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The U.S. Surgeon General is talking about structural racism, saying it's partly why the coronavirus has disproportionately affected Black and Latino Americans.Surgeon General Jerome Adams plans to focus on two initiatives soon, high blood pressure and maternal mortality, which is women dying from pregnancy or childbirth issues.The office plans to put out science-based summaries designed to create urgent action on both issues that disproportionately affect communities of color.Earlier this month, the Institute for Health Metrics and Evaluation declared racism a public health crisis.“Racism is a public health issue,” said Dr. Ali Mokdad with the Institute for Health Metrics and Evaluation. “I’ve been on record saying it’s more dangerous than COVID-19, simply because we're going to find a vaccine for COVID-19.”They are currently working with the National Institutes of Health on providing data down to the county level of the burden of disease by race.Mokdad used life expectancy as an example. He says within a county there are high disparities, sometimes 15 years less based on where minorities or lower income people live.“Provide data in order to tell people this is what we see. These are the problems, keeping in mind you cannot change what you cannot measure,” said Mokdad.The CDC is also now requiring states to collect data about race, ethnicity, gender, and zip code for coronavirus cases.Racism in healthcare affects everyone, socially and economically.“What people don’t realize is we are paying for it one way or another and right now when you look at the United States, we spend more money on health than every other country,” said Mokdad.Mokdad and other health professionals we talked to all pointed to universal health care as another obvious solution to addressing structural racism. 1818

The US will respond to the Assad regime's alleged chemical attack against Syrian civilians, US Ambassador Nikki Haley told the United Nations as she excoriated Russia, saying its hands are "covered in the blood of Syrian children.""Chemical weapons have once again been used on Syrian men, women and children," Haley said at a special meeting of the United Nations Security Council to discuss what appeared to be a chemical attack on Douma, the last rebel-held town in Syria, on Saturday that left 49 people dead and scores injured."History will record this as the moment when the Security Council either discharged its duty or demonstrated its utter and complete failure to protect the people of Syria," Haley said. "Either way, the United States will respond."Images of gasping children struggling to breathe shocked the world and galvanized President Donald Trump, who condemned the attack as "sick" and upbraided Russian President Vladimir Putin and Iran for supporting Syrian President Bashar al-Assad.Trump threatened that there would be "a big price to pay" for the attack.On Monday, Haley made clear that Russia could "pay" as well, as tensions between Washington and Moscow were laid bare in the Security Council. Russia's ambassador accused the US of plotting against Moscow and Syria, threatening international security, stoking global tensions and operating outside the confines of international law.Haley described at length and in detail blue-skinned Syrian toddlers lying dead in their parents' arms after the suspected chemical attack and made clear that the US sees Moscow as responsible. Russia, she implied, is not even a civilized nation."The monster who was responsible for these attacks has no conscience to be shocked by pictures of dead children," Haley said, explaining that she wouldn't show photos of the victims as she had after a chemical attack in April 2017 that led to US strikes on Syria."The Russian regime, whose hands are also covered in the blood of Syrian children, cannot be shamed by pictures of its victims," she said. "We've tried that before.""Russia could stop this senseless slaughter, if it wanted," she said. "But it stands with the Assad regime and supports it without hesitation. What's the point of trying to shame such people? After all, no civilized government would have anything to do with Assad's murderous regime.""Russia's obstructionism will not continue to hold us hostage when we are confronted with an attack like this one," she added.Russia pushed back hard. "Nobody has invested you with the authority to act as gendarmes, policemen of the world ... we call on you to return to the legal fold," Ambassador Vassily Nebenzia said. Earlier, Russian Foreign Minister Sergey Lavrov had argued that there is no evidence chemical weapons were used, a claim Nebenzia echoed."The use of sarin and chlorine is not confirmed," Nebenzia echoed in the Monday meeting. He went on to say that the US, along with the UK and France, is acting "without any justifications, and without considering the consequences have engaged in a confrontational policy toward Russia and Syria."In extended, rambling remarks, Nebenzia accused the US of plotting a strike against Damascus and planting the "fake news" of the Douma attack Saturday as justification. He then veered off onto the subject of an alleged nerve agent attack on a former Russian spy in the UK, attempting to link all the events."Is it not clear to all? Syria, Russia, Salisbury," Nebenzia said, referring to the British city where the spy was poisoned.The UN's special envoy for Syria, Staffan di Mistura, noted that some states have publicly raised their suspicions that Syria was behind the attack. Other states, he said, "have strongly questioned the credibility of these allegations.""What reason more, then, for a thorough, independent investigation," he concluded, as he denounced the use of chemical weapons as "abhorrent" and called for a thorough investigation.Nongovernmental organizations on the ground had documented "hundreds of cases of civilians with symptoms consistent with exposure to chemical weapons," he said.Between August 2013 and February 2018 there have been at least 85 confirmed chemical attacks in Syria, with the Syrian government responsible for at least 50 of them, according to Human Rights Watch.Even before Nebenzia's accusations, Mistura warned about the hostilities in Syria spiraling out of control to threaten international stability. "I have reached a point in which I am expressing a concern about international security," he told the council.Telling the gathered officials that recent developments carry more danger than ever, he said that "different fault lines that are completely crossing each other and are interconnected" and escalation could "have absolutely devastating consequences that is difficult for us to even imagine.""The council cannot allow a situation of uncontrollable escalation in Syria on any front," he said.Haley and other speakers stressed that a dangerous precedent is being set."We are on the edge of a dangerous precipice," Haley said. "The great evil of chemical weapons use that once unified the world in opposition is on the verge of becoming the new normal. The international community must not let this happen." 5312

The Trump administration is at risk of wasting some of the billions of dollars it wants to spend on the US-Mexico border wall, according to a watchdog report released Monday.The Government Accountability Office concluded that the Department of Homeland Security has not conducted a full analysis of the costs of building the wall. Department officials have also not properly documented their plans for building a portion of wall in the San Diego area.Because of the shortfalls, "DHS faces an increased risk that the Border Wall System Program will cost more than projected, take longer than planned, or not fully perform as expected," GAO wrote.The report also said DHS does not consider costs when deciding where to build. That means it "does not have complete information to determine whether it is using its limited resources in the most cost-effective manner." 872

The U.S. regulators who will decide the fate of COVID-19 vaccines are taking an unusual step: Asking outside scientists if their standards are high enough.The Food and Drug Administration may have to decide by year’s end whether to allow use of the first vaccines against the virus. Thursday, a federal advisory committee pulls back the curtain on that decision process, debating whether the guidelines FDA has set for vaccine developers are rigorous enough.“We will not cut corners, and we will only use science and data to make that determination,” FDA Commissioner Stephen Hahn pledged at a meeting of the Milken Institute Wednesday.Exactly how much data his agency needs to be sure a vaccine is safe and effective is a key question for the advisers. An even bigger one: If the FDA allows emergency use of a vaccine before final testing is finished, will that destroy chances of ever learning just how well that shot -- and maybe competitors still being studied -- really work?“We can’t lose sight of the fact that it is in our societal interest to see these trials to completion,” said Dr. Luciana Borio, a former FDA acting chief scientist who will be watching the advisers’ debate.Plus, multiple vaccines are being studied -- shots made with different technologies that each have pros and cons.“The first vaccine is not necessarily the best vaccine,” cautioned Dr. M. Miles Braun, a former FDA scientist now with Georgetown University School of Medicine. If the trials aren’t allowed to finish, it may be difficult or impossible to ever know for sure.It’s a critical moment in FDA’s 114-year history. The government has spent billions to race a vaccine through a research process that usually takes years, and FDA faces unprecedented pressure from the Trump administration, fueling public skepticism that politics could overrule science.Interest is so high, FDA is airing the meeting on YouTube. Here are some key issues the committee will discuss:HOW MUCH EVIDENCE IS NEEDED?FDA is requiring manufacturers to do studies of at least 30,000 people to prove if a vaccine protects and how safe it is. Those studies must include adequate numbers of people at highest risk from COVID-19 -- older adults, minorities and anyone with underlying health problems.FDA has made clear that any vaccine must be at least 50% effective. And while the studies are designed to run for two years, companies may get enough evidence the shots are protective -- in at least some people -- to stop the trials early and seek what’s called an “emergency use authorization” for wider vaccinations.Despite White House objections, the FDA told vaccine makers earlier this month not to seek that speedier review until they’ve tracked at least half their trial participants for two months. With other vaccines, that’s about the amount of time when major side effects crop up.That’s not long enough, said the head of the non-profit ECRI Institute, which reviews medical technology for hospitals and insurers. In comments submitted to the advisory committee, ECRI’s Dr. Marcus Schabacker said FDA should require six months of follow-up.“Doing any less would simply risk too much, and the consequences may be severe,” he wrote. “A weak vaccine that loses public trust could poison the well for epidemic control for many years.”WOULD EMERGENCY USE DERAIL FULL ANSWERS ABOUT VACCINES?Normally when a study ends because of evidence that a vaccine is working, the participants who got dummy shots are offered the real thing.But if FDA allows emergency use of a COVID-19 vaccine, that’s not the same as having full proof the shot works, Borio cautioned.And if the participants in the placebo group are immediately offered the real shot, researchers may not be able to get answers about all the high-risk groups in the study — or tell how long the vaccine’s protection lasts, a process expected to take many more months.But Pfizer Inc., which with Germany’s BioNTech is developing one of the leading candidates, told FDA that if it’s granted emergency use authorization, it “would have an ethical obligation” to alert study participants who got a placebo and allow them vaccine access. The company wants FDA to look into “other scientifically and statistically sound methods” to determine long-term safety and effectiveness.Pfizer’s stance is likely to face pushback. The Infectious Diseases Society of America states that FDA’s panelists “should insist” that vaccine developers “present a compelling case” for how they will complete their trials if FDA grants early authorization of their vaccine.Clearing a vaccine based on premature or faulty data “could cause more harm” by “further eroding public confidence in all vaccines,” the group said.It’s an unprecedented dilemma. The FDA has previously allowed emergency use of only one vaccine, a decades-old shot that in 2005 was authorized to prevent anthrax poisoning.This time around, multiple COVID-19 vaccines are in the pipeline. Pfizer competitor Johnson & Johnson cautioned that early FDA clearance of one vaccine could “jeopardize integrity” of other ongoing trials if patients decide to drop out to seek the first cleared shot instead.The company asked regulators to explain what options are available to ensure completion of all ongoing COVID-19 vaccine trials.WHAT ABOUT LONG-TERM SAFETY MONITORING?Even a study of 30,000 people cannot spot a side effect that only strikes 1 in 100,000. So the government is planning extra scrutiny of every COVID-19 vaccine to hit the market.At first there will be limited doses given to just certain high-risk people -- and those early recipients are to get text messages daily for the first week after vaccination, and then weekly out to six weeks, asking how they’re feeling.FDA also will be checking databases of electronic health records and insurance claims, looking for any red flags.“There’s a kind of tracking that has to take place here on a massive basis that hasn’t taken place before,” said Dr. Jesse Goodman of Georgetown University, a former director of the FDA’s vaccine and biologics center.___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 6274

The way lawyers for Kyle Rittenhouse tell it, he wasn’t just a scared teenager acting in self-defense when he shot to death two Kenosha, Wisconsin, protesters. He was a courageous defender of liberty, a patriot exercising his right to bear arms amid rioting in the streets.The dramatic rhetoric has helped raise nearly million to pay for the 17-year-old’s defense against homicide charges in the killing of two protesters, and wounding of a third. The shootings happened on the third night of demonstrations following the police shooting of Jacob Blake. “A 17-year-old citizen is being sacrificed by politicians, but it’s not Kyle Rittenhouse they are after. Their end game is to strip away the constitutional right of all citizens to defend our communities,” says the voice-over at the end of a video released this week by a group tied to Rittenhouse’s legal team.But some legal experts say there are risks in turning a fairly straightforward self-defense case into a sweeping political argument that could play into a stereotype that he is a gun-crazed militia member out to start a revolution.“They’re playing to his most negative characteristics and stereotypes, what his critics want to perceive him as — a crazy militia member out to cause harm and start a revolution,” said Robert Barnes, a prominent Los Angeles defense attorney.Rittenhouse’s high-profile defense and fund-raising teams, led by Los Angeles-based Pierce and Atlanta attorney Lin Wood, respectively, refused to speak to The Associated Press about their strategy ahead of the teen’s next court appearance Friday, a hearing in Illinois on whether to return him to Wisconsin.Earlier this week, a new lawsuit claims Facebook promoted conspiracy theories among the members of militia groups and is responsible for a series of shootings in Kenosha that left protesters dead in the days following the shooting of Jacob Blake. 1902