text:
package com.greenpepper.interpreter;

import java.util.ArrayList;
import java.util.Collection;

import static com.greenpepper.Assertions.assertAnnotatedException;
import static com.greenpepper.Assertions.assertAnnotatedMissing;
import static com.greenpepper.Assertions.assertAnnotatedRight;
import static com.greenpepper.Assertions.assertAnnotatedStopped;
import static com.greenpepper.Assertions.assertAnnotatedSurplus;
import static com.greenpepper.Assertions.assertNotAnnotated;
import com.greenpepper.GreenPepper;
import com.greenpepper.document.FakeSpecification;
import com.greenpepper.interpreter.collection.RowFixtureTarget;
import com.greenpepper.reflect.DefaultFixture;
import com.greenpepper.reflect.Fixture;
import com.greenpepper.reflect.PlainOldFixture;
import com.greenpepper.util.Tables;
import junit.framework.TestCase;

public class SetOfInterpreterTest
    extends TestCase
{
    private RowFixtureTarget target = new RowFixtureTarget();
    private SetOfInterpreter interpreter = new SetOfInterpreter( new PlainOldFixture( target ) );
    private Tables tables;

	@Override
	protected void setUp()
			throws Exception
	{
		GreenPepper.setStopOnFirstFailure(false);
	}

	@Override
	protected void tearDown()
			throws Exception
	{
		GreenPepper.setStopOnFirstFailure(false);
	}

    public void testInterpretsOneRowOfSpecification() throws Exception
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[a][b][c]\n" +
            "[1][2][3]"
        );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 2, 1 ) );
        assertAnnotatedRight( tables.at( 0, 2, 2 ) );
    }

    public void testInterpretAllRowsOfSpecification() throws Exception
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[a][b][c]\n" +
            "[1][2][3]\n" +
            "[1][2][3]\n" +
            "[1][2][3]"
        );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 2, 1 ) );
        assertAnnotatedRight( tables.at( 0, 2, 2 ) );
        assertAnnotatedRight( tables.at( 0, 3, 0 ) );
        assertAnnotatedRight( tables.at( 0, 3, 1 ) );
        assertAnnotatedRight( tables.at( 0, 3, 2 ) );
        assertAnnotatedRight( tables.at( 0, 4, 0 ) );
        assertAnnotatedRight( tables.at( 0, 4, 1 ) );
        assertAnnotatedRight( tables.at( 0, 4, 2 ) );
    }

    public void testInterpreterCanWorkWithCollectionReturnedFromQueryAction() throws Exception
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[a][b][c]\n" +
            "[1][2][3]"
        );
        interpreter = new SetOfInterpreter( fixtureThatReturnsABaz() );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 2, 1 ) );
        assertAnnotatedRight( tables.at( 0, 2, 2 ) );
    }

    public void testInterpreterWhenSpecificationDoesRespectsOrder() throws Exception
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[bar]\n" +
            "[1]\n" +
            "[2]\n" +
            "[3]"
        );
        interpreter = new SetOfInterpreter( fixtureThatReturnsFoosAndBars() );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 3, 0 ) );
        assertAnnotatedRight( tables.at( 0, 4, 0 ) );
    }

    public void testInterpreterWhenSpecificationDoesNotRespectsOrder() throws Exception
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[bar]\n" +
            "[1]\n" +
            "[3]\n" +
            "[2]"
        );
        interpreter = new SetOfInterpreter( fixtureThatReturnsFoosAndBars() );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 3, 0 ) );
        assertAnnotatedRight( tables.at( 0, 4, 0 ) );
    }

    public void testInterpreterWhenSpecificationDoesNotMatchFixture() throws Exception
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[bar]\n" +
            "[1]\n" +
            "[5]\n" +
            "[2]"
        );
        interpreter = new SetOfInterpreter( fixtureThatReturnsFoosAndBars() );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedMissing( tables.at( 0, 3, 0 ) );
        assertAnnotatedRight( tables.at( 0, 4, 0 ) );
    }

    public void testThatTheMethodNameIsCallOnTheObjectCollection()
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[intValue]\n" +
            "[1]\n" +
            "[2]\n" +
            "[3]\n" +
            "[4]"
        );
        interpreter = new SetOfInterpreter( new PlainOldFixture( new Integer[]{1, 2, 5, 4} ) );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 3, 0 ) );
        assertAnnotatedMissing( tables.at( 0, 4, 0 ) );
        assertAnnotatedRight( tables.at( 0, 5, 0 ) );
        assertAnnotatedSurplus( tables.at( 0, 6, 0 ) );
    }

    public void testThatMissingRowsAreAnnotatedMissing()
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[intValue]\n" +
            "[1]\n" +
            "[2]\n" +
            "[3]\n" +
            "[4]"
        );
        interpreter = new SetOfInterpreter( new PlainOldFixture( new Integer[]{1, 2, 4} ) );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 3, 0 ) );
        assertAnnotatedMissing( tables.at( 0, 4, 0 ) );
        assertAnnotatedRight( tables.at( 0, 5, 0 ) );
    }

	public void testThatMissingRowsAreAnnotatedMissingAndStoppedWhenStopOnFirstFailure()
	{
		GreenPepper.setStopOnFirstFailure(true);

		tables = Tables.parse(
			"[set of][values]\n" +
			"[intValue]\n" +
			"[1]\n" +
			"[2]\n" +
			"[3]\n" +
			"[4]"
		);
		interpreter = new SetOfInterpreter( new PlainOldFixture( new Integer[]{1, 2, 4} ) );

		FakeSpecification document = document();
		interpreter.interpret( document );
		assertTrue(document.stats().indicatesFailure());

		assertAnnotatedRight( tables.at( 0, 2, 0 ) );
		assertAnnotatedRight( tables.at( 0, 3, 0 ) );
		assertAnnotatedMissing( tables.at( 0, 4, 0 ) );
		assertAnnotatedStopped( tables.at( 0, 4, 1 ) );
		assertAnnotatedRight( tables.at( 0, 5, 0 ) );
	}

	public void testThatSurplusRowsAreAnnotatedSurplus()
	{
		tables = Tables.parse(
			"[set of][values]\n" +
			"[intValue]\n" +
			"[1]\n" +
			"[2]"
		);
		interpreter = new SetOfInterpreter( new PlainOldFixture( new Integer[]{1, 2, 4} ) );
		interpreter.interpret( document() );

		assertAnnotatedRight( tables.at( 0, 2, 0 ) );
		assertAnnotatedRight( tables.at( 0, 3, 0 ) );
		assertAnnotatedSurplus( tables.at( 0, 4, 0 ) );
	}

	public void testThatSurplusRowsAreAnnotatedSurplusAndStopWhenStopOnFirstFailure()
	{
		GreenPepper.setStopOnFirstFailure(true);

		tables = Tables.parse(
			"[set of][values]\n" +
			"[intValue]\n" +
			"[1]\n" +
			"[2]"
		);
		interpreter = new SetOfInterpreter( new PlainOldFixture( new Integer[]{1, 2, 4} ) );

		FakeSpecification document = document();
		interpreter.interpret( document );
		assertTrue(document.stats().indicatesFailure());

		assertAnnotatedRight( tables.at( 0, 2, 0 ) );
		assertAnnotatedRight( tables.at( 0, 3, 0 ) );
		assertAnnotatedSurplus( tables.at( 0, 4, 0 ) );
		assertAnnotatedStopped( tables.at( 0, 4, 1 ) );
	}

    public void testThatWeCanTestMoreThenOneMethodOnARow()
    {
        tables = Tables.parse(
            "[set of][values]\n" +
            "[a][b]\n" +
            "[11][12]\n" +
            "[21][22]\n" +
            "[31][0]\n" +
            "[41][42]"
        );

        IntegersFixture[] collection = {
            new IntegersFixture( 11, 12 ),
            new IntegersFixture( 21, 22 ),
            new IntegersFixture( 31, 32 ),
            new IntegersFixture( 41, 42 )};

        interpreter = new SetOfInterpreter( new PlainOldFixture( collection ) );
        interpreter.interpret( document() );

        assertAnnotatedRight( tables.at( 0, 2, 0 ) );
        assertAnnotatedRight( tables.at( 0, 2, 1 ) );

        assertAnnotatedRight( tables.at( 0, 3, 0 ) );
        assertAnnotatedRight( tables.at( 0, 3, 1 ) );

        assertAnnotatedMissing( tables.at( 0, 4, 0 ) );
        assertAnnotatedMissing( tables.at( 0, 4, 1 ) );

        assertAnnotatedRight( tables.at( 0, 5, 0 ) );
        assertAnnotatedRight( tables.at( 0, 5, 1 ) );

        assertAnnotatedSurplus( tables.at( 0, 6, 0 ) );
        assertAnnotatedSurplus( tables.at( 0, 6, 1 ) );
    }

	public void testThatFixtureWithoutAProperCollectionQueryHasAnnotatedCellToException()
	{
		tables = Tables.parse(
			"[set of][values]\n" +
			"[bytes]\n" +
			"[]"
		);
		interpreter = new SetOfInterpreter( new DefaultFixture( "" ) );

		FakeSpecification document = document();
		interpreter.interpret( document );
		assertTrue(document.stats().indicatesFailure());

		assertAnnotatedException( tables.at( 0, 1, 0 ) );
	}

	public void testThatFixtureWithoutAProperCollectionQueryHasAnnotatedCellToExceptionAndStopWhenStopOnFirstFailure()
	{
		GreenPepper.setStopOnFirstFailure(true);

		tables = Tables.parse(
			"[set of][values]\n" +
			"[bytes]\n" +
			"[]"
		);
		interpreter = new SetOfInterpreter( new DefaultFixture( "" ) );

		FakeSpecification document = document();
		interpreter.interpret( document );
		assertTrue(document.stats().indicatesFailure());

		assertAnnotatedException( tables.at( 0, 1, 0 ) );
		assertAnnotatedStopped( tables.at( 0, 1, 1 ) );
	}

	public void testThatCellWithMethodThrowingAnExceptionIsConsideredAsMissing() throws Exception
	{
		tables = Tables.parse(
			"[set of][values]\n" +
			"[ex]\n" +
			"[1]\n" +
			"[2]\n" +
			"[3]"
		);
		interpreter = new SetOfInterpreter( fixtureThatReturnsFoosAndBars() );

		FakeSpecification document = document();
		interpreter.interpret( document );
		assertTrue(document.stats().indicatesFailure());

		assertAnnotatedMissing( tables.at( 0, 2, 0 ) );
		assertAnnotatedMissing( tables.at( 0, 3, 0 ) );
		assertAnnotatedMissing( tables.at( 0, 4, 0 ) );
	}

	public void testThatCellWithMethodThrowingAnExceptionIsConsideredAsMissingWhenStop() throws Exception
	{
		GreenPepper.setStopOnFirstFailure(true);

		tables = Tables.parse(
			"[set of][values]\n" +
			"[ex]\n" +
			"[1]\n" +
			"[2]\n" +
			"[3]"
		);
		interpreter = new SetOfInterpreter( fixtureThatReturnsFoosAndBars() );

		FakeSpecification document = document();
		interpreter.interpret( document );
		assertTrue(document.stats().indicatesFailure());

		assertAnnotatedMissing( tables.at( 0, 2, 0 ) );
		assertAnnotatedStopped( tables.at( 0, 2, 1 ) );
		assertNotAnnotated( tables.at( 0, 3, 0 ) );
		assertNotAnnotated( tables.at( 0, 4, 0 ) );
	}

    private FakeSpecification document()
    {
        return new FakeSpecification( tables );
    }

    public class IntegersFixture
    {
        public Integer a;
        public Integer b;

        IntegersFixture( Integer a, Integer b )
        {
            this.a = a;
            this.b = b;
        }
    }

    private Fixture fixtureThatReturnsABaz()
    {
        return new PlainOldFixture( new FixtureThatReturnsCollection() );
    }

    public static class FixtureThatReturnsCollection
    {
        public Collection query()
        {
            ArrayList<Object> list = new ArrayList<Object>();

            list.add( new RowFixtureTarget.TestObject() );
            return list;
        }
    }

    private PlainOldFixture fixtureThatReturnsFoosAndBars()
    {
        return new PlainOldFixture( new FixtureThatReturnsCollection2() );
    }

    public class FixtureThatReturnsCollection2
    {
        public Collection query()
        {
            Collection<Foo> c = new ArrayList<Foo>();
            for (int i = 0; i < 3; i++)
            {
                c.add( new Foo( new Integer( i + 1 ) ) );
            }
            return c;
        }

        public class Foo
        {
            private Integer bar;

            public Foo( Integer bar )
            {
                this.bar = bar;
            }

            public Integer getBar()
            {
                return bar;
            }

			public Integer getEx()
			{
				throw new RuntimeException(String.valueOf(bar));
			}
        }
    }
}

redpajama_set_name: RedPajamaGithub


text:
DOJ Recovers More Than $3 Billion in False Claims Act Cases in FY 2019
Alexander Canizares, Barak Cohen, David B. Robbins, David Taylor
The Department of Justice (DOJ) recovered more than $3 billion in settlements and judgments from civil cases involving the False Claims Act (FCA) in the fiscal year ending September 30, 2019, according to statistics released by DOJ on January 9, 2020. DOJ's recoveries for the last fiscal year were slightly higher than in FY 2018 and reflect a robust level of enforcement against companies in healthcare and government contracting consistent with past years.
A large majority of these recoveries in the past fiscal year—about $2.6 billion—concerned the healthcare and life sciences industries, a modest increase from the prior year. DOJ recovered $252 million in defense contract cases—more than double the prior year's figure—while the total for settlements and judgments in non-defense, non-healthcare cases dropped.
Following is an overview of DOJ's FCA statistics for 2019, which reflect the government's priorities in the use of its primary civil remedy to combat fraud. It also addresses some of the key developments relevant to FCA investigations and litigation occurring in the last year.
Highlights From 2019's FCA Enforcement Statistics
Since 1986, when Congress amended the FCA, DOJ has recovered more than $62 billion under the statute, according to DOJ's announcement releasing its annual update to its civil fraud statistics. DOJ has obtained more than $2 billion in FCA cases each year since 2009.
Among the key takeaways from the newly released statistics:
Settlements and Judgments Are Mostly Consistent With Prior Years. The government's recovery of about $3 billion in FCA settlements and judgments in FY 2019 is a slight (about $151 million) increase from FY 2018, when it obtained $2.9 billion. FY 2018 represented a roughly $500 million decrease from the prior year, and was the first time in eight consecutive years that FCA recoveries fell below $3 billion. Overall, the government's total FCA recoveries in FY 2019 are mostly consistent with those obtained in recent years, showing that the risks for companies that are subject to potential exposure under the statute remain significant.
Qui Tam Suits Remain Steady. In 2019, 636 new qui tam cases were filed, according to DOJ's statistics. That is an average of about 12 cases per week. By comparison, 646 new qui tam cases were filed in FY 2018 and 681 in FY 2017.
Healthcare Recoveries Increase. As in prior years, the large majority of DOJ's settlements and judgments under the FCA related to healthcare, including actions brought against drug and medical device manufacturers, managed care providers, hospitals, pharmacies, and physicians. FY 2019 was the 10th consecutive year that DOJ's civil healthcare fraud recoveries exceeded $2 billion. DOJ's recovery of $2.6 billion in FCA healthcare cases in FY 2019 reflects a modest upward trajectory. In FY 2018, the value of FCA recoveries in healthcare cases totaled roughly $2.53 billion, which was moderately higher than the previous year's figure of about $2.14 billion. According to DOJ, two of the largest recoveries in the healthcare industry this past year came from settlements with opioid manufacturers.
Department of Defense Recoveries Bounce Back. Recoveries in defense procurement fraud-related cases bounced back after a drop in FY 2018. DOJ's figures show that FCA settlements and judgments in Department of Defense (DOD) cases totaled approximately $252 million in FY 2019. That is more than double the $107 million recovered in FY 2018, which was a sharp drop from FY 2017's total of $220 million. According to DOJ, 53 new DOD-related FCA cases were filed in 2019, up from 47 in 2018. Forty of those cases were initiated by qui tam relators.
Other Areas. DOJ recovered about $196 million in non-defense, non-healthcare FCA cases in FY 2019, compared to approximately $260 million in 2018. The new figure reflects a drop-off in total recoveries in this category compared to past years.
Qui Tam Suits Continue to Generate Cases. Lawsuits brought by relators under the FCA's qui tam provisions continue to be the source of most of the government's settlements and judgments. Of the $3 billion in FCA recoveries reported in FY 2019, about $2.2 billion arose from qui tam cases. However, the total value of share awards paid to relators dropped markedly during the past fiscal year to about $271 million, compared to roughly $341 million in FY 2018 and $536 million the year before that.
FCA Enforcement Developments and Case Law in 2019
Behind the numbers are several developments occurring in the last year relevant to enforcement and judicial interpretation of the statute that will likely continue to play out this year.
DOJ's Increased Use of Dismissal Authority
DOJ's press release notes that, during the past year it "made increasing use" of its statutory authority to seek dismissal of qui tam actions "to help prioritize and protect the expenditure of government resources." The so-called "Granston Memo," codified in Section 4-4.111 of the Justice Manual, directs DOJ attorneys to consider whether the government's interests are served by seeking dismissal of a qui tam suit under 31 U.S.C. § 3730(c)(2)(A), citing various factors. In a December 19, 2019, letter to Senator Chuck Grassley, DOJ noted that it has filed motions to dismiss in 45 FCA cases since January 2018, accounting for less than 4% of the 1,170 qui tam suits filed during that period. The U.S. Circuit Courts of Appeals are split as to the proper standard of review for such motions, and further litigation on that topic is likely in 2020.
Post-Escobar Issues
Lower courts in 2019 continued to address various FCA-related questions left open by the Supreme Court's 2016 opinion in Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 1989. Courts continue to grapple with what evidence is necessary to establish that false claims are material to the government's payment decisions. Also, the circuits are split as to the proper standard for a motion to dismiss under Rule 9(b) and whether the FCA's first-to-file bar, which precludes a qui tam suit based on the facts underlying a pending action, is jurisdictional. The U.S. Supreme Court has so far declined to address such issues.
Restrictions on Use of Sub-Regulatory Guidance
Recent developments illustrate the increasing limitations on the use of sub-regulatory guidance in enforcement of the FCA.
In Azar v. Allina Health Services et al., 139 S. Ct. 1804, the Court held that notice-and-comment rulemaking must be used for any Medicare issuance that establishes or changes a "substantive legal standard" governing the scope of benefits and other matters. Although Allina was not an FCA case, it appears likely to have a significant impact on healthcare FCA cases, which are routinely grounded on alleged violations of sub-regulatory guidance issued by federal agencies, as demonstrated by an October 31, 2019, memorandum issued by the U.S. Department of Health and Human Services' (DHS) deputy general counsel advising agencies to conform their practices to Allina.
The judicial application of Allina in FCA cases has started. A federal district court in Pennsylvania recently stated that a relator's claims failed as a matter of law because the Center for Medicare and Medicaid Services' (CMS) sub-regulatory guidance that he alleged had been violated was a substantive legal standard that required notice-and-comment rulemaking. Polansky v. Executive Health Resources, Inc., et al., Final Memorandum No. 12-CV-4239 (E.D. Pa.) (Nov. 5, 2019).
Also, on October 9, 2019, President Trump issued Executive Order 13892, which, among other things, prohibits agencies from using guidance documents to "impose new standards of conduct" on persons outside the executive branch "except as expressly authorized by law or as expressly incorporated into a contract." The executive order effectively models DOJ's approach under the so-called "Brand Memo" limiting DOJ's use of guidance documents in affirmative civil cases.
DOJ Cooperation Credit Guidance
In May 2019, DOJ issued guidance giving DOJ civil attorneys express discretion to award credit to cooperative defendants in FCA cases. The guidance, codified in section 4-4.112 of the Justice Manual, identifies various factors that DOJ will consider when defendants self-disclose misconduct, cooperate with FCA investigations or settlements, or take effective remedial measures. The implications of the guidelines in settlements will continue to play out.
In a May 2019 decision, the Supreme Court resolved a circuit split regarding the FCA's statute of limitations in a way that favors relators. In Cochise Consultancy, Inc. et al. v. United States ex rel. Hunt, 139 S. Ct. 1507, the Court held that relators have up to 10 years to file suit against defendants in cases in which the government declines to intervene, provided that the suit is filed within three years of the government knowing, or having reason to know of, the relevant facts. The Court also held that relators' knowledge of the facts is irrelevant to the statute of repose.
DOJ-HUD Memorandum of Understanding
In October 2019, DOJ and the U.S. Department of Housing and Urban Development (HUD) issued a Memorandum of Understanding (MOU) setting prudential guidance on the use of the FCA against Federal Housing Administration (FHA) lenders. The MOU sets forth criteria for when violations of FHA program requirements should be enforced administratively by HUD rather than be referred to DOJ for potential FCA litigation.
Procurement Collusion Strike Force
Also, on November 5, 2019, DOJ announced the formation of a Procurement Collusion Strike Force focusing on combating procurement-related antitrust crimes such as bid-rigging conspiracies and related fraudulent schemes. The strike force will be an inter-agency partnership consisting of DOJ prosecutors from the Antitrust Division and U.S. Attorneys' Offices, FBI investigators, the DOD Office of Inspector General, the U.S. Postal Service Office of Inspector General, and other federal offices of inspector general. The strike force will focus on investigating and prosecuting antitrust crimes in procurement, grant, and program funding.
Blockchain Week in Review - January 2020
Labor Law Today—2019 Year in Review
Ninth Circuit Issues Favorable Class Action Ruling for Defendants
CEQA Year in Review 2019
Why Chinese Companies File Chapter 15 Cases in US Bankruptcy Courts
© Perkins Coie | Attorney Advertising
Alexander Canizares
Barak Cohen
David B. Robbins
Department of Defense (DOD)
False Claims Act (FCA)
Federal Contractors
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redpajama_set_name: RedPajamaCommonCrawl


text:
Carm Milioto photo by Mike Cameron
Carm Milioto: Rocking the Hamilton Music Scene for Over 20 Years
By Charlie Ricottone
"Hamilton, Ontario has a very supportive music scene," says Carm Milioto, a musician and sound engineer, who was born and raised in the city. "Clubs, musicians, and studios for the most part, promote one another and represent the city as a whole… It's inspiring, especially when those involved take part in that idealism and act as team players," he says.
Carm Milioto doing what he loves. Photo by Mike Cameron.
The support system is not just limited to the industry pros either. "I find that people show support based on passion, not necessarily preference of style or genre," Carm states. On any given night there could be up to a dozen live shows or more taking place throughout the city. At each of the venues, you will find fans of multiple genres, sporting a variety of looks, personalities, and attitudes that seamlessly come together in the interest of showing support for local talent, family, and friends. He has experienced this type of support for most of his life, dating back to his childhood.
"I've been singing my whole life, even as a kid, as young as four, five, and six," says Carm. "My mom and dad used to always get me to sing for company because I used to sing Italian songs," he adds. He continued singing over the next several years, and picked up his first guitar at the age of 13. He played consistently over the next few years, honing his skills. In high school he would perform alongside his musician friends, in talent shows, and in the courtyard at school pep rallies. When he turned 19 and was old enough to play in bars and clubs, Carm decided to pursue music professionally.
His first band was called Earl, which played at parties and local bars. As a cover band with a ton of energy, Earl was quite popular, playing rock music that spanned the 70's, 80's, and 90's. Eventually, Earl began to write their own original music and went through a name change, becoming The Feels.
The Feels wrote three studio albums, all of which were produced by Carm and his band mates. The funky/rock style complimented the fun that was being had on stage as well as in the crowd. They played together for several years, and won the Hamilton Music Award for "Best Local Act by People's Choice," however; the band's life was coming to a close. "The Feels eventually capped off because we were more hobby based. Adam and Mike [Clannon] were focused on their careers and I wanted to continue to focus on my career, as a full time musician," states Carm.
While Carm and Todd Hornby, the drummer from The Feels, were working on their next project, Carm released a solo album, which he wrote and produced, called Scenes From Then and Now. The album took a different approach when compared to the music of The Feels, by focusing on a softer style of rock, without falling into the category of adult contemporary. He also played solo shows, recalling one of his most unique performances; "I played a [solo acoustic] gig at the Whiskey-A-Go-Go in Hollywood, California." This once in a lifetime show, among other experiences would act as a catalyst into a new style, which he would combine with the style of The Feels, to create the band Live How You Live (LHYL).
Carm and Todd started LHYL with the intention of pursuing a career in music performance. Dylan Panton, a long time fan of Carm's music, joined the band as lead guitar. John Morley, now a tour manager for Walk Off the Earth, was so eager to be in the music industry, that he learned how to play the bass parts and worked closely with Carm to develop his skills and become LHYL's bassist. "We all entered into this as a work project, and everyone who was in was asked to be in for the long haul," says Carm. The band released four studio albums; all produced by Carm, and saw some success through playing tours and shows alongside famous acts such as Sheepdogs, Arkells, 5440, Crash Karma, Organ Thieves, USS, Brian Byrne, The Trews, Monster Truck, and Chubby Checker. They gained global attention by winning the John Lennon 70th Birthday Anniversary Contest in 2010, for the song One Life, which happened to be hand picked by Yoko Ono herself. LYHL also won the Hamilton Music Award for "Best Local Act by People's Choice," three times. LHYL had a great run, but as Carm explains, the end was nearing, "We laid it out as long as we could and eventually the studio [410] expanded and needed more of my attention."
Around the time that LHYL began to slow down, Carm turned his attention to collaboration projects and Studio 410, which is located in Stoney Creek. He and his partner, Adrian Fidanza who specializes in video production, opened 410 in 2003. They have built up the studio from a single small, renovated building into multi-suite media centre with 22-25 bands (approx. 80-100 people) using the available amenities every week to rehearse for tours and recording sessions. They also offer audio recording for both studio sessions and live recordings off of the stage, photography, videography, and video editing services. Other services are also offered such as hosting private events and educational courses for high schools where classes can visit the studio. Carm conducts an hour lecture/tutorial on the basics of audio engineering. Afterward, the students have a chance to sing, play, and record some music, providing a realistic experience in the studio.
Carm is pictured here after a day of recording with local musicians. From left: John Godek, Glen Brown, Carm, Robert Nind and in front, singer-songwriter George Lardie. Photo: Glen Brown.
For Carm, the work they do at Studio 410 is all about the music without the flash. "Here at 410, we're about supporting local acts, giving people opportunities, and making it affordable," says Carm. "We've also had international acts here to rehearse, like Big Sugar, Randy Bachman, and Buffy St. Marie. We've also had Walk Off The Earth, and we regularly host Tim Hicks, the country artist," he adds. For 410 the future holds a plethora of opportunities. "We'll continue to improve our existing infrastructure, grow the business, expand clientele, increase the number of hourly bookings, and do our best to bring the community together as much as we can." Which is exactly what Carm has done through multiple projects, including one near and dear to his heart, a collaborative project with a young girl named Anya Martinez, who suffers from leukemia.
Carm recalls his first introduction to Anya; "Her dad came to me and said that she liked singing, so we brought her into the studio to do a cover tune for fun." He quickly realized the drive and passion that Anya had for music, so he volunteered his time for her to come in once a week to work on some original music together. "I helped her to develop writing ideas. I would ask her how she's feeling that day, or what she wants to write about. If it were a day that she's happy, I would ask her, 'what makes you happy?' We would discuss whatever she came up with, and I would put together a melody. I would try to incorporate her input as much as possible, and ask her for ideas when it came to rhyming lyrics. Sometimes she'd come up with something silly, and sometimes it was really good," he says. Unfortunately due to Anya's illness, she's not always available or physically strong enough to head to the studio, but Carm always keeps the lines of communication open and looks forward to her visits and getting to spend time with her. "She's very inspiring to me, and has motivated me to want to work hard alongside her. I feel very blessed to have time with her."
Anya gets visited by a couple of Hamilton Bulldog players. Twitter post photo.
Carm is always helping out family, friends both old and new, and looking for new projects and collaborations. He has recently begun working on a new solo project called Izzy Slik and will be releasing some exciting new music in the near future. "It could turn into a band or stay as a solo act, I don't really know," Carm says. "But I'm going to release a new song that I'm ecstatic about, called Let Love Be. I'll put that out, and then it should give me some inspiration to keep writing," he adds.
For Carm Milioto, the past 20 years are filled with great memories and experiences, and he hopes to continue the tradition of rocking the Hamilton music scene for many more years to come.
carm milioto
Music Editor


text:
Your problems, with Anna Tims
Our two-night stay at the inn was a real turn-off
We woke to find urine in the bath, but we can't get a refund
Anna Tims
Thu 29 Nov 2018 02.00 EST Last modified on Thu 29 Nov 2018 02.02 EST
Beware unplugging the sewage pump in rural buildings. Photograph: Graham Turner/The Guardian
We used Booking.com to reserve a room for two nights at the Ship Inn in Solva, Pembrokeshire.
I charged my mobile in a double socket outside the bathroom door. Beside the socket were two switches. I must have accidentally knocked one because we awoke the next day to an unpleasant smell and found urine in the bathtub. This put us off staying the second night and we asked to be refunded.
The landlord explained that many rural buildings have electric pumps for sanitation and that if it is off, effluent doesn't drain away but flows into the bath. He declined to refund us and referred us to Booking.com which has offered £20 against the £144 we paid. JA, Bristol
Your pictures show a couple of inches of yellow liquid in the bath and of identical sockets with nothing to show the crucial function of one of them.
The Ship Inn lays the blame squarely on you. Landlord Simon Greene says that the situation has been exaggerated "way out of proportion" and questions why you chose that particular socket to charge your phone when there are others behind the TV and beside the bed. "The pumping system has been around since the early seventies and is effective when not meddled with," he says. He explains he referred you to Booking.com because it takes a month before the Inn receives payment for bookings.
The Ship Inn has a four-star rating on review websites and most guests are pleased with their stay, so it's a pity your mishap was not handled more gracefully. The good news is that Booking.com, when contacted by the Observer, has refunded you in full. "We are in communication with the property regarding making some adjustments to avoid a similar situation occurring again," it says .
The Ship Inn says it has now labelled the switch.
If you need help email Anna Tims at your.problems@observer.co.uk or write to Your Problems, The Observer, Kings Place, 90 York Way, London N1 9GU. Include an address and phone number. Submission and publication are subject to our terms and conditions


Updating your home's rail system is a great way to increase the value and change the overall appearance of your home. Replace old or worn railing systems with a new wood or metal baluster. Open up a room, loft or stair area by replacing a half wall with a beautiful rail system. Titan Stairs, Inc. offers a wide variety of products and materials that can accommodate a budget. Consider skirt board, kick board or wall treads to really make your stairway stand out.
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"These unscrupulous speculators and their underhanded tactics have manipulated the marketplace and often leave New Yorkers and visitors alike with little choice but to buy tickets on the secondary market at an exorbitant mark-up," Governor Cuomo said.
(most) American Football Webster Hall tickets on sale at noon, don't buy on StubHub!
"Shameless scalpers are making big bucks by marking up tickets to a star-studded benefit concert for victims of Hurricane Sandy.


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Kurseong Tourism
About Kurseong
Location & how to reach
Sites & sightseeing tours
Shops & market area
Weather & best time
Kurseong is a sub-division of Darjeeling district. In 1835 it was handed over to the British by the King of Sikkim. It was a small village then. However it gained importance when the Darjeeling Himalayan Railway (DHR) Toy Train service was extended to Kurseong in August 1880. It then became the Head Quarter of the subdivision.
So is Kurseong a place worth a vacation stay for tourists? I would certainly say yes. Although from the face of it, it looks like a congested township which has grown predominantly along the Hill Cart Road that passes through the mountains. But if you start exploring the spreads of Kurseong, it starts exposing its charm.
The Name Kurseong means 'The place of white orchids'. So as expected, white orchids grow in abundance in this area. The area is also full of beautiful tea gardens, forests and year round vegetation on the hill slopes. From some parts of Kurseong, you get magnificent views of Mt. Kanchejunga, Kabru and Jannu, and the meandering rivers Teesta and Mahananda flowing down to the lower plains & medows.
The toy train track runs alongside the road. The whistling sound of the steam engine can often be heard from your room and you can come out to see the mini train negotiating its way through the mountains. Overall a very romantic feeling.
Kurseong has seen many special personalities in the past. Nobel Laureate and poet Rabindranath Tagore composed several of his poems in Kurseong. The great disciple of Swami Vivekananda Sister Nivedita settled down here. Mark Twain also spent some time in the place in 1885. And in 1936 Netaji Subhash Chandra Bose was confined for couple of months by the British in a Bungalow at Kurseong. The buangalow is now a well known Museum with many original furniture and other belongings of Netaji.
Location of Kurseong & How to Reach
Kurseong is located in Darjeeling district and is on National Highway NH 55 (I.e. Hill Cart Road) that originates from Siliguri and goes all the way to Darjeeling. It's about mid way to Darjeeling and you can easily combine a couple of nights stay here when you plan a vacation in and around Darjeeling. The altitude of Kurseong is moderate 4,864 ft and therefore the climate for most part of the year also remains temperate. However it can get quite cold during the winter.
From Siliguri, the distance to Kurseong is 51kms. From New Jalpaiguri (NJP) station, the distance is about 57 kms and from Bagdogra airport Kurseong is 60kms. From Bagdogra the usual route is via Matigara and Rohini. From NJP and Siliguri, the public transports would usually take the Hill Cart Road unless it's closed for some reason. It takes about 2 hours to reach Kurseong from both Bagdogra and NJP. Darjeeling is about 33 kms from Kurseong and takes about 1 hour 15 minutes to reach.
Kurseong town on the hill slope
Kurseong has several great view points offering spectacular views of the landscapes, tea gardens and the snow peaks. There are some great heritage schools here which the British had established. You can visit some nice museums (including DHR Museum that showcases original railway archives & exhibits), tea estates & factories, temples and even interior villages to know the life and culture of the locals. Most taxi drivers will offer standard half and full day local sightseeing tours. More info...
Where to stay in Kurseong
There are several nice hotels, lodges and even home stays in Kurseong. While most hotels are in the main market area, Kurseong Tourist Lodge run by the state tourism department is about 1km from the market towards Darjeeling. More info on all types of accommodations in Kurseong...
There are only very few proper restaurants in Kurseong. Couple of them are near the main taxi stand close to the station. Kurseong tourist lodge also runs a nice multi cuisine restaurant with a bar. However there are also few small budget eateries located on alleyways and serve nice local Nepali food. More info on all types of restaurants in Kurseong...
Shops & Market Area in Kurseong
Nobody comes to Kurseong for shopping. However the main market area starts from the Kurseong Railway station and stretches along both sides of the Hill Cart Road for about quarter of a mile towards the Tourist Lodge. There are all sorts of small to medium shops including clothing, shoes, bags, stationery and essentials. If you are walking from the station towards the Tourist Lodge, on your right there are several alleyways that lead to the extended market at an elevated level. This is where you will find many stores selling dress materials and all types of house hold stuffs.
Kurseong Market
(see the toy train track on the road)
If you are looking specifically for local food products of Kurseong and of Darjeeling hills that you like to carry back home, then it can be worth visiting the store Kay Deez run by a charming local.
Weather and best time to visit
Due to low altitude, Kurseong's temperature remains temperate for most part of the year. The average temperature varies from about 10°C in January and goes up to an average of about 20°C in August and again falls to an average of 10°C in December. August is usually the warmest month when the maximum temperature can touch about 25°C. while January is the coolest month. Minimum temperature can fall to about 5°C.
Monsoon is heaviest in July when the rain fall is at an average of 896mm while December is the driest time with virtually no rainfall. The best time to visit Kurseong is between March to Mid June and September to December. During summer (April to September) you will need light woollens, while in winter (December to February) you will need heavy woollens (particularly for nights and early mornings).
1) Explore villages in Kurseong
Visitors' Reviews/Comments
Pema Tshering Lama (December 2017)
I have always been one optimistic local, always believing that someday Kurseong's time will come to be vividly noticed as a prime destination in Darjeeling hills which it is not so today. I as a local feel it's a great destination with the town a sleepy one but with a great vibrant natural surrounding that is not cramped for space. Its spacious as only nature should be. On the whole Kurseong is just like Darjeeling but it needs people to visit it sometimes and discover its quiet and pleasant solitude.
Dr Dhiman Bhattacharyya (November 2016)
Dear Raj, Your every note is splendid and I have gone through all your threads. Congratulations.
I have a few queries. 1. From NJP station or Darjeeling more will I be able to get cars for kurseong or is there any other stand? 2. Is there any bus service between kurseong and siliguri? 3. What is the time of shuttle cars between kurseong and siliguri and siliguri to kurseong?
Hello, from NJP station you will get cabs (both reserved and shared) to Kurseong. Buses between Siliguri and Darjeeling ply through Kurseong. The shared taxis (shuttles) between Siliguri and Kurseong (and onward to Darjeeling) operate almost every hour during the day time. The timing actually depends mostly on when it gets full.
Vincent Dcruz (March 2016)
Do we get shared jeep to Kurseong from NJP or Silliguri bus stand & where does it drop us at Kurseong.
Yes, all shared jeeps to Darjeeling (from NJP and Siliguri) go via Kurseong. You can get dropped at Kurseong taxi stand, train station or along its route anywhere (like at Kurseong Tourist Lodge on Hill Cart road etc). There would be few jeeps that go only up to Kurseong stand.


We appreciate your participation in this brief survey.
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Senate Demonstrates Support for Continued Research for Veterans Living with Hydrocephalus
June 9, 2016 /0 Comments/by Jenna Koschnitzky, PhD
The hydrocephalus community claimed a big victory on Capitol Hill this week, thanks in large part to your advocacy efforts! Together, we helped ensure Congress did not restrict medical research for veterans living with hydrocephalus or normal pressure hydrocephalus.
The question of whether or not to continue this research came up as part of a debate in the Senate on Tuesday regarding defense-related programs. At issue was the Congressionally Directed Medical Research Program (CDMRP), which provides funding to researchers working to improve the health of active duty service members, veterans, and their families. Several years ago, hydrocephalus advocates were able to convince Congress to add hydrocephalus to the list of conditions to be researched. This inclusion paves the way for further research to come up with new ways to support veterans living with acquired hydrocephalus and NPH.
The program was threatened this week, however, when the Senate considered legislation to continue to authorize Department of Defense-related programs. The bill included language that would have restricted the scope of the CDMRP's research. Specifically, it would have required the CDMRP to focus on the military health of active duty service members, as opposed to veterans or military families. It also would have imposed stricter oversight guidelines for grant applications that could have made the process of securing research funding more cumbersome and time-consuming.
Spearheaded by Senator Dick Durbin (D-IL), a coalition of senators offered an amendment to protect the CDMRP's ability to conduct research that would benefit both active service military and veterans. After calls, e-mails and social media posts from a variety of different groups, including the Hydrocephalus Association, Senators passed the proposal to protect medical research for veterans by a vote of 66-32. The strong bipartisan support means that Department of Defense can continue to conduct research to support veterans living with hydrocephalus and NPH. Please take a moment to thank Senators Durbin (D-IL), Murray (D-WA), Cochran (R-MS), Reid (D-NV), Blunt (R-MO), Mikulski (D-MD), Murkowski (R-AK) , Feinstein (D-CA), Casey (D-PA), and Collins (R-ME) for leading the charge on this important issue.
The exciting outcome of this vote is just one more example of how your advocacy efforts can truly make a difference! We asked you to make phone calls to your Senators urging them to support Senator Durbin's amendment, and they ultimately did. Congress has been supporting medical research and innovation that helps patients with hydrocephalus time and again, and that's in large part because they're hearing that you—their constituents—care how they vote on these important issues.
To learn more about HA's Advocacy program, click here.
To become a grassroots advocate, join HA's Hydrocephalus Action Network.
Tags: dementia, normal pressure hydrocephalus, traumatic brain injury, veterans, water on the brain
The Difficulties of Diagnosing Normal Pressure Hydrocephalus
FOX News Educates the Public on Normal Pressure Hydrocephalus
Building Community: A case for adult hydrocephalus research
Happening NOW! American Academy of Neurology Annual Meeting in Washington DC
Finding that Perfect Fit
AHCRN Update (8)
Other Advisor (6)
Finding that Perfect Fit Like Father, Like Son: An NPH Journey


The three Indian teams were selected among hundreds of teams from 17 countries who submitted projects for the chance to move forward to the Asia Regional Finals of the mega championship to be held in Sydney on Tuesday.
Three teams from India are among the 12 finalists who are eyeing the top slot in Microsoft's global competition for the most original technology solutions vying to win the grand prize of USD 100,000 at the world championship in the US. The three Indian teams were selected among hundreds of teams from 17 countries who submitted projects for the chance to move forward to the Asia Regional Finals of the mega championship to be held in Sydney on Tuesday.
Imagine Cup is all about innovation today to create technology solutions for tomorrow.
With over 2 million past competitors, participants consistently push the bounds of what's possible and inspire us with their projects.
Students this year were challenged to develop an original idea in teams of up to three and submit a project proposal and video pitch for the preliminary round of judging, according to the website of Imagine Cup.
The projects made by the Indian teams include "Caeli", a smart automated anti-pollution and drug delivery mask specifically designed for Asthmatic and Chronic Respiratory Patients.
"Caeli implements breakthrough features to improve the quality of life for respiratory patients living in polluted areas," according to the website that mentions about the project details of its regional finalists.
The second Indian team has developed a project called "Spot", which allows people to recognise packaged foods and check if it contains a certain ingredient or exhibits a certain character.
"If a tourist visits India, he/she is unaware of what he can eat because packets have information written in a foreign language," the website said.
The third project is RVSAFE, a one stop solution for effective communication and proper management during both natural and man-made destructions.
"The loss caused by disasters can be significantly reduced with better communication and proper management. Keeping this in mind, we designed RVSAFE, a one stop solution for effectively handling any kind of disasters (natural or man-made)," the website said mentioning about the team that developed RVSAFE.
These teams will compete for over USD20,000 in prizes in Sydney on February 12 and for a spot in the 2019 Imagine Cup World Championship in the United States in May this year.
Apart from the Indian teams there are entries from Sri Lanka, Indonesia, Singapore among the regional finalists.


Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find the Traveller's Diarrhoea article more useful, or one of our other health articles.
Use antibiotics responsibly, considering issues such as safety, resistance and cost.
Check that an antibiotic is really needed - history and examination may yield clues as to whether a condition is bacterial or viral; however, this is not always easy. Consider delayed antibiotics. Some viral conditions may need prophylaxis to prevent secondary bacterial overgrowth - eg, acute necrotising ulcerative gingivitis secondary to herpes simplex infection.
The use of point of care rapid CRP testing may reduce the precription of antibiotics. There is evidence of an overall reduction in the use of antibiotics when using CRP tests to guide whether antibiotic treatment is required.
However, the CRP result is nonspecific and should be considered in the context of the clinical presentation. The usefulness of the CRP level can be affected by various factors, including the age of the patient, site of infection and the timing of the test. CRP values are often slightly raised in the indeterminate range and therefore may be of limited value.
Blind prescribing does not obviate the need to take samples for culture and sensitivity, before starting treatment, whenever appropriate.Depending on the clinical picture, this may include skin or wound swabs, high vaginal swabs, endocervical swabs, urine, faeces, sputum, blood, aspirate. In the hospital environment, consider cerebrospinal fluid.
Where clinically appropriate, consider FBC, ESR, CRP, U&Es, LFTs, clotting, atypical serology, malaria film, serum for virology, CXR and arterial blood gas analysis. Perform urinalysis.
Blind antibiotic prescribing for pyrexia of unknown origin (PUO) in a relatively well and stable patient is rarely helpful.
Underdosing may result in significant failure of treatment and bacterial resistance in serious infection.
An excessive dose may result in toxicity, particularly for antibiotics with a narrow margin between the toxic and therapeutic dose (eg, an aminoglycoside).
Consider drug plasma monitoring, although this is difficult in primary care and may be more appropriate in an intermediate care setting.
Route of administration - most patients in primary care will cope with oral antibiotics, although some patients have difficulty swallowing tablets and may need liquid or dispersible preparations. Serious infections may require intravenous (IV) administration. Avoid intramuscular (IM) antibiotics in children, as these are likely to be painful.
Duration depends on condition and severity. Chronic infections such as tuberculosis may require prolonged treatment.
Follow local policy and national guidelines.
Consider any other factors relating to the patient which are likely to be relevant - eg, ethnicity, history of allergy, whether immunocompromised, severity of condition and whether taking other medication.
Check whether pregnant, breast-feeding or taking an oral contraceptive.
In pregnancy avoid tetracyclines, aminoglycosides, quinolones, high-dose metronidazole.
Short-term use of trimethoprim (there is a theoretical risk in the first trimester in patients with a poor diet, as it is a folate antagonist) or of nitrofurantoin (at term, there is a theoretical risk of neonatal haemolysis) is unlikely to cause problems.
Prescribing antibiotics after a telephone consultation should be the exception rather than the rule.
Choose simple generics first-line unless there is a very good case for using newer more expensive antibiotics.
Avoid widespread use of topical antibiotics, especially those readily used in oral forms, as this may spread resistance.
Clarithromycin is an acceptable alternative in patients who have gastrointestinal side-effects with erythromycin.
If blind treatment fails and test results are not available, check with a microbiologist.
A detailed history may reveal the source of infection.
Ask about respiratory, gastrointestinal or genitourinary symptoms.
Ask about recent travel or treatment or conditions which could compromise the immune system.
Check vital signs: temperature, pulse, blood pressure, respiratory rate and capillary return, to assess the severity of illness and signs of septicaemia.
After 'best guessing' the source of infection, follow local guidelines.
Be ready to change treatment once drug sensitivities are known.
Treatment of most infections should not exceed seven days.
In a hospital or intermediate care setting, IV antibiotic therapy is usually reviewed after 48 hours and changed to oral preparations when possible.
If in doubt, ask a microbiologist.
Unless otherwise specified, the antibiotic doses in the following table are for adults. Always check a drug formulary such as the British National Formulary for Children when prescribing for children.
Phenoxymethylpenicillin 500 mg QDS or 1 g BD for 10 days.
If allergic to penicillin, clarithromycin 250 mg-500 mg BD for 10 days.
Amoxicillin first-line - 40 mg/kg/day in three divided doses.
Maximum 1 g TDS for 5 days.
Erythromycin first-line - under 2 years 125 mg QDS; 2-8 years 250 mg QDS; other 250-500 mg QDS.
Avoid antibiotics unless severe, or where symptoms are lasting more than 10 days. 80% resolve within 14 days without antibiotics.
First-line - amoxicillin 500 mg TDS for 7 days or doxycycline or 200 mg stat/100 mg OD for 7 days or clarithromycin 250 mg/500 mg BD for 7 days or phenoxymethylpenicillin 250 mg QDS/500 mg BD for 7days.
For persistent symptoms - co-amoxiclav 625 mg TDS for 7 days.
Amoxicillin 500 mg TDS or or doxycycline 200 mg stat then 100 mg OD for 5 days.
If there is penicillin allergy and tetracycline is contra-indicated, use erythromycin.
First-line - amoxicillin 500 mg TDS or doxycycline 200 mg stat then 100 mg OD or clarithromycin 500mg BD, for 5 days.
If resistance - co-amoxiclav 625 mg TDS for 5 days.
First-line: amoxicillin 500 mg-1 g TDS or clarithromycin 500 mg BD or doxycycline 200 mg stat the 100 mg OD for up to 10 days.
Consider risk factors for Staphylococcus aureus and Legionella spp.
Assess need for dual therapy for atypical organisms: amoxicillin and clarithromycin, or doxycycline alone.
Benzylpenicillin or cefotaxime prior to admission, unless there is history of anaphylaxis, (NOT allergy). Ideally, IV but IM if a vein cannot be found.
Benzylpenicillin: adults and children 10 years and over: 1200 mg. Children 1-9 years: 600 mg. Children under 1 year: 300 mg.
Cefotaxime: age 12+ years: 1 gram. Age < 12 years: 50 mg/kg.
Amoxicillin resistance is common; therefore, ONLY use it if culture confirms susceptibility.
In the elderly (>65 years), do not treat asymptomatic bacteriuria; it occurs in 25% of women and 10% of men and is not associated with increased morbidity.
In the presence of a catheter, antibiotics will not eradicate bacteriuria; only treat if systemically unwell or if pyelonephritis is likely.
Do MSU on all treatment failures - extended-spectrum beta-lactamase enzyme-producing organisms increasing multiple resistance but still sensitive to nitrofurantoin.
Use urine dipstick to assess for UTI: nitrite plus blood or leukocytes 92% positive predictive value; negative for nitrite, blood and leukocyte 76% negative predictive value.
Use nitrofurantoin first-line as general resistance and community multi-resistant.
Trimethoprim 200 mg BD, nitrofurantoin 50-100 mg QDS or pivmecillinam 200 mg TDS (400 mg TDS if resistance risk).
Treat for 3 days in women and for 7 days in men.
Send MSU for culture and start antibiotics.
Avoid trimethoprim if low folate status or on folate antagonist (eg, antiepileptic or proguanil).
Short-term use of nitrofurantoin in pregnancy is unlikely to cause problems to the fetus.
First-line - nitrofurantoin 100 mg MR BD; or amoxicillin 500 mg TDS (if organism susceptible); treat for 7 days.
Second line - trimethoprim 200 mg BD for 7 days (also give folate if in first trimester).
Third-line - cefalexin 500 mg BD for 7 days.
Lower UTI: trimethoprim or nitrofurantoin (or amoxicillin if susceptible); second-line - cefalexin.
Upper UTI: co-amoxiclav; second-line - cefixime.
See also separate Recurrent Urinary Tract Infection article.
Postcoital prophylaxis is as effective as prophylaxis taken nightly.
For prophylaxis use nitrofurantoin 50-100 mg or trimethoprim 100 mg; stat postcoital or OD at night (review at 6 months).
Reserve topical antibiotics for very localised lesions to reduce risk resistance.
Reserve mupirocin for meticillin-resistant S. aureus (MRSA).
First-line oral medication - flucloxacillin 500 mg or, if penicillin allergy, clarithromycin 250-500 mg BD; treat for 7 days.
Topical - use fusidic acid TDS for 5 days.
Using antibiotics, or adding them to steroids, in eczema does not improve healing unless there are visible signs of infection.
Flucloxacillin 500 mg QDS for 7 days. Use clarithromycin if there is allergy to penicillin.
If febrile and ill, admit for IV treatment.
If on statins use doxycycline 200 mg stat then 100 mg OD for 7 days.
If unresolving: clindamycin 300-450 mg QDS 7 days.
In facial cellulitis, use co-amoxiclav 625 mg TDS for 7 days.
Initially treat for 7 days but continue for a further 7 days if there is slow response.
Bacteria will always be present. Antibiotics do not improve healing unless there is active infection. Culture swabs and review antibiotics after culture results.
Active infection indicated if there is cellulitis, increased pain, pyrexia, purulent exudate or odour.
If there is active infection, use flucloxacillin or clarithromycin as for cellulitis.
Assess tetanus, rabies, HIV and hepatitis B/C risk.
Bite involving a hand, foot, face, joint, tendon or ligament.
Immunocompromised, diabetes, asplenic, cirrhotic or presence of prosthetic valve or prosthetic joint.
First-line is co-amoxiclav 375-625 mg TDS for 7 days.
Metronidazole PLUS clarithromycin (for human bite).
Review at 24 hours and 48 hours.
NB: doses are for adults unless otherwise stated - for further details see the British National Formulary.
The table is a brief summary. Guidance changes from time to time depending on prevailing antibiotic sensitivities.
Cunha BA; Fever of unknown origin: focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests. Infect Dis Clin North Am. 2007 Dec21(4):1137-87, xi.
Aabenhus R, Jensen JU, Jorgensen KJ, et al; Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care. Cochrane Database Syst Rev. 2014 Nov 6(11):CD010130. doi: 10.1002/14651858.CD010130.pub2.


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Q: Should the cross validation have the natural rate of unbalanced data set I have a classification problem with unbalanced classes where the natural proportion of the positive class is 0.02% but the total number of cases is high (+300k) which allows to change it when training the model using a higher rate (+2% of positive class).
I am doing a CrossValidation with 10 folds keeping that rate = 2% and then I have a test set that has a natural rate of 0.02%.
What I would like to know is: Should the validation set in the K-folds have the natural rate (0.02%) or the it's ok to have a 2% rate since we are testing later on a 0.02% test-set ?

A: Usually, it's better if validation mimics the test set. This is to ensure your validation score is close to your test score. Because, you're optimising validation performance in CV loop, with the motivation of performing well on the test set.
Here, you have the test set, so you can make it happen but sometimes, this might not be even possible. For example, assume you train a classifier to detect lung cancer. The dataset you'll have might not represent the cancer ratio across the entire population (the cancer ratio in the population can be much much smaller). And, when you use it as a diagnostic tool, you may encounter a much different test set. On the other hand, it there was such a diagnostic tool, it'd keep on learning with new data.
So, this is not a necessity (e.g. no data leakage); you can manipulate the data as you want leaving the test set untouched, but it's your own risk. I'd usually expect to find a better a model when distributions match.

redpajama_set_name: RedPajamaStackExchange


Shipping printers--especially commercial grade printers, copiers and plotters--is a heavy job. Standard parcel carriers (such as USPS) can't handle any item that weighs more than 150 lb. or doesn't meet dimension requirements. For commercial printing equipment, shipping by freight is the answer.
Make sure you secure all loose pieces with masking tape and use shrink wrap or paper to cover any plastic pieces from getting easily scratched. Secure any casters that will allow the unit to roll.
Unless you are shipping enough pieces to require a full truckload (TL), your shipment will be classified as less-than-truckload (LTL). LTL shipments are consolidated onto one truck with loads from other shippers, thereby saving all the shippers money. However, this means you must package your machinery so that it will easily withstand any minor impact with another shipment that might occur in transit.
We recommend using one of these two techniques to protect your shipment.
Band your shipment to a pallet and shrink wrap it to add additional security. Protective shipping blankets are also advised.
Crating your shipment,will provide the best protection.
HOW MUCH WILL IT COST TO SHIP A PRINTER?
If you are no more than an occasional shipper, major freight carriers will not be interested in your business unless you pay full rate card. Because FreightCenter books so much shipping, we receive very deep discounts from carriers and pass savings on to our customers. Typically, FreightCenter customers receive discounts of 25%, 50%, 75% or more versus the cost of shipping directly through the carrier.
FreightCenter is where the best freight carriers compete for your business. We enable you to compare multiple carriers' rates and expected transit times in a matter of seconds.
Originating and destination zip codes.
In a matter of seconds you will receive quotes from leading carriers who want to carry your shipment, as well as estimates on the transit time for each carrier. Select the carrier of your choice to save your quote. If you're ready to move forward, book your shipment online.
FreightCenter's team of shipping experts is ready to help you at each step along the way.
Call 800.716.7608 for assistance or fill out the free quote form. Shipping is easy and affordable with FreightCenter.


Give your friends their hearts' desire: a room of their own, a flock of friends, or a seat by the window. Deborah Zemke's animals make this book a charming gift for any occasion!
Deborah Zemke has illustrated more than 30 books for children and adults, including picture books, activity books, cookbooks, and business guides. She is also the designer of two illustration fonts for the International Typeface Corporation. She lives and works in Missouri.


text:
Baxter Family Drama--Sunrise Series: Sunset
Kingsbury, Karen
Descarga del libro
ePub con DRM
Tyndale House Publishers, Inc.
Book 4 in the bestselling 4-book Christian fiction series that has sold over 1.3 million copies!
A story about God's unending faithfulness, the power of family love, and the healing miracle of redemption, from Karen Kingsbury, the #1 New York Times bestselling author of "heart-tugging and emotional" (Romantic Times) life-changing fiction.
With the demands of Hollywood life behind them for now, Dayne and Katy Matthews continue to adjust to life in Bloomington as they look forward to a new chapter together-expanding their family. Meanwhile, the entire CKT staff is busy preparing for the first production in Dayne and Katy's theater.
A Time of Uncertainty
The Flanigans rally to support Bailey and Connor as they try out for lead roles in the musical, but then the family receives tragic news that weighs heavily on everyone's mind. At the same time, Jim Flanigan faces a decision that could drastically change his family's life.
A Beautiful Beginning
As John Baxter prepares for his marriage to Elaine Denning, one of the Baxters enters the most trying season of all. Will a time of renewed love and hope be strong enough to establish the sacred ground of marriage and chart a course for the future? And when the time comes to finally sell the beloved Baxter house, memories of times gone by meet with the changes of today, proving that only the support of faith and family can take a person into the sunset years of life.
The Sunrise series is the third installment in the continuing Baxter Family Drama from America's number-one inspirational novelist, Karen Kingsbury. Revisit the Baxter family in all their life-changing events, or share the series with someone who hasn't discovered it yet.
Winner of Christian Retailing's Retailer's Choice Award for Best Series!
Mom Heart Moments
Frame 232
Kingdom Woman
31 días para ser una mamá feliz
Precio regular: 10,99 $
Special Price 8,79 $
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