-term sterility of all epinephrine syringes. Any prefilled syringes distributed to patients or used in the hospital setting would need to be properly tested for sterility as would be expected for a commercial product distributed under national guidelines.
The idea of using prefilled syringes to treat anaphylaxis is not new: a paper published in 1975 describes kits containing antihistamine tablets and a preloaded syringe of epinephrine available by prescription [46]. While an epinephrine prefilled syringe was recently approved by the United States Food and Drug Administration and brought to market in clinical settings [47], general inaccessibility of affordable epinephrine devices has led to "off-label" use of epinephrine prefilled syringes in many allergists' offices of the United States (personal communication), and in community and hospital environments around the world. In countries where diluted (0.1 mg/mL) solutions of epinephrine are unavailable, stock epinephrine may be routinely diluted and stored in syringes as ready-to-use preparations in the hospital setting [11]. While there are United States Pharmacopeia standards for compounded medications allowing only 1–3 days of storage (depending on conditions) after compounding [48, 49], we are unaware of any industry standards specific to drawing up epinephrine or other medications without compounding or dilution, and intended for intramuscular use. There have been reports of infections associated with medications stored in syringes and then delivered intravenously [50], but we are unaware of any infections associated with intramuscular use of syringes. There has, however, been one reported Clostridial infection following an EpiPen injection in a thigh [14], suggesting that this potential exists.
Prefilled syringes are inexpensive and allow the provider to tailor the dose and needle length to meet the patient's needs. However, prefilled syringes might be most valuable in pre-hospital and hospital settings, where the high costs of EAIs has resulted in increased use of epinephrine in syringes, most commonly drawn up from ampules or vials at the time of use [9, 10, 51]. Epinephrine prefilled syringes may be a better alternative to drawing up epinephrine at the time of need, as drawing up doses using an ampule and syringe under time pressure is prone to errors even among medical professionals [12]. Thus, stocking prefilled syringes in the medical setting, ideally with a range of weight-based doses, might minimize errors and potentially reduce the time taken to get epinephrine to a patient experiencing anaphylaxis. Storing resuscitation medications in color-coded prefilled syringes has been shown to reduce administration time and errors among emergency medical professionals [52].
To date, there is no definitive evidence to suggest how long 1 mg/mL epinephrine prefilled syringes are stable or sterile, as the current research has only indicated stability and sterility for up to 3 months. This potentially limited time to expiration may be problematic particularly in the community setting, where patients might not reliably change out their medication on time. Prefilled syringes also require protection from light exposure and must be stored in a container that prevents the syringe plunger from being unintentionally depressed prior to use, limitations that must be addressed before prefilled syringes can be a feasible storage mechanism for ready-to-use epinephrine.
Limitations of the research
In order to find every potential study, we did not limit the results of the literature search to English. We used Google Translate to translate the six non-English studies found in the search. We did not verify that our translations were correct with someone fluent in each language, so we may have missed pertinent information from these six studies. However, we do not believe that this is probable, given that none of these studies appeared relevant or remotely likely to be eligible for inclusion in this review.
In one study, mean storage room temperatures measured between 8 and 9 a.m. were 26 ± 3 °C [24]. Daily temperatures could have exceeded recommended room temperature ranges (20–25 °C, with excursions allowed up to 30 °C but a 24-h mean of no more than 25 °C) [14–21]. Since no 24-h mean temperature was provided in the study or was available after personal communication with the author, we decided that we did not have sufficient evidence that the mean daily temperatures exceeded those allowed under manufacturer recommended storage temperatures, and concluded that this study was eligible for inclusion. Fortunately, the possible heat exposure in this study does not appear to have impacted study conclusions. If the epinephrine had been exposed to excessive heat during the study, it would have been expected to cause increased degradation of epinephrine, which was not seen.
All three of the authors we attempted to contact replied (Benjaponpitak, Invernizzi, Donnelly), and two (Invernizzi and Donnelly) were able to provide additional information. However, no study was excluded based on lack of information.
Only three studies were eligible for this systematic review, and only one eligible study tested epinephrine at the 1 mg/mL concentration that would be appropriate in an epinephrine prefilled syringe for use in anaphylaxis [24]. Only a small range of different syringe brands were tested; results could vary by syringe type and storage conditions. Only two studies tested samples for bacterial contamination and one for fungal contamination. One of these studies tested 12 syringes total [24] and the other tested 6 syringes total [11]. These small sample sizes may have been insufficient to detect rare contamination events. Therefore, the implications of this systematic review are limited due to the small number of relevant studies.
EAIs are the preferred method for epinephrine administration during an anaphylactic event, and the ideal solution to their current inaccessibility is making the devices affordable and widely available in a range of doses and needle lengths that meet the needs of all patients with allergies. Epinephrine prefilled syringes for intramuscular delivery might offer an alternative when EAIs are not an option. They might also have a valuable role in prehospital and hospital care. Prefilled syringes have the potential to reduce dosing errors and decrease time to drug administration when compared with the traditional ampule, needle, and syringe method. Commercially-produced prefilled syringes may offer an even better alternative, if they remain affordable.
Syringes filled with 1 mg/mL epinephrine, the concentration typically used for anaphylaxis, have been shown by one study to be stable and sterile for at least 3 months [24]. One study has demonstrated that syringes containing 0.7 mg/mL epinephrine remain stable for at least 8 weeks [22], while the two studies examining 0.1 mg/mL epinephrine syringes show varied results [11, 22]. No study testing for sterility has found bacterial or fungal contamination of the prefilled syringes after storage for up to 3 months [11, 24], although this testing was limited to a small number of samples and may not reflect long-term sterility of all epinephrine prefilled syringes. More research is needed on the duration of stability and sterility of 1 mg/mL epinephrine prefilled syringes, as only one study thus far has examined this concentration of epinephrine that is relevant for the intramuscular treatment of anaphylaxis. If used, epinephrine prefilled syringes should be stored with sealed caps in light-blocking containers that prevent the syringe plungers from depressing, either at room temperature or refrigerated. They should be stored along with an appropriately sized needle in a sterile package, ideally along with alcohol swabs and gauze. As EAIs remain unaffordable and inaccessible for many patients, there may be an increasing place for these epinephrine prefilled syringes in the treatment of anaphylaxis.
EAI:
EMS:
HP reviewed all study titles and abstracts, reviewed full studies for inclusion, extracted data, and wrote the manuscript. JM performed the literature search to retrieve articles for review. JB reviewed studies for inclusion, extracted data, and assisted in writing and revising the manuscript. All authors read and approved the final manuscript.
HP has a Bachelor of Science in Biology and Public Health and is a Research Assistant at Seattle Children's Hospital. She has previously published a systematic review on epinephrine exposed to temperatures outside of the recommended range as first author. She has an additional work-in-progress on epinephrine auto-injector injuries reported to the Washington Poison Center.
JM is a Librarian at Seattle Children's Hospital. She is a skilled information specialist with over 30 years of experience in searching the biomedical literature databases to support patient safety, research, and publication in both health care delivery systems and the pharmaceutical industry.
JB is Co-Director of research for the Division of Emergency Medicine at Seattle Children's Hospital and is experienced in clinical research. She is/has been the lead investigator in a number of pediatric emergency department clinical studies. She is the 1st author on 13 peer-reviewed articles and 4 book chapters covering topics relative to pediatric emergency practice, most recently focusing on anaphylaxis and the use of auto-injectors. She has many additional works-in-progress, including the development and validation of a new clinical score for anaphylaxis. She led a multi-disciplinary team at her hospital through a rigorous clinical standard work process to standardize and improve anaphylaxis care. She was recently accepted for membership to the American Academy of Asthma, Allergy and Immunology. She actively pursues social media avenues for education and research, including Pinterest pages (324 followers) which focus on allergies and auto-injectors, the creation of over two dozen YouTube videos about epinephrine auto-injectors (over 380,000 views), and Twitter posts (nearly 1000 mostly allergy parent, allergist, and emergency provider followers). She uses social media as a platform to improve emergency care of anaphylaxis, and to lobby for improved epinephrine auto-injector quality, affordability, and access.
We would like to thank Brittany Switzer for her assistance with the preparation of this manuscript.
This review is a secondary analysis of data from other studies. When needed, corresponding authors were contacted for additional information as described in the study methods. The data that support the findings of this article are available from the respective corresponding author of each included study.
Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA
Department of Pediatrics, Division of Emergency Medicine, University of Washington, Seattle, WA 98195, USA
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Belcher Pharmaceuticals, LLC. Epinephrine injection USP, 1 mg/mL (1:1,000) ampule, prescribing information. 2016. http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/205029s004lbl.pdf. Accessed 1 Dec 2018.
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Thanks to Jamie & his team, of the Lake Country Log Homes!
Thanks to Jamie & his team at Lake Country Log Homes in Sicamous, B.C who built us our beautiful Custom Western Red Cedar Log Cabin Home. LCLH is the best. It would be a shame not to share photos of our home!


text:
Rumor: Cavs, Raptors interested in Dragan Bender?
G, Denver Nuggets
Isaiah Thomas played just 15 minutes in a home win over the Thunder on Tuesday, contributing 11 points and two threes.
It's a step back in minutes for Thomas, whose time has been limited since his return to the court. With serious depth all over the place on the Nuggets, it's going to be hard for IT3 to help fantasy teams on a regular basis.
Denver NuggetsIsaiah Thomas
Dragan Bender
PF, Phoenix Suns
As Dragan Bender continues to explore the NBA market, the Cavs and the Raptors are among the teams that have inquired about the former lottery pick.
The European market also remains an option for the Croatian forward as CSKA Moscow and Fenerbache are monitoring his situation. Bender is still only 21 years old and teams around the NBA could still take a chance on him after what has been a disappointing NBA career so far with averages of 5.3 points and 3.8 rebounds in 131 career games.
Source: Orazio Francesco Cauchi on Twitter
Dragan BenderPhoenix Suns


This check monitors the general status of the units attached to the Rittal CMC-III. The state given by the system is taken as the state of the check as follows: If the device returns lost or error, the check is CRIT. If the device returns detect, the check is WARN. if the device return changed or OK, the check is OK. Otherwise the check is UNKNOWN.


Afterschool Nanny sought to care for a primary school aged child in Hackney, London. The family is looking for someone who is positive, self-reliant and punctual. The working hours for this job would be every Thursday, ideally 3 pm to 7 pm. with additional babysitting when needed. Someone who speaks French would be a bonus but not a must.


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redpajama_set_name: RedPajamaGithub


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text:
Satu Kontinen
Estonian rights sold for ENCHANTED PLANET EARTH!
We are very glad to announce that Laura Ertimo and Satu Kontinen's ENCHANTED PLANET EARTH has an Estonian publisher: Avita!
Avita is the largest educational publisher in Estonia.
Previously the title with amazing maps and stories has been sold to Alfa in Turkey, AST in Russia and Eurograf in Poland.
Download the Full Finnish pdf and English sample for ENCHANTED PLANET EARTH here
ABOUT THE ENCHANTED PLANET EARTH:
There is a planet where plants plan world domination. Where beasts are good, and trees live for thousands of years, collecting memories in their bark. This enchanted place is Earth.
This book has 10 stories, and 10 maps. They may sound or look like they are out of a fairy-tale, but they are real, true maps of our planet. The Enchanted Planet Earth is a children's non-fiction book that also engages adults. Through magical maps it teaches about nature, oceans and the history of continents. The stories also provide a context where adults and kids can discuss the environmental issues and how people's actions affect nature. Through narratives the book explains the real processes that change our planet and make the Earth habitable.
The maps in the book include:
Hidden by Earth – Treasure Map
Invisible World – Underwater
Stormy Weathers – A different climate map
Meeting of Trees – The oldest forests and trees
Plant Love – Map of Flowers
Story of the Kind Wolf – Map of Extinct Animals
Travelling Animals – Migration map
Fairies and Goblins – Map of the Little Folk
Stories of Travel and Travelling Stories – Travel Map
Changes – Map of Disappeared Things
Visions from outer Space – Small maps of moving continents
FINLAND (orig.):
Kustantamo S&S
ESTONIA: Avita
POLAND: Eurograf
RUSSIA: AST
TURKEY: Alfa
Laura Ertimo
Laura Ertimo is a geographer and author. She has previously worked in publishing of geography-related non-fiction and maps, and now she writes full time, specializing in children's non-fiction. A recurring theme in her work is the holistic worldview, the interaction between phenomena, people and nature.
In 2020, she received the prestigious Tietopöllö Award for her work as a Non-Fiction writer. Her children's title WHERE DID THE ANIMALS GO, illustrated by Mari Ahokoivu, was nominated for the 2021 Finlandia Award and has also won the Tieto-Lauri award!
The Tietopöllö award jury: Laura Ertimo knows how to sum up difficult things appropriately in the blink of an eye. Her works can provide information and joy to a wide range of readers, and they also attract people of all ages to delve deeper into the book and consider even difficult issues together. Laura Ertimo's books open paths to important and current topics.
The Tieto-Lauri award jury: Children today grow up among worldwide ecological crises. It presents a great challenge for nonfiction literature: how to tell children about the complex phenomena in an easily understandable way and give factually based hope that even the hardest crises can be solved. Ertimo and Ahokoivu have successfully taken on this challenge.
Satu Kontinen is a graphic designer and illustrator obsessed with flowers. She is known for her detailed ink works as well as creating quirky creatures and imaginary worlds that spark the imagination of kids and adults alike. She has been awarded for designing and illustrating one of the most beautiful books/book covers in Finland (_Vuoden kaunein kirja_ by the Finnish Book Art Committee) in 2008, 2015, 2016 and in 2018. In 2004 she was nominated for the Finlandia Junior Prize and in 2017 she was one of the top 10 finalists in the prestigious Rudolf Koivu illustration awards. In 2020 she was given a Merit Award in the Three x Three International Illustration Awards.
In her free time Satu enjoys designing floral fabrics and writing children's and YA fiction in secrecy. Maybe some day she will show them to a publisher.
Latvian rights sold for WEIRD WEATHER! Turkish for ENCHANTED PLANET EARTH!
Today we are very glad to announce that Laura Ertimo and Mari Ahokoivu's WEIRD WEATHER has now sold to Latvia – the happy publishing house is Jumava!
This paramount title about climate change has now already sold to 15 territories!
Download the full English pdf for WEIRD WEATHER here
Also, Laura Ertimo and Satu Kontinen's ENCHANTED PLANET EARTH now has a Turkish publisher: Alfa publishing house! Previously the title with amazing maps and stories has been sold to AST in Russia and just last week to Eurograf in Poland.
We are also excited to share for the first time full English pdf for very timely MINI SCIENCE 2: INVISIBLE WORLD – another very important title by Laura Ertimo, illustrated by Sanna Pellicioni.
The book teaches small children about invisible things – imaginary friends, bacteria and viruses. It also covers the very important topic of vaccinations and how to behave when you are sick.
Download the full English pdf for this timely title here.
ABOUT WEIRD WEATHER:
Climate changes, why don't we?
Weird Weather! is accurate but hopeful children's nonfiction that explains how humans are responsible for climate change and what we can do to ensure a brighter future. It also gives tips on how everyone can make better choices and practice climate skills every day. But climate change won't be beaten with tiny tricks, and this book also encourages talking to children about how to make changes in society, and how working together can change everything.
The maps in the book include: Hidden by Earth – Treasure Map, Invisible World – Underwater, Stormy Weathers – A different climate map, Meeting of Trees – The oldest forests and trees, Plant Love – Map of Flowers, Story of the Kind Wolf – Map of Extinct Animals, Travelling Animals – Migration map, Fairies and Goblins – Map of the Little Folk, Stories of Travel and Travelling Stories – Travel Map, Changes – Map of Disappeared Things, Visions from outer Space – Small maps of moving continents
ABOUT MINI SCIENCE SERIES:
Mini Science is a new nonfiction series for the smallest in the family. The series will tackle big science questions with lovely illustrations, and encourages kids to wonder and ask questions. It feeds curiosity and is designed to start conversations about different topics that children might not think about on their own.
In #1 Where Are You? we follow Plop, a little creature who guides us through space to the Earth and from there to the human DNA and finally to the world of atoms. Zooming in all the way from the enormities of space to the minisculness of atoms, we learn a great deal in between.
In #2 Invisible World Plop will discover the things one cannot see: electricity, garden in the fog, darkness, micro-organisms and other invisible things.
When Plop will get sick, he will learn about bacteria and viruses and how to avoid them. Vaccinations can seem scary, but they keep us healthy!
Sometimes it's better to stay home, even if this makes you bored, so that soon you could go discovering the Dark Side of The Moon!
Mari Ahokoivu
Mari Ahokoivu is a Finnish illustrator and a comics artist. She's been drawing professionally for over 10 years, mainly drawing graphic novels and comics for children, including Sanni & Joonas and Lola Olifante. Ahokoivu loves everything cute and scary. She lives and works in Copenhagen. Mari Ahokoivu has illustrated WHERE DID THE ANIMALS GO which was nominated for the 2021 Finlandia Award and has also won the Tieto-Lauri award!
Sanna Pelliccioni
Sanna Pelliccioni is a Finnish illustrator, graphic designer and children's author living in Helsinki with her Finnish-Italian family. Pelliccioni utilizes many different techniques in her illustrations, some of her favourites are collage and mixed techniques. She studied Arts and Illustration in Bologna and Macerata, Italy, and Graphic Design at the Pekka Halonen Institute in Finland.
She loves illustrating picture books and poems and making graphic design for book covers and her own books. She also writes for children and young people and concerning the themes of books she's especially interested in equality, indigenous people, myths and taboos, forest and nature. Pelliccioni is mostly known for her Onni-poika picture book series which started in 2007 and contains 15 books so far.
Pelliccioni collaborates with authors writing for children and young people and works with many Finnish editors. Some of her books have been translated to Chinese, Korean, Arabic, English and Swedish, Turkish and Estonian.
Polish rights sold for ENCHANTED PLANET EARTH!
Today we are extremely happy to announce that Laura Ertimo and Satu Kontinen's ENCHANTED PLANET EARTH now has a Polish publisher.
The happy publishing house is Eurograf. Previously the rights for this wonderful children's atlas have also been sold to AST in Russia.We are happy to be the future publisher of this beautiful book. Those maps of the enchanted planet Earth will help children learn a lot more about our planet and will fascinate the adults, too. We feel that such wonderful books may become even more important in this time of uncertainty to show us that life on the planet Earth still goes on and on.
– Anastasia Filippova, AST Publishing Group, Russia
Ask the Full Finnish pdf and English sample by clicking here
Stories of Travel and Travelling Stories
a map from ENCHANTED PLANET EARTH
ABOUT THE AUTHORS:Laura Ertimo is a geographer and author. She has previously worked in publishing of geography-related non-fiction and maps, and now she writes full time, specializing in children's non-fiction. A recurring theme in her work is the holistic worldview, the interaction between phenomena, people and nature.
Satu Kontinen is a graphic designer and illustrator obsessed with little animals and Instagram photography. She is known for using bold colours and creating quirky creatures and worlds of cuteness that spark the imagination of kids and adults. In 2008 she was given an award for designing and illustrating one of the most beautiful book covers in Finland (Vuoden kaunein kirja) by the Finnish Book Art Committee, and in 2004 she was nominated for the Finlandia Junior Prize.
Russian rights sold for ENCHANTED PLANET EARTH
Today we are very happy to announce that Laura Ertimo and Satu Kontinen's ENCHANTED PLANET EARTH now has a Russian publisher.
The publishing house is AST – one of the biggest publishers in Russia.
Here is what they said about the title:
"We are happy to be the future publisher of this beautiful book. Those maps of the enchanted planet Earth will help children learn a lot more about our planet and will fascinate the adults, too. We feel that such wonderful books may become even more important in this time of uncertainty to show us that life on the planet Earth still goes on and on."
ENCHANTED PLANET EARTH
by Laura Ertimo, illustrated by Satu Kontinen
This book has 10 stories and 10 maps. They may sound or look like they are out of a fairy-tale, but they are real, true maps of our planet. The Enchanted Planet Earth is a children's non-fiction book that also engages adults. Through magical maps, it teaches about nature, oceans and the history of continents. The stories also provide a context where adults and kids can discuss environmental issues and how people's actions affect nature. Through narratives, the book explains the real processes that change our planet and make the Earth habitable.
FINLAND (orig.): Kustantamo S&S
MARESI is now sold to 24 territories! Excellent reviews for LITTLE MOUSE'S SUMMER, AGNES and ENCHANTED PLANET EARTH!
MARESI is now sold to 24 territories!
Excellent reviews for LITTLE MOUSE'S SUMMER, AGNES and ENCHANTED PLANET EARTH!
We are very happy to announce that MARESI by Maria Turtschaninoff has now been sold to 24 territories!
The Azerbaijani rights were bought today by Alatoran. Rights were also recently acquired in Bulgaria by Izida.
This bestselling YA title has sold to already 24 territories, but the rights are still available in Russia, Czech Republic, Greece, Lithuania, Slovenia, Japan, Portugal, Croatia and in many other countries. See the rights sold list.
MARESI is the first title in The Red Abbey Chronicles and an international feature film is under development by Film4/The Bureau.
MARESI RED MANTLE, book 3 in the trilogy, was awarded earlier this month the 2020 Global Literature in Libraries Translated Book Prize, as the best translated book of the year!
Request the full English PDFs for the trilogy by clicking here.
About THE RED ABBEY CHRONICLES: The Red Abbey is a refuge for women and girls, where everyone pursues their own areas of interest. Maresi prefers to spend her time reading and learning. Everything changes when the frightened Jai arrives on the island. She has seen her sister get buried alive for speaking to a young man, and her father and a crew of thugs are after her. Maresi and her friends have to fight to defend both Jai and their community.
Meanwhile, Finland's biggest daily Helsingin Sanomat has reviews for just-published children's titles LITTLE MOUSE'S SUMMER, AGNES AND THE GARDEN OF DREAMS and ENCHANTED PLANET EARTH.
LITTLE MOUSE'S SUMMER
"Good-mood book for children and adults!"
– Helsingin Sanomat
The 6th title of Little Mouse picture book series deals with summer.
Summer holiday is full of fun: going to the amusement park, playing by the beach and visiting the art museum. Buying strawberries and ice cream, and going to the cinema when the weather is too hot. Little Mouse knows that one must enjoy the summer, because it doesn't last forever.
Ask for English materials here
"Text is flowy and interesting, but the illustrations make this surprising, almost lyrical!"
This book has 10 stories, and 10 maps. They may sound or look like they are out of a fairy-tale, but they are real, true maps of our planet. THE ENCHANTED PLANET EARTH is a children's non-fiction book that also engages adults. Through magical maps it teaches about nature, oceans and the history of continents.
Ask for English materials here.
AGNES AND THE GARDEN OF DREAMS
"Fast-paced mystery plot and relatable strong characters."
11-years-old Agnes has to move to a small countryside town with her mother. Her parents are divorced, and Agnes doesn't know anyone
from her new hometown. She is not having the best summer of her life.
But then something weird happens. Agnes finds an old tombstone that has her name and birthday engraved on it – only the birth year is different. Whose grave is it?
RED ABBEY CHRONICLES
Rights sold: for the series:
FINLAND (orig.)
CHINA (Simplified)
WORLD SPANISH
FILM RIGHTS
Rights sold for the series:
ESTONIA,


text:
Piper Perabo Is Engaged!
"Coyote Ugly" star Piper Perabo is set to walk down the isle with director boyfriend Stephen Kay, reports People.
"They're very happy," a source close to the couple told the magazine.
Kay is the director and co-executive of Perabo's USA Network series, "Covert Affairs," which is currently filming its fourth season. The actress' fiancé has also appeared as an actor on "General Hospital" and "Party of Five."
Perabo was nominated for a Golden Globe in 2011 for her work as a CIA agent on "Covert."
#CouplesNews #TopStories


Zéfiro was born in 2017 and groups DIANIME and ATARAINA brands.
Our activity focuses on the import of Japanese products to Europe, distributing to wholesalers and individuals.
We work together with ATARAINA as exclusive distributors of the brand in Europe.
Quality. Working with products that have quality standards above the average is a priority for us.
Security and Trust. Offering security to our clients is an important part of reaping a firm and lasting confidence. That is why it is always a matter of checking that the product maintains the characteristics that were offered before its sale, guaranteeing its similarity and quality.
Novelty. Exclusivity and Innovation. It is about constantly searching for unique and innovative products, both for the Spanish and Japanese markets.
Personalized service. A direct and effective service is a fundamental part to create a stable and effective link between companies.
Easy communication. Facilitate the connection and the deal between companies to make their negotiation more fluid.


Tiny Twig garments are made with super soft organic cotton that is kind & gentle on your precious babies' skin.
This suit feature a zip with a slider on both ends for easy changing. Also the cuffs on wrist and ankles can be turned to keep the little hands and feet warm.
The Pink Mellow print is very dainty and sweet.