Daily Archives: June 2, 2021

Bluebook Rule (21st): 1.2(a)

Law Review Typeface For Introductory Signals:Italics

Signals indicating that the cited work is supportive of the author's text are the most commonly used type of signal. There are six supporting signals:

The most frequently used are probably [no signal], E.g., See, and See Also.

[no signal]

No signal is necessary if a cited authority:

E.g.,

"E.g.," is the abbreviation for the Latin phrase "exempli gratia," and can loosely be translated to mean "good example." "E.g." is used when the cited authority states the proposition and when citation to other authorities also stating the proposition would be unhelpful or unnecessary.

NOTE: "E.g." can be combined with other signals, such as "See." When communed with another signal, the other signal should be given first, separated by an italicized comma but ending with a non-italicized comma:

See, e.g.,

See

See is probably the most frequently used (and abused) introductory signal. It is used when the cited authority clearly supports a proposition but there is an inferential step between the proposition as stated and the cited authority. Although not a catch-all signal, it is often inappropriately used as such.

See also

"See also" is used to cite to additional materials and authority that supports a proposition but when other authority has already been cited to using either See or [no signal]. An explanatory parenthetical stating the relevance of the additional material is strongly encouraged.

NOTE: It is not appropriate to use See also for general background-reading materials; in that case, the signal "See generally" should be used (rule 1.2(d)). Again, an explanatory parenthetical explaining the relevance of the material is strongly encouraged.

Read more:

Intro signals: E.g., See, See also, Cf., etc. - Bluebook ...

The Gold Standard

The sweat test is considered the gold standard for diagnosing cystic fibrosis. Sweat tests should be done at a CF Foundation-accredited care center, where guidelines are used to help ensure accurate results. The sweat test is performed by a trained technician and the results are evaluated in an experienced and reliable laboratory.

Did You Know?

The sweat test is the gold standard for diagnosing cystic fibrosis.

The sweat test can be done on an individual of any age. However, some infants may not make enough sweat to do the test. If an infant does not produce enough sweat the first time, the test should be repeated.

If your baby had a positive newborn screen (NBS) or you received a positive prenatal genetic test, its important to schedule a sweat test as soon as possible once your newborn reaches 10 days of age. At the latest, babies with a positive NBS or prenatal genetic test should have a sweat test performed by the age of 4 weeks to ensure that any health issues or changes can be found early and treated quickly.

The sweat test measures the amount of chloride (a component of salt) in the sweat. There are no needles involved in this test. In the first part of the test, a colorless, odorless chemical (pilocarpine) and a little electrical stimulation is applied to a small area of the arm or leg to encourage the sweat glands to produce sweat. A person may feel tingling in the area, or a feeling of warmth. This part of the test lasts about five minutes.

The sweat is then collected on a piece of filter paper or gauze or in a plastic coil. This step lasts for 30 minutes. The collected sweat is then sent to a hospital laboratory to measure how much chloride is in the sweat. The sweat test usually takes about an hour, but it may take longer. When you schedule the test, ask how long it will take and when you can expect to learn the results.

Watch a video that further explains the sweat test and shows how it is done.

There is no activity limit or special diet needed before the sweat test. However, you should not apply creams or lotions to the skin 24 hours before the test. You can continue all regular medications. These will have no effect on the test results.

Babies should be fed their usual amount at their usual times.

Read theCF Foundation's guidelines for sweat testing.

People with CF have more chloride in their sweat than people who do not have CF.

For a child who has CF, the sweat chloride test results will confirm the diagnosis by showing a high chloride level. A baby has to sweat enough to do the test. Full-term babies usually produce enough sweat by 2 weeks of age. The test should be done as soon as possible between 10 days and, at the latest, 4 weeks of age for babies who have had a positive NBS or prenatal genetic test.

Typically, sweat chloride values do not change from positive to negative or negative to positive, as a person grows older. Sweat test results also do not vary when a person has a cold or other brief illness. If a sweat test is done correctly, then results that are positive will show a high chloride level.

To understand what the sweat test results mean, a chloride level of:

When sweat chloride test results fall between the range of 30-59 mmol/L, the sweat test is usually repeated.

If your child received a positive NBS and has sweat test results that fall into the intermediate range and one or no CF-causing mutations, he or she will be classified as having CF-related metabolic syndrome (CRMS), also known as CF Screen Positive, Inconclusive Diagnosis (CFSPID). This designation also applies to children who have a positive NBS, a sweat test result less than or equal to 29 mmol/L, and two CFTR gene mutations, with at least one that does not cause any physical CF symptoms. A CRMS/CFSPID designation is only applicable to those who had a positive NBS.

Further testing may be recommended for those whose sweat test results fall into the intermediate range and whose genetic analysis determines unknown mutations or that their CFTR genotype is undefined. If further testing is unavailable or found to be inconclusive, the diagnosis cannot be resolved, and they may be considered to have CF-Related Disorder. A positive NBS is not required for this classification.

The rest is here:

Sweat Test | CF Foundation

BRAVE CF touches down in Minsk, Belarus, this Friday (June 4) for BRAVE CF 51. The Eastern European country will be the 22nd nation BRAVE CF has staged an event in, an impressive figure considering the promotion only launched five years ago.

Carlos The Roaring Lion Kremer, the promotions indefatigable cage announcer, has been with the company since the start, holding court for every event from the moment Atif Mohammad and Sunny Khatri walked into the cage for the opening bout of BRAVE CF 1.

LowkickMMA caught up with Kremer recently to discuss his start in MMA and how he ended up working with the Middle Easts premier MMA promotion. MMA is a tough industry to break into regardless of what side of the cage you want to be on, and Kremers story is a testament to the importance of creating opportunities rather than waiting for them to appear.

I was living in San Diego and was hungry to get involved in mixed martial arts. I started doing interviews at different MMA functions in Ventura and Los Angeles, and just bidding my time and doing it for free, and [ it was my] passion, Kremer said, speaking to LowkickMMA

The former marine captain began working for the San Diego promotion Epic Fighting, run by Jason Stewart. Kremers love of MMA and drive to establish himself in the industry saw him dip into his own pockets to hire camera operators and an editor to start EpicTv.

You have to think big picture, and the marketing alone from those early days came back to me tenfold, Kremer explained.

To those outside looking in, it was a risky move, but it was one that has since paid dividends in ways Kremer could never have foreseen at the time. After being offered an opportunity to be Epic Fightings cage announcer, his career trajectory was set on a course that would lead him to BRAVE CF.

Once I hit that cage, you know I have always loved drama, Ive been in plays, Ive been an actor in Hollywood, and I wanted to bring that broadway show style feel, like a major Hollywood, Bollywood production into the cage of mixed martial arts. And give the fans an experience they would never forget, he said.

Kremers busy schedule also included hosting a podcast, and it was when he had Manolo Hernandez and Alex Soto on as guests that the next chapter of his career began taking shape. Hernandez was matchmaking for the BRAVE CF and mentioned to Kremers wife, Teca, that the promotion was still in the process of deciding who would be their cage announcer. She immediately recommended her husband, footage made its way to Bahrain, and the rest is history.

I started with BRAVE CF 1. The Kingdom of Bahrain has taken me in like family, one of their own, Kremer said,

Its been a whirlwind, and its just been an unbelievable journey.

Cage announcer positions are sought-after roles regardless of the market a promoter is operating in. The choice of Kremer to be the announcer for BRAVE CF, a Bahrain-based company, did not pass without a few obstacles, especially given the fact that, at the time, he was an unknown figure in the Middle East.

There are so many Arabic speaking celebrities, announcers, so many quality amazing individuals that they[BRAVE CF] were pressured to put someone like that on their show, and rightfully so, Kremer said.

But they had the belief in me and said, wait, just watch, listen, see this guy in the cage. See how the fighters relate to him, and sure enough, it happened.

I am very grateful because there were so many other people deserving in the area, so I had to come through with the biggest, most grand extraordinary performance, night after night, to not only secure my job but to make history together.

The Roaring Lion is not the only one at BRAVE CF leaving everything inside the cage. The company has created a platform for fighters from regions other promotions have often overlooked. Kremer believes that for the athletes, knowing the company that they compete for has complete faith in their talents results in even better performances from the fighters.

Ill tell you what when you watch BRAVE and you watch our fighters because his High Highness [ BRAVEs founder Sheikh Khalid Bin Hamad]believes in them and Mohammed Shahid [BRAVEs president] believes in them, these guys fight like no one else in the world, in my opinion.

Kremer adds that it is not just the fighters that BRAVE CF forms a bond with, but also the countries they visit.

What Brave Combat Federation does is form relationships with countries, not for one event but forever. We want to help their economy, we want to help their businesses. We want their fans and their people to take pride in whats happening and that we include them on this incredible mission.

He references a moment from BRAVE CFs early days that left a lasting impact on him to highlight his point. The promotion had just wrapped up its inaugural show, and Shahid was fielding questions from the assembled media. Reporters began asking what would happen if BRAVE CF did not become as financially successfully as the company hoped it would. Shahids reply, Kremer says cut straight to the core of the values that BRAVE CF represent.

[He said] We dont care about any of that. We are here to create a global imprint on MMA for the entire world to see. Its like how can you compete against someone who said that ?

He wasnt talking about money, he wasnt talking about revenue. He was talking about His Highness wants to make a global imprint on MMA period, and that is what were going to do.

Since BRAVE CF 1, Kremers career has gone from strength to strength. His success mirroring that of the company he calls home. There are still many fights to announced and events to be held, but Kremer, like BRAVE CF, looks set to leave a lasting legacy on the MMA landscape.

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Exclusive: How Carlos Kremer Became The Voice Of BRAVE CF - LowKick MMA

POWASSAN -- May is Cystic Fibrosis (CF) Awareness Month and Wendy Carruthers of Powassan, Ont., decided to shave her head in support.

Carruthers told CTV News she wants to "bring the community together" and wants to make a change in her community.

"I want to start the conversation about CF," said Carruthers.

"If you cant give, you cant give. You can still talk about CF, you can still raise awareness. Were only as strong as a community as our weakest members and right now, CF has affected some members of our community so we need to pull together to raise them up."

Cystic fibrosis is a progressive, genetic disease that causes persistent lung infections, limits the ability to breathe over time, and affects other organs as well according to the Cystic Fibrosis Foundation.

"In the lungs, the mucus clogs the airways and traps germs, like bacteria, leading to infections, inflammation, respiratory failure, and other complications. For this reason, minimizing contact with germs is a top concern for people with CF," the organization's website reads. "In the pancreas, the buildup of mucus prevents the release of digestive enzymes that help the body absorb food and key nutrients, resulting in malnutrition and poor growth."

Cystic Fibrosis hits close to home for Shelley Ortepi, the co-owner of a Zumba gym in North Bay called The Studio. Shes been raising money for CF for the past six years.

"One of my business partners, Macrena Parron, both of her children have CF. So her cause has really become my cause," Ortepi said.

The Studio's goal was to raise $10,000 for the disease and even though classes have been put on hold due to the pandemic, The Studio was able to raise more than $13,000, which ultimately led to Carruthers shaving her head.

"To have someone who really doesnt know me say,' yeah, I want to do this,' that is probably one of the most selfless acts Ive experienced in my life," Ortepi said. "Thank you is not enough words. What she did today was incredible."

Although there is currently no cure for cystic fibrosis, Carruthers hopes her head-shaving will raise awareness and bring in more donations.

"My philosophy is: be the change you want to see, and I want to see our community grow together not apart," she said. "Im just kind of modelling what I think we all have the ability to do. So, in a random act of kindness, I shaved my head for CF and Im hoping that starts the conversation."

Carruthers admits she was "terrified" to see the end result. Now, she said her head feels a bit chilly with the breeze, but its worth supporting a cause like cystic fibrosis.

Ortepi said The Studio will continue to raise money for CF every May.

"Hopefully we will soon find out that CF stands for cure found," she said.

Read the original post:

Powassan woman shaves head in support of cystic fibrosis - CTV Toronto

Rebekah Jessen is a full-time carer for her 18-year-old son, who has the double-whammy diagnosis of cysitic fibrosis (CF) and autism.

As Matthew Lamberts autism prevents him from performing his own care, Jessen has had to give up work to look after him.

And with his CF rapidly deteriorating, Matthews quality of life is very poor. His life expectancy is likely only another couple of years.

Rebekah Jessen

Matthew Lambert during a recent hospital stay wearing a vest that shakes his chest and helps to break up mucus.

The familys only hope is the drug trikafta, which is the first treatment to treat the underlying causes of CF, rather than the symptoms.

READ MORE:* The life-changing drug that could help Brett, 11, live long enough to fulfil his dream* New drug gives hope to 14-year-old boy with cystic fibrosis* 'Life-changing' drug not accessible for New Zealanders living with cystic fibrosis

But with trikafta not funded by Pharmac, and at a cost of about $430,000 a year, the outlook is grim.

For anyone, CF is a nasty illness. A genetic condition that causes the body to produce abnormally thick, sticky mucus, CF causes lung and chest infections, digestive problems, and issues with other internal organs.

Rebekah Jessen

Rebekah Jessen has given up her work as a midwife to care for Matthew fulltime.

Theres no cure, but symptom management requires daily physiotherapy to help break down the mucus on top of a drug regimen. As CF is degenerative, the regime becomes longer and more involved as the patient ages.

It takes several hours of physio and treatments just to keep [Matthew] well on the daily, Jessen explained. That includes physio three times a day, plus time on a nebuliser inhaling antibiotics and another mucus-thinning drug.

People without autism can start to become a bit more independent with their own treatment but Matthews never been able to gain any independence with his treatment, so anything that has to be done has to be done by me, Jessen said.

Matthews condition has worsened over the last year. Hes been hospitalised four or five times, for weeks at a time.

His quality of life is poor, said Jessen. Matthew used to be a vibrant, happy boy who went to school, danced with the charity StarJam, and participated in his community. Now hes almost completely housebound.

He knows that hes sick, and he will comment a lot: Im having trouble breathing, Im coughing a lot, I cant breathe. Hes in a lot of discomfort.

Rebekah Jessen

Matthew spends several hours undergoing physical therapy and on a nebuliser every day, but his condition is worsening.

For most CF sufferers in New Zealand the only hope of significantly prolonging their life is a lung transplant, but Matthew isnt a candidate because he has liver damage that would make the surgery too risky.

Trikafta is his last chance, and its a good one: Internationally, it has shown to work for around 90 per cent of CF patients.

Thereve been people that have gone from 20 per cent lung function to 60 per cent lung function, Jessen said. Gaining weight, able to be off oxygen, having better quality of life and less hospitalisations because of this drug.

REbekah Jessen

Matthew has been hospitalised a number of times in the last year. Trikafta campaigners claim the drug could radically improve his condition.

Trikafta has been the subject of a large campaign on behalf of a number of patient advocacy groups. It was one of the drugs named in the petition Patient Voice Aotearoa took to Parliament the week before the budget, when Jessens hopes were buoyed by the number of MPs who came out to acknowledge the demonstrators.

We all thought, Theyre hearing us, theyre seeing us. And then [when] that menial amount that was given to Pharmac, we thought: Nobodys hearing us at all.

The $200 million over four years given to Pharmac in the 2021 budget has been widely criticised, with Patient Voice Aotearoa spokesperson Malcolm Mulholland calling it nowhere near enough.

Rebekah Jessen

Rebekah Jessen says she will keep fighting for trikefta to be funded, as it is her only option left.

In order to consider funding a drug, Pharmac needs to receive an application from a supplier, in trifaktas case a company called Vertex. It has not received an application to date, but critics say with Pharmacs funding at the current level, it would be meaningless.

Patient Voice Aotearoa said New Zealands spending on medicine was about $2 billion a year behind other OECD countries. Trikafta is funded in countries including the UK, the US, Denmark, Germany, Switzerland and the Republic of Ireland.

Jessen said she had always been a Labour supporter, but she was frustrated at the current Governments lack of action on drug funding.

People with CF in New Zealand had some of the worst outcomes of any internationally, she said.

Young people will die. If they dont get access to these drugs, they will die. Give Pharmac the money they need.

One of those young people is Matthew, whose treatments are reaching the maximum point of what they are able to do for him.

Matthew was unlucky to be born in this country, Jessen said.

As a parent this is my only option, and my sons life is worth fighting for, and I will keep fighting for as long as required. What choice do I have? I shouldnt have to fight, but this is what it comes down to.

Follow this link:

Unfunded drug the last hope for 18-year-old with cystic fibrosis, autism, and two years to live - Stuff.co.nz

UCLA researchers published a new study in May on how a life-threatening lung disorder affects patients cells.

Cystic fibrosis is a genetically inherited disease that causes a buildup of mucus in the lungs and makes it harder to breathe over time, according to the Cystic Fibrosis Foundation. It affects about 30,000 people in the U.S. and around 70,000 globally, said Brigitte Gomperts, a professor of pediatric-hematology and one of the studys co-authors.

The researchers found there were several key differences between the lung cells of patients with and without CF.

Patients with severe CF do not have a functional protein that normally assists in clearing built-up mucus from the lungs, Gomperts said.

Mucus is the bodys greatest defense mechanism, Gomperts said, trapping microscopic invaders such as bacteria and viruses. However, individuals with CF are unable to clear old mucus, allowing germs to accumulate and cause chronic infections.

Current treatments for CF include medications and mechanical ventilators that are used to thin down and remove mucus from airways. However, these treatments do not work in patients that have severe CF, Gomperts said.

Currently, the drug therapies are only effective in between 85 and up to 90% of individuals with fibrosis, said Scott Randell, a cell biology and physiology professor at the University of North Carolina at Chapel Hill, a co-author on the study.

CF patients may be able to reach adulthood without extensive medical intervention, though they typically require lung transplants in order to live to middle age, said Justin Langerman, a biological chemistry researcher at UCLA and a primary author of the study.

Gene therapy could become a common treatment in the medical field that could potentially cure patients with genetic disorders like CF, Randell said.

The study could inform future gene therapy procedures, as gene therapy could treat CF by inserting a correct copy of the affected gene into a patients stem cells, Randell said. The treated stem cells would then mature and become healthy lung cells, potentially providing a decisive cure to the disease compared to current treatments, which provide temporary relief from symptoms, Gomperts said.

[Related: UCLA-led team develops potential treatment for children with rare immune disease]

The Cystic Fibrosis Foundation recruited Gomperts, along with other experts across the U.S., to understand key differences between CF patients and healthy individuals to complement research on potential gene therapy treatments, Gomperts said.

The research group created a detailed map of the various types of cells in the lungs to realize each types unique function, Gomperts said. These cells include those that produce mucus, cells that move mucus out of the airways and a store of stem cells special immature cells that can transform into the other two types Gomperts added.

The CF patients had lower amounts of immature cells compared to healthy patients, which made it harder for them to regenerate new lung cells and repair damaged tissues, Gomperts said.

The research would not have been possible without the use of modern genetic sequencing technology to map out the cells of the airway, Gomperts said.

Researchers had been working on potential cures for CF after discovering the genetic basis for the disease in 1989, Randell said. There had not yet been a study analyzing the lung cells of CF patients in as much detail, he added.

Randell said the possibility of a permanent cure for CF using gene therapy would allow young children to not depend on medications for the rest of their lives. For those kinds of therapies, we really need to understand the cell biology, Randell said. Thats why this study is important.

Link:

UCLA researchers publish study on the effects of cystic fibrosis on lung cells - Daily Bruin