 and interactions within the transportation system and to help maximize general public ridership during peak travel times.
Sign and return the enclosed opt-in form to their high school office, starting Nov. 19.
Once the form has been returned, the students will receive a tamper-proof bus pass sticker to place on their school ID. This will allow them to continue to ride the Metro buses as part of the pilot project.
In January 2020, students with the temporary bus stickers will be issued a new Youth Mobility Bus Pass, valid through Sept. 1. The new pass will have the student ID on one side and the bus pass on the other side. Students may continue to opt-in to the Youth Mobility Bus program — and to receive a bus pass — through June 1.
Second, to address capacity issues during peak ridership times, Metro will not be accepting the Youth Mobility Bus Pass or the temporary sticker pass from 2 to 4 p.m. Monday through Friday, beginning Dec. 2. These reduced service hours will run through Feb. 3.
Parents and guardians are asked to review the rules of conduct for Metro buses and the Kalamazoo Transportation Center with their students prior to signing the opt-in form. The rules of conduct will help ensure students know how to be responsible public transportation users and help create a safe and positive riding environment for the entire community. Failure to abide by the Rules of Conduct for Metro and the Kalamazoo Transportation Center could result in loss of Youth Mobility Bus Pass privileges and/or banning from the Kalamazoo Transportation Center or Metro public transportation.
For further information regarding the opt-in process and form, please contact your student’s high school. For specific information on bus routes, bus schedules, rules of conduct for Metro, or learning how to ride the bus, please call |||PHONE_NUMBER|||.
Copies of this text in the form of letters sent families, as well as the opt-in forms can be found as PDFs at the bottom of this page. Forms are in English, Spanish, and Arabic.
Metro websiteRead more about the Youth Mobility Fund on the Metro website.In an age when software dominates the world, code security and quality must remain a high priority. Delivering secure and reliable software at a rapid pace is critical to most organizations today, but it is not an easy task. What security best practices do organizations put in place to successfully produce secure software? How should DevOps teams integrate updated security practices and tools throughout the software development lifecycle? At the Secure Software Summit, which will take place January 27 at 9 AM PT, the world’s leading cybersecurity experts will gather to share and teach the latest methods and hacks in encryption and secure deployment practices.
Dan Lorink, founder and CEO of Chainguard, Inc.
Jonathan Schneider, co-founder and CEO of Moderne, Inc.
Attendees will have access to valuable resources available for download and will also receive a link to access the virtual environment on demand. To view the full agenda and to register, please visit the Secure Software Summit website.
The primary aim of this study was to investigate the diagnostic value of procalcitonin (PCT) and C-reactive protein (CRP) in septic complications after major trauma. A secondary aim was to determine whether there was a prognostic value of PCT for severity of injury, organ dysfunction, and sepsis.
Medical/surgical intensive care unit (ICU).
Ninety-four patients with consecutive trauma >=16 years who were admitted to the ICU for an expected stay of >24 hours.
PCT and CRP were collected at admission and every day thereafter. The American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definition was used to identify sepsis criteria. The Sequential Organ Failure Assessment score was used to describe the severity of organ dysfunction. We retrospectively analyzed the occurrence of systemic inflammatory response syndrome and sepsis using the collected variables (criteria fulfilled at least during three continuous days).
Patients with trauma presented an early and significant increase in PCT at the moment of septic complications compared with concentrations measured 1 day before the diagnosis of sepsis: 0.85 vs. 3.32 ng/mL for PCT (p < 0.001) and 135 vs. 175 mg/L for CRP (p = not significant). The areas under the respective curve at admission in the diagnosis of sepsis were 0.787 (p < 0.001) and 0.489 for PCT and CRP, respectively.
PCT plasma reinduction marks possible septic complication during systemic inflammatory response syndrome after major trauma. In addition, high PCT concentration at admission after trauma in ICU patients indicates an increased risk of septic complications.
We previously demonstrated that uncorrected coagulopathy in patients receiving massive transfusion was associated with increased mortality. Based on these findings we implemented early goal directed therapy beginning at the time of injury to approach an optimal plasma:PRBC ratio of 1:1. The aim of the current study was to evaluate mortality after implementation of this practice.
We performed a retrospective chart review of 246 patients at a US Army combat support hospital, each of who received a massive transfusion (>=10 units of RBCs in 24 hours). Three groups of patients were constructed according to the plasma to RBC ratio transfused during massive transfusion. Mortality rates and the cause of death were compared among groups.
For the low ratio group the plasma to RBC median ratio was 1:8 (interquartile range, 0:12–1:5), for the medium ratio group, 1:2.5 (interquartile range, 1:3.0–1:2.3), and for the high ratio group, 1:1.4 (interquartile range, 1:1.7–1:1.2) (p < 0.001). Median Injury Severity Score (ISS) was 18 for all groups (interquartile range, 14–25). For low, medium, and high plasma to RBC ratios, overall mortality rates were 65%, 34%, and 19%, (p < 0.001); and hemorrhage mortality rates were 92.5%, 78%, and 37%, respectively, (p < 0.001). Upon logistic regression, plasma to RBC ratio was independently associated with survival (odds ratio 8.6, 95% confidence interval 2.1–35.2).
Trauma is a leading cause of mortality and morbidity, with traumatic brain injury (TBI) and uncontrolled hemorrhage responsible for the majority of these deaths. Recombinant activated factor VIIa (rFVIIa) is being investigated as an adjunctive hemostatic treatment for bleeding refractory to conventional replacement therapy in trauma patients. TBI is a common component of polytrauma injuries. However, the combination of TBI with polytrauma injuries is associated with specific risk factors and treatment modalities somewhat different from those of polytrauma without TBI. Although rFVIIa treatment may offer added potential benefit for patients with combined TBI and polytrauma, its safety in this population has not yet been assessed. We conducted a post hoc sub analysis of patients with TBI and severe blunt polytrauma enrolled into a prospective, international, double-blind, randomized, placebo-controlled study.
A post hoc analysis of study data was performed for 143 patients with severe blunt trauma enrolled in a prospective, randomized, placebo-controlled study, evaluating the safety and efficacy of intravenous rFVIIa (200 + 100 + 100 μg/kg) or placebo, to identify patients with a computed tomography (CT) diagnosis of TBI. The incidences of ventilator-free days, intensive care unit-free days, and thromboembolic, serious, and adverse events within the 30-day study period were assessed in this cohort.
Thirty polytrauma patients (placebo, n = 13; rFVIIa, n = 17) were identified as having TBI on CT. No significant differences in rates of mortality (placebo, n = 6, 46%, 90% confidence interval (CI): 22% to 71%; rFVIIa, n = 5, 29%, 90% CI: 12% to 56%; P = 0.19), in median numbers of intensive care unit-free days (placebo = 0, rFVIIa = 3; P = 0.26) or ventilator-free days (placebo = 0, rFVIIa = 10; P = 0.19), or in rates of thromboembolic adverse events (placebo, 15%, 90% CI: 3% to 51%; rFVIIa, 0%, 90% CI: 0% to 53%; P = 0.18) or serious adverse events (placebo, 92%, 90% CI: 68% to 98%; rFVIIa, 82%, 90% CI: 60% to 92%; P = 0.61) were observed between treatment groups.
The use of a total dose of 400 (200 + 100 + 100) μg/kg rFVIIa in this group of hemodynamically unstable polytrauma patients with TBI was not associated with an increased risk of mortality or with thromboembolic or adverse events.Cancer is a complex problem that needs multi-approaches to achieve healing. The strategy is to heal from within, while at the same time, resolve some uncomfortable symptoms. The Cancer Care Therapy is a healing-orientated therapy that is being used since 1995, mostly by patients in Malaysia, Singapore, Indonesia and Thailand. There are also patients from Australia, UK, France, US and the Philippines who follow the Cancer Care Therapy.
This is your sickness and only you can heal yourself, others can only help. Living a positive life and managing cancer is your responsibility, not the doctor’s. If you refuse to change your ways and lifestyle or if you refuse to provide a helping hand to the healing power within you, who else can?
Our experiences show that those who actually participate in the healing process benefited and won.
CA