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Lil Durk Wanted in Connection to Atlanta Shooting, Turns Himself In
Lil Durk Turns Himself In To Police ... After Arrest Warrant Issued In Connection With Shooting
5:52 PM PT -- Our law enforcement sources tell us Lil Durk just turned himself in to police.
Lil Durk is a wanted man in Atlanta, because a warrant has been issued for his arrest ... and we're told it's in connection with a shooting.
The Atlanta Police Department tells TMZ ... cops have obtained arrest warrants for Lil Durk, but the rapper is not yet in police custody.
Law enforcement sources tell us cops want to bring Lil Durk in to book him on 5 FELONY charges ... including criminal attempt to commit murder, aggravated assault, possession of a firearm during commission of a felony, possession of a firearm by a convicted felon, and another charge of associating with a criminal street gang to participate in a crime.
Lil Durk -- government name Durk Banks -- went on Instagram Wednesday night and said he's turning himself into police on Thursday ... but he hasn't done so yet.
As for the shooting, it's all detailed in a police report ... cops say officers responded to reports of a person shot around 5:45 AM Feb. 5 at a restaurant called The Varsity, where they found a man suffering from a gunshot wound. Police say they recovered 13 shell casings from a rifle and pistol at the scene and found a firearm.
According to cops, the shooting victim was rushed to a hospital and underwent surgery ... and we're told he survived.
Cops say they spoke to 2 witnesses and were told the victim appeared to be in a verbal dispute with an unknown black male before the shooting. Police say they've reviewed surveillance footage, and are still investigating.
Story developing ...
Kodak Black Arrested at Rolling Loud for Allegedly Lying On Gun Apps
Nipsey Hussle Dead at 33, Cause of Death Gunshots to Head and Torso
Weapons & Guns Crime & Arrests Crime Exclusive Music


My early morning walks continue, and throw up new challenges. As I make my way down the lanes many creatures dash away from me in terror, pigeons clatter out of trees, rabbits burst out of hedgerows, pheasants explode like rockets from the tall maize. It's all very disconcerting. I feel like some sort of ogre menacing their peaceful existence as I clomp by. But most disconcerting of all is the discovery that there is another human on the lanes, a fellow walker whose route follows mine. I come upon him at the halfway point for me, which is the village, from which he is presumably just setting out. He's a courteous elderly man with a stick, but not for all that a slow walker. Twice now he's appeared ahead of me. My own pace, being a little faster, means that I come up behind him like a mugger, and pass him slowly, and then feel his eyes on me for the next half mile. This is of course ridiculous. I should be happy to have company on my road. But I'm not. I feel aggrieved. I feel invaded. I feel the solitude of my early mornings has been compromised. There are cars that pass me, but they don't count. Cars aren't people. Another walker, on my route, going in my direction, at almost my pace – that's crowding me.
Virginia produced the obvious solution: go round the other way. This morning I did this. Setting off just after 6.30 I found that the sun had not yet risen, and I was walking into the sunrise. It was a crisp early morning, the air sharp, my hands chilly, the pre-sunrise sky pale blue, streaked with white cloud. This was a bonus that I had not expected. With each gap in the hedge I got a new glimpse of the brightening sky, until the sun itself appeared. And then so did my fellow walker – but of course, this time he was heading towards me. This was just fine. We passed, greeting each other, and he was gone.
As I looped back down the far side of the circular walk, there he was coming towards me once more. 'Ah,' he said, 'take care, you're going anti-clockwise.' 'But I'm walking into the sunrise,' I said.


ProcessUnity is looking for a dynamic individual with hands-on business, leadership, and technical implementation experience to join our Customer Success team focused on consulting and configuring solutions on the ProcessUnity risk and compliance platform. The ideal candidate will have strong communication skills, creative problem solving, and project management experience to support the company's growth in a customer-facing role. In this position, you will be a member of our Customer Success team but also interface with sales, marketing, finance, support, product, and engineering teams while developing deep technical expertise in ProcessUnity's software solutions to lead client implementations. Only confident, highly self-motivated candidates capable of coordinating multiple projects and priorities in a fast-paced environment should apply.
Manage and coordinate multiple customer implementations simultaneously as the implementation lead.
Gather customer requirements through interview and analysis and translate to ProcessUnity's capabilities.
Configure ProcessUnity's software applications for customers using a training and enablement approach.
Track project plans, and report project progress to appropriate parties.
Provide a mixture of remote and onsite customer implementation workshops.
Consult with customers on system configuration based on product and industry best practices.
Facilitate touchpoints and status meetings with customers in a timely and professional manner.
Work collaboratively with ProcessUnity Customer Success team members as needed.
Contribute to the development of best practices, project standards and methodologies to improve efficiency and effectiveness of implementations and team processes/policies/procedures.
Troubleshoot functional issues arising from implementations.
Escalate product issues when all avenues of resolution are exhausted.
BS/BA degree in Computer related discipline or equivalent experience.
Minimum 3 years of experience in client-facing roles.
Minimum of 1-2 years of experience in the implementation of software solutions.
Competency with spreadsheets (data manipulation, formula writing, CSV support, pivot tables).
Technical knowledge of fundamental database concepts.
Proficiency and experience with systems integration and report-writing software.
Approximately 10% – 30% travel.
Experience with VBA a plus.


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Overcoming Sickle-Cell Disease
In 2006, when Lindsy Osouna was on the cusp of her third trimester, prenatal testing showed that her daughter would be born with sickle-cell disease (SCD). "It was devastating," she says, "but we decided that we have to face this." After an intensive search, she and her husband, Kwasi, decided to entrust daughter Aniyah's care to the SCD specialists at Children's Hospital at Montefiore (CHAM), who collaborate with Einstein's SCD researchers. These experts are focused on gaining insight into SCD and developing new therapies to transform the way the disease is treated.
Today, Aniyah is a charming and vivacious 11-year-old, healthy enough to attend school and even participate in gym class. But as with virtually all kids with SCD, her childhood has been far from easy, despite significant improvements in the care of children with the disease over the past few decades.
Kids with SCD now receive penicillin as standard treatment to prevent blood infections, a common and potentially fatal complication. Repeated blood transfusions can help keep anemia in check. And the drug hydroxyurea reduces the frequency of debilitating pain crises. As a result, the vast majority of children with SCD survive into their 40s—a significant improvement compared with the life spans of children born with SCD just a generation ago. But more advances are needed.
"For kids born with SCD, a minor cold or infection can turn into a major health crisis, and a case of the flu can be deadly," says Henny Billett, M.D., professor of medicine and of pathology at Einstein and chief of the division of hematology at Einstein and Montefiore. "We've clearly got work to do to prevent these crises and to further extend the lives of SCD patients."
Aniyah's first crisis occurred when she was two and began gasping for breath. The Osounas rushed her from their home in Queens to CHAM, where they learned that her lungs were filling with fluid and verging on collapse due to acute chest syndrome, a potentially fatal pneumonia-like condition.
Her health stabilized after nine days, thanks to expert care from CHAM doctors and nurses—the type of care that should be available to all SCD patients but all too often is not. (See "Efforts to Increase Access," below.)
Aniyah would experience the same emergency just a year later. Over the ensuing years came headaches, stomach cramps, gallstones, fevers, painfully swollen joints, an enlarged liver and early signs of retinal disease. In her short life, Aniyah has faced more health issues than many a frail octogenarian.
The sickle-cell center at CHAM is helping Aniyah and some 650 other children and adolescents with SCD overcome such challenges. It focuses on offering the best evidence-based treatments, recognizing preventable complications as early as possible, providing support for affected families and teaching its young patients how to manage their disease.
Deepa Manwani, M.B.B.S., with Lindsy Osouna and her children, Aniyah and Tristan.
Sickle-Cell Disease Explained
Sickle-cell disease is a debilitating condition that affects approximately 100,000 Americans and occurs in about one in 365 African American births. The disease affects millions of people throughout the world, particularly those with ancestors from sub-Saharan Africa and Spanish-speaking regions of the Western Hemisphere (South America, the Caribbean and Central America).
People with SCD typically have inherited two mutated copies of the gene that codes for the beta subunit of hemoglobin, the protein in red blood cells that acquires oxygen from the lungs and carries it to tissues throughout the body. As a result, their hemoglobin differs by a single amino acid from "normal" hemoglobin. Individuals with a single errant copy of the gene carry the sickle-cell trait but do not develop SCD.
Blood cells normally are disc shaped, like a doughnut without a hole, which provides flexibility to the cells as they glide through blood vessels large and small. But in SCD, abnormal hemoglobin molecules aggregate to form filaments that distort red cells into their characteristic sickle shape.
How vessels get clogged in SCD: Sickled cells irritate and inflame a blood vessel's inner lining (1), which responds by producing cell-surface receptors called E-selectins that entrap white cells (2). Trapped white cells express activated Mac-1 adhesion molecules that bind sickled red cells, culminating in white cell/red cell clumps that hinder blood flow (3).
Sickled red cells are fragile and often burst, leading to anemia that reduces oxygen delivery to tissues. Even more important, their distorted shape makes the sickled cells sticky, causing vaso-occlusion—the clogging of small blood vessels that impairs oxygen delivery. Indeed, SCD is primarily a disease of oxygen starvation.
A chronic lack of oxygen causes organ damage that contributes to shorter life spans. Starting in early childhood, for example, SCD patients face a high risk of stroke due to faulty blood flow in the brain. (See "Silence of the Strokes," below.) But long before such problems occur, oxygen deficits caused by SCD can cause excruciating pain.
No Stranger to Pain
"I get a lot of headaches and stomach pain," says Aniyah matter-of-factly. "Sometimes my left arm hurts a little bit when I bend it." If she is like most other SCD patients, the pain from too little oxygen nourishing her tissues is much worse than Aniyah lets on.
The scientific term for a painful red-cell clogging episode is a "vaso-occlusive crisis," more commonly known as a sickle-cell crisis. It's characterized by pain in the limbs, chest, stomach or lower back that can last from hours to weeks. Sickle-cell crises are the main reason that SCD patients require hospitalization. And over time, the crises contribute to the tissue and organ damage that impair quality of life and increase the risk of death for patients.
Patients experiencing sickle-cell crises must make do with supportive measures such as over-the-counter pain medications, heat compresses or massage, with a significant number of patients turning to potent painkillers such as opioids, putting them at risk for addiction. Pain that becomes chronic, as it often does in adulthood, is even harder to treat.
EFFORTS TO INCREASE ACCESS
"Outside New York City and other major metropolitan areas, experts in sickle cell are hard to find," says Suzette Oyeku, M.D., M.P.H., associate professor of pediatrics at Einstein and chief of the division of academic general pediatrics at CHAM. "Many primary care providers have never even seen a child with SCD. This is a travesty. Access to proper care shouldn't be limited by your zip code." Dr. Oyeku recently participated in the Hemoglobinopathy Learning Collaborative, a group of 15 institutions around the country that was formed to reduce disparities in SCD care. The collaborative is part of the Sickle Cell Disease Treatment Demonstration Program, funded by the federal Health Resources and Services Administration. "Clinical trials tell us what therapies are effective," she says. "Our collaborative shows healthcare practitioners how they can implement these therapies in real-world settings."
As an example, Dr. Oyeku cites the underused drug hydroxyurea, which, among other things, reduces the number of pain crises experienced by SCD patients. It works by reactivating the body's production of fetal hemoglobin, which has an even higher affinity for oxygen than normal hemoglobin does. "But we've learned that many patients don't take hydroxyurea because of misconceptions about the risks and benefits or because it wasn't even offered to them," she says. "In response, we've developed decision-making tools that encourage families and providers to have conversations about hydroxyurea. This approach, along with other strategies, has increased the proportion of patients who are taking the drug." Other collaborative efforts include encouraging the use of telemedicine to bring hematology expertise to the hinterlands and developing expedited treatment protocols in emergency rooms to reduce the time that SCD patients must wait for pain relief.
"There's a dire need for new therapies for sickle-cell crises," says Deepa Manwani, M.B.B.S., who is Aniyah's physician as well as a professor of pediatrics at Einstein and the director of pediatric hematology at CHAM. The program's research arm is aimed at developing such therapies. One is a promising treatment for sickle-cell pain from the work of Einstein scientist Paul Frenette, M.D., professor of medicine and of cell biology and director of the Gottesman Institute for Stem Cell and Regenerative Medicine Research. Unlike opioid therapy used to dull pain, this approach instead blocks the underlying cause, which is vaso-occlusion.
In a 2002 PNAS paper, Dr. Frenette showed that sickled cells sticking to white cells and white cells sticking to the lining of blood vessels play a key role in vaso-occlusion. The process starts when sickled cells irritate and inflame the inner wall, or endothelial lining, of blood vessels, stimulating endothelial cells to produce cell-surface receptors called E-selectins. They entrap white cells, which in turn express adhesion molecules called activated Mac-1 that bind sickled red cells. The result: white cell/red cell clumps that cling to the lining of vessels and hinder blood flow (see illustration above).
To identify the specific adhesion molecules that cause cell clumping, Dr. Frenette added antibodies to blood to inactivate adhesion molecules one at a time and observe if vaso-occlusion occurred. Then he made an unexpected discovery: Unrelated antibodies he'd added for comparison purposes were preventing vaso-occlusion from occurring—suggesting that a widely available product rich in antibodies might help relieve sickle-cell crises.
The product, intravenous immunoglobulin (IVIG), is used to treat autoimmune diseases and has anti-inflammatory effects. Dr. Frenette's research group gave IVIG to an SCD mouse model experiencing potentially fatal sickle-cell crises. A 2004 paper in Blood reported that IVIG dramatically inhibited interactions between red and white cells, increased microcirculatory blood flow and extended animals' lives.
A phase 1 IVIG clinical trial directed by Dr. Manwani was completed in 2013. Children and adults admitted to CHAM and Mount Sinai for acute-pain crises were infused with varying doses of IVIG or a placebo solution. The trial yielded an IVIG dose that seemed well tolerated and effectively reduced activated Mac-1 adhesion molecules on white cells, making the cells less sticky.
In 2015, the National Institutes of Health (NIH) awarded Drs. Manwani, Frenette and colleagues a $1.6 million grant to conduct a phase 2 clinical trial assessing IVIG for treating sickle-cell patients eight to 21 years old admitted to CHAM with sickle-cell crises. The trial is assessing how well and how rapidly IVIG resolves pain crises and whether it helps reduce opioid use and the length of hospitalization.
Dr. Frenette's cell-adhesion findings contributed to another promising therapy for SCD crises. In the 2002 PNAS study cited above, Dr. Frenette used a mouse model of SCD to show that P-selectin (a cell-adhesion molecule on endothelial cells) promotes vessel clogging by binding to white blood cells. Moreover, disrupting the expression of P-selectin on endothelial cells prevented binding from occurring and also prevented lethal vaso-occlusion.
Earlier this year, the New England Journal of Medicine published results of a multicenter, double-blind, placebo-controlled phase 2 trial in which 198 SCD patients received periodic infusions (14 per year) of a monoclonal antibody that neutralizes P-selectin. The treatment significantly reduced the number of pain crises compared with those reported by patients taking a placebo. Dr. Billett led the Montefiore portion of the study. A phase 3 clinical trial assessing anti-P-selectin antibodies (and again involving SCD patients cared for at Montefiore) is now under way.
In other sickle-cell adhesion work, Dr. Manwani is collaborating with Case Western Reserve University engineers to develop a way to measure the "stickiness" of red and white cells. "Our hypothesis is that acute vaso-occlusive pain is different from other types of pain commonly seen in SCD, such as neuropathy [nerve pain] and chronic pain," explains Dr. Manwani. "If so, a marker for blood-cell adhesion would help us identify which patients would benefit from IVIG and other novel therapies, and perhaps allow us to predict and even prevent pain crises." The researchers on this project are studying pediatric SCD patients being treated at Einstein-Montefiore.
The Microbiome and Sickle-Cell Disease
Another Einstein-CHAM collaboration involves the surprising connection between the gut microbiome and the risk for a sickle-cell crisis.
Early in his career, Dr. Frenette discovered that vessel blockages in SCD occur when sickled red cells bind to white cells called neutrophils that have adhered to the vessel walls. He also noted that not all neutrophils were the same; some seemed inert, while others actively promoted inflammation—which is useful for attacking microbes but causes neutrophils to capture sickled red cells inside vessels.
In a 2015 paper in Nature, Dr. Frenette's group reported that neutrophils become more pro-inflammatory as they age, in response to signals from the gut's microbiome—the diverse populations of microorganisms in the intestines. Chemicals produced by the microbiome cross the intestinal barrier and enter the bloodstream, where they generate the old, overly active neutrophils that contribute to SCD crises.
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Science Talk: Antibiotics May Thwart Sickle Cell Crisis
Paul Frenette, M.D.
"Since the body's microbiota seems to 'educate' neutrophils to age," says Dr. Frenette, "we realized that purging those microbes with antibiotics might help against SCD." As it turned out, administering antibiotics to SCD mice did appear to prevent sickle-cell crises; it markedly reduced interactions between neutrophils and red cells, resulting in increased blood flow and greatly improved survival of the mice.
"What was most exciting to us was the antibiotics' beneficial effects on chronic tissue damage," says Dr. Frenette. "Spleen enlargement in SCD mice was significantly reduced in the microbiota-depleted animals, and we also saw major reductions in liver damage. This is the first time that any drug therapy has been found to have an impact on the organ damage that can be so devastating in SCD."
Were the findings in mice relevant to people? To find out, Drs. Frenette and Manwani obtained blood samples from SCD children being treated at CHAM and found that children taking penicillin had significantly fewer aged neutrophils than those not taking the antibiotic. "Daily penicillin for patients with SCD younger than five works really well in preventing infections," says Dr. Frenette. "Our study suggests that antibiotics could potentially play an even broader role in benefiting older patients."
Drs. Frenette and Manwani are planning a clinical trial to see if antibiotics can help SCD patients by preventing vaso-occlusive crises and the related long-term organ damage that shortens the lives of patients. Dr. Frenette is also working to identify which gut microbiome bacteria in particular are responsible for driving neutrophils to age.
Lightning Strikes Twice
When two SCD "carriers" like Lindsy and her husband Kwasi conceive, they have a three in four chance of having a baby free of the disease. The Osounas were counting on these odds when they decided to have a second child. "We also thought that if we had a healthy baby, we could bank the child's cord blood and have a cure for Aniyah," says Lindsy, referring to a stem-cell transplant.
Umbilical cord blood is rich in blood-forming, or hematopoietic, stem cells. Transplanting those stem cells into someone with SCD can provide a healthy blood supply, if the recipient's marrow is first wiped out with chemotherapy. Such transplants are the only cure for SCD but are used sparingly because recipients and their donors—typically siblings—usually must have closely matching blood antigens, and risks for fatal complications are high.
Unfortunately, prenatal testing revealed that their new baby would also have SCD. "It was a big blow," says Lindsy. "But again, we decided that we could deal with this." The Osounas are not unusual in this regard. "Maybe 10 percent of parents will opt to terminate an SCD pregnancy based on genetic testing," says Dr. Manwani. "It's a very personal decision, guided by complex social and spiritual beliefs."
Although Tristan, now six, has had fewer health problems than his sister, he struggles with severe asthma. "I'm sorry he's not well," says his mom, "but I'm happy he's here."
The Osounas take their children regularly to the CHAM sickle-cell center, despite the long drive from Queens. The family had considered moving to Nassau County, but didn't want to change doctors. "I'm not sure I want to move farther away from CHAM," says Lindsy. "It's like a family there."
Doctors are hoping that a stem-cell transplant may still be an option for both Aniyah and Tristan, even without a healthy sibling who can serve as a donor. CHAM's bone marrow transplant program—one of the country's largest—provides "haplo-identical" transplants that use partially matched family members (usually the mothers or fathers) as donors. Such transplants do involve serious risks, including infection and graft-versus-host disease. But they make cures at least theoretically possible for the majority of SCD patients.
Scientists recently developed a gene-editing technology called CRISPR that may offer a safer and more reliable SCD cure. CRISPR can cut out undesirable genes, or specific DNA sequences within genes, and splice in "normal" DNA—making it ideally suited for SCD, which results from a mutation involving a single nucleotide. Researchers have already used CRISPR to correct SCD mutations in animal models of the disease. A grant awarded to a Montefiore clinician and an Einstein basic scientist may bring CRISPR for SCD patients closer to reality.
Caterina Minniti, M.D., professor of medicine and of pediatrics at Einstein and director of the Sickle-Cell Center for Adults at Montefiore, and Eric Bouhassira, Ph.D., professor of cell biology and of medicine and the Ingeborg and Ira Leon Rennert Professor of Stem Cell Biology and Regenerative Medicine, received a $1 million grant from the Doris Duke Foundation's Sickle Cell Disease/Advancing Cures program. Using blood and bone marrow samples from SCD patients, they'll work to perfect CRISPR for editing the mutated hemoglobin gene in hematopoietic (blood-forming) stem cells. The ultimate goal: harvest an SCD patient's hematopoietic stem cells, correct the defective hemoglobin gene and reinfuse the blood-producing cells into the patient. Depending on the percentage of normal blood cells produced, the procedure could reduce a patient's symptoms or even provide a cure.
Ken Chen, Ph.D. (left), and Marc Vargas, B.S., use the CRISPR gene-editing technique in Einstein's Transgenic Mouse Facility.
The Stark Transition to Adulthood
In caring for children who have SCD, the Osounas seek a healthy middle ground between helicopter and latchkey parenting. "We try to stress the importance of getting rest, staying hydrated, eating properly and taking their meds," says Lindsy. As if on cue, Aniyah runs to the kitchen to retrieve her weekly pill organizer for an impromptu show-and-tell.
"We imagine there will be rough times ahead," says their mom. "But we hope we've laid the foundation so that they will be able to take care of themselves later in life."
When they turn 18, SCD patients "age out" of the nurturing world of pediatric care and must deal with the disease on their own. "For many young adults, it's the first time they've had to make their own doctors' appointments, and they have to get used to a whole new team of doctors and nurses," says Dr. Minniti. "It's a perilous time, when emergency room visits, hospital admissions and readmissions and even mortality rates increase greatly."
Adult SCD patients may actually fare worse now than in the past. In a study published in 2013 in Public Health Reports, researchers used National Center for Health Statistics data to calculate SCD mortality rates (deaths per 100,000 African Americans) between 1979 and 2005. As expected, the mortality rate for children with SCD declined significantly over that time interval. But for adult SCD patients 19 and older, the mortality rate increased by one percent each year from 1979 to 2005. The authors, led by Einstein alum Sophie Lanzkron, M.D., '91, M.H.S., attributed that rising mortality rate to "the lack of comprehensive care for adults with SCD."
Caterina Minniti, M.D., with a patient, Joseph Peay.
Care Over the Life Span
At Montefiore, Dr. Minniti is working to eliminate the artificial transition from pediatric to adult care. "I'm a proponent of life-span care, with one group of physicians caring for patients throughout their lives," she says. She worries that adult SCD patients in many parts of the country receive only episodic care, usually prompted by a sickle-cell crisis—a far cry from the care available to children.
"Visit pediatric clinics with their happy kids and then see how much worse the care is for adults with SCD," says Dr. Minitti. "I encourage every pediatric hematologist to go to hospitals in their area to see what happens when their beautiful young patients become adults."
When crises send SCD adult patients to the emergency room, "the focus is mainly on pain relief," says Dr. Minniti. "But the pain, as bad as it may be, isn't going to kill the patient. He is going to die because his kidneys are crashing or his heart is failing. Adult care must be multidisciplinary, because SCD causes complications that can damage all areas of the body, from the brain to the heart to the kidneys to the extremities."
One of her own research interests is finding treatments for leg ulcers—painful and often disabling complications of SCD that affect 5 to 10 percent of all SCD patients and often take months or even years to heal. In July, the U.S. Food and Drug Administration awarded her a four-year, $1.9 million grant to carry out a phase 2 trial of a promising sodium-nitrite cream for treating leg ulcers in SCD patients.
In earlier work at the NIH, Dr. Minniti carried out a phase 1 trial of sodium-nitrite cream that found it was safe and well tolerated, and significantly reduced ulcer size and pain in the small number of patients treated. Applying the cream to the wound converts sodium nitrite into nitric oxide gas, which dilates vessels by relaxing their smooth muscle cells. This aids healing by increasing the amount of oxygenated blood that reaches the wound.
"We hope our phase 2 trial will confirm the promising results of our phase 1 study," says Dr. Minniti. "No approved treatments for leg ulcers in SCD are available, and many patients with leg ulcers must now rely on chronic use of opioid drugs to relieve the excruciating pain that ulcers can cause."
SCD-related problems tend to multiply and worsen with age. For example, years of working overtime to oxygenate the blood cause heart muscles to weaken and stiffen, setting the stage for heart failure and arrhythmias. Other chronic stresses compromise the joints, lungs, kidneys, gallbladder, spleen and brain.
"In treating SCD, we see all of the usual diseases of aging decades before they typically appear," says Dr. Minniti. "Unfortunately, there's only so much we can offer those patients. It's hard to believe, more than a century after the disease was first characterized, that we have just two FDA-approved drugs. (Hydroxyurea and L-glutamine [approved in July 2017] both reduce the frequency of pain crises and the number of hospital visits needed to treat them.) In contrast, we have perhaps 25 drugs for HIV and 15 for cystic fibrosis."
Nevertheless, Dr. Minniti is optimistic that things are heading in the right direction. "A number of drugs are now in clinical testing, including several at Einstein-Montefiore," she says. "I think that in a few years we'll have several therapeutic options. Then, perhaps, we'll be able to move to the sort of combination therapy that transformed HIV from a deadly illness to a chronic one. If we can develop a cocktail of drugs that attack the different pathways leading to sickling, adhesion and vaso-occlusion—and if we can implement therapy early in life, before organ damage occurs—we will be able to extend and improve the lives of adults with sickle-cell disease."
Tristan Osouna has high hopes that Dr. Minniti is correct. In a recent school assignment, he wrote: "The one thing in the world I would change is sickle-cell disease. I would change it by donating money to help hospitals get a cure. I have sickle-cell disease and I wish it would go away."
Researchers at Montefiore and Einstein hope to make Tristan's wish come true.
SILENCE OF THE STROKES
Strokes—both silent and overt—are extremely common among SCD patients, affecting between 25 and 40 percent of them. But why are SCD patients so susceptible to strokes?
Over the past four years Craig Branch, Ph.D., associate professor of radiology and of physiology & biophysics and director of the Gruss Magnetic Resonance Research Center at Einstein, has sought the answer through in-depth research on the biological mechanisms that underlie strokes in SCD. He is one of the only researchers to have used animal models of SCD to do so.
SCD-associated strokes are assumed to result from sickled cells clogging brain arteries and restricting blood flow, as occurs elsewhere in the body. But by studying mouse models of SCD, Dr. Branch found that brain blood flow associated with SCD strokes is actually unusually high—a finding recently confirmed in SCD patients studied in his laboratory and in others. Dr. Branch attributes this high blood-flow rate in the SCD brain to anemia and oxidative stress. But he has also observed a related alteration in brain metabolism never before seen, possibly in response to mild but chronic oxygen deficits in the brain.
"In SCD, the brain may be changing the way it manages its energy needs to reduce the likelihood of a major hypoxic event [a sudden loss of oxygen]," says Dr. Branch. "This compensation may unfortunately lead to increased blood flow in the brain, along with inflammation and a reduction in the brain's ability to respond to conditions requiring increased oxygen—a combination that raises the risk of stroke."
Today, physicians caring for SCD patients regularly assess their stroke risk by measuring blood-flow rate in the carotid artery; if the flow rate is abnormally high, they consider giving blood transfusions or treatment with hydroxyurea to increase the amount of oxygen reaching the brain. But confirmation of Dr. Branch's studies could lead to other treatments—to reduce oxidative stress or improve oxygen delivery—that might ward off strokes among SCD patients.
Studies by Dr. Branch and Dr. Billett suggest that many SCD patients are experiencing silent, or subclinical, strokes that cause no obvious signs or symptoms. But silent does not mean harmless. "When we examine these SCD patients more closely," he says, "we see clear evidence of cognitive deficits and brain pathology even though they've never been diagnosed as having stroke. Some of these findings may also be due to impaired metabolic brain processes."
In a paper now under review for publication, Drs. Branch and Billett and a former Einstein medical student, Nicholas Farris, M.D., recruited adult sickle-cell patients who had no known history of stroke and an equivalent cohort of control individuals. All subjects underwent MRI brain scans as well as cognitive tests. The testing revealed that eight of 15 SCD patients had evidence of possible silent strokes and that all 15 SCD patients had significantly elevated brain blood flow and inflammation compared with the control subjects.
Jorge Aguilar's American Journey
An Exclusive Interview with Dr. Tom Frieden
Addressing M.D. Students' Wellness Needs
Actors Training Doctors
Download PDF of the overcoming-sickle-cell-disease Issue

redpajama_set_name: RedPajamaCommonCrawl


No doubt about it, McDonald's of Chiefland owner/operators, Andree and Kenneth Kocian, appreciate the Levy County Sheriff's Office. On Monday, March 31, Mr. and Mrs. Kocian arrived with crates of sausage, egg, and egg white McMuffins, cinnamon melts, and fresh hot coffee, plus all the essentials to enjoy a delicious hot breakfast. The couple wanted to express their thanks for the job that first responders do each and every day.
Mr. Kocian said they recognize the commitment it takes for individuals to put their lives on the line to keep the public safe. Kenneth is a retired New York City Police Department Lieutenant and is pictured in his agency uniform. Andree also comes from a lineage of Law Enforcement. Her father is retired from NYPD. The Kocians are the owner/operators of several area McDonald's Restaurants and operate these businesses as R.A.N.K. Quality Restaurants located in Gainesville.
The Levy County Sheriff's Office thanks McDonald's of Chiefland and Mr. and Mrs. Kocian for their generosity and support.
A suspicious package was delivered to a local business man in Bronson today. An envelope containing a clear plastic baggie with an unknown tan/white residue was found inside. No letter accompanied the substance.
The Levy County Sheriff's Office responded and immediately contacted the Levy County Public Safety Department, who in turn contacted a regional Haz-Mat team. The building was evacuated and the employees were assessed by Levy County EMS.
The Hazardous Material Response Team from the City of Gainesville responded and conducted preliminary testing of the substance. These tests were inconclusive. Further testing to make a positive identification of the substance will be performed by the Florida Department of Health Laboratory in Jacksonville.
The Levy County Sheriff's Office is now able to provide the name of the victim involved in the fatal accident which occurred on March 11, 2014 in Inglis, Fl. The victim has been identified as William Gerard Walsh W/M 12-9-1974, an Inglis resident. A preliminary report from the Fifth Circuit Medical Examiner's Office revealed during their examination that the manner and cause of death was accidental due to blunt head trauma.
The family has provided a picture of Mr. Walsh for this updated release.
The Levy County Sheriff's Office responded to Rivals Bar located at 439 Highway 40 West in Inglis, Fl., shortly before midnight on March 11, 2014. A patron called 911 reporting a fight between multiple people inside the bar. 911 communications officers continued updating Deputies as they responded. The 911 caller described a Jeep leaving the scene and told dispatchers the Jeep was occupied by the people involved in the fight.
A responding LCSO deputy located the vehicle east bound on SR 40 in the Town of Inglis. He turned around to conduct a traffic stop. As the deputy gained on the vehicle, he observed a person lying in the road. The deputy immediately stopped to render aid and observed the Jeep pull into an adjacent parking lot. Additional responding units contacted the driver and occupants. Statements taken on scene by Deputies determined the occupant jumped from the moving vehicle in an attempt to avoid apprehension.
The victim, a 39 year old Inglis resident succumbed to his injuries. His name is being withheld until proper family notification has been completed. The investigation is continuing.
On March 10, 2014 Johnny Jerome King registered as a Sexual Predator with the Levy County Sheriff's Office. By Florida law King is required to notify law enforcement whenever he changes addresses.
Johnny Jerome King was convicted in 2004 in Alachua County, Fl for Lewd or lascivious molestation victim under 12 years offender 18 or older; F.S. 800.04(5)(b) (PRINCIPAL). King has changed his address and registered his new address as: 17193 NE 40 Street Williston, Fl.
Cooperation and conditioning at their finest.
Yesterday, March 4, 2014 the Florida Highway Patrol was monitoring traffic on CR 335 east of SR 41 in the Raleigh area of Levy County. Trooper Michael Corrao clocked a vehicle in excess of the posted speed limit and initiated a traffic stop. The driver made an abrupt turn onto NE 190 Avenue and fled on foot from the vehicle. The driver left a passenger and her two children in the vehicle to deal with the Trooper's questions. An "All Call" for assistance from Trooper Corrao was answered by Lieutenants Shawn Hunt and Perry Ott and Deputy Patricia Horne.
Lt. Ott spotted the suspect and radioed his location to responding units as the suspect fled on foot. Lt. Hunt gave chase on foot, and due to his after hours conditioning, was able to chase down and apprehend the suspect after a lengthy foot chase through fields, yards and woods.
Arrested was Shaun M. Klein 12-13-83 of Gainesville on numerous charges. These charges include possession of cocaine, resisting arrest, driving on a suspended license, and failure to obey Law Enforcement order to stop. In addition, Klein was also booked at the Levy County Detention Center on several outstanding warrants for Violation of Probation/grand theft, dealing in stolen property and false information to a pawn broker.
LCSO thanks the FHP for their continued assistance in making Levy County safer.


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The Washington Post, Picking Up Where They Left Off in 2016, Runs Four Negative Bernie Sanders Stories in Two Days
By Shane Ryan | February 21, 2019 | 10:55am
Photo courtesy of Getty Politics Features Bernie Sanders
I'll come clean here: Before the 2016 Democratic primary, I thought the idea of a "biased" mainstream media was mainly a fever dream of the conservative right who (for instance) didn't like when reporters wrote that climate change was real. By and large, I trusted the major outlets like the New York Times and Washington Post, and in terms of reporting and investigative journalism, I still do. But as far as the editorial pages go, the corporate agenda became abundantly, distressingly clear over the course of that campaign, and certain illusions were shattered. The evidence was continuous, but it's impossible to forget this staggering moment from the heart of the primary:
My latest:
The Washington Post Ran 16 Negative Stories on Bernie Sanders in 16 Hourshttps://t.co/X7OLqdxGcCpic.twitter.com/JeiDyKPybD
— Adam H. Johnson (@adamjohnsonNYC) March 8, 2016
The Post is owned by Jeff Bezos, and while I don't think he was calling down these headlines to his editors from the heights, the paper's corporate agenda became impossible to disguise—Bernie Sanders was the enemy, and they weren't even trying to hide their pro-Clinton antagonism.
Here we are in 2019, and it appears that absolutely nothing has changed. In fact, after Sanders helped shame Amazon into raising its minimum wage to $15, the specific antipathy toward him at the Post has surely only gotten worse. The proof is in the pudding—Sanders declared his candidacy for president on Tuesday, and in the space of 48 hours, the Post churned out four negative pieces—two of them by the same writer!
In that same span, there did not appear to be more than one story (period) about any other candidate, and there was a fifth Bernie story that could charitably be called "neutral," in which Helaine Olen, responding to his big fundraising numbers, wrote about something called the "Golden Girls Effect" and expressed sentiments like, "Don't count the Vermont senator out." Sure, I guess…why would you? He consistently polls as the first or second-most popular candidate in the field, and the idea that he would be dismissed out of hand only makes sense if you're writing for a publication that desperately harbors that desire.
That piece aside, let's look at the other four.
1. "Bernie Sanders is no big deal the second time around," by Jennifer Rubin
This ran on Tuesday, when Sanders announced, and includes passages like this:
In short, Sanders is offering little different from many younger, less cranky Democrats, including nonwhite candidates who haven't struggled to win over African Americans and women and who haven't had to explain complaints of sexual harassment in their campaigns.
When she wasn't pushing the same tired narratives—Bernie has a racism and sexism problem, most prominently—Rubin was dismissing his old policy proposals as old hat, as though the fact that they're "endorsed" by the other candidates isn't a direct rest of his advocacy four years ago. Eventually, she convinces herself that someone like Amy Klobuchar can play spoiler (lol), and that Sanders' launch would go so poorly that it might prevent Joe Biden from running since it would clearly show that the electorate doesn't want old men or familiar faces.
2. "Why Sanders's money haul doesn't matter very much," by Jennifer Rubin
Oops! A day later, Rubin's piece had aged rather poorly. He set a first-day record with almost $6 million raised from over 200,000 people, and basically proved that all of Rubin's contentions from a day earlier were exactly as idiotic as they seemed on first read. Which meant, of course, that Rubin had to diminish the accomplishment in any way possible:
Sanders is the only Democratic contender for 2020 who ran for president in 2016, during which he raised about $230 million. For someone with nearly universal name recognition, an extensive donor list and a long run-up to his announcement, Sanders's haul shouldn't impress knowledgeable political watchers. (Should Joe Biden announce, I would bet his 24-hour fundraising total will dwarf Sanders's total. A former vice president shouldn't have to lift a finger to trigger a flood of money.)
But wait! Wouldn't Sanders' failure be a "blinking red light" to Biden? Not anymore. You see, the goalposts have shifted—now, the sheer amount Bernie raised (which doesn't matter, remember) will apparently serve as a green light to Biden, who will then destroy Sanders. Rubin goes on to argue that money doesn't really matter, but any decent point she accidentally approaches is undermined by the fact that she misses the forest for the trees—not once does she mention the 200,000+ donors, and what the money says about the enthusiasm for Sanders' campaign. It's a great big point-missing whiff, and a lame attempt at self-justification after being made to look like a fool a day earlier.
3. "Bernie, your moment has come—and gone," by David Von Drehle
If prose were a living entity, this column would be a violation of the Geneva Convention. Von Drehle spends way too many words comparing Bernie Sanders to Eugene McCarthy—an old and obvious analogy that has been done in fewer words thousands of times by now—and attempting to make the point that like McCarthy, Sanders' time has come and gone. This ran on Tuesday, and Von Drehle's contention that "the moment doesn't last," ridiculous on its face, was undermined almost as fast as Rubin's piece of wishful thinking. Which is no surprise—unlike McCarthy, who ran for president again and again after his failure in '72, Bernie's moment has literally just begun, and his ideas have done nothing but gather momentum since 2016 as the establishment wing of the Democratic party has floundered from one failure to the next. McCarthy was a cautionary tale when he lost to Nixon, but what many don't seem to understand is that the modern cautionary tale is Hillary Clintion, who—centrists don't enjoy recalling—lost her election to Donald Trump.
However the 2020 campaign might unfold for the Democrats, there is no wounded giant to define the party fray. Minus the vacuum, Sanders will find, like gruff Gene, that his moment is gone, his agenda absorbed by more plausible candidates, his future behind him. Only the residue of unslaked ambition remains.
Narrator Voice: "That same Day, Sanders broke every fundraising record on the books."
4. "Bernie Sanders is probably just another one-hit wonder," by Henry Olsen
This is basically the same piece that Von Drehle wrote, on the same day:
The Democratic presidential jam session gained a new act Tuesday with Sen. Bernie Sanders's (I-Vt.) entry into the race. Despite running second in most early polls, Sanders is likely to find that he can't recapture the magic once he goes back out on tour.
He goes on to make the same exact points Rubin made:
Today, however, Sanders's songs are not novel. Just as the Beatles begat a host of imitators, it seems that virtually every Democratic contender sings some sort of Bernie-inspired tune. He launches a new single, "Medicare-for-all," and suddenly most other Democrats are covering it. The hot new artist from the Bronx, Rep. Alexandria Ocasio-Cortez — who goes by the stage name "AOC" — launches "The Green New Deal," and suddenly he's the one covering someone else's tune. Progressive politics is hot, and like the disco era in the late 1970s, it seems there's a new successful act every minute.
You get the idea: All the other Democrats are Bernie now, and nobody cares about him! He's done!
Except, he's not. This is pure wish fulfillment on one hand, but on the other it's a little more nefarious—a coordinated, corporate campaign that is starting even earlier, and with greater energy, than we saw in 2016. You'd think someone on the editorial board at the Post might have stopped at least one of these stories in its tracks, since they're incredibly redundant, but I think—just as we saw with the 16 stories in 16 hours debacle—that quantity is part of the point. It's about throwing everything at the wall until something sticks, and it's about repeating a talking point so often that, they hope, it becomes truth in the mind of the reader.
Whatever their rhetoric, they're taking Sanders extremely seriously much earlier than they did last time, and the onslaught of negative coverage will continue unabated. It's my contention that Sanders has, by far, the best chance of any candidate in the primary, and I think people like Rubin, Von Drehele, and Olsen understand this too. And they understand that the best way to stop him—the only way, maybe—is by sheer propaganda volume. If they can drown the obvious enthusiasm in manufactured narrative, they might be able to stop him in his tracks, and one of the most fascinating storylines of the 2020 campaign will be witnessing exactly how much power these people have left.
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The hip is a ball-and-socket joint made up of the head of the thigh bone or femur that acts as the ball and fits into the rounded socket of the hip bone or acetabulum. The neck of the femur is the region just below the ball of the hip joint.
Fractures to the femoral neck can completely or partially disconnect the femoral head from the rest of the femur. Femoral neck fractures may be either displaced, where the bone is moved out of its original position, or non-displaced, where there is no instability of the bone. These fractures may disrupt the blood supply to the fractured portion of the bone. In cases of badly displaced femoral neck fractures, the decreased blood supply prevents these fractures from healing.
Femoral neck fractures are diagnosed based on physical examination, your symptoms and circumstances of the accident.
Your doctor will order an X-ray to diagnose a femoral neck fracture. Your doctor may also perform other imaging tests such as the magnetic resonance imaging (MRI), and computer tomography (CT) scan to obtain further information.
Radiographic image of a broken shenton's curve, which shows the relationship of the femoral head to the acetabulum, indicates a femoral neck fracture.
Treatment of a femoral neck fracture will depend on your age and the extent of displacement of the fractured bone.
Conservative therapeutic approaches are suggested for uncomplicated fractures and include bed rest for a few days followed by a physical rehabilitation program after 2 or 3 days. Your doctor may also prescribe medications to prevent blood clots, relieve pain and treat any infection that may be present.
However, femoral neck fractures are rarely stable enough to manage with only conservative therapy and usually require surgical repair.
Surgery for a femoral neck fracture is performed under general or spinal anesthesia.
Hip pinning is recommended if your facture is minimally displaced and you have sufficient bone density. Your surgeon will make a small incision on the outside of your thigh and insert several screws to stabilize the broken bones.
Hip hemiarthroplasty or partial hip replacement is suggested if you have a displaced fracture. For this surgery, your surgeon will make an incision over the outside of the hip, remove the femoral head and replace it with a metal implant. The socket will not be replaced in a partial hip replacement procedure.
Total hip replacement is recommended if you have had arthritis of the hip before the fracture. Your surgeon will replace the femoral head as well as the socket of the hip joint with artificial metal implants.


This little guy is a very fitting mascot for Lady Harvatine crafts of late. Things have been happening verrrrrrrrryyyyyy slowwwwwwwwlyyyyyyyy. The recent heatwave made my craft room unbearable and kept me from using my sewing machine at all since I made this in the bedroom. The doorstop was somewhat forgiving but I didn't think quilting on the bed was such a great idea. Having these little Wee Wonderfuls hand sewing patterns to play with in the air conditioning has saved me from total craft shut down. Thankfully, it has now officially cooled off. In fact, morning and night could even be called chilly! Well, maybe not chilly, maybe just a bit nippy. But still, I can sew again! Last night I did a little quilting and this weekend I think things will be speeding up around here.
Too cute! I love his shell!
your little hand-stitched wees are quite wonderful!


With the fast-paced urgency of life, EastIdahoNews.com is slowing down for a moment to bring you some words of advice from the wisest among us. Every Tuesday, we'll be posting a "Life Lesson" from a resident of the Lincoln Court Retirement Community.
This week, Charlotte Giles shares why it's important to be kind and how understanding the feelings of others can make a big difference in life.


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le-monastierpinmories » No category » A history of Japan
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by John Thomas Ingram Bryan
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John Thomas Ingram Bryan
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The Cambridge History of Japan is a multi-volume survey of Japanese history published by Cambridge University Press (CUP). This was the first major collaborative synthesis presenting the current state of knowledge of Japanese history. The series aims to present as full a view of Japanese history as possible. The collaborative work brings together the writing of Japanese specialists and historians of Japan.
It gives a concise history of America's major ethnic groups that clearly show how ethnic history creates that group's cultural values.
view Kindle eBook view Audible audiobook. It gives a concise history of America's major ethnic groups that clearly show how ethnic history creates that group's cultural values. How did the English suppression of the Irish affect Irish political development in every country that the Irish emigrated to?
A classic of Japanese history, this book is the preeminent work on the history of Japan
A classic of Japanese history, this book is the preeminent work on the history of Japan. Newly revised and updated, A History of Japan is a single-volume, complete history of the nation of Japan. Starting in ancient Japan during its early pre-history period A History of Japan covers every important aspect of history and culture through feudal Japan to the post-cold War period and collapse of the Bubble Economy in the early 1990's. Recent findings shed additional light on the origins of Japanese civilization and the birth of Japanese culture.
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Author of The literature of Japan, The interpretation of nature in English poetry, A history of Japan, Japan from within, The feeling for nature in English pastoral . The interpretation of nature in English poetry.
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Post-Election Analysis 2016: Trade
Arnold & Porter (Republished in the Soulier AARPI Newsletter)
By Raul R. Herrera J. David Park Dana Weekes Amy Davenport
ADMINISTRATION PRIORITIES
Trade played a prominent role throughout the presidential elections. This was due in part to President-elect Trump's strong trade enforcement stance and his harsh criticism of existing and potential trade agreements. Trade enforcement will be a top priority for the Trump Administration, and, at least in the near term, the Trump Administration will not support the Trans-Pacific Partnership (TPP) or any other regional trade agreements.
Trade Enforcement. The Trump Administration will be a strong proponent of trade enforcement. President-elect Trump has stated that he will seek a blanket 45 percent tariff on goods imported from China and a 35 percent tariff on certain goods, such as cars and trucks, imported from Mexico. He also has indicated that his administration will impose defensive and countervailing duty tariffs on countries that are "currency manipulators" and will pressure the World Trade Organization (WTO) to change its treatment of value-added taxes (VAT).
Increasing Tariffs on Imports from China, Mexico, and Other Countries. President-elect Trump has not yet specified the legal basis through which his administration will increase tariffs on imports from China, Mexico, and other countries. There are certain means through which the United States can increase tariffs under current US law, such as antidumping, countervailing duty, and safeguard laws; however, these laws have specific requirements, and the resulting tariffs would be narrowly focused. Any broad imposition of blanket tariffs likely would run afoul of US WTO obligations.
Defensive and Countervailing Duties on Currency Manipulators. Claims of currency manipulation by countries such as China have been circulating for many years. The biggest challenge has been to find the right legal remedy under US law to address such conduct. Earlier in 2016, Congress amended US law, permitting the President to impose remedial measures if bilateral talks with a country accused of manipulating its currency proved ineffective. The new legal provisions, however, stopped short of making currency manipulation subject to US countervailing duty law. At this time, it is unclear whether the Trump Administration would simply pursue currency manipulation through these new legal provisions or seek to amend US countervailing duty law.
WTO Treatment of VAT. President-elect Trump has stated that, under WTO rules, countries with a VAT regime are treated more favorably than the United States, which has an income tax regime. He has claimed that the WTO permits VAT exemptions when companies export goods from a VAT regime country. When US companies export good to those countries, however, their goods are subject to VAT. Therefore, according to President-elect Trump, the VAT exemption functions as an export subsidy for companies in these other countries, while the imposition of VAT on imports of US goods serves as a trade barrier for US companies. Although President-elect Trump has suggested that his administration would "use its status as the world's largest economy, the world's largest consumer, and the world's largest importer to put pressure on the WTO to change this unequal treatment," he has not yet described the specific legal basis and mechanism through which his administration intends to bring about this change.
Trans-Pacific Partnership. President-elect Trump made his opposition to TPP one of the central trade themes of his campaign. He also announced the Trump Trade Doctrine, under which his administration would only consider trade agreements that will increase the US gross domestic product (GDP) growth rate, decrease the trade deficit, and strengthen the US manufacturing base. Based on this doctrine, it is unlikely that the Trump Administration would support TPP in its current form.
Other Regional Trade Agreements. Based on the Trump Trade Doctrine, it appears unlikely, at least in the near term, that the Trump Administration would support any other regional trade agreements, including the Transatlantic Trade and Investment Partnership (T-TIP). President-elect Trump also has stated that he intends to terminate or re-negotiate existing trade agreements such as the North America Free Trade Agreement (NAFTA). At this time, it is unclear whether the Trump Administration will seek to terminate or re-negotiate any existing agreements though it is reasonable to assume he will try to renegotiate any agreement before making a decision to terminate.
Cuba. During the campaign, President-elect Trump shifted his position on President Obama's executive orders on Cuba, with the latest order issued in October. In March, then presidential candidate Trump remarked that "[m]aybe it won't work out, but I will tell you, I think Cuba has a certain potential and I think it's OK to bring Cuba into the fold." In September, however, President-elect Trump shifted his position saying he would "reverse" President Obama's orders. Since then, his statements have been backed up by Vice President-elect Mike Pence, who has reiterated that a Trump Administration would overturn the executive orders and reinstate the 50-year embargo that President Obama had lifted. Both President-elect Trump and Vice President-elect Pence's statements do not necessarily mean there is no interest to negotiate deals with Cuba, but it appears that a Trump Administration believes that the current normalization of relations with Cuba is "one-sided" because it only advantages the "Castro regime."
President-elect Trump has not yet indicated who will take the helm of the Office of the United States Trade Representative (USTR) or the Department of Commerce. Some possibilities include:
Dan DiMicco - Former Chief Executive Officer of steel company Nucor Corporation
Peter Navarro - Professor of economics and public policy at the Paul Merage School of Business, University of California, Irvine
CONGRESSIONAL LEADERSHIP
House. Current House Ways and Means Committee Chair Kevin Brady (R-TX) is likely to retain his role in the 115th Congress with Rep. Sander Levin (D-MI) continuing to serve as ranking member. Rep. Dave Reichert (R-WA) is the current chair of the Subcommittee on Trade and also is likely to remain in that leadership role next year. Current ranking member of the Subcommittee on Trade, Rep. Charles Rangel (D-NY), will retire this year. The lead Democratic seat on the subcommittee will be up for grabs with Reps. Richard Neal (D-MA), Earl Blumenauer (D-OR), and Ron Kind (D-WI) in line for the seat.
Senate. In the Senate, current Senate Finance Committee Chair Orrin Hatch (R-UT) is likely to remain in his role as the leader of the committee along with current Ranking Member Ron Wyden (D-OR). Sen. John Cornyn (R-TX) previously served as the Subcommittee on International Trade, Customs, and Global Competitiveness chair and is likely to remain in that role unless he chooses to sit on another subcommittee on the Senate Finance Committee. Sen. Wyden is likely to remain the ranking member on the subcommittee.
CONGRESSIONAL PRIORITIES
With the July 2015 passage of Trade Promotion Authority (TPA) legislation that allows for expedited consideration of trade agreements in Congress, the 114th Congress set the stage for President Obama to push forward his agenda to approve the TPP and other free trade agreements. Yet, with a presidential campaign that was negative on trade liberalization policies and a broader electorate that now questions the value of free trade, many members of Congress in both parties who previously voted for TPA were forced to pivot their positions on free trade while on the campaign trail. These political dynamics will make it very difficult for Congress to do anything on trade in the lame-duck session and into the 115th Congress.
Trans-Pacific Partnership. While President Obama would like to see quick action in Congress to approve the TPP in the lame-duck, the election of Donald Trump means Congress will let TPP die this fall. Speaker of the House Paul Ryan (R-WI) has said that the House does not currently have the votes to pass TPP, and Senate Majority Leader Mitch McConnell (R-KY) said that TPP "will not be acted upon this year." Without buy-in from the leadership, it seems very unlikely that TPP will be voted on the lame-duck session. President Obama and outside stakeholders in support of TPP will work to convince pro-trade members of Congress that this is their best chance of passing the agreement before President-elect Trump takes office but few members of Congress will want to become new advocates for the deal after the election of a President who campaigned and won arguing against the deal.
Many members of Congress have called for the US government to renegotiate specific portions of TPP, including the provisions related to intellectual property rights for biologics and tobacco policies included in the agreement. At this point, it does not seem likely that President-elect Trump will attempt to renegotiate the TPP agreement, but in the event that he does, the 115th Congress could very likely approve it.
Transatlantic Trade and Investment Partnership. Congress will be watching closely to see what a Trump Administration does with the Obama Administration's work in negotiating the T-TIP. If negotiations move forward and the negotiators are able to reach a deal, Congress will be able to approve the final proposal by a simple majority vote under the TPA legislation. There is less resistance in Congress to the T-TIP agreement in general, particularly when compared to TPP, but it remains to be seen how the negative views on trade coming from President-elect Trump will affect how members vote if a T-TIP agreement came to a vote.
Trade Enforcement. Throughout the Obama Administration, we saw a significant increase in the number of antidumping and countervailing duties cases at the Department of Commerce. The increase is due in part to pressure from members of Congress that want to protect US industries against unfair trade. We expect this trend to continue as members of Congress encourage the Department to use all tools available to enforce antidumping and countervailing duty trade laws and ensure compliance with trade agreements. We also expect members of Congress to follow the lead of President-elect Trump and push for increased trade enforcement against products coming from China, while also calling for the Trump Administration to label China as a currency manipulator.
Cuba. Republicans in Congress will work with the Trump Administration to ensure that President Obama's executive orders on Cuba are overturned. Most Republicans have heavily criticized President Obama for ending the embargo on Cuba, including current Speaker of the House Paul Ryan, who has characterized the administration's efforts as "efforts to appease the oppressive regime." In fact, this year, Republicans already have made attempts to challenge the Obama Administration on Cuba, including through the FY 2017 appropriations process where the House has included policy riders in the Financial Services bill ensuring that the Department of Treasury's Office of Foreign Assets Control cannot use funds to ease trade and travel to Cuba. Reinstating the embargo will be a priority of both branches of government for reasons including the need to appeal to Cuban voters in the midterm election. Both the administration and Congress, however, will need to ensure they do not undermine the interests of the agriculture industry, as this sector views the lifting of the embargo as a benefit to the industry.
Our full analysis of the 2016 election is available below.
(Downloadable PDF)
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Legislative and Public Policy
Raul R. Herrera
raul.herrera@arnoldporter.com
J. David Park
david.park@arnoldporter.com
Dana Weekes
dana.weekes@arnoldporter.com
Amy Davenport
Policy Advisor*
amy.davenport@arnoldporter.com
Exxon Mobil Challenged a $2 Million OFAC Penalty—and the District Court Agreed
DOJ's Revised Self-Disclosure Policy for US Trade Sanctions and Export Control Violations Offers "Concrete and Significant" Benefits for Corporations
The US Government Increases Pressure on Industry to "Know-Your-Customers" and "Know-Your-Suppliers" While Separately Acknowledging This Is Difficult


Nicely done dragon boats. The one's I'm used to seeing are made of cardboard (for the most part) and don't last beyond the events of a particular day's racing. Wonder if these were custom made for this particular user, or if some company somewhere cranks these things out?
Those dragon boats were the sole highlight of my brief stop in Portland. Despite my love of Fred and Carrie's humorous take on the City of Roses, the city doesn't do anything for me.
PS: there were several different types of dragon boats in the marina. From what I can tell, the ones in the pictures are part of the fleet used in the Portland-Kaohsiung Sister City Association's annual dragon boat race held in June.


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Rangers Show Warrior Spirit, Complete Comeback Over Vancouver
By Zak Chiger |
On Salute To The Troops night at The Garden, the Rangers hosted the Vancouver Canucks in a clash of two young teams looking to extend their respective points streaks. The Blueshirts won a close, albeit sometimes sloppy, game to send the MSG faithful home happy.
#NYR Broadway Hat for @filip_chytil! pic.twitter.com/B5K7IQRwlo
— New York Rangers (@NYRangers) November 13, 2018
Filip Chytil – You could just sense that Filip Chytil was going to get the proverbial monkey off of his back and get his first goal of the season. And for the 19-year-old native of the Czech Republic, that finally happened in the second period of this one. With the Rangers on the man-advantage, Chytil found the rebound of Neal Pionk's point shot and deposited it behind an outstretched Jacob Markstrom.
https://twitter.com/4bnyrgameday/status/1062155580473860096?s=21
Chytil has been impressive in his last few games, always surrounding the puck and putting himself in the right position offensively and defensively. With the way Chytil has been playing, don't be surprised if he gets moved up to the first line to replace the injured Pavel Buchnevich.
Brett Howden – The 20-year-old Canadian stated often in training camp that he was going to do whatever it took to make the Rangers opening night roster. And now that we are a month into the 2018-19 season, it seems Howden won't be going anywhere for a long time. With the game tied at one in the third, Howden found a loose puck and fired it past Markstrom to give the Blueshirts a lead they wouldn't relinquish.
The goal was Howden's fourth of the season and his tenth point, tying for fourth in team scoring with linemate Jimmy Vesey and Mats Zuccarello. Howden has played so well that the Rangers coaching staff had him on the ice with the Canucks pressing for the tying goal in the final moments of the game. Brett Howden isn't going anywhere.
Cody McLeod – If you've been following me all season, you know how much I was dumbfounded by the McLeod signing and with the amount of ice time he has gotten. But, for one night, his actions helped give the Rangers life and got the team going. After Goldobin gave Vancouver a 1-0 lead, McLeod dropped the mitts, won the tilt, and, as you'll see in the clip below, turned to the bench telling his teammates to wake up. It's safe to say that, at least for one night, McLeod had a positive impact on the ice.
Henrik Lundqvist – Aside from a perfect shot from a Canucks forward, Henrik was in top of his game, backstopping the Blueshirts to their sixth win in the last seven games. Henrik made 25 stops on the night, including a flurry in the final seconds to preserve the victory. The win was the 437th of Lundqvist's illustrious career, putting him in a tie with Hall of Famer Jacques Plante for seventh all-time.
Congrats to @HLundqvist30 after tying Jacques Plante for 7th overall on the all-time goalie wins list! #NYR pic.twitter.com/6wftbL2MmM
— MSG Networks (@MSGNetworks) November 13, 2018
Next Game: The Rangers will look to extend their winning streak to three against the Islanders on Thursday. Puck drops at 7!
LETS GO RANGERS!!


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China needs red lines to protect its rivers from hydropower craze
Hydropower development has spurred energy-hungry and polluting industries, says Li Bo, former secretary of the NGO Friends of Nature
Zhang Chun
January 27, 2014 May 14, 2020
The development of China's rivers has already gone too far, says a new report – if they aren't protected by the end of the 13th Five Year Plan (FYP), in 2020, it will be too late.
Nineteen environmental groups, including Friends of Nature and the Institute for Public & Environmental Affairs, have published a report re-examining the damage done to China's rivers by the last decade of hydropower development.
The NGOs are deeply worried that both the Xiaonanhai dam, which will damage the last habitat for rare fish on the upper Yangtze, and the Nu River cascade of dams halted by Wen Jiabao, are now included in state plans.
Hydropower is being developed intensively as a substitute for fossil fuels, in order to cut down on greenhouse gas emissions, but it is spurring energy-hungry and polluting industries to develop in south-western China.
Li Bo, former secretary of Friends of Nature, said that electricity is cheap in the south-west and as many hydropower plants aren't connected to the grid, the electricity produced has to be consumed locally. All that affordable power allows local governments to attract energy-hungry industries.
Worse, the dams cannot generate power during the dry season, but the factories keep working. Electricity cannot be drawn from elsewhere in western China, as it is needed in the east, and so polluting coal-fired power is used, forming a vicious circle.
For example, in order to ensure a stable supply of at least 10GW to Guangdong and its neighbouring provinces, Guizhou built much more coal-fired generating capacity than hydropower. Sichuan, Guangxi and Yunnan, also in the south-west, are doing the same.
Li added that the last ten or more years has seen serious overcapacity in energy-hungry sectors.
A meaningless approval system
But the existing system still fails to provide for overall limits on hydropower development and there are no substantive environmental impact assessments for dam construction. Li told chinadialogue that one major failing of China's hydropower development is the lack of overall river-level planning.
Planning for the Yangtze for many years used a Yangtze River Commission document produced in 1991. A revision submitted in 2009 was only passed in 2012. The old document was far out of date: it did not consider the river's ecology or biodiversity and failed to take into account changes in the area's social and economic circumstances.
And before the new plan was published there was a rush to get hydropower projects underway. Today China has 80,000 dams built or under construction – half of all the world's dams. 20,000 of those are generating hydropower. As of 2011 China had 5,200 large (30 metres or more) dams built or under construction.
One important factor in how hydropower has been given free rein in China is a 'two-track' environmental approval system.
Hydropower developments happen in two stages. First, water and power is provided to the site, a road built, and the ground levelled. Second, the actual dam is built.
Li explained that once an application for approval for the dam project has been lodged, the project owners can go ahead with the first stage. But this alone can be a huge and damaging undertaking. On completion of the first stage the company could have already spent hundreds of millions of yuan, and badly damaged the local environment.
Diverting the river to allow for dam construction can also be included in that first stage. On the middle reaches of the Jinsha this happened at the Liyuan, Ludila, Longkaokou and Xiluodu dams, all before Environmental Impact Assessment reports (EIA) had been approved. This makes the assessment process meaningless.
And ultimately, the EIA reports are quietly approved, "all out of public view," Li says. And this is the third problem: a lack of public participation and oversight.
He gives the Shuiluo river, a tributary of the Jinsha close to the Liyuan dam, as an example. In October 2009, during the period for public comment on the EIA, Friends of Nature and other NGOs queried provision of fish reserves if the Liyuan dam was built. The company only replied in November 2010, promising that the Shuiluo would be made a part of the Yangtze fish reserve.
But, Li says, NGO investigations then found that gold mining activity had already made the river unsuitable for use as a reserve. And as far back as 2006 plans for a cascade of 11 dams had been decided upon, with work already underway.
How to turn things around?
The NGOs' report called for an urgent halt to approvals for preliminary construction, and for river protection legislation to set "red lines". This would stop some of the environmental damage development currently causes. Also, public participation and hearings during hydropower approvals would help stop arbitrary development.
There are also two economic issues which Li Bo thinks could be used to hold back river development.
First, hydropower companies do not currently pay for environmental losses or restoration. Companies should make profit-and-loss calculations when building a dam, yet in China maintenance, removal and restoration costs are borne almost entirely by the taxpayer.
Li would like to see the United States' approach used – give the company a license to operate the dam for a certain number of years, during which it will be responsible for all risks. Potential profits would then determine if the dam was built or not, and for how long it would be operated.
Second, the potential of other, non-hydropower, renewable energy sources has been underestimated. According to the report, China has exploitable hydropower resources of between 400 and 600 GW – compared to 2200 GW for solar power, and 700 to 1200 GW for wind power.
Solar and wind power are also developing at incredible speed. Between 2005 and 2012 solar power capacity leapt from 0.7 GW to 3.28 GW; the target for solar power set in the 12th Five Year Plan had to be raised 5 times – from 5 to 40 GW. Jiang Kejuan, board member of the China Energy Research Society, has told Li that even that final target is conservative. Meanwhile windpower capacity jumped from 0.131 to 70 GW, against a 12th FYP target of 100 GW.
Zhang Chun is a senior researcher at China Dialogue.
US turns back the clock on dam-building
China gives green-light to new era of mega-dams
Don't repeat our mistakes on dam building, US urges Asia
The fate of people displaced by the Mekong dams


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The Dark Garden
Late in the afternoon a man, unidentified, had been seen to throw a glove into the Midwych, Wychshire and Southern Canal…
Osman Ford said he would kill the lawyer Mr. Anderson. So when the latter is found dead, with a bullet in the back, the disagreeable Mr. Ford is top suspect. But the lawyer's office was also a cauldron of repressed feelings, and not all the staff are sorry to see the lawyer's demise. In particular, Inspector Bobby Owen fears the dark, brooding clerk Anne Earle. Will her quest for justice lead her to a terrible fate of her own, amid family secrets and lies? The novel combines a satisfying whodunit with elements of the fantastic and macabre, and contains some of Punshon's best set-pieces.
The Dark Garden was first published in 1941. It is the sixteenth of the Bobby Owen mysteries, a series including thirty-five novels. This new edition features an introduction by crime fiction historian Curtis Evans.


The correlation between fasting and blood pressure is scientifically viable with numerous studies having shown that fasting indeed does reduce high blood pressure. In recent years, many practitioners and individuals have actively began considering fasting as an alternative therapeutic dimension to managing elevated blood pressure. This probably explains how you may have landed on this page.
Fasting itself is not a new concept. What we are better understanding is its benefits. For hundreds of years people have always fasted as a means of detoxifying the body and also for religious and spiritual reasons.
The types of fasts differ with some fasts involving eating nothing at all but water, some water only, some fruit and vegetables only which has been refereed to be some in religious circles as the Daniel Fast, as found in the Christian Bible.
Fasting and blood pressure studies carried out in the last 15 to 20 years have concluded that controlled fasting is beneficial to hypertensive patients. In a study originally published in Serbian here but translated into English here, 110 extremely obese participants, male and female, were put on a fasting diet three weeks long.
At the end of the fasting diet, the patients had lost weight from about 132kg to 118kg. Their body max index also decreased and so did their blood pressure both systolic (top number) and diastolic (bottom number). The decrease in blood pressure was from about 143 mm Hg (systolic) to 132 mm Hg (diastolic). This represents a 11 mm Hg drop in blood pressure. Such a drop is very significant in reducing risk of damage to organs and development of cardiovascular disease.
Not only did the study confirm a beneficial link between fasting and blood pressure reduction in obese individuals, after the fast many of the participants, 88%, had a normal oral glucose tolerance test (OGTT). Insulin resistance also increased significantly. The researchers concluded that the 3 weeks of fasting led to normalization of blood pressure and a decrease in lipids in the individuals involved, among other health benefits.
While the study above was for three weeks of fasting, another 1988 study published in Acta Medica Scandinavica journal, later to become The Journal of Internal Medicine, indicated an acute drop in both systolic blood pressure and diastolic blood pressure after two days of fasting. This study indicated a very strong correlation between fasting and blood pressure reduction.
The study involved 11 moderately obese women between the ages of 46 and 62 years with borderline high blood pressure. At the end of the 48 hours of fasting the women had lost weight and experienced reduced systolic blood pressure from 158 mm Hg to 146 mm Hg and a diastolic blood pressure from 96 mm Hg to 86 mm Hg.
The researchers, whilst acknowledging a drastic drop in blood pressure among the participants, conceded that the mechanism by which the fast which led to a reduction in body calories actually led to blood pressure reduction was still unclear.
Earlier we mentioned that there are different types of fasting. The relationship between water fasting and high blood pressure is equally of interest to researchers. To some practitioners water-only fasting is considered a safe and effective method of bringing high blood pressure to normalize.
Water fasting for blood pressure reduction purposes is also thought to be useful in helping people take on health-promoting behavioral changes in their day-to-day lives.
A study published in 2001 in The Journal of Manipulative and Physiological Therapeutics concluded that water fasting is an effective method for high blood pressure reduction. In the investigation, 174 participants suffering from high blood pressure with readings of 140 mm Hg systolic blood pressure and 90 mm Hg diastolic blood pressure (140/90 mm Hg) were put on a water-only fasting lasting a total of 11 days.
In the days leading up to the water fast, the participants took fruits and vegetables for the first 2 to 3 days before embarking on the water fast. After the water-only fast of maximum 11 days they were reintroduced to food beginning with a low-fat, low-sodium, vegan diet for one week.
The astounding results out of the research showed that 90% of the participants had their blood pressure dropping from 140/90 mm Hg by an average of 37 mm Hg for systolic blood pressure and 13 mm Hg for diastolic blood pressure. Moreover, individuals with the most severe high blood pressure had the most significant reduction in their blood pressure.
What is most interesting about this water fasting and blood pressure reduction study is that all the participants who took hypertension medication before the study had no need for medication after the study and therefore discontinued the taking of the meds.
While water fasting is one effective way of reducing high blood pressure, there are yet other approaches to be considered.
Intermittent fasting (IF) refers to set periods of eating and fasting usually in a day and has been used for weight loss. Relatively recently, interest has also increased concerning the link between intermittent fasting and blood pressure reduction.
An example of intermittent fasting is that of practicing Muslims around the world who, during the month of Ramadan, fast everyday from dawn until dusk for the whole month.
A study published in 2015 in the The Journal of Ayub Medical College Abbottabad (JAMC) contained the results of following 40 male participants aged between 18 and 40, with normal blood pressure, during the fasting month of Ramadan. Researchers found evidence that blood pressure had dropped by 7.61 mm Hg before Iftar and by 2.72 mm Hg after Iftar. Iftar refers to the meal eaten after sunset during Ramadan.
The study concluded that intermittent fasting did result in blood pressure reduction, both systolic and diastolic, in individuals with normal blood pressure also refereed to as normotensive.
The benefits of intermittent fasting indeed go further than blood pressure to include reduce inflammation, longevity, and improves lipids levels, helps with neurological disorders and other numerous health benefits.
Scientific evidence from studies that have been completed so far, regardless of what form the fasting may take, apparently shows that there is a beneficial link between fasting and blood pressure reduction. This is very much worth considering particularly by individuals who have not found any comfort in pharmaceutical drugs or those simply looking for a natural way to manage high blood pressure.


You don't have to be a fireplace and chimney expert to have and enjoy a fireplace. After a long summer and a mild fall, you may not be used to using your fireplace on a regular basis. It's important to practice fire safety year-round, but especially in winter. There are more residential house fires in January than any other month. You can bring down the fire risk in your home when you're proactive.
Your fireplace will not be safe if your chimney isn't. The Chimney Safety Institute of America (CSIA) and the National Fire Protection Association (NFPA) recommends routine maintenance and annual inspections for the safest and most efficient chimney system. Actually, when the chimney is most efficient, it is at its safest. If you haven't scheduled a chimney sweep or inspection in the last 12 months, now is the time! You may be using an unsafe chimney that puts your family and home at risk.
If your chimney system has been inspected and is in good shape, it's important to operate your fireplace properly.
Get to know your system. Read all manuals and information provided by your manufacturer or chimney professional. Knowing your chimney anatomy is half the battle.
Burn the best fuel. You should only burn properly seasoned firewood. Do not burn trash, clothes, or other materials in your fireplace. Leaves, pine needles, and other light items (such as paper) can rise up the chimney while aflame, leading to flue fires and even yard or roof fires.
Use proper tools. There are toolsets that you can purchase and use for your fireplace needs. These tools are long-handled to prevent burn and should be well-made from durable metal. In addition to the tools, you can use leather gloves for added protection.
Remove ashes regularly. Too many ashes can make it difficult to light your fire, keep a fire lit, and can become crowded—causing coals and logs to fall out of the hearth! When you remove ashes, use a sturdy, metal bucket, protect your hands with gloves, and use an appropriate shovel. Dispose of ashes away from your house and allow to cool away from fire hazards.
Practice fire safety. Keep decorations away from the hearth. Do not leave children unattended around a fire or still-warm fireplace. Make sure your fire is completely extinguished before leaving the house or going to sleep. Use the damper properly to prevent smoke inhalation/carbon monoxide poisoning.
Make a fire-escape plan. You can do everything possible to prevent a fire, but sometimes they are inevitable. Install smoke alarms and carbon monoxide detectors—checking batteries regularly. Plan an escape (including 2 ways out) and practice it regularly with the entire family.
If a Fire Occurs . . .
If your home is affected by a fire, escape is the #1 priority. Do not fight a fire with an extinguisher. Extinguishers are for small fires and can assist with a safe escape, but the best way to salvage your property is to call the authorities. Keep your phone and car keys together near a door. Include them in your escape plan so that you can sit in a warm car while you call the fire department.


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Guillermina Baeza Spring 2009: Feminine and Dynamic
by Felicia Prince October 21, 2008
Guillermina Baeza Spring 2009
MADRID, Oct 21, 2008 / FW/ — Guillermina Baeza's 2009 collection is inspired by French haute couture of the 50s. Draped designs and sophisticated cuts enhance and harmonize the female figure without losing 21st century functionality and aesthetics.
She is a woman who retrieves the femininity of the past without losing the dynamism and freedom of the present. Satin and stretch organza in pink, fuchsia, mauve and stone dominate the collection.
Born in the Spanish protectorate of Morocco, Guillermina Baeza's exposure to different ethnicities and cultures coupled with an extremely European education have a strong influence in her design aesthetics.
In the 60s, she moved to the cosmopolitan city of Barcelona and, in the 70s, she began her professional career which, little by little, earned her a prominent space in the world of swimwear and lingerie design.
In the 80s, not only the most important European distribution circuits but also the great fashion showcases, such as the Salón Gaudí in Barcelona and the Prêt-à-porter in Paris, began to demand her presence.
Nowadays, Guillermina Baeza is a prestigious, emblematic Spanish fashion figure and the presentations of her swimwear and lingerie collections in different frameworks in the city of Barcelona have become essential engagements for the mass media and basically the specialized press twice a year.
With good reason, her ongoing presence on the catwalks over time has led her to create a style of her own overflowing with originality and glamour, and has reinforced the maxim of Guillermina Baeza's philosophy: «Swimwear and lingerie are not mere accessories. Today, they take on the same importance as outerwear».
Her return to the Madrid Pasarela Cibeles in the 2008 spring-summer edition coincides with a period of greater expansion and international impact. Guillermina Baeza's work has not only made her a leader in the international marketplace, but it has also led her to compete with the best European firms.
Her daughter, Belén Larruy, can currently be found alongside the designer directing the creative team.
Guillermina Baeza's great merit has always consisted in knowing how to apply her intuition to market needs so that she is able to cover its different segments according to styles, tastes and ages.
Photos courtesy of Cibeles Madrid Fashion Week
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Felicia Prince
A Brooklyn native, Felicia Prince began her love affair with fashion at 5 years old when she played dress up with her mother's high heels. Calling fashion as her first love, Felicia is the quintessential fashionista.
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