呼和浩特痔疮术价钱(呼和浩特治疗便秘的医院) (今日更新中)

The government of Puerto Rico has quietly admitted that the death toll from Hurricane Maria -- a subject of great controversy -- may be far higher than its official estimate of 64.In a report to Congress dated Wednesday, the US commonwealth's government says documents show that 1,427 more deaths occurred in the four months after the storm than "normal," compared with deaths that occurred the previous four years.The 1,427 figure also appeared in a draft of the report -- "Transformation and Innovation in the Wake of Devastation" -- which was published and opened for public comment July 9. The figure was first "revealed" by the Puerto Rico government, according to the final report, on June 13, one day after officials were forced by a judge to release death records that CNN and the Centro de Periodismo Investigativo in Puerto Rico had sued to make public.Officials stopped short of updating the official death toll for the September 20 storm."The official number is being reviewed as part of a study under way by George Washington University," the report says. Officials hired that university to review the toll after news reports, including those from CNN, called it into question.The George Washington University study "will have certainty" about the number of people the government believes died in Hurricane Maria and its aftermath, Pedro Cerame, a spokesman for the Puerto Rican government in Washington, told CNN. Officials initially said that report would be released in May. Now they expect it to publish this month."We understand that the number is higher," Carlos Mercader, executive director of the Puerto Rico Federal Affairs Administration, told CNN in an interview. "We didn't commission the study to prove there were 64 (deaths). We wanted a scientific and epidemiological study that would give us light, not only on the number -- we know the number is higher -- but the reasons why this happened."The 1,427 figure is "an estimate," Cerame said, and it may include deaths that weren't related to the storm.It's an estimate that follows many others like it.In November, CNN surveyed 112 funeral homes -- about half the total -- across the island, finding that funeral home directors and staff had identified at least 499 deaths they believed to be related to Hurricane Maria and its chaotic aftermath, which included months without power for many of the island's 3.3 million residents. In December, the New York Times estimated the "excess death" toll from the storm to be 1,052, based on comparisons with previous years.In May, a team that included researchers from Harvard University published a study in the New England Journal of Medicine estimating that 793 to 8,498 people died in Maria's wake, a range that some academics have criticized as overly broad. The study's midpoint estimate -- 4,645 deaths -- became a rallying cry for activists upset by what they see as a lack of accountability for the scale of the catastrophe by officials in Puerto Rico and the United States.The Harvard estimate was based on surveys of 3,299 households in Puerto Rico, in which residents were asked about deaths in their homes after Hurricane Maria.Mercader, the Puerto Rico official, criticized that study in an interview with CNN on Thursday. "We all know that's impossible, that that couldn't happen," he said of the estimate that 4,645 people may have died after Maria. "We have the data. You all know that is an exaggeration."Then last week, a research letter published in the medical journal JAMA estimated that between 1,006 and 1,272 people died in relation to the storm -- with a midpoint estimate of 1,139.An accurate death toll is important, according to officials and academics, because it can help Puerto Rico and other governments better prepare for future storms, which are expected to become worse in the era of climate change. The official count also matters a great deal to the families of the deceased. Not only are they eligible for certain federal aid if the deaths are officially counted, but some relatives of the dead simply want their loved ones to be remembered."They were not numbers; they were people," Lisa De Jesús, whose friend Reinaldo Ruiz Cintron died while working in hurricane cleanup, told CNN in June. "And the government thinks that just p

The Food and Drug Administration released updated safety standards Tuesday for makers of COVID-19 vaccines despite efforts by the White House to block them, clearing the way for requirements that are widely expected to prevent the introduction of a vaccine before Election Day.In the new guidelines posted on its website, the FDA said vaccine makers should follow trial participants for at least two months to rule out any major side effects before seeking emergency approval. That standard had been a sticking point between the FDA and White House officials, who said it could unreasonably delay the availability of COVID-19 vaccines.President Donald Trump has repeatedly insisted a vaccine could be authorized before Nov. 3, even though top government scientists working on the effort have said that timeline is very unlikely. On Monday Trump said vaccines are coming “momentarily,” in a video recorded after he returned to the White House.Former FDA officials have warned that public perception that a vaccine was being rushed out for political reasons could derail efforts to vaccinate millions of Americans.A senior administration official confirmed Monday that the White House had blocked FDA’s plans to formally publish the safety guidelines based on the two-month data requirement, arguing there was “no clinical or medical reason” for it.But on Tuesday, the FDA posted the guidance on its website, making clear that regulators plan to impose the safety standards for any vaccine seeking an expedited path to market.FDA Commissioner Stephen Hahn said in a statement that he hoped the guidelines would help “the public understand our science-based decision-making process that assures vaccine quality, safety and efficacy.”The requirements are aimed at companies seeking rapid approval through the FDA’s emergency authorization pathway. That accelerated process, reserved for health emergencies, allows medical products onto the market based on a lower bar than traditional FDA approval. But FDA has made clear only vaccines that are shown to be safe and effective will be authorized for coronavirus.Former FDA acting commissioner Dr. Stephen Ostroff said the requirements seem reasonable given the agency is in largely “uncharted territory” in terms of considering emergency use of a vaccine. The agency has only previously cleared one vaccine through the method — a decades-old shot that was authorized to prevent anthrax poisoning in 2005.“There really is no margin for error here,” Ostroff said. “Even when you’re talking about limited use of a vaccine there has to be some level of assurance that there isn’t a risk here that would far outweigh the benefit.”Dr. Peter Marks, the head of FDA’s vaccine division, said Tuesday that the two-month follow-up requirement was chosen to be “something reasonably aggressive, but not too conservative — right in the middle.” He spoke at a symposium organized by Johns Hopkins University.Initial doses of vaccines for emergency use would likely be reserved for medical workers and people with health conditions that make them particularly vulnerable to coronavirus. Full FDA approval for the general population will require significantly more data and is not expected until mid-2021.The White House attempt to block the guidance followed a string of instances in which the Trump administration has undercut its own medical experts working to combat the pandemic. FDA’s Hahn has been attempting to shore up public confidence in the vaccine review process for weeks, vowing that career scientists, not politicians, will decide if the shots are safe and effective.Pfizer CEO Albert Bourla has stoked excitement by saying that he expects data on whether the company’s candidate works to be ready in late October. But a number of variables would still have to align for the company to submit, and the FDA to review and greenlight, a vaccine application before Nov. 3. Pfizer’s competitors Moderna, AstraZeneca and Johnson & Johnson are working on longer research timelines.Vaccine development typically takes years, but the U.S. government has invested billions in efforts to accelerate the process and help multiple drugmakers prepare multiple candidates. All the doses will be purchased by the federal government for use vaccinating the U.S. population.Beyond exposing the rift between the White House and FDA, the delay in releasing the guidelines may have had limited practical effect.FDA scientists have been discussing the guidelines publicly for weeks and have made clear that the recommendations have already been shared with each of the vaccine developers.Former FDA Commissioner Scott Gottlieb said Tuesday that drugmakers depend on the FDA’s science-based endorsement to vouch for the safety and effectiveness of their products.“I can’t imagine a circumstance where a sponsor would challenge or seek to undermine the FDA’s role here,” Gottlieb said at the COVID-19 symposium. “This is precisely the moment when we need an objective, neutral arbiter.”Last week, Gottlieb and six other former FDA commissioners blasted the Trump administration for “undermining the credibility” of the agency in a op-ed calling for the release of the then-stalled vaccine guidelines.“Scientists should make decisions based on data, unfettered by political pressure or the intrusions of ideology or vested interests,” the officials wrote.___AP Medical Writer Lauran Neergaard contributed to this report.___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. 5644

The Commission on Presidential Debates announced that they've officially canceled the Oct. 15 debate between President Donald Trump and Democratic presidential nominee Joe Biden.In a press release, the commission stated that since both candidates made different arrangements for Oct. 15, the commission will focus on the third and final presidential debate, which is slated for Oct. 22."Subject to health security considerations, and in accordance with all required testing, masking, social distancing, and other protocols, the debate will take place at Belmont University in Nashville, Tennessee," the commission said in the press release.The move to a virtual debate was as a precaution since Trump tested positive for COVID-19 last week.Trump was airlifted to Walter Reed Medical Center last Friday and then discharged from Walter Reed on Monday.According to the Associated Press, The White House has been mum about releasing any information as to when the president last tested negative for the virus.Trump told Fox Business that he would not "waste his time" with a virtual debate.CNN reported that because of Trump backing out and Biden agreeing to do a town hall with ABC, the commission didn't see the Oct. 15 debate likely happening.NPR reported that another reason behind the cancelation was because the Trump campaign and the commission couldn't agree on safety protocols.The Oct. 22 debate will be divided into six 15-minute segments. NBC News' Kristen Welker, who will be serving as the moderator for the debate, will announce the topics sometime next week.Both candidates have agreed to participate in the Oct. 22 debate, the commission noted. 1665

The Food and Drug Administration (FDA) released a key report Tuesday that said a COVID-19 vaccine made by Moderna is safe and effective — the latest in a series of rubber stamp approvals that could allow the vaccine to be distributed by the end of the month.The FDA report on Tuesday upheld the clinical trials, which have shown the vaccine to be 95% effective with no severe side-effects. The FDA report says that the data is "consistent with the recommendations set forth in FDA’s Guidance on Emergency Use Authorization for Vaccines to Prevent COVID-19.""FDA has determined that the Sponsor has provided adequate information to ensure the vaccine’s quality and consistency for authorization of the product under an EUA,” the report reads.The next step in approval for the Moderna vaccine will come on Thursday when the FDA's Vaccines and Related Biological Products Advisory Committee will meet and vote on whether to approve the Moderna vaccine for Emergency Use Authorization.The vaccine would then need approval from the FDA as a whole, and then a recommendation from the CDC before health care professionals can begin injections.The release of the FDA report comes a day after the first Americans received initial doses of a COVID-19 vaccine made by Pfizer.Should Moderna's vaccine follow the same approval schedule as the Pfizer vaccine, health care professionals should begin injections by Monday.The U.S. purchased 100 million doses of the Moderna vaccine earlier this year, and Moderna will have millions of doses ready to ship as soon as it receives Emergency Use Authorization.Late last week, the federal government purchased an additional 100 million doses of the vaccine, meaning it expects to have 200 million doses by spring 2021.The decision to purchase more doses of Moderna's vaccine came days after the New York Times reported that the U.S. government chose not to purchase more doses of the Pfizer vaccine when it had the chance earlier this year. 1977

The county of San Diego is preparing to ask the state for nearly million to repave stretches of hundreds of roads it maintains.The Board of Supervisors could vote Wednesday to seek revenue from the recent gas-tax hike to repair the roads. The roads are in all ends of the county, from Bonita to Alpine to Vista. You can see a list of the roads here (it starts on page 3)."The proposed projects will improve the overall condition of the roads and will protect roads from deterioration and costly future repairs," a county staff report said. Gov. Jerry Brown signed the billion gas tax hike into law last year. Californians already pay a series of gas taxes ranking among the highest in the nation. The tax hike raised the per-gallon tax by 12 cents last November, with future increases planned. The bill, SB1, also added a 0 fee to the annual registration for electric vehicles, starting with model year 2020."People can't afford it. I'm retired but if you're working and have to commute, I don't think people realize how much of a dent that's going to make," said Vicky Bamburger, a Bonita resident who is supporting an effort to repeal the tax that appears to be headed to this November's ballot.But those who support the increase say fixing the roads will save California drivers from expensive car repairs due to problems like potholes, and save taxpayers from larger repairs later."A small improvement now - if you have a road that needs to be covered - that's going to be so much more cost effective, cost saving in the long run," said Catherine Hill, of the League of California Cities.Local governments have until May 1 to submit their gas-tax revenue road repair requests to the state. Still, county agencies have already received millions of dollars in new revenue for road repairs, which includes major improvements to Interstate 5 in North County.  1892

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