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Rare Fe-refractory genetic disorder due to hepcidin dysregulation (Nat Genet 2008;40:569). Plts 10,000/ L or 20,000/ L with infection or c bleeding risk or 50,000/ L with active bleeding or preprocedure. Goal is eradication of underlying disease for which transplant is being performed. Chemotherapy (Lancet 2008;371:29): in adjuvant setting usually anthracycline-based (eg, adriamycin cyclophosphamide). Staging is complex and based on pathologic correlation with observed survival data. Deficiencies in terminal complement predispose to recurrent meningococcemia & rarely, meningitis. Seen in elderly, alcoholics, or patients with malignancy, immunosuppression, or iron overload. Source control essential when possible for cure and preventing recurrent infection. Due to breakdown of granuloma w/ spilling of contents into pleural cavity and local inflammation. Pulmonary effusion pericardial and peritoneal effusions (tuberculous polyserositis). Reinfection (including w/ drug-resistant strains) is clinically significant, particularly in hyperendemic areas. Bone marrow aspirate & bx (esp if signs of marrow infiltration) or liver bx (espec. Suspicious features: size 4 cm or c size on repeat scan; irregular margins, heterogeneous, dense, or vascular appearance; h/o malignancy or young age (incidentaloma less common). In T2D, consider starting if mono oral Rx not adequate (espec if c HbA1c high) and definitely start if combo oral Rx not adequate. Associated with c risk of cardiovascular death compared with that of general population (Rheum 2009;48:1309). Criteria Other Features Constitutional Fever, malaise, anorexia, (84%) weight loss Cutaneous 1. Discoid rash (erythematous Subacute cutaneous lupus papules w/ keratosis & plugging) 3. Pt needs to be off sedation for adequate time to evaluate (depends on doses used, duration of Rx, metabolic processes in the individual Pt). Generation Natural (eg, penicillin) Anti-Staph (eg, nafcillin) Amino (eg, ampicillin) Extended (eg, piperacillin) Carbapenem (eg, imipenem) Monobactams (aztreonam) -lact. The convex right cardiac border is formed by the right atrium (straight arrows), and the curved arrows indicated the location of the superior vena cava. The left cardiac and great vessels border what might be considered as four skiing moguls.
Transitional Centers shall continue to utilize their established procedures for access to telephones. Customer Service/Reporting of Telephone Problems: If complaints are received at the facility from family members of offenders or others related to the Offender Phone System, designated staff at the facility will advise the caller to contact the Service Provider directly. If the complaint is not addressed by the Service Provider, the facility will provide contact information for the Offender Phone System Compliance Monitor. This request of a called information should also be recorded in the Offender Phone System Logbook. Attachment 2 shall be kept on file by the Offender Phone System Facility Point of Contact for one year for audit purposes and then destroyed. A copy shall be returned to the offender informing them ofthe status ofthe problem reported. Only those individuals approved for visitation with the offender will be allowed to correspond with the offender through Electronic Mail/Messaging, Video Grams, and Video Visitation. When an offender is transferred to another facility, his/her previously approved visitation list shall be honored unless extenuating circumstances come to light that would threaten the security and orderly operating of the receiving facility. An offender may request to add or delete a name on their visitation list by contacting their counselor and providing the necessary information. If the offender is requesting to add a visitor(s), the visitor(s) must complete all necessary paperwork prior to approval. Visitation lists may only be changed when the offender arrives at their first permanent facility or during the months of May and November. The results of these requested revisions shall be completed and forwarded back to the offender within fourteen (14) working days from the date of the request. Handling the return of confiscated devices to an offender will be at the discretion of the facility Warden or Deputy Warden of Security. Because of the need for such inspections, both sent and received communications may be delayed. Communications which violate this policy will be intercepted (censored) without notice or explanation and no refund will be provided to the sender. This includes Video Grams, Video Visits, and photographs taken after hours and on dressed B. Adults and children must be appropriately dressed during Video Visits and in photographs. No offender group photos, group Video Grams, or group Video Visitations are permitted. No smoking is permitted, nor may alcohol be consumed or displayed in photos, Video Grams or during Video Visitation. No acts of violence or display of weapons will be tolerated, to include images of or references to any kind of weapon in photos, Video Grams, or Video Visitations. Offenders shall remain seated throughout the entire Video Gram or Video Visitation. Offenders shall not allow other offenders to participate Grams, or Video Visitation. Customers shall not share screen shots of their Video Visits with, or Video Grams of, offenders, to include sharing using social media, text messages or electronic messages. Offenders shall not request Electronic Mail/lvlessages to be forwarded, sent, or mailed to others. Customers and offenders shall not request information about another offender or send information on behalf of another offender. Offenders must follow all Kiosk rules when taking a photo, sending a Video Gram or having a Video Visitation. Violations with photos, Video Grams, or during Video Visitation will result in disciplinary action. The offender shall be responsible for notifoing his or her contacts when privileges have been terminated.
Open-circuit self-contained breathing apparatus, pressure-demand type, with full facepiece. Type C Respirator: An airline respirator, for entry into and escape from atmospheres not immediately dangerous to life or health, which consists of a source of respirable breathing air, a hose, a detachable coupling, a control valve, orifice, a demand valve or pressure demand valve, and arrangement for attaching the hose to the wearer and a facepiece, hood, or helmet. This assigned protection factor was used during the Standards Completion Program for deciding when the "most protective" respirators should be used for these four chemicals. If an offender is housed at a facility that does not offer videophones, the offender will be moved to a facility offering videophones or a videophone will be installed. Facility wardens receive copies of offender parole notices and ensure they are communicated to offenders. The offender can show their card to staff if they need help, and the card helps staff to better assist deaf and hard of hearing offenders. Plaintiffs complain about a lack of effective communication in disciplinary proceedings, Doc. Class actions are "an exception to the usual rule that litigation is conducted by and on behalf of the individual named parties only. Class "certification is proper only if `the trial court is satisfied, after a rigorous analysis, that the prerequisites of Rule 23(a) have been satisfied. The certification analysis required by the Court examines evidence, not simply the pleadings. In order to fully examine the Rule 23 prerequisites "the Supreme Court has `emphasized that it may be necessary for the court to probe behind the pleadings before coming to rest on the certification question. The importance of the class certification issue cannot be overstated as "an incorrect class certification decision almost inevitably prejudices the defendant. These prerequisites are generally referred to as "numerosity, commonality, typicality, and adequacy of representation. Here, Plaintiffs propose to satisfy Rule 23(b)(2), that: the party opposing the class has acted or refused to act on grounds that apply generally to the class, so that final injunctive relief or corresponding declaratory relief is appropriate respecting the class as a whole. Finally, Plaintiffs must also "establish that the proposed class is `adequately defined and clearly ascertainable. Courts have referred to this requirement as "an implied prerequisite of Federal Rule of Civil Procedure 23. This definition does not contain "objective criteria that allow for class members to be identified in an administratively feasible way. The 156 individuals identified as having significant hearing loss all have a level H3 or higher. Here, Plaintiffs have defined their proposed class so broadly that they cannot show that the class members have suffered the same injury. Dissimilarities within the proposed class are what have the potential to impede the generation of common answers. The Eleventh Circuit has confirmed that where, like here, differences among the class members will result "in numerous mini-trials" on the merits, class certification should be denied. Importantly, the Court made it clear that the denial of class certification was appropriate whether Plaintiff was pursuing a claim for damages or solely injunctive relief; either way the Rule 23(a) requirements of commonality and typicality had not been met. However, Defendant asserted that "he had legitimate reasons for some of his searches. Moore also alleged that he had no access to videophones to communicate with friends and family. In February, 2019, Moore signed a supplemental declaration stating that videophones are now available at Central State Prison but not in his dorm building so he needs to go to other dorms to use the videophones. He uses a hearing aid, can speak in English "about some things," and is "fluent in sign language. While his 2018 declaration complained of a lack of videophones and interpreters, his 2019 declaration acknowledges that Central State Prison now has videophones, and that interpreters are available for meetings he attends in prison. Henderson would also like to try an amplied phone and a captioned phone to see "which is better" for him. Darrell Smith states that he "communicate[s] and understand[s] best when there is at least one hearing interpreter and one Deaf interpreter," working together. The wide array of factual allegations asserted by each of the Plaintiffs here is similar to the class certification question in Fluellen v.
But other couples learned quarreling from them; this is why there are so many arguments between husbands and wives. The Huruing Wuhti of the west heard about it and soon called the goddess of the east to come over. Hopi who want something from them must deposit their prayer offerings in the village. And when they say their prayers, they think of the two goddesses who live far away, but who, the Hopi believe, still remember them. When he decided to make the world, he went down to the shallow places in the water and began to throw up great handfuls of mud that became land. He made a man out of a ball of mud and told him to take fish from the waters, and deer and other game from the forests. When the man became lonely, the Great Chief Above made a woman to be his companion and taught her how to dress skins, how to find bark and roots, and how to make baskets out of them. Once when the woman was asleep, she had a dream, and in it she wondered what more she could do to please the man. He answered her prayer by blowing his breath on her and giving her something which she could not see or hear, smell or touch. Through it, the first woman taught her daughters and granddaughters the designs and skills which had been taught her. But in spite of all the things the Great Chief Above did for them, the new people quarreled. They bickered so much that Mother Earth was angry, and in her anger she shook the mountains so hard that those hanging over the narrow part of Big River fell down. The rocks, falling into the water, dammed the stream and also made rapids and waterfalls. Then the spirits that once lived in the bones buried there will go back into them. At present those spirits live in the tops of the mountains, watching their children on the earth and waiting for the great change which is to come. Mourners who wail for their dead hear spirit voices reply, and thus they know that their lost ones are always near. We did not know all this by ourselves; we were told it by our fathers and grandfathers, who learned it from their fathers and grandfathers. But we do know this: the spirits will return only to the remains of people who in life kept the beliefs of their grandfathers. They could not return to their home in the sky, so they wept and called out, but no answer came from anywhere. They Boated about in the air, seeking in every direction for help from some god; but they found none. The animals were with them, and of these the elk inspired all creatures with confidence because he was the finest and most stately. The Osage appealed to the elk for help, and he dropped into the water and began to sink. Then he called to the winds, and they came from all quarters and blew until the waters went upward in mist. At first only rocks were exposed, and the people traveled on the rocky places that produced no plants to eat. When this happened, the elk in his joy rolled over and over, and all his loose hairs dung to the soil. The hairs grew, and from them sprang beans, corn, potatoes, and wild turnips, and then all the grasses and trees. The small monsters grew fast, much faster than ordinary children, and became very big. A wise man, who could see things in his mind which had not yet happened, said: "Kill these strange bad things before they kill you. At that point all the men in the village rushed at them to do away with them, but by then it was too late. One day they went into the middle of the camp and stood back to back, one facing east, one facing south, one facing west, and one facing north. But people who stayed farther off were seized by mile-long arms, killed, and eaten. The four monsters, now grown together, rose up to the clouds, and their heads touched the sky.
The loss of corn described here may symbolize how the Cheyenne abandoned planting f~r buffalo hunting in the la;t half of the eighteenth century. The pottery-making Pueblos have another version of this tale that they call the legend of the Water alla Boy. The people watched with great interest to see what would happen, and when the woman gave birth to a beautiful boy in the fourth year, they regarded him as supernatural. Before long the woman and her husband died, and the boy was taken in by his grandmother, who lived alone. He was given a buffalo calf robe and immediately turned it inside out so that the hair side was outward, the way medicine men wore it. Among the Cheyenne there were certain medicine men of extraor dinary wisdom and superhuman powers. Sitting in a large circle, they chanted and went through curious rituals, after which each man rose and performed wonders before the crowd. He made his grandmother ask if he could take part, and the medicine men let him enter the lodge. To the man who had ushered him in, the child gave directions to paint his body red and draw black rings around his face, wrists, and ankles. Then he passed his buffalo sinew bowstring east, south, west, and north through the smoke. He asked two men to assist him and told them to tie his bowstring around his neck, cover his body with his robe, and pull at the ends of the string. He told them to pull harder, and as they tugged at the string, his head was severed. They covered the old man with the robe and pulled it away again, this time revealing a pile of human bones with a skull. But when for a fourth time they spread the robe over the empty space and removed it, the wonderful boy sat in his place is if nothing had happened. When a kill had been made, the wonderful boy led a crowd of boys who went hunting for calves that might return to the place where they last saw their mothers. The boys found five or six calves, surrounded them, and killed a two-year-old with their arrows. They began to skin it very carefully with bone knives, keeping the hide of the head intact and leaving the hooves on, because the wonderful boy wanted the skin for a robe. It was Young Wolf, head chief of the tribe, who had come to the killing ground to gather what bones had been left. The chief pushed the wonderful boy aside, but the boy returned and resumed skin ning. Pretending that he was skinning one of the hind legs, he cut the leg off at the knee and left the hoof on. They went out to look for him near the body of their chief, but the boy had returned to camp. Quickly the wonderful boy kicked the pot over, sending the contents into the fire. The warriors looked around and saw the boy about a quarter of a mile away, walking off toward the east. Still, they looked for him every day and at last saw him on the top of a nearby hill. The whole camp gathered to watch as he appeared on the summit five times, each time in a different dress. The second time he was a Coyote warrior, with his body painted black and yellow and with two eagle feathers sticking up on his head. The third time he appeared as a Dog Men warrior wearing a feathered headdress and carrying an eagle-bone whistle, a rattle of buffalo hoof, and a bow and arrows. His body was painted, and he had a rattle to sing by and a spear about eight feet long, with a crook at one end and the shaft at the other end bent in a semicircle. The fifth time his body was painted white, and on his forehead he wore a white owl skin. No one knew where he went, people thought him dead, and he was soon forgotten, for the buffalo disappeared and famine came to the Cheyenne. During this time the wonderful boy traveled alone into the highest ranges of the mountains.
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