宜宾割双眼皮过程疼吗(宜宾假体隆鼻需要取出吗) (今日更新中)

RICHMOND, Va. (AP) — By the time drug enforcement agents swooped into his small medical office in Martinsville, Virginia, in 2017, Dr. Joel Smithers had prescribed about a half a million doses of highly addictive opioids in two years.Patients from five states drove hundreds of miles to see him, spending up to 16 hours on the road to get prescriptions for oxycodone and other powerful painkillers."He's done great damage and contributed ... to the overall problem in the heartland of the opioid crisis," said Christopher Dziedzic, a supervisory special agent for the Drug Enforcement Administration who oversaw the investigation into Smithers.In the past two decades, opioids have killed about 400,000 Americans, ripped families apart and left communities — many in Appalachia — grappling with ballooning costs of social services like law enforcement, foster care and drug rehab.Smithers, a 36-year-old married father of five, is facing the possibility of life in prison after being convicted in May of more than 800 counts of illegally prescribing drugs, including the oxycodone and oxymorphone that caused the death of a West Virginia woman. When he is sentenced Wednesday, the best Smithers can hope for is a mandatory minimum of 20 years.Authorities say that, instead of running a legitimate medical practice, Smithers headed an interstate drug distribution ring that contributed to the opioid abuse epidemic in West Virginia, Kentucky, Ohio, Tennessee and Virginia.In court filings and at trial, they described an office that lacked basic medical supplies, a receptionist who lived out of a back room during the work week, and patients who slept outside and urinated in the parking lot.At trial, one woman who described herself as an addict compared Smithers' practice to pill mills she frequented in Florida."I went and got medication without — I mean, without any kind of physical exam or bringing medical records, anything like that," the woman testified.A receptionist testified that patients would wait up to 12 hours to see Smithers, who sometimes kept his office open past midnight. Smithers did not accept insurance and took in close to 0,000 in cash and credit card payments over two years."People only went there for one reason, and that was just to get pain medication that they (could) abuse themselves or sell it for profit," Dziedzic said.The opioid crisis has been decades in the making and has been fueled by a mix of prescription and street drugs.From 2000 to 2010, annual deaths linked to prescription opioids increased nearly fourfold. By the 2010s, with more crackdowns on pill mills and more restrictive guidelines on prescriptions, the number of prescriptions declined. Then people with addictions turned to even deadlier opioids. But the number of deaths tied to prescription opioids didn't begin to decline until last year, according to data from the U.S. Centers for Disease Control and Prevention.Martinsville, where Smithers set up shop, has been particularly hard hit.A city of about 14,000 near Virginia's southern border, Martinsville once was a thriving furniture and textile manufacturing center that billed itself as the "Sweatshirt Capital of the World." But when factories began closing in the 1990s, thousands of jobs were lost. Between 2006 and 2012, the city had the nation's third-highest number of opioid pills received per capita, according to an Associated Press analysis of federal data.Andrew Kolodny, a Brandeis University doctor who has long been critical of opioids, said that in recent years, doctors became less comfortable writing lots of opioid prescriptions and many big prescribers retired. That opened an opportunity for others."If you're one of the guys still doing this," he said, "you're going to have tons of patients knocking down your door."During his trial, Smithers testified that after he moved to Virginia, he found himself flooded with patients from other states who said many nearby pain clinics had been shut down. Smithers said he reluctantly began treating these patients, with the goal of weaning them off high doses of immediate-release drugs.He acknowledged during testimony that he sometimes wrote and mailed prescriptions for patients he had not examined but insisted that he had spoken to them over the phone.Once, he met a woman in the parking lot of a Starbucks, she handed him 0 and he gave her a prescription for fentanyl, an opioid pain reliever that is 50 to 100 times more potent than morphine.When area pharmacists started refusing to fill prescriptions written by Smithers, he directed patients to far-flung pharmacies, including two in West Virginia. Prosecutors say Smithers also used some patients to distribute drugs to other patients. Four people were indicted in Kentucky on conspiracy charges.At his trial, Smithers portrayed himself as a caring doctor who was deceived by some patients."I learned several lessons the hard way about trusting people that I should not have trusted," he said.Smithers' lawyer told the judge he had been diagnosed with depression and anxiety. Family members said through a spokesperson that they believe his decisions were influenced by personal stress, and emotional and mental strain.Even before he opened his Martinsville practice in August 2015, Smithers had raised suspicions. West Virginia authorities approached him in June 2015 about a complaint with his practice there, but when they returned the next day with a subpoena, they found his office cleaned out and a dumpster filled with shredded papers and untested urine samples.Some of Smithers' patients have remained fiercely loyal to him, insisting their severe chronic pain was eased by the powerful painkillers he prescribed.Lennie Hartshorn Jr., the father of the West Virginia woman who died two days after taking drugs Smithers prescribed, testified for the defense.Hartshorn said his daughter, Heather Hartshorn, told someone "she would rather be dead than in pain all the time." According to a form Heather Hartshorn filled out when she went to see Smithers, she had chronic pain in her lower back, legs, hips and neck from a severe car accident and a fall.When asked by Smithers' lawyer if he blames Smithers for anything, Lennie Hartshorn said he does not.Smithers has been denied bond while he awaits sentencing. His attorney did not respond to inquiries from AP. Smithers has said he plans to appeal.____Associated Press reporters Geoff Mulvihill and Riin Aljas contributed to this story. 6501

SACRAMENTO, Calif. (AP) — California Gov. Jerry Brown ordered new DNA tests that a condemned inmate says could clear him in a 35-year-old quadruple murder case, which has drawn national attention.On Monday, Brown ordered new testing on four pieces of evidence that Kevin Cooper and his attorneys say will show he was framed for the 1983 Chino Hills hatchet and knife killings of four people. The items that will be tested are a tan T-shirt and orange towel found near the scene and the hatchet handle and sheath.Brown also appointed a retired Los Angeles County Superior Court judge to serve as a special master overseeing the case.Cooper was convicted in 1985 of killing Doug and Peggy Ryen, their 10-year-old daughter Jessica and 11-year-old neighbor Christopher Hughes. Prosecutors say Cooper's claims of innocence have been disproven multiple times, including by prior DNA testing, but Cooper and his attorney argue evidence against him was planted."I take no position as to Mr. Cooper's guilt or innocence at this time, but colorable factual questions have been raised about whether advances in DNA technology warrant limited retesting of certain physical evidence in this case," Brown wrote in his executive order.New York Times' columnist Nicholas Kristof, U.S. Sen. Kamala Harris, state Treasurer John Chiang and reality television star Kim Kardashian are among people who called for Brown to order new DNA tests. Cooper had his execution stayed in 2004, which drew national attention at the time.The purpose of the new testing, he wrote, is to determine whether another suspect's DNA or the DNA of any other identifiable suspect is on the items. If the tests reveal no new DNA or DNA that cannot be traced to a person, "this matter should be closed," Brown wrote.Two previous tests showed Cooper, 60, was the killer, argued San Bernardino County District Attorney Mike Ramos. He previously said the tests proved Cooper had been in the home of the Ryens, smoked cigarettes in their stolen station wagon, and that Cooper's blood and the blood of at least one victim was on a T-shirt found by the side of a road leading away from the murders.Cooper's attorney, Norman Hile, said his client's blood was planted on the T-shirt, and that more sensitive DNA testing would show who wore it. He contends that investigators also planted other evidence to frame his client, a young black man who escaped from a nearby prison east of Los Angeles two days before the murders.Other evidence points to the killers being white or Hispanic, Cooper's supporters say.A San Diego judge in 2011 blocked Cooper's request for a third round of DNA testing.Cooper's scheduled execution in 2004 was stayed when a federal appellate court in San Francisco called for further review of the scientific evidence, but his appeals have been rejected by both the California and U.S. supreme courts. Former Gov. Arnold Schwarzenegger twice denied Cooper's clemency petitions.California hasn't executed anyone since 2006.Brown issued his Christmas Eve order alongside 143 pardons and 131 commutations. They are expected to be his last clemency actions as governor, but he has until he leaves office Jan. 7 to act. 3194

RIVERSIDE, Calif. - A California couple's fiery Halloween decorations are so hot it's prompting people to call 911.According to KABC, Carmen and Travis Long of Riverside decorated their home with a "Pirates of the Caribbean" theme, along with a realistic fire coming from the house.Riverside County Media captured video of the home's decorations. 354

SACRAMENTO, Calif. (AP) — California sued Tuesday to block the Trump administration from cancelling nearly billion for the state's high-speed rail project, escalating the state's feud with the federal government.The Federal Railroad Administration announced last week it would not give California the money awarded by Congress nearly a decade ago, arguing that the state has not made enough progress on the project.The state must complete construction on a segment of track in the Central Valley agricultural heartland by 2022 to keep the money, and the administration has argued the state cannot meet that deadline. That line of track would be the first built on what the state hopes will eventually become a 520-mile (837-kilometer) line between San Francisco and Los Angeles.But Democratic Gov. Gavin Newsom says the move is retribution for California's criticism of President Donald Trump's immigration policies."The decision was precipitated by President Trump's overt hostility to California, its challenge to his border wall initiatives, and what he called the "green disaster" high-speed rail project," the state said in the lawsuit.California was not expected to tap the 9 million the Trump administration has revoked until 2021. If the lawsuit is not resolved before then, the election could put Democrats in the White House and Congress who may be friendlier to the project.The lawsuit faulted the Trump administration for halting cooperation with the state on granting environmental clearances for the project. It said terminating the funding would "wreak significant economic damage on the Central Valley and the state."Newsom told reporters the administration is "after us in every way, shape or form." But he expressed confidence the state will win in court."Principles and values tend to win out over short-term tweets," Newsom said.The lawsuit highlighted a series of tweets Trump sent about the project, including one that said California's rail project would be far more expensive than Trump's proposed border wall.That tweet came a day after California led 15 states in suing over Trump's plans to fund the border wall, and hours before the administration first threatened to revoke the rail funding.The Federal Railroad Administration did not immediately respond to an email message seeking comment about California's lawsuit.California has worked for more than a decade on the project to bring high-speed rail service between Los Angeles and San Francisco, but the project has been plagued by delays and cost overruns. It's now projected to cost around billion and be finished by 2033.The state has already spent .5 billion in federal funding, and the Trump administration is exploring whether it can try to get that money back.The lawsuit also asks the court to block the administration from awarding the money to any other project.The lawsuit was filed in the Northern District of California.The dispute over the funding was partly driven by Newsom's remarks in February that the project faced challenges and needed to shift focus. Rail officials had been planning to connect the line under construction in the Central Valley to Silicon Valley, but Newsom has proposed extending the line further north and south into the valley before heading west.The California High-Speed Rail Authority presented a plan in early May that showed it would cost .3 billion to get trains up and running between Bakersfield and Merced by 2028.The board overseeing the project voted Tuesday to further study whether it makes sense financially and otherwise to run early train service on that line. Tom Richards, the vice chairman, noted the board has not yet formally approved the new approach."The board has not been asked for, nor has the board given, any interim service direction to (the project's) management," he said. 3851

SACRAMENTO, Calif. (AP) — California Gov. Gavin Newsom is willing to throw a financial lifeline to the state's major utilities dealing with the results of disastrous wildfires — but only if they agree to concessions including tying executive compensation to safety performance.A proposal unveiled Friday by Newsom's office aims to stabilize California's investor-owned utilities and protect wildfire victims as the state faces increasingly destructive blazes. Regulators say some previous fires were caused by utility equipment.Pacific Gas & Electric Corp., the largest of the three investor-owned utilities, filed for bankruptcy in January as it faced tens of billions of dollars in potential costs from blazes, including the November fire that killed 85 people in the Paradise area.Newsom hopes to strike a deal with lawmakers in just three weeks, but leaders in the Legislature said they haven't been given a formal legislative proposal and would need to go through their normal review process.The plan comes as credit ratings agencies look wearily upon the utilities.Southern California Edison and San Diego Gas & Electric had their ratings downgraded earlier this year, and executives have pushed lawmakers to come up with a plan that stabilizes the industry.Newsom proposal would give Southern California Edison and San Diego Gas & Electric the power to decide which form of financial aid they want, based on whether they're willing to make their shareholders contribute.They could choose a liquidity fund to tap to quickly pay out wildfire claims or a larger insurance fund that would pay claims directly to people who lose their homes to fire.The ratings agency Moody's has said creating a sort of insurance or liquidity fund would have a positive impact on the credit of utilities in the state.The liquidity fund would be about .5 billion and paid for by a surcharge on ratepayers, said Ana Matosantos, Newsom's cabinet secretary. If utilities want the larger insurance fund, they'd have to pitch in another .5 billion. Both utilities have to agree on which option to choose. Officials at neither company immediately responded to requests for comment.PG&E would not get a say in which fund the state uses or be able to tap a fund until it resolves its claims from the 2017 and 2018 wildfire seasons and emerges from bankruptcy. Its exit plan could not harm ratepayers and it would have to continue the utility's contributions to California's clean energy goals.The utilities would have to implement a number of safety measures to tap into the fund, such as tying executive compensation to safety, forming a safety committee within its board of directors and complying with wildfire mitigation plans.State legislators voted last year to require California's electric companies to adopt those plans. Southern California Edison told legislative staff last year the company wants to spend 2 million to improve power lines and deploy new cameras in high-risk areas.PG&E has said it will inspect 5,500 additional miles of power lines and build 1,300 new weather stations to improve forecasting. Most of its inspections are done, officials said.The state would also require power companies to spend a combined billion on safety over three years. This would include upgrading utility infrastructure as well as developing new early warning and fire detection technologies.Companies would be able to pass on the actual costs of these measures to consumers but could not make a profit off the steps.The California Public Utilities Commission, which regulates utilities, would decide how that billion is split up. Newsom's plan would also create a Wildfire Safety Division and Advisory Board at the CPUC.Matosantos described the draft requirements for additional safety spending as unprecedented and argued that mandating companies meet those guidelines to tap into the fund protects electric customers from paying for the costs of a catastrophic wildfire.Still, lawmakers plan to do their own analysis of the proposal."In order for any solution to work, the Legislature and governor will have to work together," Senate President pro Tempore Toni Atkins, a fellow Democrat, said in a statement. 4234

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