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Category Archives: Transvaginal Mesh
FDA Recalls Mesh Products for Women
(April 17, 2019) The
US FDA announced yesterday that it was recalling all remaining surgical mesh products used on women to treat pelvic organ prolapse (POP). The FDA said it determined that Boston Scientific and Coloplast, makers of those plastic mesh products, had failed to demonstrate a reasonable assurance of their safety and effectiveness. That assurance is the premarket review standard that had applied ever since the agency reclassified POP meshes as class III (high risk) in 2016.
That reclassification meant POP mesh makers were henceforth required to submit and obtain approval through premarket approval (PMA) applications. PMA is the FDA's most stringent device review path for marketing medical devices in the US.
The agency said BSC and Coloplast now have 10 days to submit a plan to withdraw their products from the market.
FDA Announcement of April 16, 2019:
"The U.S. Food and Drug Administration today ordered the manufacturers of all remaining surgical mesh products indicated for the transvaginal repair of pelvic organ prolapse (POP) to stop selling and distributing their products in the U.S. immediately. The order is the latest in a series of escalating safety actions related to protecting the health of the thousands of women each year who undergo surgery transvaginally to repair POP."
Transvaginal Mesh not FDA Approved
Plastic mesh to treat POP and SUI was never formally approved by the FDA in the usual PMA process. These meshes were, rather, "cleared" under the auspices of the agency's 510k program, which allows some devices to reach the market if the agency determines the product in question is substantially equivalent to a product already approved. In the case of transvaginal mesh (TVM), that comparison has always been shaky at best. Polyurethane or plastic mesh was first used in hernia repair surgery in the mid 1970s, and even then it was shown to cause problems in some people. The company that made the oil-based plastic product is on record as saying it should never be implanted in the human body, but medical device companies used it anyway, and continue to use it.
FDA Dr. Jeffrey Shuren
Jeffrey Shuren, M.D., director of the FDA's Center for Devices and Radiological Health, said, "In order for these mesh devices to stay on the market, we determined that we needed evidence that they worked better than surgery without the use of mesh to repair POP. That evidence was lacking in these premarket applications, and we couldn't assure women that these devices were safe and effective long term."
100,000 + TVM Lawsuits
A multi district litigation court was created to handle more than 100,000 transvaginal mesh lawsuits filed over the plastic devices used to treat POP and SUI. It was the largest ever MDL ever assembled. Jury trials resulted in several large verdicts for plaintiffs, and several thousands of cases were quietly settled for injured women. Hundreds of TVM lawsuits are still on file, and more trials are ongoing.
One lawyer, David Matthews, who won a large jury verdict in a TVM case and later settled several others, said: "The FDA has finally done what the mesh industry would not do on its own. The adverse event reports, which reflect less than 10% of actual injuries to the women implanted with this product, coupled with multiple large jury verdicts based on expert opinions, has shown the risks of these products far outweigh their benefits, if any. This is yet more evidence that the clearance process for these dangerous products is inadequate. As lawyers who have been represented those injured by these defective products for more than eight years, we thank the FDA for declaring these plastic devices unfit for use."
Jury awards $78 Million in Transvaginal Mesh Lawsuit
Transvaginal Mesh Catastrophe
Transvaginal Mesh Media Blackout
Pelvic Mesh MDL Closing to New Cases
(July 11, 2018) The pelvic mesh
multidistrict litigation (MDL) court is closing to new cases. Judge Joseph Goodwin, who oversees the MDL court in Charleston, W. Va., made the announcement last month.
Medical Mesh News Desk reports that the pelvic mesh MDL court was created in January 2012. At its height, it was handling nearly 105,000 cases. Judge Goodwin issued orders on June 21, 2018 that no more cases would be filed in his federal court.
No More Cases Accepted in MDL 2327
With the MDL closing, any new case filings will need to be in state court, according to the order issued by Judge Goodwin. The judge issued the same order in each of the seven pelvic mesh MDLs filed in his federal court.
Charleston, WV MDL Court Closing
The largest MDL court was established for Ethicon (Johnson & Johnson). Judge Goodwin wrote in Pretrial Order #304 in the Ethicon MDL #2327, that since January 2018, his court has requested cases no longer be transferred to MDL 2327.
Related: Johnson & Johnson, Ethicon Mesh Losses Mount
On June 19, 2018, the Judicial Panel on Multidistrict Litigation entered a Minute Order:
"The court ORDERS that plaintiffs may no longer direct file claims against Ethicon, Inc. or Johnson & Johnson or any related entities in the Ethicon MDL (as set forth in PTO # 118) or in any other pelvic mesh MDL assigned to the court."
The other six MDLs with the same order include all of the major pelvic mesh makers – C.R. Bard MDL 2187; American Medical Systems MDL 2325; Boston Scientific MDL 2326; Coloplast MDL 2387; Cook Medical MDL 2440; Neomedic MDL 2511.
State Court Cases
Heretofore, it appears that any plaintiff's lawyer wishing to pursue a newly-signed pelvic mesh case will need to file it in a state court venue, either in the state where the mesh maker is located or in the state where the plaintiff lives.
Mesh News Desk reports that it is not known whether the plaintiff will be able to share in the extensive MDL "Discovery" already gathered to support the MDL cases for trial. Discovery costs can quickly reach half a million dollars or more in a single case, so the question is an important one. One advantage of an MDL court is that discovery costs can often be shared across several cases, so in theory at least, that cost savings is one advantage of the MDL court which could disappear in the face of any future pelvic mesh litigation pursued in state courts. The MDL system can also decidedly cut trial preparation time.
But before the doors close entirely, the federal West Virginia MDL court will host two Wave trials, Wave 7 and 8, against Ethicon.
Wave 7 and 8 Trials
Wave 8 cases in the Ethicon MDL, the last major trial by the federal MDL court, should be concluded with discovery by October 2018 and made trial ready in a June 13th order by Judge Goodwin.
Ethicon / Johnson & Johnson still faces Wave 7 trials of approximately 150 pelvic mesh-injured women whose cases will be heard in the West Virginia federal court. Final settlement conferences are scheduled for August 1, 2018, with trial set to begin August 14.
The West Virginia MDL once contained 104,749 cases representing plaintiffs filing pelvic mesh cases against seven mesh makers. New cases slowed to a trickle beginning in 2018.
The cases of Carolyn Lewis v. Ethicon; Donna Cisson v Bard; Jo Huskey v Ethicon; Tyree v. Boston Scientific; among others, have all been heard in Charleston since 2012.
Thousands Dismissed with Prejudice for non-revision
In the Ethicon MDL, Medical Mesh News Desk also reported that Judge Goodwin just announced that he was dismissing thousands of cases with prejudice because they were non-revision cases.
In Pretrial Order #293, issued Wednesday, April 11, 2018, Judge Goodwin said that the court would dismiss more than 13,000 Ethicon mesh cases in which the plaintiff has a mesh in place but has not attempted any removal or revision.
That judiciary decision could prove unfortunate for several women. Many suffer from such compromised health that they fear any return to a doctor's office could leave them in worse shape than if they took their chances with their current condition or injuries. Any revision or removal surgery can sometimes leave a person in worse shape than she was in before she opted for the revision or removal.
As Jane Akre reports, "There are many reasons a woman may not have her pelvic mesh removed – compromised health, a risk of going under anesthesia, a new complication to her health, a warning from her doctor that the risks of revision outweigh the benefit – all might preclude having a mesh removal. Now that may count against her."
"Dismissed with prejudice" usually means that a plaintiff may not bring another legal action with the same claim. "Dismissed with prejudice" usually means that the case is dismissed permanently, with no future recourse for the plaintiff to seek compensation.
A possible silver lining, according to Mesh News Desk, is that Ethicon/JJ has reportedly agreed that plaintiffs with more than one office revision who have trigger point injections, vaginal physical therapy or vaginal Valium will be treated the same as those plaintiffs who undergo revision surgery within five years.
Transvaginal Mesh Lawsuit | Lawyer
Johnson & Johnson Mesh Verdicts Mount
Johnson & Johnson, Ethicon Mesh Losses Mount
(July 10, 2018) –
In 31 transvaginal mesh (TVM) trials so far, 22 have concluded with verdicts in favor of plaintiffs. Eleven (or half) of those verdicts have gone against Johnson & Johnson and Ethicon, which has seen its mesh losses mount faster than any other TVM manufacturer. J&J has lost five verdicts over its Gynecare Prolift mesh, three for its TVT-O mesh, one for TVT-Abbrevo, one for TVT-Secur, and one for its polypropylene tape used to treat stress urinary incontinence (SUI).
Related: Transvaginal Mesh Lawsuit
In 2016, the FDA reclassified transvaginal mesh for prolapse repair (but not SUI) as Class III (high risk) medical devices. The reclassification made TVM implants ineligible for FDA's 510(k) clearance program. That program had previously allowed mesh products on the market without prior clinical trial testing on human beings. But 510(k) clearance does not amount to FDA approval. TVM or pelvic mesh devices are not FDA approved.
Besides fighting TVM cases in the courts, Johnson & Johnson and other defendants have also quietly settled hundreds of them. As with most settlements, terms are not disclosed and the companies that pay admit no wrongdoing.
Johnson & Johnson (Ethicon) Trials have yielded at least eleven (11) wins for plaintiffs so far. These include:
March 8, 2018 – $35 Million for Plaintiff (Gynecare Prolift)
A U.S. District Court for Northern Indiana jury hit Johnson & Johnson's Ethicon with a $35 million verdict over its Prolift pelvic mesh. ($10 million in damages and $25 million in punitive damages). Barbara Kaiser and her husband Anton Kaiser sued Ethicon in March 2012 after learning that the Prolift mesh her doctor implanted in 2009 to treat pelvic organ prolapse might be causing her low pelvic pain. The lawsuit petition accused J&J and Ethicon of concealing Prolift problems that included high failure, injury and complication rates, as well as "frequent and often debilitating re-operations." Prolift "caused severe and irreversible injuries, conditions, and damage to a significant number of women, including plaintiff," said the complaint.
The Kaisers also alleged that "[Ethicon] consistently under-reported and withheld information (about) Prolift's propensity to fail and cause injury and complications, and have misrepresented the efficacy and safety of the products through various means and media, actively and intentionally misleading the medical community, patients, and the public at large."
The Kaisers also alleged. "Defendants actively and intentionally misled and continue to mislead the public, including the medical community, health care providers, and patients, into believing their Prolift is safe and effective. . ."
Dec. 14, 2017 – $15 Million for Plaintiff (Prolift)
A New Jersey woman was awarded $15 million by a Bergen County (New York) Superior Court jury in her transvaginal mesh lawsuit. The verdict followed 2 ½ weeks of trial testimony and nearly a day of jury deliberation. The woman testified that she had been in constant pain since receiving an Ethicon mesh implant. Jurors found the Johnson & Johnson subsidiary had failed to adequately warn her of the risks associated with Ethicon's Prolift mesh implant. They awarded her $4 million in compensatory damages and $10 million in punitive damages, as well as awarding her husband $1 million for his loss of conjugal affection.
The jury also found Ethicon had failed to provide the woman with adequate safety warnings in regards to the TVT-O mesh implant, but they determined the Prolift mesh alone was responsible for her injuries. (Case No. L-13686-14)
September 6, 2017 – $57 Million for Plaintiff (TVT-Secur)
A Philadelphia jury awarded a woman $57.1 million in damages over a TVT-Secur mesh implant. Ella Ebaugh accused Johnson & Johnson unit Ethicon of making a defective pelvic mesh implant that scarred her urethra and left her incontinent. Her award included $50 million in punitive damages. The jury unanimously backed her claims that two negligently and defectively designed mesh devices had "mutilated" her urethra and left her with little control over her urinary flow.
May 26, 2017 – $2.16 Million for Plaintiff (Prolift)
A Pennsylvania jury awarded $2.16 million to a woman who suffered serious complications from Ethicon, Inc.'s Gynecare Prolift mesh. The verdict came in the Philadelphia Court of Common Pleas. It was the fourth straight loss for Johnson & Johnson and its Ethicon division in a Pennsylvania transvaginal mesh lawsuit. (Case No. 130603835)
April 28, 2017 – $20 Million for Plaintiff (TVT-Secur)
A state-court jury in Philadelphia ordered Johnson & Johnson to pay a New Jersey woman $20 million over a TVT-Secur pelvic mesh. The woman blames J&J's vaginal-mesh inserts for leaving her in constant pain. The jury concluded that the TVT-Secur was defectively designed and caused Margaret Engleman's injuries. They awarded her $2.5 million in damages and then hit J&J and Ethicon with $17.5 million in punitive damages.
February 2016 – $13.5 Million for Plaintiff (Polypropylene tape)
A jury in Philadelphia hit Johnson & Johnson subsidiary Ethicon with a $13.5 verdict in the second case involving its pelvic mesh products to go to trial in the city. The Philadelphia Court of Common Pleas jury awarded Sharon Carlino $3.5 million in compensatory damages, $10 million in punitive damages. It found Ethicon transvaginal polypropylene tape implanted during a 2005 hysterectomy was defective. It also found that Ethicon failed to adequately warn of its risks. Ms. Carlino required three revision surgeries to remove the eroded mesh.
March 4, 2015 – $5.7 Million for Plaintiff (TVT Abbrevo)
A California jury in Los Angeles hit Johnson & Johnson's Ethicon Inc. unit with a $5.7 million verdict. The jury sided with a woman who claimed her doctor had given her an older, heavier version of a pelvic mesh product that will cause her a lifetime of pain. The jury awarded plaintiff Coleen Perry $700,000 in compensatory damages and $5 million in punitive damages. Ms. Perry had been implanted with Ethicon's TVT Abbrevo mesh.
December 2015 – $12.5 Million for Plaintiff (Prolift)
A Philadelphia jury ruled Johnson & Johnson must pay $5.5 million to a Pennsylvania woman over its Ethicon unit's Gynecare Prolift mesh implant. The jury found J&J liable based on the negligence of its scientists in relation to its Prolift pelvic mesh implant. They cited the mesh as the root cause of plaintiff Patricia Hammons' inability to have sex after it was implanted. The jury later added $7 million in punitive damages.
A Pennsylvania state court judge ruled in 2014 that Johnson & Johnson and other pelvic mesh makers like Boston Scientific and Bard will need to challenge more than 860 product liability lawsuits on a case-by-case basis.
September 2014: $3.3 Million for Plaintiff (TVT-O)
In West Virginia, a federal jury in the MDL court hit Ethicon with a $3.3 million verdict over its TVT-O transvaginal sling. The jury found in favor of plaintiff Jo Huskey on all counts, which included strict liability, design defect, failure to warn, negligence.
April 3, 2014: $1.2 Million for Plaintiff (TVT-O)
A Dallas jury ordered Johnson & Johnson to pay a Texas woman $1.2 million for a defective plastic sling – the TVT-O – which J & J's Ethicon division makes and markets for stress urinary incontinence. Freese & Goss and Matthews & Associates represented the woman, Ms. Linda Batiste.
February 2013 – $11.11 Million for Plaintiff (Prolift)
A New Jersey jury awarded Linda Gross an $11.11 million verdict in her lawsuit against Johnson & Johnson's Ethicon over the company's Prolift vaginal mesh product. Ms. Gross suffered 18 surgeries in repeated attempts to remove the failed mesh and resultant scar tissue. The jury found J&J had failed to warn patients and doctors about the risks of its mesh products and that the company made fraudulent misrepresentations.
Johnson & Johnson TVM Court Wins
Johnson & Johnson settled at least one Prolift trial which had reached the MDL courtroom, and it has won two TVM trials so far. In February 2014, company lawyers were able to have Judge Goodwyn dismiss the case of a Texas woman against Ethicon and J&J (Lewis v. Ethicon/JJ) in a TVT-O case, and a Texas jury awarded nothing in a Nov. 2015 case over a Prosima device that reached trial (Cavness v. Ethicon/JJ). J&J also settled with the plaintiff in at least one TVM case which reached trial in March 2015 (Bellew v. Ethicon/JJ).
Transvaginal Mesh Lawsuits
Today, many thousands of TVM cases remain unresolved, parked in various state courts across the U.S. and in the federal MDL in West Virginia. The overseer of the federal MDL court, Justice Joseph Goodwyn, announced in June 2018 that he will no longer accept new mesh cases. Judge Goodwin has overseen several MDL trials and still has more than 100,000 cases on his books. He has urged the defendants to settle, some have occasionally obliged, but the sheer number of cases in the MDL makes it the largest federal court docket for mass tort litigation since asbestos.
Transvaginal Mesh Lawsuit | Pelvic Mesh Lawsuit
States sue J&J Transvaginal Mesh Maker
Jury awards $73 Million Transvaginal Mesh Verdict
100,000 Women suing over Gynecological Mesh
(July 7, 2018) The
mainstream media has finally recognized that a huge number of women are suing mesh manufacturers over their plastic products. A CBS news story reported last month that nearly 50,000 women are suing one mesh maker alone over gynecological mesh. The polypropylene (plastic) mesh is often used to treat pelvic organ prolapse (POP) and stress urinary incontinence (SUI), which affect millions of women. At least 100,000 women across the country are suing over gynecological mesh. Many have filed their cases in the multidistrict litigation court in West Virginia. Several other pelvic mesh lawsuits have been filed in various state courts throughout the country.
Related: Transvaginal Mesh Lawsuit | Pelvic Mesh
Gynecological Mesh Makers
The CBS news story mentioned only Boston Scientific as a defendant in transvaginal mesh (TVM) cases, though several other gynecological mesh makers also face lawsuits. Other defendants include Johnson & Johnson (Ethicon), American Medical Systems (AMS), C.R. Bard, Coloplast, and Cook Medical.
Sixty Minutes reported that Boston Scientific faces some 48,000 lawsuits in what has generated the largest multi-district litigation since asbestos. The suits claim mesh can inflict life-changing pain and injury. Suits against Boston Scientific also claim the company used a mesh product never meant to be put inside the human body.
Related: Johnson & Johnson Mesh Verdicts Mount
More than two million American women have received gynecological mesh implants. All the mesh makers claim their products are safe.
CBS News reported the story of one woman implanted with a Boston Scientific gynecological mesh for stress urinary incontinence and also to lift organs that shifted after pregnancy. Gwyn Madsen had a Boston Scientific implant in 2012.
Gwyn Madsen told CBS that the mesh "felt like a cheese grater inside of me."
Ms. Madsen said she suffered pain which left her barely able to sit or play with her children. She said, "It felt like the material was pulling on the muscles and I'd get shooting pains. You almost felt like there was something inside of you that was like sandpaper back and forth, every time you'd walk."
Boston Scientific, which lost a $73 million verdict over one of its TVM products following a 2016 trial in Texas, has fought allegations like Ms. Madsen's for years. The company told CBS: "Nearly one million women have been successfully treated. (We) have extensively tested the [plastic] resin to confirm its composition, safety and performance."
The American Urogynecological Society – which has embraced the plastic mesh because it is easier to apply than the gold standard suture method for repairing POP or SUI – has also claimed plastic mesh is "safe and effective." Many doctors, however, disagree.
Dr. Michael Margolis testified for the woman who won a $73 million verdict in the Texas case. He told CBS that the women's mesh causes a chronic inflammatory reaction. He has removed more than 350 mesh implants.
"The slings I've removed are substantially altered in their architecture," Dr. Margolis told CBS. "They are shrunk by at least 50% in width. They are encased in scar tissue. The pores [in the mesh] shrunk substantially."
Dr. Margolis showed CBS a mesh he removed which had been implanted. It had shrunk substantially, he said, had folded, contracted, embedded in scar tissue, and was choking off the woman's urethra. He said it was half the size it had been upon implant.
Dr. Margolis told Scott Pelley the implant is "not supposed to change."
Missing from the CBS story and interviews was the fact that Boston Scientific, as well as Johnson & Johnson (Ethicon, American Medical Systems (AMS), and Bard have all lost multi-million-dollar verdicts to women implanted with the companies' transvaginal mesh products.
FDA: Serious Adverse Events "not rare"
The story did include the fact that the FDA has issued a damning report regarding TVM mesh. In 2011, the FDA said that it found mesh used to support organs after pregnancy had resulted in nearly 4,000 "reports of injury, death, and malfunction" and complications including "pain, infection, urinary problems, bleeding and organ perforation." The FDA wrote that, "Serious adverse events are not rare."
Indeed. At least 100,000 women would apparently agree with that statement.
$73 Million TVM Verdict
Johnson & Johnson illegally destroyed Mesh Evicdnce
ProLift Mesh Recalled
Washington State sues Johnson & Johnson Mesh Maker
is suing Johnson & Johnson mesh maker Ethicon for defective pelvic mesh sold to Washington women. The state of Washington vs. Johnson & Johnson, et al. petition, filed May 24, 2016, says J&J sold some 12,000 pelvic or transvaginal mesh devices to unsuspecting Washington women from 2005-2015.
The Washington petition alleges that J&J marketed its mesh products as "new and revolutionary," claimed that they saved time in the operating room, offered superior outcomes to traditional POP or SUI stitch-surgery methods, and had the advantage of faster recovery times.
The complaint reads, "Defendants made these representations without disclosing to doctors the serious complications their mesh can cause women."
The petition further states that J&J marketed its mesh products as "improvements over traditional repair methods (i.e. native tissue repair) when they knew such claims were inaccurate."
Severe, Unavoidable Complications
The petition language is clear and forthright, alleging similar problems about which more than 100,000 women across the country have complained and filed suit:
"Defendants knew at all relevant times that the presence of polypropylene [plastic] in the body and the process of implanting mesh through the vagina could cause severe unavoidable complications. (Defendants) knew these complications are caused by the design and placement of the mesh and cannot be avoided by good surgical technique alone."
Permanent Disability, Egregious Suffering
The petition alleges that some women become "permanently disabled" from mesh complications, from mesh that can erode and migrate into internal organs, becoming nearly impossible to remove:
"The suffering by these women is even more egregious considering that the underlying condition the mesh is meant to treat is not life threatening. Further, women have a non-mesh surgical alternative [with native tissue] that has been used for decades. Native tissue repair does not pose the same risks as mesh and can be just as effective for treating pelvic floor conditions."
Mesh misrepresented, adds Risks
The main problem with plastic mesh for women's pelvic floor repairs is tidily summed up in the complaint section which says J&J misrepresented the safety of its products by failing to disclose risks and complications associated with pelvic floor surgery: "Defendants failed to disclose that their mesh devices carry similar risks as other pelvic floor surgeries and additional risks caused by the mesh."
All mesh makers have always had a fundamental problem with the very idea of selling a medical device designed to be implanted in an open-contaminated area such as the vagina, which cannot be sterilized, ever. Such a procedure violates the first rule of surgery, that one needs a clean, sterile field of operation.
Contaminated Surgical Procedure
The petition reads: "Although all of Defendants' products were used in contaminated areas – the vagina, Defendants misrepresented that 'if the mesh implant is to be used in contaminated areas, it must be only with the understanding that subsequent infection may require its removal.'"
The petition further states that Defendants misrepresented plastic mesh's risk in other ways, including that mesh causes infection in a cavity that can never be completely sterilized; mesh is not inert as claimed by Defendants, on the contrary, it causes a foreign body reaction; the mesh hardens, contracts, erodes into other body organs, becomes so rigid and distorted that complete mesh removal is extremely difficult or impossible.
The petition details several complications that can result:
• chronic infection
• chronic foreign body reaction
• chronic inflammation
• mesh hardening
• mesh contracture, erosion into other body organs
• mesh exposure (migration of mesh into the vagina)
• mesh extrusion
• mesh degradation (breakdown of mesh particles)
• permanent dyspareunia (inability to have sex)
• chronic pain
• vaginal shortening, stiffness, distortion
• sexual dysfunction
• injury to sexual partners
• urinary and bowel dysfunction
• other lifelong problems
The petition reads: "Mesh removal is the only treatment option for most continuing mesh complications. Removal often requires multiple surgeries, which may or may not resolve complications, and may in fact result in new problems. (Yet) Defendants failed to disclose the lack of a safe and effective means for removal."
Mesh not FDA Approved
The petition also alleges that J&J and its subsidiaries misrepresented in their informational and marketing materials that their Polypropylene Mesh Products were FDA Approved. Mesh was never approved. It was only cleared by the FDA 510(k) equivalency process, which fails to verify safety or efficacy of the product in question and does not usually require clinical trials.
J&J and its subsidiaries also stand accused by the petition of failing to disclose adverse events reported by women who had been implanted with transvaginal or pelvic mesh
Mr. Bob Ferguson first launched an investigation into J&J's pelvic or transvaginal mesh implants when a Washington state woman wrote the DA a letter detailing the problems she had with mesh and complaining that she had not been warned of the risks.
Mr. Ferguson filed the petition, which was also signed by Washington State Senior Counsel Elizabeth J. Erwin, Asst. AG Andrea M. Alegrett, Asst. AG Leilani N. Fisher.
Transvaginal Mesh Lawsuit
Pelvic Mesh not approved by FDA
Pelvic Mesh contracts, shrinks, degrades: Expert
J&J hit with State Lawsuits over Pelvic Mesh
The states of
California and Washington have filed lawsuits against Johnson & Johnson for false advertising and deceptive marketing of surgical mesh for women. The lawsuits say J&J failed to properly inform patients and doctors of the potential severity of mesh complications.
Washington Woman Blows Whistle
According to Mesh News Desk, the Washington state lawsuit has its roots in 2012 when a Washington woman wrote her attorney general to report that women were not warned about the dangers of mesh, that there was no informed consent, and thousands of women like her were duped into believing that what J&J called a "minimally invasive" procedure could not end in a lifetime of pain. (Washington Mesh Complaint.)
J&J Concealed Mesh Risks
Attorneys general Kamala D. Harris of California and Bob Ferguson of Washington say Johnson & Johnson knowingly concealed the risks associated with their pelvic mesh products. The mesh in question is designed to treat common conditions in women such as stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The plastic mesh material can cause serious complications including loss of sexual function, chronic pain, infection, permanent urinary or defecatory dysfunction, a devastating impact on quality of life.
The attorneys general launched the lawsuits against J&J and its subsidiary Ethicon Inc. in California and Washington state courts. California alleges violations of the state's unfair competition and false advertising laws. Washington state charges "tens of thousands of violations" of the state's consumer protection laws.
Deceptive Practice Charges
California and Washington are both seeking injunctive relief and monetary penalties potentially in the millions of dollars. Harris wrote that her action is meant, "to ensure that J&J stops its deceptive practices."
Ms. Harris said, "Johnson & Johnson put millions of women at risk of severe health problems by failing to provide critical information to doctors and patients about its surgical mesh products. Johnson & Johnson's deception denied women the ability to make informed decisions about their health and well-being."
Mr. Ferguson said in a statement May 24, 2016 that complications can crop up years after surgery and are in many cases irreversible, while mesh removal mesh can be nearly impossible.
Horrific Injuries, Doctors duped
Mr. Ferguson said, "It's difficult to put into words the horrific injuries and pain many women are still suffering as a result of Johnson & Johnson's deception. They believed they were making informed medical decisions, but that was impossible when Johnson & Johnson was spreading inaccurate information about its products' risks, essentially duping doctors into using their own patients as clinical trials."
J&J Responds
A J&J spokeswoman told Law360 this week that J&J plans to "vigorously defend itself against the allegations." J&J said in the statement that both states' lawsuits were "unjustified."
The J&J statement further said, "The evidence will show that Ethicon acted appropriately and responsibly in the marketing of our pelvic mesh products. The use of implantable mesh is often the preferred option to treat certain female pelvic conditions, including pelvic organ prolapse and stress urinary incontinence, and is backed by years of clinical research."
J&J Lawsuit Verdicts Upheld
The states' lawsuits continue a long series of litigation against J&J over its pelvic mesh products.
In some of the latest developments, in March 2016 a New Jersey appeals court upheld a $11.1 million jury award for a woman who claimed Ethicon's pelvic mesh caused debilitating nerve pain. The appeals court ruled that ample evidence presented at trial showed that better warnings of the product's risks might have prevented her injuries.
In April 2016, a Philadelphia jury returned a $13.5 million verdict against J&J and Ethicon in another case brought by a woman who claimed J&J's mesh implant was defective and that it reduced her to nearly constant pain, discomfort, and sexual dysfunction. J&J appealed that verdict, as it has appealed every pelvic mesh verdict rendered against it.
Both Ms. Harris and Mr. Ferguson said May 24 that in addition to false advertising and deceptive marketing, J&J misrepresented the severity and frequency of common complications, and failed to disclose that its surgical meshes "presented risks not present in alternative treatment options."
Ms. Harris said that J&J had sold more than 42,000 pelvic mesh devices in California from 2008- 2014. She said the company faces more than 35,000 personal injury lawsuits across the country..
Mr. Ferguson said J&J had sold 12,000 mesh products in Washington state during roughly that same time period. He said he would seek the maximum $2,000 penalty for each violation of Washington's consumer protection laws.
Law360 reports the state of California is represented by Kamala D. Harris, Judith A. Fiorentini, Jinsook Ohta, Sanna Singer and Michelle Burkart of the state Attorney General's Office.
Washington state is represented by Robert W. Ferguson, Elizabeth J. Erwin, Andrea M. Alegrett and Leilani N. Fisher of the state Attorney General's Office.
The cases are California v. Johnson & Johnson et al., in the Superior Court of the State of California, County of San Diego, and Washington v. Johnson & Johnson et al., in the King County Superior Court in the State of Washington.
Pelvic Mesh contracts, shrinks, degrades
J&J hit with $5.7 Million Mesh Verdict
$73 Million Pelvic Mesh Verdict
Pelvic Mesh Catastrophe
FDA reclassifies Pelvic Mesh as High Risk
The FDA now reclassifies pelvic mesh as high risk. On January 4, 2016,
the FDA announced that transvaginal or pelvic mesh used to treat pelvic organ prolapse (POP) will be reclassified as a high risk or class III device. The mesh previously held "moderate risk" or class II status. (See the FDA Release.)
Scotland regulates Pelvic Mesh
Unlike the U.S., where
industry calls the shots and regulators mostly abide with business, the Scottish government has moved to regulate transvaginal or pelvic mesh treatment options offered to women with pelvic organ prolapse and stress urinary incontinence.
The UK Daily Record reported this week that three of four mesh procedures used routinely in Scottish hospitals will no longer be recommended by doctors. Scotland seems truly interested in protecting women at the expense of mesh makers, rather than the other way around, U.S. style.
Plaintiff's Pelvic Mesh Expert Testimony continues
DALLAS –
Mesh News Desk reported that plaintiff's expert Dr. M (name withheld to avoid red herring arguments from defense counsel) continued to testify for a second day, September 29, 2015. It would be the final day of the Plaintiff's case in Cavness v. Ethicon (Cavness v. Kowalczyk et al., case # DC-14-04220).
A California urogynecologist and mesh removal expert, Dr. M continued his testimony about the pelvic mesh implanted in the plaintiff. He opined that the pain she continues to experience three years after her April 2012 implant is the same chronic pain felt by thousands of other women with pelvic mesh implants.
Pelvic Mesh contracts, shrinks, degrades – Expert
Day 6 – Sept. 28, 2015 –
of the latest trial against Ethicon in Dallas brought testimony from Dr. M (name withheld to prevent defense lawyers' red herring arguments), a urogynecologist from the San Francisco bay area, double board certified in Ob-Gyn and Urogynecology. Dr. M testified that he has done more than 25,000 surgical procedures, including 5,000 to 6,000 for stress urinary incontinence and the rest – some 14,000 – related to POP (pelvic organ prolapse). He also performs about six surgeries a week to remove plastic mesh from women.
Note: Much of this story comes from Mesh News Desk.
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Displaying all 58 items (0.000 seconds)
State & Province: New Mexico Place: Mescalero Indian Reservation (N.M.)
1. Antonio Apache and His Garden, Mescalero, New Mexico
2. Apache Child, Mescelero, New Mexico
3. Apache Man Wearing a Blanket
4. Apache Scout, Mescalero Indian Reservation, New Mexico
5. Boys at Mescalero Boarding School
6. Bride, Groom, Bridesmaid, and Mr. Overman, Mescalero, New Mexico
7. Church Choir, Mescalero, New Mexico
8. Club House of Roman Catholic Church, Mescalero Indian Reservation, Mescalero, New Mexico
10. Coming Out Party Dress, Mescalero Apache Girl
11. Community House, or the Lodge of the Reformed Church, Mescalero Indian Reservation
13. Dancer, Mescalero, New Mexico
14. David Fatty, Mescalero, New Mexico
15. Group of Men with a Steam Tractor
16. Group of Mescalero Girls with Miniature Tipis, Mescalero, New Mexico
17. Indian Arrow Heads Picked up in Mescalero, New Mexico
18. Indian Reservation School and Other Buildings, Mescalero, New Mexico
19. Indians Gathered in Camp for Annual Feast, Mescalero, New Mexico
20. Logging at Mescalero, New Mexico
21. Lucy Kanseah and Baby
22. Mescalero Adults and Children Sitting on Porch of House, Mescalero, New Mexico
23. Mescalero Apache School Girls with Mrs. Overman
24. Mescalero Children, Mescalero, New Mexico
25. Mescalero Family and Their Dog in front of House
26. Mescalero Indian on a Horse, New Mexico
27. Mescalero Medicine Tipi
28. Old Apache Scouts, Mescalero Indian Reservation, Mescalero, New Mexico
29. Outdoor Wedding of Two Mescalero Couples, Overman (Missionary) Officiating
30. Parsonage, Reformed Church, Mescalero Indian Reservation, Mescalero, New Mexico
32. Parsonage, Reformed Church, Mescalero Resvervation, Whitetail, New Mexico
34. Portrait of Uncas Noche an Interpreter for the Government Office at Mescalero
35. Reformed Church, Mescalero Indian Reservation, Mescalero, New Mexico
39. Roman Catholic Church, Mescalero Indian Reservation, Mescalero, New Mexico
41. Round-up, Mescalero, New Mexico
43. Salon on Horse-Hack, Mescalero, New Mexico
44. School Dormitories and Dining Room, Mescalero, New Mexico
45. Teacher (Mrs. Overman) and School Girls at Mescalero, New Mexico
46. Threshing Grain at Mescalero, New Mexico
47. Tipis and Other Buildings on Mescalero Reservation, New Mexico
49. Two American Indian Women on a Donkey, Mescalero, New Mexico
50. Type of House Built for Fort Sill Group at Whitetail, Mescalero Reservation, New Mexico
52. Uncas Noche and Apache Men at Mescalero Lodge
53. View of Mescalero, New Mexico, 1910
54. Waiting for Beef Ration, Summer 1910
56. White Tail Chapel, Mescalero Indian Reservation
58. Woman with Infant in Cradleboard on Her Way to Church, Mescalero, New Mexico
Mescalero Indian Reservation (N.M.) (58)[x]
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Noche, Uncas (3)
Overman, Nathan E., 1860-1937 (3)
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Fatty, David (1)
Kanseah, Lucy (1)
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New Mexico (58)[x]
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text:
Maxence Sibille
French drummer Maxence Sibille was born in 1983 in Geneva, Switzerland. He began playing the drums at the age of ten. In 2003,
he was admitted to the École des Musiques Actuelles et des Technologies Musicales (ETM) in Grenoble, France, and graduated in 2006. That same year, he went on to study at the prestigious Haute École de Musique in Lausanne, Switzerland. He graduated with a master's
degree in performance in 2012. While in college, he also studied at the Centre des Musiques Didier Lockwood (CMDL) under André Charlier, and regularly took classes with FranckAguhlon, Loïc Pontieux, and Simon Goubert.
Maxence has played with numerous artists ranging from jazz to hip-hop to rock, Swiss, French, and Danish musicians such as Erik Truffaz, Flavio Boltro, Didier Lockwood,
Glenn Ferris, Malcolm Braff, Matthieu Michel, Guillaume Perret, Jeff Baud, Patrice Moret, Banz Oester, Jonas, That Pork, Jean-Lou Treboux 5tet, Matthieu Llodra Trio, Trip.in, and the Kenneth Dahl Knudsen Group. He has performed at
Jazz à Vienne, the Koktebel Festival, Bern, Fribourg, the Cully Jazz Festival, the Montreux Jazz Festival, Verbier, Lugano, Jazz à Juan-les-Pins, the Paléo Festival in Nyon, Rock'Oz Arènes in Avenches, Festi'neuch, the Caprices Festival in Crans-Montana, the Festival des Puces de Saint-Ouen (Paris), the Festival de la Francophonie in China and in central Asia, Jazz in Fabrica in São Paulo, and B-Flat in Berlin.
Photo : Maxence Sibille © Gambrinus
Maxence Sibille on Twitter
Simon Tailleu
Gauthier Toux


text:
Fort Collins' Parking Problem
by meg | Jul 18, 2016 | Car Parking, Transportation | 0 comments
Fort Collins has a parking problem and it's evident every time you get in a car and hit the road. Although neighborhood streets aren't so bad, once you hit an arterial, the congestion is noticeable. There are some streets in the City (I'm looking at you College, Shields, Harmony and Timberline.) that get so full up with cars that the absolute fastest you can drive is 10 mph under the speed limit. The subsidized, abundant availability of parking in Fort Collins has led to ever increasing amounts of congestion, even in areas that are relatively new to the city (and therefore should have theoretically been built to accommodate the volume of cars).
It doesn't have to be this way.
Research published in November 2015 has shown that the more parking is available, especially "free" parking, the more people will choose to drive their cars. As parking becomes limited, people are more willing to consider carpooling or other types of transportation options such as walking, biking, public transit, or ride sharing. The study by Chris McCahill (from the University of Wisconsin) and Norman Garrick, Carol Atkinson-Palombo, and Adam Polinski (all from the University of Connecticut) used a combination of prior and original research to determine causality between the availability of parking and car use. What they found was a clear connection between the two — that parking led to increased car use, but increased car use did not necessarily lead to more parking.
We have several great examples of this effect that play out every summer in downtown Fort Collins. During most of the year, it's fairly easy to find parking in Old Town. It might not be right smack in front of the place you want to visit, but then again, when you visit Walmart or Target, it's pretty rare to get a spot right in front of the door there either. So you end up in a spot that's nearby and you walk the remaining distance to the shop. But, in the summer when we have festivals such as New West Fest, when not only are several parking spots taken up with vendors booths, but also tens of thousands of people are flooding in from not only the farthest reaches of Fort Collins but from neighboring cities as well, that's when suddenly the MAX rapid bus transit line, or the dusty bicycle hanging up in the garage, or carpooling with a bunch of friends, suddenly becomes a far better option than everyone hopping in their own car and circling the area for an hour trying to find a spot.
Front Range Village at Harmony and Ziegler as seen from Google Earth.
New development with enough parking space to fit several more Super Targets.
The irony is that this parking problem is only compounding another one of our local problems… affordable housing.
According to Pat Ferrier at the Coloradoan, building projects north of the Poudre river, in the East Larimer County (ELCO) Water District, are becoming increasingly expensive, in part due to the cost of the water rights. Connecting to Fort Collins Utilities' water system is cheaper because the City holds more senior water rights. (If you're interested in water issues in Fort Collins, you may want to check out this recent article I wrote for Forgotten Fort Collins entitled, Poudre River Water in Your Tap.)
So every development project that's taking place within the Fort Collins Utilities water district has the advantage of tapping into a cheaper water supply system, making the overall cost of the project less expensive. But a lot of the available land within this water district is already taken up… quite a bit of it with vast, sprawling parking lots. And even new developments, such as Front Range Village at Harmony and Ziegler, opted for prodigious amounts of parking rather than mixed-use, dense development that would provide housing, office space and amenities in a walkable/bikeable people-friendly environment. (If you've ever tried walking from the Council Tree library to the Super Target, you've probably experienced first hand the car-oriented design of the "Village.")
JC Penney on S. College as soon from Google Earth.
There are several reasons why development like this happens. For one thing, we're used to it. It's been happening ever since the 1950s when the automobile became the mediator of urban planning across the continent. Prior to that point in time, we saw commercial buildings that often included retail on the first floor and offices or residential units upstairs. (Take a look at almost any commercial building downtown built before the war and you'll see what I mean.) After World War II, retail properties in particular expanded outward, but not upward, and they were built as islands in the midst of a sea of parking. After 65 years of this type of development, it's come to feel normal for most people. It's what we grew up with. We don't think in terms of shopkeepers who live over their stores any more. Now our expectations revolve around big box stores with shareholders, not shopkeepers.
Zoning can also be a problem. When the JC Penney's building (originally a Shopko) was built in 1994, parking minimums appear to have been pretty high (based on the aerial view shown above). I don't know that I've ever seen the parking lot more than half full. Another classic example is the Target on W. Troutman with the parking lot that doesn't even fill up all the way on Black Friday. (That Target was built in 1979, when parking minimums were at their maximum.) But the City of Fort Collins has taken great strides to reign in the parking minimums and has even created a Transit-Oriented Development (TOD) overlay zone that radically cuts into the parking requirements (as residents around The Summit on S. College discovered when residents started parking their cars in the nearby residential neighborhoods instead).
But probably the biggest reason of all has to do with the pushback from residents. As the problem at the Summit made clear, people aren't going to pay to park their car somewhere when they can just drive out a little further and park it for free in front of someone else's house. Why pay for parking when the local government is providing a subsidized benefit that simply requires walking a little further? The same kind of attitude rules in Old Town. With on street parking being free, people would rather circle the block than head to a parking structure (where parking is still very cheap).
But whether we use a car or not, we're all paying for the "free" parking we have in Fort Collins. We pay in terms of higher taxes that are used to build and maintain public parking throughout town (in garages, in lots, and on the street). We pay at the checkout counter when we shop with a retailer that provides "free" parking, the cost of which has lead to increased rents or higher building costs, and which are being passed on to shoppers in the form of higher prices.
We also pay in other ways as well. We have reduced air quality, reduced quality of life (as a result of being stuck in traffic), and reduced housing availability as well as higher rent costs. And the icing on the cake is that the more cars there are on the street, the more deaths and injuries there are due to crashes. In other words, while most of us pay for this free parking in the form on higher taxes and retail costs, there are some who end up paying with their lives. Is free parking really worth that?
The parking lot by the Walmart on S. College, on the south end of Mason street. (via Google Maps)
If we really want to tackle traffic congestion in Fort Collins, if we really want to reduce the amount of traffic violence, cap greenhouse emissions, and breath easier (literally), then one of the most effective steps we can take today is to reduce the amount of parking that's being added to our city.
Ferrier, Pat. "Water Costs Drive NE Fort Collins Home Prices." Coloradoan[Fort Collins] 28 Aug. 2015: n. pag. Coloradoan. Gannett, 28 Aug. 2015. Web. 18 July 2016.
McCahill, Chris, Norman Garrick, Carol Atkinson-Palombo, and Adam Polinski. Effects of Parking Provision on Automobile Use in Cities: Inferring Causality. SFMTA: Municipal Transportation Agency. N.p., n.d. Web. 18 July 2016.
Pearce, Matt. "Here's Why More U.S. Drivers Are Dying in Crashes This Year."Los Angeles Times. N.p., 11 Sept. 2015. Web. 18 July 2016.
Fort Collins' Parking Problem - with added color coding - Pedal Fort Collins - […] my last article, Fort Collins' Parking Problem, I included an aerial view of the fairly new Front Range Village…
Parking, Parking, and More Parking - Pedal Fort Collins - […] that they might not otherwise choose to include in a new development. So, for example, the shops at Front…
How to Fix Parking Problems in Cities - Los Angeles High Tech News - […] However with the number of cars on the street increasing, and along with it the time taken to park,…


text:
Q: Python GEKKO ODE unexpected results I've been trying to implement an ODE model for simulation of the insulin signaling pathway, as it is presented in the supplementary material of this paper, using python's GEKKO.
The model variation implemented was the 'Md3', with the following equations, constant and initial values:

Even though the paper does not provide the supplementary code's outcome, one would expect the results to be curves, instead of the ones that result from my code:
I have checked the equations and constant values, tried adding lower and upper bounds to the variables and experimented with the m.options.IMODE and m.options.NODES parameters, but these didn't seem to help.
Any piece of advice would be much appreciated.
def insulin_pathway_CM(time_interval, insulin=0):

    m = GEKKO()
    t = np.linspace(0, time_interval-1, time_interval)
    m.time = np.insert(t,1,[1e-5,1e-4,1e-3,1e-2,0.1])

    # initialization of variables
    ins = m.Param(value=insulin)
    IR = m.Var(10)
    IRp = m.Var()
    IRS = m.Var(10)
    IRSp = m.Var()
    PKB = m.Var(10)
    PKBp = m.Var()
    GLUT4_C = m.Var(10)
    GLUT4_M = m.Var()

    # initialization of constants
    k1aBasic = 1863.78
    k1f = 38668.300000000003
    k1b = 40229000
    k2f = 401394
    k2b = 36704300
    k4f = 336782
    k4b = 187399
    k5Basic = 85530.899999999994
    k5f = 11264.799999999999
    k5b = 26389900

    # equations
    m.Equation(IR.dt() == k1b*IRp - (k1f*ins*1000*IR + k1aBasic*IR))
    m.Equation(IRp.dt() == -k1b*IRp + k1f*ins*1000*IR + k1aBasic*IR)
    m.Equation(IRS.dt() == k2b*IRSp - (k2f*IRp*IRS))
    m.Equation(IRSp.dt() == -k2b*IRSp + k2f*IRp*IRS)
    m.Equation(PKB.dt() == k4b*PKBp - k4f*IRSp*PKB)
    m.Equation(PKBp.dt() == -k4b*PKBp + k4f*IRSp*PKB)
    m.Equation(GLUT4_C.dt() == k5b*GLUT4_M - (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))
    m.Equation(GLUT4_M.dt() == -k5b*GLUT4_M + (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))

    m.options.IMODE = 7
    m.options.OTOL  = 1e-8
    m.options.RTOL  = 1e-8
    m.options.NODES = 3
    m.solve(disp=False)

    # plotting
    fig, axs = plt.subplots(4, 2, figsize=(20, 20))
    axs[0, 0].plot(m.time, IR)
    axs[0, 0].set_title('IR(t)')
    axs[0, 1].plot(m.time, IRp)
    axs[0, 1].set_title('IRp(t)')
    axs[1, 0].plot(m.time, IRS, 'tab:orange')
    axs[1, 0].set_title('IRS(t)')
    axs[1, 1].plot(m.time, IRSp, 'tab:green')
    axs[1, 1].set_title('IRSp(t)')
    axs[2, 0].plot(m.time, PKB, 'tab:red')
    axs[2, 0].set_title('PKB(t)')
    axs[2, 1].plot(m.time, PKBp, 'tab:purple')
    axs[2, 1].set_title('PKBp(t)')
    axs[3, 0].plot(m.time, GLUT4_C, 'tab:olive')
    axs[3, 0].set_title('GLUT4_C(t)')
    axs[3, 1].plot(m.time, GLUT4_M, 'tab:cyan')
    axs[3, 1].set_title('GLUT4_M(t)')

    plt.figure()
    plt.show()
    return

time_interval = 60
insulin = 100
insulin_pathway_CM(time_interval, insulin)

A: Lutz Lehmann is correct. A plot of the derivatives with an ending time of 1e-5 shows that most of the action happens in a short period of time.

Try a shorter time span.
m.time = np.linspace(0,1e-5,100)

This shows the fast dynamics.

There is likely an error with the equations such as a units issue (time in days or years?) or the authors forgot to include some type of volume factor for the patient such as blood volume or body volume.
# equations
V1 = 1e9  # hypothetical volume 1
V2 = 10   # hypothetical volume 2
m.Equation(V1*IR.dt() == k1b*IRp - (k1f*ins*1000*IR + k1aBasic*IR))
m.Equation(V1*IRp.dt() == -k1b*IRp + k1f*ins*1000*IR + k1aBasic*IR)
m.Equation(V1*IRS.dt() == k2b*IRSp - (k2f*IRp*IRS))
m.Equation(V1*IRSp.dt() == -k2b*IRSp + k2f*IRp*IRS)
m.Equation(V2*PKB.dt() == k4b*PKBp - k4f*IRSp*PKB)
m.Equation(V2*PKBp.dt() == -k4b*PKBp + k4f*IRSp*PKB)
m.Equation(V2*GLUT4_C.dt() == k5b*GLUT4_M - (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))
m.Equation(V2*GLUT4_M.dt() == -k5b*GLUT4_M + (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))

Here are more reasonable dynamics with the original time scale (0-60 hrs).

from gekko import GEKKO
import numpy as np
import matplotlib.pyplot as plt

def insulin_pathway_CM(time_interval, insulin=0):

    m = GEKKO()
    t = np.linspace(0, time_interval-1, time_interval)
    m.time = np.insert(t,1,[1e-5,1e-4,1e-3,1e-2,0.1])

    # initialization of variables
    ins = m.Param(value=insulin)
    IR = m.Var(10)
    IRp = m.Var()
    IRS = m.Var(10)
    IRSp = m.Var()
    PKB = m.Var(10)
    PKBp = m.Var()
    GLUT4_C = m.Var(10)
    GLUT4_M = m.Var()

    # initialization of constants
    k1aBasic = 1863.78
    k1f = 38668.300000000003
    k1b = 40229000
    k2f = 401394
    k2b = 36704300
    k4f = 336782
    k4b = 187399
    k5Basic = 85530.899999999994
    k5f = 11264.799999999999
    k5b = 26389900

    # calculate derivatives
    d = m.Array(m.Var,8)
    m.Equation(d[0] == k1b*IRp - (k1f*ins*1000*IR + k1aBasic*IR))
    m.Equation(d[1] == -k1b*IRp + k1f*ins*1000*IR + k1aBasic*IR)
    m.Equation(d[2] == k2b*IRSp - (k2f*IRp*IRS))
    m.Equation(d[3] == -k2b*IRSp + k2f*IRp*IRS)
    m.Equation(d[4] == k4b*PKBp - k4f*IRSp*PKB)
    m.Equation(d[5] == -k4b*PKBp + k4f*IRSp*PKB)
    m.Equation(d[6] == k5b*GLUT4_M - (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))
    m.Equation(d[7] == -k5b*GLUT4_M + (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))

    # equations
    V1 = 1e9  # hypothetical volume 1
    V2 = 10   # hypothetical volume 2
    m.Equation(V1*IR.dt() == k1b*IRp - (k1f*ins*1000*IR + k1aBasic*IR))
    m.Equation(V1*IRp.dt() == -k1b*IRp + k1f*ins*1000*IR + k1aBasic*IR)
    m.Equation(V1*IRS.dt() == k2b*IRSp - (k2f*IRp*IRS))
    m.Equation(V1*IRSp.dt() == -k2b*IRSp + k2f*IRp*IRS)
    m.Equation(V2*PKB.dt() == k4b*PKBp - k4f*IRSp*PKB)
    m.Equation(V2*PKBp.dt() == -k4b*PKBp + k4f*IRSp*PKB)
    m.Equation(V2*GLUT4_C.dt() == k5b*GLUT4_M - (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))
    m.Equation(V2*GLUT4_M.dt() == -k5b*GLUT4_M + (k5f*PKBp*GLUT4_C + k5Basic*GLUT4_C))

    m.options.IMODE = 4
    m.options.OTOL  = 1e-8
    m.options.RTOL  = 1e-8
    m.options.NODES = 3
    m.solve(disp=True)

    # plotting
    fig, axs = plt.subplots(4, 2, figsize=(20, 20))
    axs[0, 0].plot(m.time, IR)
    axs[0, 0].set_title('IR(t)')
    axs[0, 1].plot(m.time, IRp)
    axs[0, 1].set_title('IRp(t)')
    axs[1, 0].plot(m.time, IRS, 'tab:orange')
    axs[1, 0].set_title('IRS(t)')
    axs[1, 1].plot(m.time, IRSp, 'tab:green')
    axs[1, 1].set_title('IRSp(t)')
    axs[2, 0].plot(m.time, PKB, 'tab:red')
    axs[2, 0].set_title('PKB(t)')
    axs[2, 1].plot(m.time, PKBp, 'tab:purple')
    axs[2, 1].set_title('PKBp(t)')
    axs[3, 0].plot(m.time, GLUT4_C, 'tab:olive')
    axs[3, 0].set_title('GLUT4_C(t)')
    axs[3, 1].plot(m.time, GLUT4_M, 'tab:cyan')
    axs[3, 1].set_title('GLUT4_M(t)')

    plt.figure()
    for i in range(8):
        plt.plot(m.time,d[i].value)

    plt.show()
    return

time_interval = 60
insulin = 100
insulin_pathway_CM(time_interval, insulin)

For reference, here is a simplified blood glucose response model (similar to Bergman model) for your reference. Richard Bergman and Claudio Cobelli proposed a minimal model in 1979 to describe blood glucose and insulin dynamics.

redpajama_set_name: RedPajamaStackExchange


Though G-Secs yields have moved up from 6.4% in July to 7% now, in the absence of any strong driver to move interest rates down, there isn't any strong case for taking exposure to duration products. Rather, short bond products look better on a risk-reward basis.
In the G-Secs market, there has been an upward movement of yields (i.e., decline in prices) over the last four months.
• Crude oil price up-tick, with consequent impact on our inflation and trade deficit.
One argument at this juncture, after yields having moved up, is that if you were wondering in July whether to enter duration funds, you have a better entry point now. The positive aspects, in favour of yields coming down (i.e. bond prices moving up) are: Real positive interest rates are at a historical high. Taking the representative yield rate as the 1-year Treasury Bill yield level, which is approximately 6.27% and the latest CPI inflation data at 3.58%, the real interest rate is 2.69%. Even if we take inflation at the mid-point of RBI's projection of 4.2- 4.6%, i.e., at 4.4%, interest rate is positive at 1.87%. This provides enough room to the RBI to take a benign view on the interest rate structure.
On events, the India rating upgrade by Moody's is a positive on INR levels and FII investments. FII investments in debt is subject to limits, but equity investments are buoyant. Crude oil prices have stabilised, and US shale oil supplies would kick in, after a time lag, if oil prices remain consistently high.
On a risk-reward basis, even at a better entry level than earlier, it does not look like a favourable case at this juncture. Why? Let's distinguish between 'what should happen' and 'what is likely to happen'. While real interest rates are positive, and highly positive as per historical standards, the RBI's stance on rate is neutral. This means, unless there is a compelling case for reduction of interest rates, they would hold status quo. Inflation may inch up in the second half of the current financial year, the US is likely to hike interest rates, and there are apprehensions of a fiscal slippage in the current year. In the absence of any strong driver to move interest rates down, there isn't any strong case for taking exposure to duration products.
The other risk is the 'spread' between G-Secs and corporate bonds. Corporate bonds trade at a spread, i.e., higher yield over G-Secs. While G-Sec yields have moved up over the last four months or so, corporate bond yields have not moved up as much, and there is a possibility bond yields may tick up. Net-net, for fresh exposures, short bond products look better on a risk-reward basis.


text:
Mount Sneffels je třetí nejvyšší hora pohoří San Juan Mountains ležící v jižní části Skalnatých hor. Mount Sneffels se nachází na jihozápadě Colorada, v Ouray County, ve Spojených státech amerických.
Je osmnáctým nejvyšším vrcholem Colorada a třicátou sedmou nejvyšší horou Spojených států. Hora je známá pro svůj výrazný štít převyšující okolí. Je pojmenovaná podle západoislandského  stratovulkánu Snæfellsjökull.

Reference

Externí odkazy

Hory a kopce ve Skalnatých horách
Hory a kopce v Coloradu
Čtyřtisícovky v USA
Fourteeners

redpajama_set_name: RedPajamaWikipedia


The Second Action Plan 2013-16 is the second of four stages of the National Plan to Reduce Violence against Women and their Children 2010-2022. The Second Action Plan outlines how the Commonwealth, state and territory governments plan to move ahead in addressing the violent crimes of domestic and family and sexual assault. The Second Action Plan has five national priorities and contains 26 practical actions that are important for improving women's safety.


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redpajama_set_name: RedPajamaGithub


President Obama announced Monday that the U.S. and China would start issuing visas to each other's citizens valid for up to a decade for entrance only.
Putting a bright face on the future of U.S. ties to China, President Obama announced Monday that the two countries would start issuing visas to each other's citizens valid for up to a decade for entrance only. The White House said it hoped the deal would attract more travelers to the U.S. Officials said it could drive up demand that would create hundreds of thousands of jobs in the U.S., without sacrificing national security. About 100 million Chinese traveled last year, but less than 2% of those came to the U.S. The actual benefits, however, may be modest. The visa arrangement doesn't increase how long an American can remain in China or vice-versa, but rather how long the visa can be used to enter the country. And the same restrictions remain on who is eligible for a U.S. visa, including a mandatory in-person interview that is a pain for those who don't live near a U.S. embassy.


hi guys im paris, ive travelled all the way from thailand just to meet very cute and friendly so youll feel so relaxed with me. At size 6 im petite, long brown hair brown eyes, lovely tanned skin. Im such a naughty lady, you see.


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Home The Hotel Restaurant Conference Hall Recreation Center Special offers The staff Awards Location Contacts Foundation
Award for contribution in the development of tourism in the region of Ruse municipality
On 27th of September 2012 - the World Tourism day, Bistra & Galina hotel received its consecutive acknowledge - Award for contribution in the development of tourism in the region of Ruse municipality, category "Spa & Business hotel".
The prize was presented by Ministry of Economy, Energy and Tourism and National media group "Paradigma" at National review - competition "The municipalities for the tourism development".
International Award "The Arch of Europe"
The "Bistra and Galina" Hotel received its first international recognition in 2001 - this is the International Award "The Arch of Europe" - golden category of B.I.D. (Business Initiative Directions). The hotel was nominated by an international selecting panel who evaluate the companies as to the system "Total Quality Management" (TQM), comprising 110 criteria, which the hotel management and staff meet. On behalf of the owners the first international award was received by Mrs. Zdravka Burdarova on March 5th, 2001 in Frankfurt, Germany.
Annual Prize of the Bulgarian Hoteliers Restauranteurs Association (BHRA) for Building the Tourist Image of Bulgaria
In 2001 the Bulgarian Hoteliers Restauranteurs Association (BHRA) awarded the "Bistra and Galina" Hotel the annual prize of the Association for valuable contribution in building the tourist image of Bulgaria. The prize was presented at a formal ceremony in Sofia under the aegis of Mr. Simeon Sakskoburggotski Prime Minister of the People's Republic of Bulgaria at that time.
International Award for Quality "ERA"
The "Bistra and Galina" Hotel received its second international award three years after its opening. The International Platinum Award for Quality "ERA" was presented at a formal ceremony in July 2002 in Geneva, Switzerland, by B.I.D. (Business Initiative Directions). Among the criteria according to which the hotel was nominated for the award as to the system "Total Quality Management" (TQM), are the quality of the service offered, the guest's satisfaction, innovations, management, leadership, communications and others.
International Award for Tourist, Hotel and Catering Industry
The "Bistra and Galina" Hotel Complex was awarded the International Award for Tourist, Hotel and Catering Industry (platinum category) in 2004 in Madrid, Spain as a recognition of the professional efforts of the staff of the hotel.
Annual Prize of the Bulgarian Hoteliers Restauranteurs Association (BHRA) for "City Hotel of the Year 2004"
The "Bistra and Galina" Hotel again won the acknowledgement of the professionals in tourism in 2004 - the Bulgarian Hoteliers Restauranteurs Association presented it with the prestigious award "City Hotel of the Year 2004".
Prize for the Greatest Contribution in the Development of Cultural Tourism 2009
At the International Exposition "Cultural Tourism 2009" in Veliko Turnovo the Bulgarian Hoteliers Restauranteurs Association, co-organiser of the event, awarded its Prize for the Greatest Contribution in the Development of Cultural Tourism for the period April 2008 - April 2009 to the "Bistra and Galina" Hotel Foundation. The distinction was conferred because of the Foundation sponsorship for the elaboration of a scale model of "The Profitable House" in Rousse. The scale model of this unique building is part of the exposition "Bulgaria in Miniature", which presents scale models of the best known historical and cultural landmarks in Bulgaria.
©2002-2020 Bistra & Galina Hotel Complex. All rights reserved.
Design and support FIL Ltd.


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Twilight Purple BMW i8 with AC Schnitzer Parts Arrives in Abu Dhabi
Home » Models » BMW i » Twilight Purple BMW i8 with AC Schnitzer Parts Arrives in Abu Dhabi
Gabriel Nica
September 30, 2016 / 1 minutes read
The BMW i8 is already a car that attracts a lot of attention, thanks to its futuristic design. Looking like a real-life concept approved for mass production, the i8 is a magnet and a head-turner, even without any other flashy additions. However, that's even more the case when you add a psychedelic color to the mix.
The guys from BMW Abu Dhabi are known for their daring projects and this one makes no exception.. Few dealerships in the world have delivered such bespoke projects as they did in their rather short life span. Yet, they're not showing any signs of slowing down and their most recent project involved BMW's plug-in hybrid sports car and a color called Twilight Purple. With enough money, the BMW Individual treatment can turn your car into anything you can think of, including Twilight Purple if you so desire.
Apart from the special exterior color, the car also received a full set of AC Schnitzer tuning parts as we've been getting used to when it comes to BMW i8 models delivered in Abu Dhabi. The list includes a set of AC Schnitzer wheels, a new splitter up front and a wing at the back, both made of carbon fiber for the best performance/weight ratio.
Under the hood, however, nothing was changed as AC Schnitzer doesn't offer a tuning kit that improves the i8's performance. That means we're still dealing with 131 HP from the electric motor coupled with the 231 HP of the 1.5-liter 3-cylinder turbocharged mill at the back for a combined power of 362 HP and 570 Nm (420 lb-ft). No worries though, as that's enough to allow the car to reach 100 km/h (62 mph) in just 4.4 seconds from standstill.
ac-schnitzer
Dinan Launches Stage 1 Software Upgrade For S63 Engine
by Adrian Padeanu Date: January 20, 2022
More from BMW i
Photo Gallery: BMW M850i Gets Pushed to 670 HP by G-Power
Vorsteiner VRS G8X Aero Program for M3 and M4 Aims to Fix the Grille
13 responses to "Twilight Purple BMW i8 with AC Schnitzer Parts Arrives in Abu Dhabi"
Icebreakerr says:
ACS seems quite popular in Abu Dhabi.
BMW M8 Gran Coupe in Twilight Purple – Go Big or Go Home! - PistonLeaks says:
[…] color definitely rings a bell since we've seen in on other BMWs, like the i8, M3, 7 and 8 Series. But for some reason, it works best on this grand tourer. The elegant lines of […]
BMW M8 Gran Coupe in Twilight Purple – Go Big or Go Home! – Feeds.24On says:
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BMW M8 Gran Coupe in Twilight Purple – Go Big or Go Home! – Noticiasimpresionantes.com says:
BMW M8 Gran Coupe in Twilight Purple – Go Big or Go Home! | TECHMUGG says:
BMW M8 Gran Coupé en el Crepúsculo Púrpura – Grande o Vaya a Casa! – es.24on.net says:
[…] color definitivamente suena una campana que ya hemos visto en otros Bmw, como el i8, M3, 7 y 8 de la Serie. Pero por alguna razón, funciona mejor en este grand tourer. Las líneas […]
BMW M8 Gran Coupe in Twilight Purple – Go Big or Go Home! – Cars and News says:
BMW M8 Gran Coupe in Twilight Purple – Go Big or Go Home! – Web Technologies says:
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Book review of Anita Nahal's "What's Wrong with Us Kali Women" by Megha Sood
August 19, 2021 August 20, 2021 ~ Megha's World
I'm delighted and honored to share the book review of he Dr Anita Nahal's third full length poetry collection "What Wring with Us Kali Women" by Kelsey Books.
Here is the link on Amazon
Book Review for Anita Nahal's "What Wrong with us Kali Women" by Megha Sood
This riveting collection of seventy prose poems exposes the artful mastery of lyrical intensity seeded in Nahal's poetic craft through which she brilliantly brings out the spectrum of the human emotions. The poet speaks with razor sharp clarity and a deep understanding of the topics ranging from feminism, immigrant, motherhood, racial/gender-based discrimination and sexual violence against women.
The deep exposition of the complex and layered understanding of the human's emotions is masterfully portrayed in this collection. Nahal's sensitivity of human emotions coupled with her poetic craft brings out this collection of prose poems to the readers. She portrays the misogynist nature of the society towards women and strips it of its disguises through her words for the whole world to see.
The brilliant collection opens with a powerful prose poem "What's Wrong with Us kali Women" where she debunks the myth of the goddess to be a metaphor of kindness and forgiveness. She also speaks directly to the double standards prevailing in the patriarchal society where the goddess is being worshipped and the women are being violated in the same breath. The poet renders the timely assurance to the readers that the strength we need dwells within us and there is nothing wrong with us women. She calls out the brazen behavior of men in the society worshipping the goddess Kali and abusing the woman in the same breath through her razor-sharp words. The author requests the readers to identify such behavior and with a clarion call through her poems demands this to be nipped in the bud.
Through her second prose poem, "Homo sapiens and Hindu goddesses in India and America", Nahal demands the women to be treated with the same request and equality rather than to be put on a pedestal and being worshipped like a deity.
This collection is a deep exegesis of the emotion where the woman is put on a pedestal and stripped from worldly desires thus creating a chasm between the desires and reality.
Through her poems like "Spilt milk in native and foreign lands", "Paying my debts in two lands"," and There's a hole in my heart but my heart is whole" , She portrays her journey from India to the United States as a first-generation immigrant that infused the sense of perseverance and resilience in her. The journey that finally made her the embodiment of strength and survival for her son, her inspiration.
Invariably in her collection she also brings the pain of losing a parent to terminal disease and the pain of living apart from them through her poems like "I did not say, I love you to my mama". She poignantly brings out the fecundity of emotions birthing in an immigrant mind.
Nahal tugs at the heart through her various poems namely "Tequila and spice memories" "Forgotten musical instruments: No words for our music", representing many first-generation immigrants that are caught between the struggles of making a life in a foreign land and living in the nostalgia of a place they once called home. Through many of her poems, like "Claustrophobia", she brings us back to the nostalgia and the pain simmering in the heart of an immigrant going back to revisit their roots occasionally.
Her poem "Gandhi Chaddar" reflects on the woes and the struggles of the many caught between the partition of India and Pakistanis with their legacy floating between the borders soiled with blood and nostalgia spanning the two nations suffering from displacement and migrations of millions.
Her poems dazzle with vivid imagery and metaphors and bring forth the pain of angst and pain suffered by the women subjugated by the rules of the patriarchal society for generations. The collection poses a deep poignant question to every single woman in the society facing the challenges. The one who is feverishly trying to make their space in this world and trying to speak their truths. The collection presents itself with a question to these women who are compared to the Goddess Kali, a great dissenter.
Nahal also addresses the deeply rooted systemic oppression of the African American communities and other minorities through her poem "How easy for the black Life to be Taken". She brings out the atrocities and the systemic oppression faced by the African American community for generations under the guise of deep system oppression and brutal police violence. The violence that finally paved the way for the Black Lives Matter movement that galvanized the whole country and the world. The poem brings out the horrid emotions that go through the mind of a black person when his life is slowly inching away from them. Through the deep-seated satire in the title, the poet brings out the pain and angst faced by the black community for generations.
No creative collection born during a pandemic can remain untouched by the effect of the pandemic on us. The pain the whole world has witnessed for the last 14 months living their own version of life isolated from their loved ones in their own islands of reality.
Nahal's poem "Breathe" through her masterful words talks about the haunting reality and the necessity of breath, a testament of life, and how that basic privilege is also denied to some. Through the poem "What Happened to their clothes" brings out the deeply seeded sorrow and the fear of dying alone in the pandemic.
In "Corona and love-life layers", "The crystal ball is "sick and tired", "Teaching chair yoga at an assisted living home" Nahal uses the poems to reflect on the indifference of human beings to the suffering of others in times like pandemics. The poems reflect the callous and indifferent nature of humankind to which history has been a witness. Through poems like "The ghost of COVID19 roaming the corridors of organizations", the poet reflects how the pandemic has churned out and brought the biases like gender and religion to the surface bringing forth the dark face of humanity. "Hold on, baby, we'll soon be home" reflects the resilience in the face of atrocity by humans in these trying times.
Nahal also tackles the sensitivity and the erotic nature of love through her poem, "A Sip of Wine" a poem about needs, wants, and desires which tug at the human heart and bring our out vulnerable nature towards love. In "Sleepless Nights" the poet gorgeously describes the effect of the night on her and her transgressions. She takes on a journey undulating between the lull and storm and how it leaves a riveting effect on her. Another poem, "It's Not all about Sex" brings out the deep sensitivity that should be an integral part of a marital relationship and the poet uses the metaphor of sloth to capture this sensitive emotion. Often the lack of this understanding leads to marital discord. Through her brilliant use of the poetic craft, Nahal presents this to her readers.
Through her poems "Chase Away Demons Left Behind," Nahal speaks about the inner turmoil and the tribulations we often go through in our lives, and she proudly mentioned "The trident in my hand did not fall. Neither did my grace." which is a brilliant testament to her resilience during the testing times.
Through the sharpness in her words, Nahal talks about the insensitivity in bracketing the women 's desires as per her age. Through her bold declaration with her poem "A woman's age is kicking and alive," "Babylon, my sinful dance muse," "Finally She showered," "And then the pundit asked for my son's father's family name," she packs a punch to the naysayers in the society trying to define the cookie-cutter rules she aggressively denies following.
Her poem "Democracy in Decline" is a deep exposition of the failing state of democracy in our country where food and health care are privileges but owning a gun is considered a constitutional right. The immediacy and the tenderness in her words describing the pain are brilliant.
The poem "Blues of a strong Indian woman in a mid-America small town"" is yet again a brilliant wordplay that depicts the fecundity of the emotions the mind and the body go through as a result of being a first-generation immigrant. With masterful wordplay she brings out the juxtaposition between the patriarchy and feminism in her poem "Diasporic feminism's lovemaking". She also addresses the brutalities of child marriage and the abuse followed through a homage poem to the infamous "Bandit Queen, Phoolan Devi". In her poems, "Holika, Sita, and Sati" and "Fire couldn't stop laughing", Nahal compares and contrasts the misogyny deeply seeded for eons in our traditional Hindu systems where the burden of responsibility always shamelessly falls on the woman.
Nahal brings out the strength and effervescence in womanhood through the following brilliant lines in her poems:
"I want to feel grounded when I lay down…unforgettable So, I chose to be me. A woman. Earthy and sensual." (Excerpt from Maryada and modern Draupadi)
"Strength of a woman can be underrated like bamboo sticks that hold immense weight in muddy backwater canal hutments." (Excerpt from the poem "Bandit Queen, Phoolan Devi")
There are many stunning poems in the collection but a few of my favorites are "Holika, Sita, and Sati," "What's Wrong with Us Kali Women," "Sleepless Nights,"Maryada, and modern Draupadi," and "Bandit Queen, Phoolan Devi. Other favorites from her collection are the "I did not say, "I love you to my mama," and "Fallacy of a single, immigrant mom," Another favorite of mine is "Rape", where Nahal points out the atrocities of gang rapes and mutilation that followed. She fiercely points out that the onus of this sexual violence against women falls on the shoulder of parents to certain extent.
"Why do parents not teach their sons that another human body is as important and sacred as theirs? Period. Full stop. (An excerpt from the poem)"
The author, through her sharp choices of words, stresses the fact that misogynistic rules have been used to subjugate women for generations in a patriarchal society. The poems bring forth the sensitivity of poet as an author, a woman, an immigrant, a single parent, an activist, feminist, and above all as a human being. Nahal brings out the beauty of her diasporic poetry through poetic brilliance and strings her global and local experience as a literary treat for her readers.
Overall, the poems in this collection speak to the readers through their brilliant perspectives and leave the readers with profound questions much after they read. I highly recommended this collection of prose poems and to my readers for a thoughtful read. Nahal brings out the beauty of her diasporic poetry through poetic brilliance and strings her global and local experience as a literary treat for her readers.
–Megha Sood
Posted in Book Reviews, Megha Sood poetry Anita NahalKelsey Books
Published by Megha's World
I'm a mother of a smart and energetic seven-year-old. I started expressing myself creatively since the last two years. Since then I have been continuously inspired by events in my life and around me which has helped me in penning my thoughts. I'm an avid reader, loves to sing, an ardent lover of poetry and sometimes can scribble few lines too. Loves to dance in the rain, have an undying love for nature, can watch the beautiful sunset for hours. Love to kiss and hug my loved ones. I have worked in the IT field for almost a decade as a manager, worked crazy hours and traveled around the world. In that busy schedule, I never got the time to creatively express my thoughts. Now every time I finish a poem, free verse anything it fills me with so much happiness and excitement and a feeling to have created something of my own. I'm planning to post at least one creation of mine weekly. Lastly, a million thanks to all who visit, like or follow my tiny bits of creation. Every time you do that, I get to know one more beautiful person in my life and get the chance to see their creation too. View all posts by Megha's World
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Next ›Walk_Exhibit "The Women" part of the upcoming Paterson Poetry festival, Oct 1-3, 2021
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Some very sad news out of Portland: longtime Trail Blazer Jerome Kersey has passed away at the age of 52, the team announced Wednesday night.
Kersey played 11 season in Portland, and became one of the most beloved players in franchise history.
The big fella leaves his wife Teri and four daughters.
The cause of death was not immediately known, but his passing was unexpected, if not shocking. Kersey, who has remained a fabric of the Blazers franchise for years, made an appearance on behalf of the team Tuesday night at Madison High School, where he spoke with fellow former Blazers Terry Porter and Brian Grant about Black History Month. […] But one day later, around 5 p.m. Wednesday, the Lake Oswego Fire Department was called to Kersey's home and he was taken to Legacy Meridian Medical Center in Tualatin. He was admitted and later died, a hospital spokesperson confirmed.


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Low gloss coatings have been gaining more and more interest in the recent years. Not only in wood coatings we can see this trend - even matt painted cars can be found in almost any manufacturers catalogue. In case of wood coatings, consumers like the more natural look of untreated wood over a glossy finish. A low glare coating is less distrubing to the eye, which is a true benefit in larger rooms. Because of that, oiled or wax treated surfaces gained a lot of market share due to their low gloss surface - however, they need a much more intense care and maintenance than most consumers realise, since oils or waxes don't form a protective film. A true matt varnish could offer the beauty of an oil / wax but providing more protection and less necessity for intensive care whilst resulting in the desired appearance. Unfortunately, coatings where the low gloss values have been obtained by extensive formulation are very often much more slippery. That makes it difficult to use them in public areas with a lot of traffic where a high coefficient of friction (CoF) is needed.


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Sen. Celsi: Public schools are the heart of Iowa's communities
Sen. Claire Celsi
Now that the COVID-19 pandemic has dramatically changed our daily routines, it is becoming crystal clear how important schools are to our lives and communities.
I'm so proud of the way our district leaders, teachers and staff have responded to this challenge. As always, children are at the heart of the matter. Keeping kids safe, healthy and fed is the priority, and our educators have stepped up to the challenge.
In order to fulfill their mission, schools have rapidly adapted to the changing landscape. The first challenge was to figure out how to provide daily meals to children who depend on the school lunch program for nutritional support. Districts rapidly sought approval for funding, quick rule modifications and logistical support from the Federal government. Those rules were quickly adapted to help provide the necessary flexibility and schools immediately rolled out their new plans.
Another challenge was how to retain and pay the thousands of hourly support workers who work alongside teachers. Bus drivers, paraprofessional classroom aids, cafeteria workers, administrative professionals, nurses and custodians, are the glue that holds everything together in our schools. Especially in an emergency with no forewarning, it became clear that paying and retaining these important partners was paramount.
I'm proud to report that the majority of school boards decided to pay those hourly staff members at least until the first 30-day school closing is over. This solidarity is very much appreciated by valued team members in our schools, especially after the loss of collective bargaining in our state. At a time when the whole world seems to be teetering on chaos, it helps tremendously to know that your pay will be stable.
Iowa's school funding cuts over the past ten years have reduced the emergency cushion that is necessary to deal with our current pandemic. Extra expenses for deep cleaning and online courses will have to be absorbed in the current budget. Administrators are counting every penny, weighing every decision and nervously waiting for decisions concerning the rest of the school year.
Parents are also scrambling to replace the steady support offered by their kids' school. Those that are still working face the loss of childcare and also the daunting task of providing educational support to their children. Even the most patient and well-meaning parents have quickly discovered how hard it is to entertain and engage children for a few weeks at a time. Most have expressed admiration and thanks for the teachers who make it look easy.
I would like to personally thank our education support professionals and teachers for stepping up to ease the burden for their students – even while dealing with the closures and changes to their own family routines.
As things slowly get back to normal in the coming months, I hope that Iowans will remember how our schools rallied around Iowa families and children to lessen the impact, keep people safe and provide crucial supports to our communities.
STATE SEN.CLAIRE CELSI, D-West Des Moines, represents District 21, which includes portions of Des Moines' south and west sides, West Des Moines and Cumming. She can be reached at 515-281-3371 or claire.celsi@legis.iowa.gov.
Claire Celsi is a public education supporter and a state senator from West De Moines. She can be contacted at Claire.celsi@legis.iowa.gov or 515-462-0487.
Your subscription makes work like this possible. Subscribe today at DesMoinesRegister.com/Deal.


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Home Retracing Namibia's forgotten stars
Retracing Namibia's forgotten stars
By: Julia Heita and Frédéric Buchane
Namibia has seen the rise and fall of many talented artists over the years, many go under the radar for years and leave fans and critics clueless.
So, if you have been wondering what some of your favourites have been up to over the years and outside the industry look no further as unwrap.online has the scoop for you.
Tunakie
Tunakie, real name Maria Tuna-Omukwathi Uushona is one of Namibia's young, popular and respected cultural, traditional and inspirational artists. In her music approach, Tunakie goes back to her roots and discovers the beautiful melodies of Namibia's cultural and traditional music, and takes them to the modern times by introducing modern instruments and making her music more modern, but yet remaining true to Namibian culture and tradition.
Ekalanyana remains 1 of the best songs she ever released.
"Every time I perform till now, 1 or more people ask me to perform it again," she said.
Tunakie said that she performs when she gets gigs and that she hasn't released a new album in a while because she feels she didn't do enough promotion on her last album.
"I have been very busy with my hair and beauty salon business, but I will be releasing an album mid next year and I should have a single out before the end of this year," said Tunakie.
She advised upcoming artists to always believe in themselves and never allow anybody to tell them not to follow their dreams.
"I was told that the type of music I do will never take me anywhere but look at me now, I have been performing all over the world and winning awards especially because of the type of music I'm doing," she concluded.
Kuku Kandanga
Kwaito artist OmZoo who takes on the character artist Kuku Nkandanga is
portrayed as an old man, with a white and black beard, in an old blazer and a hat.
Shambo is a genre that is popular across Namibia, although you don't hear new artists exploring the possibilities within this traditional music.
Nkandanga certainly stepped up to the plate and revived the genre with a modern twist
According to sources Kuku Nkandanga took a break from music in 2016 to give himself a breather and started releasing from in 2017.
He released 'Ondonga – Uukwanyama' sees Nkandanga teaming up with Young T, a collaboration that proved to be fruitful as the featured artist's vocals fit perfectly with this style of music.
A slower addition to the tracklist, this song is one of the outstanding ones on the project.
Tekla Iita aka Tequila
Tekla Iita better known as Tequila is one of Namibia's most gifted vocalists. Tekla started her career as a featuring artist appearing on Sunny Boy's sophomore breakthrough hit single "Serious", for his debut album Young, Black en Gifted. Her appearance on the song brought her more attention, as she began getting popular.
https://www.instagram.com/p/B44d6pFAtft/?igshid=1nai6ajumkr84
In, 2012 she was nominated in 6 categories at for the Namibian Annual Music Awards of which she won 5, including "Best Female Artist of the Year".
Tequila said she took a break from the industry because she had a lot on her plate but that doesn't mean that she's gone forever.
"Music is part of who I am I could never just completely walk away from it," she said.
Tekla said her best song may not be the most popular song but she loves it.
"It's titled HUSTLE it's in the GOLDEN SUNSET album, it's all about being a strong woman and a go-getter.
Boli Mootseng
Namibian Musician and producer Boli Mootseng has been in the industry for over ten years.
Most of his songs have vernacular lyrics as well as a comedic spin to it.
Mootseng has always been in the industry as he is not one to shy away from the public eye but as of late, he has been working behind the scenes in various aspects of production
He released a song in 2019 titled "Sisa Namandje He Got The law In His Bank Account" which takes aim at one of Namibia's top law Attorneys Sisa Namandje.
Mootseng says the song was recorded due to how he felt that Namandjes involvement in the "Fishrot" case was Outrages.
"He is supposed to protect the people and he does this! I just thought it was poetic justice"
Mootseng advises that the industry is not a place for impressing people, it takes funds to have a music career as well as to maintain it for studio time and other expenses
When asked about the impact of the lockdown on his career, Mootseng says that he is inspired to work and due to public demand he is working on his debut studio album.
"With people who like my work and social commentary they have been pressure for me to release an album because people tell me I can do it so I am looking forward to the returns and feedback".
Mootseng believes that as an artist one needs to get organized in order to get the basics.
"The lockdown is a time for artists to evaluate their lives and take their careers seriously," says Mootseng.
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