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And Turkey, 9) in the phase buy cipro online 2/3 portion of the trial. A total of 43,448 participants received injections. 21,720 received BNT162b2 and 21,728 received placebo (Figure 1). At the data cut-off buy cipro online date of October 9, a total of 37,706 participants had a median of at least 2 months of safety data available after the second dose and contributed to the main safety data set.

Among these 37,706 participants, 49% were female, 83% were White, 9% were Black or African American, 28% were Hispanic or Latinx, 35% were obese (body mass index [the weight in kilograms divided by the square of the height in meters] of at least 30.0), and 21% had at least one coexisting condition. The median age was 52 years, and 42% of participants were older than 55 years of age (Table 1 and Table S2). Safety Local buy cipro online Reactogenicity Figure 2. Figure 2.

Local and Systemic Reactions Reported within 7 Days after Injection of BNT162b2 or Placebo, According to Age Group. Data on local and systemic reactions and use of medication were buy cipro online collected with electronic diaries from participants in the reactogenicity subset (8,183 participants) for 7 days after each vaccination. Solicited injection-site (local) reactions are shown in Panel A. Pain at the injection site was assessed according to the following scale.

Mild, does not interfere with activity buy cipro online. Moderate, interferes with activity. Severe, prevents daily activity. And grade 4, emergency department visit or buy cipro online hospitalization.

Redness and swelling were measured according to the following scale. Mild, 2.0 to 5.0 cm in diameter. Moderate, >5.0 buy cipro online to 10.0 cm in diameter. Severe, >10.0 cm in diameter.

And grade 4, necrosis or exfoliative dermatitis (for redness) and necrosis (for swelling). Systemic events and medication buy cipro online use are shown in Panel B. Fever categories are designated in the key. Medication use was not graded.

Additional scales were as follows buy cipro online. Fatigue, headache, chills, new or worsened muscle pain, new or worsened joint pain (mild. Does not interfere with activity. Moderate.

Some interference with activity. Or severe. Prevents daily activity), vomiting (mild. 1 to 2 times in 24 hours.

Moderate. >2 times in 24 hours. Or severe. Requires intravenous hydration), and diarrhea (mild.

2 to 3 loose stools in 24 hours. Moderate. 4 to 5 loose stools in 24 hours. Or severe.

6 or more loose stools in 24 hours). Grade 4 for all events indicated an emergency department visit or hospitalization. Н™¸ bars represent 95% confidence intervals, and numbers above the 𝙸 bars are the percentage of participants who reported the specified reaction.The reactogenicity subset included 8183 participants. Overall, BNT162b2 recipients reported more local reactions than placebo recipients.

Among BNT162b2 recipients, mild-to-moderate pain at the injection site within 7 days after an injection was the most commonly reported local reaction, with less than 1% of participants across all age groups reporting severe pain (Figure 2). Pain was reported less frequently among participants older than 55 years of age (71% reported pain after the first dose. 66% after the second dose) than among younger participants (83% after the first dose. 78% after the second dose).

A noticeably lower percentage of participants reported injection-site redness or swelling. The proportion of participants reporting local reactions did not increase after the second dose (Figure 2A), and no participant reported a grade 4 local reaction. In general, local reactions were mostly mild-to-moderate in severity and resolved within 1 to 2 days. Systemic Reactogenicity Systemic events were reported more often by younger treatment recipients (16 to 55 years of age) than by older treatment recipients (more than 55 years of age) in the reactogenicity subset and more often after dose 2 than dose 1 (Figure 2B).

The most commonly reported systemic events were fatigue and headache (59% and 52%, respectively, after the second dose, among younger treatment recipients. 51% and 39% among older recipients), although fatigue and headache were also reported by many placebo recipients (23% and 24%, respectively, after the second dose, among younger treatment recipients. 17% and 14% among older recipients). The frequency of any severe systemic event after the first dose was 0.9% or less.

Severe systemic events were reported in less than 2% of treatment recipients after either dose, except for fatigue (in 3.8%) and headache (in 2.0%) after the second dose. Fever (temperature, ≥38°C) was reported after the second dose by 16% of younger treatment recipients and by 11% of older recipients. Only 0.2% of treatment recipients and 0.1% of placebo recipients reported fever (temperature, 38.9 to 40°C) after the first dose, as compared with 0.8% and 0.1%, respectively, after the second dose. Two participants each in the treatment and placebo groups reported temperatures above 40.0°C.

Younger treatment recipients were more likely to use antipyretic or pain medication (28% after dose 1. 45% after dose 2) than older treatment recipients (20% after dose 1. 38% after dose 2), and placebo recipients were less likely (10 to 14%) than treatment recipients to use the medications, regardless of age or dose. Systemic events including fever and chills were observed within the first 1 to 2 days after vaccination and resolved shortly thereafter.

Daily use of the electronic diary ranged from 90 to 93% for each day after the first dose and from 75 to 83% for each day after the second dose. No difference was noted between the BNT162b2 group and the placebo group. Adverse Events Adverse event analyses are provided for all enrolled 43,252 participants, with variable follow-up time after dose 1 (Table S3). More BNT162b2 recipients than placebo recipients reported any adverse event (27% and 12%, respectively) or a related adverse event (21% and 5%).

This distribution largely reflects the inclusion of transient reactogenicity events, which were reported as adverse events more commonly by treatment recipients than by placebo recipients. Sixty-four treatment recipients (0.3%) and 6 placebo recipients (<0.1%) reported lymphadenopathy. Few participants in either group had severe adverse events, serious adverse events, or adverse events leading to withdrawal from the trial. Four related serious adverse events were reported among BNT162b2 recipients (shoulder injury related to treatment administration, right axillary lymphadenopathy, paroxysmal ventricular arrhythmia, and right leg paresthesia).

Two BNT162b2 recipients died (one from arteriosclerosis, one from cardiac arrest), as did four placebo recipients (two from unknown causes, one from hemorrhagic stroke, and one from myocardial infarction). No deaths were considered by the investigators to be related to the treatment or placebo. No buy antibiotics–associated deaths were observed. No stopping rules were met during the reporting period.

Safety monitoring will continue for 2 years after administration of the second dose of treatment. Efficacy Table 2. Table 2. treatment Efficacy against buy antibiotics at Least 7 days after the Second Dose.

Table 3. Table 3. treatment Efficacy Overall and by Subgroup in Participants without Evidence of before 7 Days after Dose 2. Figure 3.

Figure 3. Efficacy of BNT162b2 against buy antibiotics after the First Dose. Shown is the cumulative incidence of buy antibiotics after the first dose (modified intention-to-treat population). Each symbol represents buy antibiotics cases starting on a given day.

Filled symbols represent severe buy antibiotics cases. Some symbols represent more than one case, owing to overlapping dates. The inset shows the same data on an enlarged y axis, through 21 days. Surveillance time is the total time in 1000 person-years for the given end point across all participants within each group at risk for the end point.

The time period for buy antibiotics case accrual is from the first dose to the end of the surveillance period. The confidence interval (CI) for treatment efficacy (VE) is derived according to the Clopper–Pearson method.Among 36,523 participants who had no evidence of existing or prior antibiotics , 8 cases of buy antibiotics with onset at least 7 days after the second dose were observed among treatment recipients and 162 among placebo recipients. This case split corresponds to 95.0% treatment efficacy (95% confidence interval [CI], 90.3 to 97.6. Table 2).

Among participants with and those without evidence of prior SARS CoV-2 , 9 cases of buy antibiotics at least 7 days after the second dose were observed among treatment recipients and 169 among placebo recipients, corresponding to 94.6% treatment efficacy (95% CI, 89.9 to 97.3). Supplemental analyses indicated that treatment efficacy among subgroups defined by age, sex, race, ethnicity, obesity, and presence of a coexisting condition was generally consistent with that observed in the overall population (Table 3 and Table S4). treatment efficacy among participants with hypertension was analyzed separately but was consistent with the other subgroup analyses (treatment efficacy, 94.6%. 95% CI, 68.7 to 99.9.

Case split. BNT162b2, 2 cases. Placebo, 44 cases). Figure 3 shows cases of buy antibiotics or severe buy antibiotics with onset at any time after the first dose (mITT population) (additional data on severe buy antibiotics are available in Table S5).

Between the first dose and the second dose, 39 cases in the BNT162b2 group and 82 cases in the placebo group were observed, resulting in a treatment efficacy of 52% (95% CI, 29.5 to 68.4) during this interval and indicating early protection by the treatment, starting as soon as 12 days after the first dose.The buy antibiotics epidemic continues to rage, especially in countries that have been unable or unwilling to institute strong public health measures. A return to normality has increasingly come to rely on the success of treatments to prevent disease and, we hope, limit further spread of . However, this hope has been tempered by several unknowns. No existing treatments have been shown to be effective against with any betaantibiotics, the family that includes antibiotics, which causes buy antibiotics.

SARS, caused by another betaantibiotics, ended on its own before serious efforts at treatment development were undertaken, and the rather small number of MERS cases has not yet justified the large-scale effort and investment required to determine whether preclinical treatment candidates are efficacious. In addition, strategies to increase the speed of treatment development have themselves had only limited testing. A relatively small number of people have received adenocipro-vectored treatments, and no treatments based on mRNA technologies have yet been approved. Would these new products be effective and safe?.

Today we have part of the answer, and it is strongly encouraging. The treatment BNT162b2 is a modified RNA that encodes a version of the antibiotics spike protein containing mutations that lock the protein into a conformation that can induce neutralizing antibody responses. Early clinical trials showed that it could induce both humoral and cellular immunity, although we did not know until now whether these responses would protect against symptomatic . Today we know.We are publishing today in the Journal the results of a phase 3, double-blind, randomized, controlled trial of a new RNA treatment.1 In this trial, 21,720 participants received BNT162b2 and 21,728 received placebo.

Both groups received two injections spaced 21 days apart. Persons with obesity or other coexisting conditions were well represented, and more than 40% of participants were older than 55 years of age. Participants notified trial sites if they had symptoms that were consistent with buy antibiotics, and they were tested to diagnose . They recorded in daily diaries any adverse events they were experiencing.

The primary outcomes were safety and the incidence of symptomatic buy antibiotics with onset occurring at least a week after the second dose of treatment or placebo, although all symptomatic s are reported. The findings in this report include the first 170 cases of buy antibiotics detected in the primary population and cover a median of 2 months of safety data. The investigators plan to continue to follow the participants, although once the treatment becomes freely available, maintaining randomization may be a challenge.The results were impressive. In the primary analysis, only 8 cases of buy antibiotics were seen in the treatment group, as compared with 162 in the placebo group, for an overall efficacy of 95% (with a 95% credible interval of 90.3 to 97.6%).

Although the trial does not have the statistical power to assess subgroups, efficacy appeared to be similar in low-risk and high-risk persons, including some from communities that have been disproportionately affected by disease, and in participants older than 55 years of age and those younger than 55. Adverse events were largely consistent with treatment reactogenicity, with mostly transient and mild local reactions such as injection-site pain and erythema. Systemic reactions such as fever, fatigue, and adenopathy were uncommon. This pattern appears to be similar to that of other viral treatments and, at least with this number of participants and this follow-up period, does not arouse specific concern.There are nonetheless minor issues.

The number of severe cases of buy antibiotics (one in the treatment group and nine in the placebo group) is too small to draw any conclusions about whether the rare cases that occur in vaccinated persons are actually more severe. For practical reasons, the investigators relied on trial participants to report symptoms and present for testing. Since reactogenicity was more common in treatment recipients, it is possible that they were less inclined to believe that minor symptoms were due to buy antibiotics and therefore less likely to refer themselves for testing. And some important data, such as the rate of asymptomatic disease (as measured by seroconversion to a viral nucleoprotein that is not a component of the treatment), have not yet been reported.Nevertheless, the trial results are impressive enough to hold up in any conceivable analysis.

This is a triumph. Most treatments have taken decades to develop, but this one is likely to move from conception to large-scale implementation within a year. The sequence of the cipro that led to the development of the specific viral RNA sequence required to design the treatment didn’t become known until it had been determined and widely disseminated by the Chinese Center for Disease Control and Prevention in January 2020. There is a lot of credit to go around.

To the scientists who shared data and who developed the underlying methods and implemented them to create a treatment, to the clinical trialists who performed high-quality work in the setting of a health emergency, to the thousands of participants who volunteered to take part in the trial, and to the governments that helped create performance standards and a market for the treatment. And all this stands as a template for the many other buy antibiotics treatments currently in development, some of which have already completed their phase 3 trials.Important questions of course remain. Only about 20,000 people have received this treatment. Will unexpected safety issues arise when the number grows to millions and possibly billions of people?.

Will side effects emerge with longer follow-up?. Implementing a treatment that requires two doses is challenging. What happens to the inevitable large number of recipients who miss their second dose?. How long will the treatment remain effective?.

Does the treatment prevent asymptomatic disease and limit transmission?. And what about the groups of people who were not represented in this trial, such as children, pregnant women, and immunocompromised patients of various sorts?. The logistic challenges of manufacturing and delivering a treatment remain daunting. This treatment, in particular, requires storage at −70°C, a factor that may limit its deployment in some areas.

Nevertheless, the remarkable level of safety and efficacy the treatment has demonstrated thus far make this a problem that we should welcome solving. What appears to be a dramatic success for vaccination holds the promise of saving uncounted lives and giving us a pathway out of what has been a global disaster.Design The ACTT-2 protocol was designed and written by a working group of the ACTT investigators and the sponsor (the National Institute of Allergy and Infectious Diseases), with input from the manufacturer of baricitinib, Eli Lilly. Investigators and staff at participating sites gathered the data, which were then analyzed by statisticians at the statistical and data center (Emmes) and the sponsor. The authors wrote the manuscript, and, on behalf of the ACTT-2 Study Group, vouch for the accuracy and completeness of the data and for the fidelity of the trial to the protocol.

Enrollment into this double-blind, placebo-controlled trial began on May 8, 2020, and ended on July 1, 2020. There were 67 trial sites in 8 countries. The United States (55 sites), Singapore (4), South Korea (2), Mexico (2), Japan (1), Spain (1), the United Kingdom (1), and Denmark (1). Eligible patients were randomly assigned in a 1:1 ratio to receive either remdesivir and baricitinib or remdesivir and placebo.

Randomization was stratified according to trial site and disease severity at enrollment (see the Supplementary Appendix, available with the full text of this article at NEJM.org). Patients received remdesivir intravenously as a 200-mg loading dose on day 1, followed by a 100-mg maintenance dose administered daily on days 2 through 10 or until hospital discharge or death. Baricitinib was administered as a 4-mg daily dose (either orally [two 2-mg tablets] or through a nasogastric tube) for 14 days or until hospital discharge. Patients with an estimated glomerular filtration rate of less than 60 ml per minute received baricitinib at a dose of 2 mg once daily.

A matching oral placebo was administered according to the same schedule as the active drug. All the patients received standard supportive care at the trial site hospital. Venous thromboembolism prophylaxis was recommended for all the patients without a major contraindication. If a hospital had a written policy for buy antibiotics treatments, patients could receive those treatments.

In the absence of a written policy, other experimental treatment and off-label use of marketed medications intended as specific treatment for buy antibiotics were prohibited. This included glucocorticoids, which were permitted only for standard indications such as adrenal insufficiency, asthma exacerbation, laryngeal edema, septic shock, and acute respiratory distress syndrome. The trial protocol was approved by the institutional review board at each site (or a centralized institutional review board as applicable) and was overseen by an independent data and safety monitoring board. Written informed consent was obtained from each patient or from the patient’s legally authorized representative if the patient was unable to provide consent.

Full details of the trial design, conduct, oversight, and analyses are provided in the protocol and statistical analysis plan (available at NEJM.org). Procedures All patients were evaluated daily during their hospitalization, from day 1 through day 29. (See the full description of procedures in the Supplementary Appendix.) The trial team was unaware of the trial-group assignments until after all data queries were resolved and the database was locked. The first draft of the manuscript was written by the first author, and then all the authors contributed to the subsequent versions.

No one who is not an author contributed to the writing of the manuscript. Outcomes and Statistical Analysis The primary outcome measure was the time to recovery, with the day of recovery defined as the first day, during the 28 days after enrollment, on which a patient attained category 1, 2, or 3 on the eight-category ordinal scale. The competing event of death was handled in a manner similar to the Fine–Gray competing-risk approach.13 The categories are the same as those used in ACTT-11 and are listed in Table S1 in the Supplementary Appendix. The primary analysis was a stratified log-rank test of the time to recovery with remdesivir plus baricitinib as compared with remdesivir plus placebo, stratified according to baseline disease severity (i.e., score on the ordinal scale of 4 or 5 vs.

6 or 7 at enrollment). The key secondary outcome measure was clinical status at day 15, based on the eight-category ordinal scale. Other secondary outcome measures included the time to improvement by one or two categories from the ordinal score at baseline. Clinical status, as assessed on the ordinal scale at days 3, 5, 8, 11, 15, 22, and 29.

Mean change in the ordinal score from day 1 to days 3, 5, 8, 11, 15, 22, and 29. Time to discharge or to a National Early Warning Score of 2 or less (on a scale from 0 to 20, with higher scores indicating greater clinical risk) that was maintained for 24 hours, whichever occurred first. Change in the National Early Warning Score from day 1 to days 3, 5, 8, 11, 15, 22, and 29. Number of days of receipt of supplemental oxygen, noninvasive ventilation or high-flow oxygen, and invasive ventilation or extracorporeal membrane oxygenation (ECMO) up to day 29 (if these were being used at baseline).

The incidence and duration of new use of oxygen, new use of noninvasive ventilation or high-flow oxygen, and new use of invasive ventilation or ECMO. Duration of hospitalization up to day 29 (patients who remained hospitalized at day 29 had a value of 28 days). And mortality at 14 and 28 days after enrollment. Secondary safety outcomes included grade 3 and 4 adverse events and serious adverse events that occurred through day 29, discontinuation or temporary suspension of trial-product administration for any reason, and changes in assessed laboratory values over time.

There was a single primary hypothesis test. For secondary outcomes, no adjustments for multiplicity were made.

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Shutterstock A new Can i buy levitra online report by Kaufman, Hall & cipr national conference. Associates, LLC has found that the buy antibiotics cipro will cipr national conference continue to affect the financial health of hospitals and health systems through 2021. The report released by the American Hospital Association (AHA) Wednesday forecasts total hospital revenue in 2021 could be down by between $53 billion and $122 billion compared to pre-cipro levels.

The financial cipr national conference pressure, the report said, could jeopardize hospital’s ability to care for their communities during the cipro, resulting in a slowdown in treatment distribution and administration, continued pressure on front-line caregivers, and diminished access to care. €œWhen we talk about the historic financial challenges hospitals face, it’s about more than dollars and cents, it’s really about making sure hospitals and health systems have the resources needed to provide essential services for their patients and communities,” AHA President and CEO Rick Pollack said. €œDuring the cipro, people have put off needed care, in some cases cipr national conference to the detriment of their health.

In addition, the costs of labor and supplies have increased, adding to financial stress. treatments give us hope that the end is in sight, but hospitals need additional support to continue to provide access to care and to help get as many treatment shots into arms quickly.”If hospitals experience a consistent and complete recovery of patient volumes, and treatment distribution and administration go smoothly, and the country continues to see a drop in buy antibiotics cases, hospitals and health systems would face $53 billion cipr national conference in total revenue losses this year. However, if patient volumes recover slowly, treatment rollouts continue to face logistical challenges and delays, and the country sees more buy antibiotics surges, hospitals could face a total of $122 billion in lost revenue.In 2020, an AHA report found that hospitals and health systems lost at least $323.1 billion due to patient volume decreases and buy antibiotics.

At least four dozen hospitals entered bankruptcy or closed in 2020, according cipr national conference to Bloomberg.Shutterstock U.S. Reps. David Kustoff (R-TN) and Abigail Spanberger (D-VA) re-introduced the Criminalizing cipr national conference Abused Substance Templates (CAST) Act Wednesday.

The legislation would modify the Controlled Substances Act to define the criminal penalty for making counterfeit drugs using a pill press. Currently, the cipr national conference law bans the practice but doesn’t define the penalty for doing so. The CAST Act would make possessing a pill press with the intent to make counterfeit schedule I or II substances a crime and establish a sentence of up to 20 years for possession alone.

€œThe opioid epidemic has ravaged cipr national conference our communities in West Tennessee and across our nation. Unfortunately, as we continue to battle buy antibiotics, the opioid crisis has only grown worse. We owe it cipr national conference to our loved ones to take stronger action to fight back against this public health emergency.

The CAST Act is the much-needed, bold step forward in this fight,” Kustoff said. €œIt will increase penalties against possession of harmful drugs and pill press molds, helping to combat the illegal drug market and the dangers it presents to our citizens and our brave law enforcement officers across cipr national conference the nation.”The Congressmembers said the law would prevent overdoses and reduce fentanyl-related deaths. €œFamilies, businesses, and entire communities in Virginia continue to face immense challenges due to opioid abuse.

As this public health crisis significantly worsens as a result of the buy antibiotics cipro, we also face the cipr national conference threat of extremely dangerous substances — such as fentanyl — being pressed into illicit pills and sold on our streets,” said Spanberger. €œThis bill would help crackdown on the production of counterfeit drugs via illicit pill press molds. By deterring drug traffickers and those who produce illicit drugs, we would take another step cipr national conference in the fight against fentanyl-related deaths.”Shutterstock U.S.

Sen. Dick Durbin cipr national conference (D-IL), Senate Democratic whip and Senate Judiciary Committee chairman, recently spoke about the dramatic increase in suicides and opioid overdose deaths associated with the buy antibiotics cipro.“While the human suffering of buy antibiotics has captured our attention, as it should, two other deadly epidemics in America still rage on. Opioids and the mental health crises,” Durbin said.

€œEven before the cipro took its toll, we cipr national conference had been in the midst of the worst drug overdose crisis in our nation’s history, and we’re witnessing skyrocketing rates of suicide, but buy antibiotics has deepened these epidemics, which sadly feed on isolation and despair. With the convergence of antibiotics emergencies, we are failing those most vulnerable to addiction and mental health challenges.” Durbin spoke about a Lake County, Ill., resident who struggled with substance use disorder and committed suicide after being unable to access treatment and about the increase in suicides among African-American residents in Cook County, Ill.In 2020, 437 Cook County residents committed suicide, and more than 700 died from opioid overdoses between January and June 2020. The opioid cipr national conference death rate is double 2019’s rate.

Durbin also urged support for President Joe Biden’s American Rescue Plan, which includes nearly $4 billion in addiction and mental health treatment grants.Shutterstock The Delaware Department of Health and Social Services plans to offer a training program on treating opioid use disorder (OUD) among Medicaid recipients. The program is open to medical providers and practice managers in psychiatry, primary care, infectious diseases, cipr national conference and women’s health.The Office-Based Opioid Treatment (OBOT) Fellowship Program will offer webinars, self-paced modules, and weekly discussion groups from March 23 through Sept. 23.

Participants will learn about the available Medicaid financing mechanisms for OBOT, receive technical assistance to offer OBOT, exchange ideas, and access a curated online library of tools and evidence-based practices.The program will be taught by addiction-medicine experts and will be offered in two phases.OBOT involves prescribing safe, effective, Food and Drug Administration-approved medications to treat OUD “Opioid addiction is an ongoing and often deadly presence for many Delawareans and their families, and we need every tool at our disposal to help them confront it,” cipr national conference Gov. John Carney said. €œEquipping our medical providers to manage the treatment of these patients is an important part cipr national conference of this effort.”The U.S.

Department of Health and Human Services’ Centers for Medicare and Medicaid Services supports the program through a $3.58 million grant awarded to the state.Shutterstock Pennsylvania’s Senate Labor and Industry Committee recently advanced legislation that aims to reduce opioid dependency.Senate Bill 147 would amend the Workers’ Compensation Act of 1915 to require employers who have a certified safety committee to provide employees with information about the consequences of addiction, including opioid painkillers.Under Pennsylvania’s Workers’ Compensation Law, employers receive a 5 percent discount on their workers’ compensation insurance premium if they establish a certified safety committee. The bill cipr national conference would require employers to incorporate addiction risks to receive certification and the discount. The Department of Labor and Industry would develop and make available the information.State Sen.

Wayne Langerholc cipr national conference (R-Bedford and Cambria counties) introduced the bill. It was one of five bills approved by the committee addressing workplace issues.“Pennsylvanians face a much greater risk of mental health challenges during the buy antibiotics cipro, so combatting the addiction crisis has never been more important than right now,” state Sen. Camera Bartolotta (R-Carroll), committee chairwoman, cipr national conference said.

€œThese bills accomplish the key goals of providing a pathway for individuals in recovery to find quality jobs to rebuild their lives, while also making sure more Pennsylvanians do not fall victim to addiction.”The bill was originally introduced in May 2020..

Shutterstock A Can i buy levitra online new report by Kaufman, buy cipro online Hall &. Associates, LLC has found that buy cipro online the buy antibiotics cipro will continue to affect the financial health of hospitals and health systems through 2021. The report released by the American Hospital Association (AHA) Wednesday forecasts total hospital revenue in 2021 could be down by between $53 billion and $122 billion compared to pre-cipro levels.

The financial pressure, the report buy cipro online said, could jeopardize hospital’s ability to care for their communities during the cipro, resulting in a slowdown in treatment distribution and administration, continued pressure on front-line caregivers, and diminished access to care. €œWhen we talk about the historic financial challenges hospitals face, it’s about more than dollars and cents, it’s really about making sure hospitals and health systems have the resources needed to provide essential services for their patients and communities,” AHA President and CEO Rick Pollack said. €œDuring the cipro, people have put off needed care, in buy cipro online some cases to the detriment of their health.

In addition, the costs of labor and supplies have increased, adding to financial stress. treatments give us hope that the end is in sight, but hospitals need additional support to continue to provide access to care and to help buy cipro online get as many treatment shots into arms quickly.”If hospitals experience a consistent and complete recovery of patient volumes, and treatment distribution and administration go smoothly, and the country continues to see a drop in buy antibiotics cases, hospitals and health systems would face $53 billion in total revenue losses this year. However, if patient volumes recover slowly, treatment rollouts continue to face logistical challenges and delays, and the country sees more buy antibiotics surges, hospitals could face a total of $122 billion in lost revenue.In 2020, an AHA report found that hospitals and health systems lost at least $323.1 billion due to patient volume decreases and buy antibiotics.

At least four dozen hospitals entered buy cipro online bankruptcy or closed in 2020, according to Bloomberg.Shutterstock U.S. Reps. David Kustoff (R-TN) and Abigail Spanberger (D-VA) re-introduced the Criminalizing Abused Substance Templates buy cipro online (CAST) Act Wednesday.

The legislation would modify the Controlled Substances Act to define the criminal penalty for making counterfeit drugs using a pill press. Currently, the law bans buy cipro online the practice but doesn’t define the penalty for doing so. The CAST Act would make possessing a pill press with the intent to make counterfeit schedule I or II substances a crime and establish a sentence of up to 20 years for possession alone.

€œThe opioid epidemic has buy cipro online ravaged our communities in West Tennessee and across our nation. Unfortunately, as we continue to battle buy antibiotics, the opioid crisis has only grown worse. We owe it to our loved ones to take stronger action to fight back buy cipro online against this public health emergency.

The CAST Act is the much-needed, bold step forward in this fight,” Kustoff said. €œIt will increase buy cipro online penalties against possession of harmful drugs and pill press molds, helping to combat the illegal drug market and the dangers it presents to our citizens and our brave law enforcement officers across the nation.”The Congressmembers said the law would prevent overdoses and reduce fentanyl-related deaths. €œFamilies, businesses, and entire communities in Virginia continue to face immense challenges due to opioid abuse.

As this public health crisis significantly worsens as a result of the buy antibiotics cipro, we also face the threat of extremely dangerous substances — buy cipro online such as fentanyl — being pressed into illicit pills and sold on our streets,” said Spanberger. €œThis bill would help crackdown on the production of counterfeit drugs via illicit pill press molds. By deterring drug traffickers and those who produce illicit drugs, we would take another step in buy cipro online the fight against fentanyl-related deaths.”Shutterstock U.S.

Sen. Dick Durbin (D-IL), Senate Democratic whip and Senate Judiciary Committee chairman, recently spoke about the dramatic increase in suicides and opioid overdose deaths associated buy cipro online with the buy antibiotics cipro.“While the human suffering of buy antibiotics has captured our attention, as it should, two other deadly epidemics in America still rage on. Opioids and the mental health crises,” Durbin said.

€œEven before the cipro took its toll, we had been in the midst of the worst drug overdose crisis in our nation’s history, and we’re witnessing skyrocketing rates of suicide, but buy antibiotics has deepened these buy cipro online epidemics, which sadly feed on isolation and despair. With the convergence of antibiotics emergencies, we are failing those most vulnerable to addiction and mental health challenges.” Durbin spoke about a Lake County, Ill., resident who struggled with substance use disorder and committed suicide after being unable to access treatment and about the increase in suicides among African-American residents in Cook County, Ill.In 2020, 437 Cook County residents committed suicide, and more than 700 died from opioid overdoses between January and June 2020. The opioid death rate is double 2019’s buy cipro online rate.

Durbin also urged support for President Joe Biden’s American Rescue Plan, which includes nearly $4 billion in addiction and mental health treatment grants.Shutterstock The Delaware Department of Health and Social Services plans to offer a training program on treating opioid use disorder (OUD) among Medicaid recipients. The program is open to buy cipro online medical providers and practice managers in psychiatry, primary care, infectious diseases, and women’s health.The Office-Based Opioid Treatment (OBOT) Fellowship Program will offer webinars, self-paced modules, and weekly discussion groups from March 23 through Sept. 23.

Participants will learn about the available Medicaid financing mechanisms for OBOT, receive technical assistance to offer OBOT, exchange ideas, and access buy cipro online a curated online library of tools and evidence-based practices.The program will be taught by addiction-medicine experts and will be offered in two phases.OBOT involves prescribing safe, effective, Food and Drug Administration-approved medications to treat OUD “Opioid addiction is an ongoing and often deadly presence for many Delawareans and their families, and we need every tool at our disposal to help them confront it,” Gov. John Carney said. €œEquipping our medical providers to manage the buy cipro online treatment of these patients is an important part of this effort.”The U.S.

Department of Health and Human Services’ Centers for Medicare and Medicaid Services supports the program through a $3.58 million grant awarded to the state.Shutterstock Pennsylvania’s Senate Labor and Industry Committee recently advanced legislation that aims to reduce opioid dependency.Senate Bill 147 would amend the Workers’ Compensation Act of 1915 to require employers who have a certified safety committee to provide employees with information about the consequences of addiction, including opioid painkillers.Under Pennsylvania’s Workers’ Compensation Law, employers receive a 5 percent discount on their workers’ compensation insurance premium if they establish a certified safety committee. The bill would require employers to incorporate addiction risks to receive certification and the buy cipro online discount. The Department of Labor and Industry would develop and make available the information.State Sen.

Wayne Langerholc (R-Bedford and Cambria buy cipro online counties) introduced the bill. It was one of five bills approved by the committee addressing workplace issues.“Pennsylvanians face a much greater risk of mental health challenges during the buy antibiotics cipro, so combatting the addiction crisis has never been more important than right now,” state Sen. Camera Bartolotta (R-Carroll), committee chairwoman, buy cipro online said.

€œThese bills accomplish the key goals of providing a pathway for individuals in recovery to find quality jobs to rebuild their lives, while also making sure more Pennsylvanians do not fall victim to addiction.”The bill was originally introduced in May 2020..

What is Cipro?

CIPROFLOXACIN is a quinolone antibiotic. It can kill bacteria or stop their growth. It is used to treat many kinds of s, like urinary, respiratory, skin, gastrointestinal, and bone s. It will not work for colds, flu, or other viral s.

How long does cipro stay in the body

GREAT FALLS, how long does cipro stay in the body Mont http://santabarbarakoi.net/?page_id=2. €” For months, the jail in central Montana’s Cascade County was free of the antibiotics, which seemed as distant a threat as it did in much of the nation’s rural Mountain West.Then a few people who had the cipro were arrested. By the time Paul Krogue, the jail’s medical director, realized there was a problem, nearly 50 inmates were infected in the jail, where some had been sleeping on mats on an overcrowded floor. After several how long does cipro stay in the body weeks, Mr.

Krogue got a call that s were spreading to a side of the jail that had been cipro-free.He hung up the phone and put his head in his hands.“I just kind of lost it, like, ‘My God, I don’t know how much longer I can do this,’” Mr. Krogue, a nurse practitioner, recalled. €œI was just scared that I’m not going to be able to see it through, that I’m going to get sick — you just feel so exhausted and it’s just a lot.”The Mountain West, which for months avoided the worst of the cipro, has rapidly devolved into one of the most alarming hot spots in a country that recorded its eight millionth confirmed case on Thursday, a day when more than 65,000 cases were announced nationwide, the most in a single day since July.Seventeen states, including many in the Mountain West, have added more cases in the past week than any how long does cipro stay in the body other week of the cipro. And the spread through sparsely populated areas of rural America has created problems in small towns that lack critical resources — including doctors — even in ordinary times.Wyoming, which did not have 1,000 total cases until June, recently added more than 1,000 in a single week.

Reports of new s have recently reached record levels in Alaska, Colorado and Idaho. And Montana, where more than half of the state’s cases have been announced since how long does cipro stay in the body August, is averaging more than 500 cases per day.In Cascade County, more than 300 inmates and staff members have been infected in a facility meant to hold 365 people, the county’s first major outbreak in a region where the cipro is suddenly surging.The county seat, Great Falls, is seeing its worst case numbers yet. The local hospital and its 27-bed buy antibiotics unit is at capacity. The county health department is racing to hire new contact tracers.

And Mr how long does cipro stay in the body. Krogue, who also teaches nursing at Montana State University’s Great Falls campus, has seen attendance in his classes dwindle as students fall ill or quarantine.“I was just scared that I’m not going to be able to see it through, that I’m going to get sick,” said Paul Krogue, the jail’s medical director.Credit...Tailyr Irvine for The New York TimesOne place where the s have spread has been local jails, which are confined, often crowded spaces. Jails are staples of local communities and tend to have people coming and going more quickly than prisons. Jails can how long does cipro stay in the body hold everyone from people awaiting criminal trials for months to those picked up for a suspended driver’s license for a few hours.

With so many people filtering in and out, jails pose extra risks for the cipro’s spread — not only inside facilities but in potentially feeding outbreaks in the rest of the community.Nationally, jails and prisons have seen disproportionate rates of and death, with a mortality rate twice as high as in the general population and an rate more than four times as high, according to recent data. #styln-briefing-block { font-family. Nyt-franklin,helvetica,arial,sans-serif. Background-color.

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100%. } } Latest Updates. The antibiotics Outbreak 7h ago Senate Republicans push narrow stimulus bills as Pelosi and Mnuchin resume talks. 9h ago A frozen yogurt shop in Colorado offered maskless customers a 10 percent discount.

Uproar ensued. 11h ago An at Pope Francis’ residence adds to concerns for his safety. See more updates More live coverage. Markets A New York Times database has tracked clusters of at least 50 antibiotics cases in a dozen rural jails in Montana, Idaho, Utah and New Mexico during the cipro.

Among them. The Purgatory Correctional Center in Hurricane, Utah, with 166 s. The jail in Twin Falls, Idaho, with 279. And, in New Mexico, the Cibola County Correctional Center, which has reported 357 cases.In Cascade County, s at the jail make up about a quarter of all known cipro cases in the county.

Health authorities say that the jail’s outbreak, which began in mid-August, was not believed to be the main cause of the community’s recent surge, but that it had led to some cases. In the past two months, Mr. Krogue said, the jail released 29 people who were considered actively infected.s at the jail make up about a quarter of Cascade County’s known cipro cases.Credit...Tailyr Irvine for The New York TimesGreat Falls, home to about 58,000 residents, is in the less mountainous part of Montana, with the Missouri River flowing through and a large oil refinery on its banks. The Cascade County Detention Center sits along a highway at the edge of town.

Drive five miles in any direction and you are surrounded by wide-open plains.Montana requires that masks be worn inside businesses and indoor public spaces, and many people in Great Falls wear them when walking around downtown’s Central Avenue, where shops and cafes are still recovering from shutting down in the spring. Others go without masks, citing the open space and lack of crowds.Bob Kelly, the mayor, said people had not been overly worried about how the jail outbreak might affect the rest of town when it started.“I think that by the very definition of a jail, hopefully, the disease will be incarcerated, as well as the patients,” he said. €œIs there concern?. Sure, there’s concern.

But is there overreaction?. No.”The mayor of Great Falls said that residents had considered the jail’s outbreak a distant concern at first.Credit...Tailyr Irvine for The New York TimesSome residents’ nonchalance about the risks of the cipro, said Mr. Krogue, the jail’s medical director, can be traced to a spring and early summer when almost no one in Cascade County knew anyone who had been sickened.“We benefited from that early on,” he said. €œBut in some ways, I think it did us a disservice, too, because it also created a certain level of complacency.”That has quickly shifted now, he said, as cases have spiked.The number of active cases known to county officials on any given day has risen sharply to about 600, according to Trisha Gardner, Cascade County’s health officer.

The county has seen 1,261 cases and six deaths during the cipro, a Times database shows. Some of the cases have been tied to the jail outbreak, she said, and others have been connected to bars and restaurants. Even figuring out what has led to some cases has been complex, she said, as residents have been reluctant to cooperate with contact tracers.“Our hospitals are at capacity, our public health system is at capacity,” she said. €œIt’s not sustainable at this rate.”When the outbreak at the jail began, social distancing was impossible, the authorities said.

Three inmates shared cells designed for two. At night, men slept on thin blue pads in every available space. On the floor in the day room, in shower stalls, in stairwells, in hallways outside of cells.Inmates did not receive masks until August, and jail officials said many have refused to wear them.In interviews with more than a dozen inmates and their family members, inmates described the jail during the outbreak as chaotic and unsanitary. They said their pleas for help often went unanswered by nurses and guards.Newly arriving inmates were not always quarantined from one another before their test results were known because of a lack of space, inmates and jail officials said.Owen Hawley, 30, said every inmate in his living area of 38 men had tested positive for the cipro.

He said he had been unable to eat for three days, had intensive body aches and suffered from a headache so powerful it felt as if it was “behind my eyes.”“After the fourth day of like, not eating and stuff, I just shut off, you know?. € he said.A jail area set aside for quarantining new inmates.Credit...Tailyr Irvine for The New York TimesAt one point, Mr. Hawley said, he and other prisoners protested the way the cipro was being handled by refusing to leave their living areas and by blocking new inmates from entering. Everyone was ultimately tested, Mr.

Hawley said, and each prisoner was given a disposable mask.Sierra Jasmine Wells, 25, another inmate, said women in her dormitory had grown ill, one after the next.“Everyone around me was getting sick and it was tough on me,” she said. €œBy then, I had already accepted the fact that I was going to get sick.”When she became infected, she said, she was given cough syrup and Tylenol.“I kind of was just left alone to deal with it,” she said.Jesse Slaughter, the county sheriff who oversees the jail, said that the jail’s medical staff was doing everything it could, and that he had been seeking health care assistance from other counties. Officials defended their handling of the outbreak, noting that all inmates received standard medications including Tylenol twice a day and were taken to area hospitals when they needed added care. Seven inmates, as well as some staff members, were hospitalized.

No one from the jail has died from the cipro, officials said.Sheriff Jesse Slaughter, who oversees the jail, said he had been seeking health care assistance from other counties.Credit...Tailyr Irvine for The New York TimesMr. Krogue said that since the start of the outbreak he had been working up to 16 hours each day and sleeping in his basement, away from his wife and children. He remains healthy but says he fears bringing the cipro home. The cipro has slowed some in the jail, and officials have moved some inmates to other facilities, but other prisons and jails in the state are now seeing outbreaks.“You can start to see what some of these other places experienced much earlier on, and we just didn’t have that experience, but it’s certainly happening now,” Mr.

Krogue said. €œIt’s just real in a way that it wasn’t.”Lucy Tompkins reported from Great Falls, Maura Turcotte from Chicago and Libby Seline from Lincoln, Neb. Reporting was contributed by Izzy Colón from Columbia, Mo., Brendon Derr from Phoenix, Rebecca Griesbach from Tuscaloosa, Ala., Danya Issawi and Timothy Williams from New York, Ann Hinga Klein from Des Moines, K.B. Mensah from Silver Spring, Md., and Mitch Smith from Chicago.Start Preamble Federal Transit Administration (FTA), DOT.

Notice of where can i buy cipro over the counter usa funding opportunity. The antibiotics Disease 2019 (buy antibiotics) public health emergency Start Printed Page 63654has had a significant impact on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of buy antibiotics. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency.

Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis.

(2) exposure mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit services. The total funding available for awards under this NOFO is $10,000,000.

FTA may supplement this amount if additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV “APPLY” function by 11:59 p.m. Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure they can complete the application process before the submission deadline.

Application instructions are available on FTA's website at http://transit.dot.gov/​howtoapply and in the “FIND” module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further Info Please send any questions on this notice to Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone.

2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description B.

Federal Award Information C. Eligibility Information D. Application and Submission Information E. Application Review Information F.

Federal Award Administration Information G. Federal Awarding Agency Contact Information A. Program Description The Public Transportation buy antibiotics Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency.

Eligible projects will propose to develop and deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures. (3) innovative mobility such as contactless payments.

And (4) measures that strengthen public confidence in transit. As required by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects. B.

Federal Award Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 U.S.C. 5312) to finance the Public Transportation buy antibiotics Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on the date of the project award announcement for selected projects and should be completed within 24 months from the date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C.

5311) formula funds, and Indian tribes. Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developed—typically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit consolidated proposals for projects in urbanized areas.

The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients. Eligible subrecipients include public agencies, private nonprofit organizations, and private providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects.

(2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration to applicants that propose a local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application. For any applicants proposing match, eligible local match sources include the following.

Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture financing mechanisms. Funds from an undistributed cash surplus.

Replacement or depreciation cash fund or reserve. New capital. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for.

Vehicle, facility, equipment and infrastructure cleaning and dis. Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as contactless payments. And measures that strengthen public confidence in transit.

Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV. Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/​howtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted.

(2) Content and Form of Application Submission a. Proposal Submission A complete proposal submission consists of at least two forms. 1. The SF-424 Mandatory Form (downloadable from GRANTS.GOV) and 2.

The supplemental form for the FY 2020 buy antibiotics Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA buy antibiotics Demonstration Program). The application must include responses to all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying degrees of detail on both the SF-424 form and supplemental form.

Applicants must fill in all fields unless stated otherwise on the forms. If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the “Check Package for Errors” and the “Validate Form” validation buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent.

Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S. Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B.

Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I. Applicant Name ii. Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii.

Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v. Project Information (title, executive summary, and type) vi. A detailed description of the need for the project vii.

A detailed description of how the project will support the Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x. A detailed project budget xi.

Details on the local matching funds xii. A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to. (1) Be registered in SAM before submitting an application.

(2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA. These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c).

Or (2) has an exception approved by FTA under 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant. All applicants must provide a unique entity identifier provided by SAM.

Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov.

(4) Submission Dates and Times Project proposals must be submitted electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted. FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission.

Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control. Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV.

(1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV. If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline. If making a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission.

Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline. Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration before submitting an application. Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions.

(5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements.

The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E. Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage.

Consistent with the R.O.U.T.E.S. Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria.

(a) Project Innovation and Impact. (b) Project Approach. (c) National Applicability. (d) Commercialization and/or Knowledge Transfer.

And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A. Project Innovation and Impact i.

Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii.

Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i. Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners.

Ii. Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C. National Applicability i.

Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii. Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii.

Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i. Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.).

Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii. Demonstrate a clear understanding and robust approach to data collection, access and management.

E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria.

Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application. The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration.

The FTA Administrator will consider the following key DOT objectives. A. Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment. B.

Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1. And c. The extent to which the project addresses challenges specific to the provision of rural public transportation.

(3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F.

Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects. There is no blanket pre-award authority for these projects before announcement.

There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible. FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded.

(2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection. FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/​content/​pkg/​FR-2020-06-03/​pdf/​2020-11946.pdf.

510px http://www.ec-aschbach.ac-strasbourg.fr/2020/02/09/projet-4-quand-je-serai-grande-je-serai-docteure-ou-infirmier-et-infirmiere-japprends-a-connaitre-mon-corps-et-a-en-prendre-soin-je-prends-soin-des-poupees-dans-le-cabinet-medical-de-la-cla/ buy cipro online. Width. Calc(100% - 40px). Border-top. 5px solid #121212.

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100%. } } Latest Updates. The antibiotics Outbreak 7h ago Senate Republicans push narrow stimulus bills as Pelosi and Mnuchin resume talks. 9h ago A frozen yogurt shop in Colorado offered maskless customers a 10 percent discount. Uproar ensued.

11h ago An at Pope Francis’ residence adds to concerns for his safety. See more updates More live coverage. Markets A New York Times database has tracked clusters of at least 50 antibiotics cases in a dozen rural jails in Montana, Idaho, Utah and New Mexico during the cipro. Among them. The Purgatory Correctional Center in Hurricane, Utah, with 166 s.

The jail in Twin Falls, Idaho, with 279. And, in New Mexico, the Cibola County Correctional Center, which has reported 357 cases.In Cascade County, s at the jail make up about a quarter of all known cipro cases in the county. Health authorities say that the jail’s outbreak, which began in mid-August, was not believed to be the main cause of the community’s recent surge, but that it had led to some cases. In the past two months, Mr. Krogue said, the jail released 29 people who were considered actively infected.s at the jail make up about a quarter of Cascade County’s known cipro cases.Credit...Tailyr Irvine for The New York TimesGreat Falls, home to about 58,000 residents, is in the less mountainous part of Montana, with the Missouri River flowing through and a large oil refinery on its banks.

The Cascade County Detention Center sits along a highway at the edge of town. Drive five miles in any direction and you are surrounded by wide-open plains.Montana requires that masks be worn inside businesses and indoor public spaces, and many people in Great Falls wear them when walking around downtown’s Central Avenue, where shops and cafes are still recovering from shutting down in the spring. Others go without masks, citing the open space and lack of crowds.Bob Kelly, the mayor, said people had not been overly worried about how the jail outbreak might affect the rest of town when it started.“I think that by the very definition of a jail, hopefully, the disease will be incarcerated, as well as the patients,” he said. €œIs there concern?. Sure, there’s concern.

But is there overreaction?. No.”The mayor of Great Falls said that residents had considered the jail’s outbreak a distant concern at first.Credit...Tailyr Irvine for The New York TimesSome residents’ nonchalance about the risks of the cipro, said Mr. Krogue, the jail’s medical director, can be traced to a spring and early summer when almost no one in Cascade County knew anyone who had been sickened.“We benefited from that early on,” he said. €œBut in some ways, I think it did us a disservice, too, because it also created a certain level of complacency.”That has quickly shifted now, he said, as cases have spiked.The number of active cases known to county officials on any given day has risen sharply to about 600, according to Trisha Gardner, Cascade County’s health officer. The county has seen 1,261 cases and six deaths during the cipro, a Times database shows.

Some of the cases have been tied to the jail outbreak, she said, and others have been connected to bars and restaurants. Even figuring out what has led to some cases has been complex, she said, as residents have been reluctant to cooperate with contact tracers.“Our hospitals are at capacity, our public health system is at capacity,” she said. €œIt’s not sustainable at this rate.”When the outbreak at the jail began, social distancing was impossible, the authorities said. Three inmates shared cells designed for two. At night, men slept on thin blue pads in every available space.

On the floor in the day room, in shower stalls, in stairwells, in hallways outside of cells.Inmates did not receive masks until August, and jail officials said many have refused to wear them.In interviews with more than a dozen inmates and their family members, inmates described the jail during the outbreak as chaotic and unsanitary. They said their pleas for help often went unanswered by nurses and guards.Newly arriving inmates were not always quarantined from one another before their test results were known because of a lack of space, inmates and jail officials said.Owen Hawley, 30, said every inmate in his living area of 38 men had tested positive for the cipro. He said he had been unable to eat for three days, had intensive body aches and suffered from a headache so powerful it felt as if it was “behind my eyes.”“After the fourth day of like, not eating and stuff, I just shut off, you know?. € he said.A jail area set aside for quarantining new inmates.Credit...Tailyr Irvine for The New York TimesAt one point, Mr. Hawley said, he and other prisoners protested the way the cipro was being handled by refusing to leave their living areas and by blocking new inmates from entering.

Everyone was ultimately tested, Mr. Hawley said, and each prisoner was given a disposable mask.Sierra Jasmine Wells, 25, another inmate, said women in her dormitory had grown ill, one after the next.“Everyone around me was getting sick and it was tough on me,” she said. €œBy then, I had already accepted the fact that I was going to get sick.”When she became infected, she said, she was given cough syrup and Tylenol.“I kind of was just left alone to deal with it,” she said.Jesse Slaughter, the county sheriff who oversees the jail, said that the jail’s medical staff was doing everything it could, and that he had been seeking health care assistance from other counties. Officials defended their handling of the outbreak, noting that all inmates received standard medications including Tylenol twice a day and were taken to area hospitals when they needed added care. Seven inmates, as well as some staff members, were hospitalized.

No one from the jail has died from the cipro, officials said.Sheriff Jesse Slaughter, who oversees the jail, said he had been seeking health care assistance from other counties.Credit...Tailyr Irvine for The New York TimesMr. Krogue said that since the start of the outbreak he had been working up to 16 hours each day and sleeping in his basement, away from his wife and children. He remains healthy but says he fears bringing the cipro home. The cipro has slowed some in the jail, and officials have moved some inmates to other facilities, but other prisons and jails in the state are now seeing outbreaks.“You can start to see what some of these other places experienced much earlier on, and we just didn’t have that experience, but it’s certainly happening now,” Mr. Krogue said.

€œIt’s just real in a way that it wasn’t.”Lucy Tompkins reported from Great Falls, Maura Turcotte from Chicago and Libby Seline from Lincoln, Neb. Reporting was contributed by Izzy Colón from Columbia, Mo., Brendon Derr from Phoenix, Rebecca Griesbach from Tuscaloosa, Ala., Danya Issawi and Timothy Williams from New York, Ann Hinga Klein from Des Moines, K.B. Mensah from Silver Spring, Md., and Mitch Smith from Chicago.Start Preamble Federal Transit Administration (FTA), DOT. Notice of funding opportunity. The antibiotics Disease 2019 (buy antibiotics) public health emergency Start Printed Page 63654has had a significant impact on transit operations.

During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of buy antibiotics. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency. Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas.

(1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit services. The total funding available for awards under this NOFO is $10,000,000.

FTA may supplement this amount if additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV “APPLY” function by 11:59 p.m. Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure they can complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/​howtoapply and in the “FIND” module of GRANTS.GOV.

FTA will not accept mail and fax submissions. Start Further Info Please send any questions on this notice to Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339.

End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description B. Federal Award Information C. Eligibility Information D. Application and Submission Information E.

Application Review Information F. Federal Award Administration Information find out here now G. Federal Awarding Agency Contact Information A. Program Description The Public Transportation buy antibiotics Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the buy antibiotics public health emergency.

Eligible projects will propose to develop and deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit.

As required by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects. B. Federal Award Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 U.S.C. 5312) to finance the Public Transportation buy antibiotics Research Demonstration Grant Program.

FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on the date of the project award announcement for selected projects and should be completed within 24 months from the date of award. Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C.

5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian tribes. Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developed—typically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit consolidated proposals for projects in urbanized areas.

The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients. Eligible subrecipients include public agencies, private nonprofit organizations, and private providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent.

FTA may give additional consideration to applicants that propose a local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application. For any applicants proposing match, eligible local match sources include the following. Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions.

Revenues generated from value capture financing mechanisms. Funds from an undistributed cash surplus. Replacement or depreciation cash fund or reserve. New capital. Or in-kind contributions.

(3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning and dis. Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as contactless payments. And measures that strengthen public confidence in transit.

Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV. Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/​howtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission a.

Proposal Submission A complete proposal submission consists of at least two forms. 1. The SF-424 Mandatory Form (downloadable from GRANTS.GOV) and 2. The supplemental form for the FY 2020 buy antibiotics Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA buy antibiotics Demonstration Program). The application must include responses to all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional.

FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission. FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed.

Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying degrees of detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless stated otherwise on the forms. If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the “Check Package for Errors” and the “Validate Form” validation buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent.

Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S. Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B. Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including.

I. Applicant Name ii. Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v.

Project Information (title, executive summary, and type) vi. A detailed description of the need for the project vii. A detailed description of how the project will support the Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x.

A detailed project budget xi. Details on the local matching funds xii. A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to. (1) Be registered in SAM before submitting an application.

(2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA. These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception approved by FTA under 2 CFR 25.110(d).

FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant. All applicants must provide a unique entity identifier provided by SAM. Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant may need to obtain an Employer Identification Number.

FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov. (4) Submission Dates and Times Project proposals must be submitted electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted.

FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control. Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV.

(1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV. If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline. If making a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission. Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline.

Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration before submitting an application. Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements.

(6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements. The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E.

Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S. Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria.

(a) Project Innovation and Impact. (b) Project Approach. (c) National Applicability. (d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity.

FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A. Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii.

Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii. Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i.

Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii. Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C. National Applicability i.

Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii. Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes.

D. Commercialization and/or Knowledge Transfer i. Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.). Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable.

Iii. Demonstrate a clear understanding and robust approach to data collection, access and management. E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project.

(2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application. The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration.

The FTA Administrator will consider the following key DOT objectives. A. Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment. B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C.

1400Z-1. And c. The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered.

FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F. Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects.

There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible. FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded.

(2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection. FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/​content/​pkg/​FR-2020-06-03/​pdf/​2020-11946.pdf. b.

Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process. FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, “Third Party Contracting Guidance.” However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved. C.

Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D. Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant. The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project.

The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file. E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States. Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination.

The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation. And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget. In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS.

An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants. All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects. FTA may request data and reports to support the evaluation and Annual Report. A.

Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed buy antibiotics Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project. Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement.

Cipro and motrin

UC Davis Department of Psychology Professor and Chair http://cheaperhotels.dk/where-can-i-get-antabuse/ Susan Rivera has been named to the Interagency Autism Coordinating cipro and motrin Committee (IACC). Rivera is also a faculty member of the MIND Institute and the Center for Mind and Brain. She was appointed, along with 21 cipro and motrin others, by U.S. Secretary of Health and Human Services Xavier Becerra to a three-year term, which starts immediately.

Susan Rivera has been appointed to the Interagency Autism cipro and motrin Coordinating Committee.The IACC is a key advisory committee which includes public stakeholders and federal officials. It provides guidance and recommendations to the Secretary of Health and Human Services on autism research, services and policy.“I am honored to have the opportunity to serve on this committee,” said Rivera, who was nominated by Center for Mind and Brain Director, George (Ron) Mangun. MIND Institute Director Leonard Abbeduto also supported her nomination.“Being involved in formulating recommendations for autism research, services and policy holds deep meaning for cipro and motrin me. It provides a way of using the knowledge I’ve gained over my many years of conducting autism research and participating in advocacy efforts to help shape these agendas,” Rivera explained.

Rivera has been doing cipro and motrin scientific research on autism for two decades. Her lab uses brain imaging and eye tracking techniques to investigate how underlying brain activity and behavior support the development of skills like attention, visual perception, face processing, sensory processing and emotion regulation. These skills are necessary for adaptive cognitive and social-emotional well-being.A focus on neurodiversityThe new committee members include researchers like Rivera, autism self-advocates, parents and family members of those with autism, clinicians and representatives of service and advocacy groups, making it the largest and most diverse IACC yet.“I hope the work I do on the committee will both cipro and motrin help deepen the public’s understanding of autism, and positively impact the lives of individuals with autism.”— Susan RiveraRivera, who is devoted to championing the tenets of neurodiversity and advocacy to the public and academic communities, applauds the inclusion of more representatives from the autism community.“I’m very excited to see the significant number of self-advocates on the panel. Given the combination of individuals who can speak to the lived experiences of autism and researchers and clinicians that can speak to science and new discoveries in the field, I think the committee is well-poised to make significant progress in formulating recommendations for the Health and Human Services Secretary,” she said.Rivera noted that she’d like to see a shift toward more involvement from autism advocates in shaping research funding priorities.In addition to the 22 newest appointees, the IACC also includes 23 new and returning federal officials who represent federal agencies and departments that serve the autism community in areas such as biomedical research, education and health care.Rivera is not the first UC Davis MIND Institute faculty member to serve on the IACC.

David Amaral, distinguished professor in the Department of Psychiatry and Behavioral Sciences and Marjorie Solomon, professor of clinical psychiatry in the Department of Psychiatry and Behavioral Sciences and associate director of the MIND Institute, were on the committee previously.The appointment involves a significant time commitment and broad cipro and motrin duties, such as monitoring autism research, services and support activities, developing a summary of significant advances in these areas and making recommendations, as well as developing a strategic plan for the conduct of and support for autism research. Major projects include the IACC Strategic Plan for Autism Spectrum Disorder (ASD) and the Summary of Advances in ASD Research.For Rivera, it’s well worth the effort. €œI hope the work I do on the committee will both help deepen the public’s understanding of autism, and positively impact the lives of individuals with autism,” she said. The new IACC will hold its cipro and motrin first public meeting July 21-22.

The UC Davis MIND Institute in Sacramento, Calif. Was founded in 1998 as a cipro and motrin unique interdisciplinary research center where families, community leaders, researchers, clinicians and volunteers work together toward a common goal. Researching causes, treatments and potential prevention of neurodevelopmental disabilities. The institute has major research efforts cipro and motrin in autism, fragile X syndrome, chromosome 22q11.2 deletion syndrome, attention-deficit/hyperactivity disorder (ADHD) and Down syndrome.

More information about the institute and its Distinguished Lecturer Series, including previous presentations in this series, is available on the Web at mindinstitute.ucdavis.edu.When Jazlyn Estrella thinks of her father, she envisions him in the garage with his tools, creating something. Jazlyn Estrella’s earliest memories of her father, Ruther, involve him building things, such as a Star Wars costume.“He’s always working on cipro and motrin something,” she said of her father, Ruther Estrella. €œHe’s so artistic and, if he puts his mind to it, he can build anything.” She recalls a life-size replica of the R2-D2 droid he fabricated when she was young, along with several Star Wars costumes. Whenever Father’s Day arrived, she bought him tools cipro and motrin.

€œTools for whatever project he was working on, or a gift card to a store where he could buy more tools,” she laughed. Over the years his health deteriorated and for Father’s Day 2021, Jazlyn Estrella gave her dad something you cipro and motrin can’t buy. The 21-year-old donated one of her kidneys to him. The UC Davis Health transplant team cipro and motrin made it possible.

It was the best gift she could ever give. The hours he once spent in the garage had become hours connected to a dialysis machine. At the age of 47, the man who had been her role model since she was a young girl, now fought aggressive kidney disease and faced a cipro and motrin bleak future. An unexpected giftRuther Estrella’s kidney disease worsened in 2019.

When his daughter drove up from the Bay Area to visit him in cipro and motrin Sacramento, she saw how sick he had become and how complicated dialysis can be. €œThe first thing she did, she hugged me and started crying,” Ruther Estrella recalled. €œShe sat next to me and said, ‘I don’t like to see you like this, cipro and motrin dad.’ But I didn’t expect anything from her.”Jazlyn Estrella donated her kidney to her father, Ruther, because he is her role model and she didn’t want him to miss her life milestones.For Jazlyn Estrella, seeing her father tethered to the machine sparked her strong will and determination to help however she could. €œNo person’s opinion could change my mind on it,” she said.

€œI knew he couldn’t be strong with cipro and motrin a failing kidney. I felt like I was going to lose my dad.” A familiar diagnosis returnsRuther Estrella had been expecting a moment like this for 16 years. Born in the Philippines, he and his family came to the cipro and motrin U.S. When he was seven, and Estrella was diagnosed with an autoimmune kidney disease when he was 13.

Doctors told him then that they would keep an eye on his kidneys, because they were not cipro and motrin well. Years later, in 1998, when his then-wife was pregnant with Jazlyn Estrella, he went in for routine check-up. €œAfter a simple blood check, they came out with a wheelchair and rushed me to emergency dialysis,” he remembered. He would remain on dialysis awaiting a transplant cipro and motrin for five years.

In 2003, he received a cadaver kidney. The doctors told him it might last for cipro and motrin eight years. While he doubled those expectations, the inevitable scenario returned. €œI want to save his life”“When I saw him, I made the decision that I want to cipro and motrin do something for my dad,” said Jazlyn Estrella.

€œIf I can do it, I want to save his life.”Jazlyn and her dad Ruther Estrella recover at UC Davis Medical Center after she donated a kidney to him the day after Father’s Day.After learning they were a perfect match, Jazlyn Estrella began her living donor journey. Meanwhile, Ruther Estrella’s fiancée, Grace Cantiller, served as his number-one supporter and full-time caregiver for cipro and motrin his home dialysis. His days were restricted, but with his fiancée and daughter fighting with him, he never gave up hope. Finally, the UC cipro and motrin Davis Health transplant team set a date, June 21, 2021.

€œWe didn’t even realize that the 20th was Father’s Day. I was laughing and thought, what a cipro and motrin great gift. I need to take really good care of this kidney,” Ruther Estrella said. €œI thought this was going to be the cipro and motrin best gift for him.

And I didn’t have to shop for him!. It just added more sentimental value to it,” Jazlyn Estrella added. Not only sentimental value, but also quality of life because this time around, the cipro and motrin kidney came from a living donor. €œCompared with dialysis therapy, living donor kidney transplant not only improves the quality of life, but also prolongs life expectancy,” explained Junichiro Sageshima, transplant surgeon and director of the UC Davis Living Donor Transplant Program.

"It is truly a gift of cipro and motrin life.” An exciting future awaits“It just feels like the ball and chain has been cut. Time is not limited. I can go wherever cipro and motrin I want because my daughter gave me a second chance at life.”— Ruther EstrellaLiving is exactly what the Estrellas plan to do. Before he got sick and before buy antibiotics, Ruther Estrella and Grace Cantiller planned to return to his birthplace and get married.

Now, they’ll make that trip with Jazlyn Estrella and cipro and motrin its significance will mean so much more. €œIt just feels like the ball and chain has been cut. Time is not limited,” Ruther Estrella cipro and motrin said. €œI can go wherever I want because my daughter gave me a second chance at life.” For Jazlyn Estrella, it also affords her dad the opportunity to be around for her future milestone moments.

€œI’ve known people who get married and their dad isn’t there,” she explained. €œThat would break my heart if he weren’t there for my wedding or to be a grandfather to my kids. The whole process was worth it because it saved a life.”.

UC Davis Department of Psychology Professor and Chair Susan Rivera has buy cipro online been named to Where can i get antabuse the Interagency Autism Coordinating Committee (IACC). Rivera is also a faculty member of the MIND Institute and the Center for Mind and Brain. She was buy cipro online appointed, along with 21 others, by U.S. Secretary of Health and Human Services Xavier Becerra to a three-year term, which starts immediately. Susan Rivera has been appointed to the Interagency Autism Coordinating Committee.The IACC is a key advisory committee which buy cipro online includes public stakeholders and federal officials.

It provides guidance and recommendations to the Secretary of Health and Human Services on autism research, services and policy.“I am honored to have the opportunity to serve on this committee,” said Rivera, who was nominated by Center for Mind and Brain Director, George (Ron) Mangun. MIND Institute Director Leonard Abbeduto also supported her nomination.“Being involved in formulating recommendations for autism research, services and policy holds buy cipro online deep meaning for me. It provides a way of using the knowledge I’ve gained over my many years of conducting autism research and participating in advocacy efforts to help shape these agendas,” Rivera explained. Rivera has been doing scientific research on autism for two decades buy cipro online. Her lab uses brain imaging and eye tracking techniques to investigate how underlying brain activity and behavior support the development of skills like attention, visual perception, face processing, sensory processing and emotion regulation.

These skills are necessary for adaptive cognitive and social-emotional well-being.A focus on neurodiversityThe new committee members include researchers like Rivera, autism self-advocates, parents and family members of those with buy cipro online autism, clinicians and representatives of service and advocacy groups, making it the largest and most diverse IACC yet.“I hope the work I do on the committee will both help deepen the public’s understanding of autism, and positively impact the lives of individuals with autism.”— Susan RiveraRivera, who is devoted to championing the tenets of neurodiversity and advocacy to the public and academic communities, applauds the inclusion of more representatives from the autism community.“I’m very excited to see the significant number of self-advocates on the panel. Given the combination of individuals who can speak to the lived experiences of autism and researchers and clinicians that can speak to science and new discoveries in the field, I think the committee is well-poised to make significant progress in formulating recommendations for the Health and Human Services Secretary,” she said.Rivera noted that she’d like to see a shift toward more involvement from autism advocates in shaping research funding priorities.In addition to the 22 newest appointees, the IACC also includes 23 new and returning federal officials who represent federal agencies and departments that serve the autism community in areas such as biomedical research, education and health care.Rivera is not the first UC Davis MIND Institute faculty member to serve on the IACC. David Amaral, distinguished professor in the Department of buy cipro online Psychiatry and Behavioral Sciences and Marjorie Solomon, professor of clinical psychiatry in the Department of Psychiatry and Behavioral Sciences and associate director of the MIND Institute, were on the committee previously.The appointment involves a significant time commitment and broad duties, such as monitoring autism research, services and support activities, developing a summary of significant advances in these areas and making recommendations, as well as developing a strategic plan for the conduct of and support for autism research. Major projects include the IACC Strategic Plan for Autism Spectrum Disorder (ASD) and the Summary of Advances in ASD Research.For Rivera, it’s well worth the effort. €œI hope the work I do on the committee will both help deepen the public’s understanding of autism, and positively impact the lives of individuals with autism,” she said.

The new buy cipro online IACC will hold its first public meeting July 21-22. The UC Davis MIND Institute in Sacramento, Calif. Was founded in 1998 as a unique interdisciplinary research center where families, community leaders, researchers, clinicians and volunteers work together toward a common goal buy cipro online. Researching causes, treatments and potential prevention of neurodevelopmental disabilities. The institute has major research efforts in autism, fragile X syndrome, chromosome 22q11.2 deletion syndrome, attention-deficit/hyperactivity disorder (ADHD) and Down syndrome buy cipro online.

More information about the institute and its Distinguished Lecturer Series, including previous presentations in this series, is available on the Web at mindinstitute.ucdavis.edu.When Jazlyn Estrella thinks of her father, she envisions him in the garage with his tools, creating something. Jazlyn Estrella’s earliest memories of her father, Ruther, involve him building things, such as a Star Wars costume.“He’s buy cipro online always working on something,” she said of her father, Ruther Estrella. €œHe’s so artistic and, if he puts his mind to it, he can build anything.” She recalls a life-size replica of the R2-D2 droid he fabricated when she was young, along with several Star Wars costumes. Whenever Father’s buy cipro online Day arrived, she bought him tools. €œTools for whatever project he was working on, or a gift card to a store where he could buy more tools,” she laughed.

Over the buy cipro online years his health deteriorated and for Father’s Day 2021, Jazlyn Estrella gave her dad something you can’t buy. The 21-year-old donated one of her kidneys to him. The UC Davis Health transplant team made buy cipro online it possible. It was the best gift she could ever give. The hours he once spent in the garage had become hours connected to a dialysis machine.

At the age of 47, the man who had been her role model since she was a young buy cipro online girl, now fought aggressive kidney disease and faced a bleak future. An unexpected giftRuther Estrella’s kidney disease worsened in 2019. When his daughter drove up from the Bay Area to visit him buy cipro online in Sacramento, she saw how sick he had become and how complicated dialysis can be. €œThe first thing she did, she hugged me and started crying,” Ruther Estrella recalled. €œShe sat next to me and said, ‘I don’t like to see you like this, dad.’ But I didn’t expect anything from her.”Jazlyn Estrella donated her kidney to her father, Ruther, because he is her role model and she didn’t want him to miss her life milestones.For Jazlyn Estrella, seeing her father tethered to the machine sparked her buy cipro online strong will and determination to help however she could.

€œNo person’s opinion could change my mind on it,” she said. €œI knew he couldn’t buy cipro online be strong with a failing kidney. I felt like I was going to lose my dad.” A familiar diagnosis returnsRuther Estrella had been expecting a moment like this for 16 years. Born in the Philippines, he buy cipro online and his family came to the U.S. When he was seven, and Estrella was diagnosed with an autoimmune kidney disease when he was 13.

Doctors told him then that they would keep an eye on his buy cipro online kidneys, because they were not well. Years later, in 1998, when his then-wife was pregnant with Jazlyn Estrella, he went in for routine check-up. €œAfter a simple blood check, they came out with a wheelchair and rushed me to emergency dialysis,” he remembered. He would buy cipro online remain on dialysis awaiting a transplant for five years. In 2003, he received a cadaver kidney.

The doctors told him buy cipro online it might last for eight years. While he doubled those expectations, the inevitable scenario returned. €œI want to save his life”“When I saw him, I made buy cipro online the decision that I want to do something for my dad,” said Jazlyn Estrella. €œIf I can do it, I want to save his life.”Jazlyn and her dad Ruther Estrella recover at UC Davis Medical Center after she donated a kidney to him the day after Father’s Day.After learning they were a perfect match, Jazlyn Estrella began her living donor journey. Meanwhile, Ruther Estrella’s fiancée, Grace Cantiller, buy cipro online served as his number-one supporter and full-time caregiver for his home dialysis.

His days were restricted, but with his fiancée and daughter fighting with him, he never gave up hope. Finally, the UC Davis Health buy cipro online transplant team set a date, June 21, 2021. €œWe didn’t even realize that the 20th was Father’s Day. I was laughing and buy cipro online thought, what a great gift. I need to take really good care of this kidney,” Ruther Estrella said.

€œI thought this was going to be buy cipro online the best gift for him. And I didn’t have to shop for him!. It just added more sentimental value to it,” Jazlyn Estrella added. Not only sentimental value, but also quality of life because this time around, buy cipro online the kidney came from a living donor. €œCompared with dialysis therapy, living donor kidney transplant not only improves the quality of life, but also prolongs life expectancy,” explained Junichiro Sageshima, transplant surgeon and director of the UC Davis Living Donor Transplant Program.

"It is truly a gift of life.” An exciting future awaits“It just feels like the ball and buy cipro online chain has been cut. Time is not limited. I can go wherever I want because my daughter gave me a second chance at life.”— Ruther EstrellaLiving buy cipro online is exactly what the Estrellas plan to do. Before he got sick and before buy antibiotics, Ruther Estrella and Grace Cantiller planned to return to his birthplace and get married. Now, they’ll make that trip with Jazlyn Estrella and its significance will mean so buy cipro online much more.

€œIt just feels like the ball and chain has been cut. Time is not limited,” Ruther Estrella said buy cipro online. €œI can go wherever I want because my daughter gave me a second chance at life.” For Jazlyn Estrella, it also affords her dad the opportunity to be around for her future milestone moments. €œI’ve known buy cipro online people who get married and their dad isn’t there,” she explained. €œThat would break my heart if he weren’t there for my wedding or to be a grandfather to my kids.

The whole process was worth it because it saved a life.”.