Daily Archives: March 13, 2022

AndersenTawil syndrome – Wikipedia

Posted: March 13, 2022 at 8:16 am

Rare autosomal dominant genetic disorder

Medical condition

AndersenTawil syndrome, also called Andersen syndrome and long QT syndrome 7, is a rare genetic disorder affecting several parts of the body. The three predominant features of AndersenTawil syndrome include disturbances of the electrical function of the heart characterised by an abnormality seen on an electrocardiogram (a long QT interval) and a tendency to abnormal heart rhythms, physical characteristics including low-set ears and a small lower jaw, and intermittent periods of muscle weakness known as hypokalaemic periodic paralysis.[1]

AndersenTawil syndrome is inherited in an autosomal dominant pattern. It is caused in most cases by a mutation in the KCNJ2 gene which encodes an ion channel that transports potassium out of cardiac muscle cells. The arrhythmias seen in the condition can be treated with flecainide or beta-blockers, but an implantable defibrillator may sometimes be required. Periodic paralysis can be treated with carbonic anhydrase inhibitors such as acetazolamide. The condition is very rare and is estimated to affect one person in every million. The three groups of features seen in this condition were first described in 1971 by Ellen Andersen, and significant contributions to its understanding were made by Rabi Tawil.

AndersenTawil Syndrome classically comprises three groups of features: abnormal electrical function of the heart, hypokalemic periodic paralysis, and characteristic physical features, although some of those affected will not exhibit all aspects of the condition.[2]

AndersenTawil syndrome affects the heart by prolonging the QT interval, a measure of how long it takes the heart to relax after each heart beat. This, as in other forms of long QT syndrome, can lead to abnormal heart rhythms such as ventricular ectopy or ventricular tachycardia causing palpitations.[2] The ventricular tachycardia seen in AndersenTawil syndrome often takes a form known as bidirectional ventricular tachycardia. The arrhythmias seen in association with the condition can cause sudden cardiac death, but the risk of this is lower than in other forms of long QT syndrome.[1]

The physical abnormalities associated with AndersenTawil syndrome typically affect the head, face, limbs and spine. Abnormalities of the head and face include an unusually small lower jaw (micrognathia), low-set ears, widely spaced eyes (hypertelorism), a broad forehead and nasal root, a high arched or cleft palate, and a long narrow head (scaphocephaly).[3] Abnormalities of the limbs and spine include an abnormal curvature of the fingers, particularly the fifth finger (clinodactyly), fused fingers or toes (syndactyly), short stature, and a curved spine (scoliosis).[3]

The third key feature of AndersenTawil syndrome is intermittent muscle weakness. This can last from seconds to minutes, but in some cases may last for days at a time. Weakness often occurs at times when the levels of potassium in the blood are lower than normal (hypokalaemia), and is referred to as hypokalaemic periodic paralysis. This weakness can however occur at times when potassium levels are normal, triggered by other factors including exercise, cold, or even menstruation.[3]

AndersenTawil syndrome is a genetic disorder which in the majority of cases is caused by mutations in the KCNJ2 gene. The condition is often inherited from a parent in an autosomal dominant manner, but may occur due to a new genetic mutation in the affected person.[3]

Two types of AndersenTawil syndrome have been described, distinguished by the genetic abnormality that is detected. Type 1 AndersenTawil, accounting for about 60% of cases, is caused by mutations in the KCNJ2 gene.[4] In type 2 AndersenTawil, accounting for about 40% of cases, a KCNJ2 mutation is not identified. Mutations in a related gene encoding a similar potassium ion channel, KCNJ5, have been identified in some of those with type 2 AndersenTawil, but in many cases a genetic mutation is not found.[1]

The protein made by the KCNJ2 gene forms an ion channel that transports potassium ions into muscle cells. This specific channel (the inward rectifier potassium channel Kir2.1) carries a potassium current known as IK1 which is responsible for setting the resting membrane potential of muscle cells and is therefore critical for maintaining the normal functions of skeletal and cardiac muscle.[3] Pathogenic mutations in the KCNJ2 gene alter the usual structure and function of potassium channels or prevent the channels from being inserted correctly into the cell membrane. Many mutations prevent a molecule called PIP2 from binding to the channels and effectively regulating their activity. These changes disrupt the flow of potassium ions, leading to the periodic paralysis and abnormal heart rhythms characteristic of AndersenTawil syndrome.[4]

AndersenTawil syndrome increases the risk of abnormal heart rhythms by disturbing the electrical signals that are used to coordinate individual heart cells. The genetic mutation disturbs an ion channel responsible for the flow of potassium, reducing the /K1 current. This prolongs of the cardiac action potential the characteristic pattern of voltage changes across the cell membrane that occur with each heart beat, and depolarises the resting membrane potential of cardiac and skeletal muscle cells.[3]

Cardiac and skeletal muscle cells, when relaxed, have fewer positively charged ions on the inner side of their cell membrane than on the outer side, referred to as their membranes being polarised.[5] The main ion current responsible for maintaining this polarity is /K1, and a decrease in this current leads to less polarity at rest, or a depolarised resting membrane potential. When these cells contract, positively charged ions such as sodium and calcium enter the cell through ion channels, depolarising or reversing this polarity. After a contraction has taken place, the cell restores its polarity (or repolarises) by allowing positively charged ions such as potassium to leave the cell, restoring the membrane to its relaxed, polarised state.[5] The genetic mutation found in those with AndersenTawil decreases the flow of potassium, slowing the rate of repolarisation which can be seen in individual cardiac muscle cells as a longer action potential and on the surface ECG as a prolonged QT interval.[3]

The prolonged action potentials can lead to arrhythmias through several potential mechanisms. The frequent ventricular ectopy and bidirectional VT typical of AndersenTawil syndrome are initiated by a triggering beat in the form of an afterdepolarisation. Early afterdepolarisations, occurring before the cell has fully repolarised, arise due to reactivation of calcium and sodium channels that would normally be inactivated until the next heartbeat is due.[6] Under the right conditions, reactivation of these currents can cause further depolarisation of the cell, facilitated by the sodium-calcium exchanger.[6] Early afterdepolarisations may occur as single events, but may occur repeatedly leading to multiple rapid activations of the cell.[6] Delayed afterdepolarisations, occurring after repolarisation has completed, arise from the spontaneous release of calcium from the intracellular calcium store known as the sarcoplasmic reticulum. This calcium release then leaves the cell through the sodium calcium exchanger in exchange for sodium, generating a net inward current and depolarising the cell membrane.[6] If this transient inward current is large enough, a premature action potential is triggered.

The muscle weakness seen in those with AndersenTawil syndrome arises from the depolarisation of the resting membrane potential caused by a decrease in /K1.[3] The depolarised resting membrane potential means that sodium channels which are responsible for initiating action potentials are unable to fully recover from inactivation, leading to a less excitable membrane and less forceful muscle contraction.[3]

The mechanisms underlying the skeletal abnormalities seen in AndersenTawil syndrome have not been fully explained. Possibilities include impaired function of osteoclasts, cells which regulate bone growth, or disruption of the bone morphogenetic protein signalling cascade.[3]

AndersenTawil syndrome is generally diagnosed based on symptoms, the findings on examination, and the results of an electrocardiogram.[3] Clinical diagnostic criteria have been proposed which suggest that a diagnosis can be made if two of the following four criteria are met: (1) periodic paralysis; (2) ventricular arrhythmias (frequent ventricular ectopic beats or ventricular tachycardia), a prolonged QT interval when corrected for rate, and/or a prominent U wave; (3) at least two of the following dysmorphic features: low-set ears, wide-set eyes, a small mandible, fifth-digit clinodactyly, and syndactyly; and (4) a family member with confirmed AndersenTawil syndrome.[3]

Genetic testing can be used to identify the specific mutation in an affected person, which if found can assist with screening family members.[3] Other investigations that may be helpful in making a diagnosis include ambulatory ECG monitoring to assess for arrhythmias, measurement of blood potassium levels at baseline and during periods of weakness, and measurement of thyroid function.[7]

The differential diagnosis for a prolonged QT interval includes other forms of long QT syndrome such as RomanoWard syndrome in which only the electrical activity of the heart is affected without involving any other organs; Jervell and Lange-Nielsen syndrome in which a prolonged QT interval is combined with congenital deafness; and Timothy syndrome in which a prolonged QT interval is combined with abnormalities in the structure of the heart, in addition to autism-spectrum disorder.[8] The frequent ventricular ectopy and bidirectional ventricular tachycardia seen in AndersenTawil syndrome can also occur in catecholaminergic polymorphic ventricular tachycardia.[2]

The intermittent weakness seen in AndersenTawil syndrome also occurs in other forms of periodic paralysis hypokalaemic periodic paralysis, hyperkalaemic periodic paralysis, and paramyotonia congenita.[7]

As a genetic condition, AndersenTawil syndrome cannot be cured. However, many of symptoms of AndersenTawil such as blackouts due to abnormal heart rhythms or periodic paralysis can be successfully treated with medication or implantable devices. The rarity of the condition means that many of these treatments are based on consensus opinion as there are too few patients to conduct adequately powered clinical trials.[3]

Medications should be avoided that further prolong the QT interval such as sotalol and amiodarone as these drugs can promote abnormal heart rhythms.[3] Lists of medications associated with prolongation of the QT interval can be found online.[9] Drugs which reduce blood levels of potassium such as diuretics like furosemide and bendroflumethiazide should also be avoided as these can worsen the tendency to periodic paralysis and arrhythmias.[3] Conversely, potassium-containing supplements to increase blood potassium levels may be helpful.[3] Very strenuous or competitive sport should be discouraged as these may increase the risk of arrhythmias, although gentle exercise should be encouraged.[8]

As in other forms of long QT syndrome which predispose those affected to dangerous heart rhythm disturbances, the risk of arrhythmias can be reduced by taking beta blockers such as propranolol that block the effects of adrenaline on the heart.[3] Other antiarrhythmic drugs such as flecainide and verapamil may also be helpful.[3] Those at highest risk of recurrent arrhythmias such as those who have already suffered a cardiac arrest may benefit from an implantable cardioverter defibrillator a small device implanted under the skin which can detect dangerous arrhythmias and automatically treat them with a small electric shock.[3]

Periodic paralysis may be improved by taking carbonic anhydrase inhibitors such as acetazolamide.[3]

AndersenTawil syndrome is very rare, and as of 2013 approximately 200 cases had been described in the medical literature.[3] The condition is estimated to affect one person in every 1,000,000.[3]

Although a description of the condition had probably been made by Klein in 1963,[3] AndersenTawil syndrome is named after Ellen Andersen who described the triad of symptoms in 1971,[10] and Rabi Tawil who made significant contributions to the understanding of the condition in 1994.[11][12]

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The Second Amendment: What Are the Limits on the Right to …

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The meaning and scope of the Second Amendment has long been one of the most hotly contested constitutional issues in the United States. In 2008, the U.S. Supreme Court ruled that the amendment protects the rights of individuals to have and use guns for legal purposes. At the same time, however, the Court clearly said that the Second Amendment right isnt unlimited. Since that decision, other courts in the country have upheld mostbut not allfederal, state, and local gun control laws.

The long-running argument over the Second Amendment largely stems from its language, especially at the beginning: A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed. For decades, many scholars and courts interpreted the amendment as preserving states authority to keep militias, which would mean that the right to have firearms was linked to militia service. But in District of Columbia v. Heller, 554 U.S. 570 (2008), the Supreme Court opted for a broader interpretation, finding that the Second Amendment gave individuals a right to have gunsunconnected to any militia serviceand to use them for traditionally legal purposes like self-defense.

The Supreme Court said that the law involved in Heller was unconstitutional because it essentially banned all handgunsthe most popular type of gun Americans choose for the core lawful purpose of self-defense. It also kept people from using their guns to defend their families and property by requiring them to keep all firearms trigger-locked or dissembled, even in the home.

Like most constitutional rights, the Second Amendment rights is not unlimited.

What about other kinds of guns and other reasons for having them? Like most constitutional rights, the Heller Court explained, the Second Amendment right is not unlimited. It is not a right to keep and carry any weapon whatsoever in any manner whatsoever and for whatever purpose. In the years since that decision, theres been a flood of legal challenges to federal and state gun control laws. According to one study, in 94 percent of those cases, courts have found that reasonable gun regulations didnt violate the Second Amendment. Theyve mostly relied on the Heller Courts explanation that its ruling shouldnt cast doubt on several longstanding gun restrictions, including bans on gun ownership by certain individuals (like felons), prohibitions on some types of dangerous and unusual weapons, limits on carrying firearms in certain public places, and requirements for gun sales. Although federal law covers some of these restrictions, most gun control is a patchwork of state and local laws and regulations. That means it can be wildly different from place to place.

Federal law outlaws the possession of firearms or ammunition by several categories of people, including:

(18 U.S.C. 922(g).)

Many states prohibit or restrict gun possession by other groups of people, such as stalkers and people subject to other kinds of restraining orders, minors, juvenile offenders, and those convicted of alcohol- and/or drug-related crimes.

Several states also allow courts to order some people to give up their guns temporarily if they pose an immediate risk to themselves or others (under so-called "red flag laws").

Under federal law, its illegal for civilians to have fully automatic weapons (referred to as machine guns in 18 U.S.C. 922(l)). In a rule that became effective in March 2019, the federal government outlawed "bump stock" devices (which attach to semiautomatic weapons to produce automatic firing with one pull of the trigger) by defining them as machine guns for purposes of federal law (27 C.F.R. 447.11).

Another federal law that banned assault weapons (semiautomatic firearms with certain features) expired in 2004, and attempts to renew it have failed so far.

Still, a handful of states and local governmentsincluding California, New Jersey, and New Yorkhave their own prohibitions or restrictions on assault weapons that have withstood court challenges. And although the Heller Court ruled out blanket bans on handguns, many states regulate handguns by requiring permits to buy them.

As the Supreme Court recognized in Heller, guns have traditionally been prohibited or restricted in certain public places under federal, state, and local laws. These sensitive places include schools, government buildings and courtrooms, public transit facilities, airports, and polling stations.

A U.S. appellate court has held that the Second Amendment doesnt protect carrying a concealed weapon in public (Peterson v. Martinez, 707 F.3d 1197 (10th Cir. 2013)). Most states require a concealed-carry permit, but the conditions vary a lot from state to state. The strictest laws allow authorities to deny a permit when the applicant doesnt have a good moral character or a good reason for carrying a gun in public. The most lenient require authorities to issue the permit to anyone who applies, with little or no discretion. Nearly all states restrict concealed weapons in some places, such as bars, hospitals, and public sporting events. But several states allow concealed weapons on public college campuses, under legislation or state court rulings that overturned longtime bans.

Finally, some states have open carry laws that ban or set conditions on openly carrying certain types of guns in public or in private cars.

Licensed gun dealers have to meet several requirements under federal law, including performing background checks, keeping records of sales, and reporting multiple sales of handguns to the same person (18 U.S.C. 923). But those requirements dont apply to private sellers, including those at gun shows. Some states have stronger laws, and a few require licensing for the sale of all guns.

If you believe that a local law or regulation infringes on your Second Amendment rights as a gun owner, you might want to speak with a civil rights attorney about your options for challenging the restriction. And if youve been charged with a crime related to owning, carrying, or using a gun, you should strongly consider consulting with a criminal defense lawyer. The circumstances in each case are unique, and the laws vary in different states and localities. An attorney whos experienced in this area can explain how the relevant laws apply in your situation and what defenses you might have.

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Supreme Court to Hear Landmark Second Amendment Case …

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Scholars and activists began to argue for an individual right to bear arms, but it would be another 31 years until the Supreme Court laid pen to paper on the 2008 and 2010 decisions that allowed citizens to keep weapons in their homes.

It was controversial. In both cases, four justices thought the amendment is just about the militia, but thats not what prevailed, says Liebell, explaining that the courts chose to rule in favor of an individuals right to self-defense, grounded in common law.

Fast forward to 2021 and New York State Rifle & Pistol Association v. Corlett, a case involving two NYSRPA members, Robert Nash and Brandon Koch. Nash and Koch had individually applied for a concealed-carry firearm license for the purpose of self-defense, citing recent neighborhood robberies (Nash) and completion of a firearms safety course (Nash and Koch).

However, both parties were denied the specific license they requested under New Yorks proper cause standard for self-defense. The law requires that an individual have a special need for self-protection distinguishable from that of the general community.

What exactly qualifies as a special need under New York law?

If youre carrying money at night, if youre doing business with people at weird hours when others arent around: Those are the scenarios in which they regularly grant this, Liebell says, adding that domestic violence survivors may also fall into this category. Its far more common than you would think.

New Yorks proper cause standard qualifies it as one of nine states with a may-issue permit policy. This means that a permit is required to carry a concealed handgun and that the granting of said permit is subject to certain criteria laid out by the state. Even then, it is up to local authorities discretion whether or not to grant the permit by determining proper cause.

Before the 14th Amendment was passed and ratified in 1868, states like Indiana, Tennessee, Virginia, Alabama, Ohio, all banned concealed weapons. You had to actually hand over your guns and put them in a box to come into Dodge City or Tombstone, Arizona places we associate with guns in the Wild West, says Liebell. So, youve got to look at the many laws that have restricted concealed carry.

New Yorks may issue is just one interpretation of the Constitution; other regulationsrange from not requiring an individual to have a permit to carry a concealed weapon, to not allowing individuals to carry a concealed weapon at all.

In a federal system like ours with 50 states, the Constitution is there to set certain standards, and then the states and localities have to actualize those standards, explains Liebell.

And so, it is up to the Supreme Court to determine if New Yorks decision to deny a license falls under its local purview, or if it violates Koch and Nashs Second Amendment rights.

There are several directions the court could go in next month and, with a number of new justices and a conservative-majority bench, it will be hard to predict which way theyll lean.

We do not know exactly what they are willing to do in terms of textualism, which is exactly what the text says, or original understanding at the time, which is very fraught and establishing it, in my scholarly opinion, is really impossible, says Liebell.

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Bill aimed at protecting 2nd amendment rights passes on House floor – ABC 36 News – WTVQ

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Proposal filed by Representative Josh Bray

FRANKFORT, Ky. (WTVQ) On Thursday, members of the House voted to approve a proposal filed by Representative Josh Brays legislation that makes Kentucky a Second Amendment Sanctuary State. The bill, HB 29, would prohibit identified entities from enforcing federal firearm bans.

Representative Bray spoke on the House floor Thursday about the importance of his legislation for the gun owners of Kentucky, Over the past year, we have seen an increase in the rhetoric. It comes from as far away as the Oval Office as the President calls for additional federal firearm restrictions.

According to the Legislative Research Commission (LRC), HB 29 would prevent any federal firearm regulations enacted after January 1, 2022, from being enforced with Kentucky tax dollars or tax payer dollars. Across the United States, 15 states have enacted similar legislation, according to the LRC. Also 115 out of the 120 counties in the commonwealth have passed similar resolutions. The bill simply prohibits the enforcement of firearm bans. It does not prevent the federal government from enforcing any new law or regulation or prevent the General Assembly from enacting new laws or restrictions.

We are all too familiar with government overreach. As we speak, the administration is looking to ban pistol braces. A ban on these braces would make felons out of thousands of Kentuckians overnight. Let me be clear: this would be without a single legislative vote cast. Were talking about law-abiding Kentuckians criminalized by a regulatory change, Rep Bray added.

The bill passed with a vote of 75-20 and now awaits further action in the Senate.

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Sunshine Week 2022: We should all agree on government transparency (Viewpoint) – MassLive.com

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We live in contentious times. According to a 2020 study by the National Bureau of Economic Research, political polarization among Americans has grown rapidly during the last 40 years.

Theres evidence that within the U.S., the two major political parties have become more homogeneous in certain ways, including ideologically and socially, said Jesse Shapiro, a co-author of the study and a professor of political economy at Brown University. So when you identify with a certain party and youre looking across the aisle, the people youre looking at are more different from you than they were a few decades ago.

Given the degradation of political discourse in our country and the growing list of hot-button issues pitting us against friends and neighbors, its easy to see the divide. But as Sunshine Week begins this year, lets remember that no matter where we stand on a particular topic, we all need accurate information to shape our opinions and best advocate for ourselves.

The mission of Sunshine Week March 13-19 this year with related events occurring throughout the month is to promote a dialogue about the importance of open government and freedom of information. The sunshine reference is attributed to U.S. Supreme Court Justice Louis D. Brandeis who famously wrote that sunlight is said to be the best of disinfectants. In other words, an informed citizenry is the best check against government corruption.

This is the idea behind state public record and open meeting laws, as well as our federal Freedom of Information Act. Government transparency is a non-partisan principle that transcends whos in office or which political party is in control. Freedom of information or sunshine laws open up government and empower people through information.

The University of Southern California Annenberg School for Communication and Journalism published a report last fall analyzing the polarization in our country. The report identified the most contentious issues which included gun legislation, policing, and vaccines. As Americans, we may have starkly different opinions about these issues. But consider the common ground we can find when looking at them relative to government transparency.

To have an informed debate about gun legislation, for example, it may be helpful to know basic data points like how many firearms are being manufactured in the country or the number of gun-related deaths each year. We may need to determine where its most difficult to obtain a firearms license or to read emails among government officials looking to curtail Second Amendment rights.

Before we discuss whether a police department should be defunded, we should first determine how much funding that agency receives. How is money spent within local, state, and county law enforcement agencies? For us to have a conversation about police officers using force against citizens, we need to know the policies within each department and under what circumstances lethal or non-lethal force can be used.

More than two years into the COVID-19 pandemic, debate still rages about vaccine efficacy and government mandates. Fueling that debate is a steady flow of misinformation that can be counteracted by federal data on vaccine trials, statistics on state resident vaccinations, local school district vaccine requirements for teachers and students, and other vaccine-related records.

While sunshine laws vary from state to state, all this information should be available to us through public record statutes and federal Freedom of Information Act. Wherever we ultimately land on the issues, these laws exist to provide us a way to learn about government and better support our positions.

But despite the mandated sunshine, shadows persist. Public record request deadlines are often ignored. Inadequate staffing and request backlogs result in delays. Documents are excessively redacted. Citizens are shut out of public meetings. The flow of information can be slowed to a glacial pace.

This is a reality that should concern us all. Every American should be waving the banner for government transparency. The consequences of secrecy affect not just our ability to have good-faith debates about the issues that matter most, but they also limit our ability to oversee government and the work it does on our behalf. When it comes to transparency, were all stakeholders.

So, here are a few things we can do to honor Sunshine Week:

Thoughtful debate about serious issues is central to our democracy, wrote the authors of the Annenberg study. But solving real problems is impossible when every issue is viewed through a distorted lens that is often informed by sources who create their own facts to further their own power.

Sunshine laws are integral to thoughtful debate. They can provide us the knowledge needed to form opinions about whats best for this country and how well our government is leading the way. But those laws need to be protected and strengthened. Thats something we can all agree on.

Justin Silverman is executive director of the New England First Amendment Coalition. Learn more about the coalitions work at nefac.org.

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A "Freedom Convoy" we can all support: Send the truckers to Russia! – Salon

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In any negotiation to stop Vladimir Putin's unprovoked terror war against the Ukrainian people,maywe add one small demand that he open his borders to anti-Americans here at home?

I think he would be good with that.

I know I would.

I'm talking about the gun-toting, flagpole-wielding insurrectionists, those faux-truckers with their faux demands for faux freedom from wearing masks they weren't wearing anyway at least not over their noses and all those folks who want to push their religious beliefs or unbelievably idiotic conspiracy theories on the rest of us, the reasonably educated "elite."

RELATED:The "People's Convoy," like Trump's social media platform, is a right-wing grift gone bust

Anyone who (at least until very recently) has openly praised Putin as being a stronger leader than their own president.

Ajury just reached the first conviction of a Jan. 6 insurrectionist, and he will be sentenced in June. Given that there are something like 750 cases coming up for the Justice Department to deal with, some have suggested that the judge in that case will hand out a severe sentence to encourage others to make a plea deal.

What if these defendants were given the freedom to make a different choice one that would save the country the expense of a trial and likely incarceration? They could emigrate to Mother Russia. (It might be more appealing if Putin rebrands that as "Daddy Russia," given the general misogyny and repressed erotic longing found on the American right.)

It's nice to see Republican support for Ukraine's struggle against Russia's war after a fair amount of initial hedging and polls show a vast majority of Americanssay theyare willing to deal with increased gas prices to support the overall effort. But there is no doubt that Republican leadership will start blaming President Biden for rising gas prices the moment they think they can get away with it oh wait,they never stoppedas if he, or any president, has any control over the price at the pump.

But to all true-red Putin fanboys, like Fox News "personality" Tucker Carlson, and those who, like him, see in Russia or Hungary a model for our future, I say: Go. Democracy makes you feel veryuncomfortable, like reading some generally beloved literature. And lots of science. And a good deal of history. And, now,gender studies.

The problem with you is that your oft-stated desire to "be free" is mostly about imposing your religious beliefs on others and curtailing your fellow citizens' freedom to life, liberty and the pursuit of their own happiness including the liberty and happiness one feels as a citizen in casting a ballot, exercising democratic responsibility and feeling that fundamental sense of agency in the world.

Your idea of freedom is that everyone is free to think like you do. (How Putin-esque!)Are your antidemocratic impulses a good fit for living in the increasingly diverse United States of America in the 21st century? Let me put it in a wayyou'll comprehend: Nyet.

Want a daily wrap-up of all the news and commentary Salon has to offer? Subscribe to our morning newsletter, Crash Course.

Perhaps the AARP magazine should include Russian Federation statesand allied countriesin upcoming features on the best places to retire. You know, the AARP staff could provide additional categories for aging Americans with pro-Putin leanings to consider. Along with the standard categories of taxes, recreation and health care, they could include how adeptly officials in the region suppress protesters, women and journalists, or how helpful they are to folks who want to launder money in the West. Some wealthy Americans might choose to retire to, say, Belarus or Kyrgyzstan instead of Florida (and not go through the current endless hassle of turning FloridaintoBelarus or Kyrgyzstan). For less affluent Russia lovers, "Borscht-ing on a Budget" and "Surviving andThriving in a Siberian Winter!" are a couple of feature story ideas that immediately come to mind.

Here at home, we would also love to be free of your endless trolling which is an impulse, come to think of it, that could stand you in good stead in the Russian Federation or its allied states. As would that strong desire you seem to have lately to suppress the vote, rat on your neighbors andturn them in to the authorities(which, OK, can sometimesbackfire).

You would have the freedom to live in a land where books don't need to be banned or burned, because theysimply aren't published in the first place; where LGBTQ rights are unknown, partly because such acronyms, as well as human rights in general, remain unworkable in Russian; and where women and people of color know better than to raise their voices as full human beings.

You know, those good old "real American" values!

We can save the nation, and the union, while not breaking it up by states or counties or ceding our reddest counties to the protectorate ofPutin's lame alt-NATO, the CSTO. You and your fellow Putin admirers, along with evangelicals (who don't comprehend the First Amendment), gun fetishists (who don't comprehend the Second Amendment) and white supremacists (who don't understand the 14th, the 15th and well, any number of amendments, as well as the life and message of Jesus) can live in a country much better suited to your zealotry and fervent beliefs.

As Christian historian Jemar Tisby, author of the bestselling "The Color of Compromise" and "How to Fight Racism," has extensively discussed, American white Christians being hellbent on white nationalism is nothing new.Writer, farmer and philosopher Wendell Berry called our deep reluctance to acknowledge our racist historyAmerica's hidden wound, and the right is very busy now further covering it up.

But fear not, Republicans Putin has your back. His form of Christianityis said to bemore about power and ideology than theology. And many Americans on the right, who have been encouraged to fear an "elite" left and to hate their political opponents for advocating diversity and inclusion in our pluralistic, multicultural democracy,greatly admire any "strongman"who might make it all go away, with a big assist from alike-minded Supreme Court.

The horrific human scenes of devastation we are witnessing from cellphone and amateur video coming out of Ukraine may be momentarily silencing mostPutin aficionados and apologists in the United States, but don't think for a moment that they don't still love him.

Watching courageous Ukrainians pushing back against the little Russian tyrant, with their lives and homeland on the line, and an empathic and competent American president methodically working with the leaders of a strengthened NATO against him, should make us appreciate the strength inherent in the American promise which is painfully slow, yes, but still a promise, a worthy aspiration of greater justice for all, as well as the creative energy that comes from our blessed diversity of thought and cultures.

I want to feel as proud of my homeland as the Ukrainians obviously do theirs.

That trucker convoy was an AstroTurf bogus protest, but a "freedom convoy" of insurrectionists and QAnoners and authoritarian-loving Putin-stooges in Congress and the media packing up and heading straight out of this country would bethe real thing.

Let's forge a moment of rare bipartisan consensus and make your freedom convoy and ours a reality.

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ECR 2022: The Role of the Radiologist in 2030 – MedicalExpo e-Magazine

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How the role of the radiologist might change in the coming years was a hot topic of discussion at this years ECR Overture from March 2-6. Methods for easing workloads, whether radiologists should become more specialized and the value in attending more multi-disciplinary team meetings (MTDs) were all areas of debate. Experts also considered the impact of artificial intelligence (AI) on radiology departments over the coming years.

Introducing a session entitled the Role of the Radiologist in 2030, Prof Regina Beets-Tan, chair of the Department of Radiology at the Netherlands Cancer Institute in Amsterdam, said:

Even though this seems so far away it is actually just around the corner and we had better be preparedit is important to look at how we can add value to radiology.

Prof Andrea GraceRockall, Clinical Chair of Radiology, Imperial College London, and Hon Consultant Radiologist at Imperial College Healthcare NHS Trust and the Royal Marsden Hospital, highlighted results from a recent ESR survey among radiologists. She explained:

Some 80% of radiologists believe radiologists should have a mandatory period of non-radiology clinical experience before or during radiology training. Over 90% felt it was important to have an area of subspecialization and we can also see this as a trend for the future.

Other likely trends saw possible increased training for the communication of bad news and significant imaging findings to the patient and workloads continuing to be heavy burden but with AI potentially able to assist.

Prof EmanueleNeri, Associate Professor at the Department of Translational Research and New Technologies in Medicine and Surgery,University of Pisa, stressed:

I will say clearly that we will not be replaced in our tasks by AI. One of the main impacts of AI will be in the workflow: prioritizing examinations and helping in image acquisition in terms of quality of images. I think this could save time. There are already tools that allow us to improve interpretation, but this has to be looked at very carefully because, at the end, the responsibility is always at the hands of the radiologist.

There was much discussion about the radiologist being brought into more MTD meetings by 2030. Prof Neri highlighted the problem of heavy workloads for the radiologist. He observed:

It is important not only to have enough time to attend the meetings but also to interpret results first.

And Prof Geerard LBeets, surgeon at the Netherlands Cancer Institute in Amsterdam, agreed. He said:

Radiology is important throughout the whole journey of the cancer patient and where it materializes is in the MDT meeting. It isnt helpful if the radiologist is only seeing the results for the first time, but it really adds to the discussion if they have had that time to interpret them beforehand. Sometimes it even changes the course of the discussion.

CarolineJustich and ErikBriers, of the ESRPatient Advisory Group, highlighted potential changes to the role of the radiologist by 2030 that could assist the patient.Ms. Justich said:

There is very little time for patients communication because of working non-stop. Our hope as patients is that AI will ease that a little bit and bring radiologists more into the focus of curing, with all the early diagnosis and treatments that might be possible in the future.

Mr. Briers added:

More subspecialization among radiologists would speed the processes up.

The concept of training more radiology assistants in the future was also debated. These members of staff could do all the preparation required before an MTD meeting, for example. Prof Rockall stressed:

We have a lot of extended role radiography in the UK. Because of real workforce pressures in the country, and some really expert and expertly trained radiographers, extended roles are seen as a real benefit to a department.

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RAF Chinook Helicopter Airlifts Massive New Radar Onto The Top Of Gibraltar Rock – The Aviationist

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The incredible scene of the RAF Chinook at work at the top of the Gibraltar rock. (All images: DM Parody http://www.dotcom.gi/photos)

On Mar. 2, 2022, a RAF Chinook helicopter carried out a pretty peculiar mission when it delivered a new radar to the top of the Gibraltar rock. The ATC radar of RAF Gibraltar airfield, that serves also as the commercial airport of the British Overseas Territory, is located at the top of the iconic rock. The radar needed to be replaced, a task that could not be completed by road, as the roads to the top of the rock are too narrow for ground transportation.

For this reason, a RAF Chinook helicopter (ZA680) was flown from the UK via Portugal and undertook the lift of the massive radar, a 11.8 meter structure weighting over 8,000 kg, to the summit, site of the former Rock Gun Battery.

The Aviationists contributorDavid Parody took the stunning photos of the Chinook helicopter at work during the radar lift operation at the summit of the Rock.

According to Aquila Air Traffic Management Services that delivered the new radar to serve RAF Gibraltar, the new radar was transported as an underslung load by the Chinook in four parts. The radars rotational turning gear, two large antennae and the horn the transmit and receive section of the antenna were each lifted in four separate journeys. Also flown to the top of the Rock was a new navigational beacon.

A temporary helicopter landing platform was built at Rock Gun Battery especially for the operation. The platform allowed the helicopter to land the loads above the rough and protected ground of the nature reserve, that is known for the apes that populate the Rock and are a major tourist attraction.

The lift was originally scheduled for Nov. 21, 2021, but the operation had to be postponed due to bad weather and rescheduled.

The upgrade to RAF Gibraltars Air Traffic Management system is part of an MOD wide 1.5 billion GBP investment in to air traffic management systems, known as Programme Marshall. The programme includes a 400 million GBP investment in advanced surveillance radars and a wide range of sophisticated equipment such as tower systems, new surveillance and navigation aids and radios, with the purpose to ensure increased reliability for air traffic management, improved safety and estimated savings of 317 million GBP for the MOD over the course of the 22-year partnership with Aquila to support the new equipment.

David Cenciotti is a freelance journalist based in Rome, Italy. He is the Founder and Editor of The Aviationist, one of the worlds most famous and read military aviation blogs. Since 1996, he has written for major worldwide magazines, including Air Forces Monthly, Combat Aircraft, and many others, covering aviation, defense, war, industry, intelligence, crime and cyberwar. He has reported from the U.S., Europe, Australia and Syria, and flown several combat planes with different air forces. He is a former 2nd Lt. of the Italian Air Force, a private pilot and a graduate in Computer Engineering. He has written five books and contributed to many more ones.

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CFD concerts to include Brooks and Dunn, Kid Rock, Nelly, Jelly Roll and more – Wyoming Tribune

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Clearmark’s coding solution the perfect blend for coffee roasters – Process & Control Today

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07/03/2022 Clearmark Solutions Ltd

A comprehensive coding upgrading project by Clearmark Solutions has enabled coffee roasters Lincoln & York Ltd to increase production efficiency by up to 25% at their Lincolnshire headquarters. By replacing legacy coding equipment across 12 lines with ICE Zodiac thermal transfer overprinters from Clearmark, Lincoln & York can now rapidly create and edit labels, enabling them to reduce changeover time between batches and cut waste caused by human error.

As one of the UKs largest coffee roasting companies, Lincoln & York sources, roasts and packs coffee for companies in the out-of-home, distributor and specialist retail markets across the UK and Europe. A privately-owned business with over 27 years experience, each day it roasts enough coffee at its British Retail Consortium AA grade-accredited roastery in Brigg, North Lincolnshire to make 1,500,000 cups.

After experiencing rapid growth, Lincoln & York sought to replace its ageing coding equipment with a more reliable and flexible solution in a bid to increase uptime and deliver higher quality prints. It contacted coding and labelling specialists Clearmark Solutions, who assessed the existing coding infrastructure and ascertained that, as well as more modern coding equipment, the company would also benefit from upgraded software to enable it to create and edit labels more quickly and efficiently. As Lincoln & York work with a range of suppliers and retailers, Clearmark recommended the flexible ICE thermal transfer technology combined with CLARiSOFT label design software.

The project saw Clearmark replace all existing coding equipment across 12 of Lincoln & Yorks lines with ICE Zodiac thermal transfer printers. This allows codes to be printed more efficiently across a range of flexible substrates, in a variety of colours, at the various throughputs required. Flexible enough to print dates in any format or size, and in any Windows TrueType font, their superior ribbon capacity means less downtime for ribbon changeovers, reducing waste and increasing production efficiency by up to 25%. In addition, the CLARiSOFT labelling software installed on each line allows operators to quickly create and edit label designs for a growing range of customers. Its built-in label error prevention feature provides added assurance, further helping to cut waste.

Each ICE machine comprises an intuitive error-proof touchscreen, making operator training a straightforward process. Clearmark also delivered comprehensive one-to-one ICE product training to two Lincoln & York operators at its Nottingham training facility.

The Clearmark solution is a considerable improvement over Lincoln & Yorks legacy equipment, which was impacting on uptime. To future-proof against further changes to the business, it has been designed with flexibility in mind, enabling Lincoln & York to meet current and future customer demand without any risk to reliability or print quality.

It is essential that we are able to change our label designs as quickly as possible to meet growing supplier requirements. The ICE Zodiacs allow us to do this efficiently without having any impact on production, says Marc Rockall, Engineering Manager at Lincoln & York.

The Clearmark team is much more reliable than our previous supplier and are only a phone call away if we have any issues, helping us to get back up and running as quickly as possible.

As a result of the responsive support provided by Clearmark and the systems ongoing efficiency and reliability, Lincoln & York plans to expand its range of ICE technology as the company continues to grow.

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