mary EPA issues summary of recent Safe Drinking Water Act orders to protect public health in Wyoming By www.epa.gov Published On :: Tue, 28 Apr 2020 00:00:00 -0400 DENVER -- The U.S. Full Article
mary U.S. EPA Honors 2020 ENERGY STAR Partners of the Year in Delaware, Maryland, Pennsylvania, Virginia, Washington, DC and West Virginia By www.epa.gov Published On :: Wed, 01 Apr 2020 00:00:00 -0400 FOR IMMEDIATE RELEASE Contact: R3press@epa.gov U.S. EPA Honors 2020 ENERGY STAR® Partners of the Year in Delaware, Maryland, Pennsylvania, Virginia, Washington, DC and West Virginia Full Article
mary Andrew Yang on attempt to cancel N.Y. presidential primary: ’Their argument just doesn’t make sense’ By www.nydailynews.com Published On :: Fri, 08 May 2020 23:53:54 +0000 “They’re still proceeding with primaries for other offices, for other races," Yang told the Daily News. Full Article
mary Sanders supporters rail at New York over cancellation of presidential primary By www.latimes.com Published On :: Mon, 27 Apr 2020 23:36:48 -0400 Bernie Sanders supporters lash out after New York cancels its presidential primary, saying Democrats are trying to deny the former candidate a voice at the convention. Full Article
mary Millions skipped California's 2020 primary. Will coronavirus change who votes in November? By www.latimes.com Published On :: Fri, 1 May 2020 22:00:32 -0400 In all, 46.89% of registered voters cast ballots in the March 3 primary, which was moved up from June with hopes that turnout would be high and presidential candidates would be forced to address issues mattering most to Californians. Full Article
mary Mary McNamara named assistant managing editor for arts and entertainment By www.latimes.com Published On :: Tue, 27 Sep 2016 18:35:00 -0400 Mary McNamara, who won a Pulitzer Prize in 2015 for her television criticism, has been named The Times' assistant managing editor for arts and entertainment. Full Article
mary Andrew Yang on attempt to cancel N.Y. presidential primary: ’Their argument just doesn’t make sense’ By www.nydailynews.com Published On :: Fri, 08 May 2020 23:53:54 +0000 “They’re still proceeding with primaries for other offices, for other races," Yang told the Daily News. Full Article
mary Andrew Yang on attempt to cancel N.Y. presidential primary: ’Their argument just doesn’t make sense’ By www.nydailynews.com Published On :: Fri, 08 May 2020 23:53:54 +0000 “They’re still proceeding with primaries for other offices, for other races," Yang told the Daily News. Full Article
mary Column: What would Mary Poppins do during the lockdown? Julie Andrews launches a podcast By www.latimes.com Published On :: Tue, 28 Apr 2020 17:26:40 -0400 Julie Andrews and her daughter give families a little lift amid the coronavirus quarantine with a new reading podcast, "Julie's Library." Full Article
mary 'Frankenstein' and Mary Lincoln: Here's Indiana Repertory Theatre's 2020-2021 season By rssfeeds.indystar.com Published On :: Wed, 11 Mar 2020 18:00:11 +0000 Indiana Repertory Theatre's new plays include Mary Lincoln's reclusiveness, 'Fahrenheit 451' and a celebration of Indianapolis' bicentennial. Full Article
mary How COVID-19 could impact the May primary in the 5th District and across Indiana By rssfeeds.indystar.com Published On :: Sat, 21 Mar 2020 05:27:11 +0000 So far, Indiana leaders haven't made a decision to postpone the May primary over coronavirus despite decisions to do so in Ohio and Kentucky. Full Article
mary Gov. Holcomb is moving Indiana primary election to June 2 By rssfeeds.indystar.com Published On :: Sat, 21 Mar 2020 05:59:38 +0000 Gov. Eric Holcomb says the Indiana primary election will be moved from May 5 to June 2. Full Article
mary How to vote in the Indiana primary and why it matters By rssfeeds.indystar.com Published On :: Sat, 21 Mar 2020 01:55:50 +0000 Indiana's 2020 primary has been moved to June 2 due to the coronavirus outbreak. Here's everything you need to know about the primary. Full Article
mary Indiana Election Commission moves deadlines, makes changes to accommodate June 2 primary By rssfeeds.indystar.com Published On :: Wed, 25 Mar 2020 17:15:55 +0000 The Indiana Election Commission on Wednesday ratified several changes that Gov. Eric Holcomb recommended at a news conference last week. Full Article
mary Despite a loss, Purdue sees positives from Big Ten tourney matchup with Maryland By rssfeeds.indystar.com Published On :: Fri, 06 Mar 2020 21:38:56 +0000 Despite a loss, Purdue sees positives from Big Ten tourney matchup with Maryland Full Article
mary AT#438 - Travel to Baltimore, Maryland By usa.amateurtraveler.com Published On :: Sat, 27 Sep 2014 19:10:09 +0000 Hear about travel to Baltimore, Maryland as the Amateur Traveler talks to Nancy Parode from about.com. Nancy has lived in the Baltimore area for a total of about 12 years and tells us about her adopted hometown. Full Article
mary Summary Outcomes of the Fifth Meeting of the BCH Informal Advisory Committee (BCH IAC). The BCH IAC provides guidance regarding the technical issues associated with the ongoing development of the BCH. By www.cbd.int Published On :: Thu, 18 Feb 2010 00:00:00 GMT Full Article
mary The summary outcomes of of the ninth meeting of the Informal Advisory Committee on the Biosafety Clearing-House is now available. By www.cbd.int Published On :: Wed, 16 Jul 2014 00:00:00 GMT Full Article
mary A CBD/Aarhus Convention checklist and summary of tools and resources are now available. By bch.cbd.int Published On :: Fri, 29 Jan 2016 00:00:00 GMT Full Article
mary CBD News: Syracuse Charter on Biodiversity and Chair's Summary - G8 Environment Ministerial Meeting, Castello Maniace, Siracusa, 22-24 April, 2009. By www.cbd.int Published On :: Thu, 23 Apr 2009 00:00:00 GMT Full Article
mary CBD News: Summary results and conclusions of the Airbus-commissioned survey referred to in the address of the Executive Secretary delivered at the Royal Geographical Society, London, on 3 September 2009. By www.cbd.int Published On :: Thu, 03 Sep 2009 00:00:00 GMT Full Article
mary CBD News: Summary of the Second Global Private Donor Forum, which took place this past October 26th, 2010 at the margins of the tenth Conference of Parties (COP10) in Nagoya, Japan. By www.cbd.int Published On :: Fri, 03 Dec 2010 00:00:00 GMT Full Article
mary CBD News: Ambassador Mary Seet-Cheng, Chair of the East Asian Seas Partnership Council, Viet Nam Deputy Minister of Natural Resources and Environment, Chu Pham Ngoc Hien, PEMSEA Executive Director, Stephen Adrian Ross, Dr. Chua Thia-Eng, Chair Emeritus of By www.cbd.int Published On :: Wed, 18 Nov 2015 00:00:00 GMT Full Article
mary Results of Primary One discretionary places to be released on Monday By www.info.gov.hk Published On :: Fri, 15 Nov 2019 15:12:55 Full Article
mary Parents reminded to choose primary schools By www.info.gov.hk Published On :: Mon, 13 Jan 2020 14:45:49 Full Article
mary Primary One Central Allocation results to be posted to parents in early June By www.info.gov.hk Published On :: Thu, 23 Apr 2020 14:50:24 Full Article
mary 2020 April Monthly Weather Summary By www.hko.gov.hk Published On :: Monthly weather summary in Hong Kong Full Article I
mary Implementing Diabetes Self-Management Education in Primary Care By spectrum.diabetesjournals.org Published On :: 2006-04-01 Sharlene EmersonApr 1, 2006; 19:79-83Articles Full Article
mary COVID prank nearly kills St Mary man By jamaica-star.com Published On :: Fri, 08 May 2020 05:02:09 -0500 A practical joke gone too far caused a St Mary resident, Byron Wilson, to burst into tears after he received a phone call from one of his mischievous friends telling him that he may be a carrier of the novel coronavirus. "A dead mi dead right... Full Article
mary 18F-DCFPyL PET/CT Imaging in Patients with Biochemical Recurrence Prostate Cancer after Primary Local Therapy By jnm.snmjournals.org Published On :: 2019-11-01T13:36:37-07:00 Objective: To investigate the lesion detection rate of 18F-DCFPyL-PET/CT, a prostate-specific membrane antigen (PSMA) targeted PET agent, in biochemical relapse prostate cancer patients after primary local therapy. Methods: This is a prospective institutional review board-approved study of 90 patients with documented biochemical recurrence (median PSA 2.5 ng/mL, range 0.21-35.5 ng/mL) with negative conventional imaging after primary local therapies, including radical prostatectomy (n = 38), radiation (n = 27) or combination (n = 25). Patients on androgen deprivation therapy were excluded. Patients underwent whole-body 18F-DCFPyL-PET/CT (299.9±15.5 MBq) at 2 h p.i. PSMA-PET lesion detection rate was correlated with PSA, PSA kinetics and original primary tumor grade. Results: Seventy patients (77.8%) showed a positive PSMA-PET scan, identifying a total of 287 lesions: 37 prostate bed foci, 208 lymph nodes, and 42 bone/organ distant sites; 11 patients had a negative scan and 9 patients showed indeterminate lesions, which were considered negative in this study. The detection rates were 47.6% (n = 10/21), 50% (n = 5/10), 88.9% (n = 8/9), and 94% (n = 47/50) for PSA >0.2 to <0.5, 0.5 to <1.0, 1 to <2.0, and ≥2.0 ng/mL, respectively. In post-surgical patients, PSA, PSAdt and PSAvel correlated with PET results but the same was not true for post-radiation patients. These parameters also correlated with the extent of disease on PET (intrapelvic vs. extrapelvic). There was no significant difference between the rate of positive scans in patients with higher grade vs lower grade primary tumors (Gleason score ≥4+3 vs <3+4). Tumor recurrence was histology confirmed in 40% (28/70) of patients. On a per-patient basis, positive predictive value was 93.3% (95% CI, 77.6-99.2%) by histopathologic validation, and 96.2% (95% CI, 86.3-99.7%) by the combination of histology and imaging/clinical follow-up. Conclusion: 18F-DCFPyL-PET/CT imaging offers high detection rates in biochemically recurrent prostate cancer patients; and is positive in about 50% of patients with PSA <0.5 ng/mL, which could substantially impact clinical management. In post-surgical patients, 18F-DCFPyL-PET/CT correlates with PSA, PSAdt and PSAvel suggesting it may have prognostic value. 18F-DCFPyL-PET/CT is highly promising for localizing sites of recurrent prostate cancer. Full Article
mary Site-specific N-glycan Analysis of Antibody-binding Fc {gamma} Receptors from Primary Human Monocytes [Research] By feedproxy.google.com Published On :: 2020-02-01T00:05:30-08:00 FcRIIIa (CD16a) and FcRIIa (CD32a) on monocytes are essential for proper effector functions including antibody dependent cellular cytotoxicity (ADCC) and phagocytosis (ADCP). Indeed, therapeutic monoclonal antibodies (mAbs) that bind FcRs with greater affinity exhibit greater efficacy. Furthermore, post-translational modification impacts antibody binding affinity, most notably the composition of the asparagine(N)-linked glycan at N162 of CD16a. CD16a is widely recognized as the key receptor for the monocyte response, however the post-translational modifications of CD16a from endogenous monocytes are not described. Here we isolated monocytes from individual donors and characterized the composition of CD16a and CD32a N-glycans from all modified sites. The composition of CD16a N-glycans varied by glycosylation site and donor. CD16a displayed primarily complex-type biantennary N-glycans at N162, however some individuals expressed CD16a V158 with ~20% hybrid and oligomannose types which increased affinity for IgG1 Fc according to surface plasmon resonance binding analyses. The CD16a N45-glycans contain markedly less processing than other sites with >75% hybrid and oligomannose forms. N38 and N74 of CD16a both contain highly processed complex-type N-glycans with N-acetyllactosamine repeats and complex-type biantennary N-glycans dominate at N169. The composition of CD16a N-glycans isolated from monocytes included a higher proportion of oligomannose-type N-glycans at N45 and less sialylation plus greater branch fucosylation than we observed in a recent analysis of NK cell CD16a. The additional analysis of CD32a from monocytes revealed different features than observed for CD16a including the presence of a predominantly biantennary complex-type N-glycans with two sialic acids at both sites (N64 and N145). Full Article
mary Dispersed lipid droplets: an intermediate site for lipid transport and metabolism in primary human adipocytes. By feedproxy.google.com Published On :: 2020-04-15 Björn MorénApr 15, 2020; 0:jlr.ILR120000808v1-jlr.ILR120000808Images in Lipid Research Full Article
mary Dispersed lipid droplets: an intermediate site for lipid transport and metabolism in primary human adipocytes. [Images in Lipid Research] By feedproxy.google.com Published On :: 2020-04-15T13:30:25-07:00 Full Article
mary Managing multimorbidity in primary care By feeds.bmj.com Published On :: Fri, 23 Jan 2015 11:56:24 +0000 Multimorbidity presents a number of different challenges, for the patients living with the conditions, but also for the health professionals caring for them in systems that often are not designed with these more complex needs in mind. Emma Wallace, general practice lecturer, and Susan Smith, a professor of general practice at the Royal College of... Full Article
mary Diagnosing COPD in primary care By feeds.bmj.com Published On :: Fri, 04 Dec 2015 10:04:39 +0000 Francesca Conway, from the Department of Primary Care and Public Health at Imperial College London is co-author of an article on diagnosis of COPD. She joins us to discuss the major guideline recommendations, and highlights where they concur and where they differ. Read the full article: http://www.bmj.com/content/351/bmj.h6171 Full Article
mary Statins for primary prevention - How good is the evidence By feeds.bmj.com Published On :: Mon, 21 Oct 2019 10:12:15 +0000 Statins are now the most commonly used drug in the UK and one of the most commonly used medicines in the world, but debate remains about their use for primary prevention for people without cardiovascular disease. Paula Byrne from the National University of Ireland Galway, joins us to talk about the evidence of benefit for low risk individuals,... Full Article
mary Too close for comfort - St Mary families in cramped homes have eyes on virus By jamaica-gleaner.com Published On :: Fri, 08 May 2020 00:26:06 -0500 Sandra Ferguson resides with her children and grandchildren in a concrete dwelling that is sectioned into four living quarters in the Fort George Road area of Annotto Bay. With 10 of them sharing kitchen and bathroom facilities, Ferguson said... Full Article
mary St Mary COVID crackdown - Health teams go house to house tracing virus as quarantine hits Dover, Annotto Bay, Enfield By jamaica-gleaner.com Published On :: Fri, 08 May 2020 00:26:31 -0500 Days after The Gleaner reported a clarion call from Port Maria Mayor Richard Creary for the quarantine of St Mary communities owing to growing concerns about the spread of COVID-19 in the parish, the Government responded with the lockdown of three... Full Article
mary PNP wants Gov’t to issue quarantine order for St Mary By jamaica-gleaner.com Published On :: Sat, 09 May 2020 00:17:24 -0500 The People’s National Party (PNP) has asserted that the absence of a quarantine order for three St Mary communities is adding to the state of confusion. The 14-day measure began on Thursday in Dover, Enfield and Annotto Bay at 6 a.m. “The lack of... Full Article
mary Bread-and-butter issues surface under St Mary community restrictions By jamaica-gleaner.com Published On :: Sat, 09 May 2020 00:15:31 -0500 DOVER, St Mary: Residents of Epsom and Dover in St Mary are on edge, but have accepted quarantine measures imposed by the Government to curtail the spread of the dreaded coronavirus in that parish. Security checkpoints at both ends of the parish... Full Article
mary George Headley Primary creates Peace Garden By jamaica-gleaner.com Published On :: Sun, 29 Mar 2020 00:20:29 -0500 A ‘Peace of Paradise’ garden has been created in George Headley Primary School, which is positively affecting behavioural change in students. The garden was created by students, teachers, and members of the community for the 2019 Trees for Peace... Full Article
mary Preoperative Localization of Adenomas in Primary Hyperparathyroidism: The Value of 11C-Choline PET/CT in Patients with Negative or Discordant Findings on Ultrasonography and 99mTc-Sestamibi SPECT/CT By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 We aimed to assess the value of 11C-choline PET in patients with primary hyperparathyroidism and negative or discordant results on 99mTc-sestamibi imaging and neck ultrasound. Methods: Eighty-seven such patients were assessed and subsequently underwent parathyroidectomy. PET/CT image data were analyzed semiquantitatively using SUVmax and SUV ratios (target to contralateral thyroid gland and carotid artery). A positive PET/CT result was defined as focal uptake significantly higher than regular thyroid tissue. Ectopic foci were also considered positive. Inconclusive PET/CT cases were defined as a lesion with uptake equal to normal thyroid tissue. If no prominent or ectopic uptake was detectable, the PET/CT result was considered negative. Results: When dichotomizing the 11C-choline PET/CT imaging results by defining lesions with both positive and inconclusive uptake as positive, we found 84 of 92 lesions (91.3%) to have true-positive uptake whereas 8 lesions (8.7%) had false-positive uptake. One lesion showed false-negative uptake; the sensitivity was 98.8%. The corresponding positive predictive value for lesions was 91.3%. The mean SUVmax was 6.15 ± 4.92 in 72 lesions with positive uptake (70 patients) and 2.96 ± 2.32 in 20 lesions with inconclusive uptake (18 patients). Conclusion: These results in a large group of patients indicate that 11C-choline PET/CT is a promising tool for parathyroid adenoma localization when ultrasound and 99mTc-sestamibi imaging yield negative or discordant results. Full Article
mary 18F-Fluorocholine PET/CT in Primary Hyperparathyroidism: Superior Diagnostic Performance to Conventional Scintigraphic Imaging for Localization of Hyperfunctioning Parathyroid Glands By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 Primary hyperparathyroidism (PHPT) is a common endocrine disorder, definitive treatment usually requiring surgical removal of the offending parathyroid glands. To perform focused surgical approaches, it is necessary to localize all hyperfunctioning glands. The aim of the study was to compare the efficiency of established conventional scintigraphic imaging modalities with emerging 18F-fluorocholine PET/CT imaging in preoperative localization of hyperfunctioning parathyroid glands in a larger series of PHPT patients. Methods: In total, 103 patients with PHPT were imaged preoperatively with 18F-fluorocholine PET/CT and conventional scintigraphic imaging methods, consisting of 99mTc-sestamibi SPECT/CT, 99mTc-sestamibi/pertechnetate subtraction imaging, and 99mTc-sestamibi dual-phase imaging. The results of histologic analysis, as well as intact parathyroid hormone and serum calcium values obtained 1 d after surgery and on follow-up, served as the standard of truth for evaluation of imaging results. Results: Diagnostic performance of 18F-fluorocholine PET/CT surpassed conventional scintigraphic methods (separately or combined), with calculated sensitivity of 92% for PET/CT and 39%–56% for conventional imaging (65% for conventional methods combined) in the entire patient group. Subgroup analysis, differentiating single and multiple hyperfunctioning parathyroid glands, showed PET/CT to be most valuable in the group with multiple hyperfunctioning glands, with sensitivity of 88%, whereas conventional imaging was significantly inferior, with sensitivity of 22%–34% (44% combined). Conclusion: 18F-fluorocholine PET/CT is a diagnostic modality superior to conventional imaging methods in patients with PHPT, allowing for accurate preoperative localization. Full Article
mary Appropriate Use Criteria for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer After Definitive Primary Treatment By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 Full Article
mary Prostate-Specific Membrane Antigen PET/CT Combined with Sentinel Node Biopsy for Primary Lymph Node Staging in Prostate Cancer By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 Our objective was to determine the diagnostic capabilities of combined prostate-specific membrane antigen (PSMA) PET/CT and sentinel node (SN) biopsy in PSMA PET/CT–negative patients for primary lymph node (LN) staging in prostate cancer (PCa) patients. Methods: Between January 2017 and March 2019, retrospectively, all consecutive patients with diagnosed intermediate- or high-risk primary PCa who underwent preoperative PSMA PET/CT (68Ga or 18F-DCFPyL) followed by robot-assisted radical prostatectomy and extended pelvic LN dissection (ePLND) were included. All patients without suspected LN metastases on PSMA PET/CT were considered candidates for SN biopsy with indocyanine green–99mTc-nanocolloid or 99mTc-nanocolloid with free indocyanine green used as tracers. The ePLND was used as a reference standard. Results: Of 53 patients, 22 had positive PSMA PET/CT results and 31 underwent subsequent SN biopsy after negative PSMA PET/CT results. In total, 23 patients (43%) were pN1, of whom 6 (26%) had negative PSMA PET/CT results and underwent subsequent SN biopsy. The combined use of SN biopsy and PSMA PET/CT identified all pN1 patients (100% sensitivity; 95% confidence interval, 86%–100%) and performed correct nodal staging in 50 of 53 patients (94% diagnostic accuracy; 95% confidence interval, 84%–99%). SN biopsy identified significantly smaller LN metastases (median diameter, 2.0 mm; interquartile range, 1.0–3.8 mm) than PSMA PET/CT (median diameter, 5.5 mm; interquartile range, 2.6–9.3 mm; P = 0.007). Conclusion: Combining both modalities led to a 94% accuracy for nodal staging in diagnosed intermediate- and high-risk primary PCa. Adding SN biopsy in patients with negative PSMA PET/CT results increased the combined sensitivity to 100% for detecting nodal metastases at ePLND. This diagnostic accuracy may provide valuable information for directing further treatment in PCa patients, such as the use of PSMA PET/CT and SN biopsy rather than ePLND as the preferred approach for staging before radiotherapy. Full Article
mary The First 100 Days: Summary of Major Immigration Actions Taken by the Trump Administration By www.migrationpolicy.org Published On :: Mon, 24 Apr 2017 17:24:00 -0400 During his first 100 days in office, President Trump has taken a sweeping set of actions on immigration, ranging from imposing a travel ban to cutting refugee admissions, "extreme" vetting, and fortifying immigration enforcement at the border and in the U.S. interior. This fact sheet examines the major immigration actions taken to date, legal challenges, and related policy and personnel developments. Full Article
mary Diabetes INSIDE: Improving Population HbA1c Testing and Targets in Primary Care With a Quality Initiative By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To improve outcomes of patients with adult type 2 diabetes by decreasing HbA1c undertesting, reducing the proportion of patients with poor glycemic control, and lowering mean HbA1c levels using a quality improvement (QI) program. RESEARCH DESIGN AND METHODS Six years of outpatient electronic health record (EHR) data were analyzed for care gaps before and 2 years after implementing a QI initiative in an urban academic medical center. QI strategies included 1) individual provider and departmental outcome reports, 2) patient outreach programs to address timely follow-up care, 3) a patient awareness campaign to improve understanding of achieving clinical goals, 4) improving EHR data capture to improve population monitoring, and 5) professional education. RESULTS Analysis (January 2010 to May 2018) of 7,798 patients from Tulane Medical Center (mean age 61 years, 57% female, 62% black, 97% insured) with 136,004 visits showed target improvements. A Cox proportional hazards model controlling for age, sex, race, and HbA1c level showed a statistically significant reduction in HbA1c undertesting >6 months (hazard ratio 1.20 ± 0.07). Statistical process control charts showed 15.5% relative improvement in the patient proportion with HbA1c >9% (75 mmol/mol) from 13% to 11% (P < 10–6) following QI interventions and a 2.1% improvement of population mean HbA1c from 7.4% (57 mmol/mol) to 7.2% (55 mmol/mol) (P < 10–6). CONCLUSIONS Multidisciplinary QI teams using EHR data to design interventions for providers and patients produced statistically significant improvements in both care process and clinical outcome goals. Full Article
mary Standards of Medical Care in Diabetes--2018 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2018-01-01 American Diabetes AssociationJan 1, 2018; 36:14-37Position Statements Full Article
mary Standards of Medical Care in Diabetes--2019 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2019-01-01 American Diabetes AssociationJan 1, 2019; 37:11-34Position Statements Full Article
mary Standards of Medical Care in Diabetes--2020 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2020-01-01 American Diabetes AssociationJan 1, 2020; 38:10-38Standards of Care Full Article