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The team of Deputy can u buy viagra over the counter and Associate Editors Heribert Schunkert, Sharlene Day and Peter SchwartzThe European Heart Journal (EHJ) wants to attract high-class submissions dealing with genetic findings that help to improve the mechanistic understanding and the therapy of cardiovascular diseases. In charge of identifying such articles is a mini-team of experts on genetics, Heribert Schunkert, Sharlene Day, and Peter Schwartz.Genetic findings have contributed enormously to the molecular understanding of cardiovascular diseases. A number of diseases including various can u buy viagra over the counter channelopathies, cardiomyopathies, and metabolic disorders have been elucidated based on a monogenic inheritance and the detection of disease-causing mutations in large families. More recently, the complex genetic architecture of common cardiovascular diseases such as atrial fibrillation or coronary artery disease has become increasingly clear. Moreover, genetics can u buy viagra over the counter became a sensitive tool to characterize the role of traditional cardiovascular risk factors in the form of Mendelian randomized studies.

However, the real challenge is still ahead, i.e., to bridge genetic findings into novel therapies for the prevention and treatment of cardiac diseases. The full cycle from identification of a family with hypercholesterolaemia due to a proprotein convertase subtilisin/kexin type 9 (PCSK-9) mutation to successful risk lowering by PCSK-9 antibodies illustrates the power of genetics in this regard.With its broad expertise, the new EHJ can u buy viagra over the counter editorial team on genetics aims to cover manuscripts from all areas in which genetics may contribute to the understanding of cardiovascular diseases. Prof. Peter Schwartz is a world-class expert on channelopathies and pioneered the field of long QT can u buy viagra over the counter syndrome. He is an experienced clinical specialist on cardiac arrhythmias of genetic origins and a pioneer in the electrophysiology of the myocardium.

He studied in Milan, worked at the University of Texas for 3 years and, as Associate Professor, at the University of Oklahoma 4 months/year for 12 years. He has been Chairman of can u buy viagra over the counter Cardiology at the University of Pavia for 20 years and since 1999 acts as an extraordinary professor at the Universities of Stellenbosch and Cape Town for 3 months/year.Prof. Sharlene M. Day is Director of Translational Research in the can u buy viagra over the counter Division of Cardiovascular Medicine and Cardiovascular Institute at the University of Pennsylvania. She trained at the University of Michigan and stayed on as faculty as the founding Director of the Inherited Cardiomyopathy and Arrhythmia Program before moving to the University of Pennsylvania in 2019.

Like Prof can u buy viagra over the counter. Schwartz, her research programme covers the full spectrum from clinical medicine to basic research with a focus on hypertrophic cardiomyopathy. Both she and Prof can u buy viagra over the counter. Schwartz have developed inducible pluripotent stem cell models of human monogenic cardiac disorders as a platform to study the underlying biological mechanisms of disease.Heribert Schunkert is Director of the Cardiology Department in the German Heart Center Munich. He trained in the Universities of Aachen and Regensburg, Germany and for 4 years in various teaching hospitals in Boston can u buy viagra over the counter.

Before moving to Munich, he was Director of the Department for Internal Medicine at the University Hospital in Lübeck. His research interest shifted from the molecular biology of the renin–angiotensin system to complex genetics of atherosclerosis. He was amongst the first to conduct genome-wide association meta-analyses, which allowed the identification of numerous genetic variants that contribute to coronary artery can u buy viagra over the counter disease, peripheral arterial disease, or aortic stenosis.The editorial team on cardiovascular genetics aims to facilitate the publication of strong translational research that illustrates to clinicians and cardiovascular scientists how genetic and epigenetic variation influences the development of heart diseases. The future perspective is to communicate genetically driven therapeutic targets as has become evident already with the utilization of interfering antibodies, RNAs, or even genome-editing instruments.In this respect, the team encourages submission of world-class genetic research on the cardiovascular system to the EHJ. The team is also can u buy viagra over the counter pleased to cooperate with the novel Council on Cardiovascular Genomics which was inaugurated by the ESC in 2020.Conflict of interest.

None declared.Andros TofieldMerlischachen, Switzerland Published on behalf of the European Society of Cardiology. All rights reserved can u buy viagra over the counter. © The Author(s) 2020. For permissions, can u buy viagra over the counter please email. Journals.permissions@oup.com.With thanks to Amelia Meier-Batschelet, Johanna Huggler, and Martin Meyer for help with compilation of this article. For the podcast associated with this article, please visit https://academic.oup.com/eurheartj/pages/Podcasts.This is a Focus Issue on genetics.

Described as the ‘single largest unmet need in cardiovascular can u buy viagra over the counter medicine’, heart failure with preserved ejection fraction (HFpEF) remains an untreatable disease currently representing 65% of new HF diagnoses. HFpEF is more frequent among women and is associated with a poor prognosis and unsustainable healthcare costs.1,2 Moreover, the variability in HFpEF phenotypes amplifies the complexity and difficulties of the approach.3–5 In this perspective, unveiling novel molecular targets is imperative. In a State of the Art Review article entitled ‘Leveraging clinical epigenetics in heart failure with preserved ejection fraction. A call for individualized therapies’, authored by Francesco Paneni from the University of Zurich in Switzerland, and colleagues,6 the authors note that epigenetic modifications—defined as changes of DNA, histones, and non-coding RNAs (ncRNAs)—represent a molecular framework through which the environment modulates gene expression.6 Epigenetic signals acquired over a lifetime lead to chromatin remodelling and affect transcriptional programmes underlying oxidative stress, inflammation, dysmetabolism, can u buy viagra over the counter and maladaptive left ventricular (LV) remodelling, all conditions predisposing to HFpEF. The strong involvement of epigenetic signalling in this setting makes the epigenetic information relevant for diagnostic and therapeutic purposes in patients with HFpEF.

The recent advances in can u buy viagra over the counter high-throughput sequencing, computational epigenetics, and machine learning have enabled the identification of reliable epigenetic biomarkers in cardiovascular patients. In contrast to genetic tools, epigenetic biomarkers mirror the contribution of environmental cues and lifestyle changes, and their reversible nature offers a promising opportunity to monitor disease states. The growing understanding can u buy viagra over the counter of chromatin and ncRNA biology has led to the development of several Food and Drug Administration (FDA)-approved ‘epi-drugs’ (chromatin modifiers, mimics, and anti-miRs) able to prevent transcriptional alterations underpinning LV remodelling and HFpEF. In the present review, Paneni and colleagues discuss the importance of clinical epigenetics as a new tool to be employed for a personalized management of HFpEF.Sick sinus syndrome (SSS) is a complex cardiac arrhythmia and the leading indication for permanent pacemaker implantation worldwide. It is characterized by can u buy viagra over the counter pathological sinus bradycardia, sinoatrial block, or alternating atrial brady- and tachyarrhythmias.

Symptoms include fatigue, reduced exercise capacity, and syncope. Few studies have been conducted on the basic mechanisms of SSS, and therapeutic limitations reflect an incomplete understanding of the pathophysiology.7 In a clinical research entitled ‘Genetic insight into sick sinus syndrome’, Rosa Thorolfsdottir from deCODE genetics in Reykjavik, Iceland, and colleagues aimed to use human genetics to investigate the pathogenesis of SSS and the role of risk factors can u buy viagra over the counter in its development.8 The authors performed a genome-wide association study (GWAS) of >6000 SSS cases and >1 000 000 controls. Variants at six loci associated with SSS. A full genotypic model best described the p.Gly62Cys association, with an odds ratio (OR) of 1.44 for heterozygotes and a disproportionally large OR of 13.99 for homozygotes. All the SSS variants increased the risk of pacemaker can u buy viagra over the counter implantation.

Their association with atrial fibrillation (AF) varied, and p.Gly62Cys was the only variant not associating with any other arrhythmia or cardiovascular disease. They also tested 17 exposure can u buy viagra over the counter phenotypes in polygenic score (PGS) and Mendelian randomization analyses. Only two associated with risk of SSS in Mendelian randomization—AF and lower heart rate—suggesting causality. Powerful PGS analyses provided convincing evidence against can u buy viagra over the counter causal associations for body mass index, cholesterol, triglycerides, and type 2 diabetes (P >. 0.05) (Figure 1).

Figure 1Summary of genetic insight into the pathogenesis of sick sinus syndrome (SSS) and the can u buy viagra over the counter role of risk factors in its development. Variants at six loci (named by corresponding gene names) were identified through genome-wide association study (GWAS), and their unique phenotypic associations provide insight into distinct pathways underlying SSS. Investigation of the role of risk factors in SSS can u buy viagra over the counter development supported a causal role for atrial fibrillation (AF) and heart rate, and provided convincing evidence against causality for body mass index (BMI), cholesterol (HDL and non-HDL), triglycerides, and type 2 diabetes (T2D). Mendelian randomization did not support causality for coronary artery disease, ischaemic stroke, heart failure, PR interval, or QRS duration (not shown in the figure). Red and blue arrows represent positive and negative associations, respectively (from Thorolfsdottir RB, Sveinbjornsson G, Aegisdottir HM, Benonisdottir S, Stefansdottir L, Ivarsdottir EV, Halldorsson GH, Sigurdsson JK, Torp-Pedersen C, Weeke PE, Brunak S, Westergaard D, Pedersen OB, Sorensen E, Nielsen KR, Burgdorf KS, Banasik K, Brumpton B, Zhou W, Oddsson A, Tragante V, Hjorleifsson KE, Davidsson OB, Rajamani S, Jonsson S, Torfason B, Valgardsson AS, Thorgeirsson G, Frigge ML, Thorleifsson G, Norddahl GL, Helgadottir A, Gretarsdottir S, Sulem P, Jonsdottir I, Willer CJ, Hveem K, Bundgaard H, Ullum H, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K.

Genetic insight into can u buy viagra over the counter sick sinus syndrome. See pages 1959–1971.).Figure 1Summary of genetic insight into the pathogenesis of sick sinus syndrome (SSS) and the role of risk factors in its development. Variants at six can u buy viagra over the counter loci (named by corresponding gene names) were identified through genome-wide association study (GWAS), and their unique phenotypic associations provide insight into distinct pathways underlying SSS. Investigation of the role of risk factors in SSS development supported a causal role for atrial fibrillation (AF) and heart rate, and provided convincing evidence against causality for body mass index (BMI), cholesterol (HDL and non-HDL), triglycerides, and type 2 diabetes (T2D). Mendelian randomization did not support can u buy viagra over the counter causality for coronary artery disease, ischaemic stroke, heart failure, PR interval, or QRS duration (not shown in the figure).

Red and blue arrows represent positive and negative associations, respectively (from Thorolfsdottir RB, Sveinbjornsson G, Aegisdottir HM, Benonisdottir S, Stefansdottir L, Ivarsdottir EV, Halldorsson GH, Sigurdsson JK, Torp-Pedersen C, Weeke PE, Brunak S, Westergaard D, Pedersen OB, Sorensen E, Nielsen KR, Burgdorf KS, Banasik K, Brumpton B, Zhou W, Oddsson A, Tragante V, Hjorleifsson KE, Davidsson OB, Rajamani S, Jonsson S, Torfason B, Valgardsson AS, Thorgeirsson G, Frigge ML, Thorleifsson G, Norddahl GL, Helgadottir A, Gretarsdottir S, Sulem P, Jonsdottir I, Willer CJ, Hveem K, Bundgaard H, Ullum H, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K. Genetic insight into sick sinus syndrome can u buy viagra over the counter. See pages 1959–1971.).Thorolfsdottir et al. Conclude that they report the associations of variants at six loci with SSS, including a missense variant in KRT8 that can u buy viagra over the counter confers high risk in homozygotes and points to a mechanism specific to SSS development. Mendelian randomization supports a causal role for AF in the development of SSS.

The article is accompanied by an Editorial by Stefan Kääb from LMU Klinikum in Munich, Germany, and colleagues.9 The authors conclude that the limitations of the work challenge clinical translation, but do not diminish the multiple interesting findings of Thorolfsdottir et al., bringing us closer to the finishing line of unlocking SSS genetics to develop new therapeutic strategies. They also highlight that this study represents a considerable accomplishment for the field, but also clearly highlights upcoming can u buy viagra over the counter challenges and indicates areas where further research is warranted on our way on the translational road to personalized medicine.Duchenne muscular dystrophy (DMD) is an X-linked genetic disorder that affects ∼1 in every 3500 live-born male infants, making it the most common neuromuscular disease of childhood. The disease is caused by mutations in the dystrophin gene, which lead to dystrophin deficiency in muscle cells, resulting in decreased fibre stability and continued degeneration. The patients can u buy viagra over the counter present with progressive muscle wasting and loss of muscle function, develop restrictive respiratory failure and dilated cardiomyopathy, and usually die in their late teens or twenties from cardiac or respiratory failure.10 In a clinical research article ‘Association between prophylactic angiotensin-converting enzyme inhibitors and overall survival in Duchenne muscular dystrophy. Analysis of registry data’ Raphaël Porcher from the Université de Paris in France, and colleagues estimate the effect of prophylactic angiotensin-converting enzyme (ACE) inhibitors on survival in DMD.11 The authors analysed the data from the French multicentre DMD-Heart-Registry.

They estimated the association between the prophylactic prescription of ACE inhibitors and event-free survival in 668 patients between the can u buy viagra over the counter ages of 8 and 13 years, with normal left ventricular function, using (i) a Cox model with intervention as a time-dependent covariate. (ii) a propensity-based analysis comparing ACE inhibitor treatment vs. No treatment can u buy viagra over the counter. And (iii) a set of sensitivity analyses. The study outcomes were (i) overall survival and (ii) hospitalizations for HF or acute respiratory failure.

Among the patients included in the DMD-Heart-Registry, 576 were eligible for this study, of whom 390 were treated with an can u buy viagra over the counter ACE inhibitor prophylactically. Death occurred in 53 patients (13.5%) who were and 60 patients (32.3%) who were not treated prophylactically with an ACE inhibitor. In a can u buy viagra over the counter Cox model, with intervention as a time-dependent variable, the hazard ratio (HR) associated with ACE inhibitor treatment was 0.49 for overall mortality after adjustment for baseline variables. In the propensity-based analysis, with 278 patients included in the treatment group and 302 in the control group, ACE inhibitors were associated with a lower risk of death (HR 0.32) and hospitalization for HF (HR 0.16) (Figure 2). All sensitivity analyses yielded similar results can u buy viagra over the counter.

Figure 2Graphical Abstract (from Porcher R, Desguerre I, Amthor H, Chabrol B, Audic F, Rivier F, Isapof A, Tiffreau V, Campana-Salort E, Leturcq F, Tuffery-Giraud S, Ben Yaou R, Annane D, Amédro P, Barnerias C, Bécane HM, Béhin A, Bonnet D, Bassez G, Cossée M, de La Villéon G, Delcourte C, Fayssoil A, Fontaine B, Godart F, Guillaumont S, Jaillette E, Laforêt P, Leonard-Louis S, Lofaso F, Mayer M, Morales RJ, Meune C, Orlikowski D, Ovaert C, Prigent H, Saadi M, Sochala M, Tard C, Vaksmann G, Walther-Louvier U, Eymard B, Stojkovic T, Ravaud P, Duboc D, Wahbi K. Association between can u buy viagra over the counter prophylactic angiotensin-converting enzyme inhibitors and overall survival in Duchenne muscular dystrophy. Analysis of registry data. See pages 1976–1984.).Figure 2Graphical Abstract (from Porcher can u buy viagra over the counter R, Desguerre I, Amthor H, Chabrol B, Audic F, Rivier F, Isapof A, Tiffreau V, Campana-Salort E, Leturcq F, Tuffery-Giraud S, Ben Yaou R, Annane D, Amédro P, Barnerias C, Bécane HM, Béhin A, Bonnet D, Bassez G, Cossée M, de La Villéon G, Delcourte C, Fayssoil A, Fontaine B, Godart F, Guillaumont S, Jaillette E, Laforêt P, Leonard-Louis S, Lofaso F, Mayer M, Morales RJ, Meune C, Orlikowski D, Ovaert C, Prigent H, Saadi M, Sochala M, Tard C, Vaksmann G, Walther-Louvier U, Eymard B, Stojkovic T, Ravaud P, Duboc D, Wahbi K. Association between prophylactic angiotensin-converting enzyme inhibitors and overall survival in Duchenne muscular dystrophy.

Analysis of registry data. See pages 1976–1984.).Porcher et al can u buy viagra over the counter. Conclude that prophylactic treatment with ACE inhibitors in DMD is associated with a significantly higher overall survival and lower rate of hospitalization for management of HF. The manuscript is accompanied by an Editorial by can u buy viagra over the counter Mariell Jessup and colleagues from the American Heart Association in Dallas, Texas, USA.12 The authors describe how cardioprotective strategies have been investigated in a number of cardiovascular disorders and successfully incorporated into treatment regimens for selected patients, including ACE inhibitors in patients with and without diabetes and coronary artery disease, angiotensin receptor blockers and beta-blockers in Marfan syndrome, and ACE inhibitors and beta-blockers in patients at risk for chemotherapy-related toxicity. They conclude that Porcher et al.

Have now convincingly demonstrated that even very young patients with DMD can benefit from the life-saving intervention can u buy viagra over the counter of ACE inhibition.Hypertrophic cardiomyopathy (HCM) is characterized by unexplained LV hypertrophy and often caused by pathogenic variants in genes that encode the sarcomere apparatus. Patients with HCM may experience atrial and ventricular arrhythmias and HF. However, disease can u buy viagra over the counter expression and severity are highly variable. Furthermore, there is marked diversity in the age of diagnosis. Although childhood-onset disease is can u buy viagra over the counter well documented, it is far less common.

Owing to its rarity, the natural history of childhood-onset HCM is not well characterized.12–14 In a clinical research article entitled ‘Clinical characteristics and outcomes in childhood-onset hypertrophic cardiomyopathy’, Nicholas Marston from the Harvard Medical School in Boston, MA, USA, and colleagues aimed to describe the characteristics and outcomes of childhood-onset HCM.15 They performed an observational cohort study of >7500 HCM patients. HCM patients were stratified by age at diagnosis [<1 year (infancy), 1–18 years (childhood), >18 years (adulthood)] and assessed for composite endpoints including HF, life-threatening ventricular arrhythmias, AF, and an overall composite that also included stroke and death. Stratifying by age can u buy viagra over the counter of diagnosis, 2.4% of patients were diagnosed in infancy, 14.7% in childhood, and 2.9% in adulthood. Childhood-onset HCM patients had an ∼2%/year event rate for the overall composite endpoint, with ventricular arrhythmias representing the most common event in the first decade following the baseline visit, and HF and AF more common by the end of the second decade. Sarcomeric HCM was more common in childhood-onset HCM (63%) and carried a worse prognosis than non-sarcomeric disease, including a >2-fold increased can u buy viagra over the counter risk of HF and 67% increased risk of the overall composite outcome.

When compared with adult-onset HCM, those with childhood-onset disease were 36% more likely to develop life-threatening ventricular arrhythmias and twice as likely to require transplant or a ventricular assist device.The authors conclude that patients with childhood-onset HCM are more likely to have sarcomeric disease, carry a higher risk of life-threatening ventricular arrythmias, and have greater need for advanced HF therapies. The manuscript is accompanied by an Editorial by Juan Pablo Kaski from the University College London (UCL) Institute of Cardiovascular Science in London, UK.16 Kaski concludes that the field of HCM is now entering the era of personalized medicine, with the advent of gene therapy programmes and a focus on treatments targeting the underlying pathophysiology can u buy viagra over the counter. Pre-clinical data suggesting that small molecule myosin inhibitors may attenuate or even prevent disease expression provide cause for optimism, and nowhere more so than for childhood-onset HCM. An international can u buy viagra over the counter collaborative approach involving basic, translational, and clinical science is now needed to characterize disease expression and progression and develop novel therapies for childhood HCM.Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by LV dilatation and systolic dysfunction in the absence of abnormal loading conditions or coronary artery disease. It is a major cause of systolic HF, the leading indication for heart transplantation, and therefore a major public health problem due to the important cardiovascular morbidity and mortality.17,18 Understanding of the genetic basis of DCM has improved in recent years, with a role for both rare and common variants resulting in a complex genetic architecture of the disease.

In a translational research article entitled ‘Genome-wide association analysis in dilated cardiomyopathy reveals two new players in systolic heart failure on chromosomes 3p25.1 and 22q11.23’, Sophie Garnier from the Sorbonne Université in Paris, France, and colleagues conducted the largest genome-wide association study performed so far in DCM, with >2500 cases and >4000 controls in the discovery population.19 They identified and replicated two new DCM-associated loci, on chromosome 3p25.1 and chromosome 22q11.23, while confirming two previously identified DCM loci on chromosomes can u buy viagra over the counter 10 and 1, BAG3 and HSPB7. A PGS constructed from the number of risk alleles at these four DCM loci revealed a 27% increased risk of DCM for individuals with eight risk alleles compared with individuals with five risk alleles (median of the referral population). In silico annotation and functional 4C-sequencing analysis on induced pluripotent stem cell (iPSC)-derived cardiomyocytes identified SLC6A6 as the most likely DCM gene at the 3p25.1 locus. This gene encodes a taurine transporter whose involvement in myocardial dysfunction and DCM can u buy viagra over the counter is supported by numerous observations in humans and animals. At the 22q11.23 locus, in silico and data mining annotations, and to a lesser extent functional analysis, strongly suggested SMARCB1 as the candidate culprit gene.Garnier et al.

Conclude that their study provides a better understanding of the genetic architecture of DCM and sheds light on novel biological pathways can u buy viagra over the counter underlying HF. The manuscript is accompanied by an Editorial by Elizabeth McNally from the Northwestern University Feinberg School of Medicine in Chicago, USA, and colleagues.20 The authors conclude that methods to integrate common and rare genetic information will continue to evolve and provide insight on disease progression, potentially providing biomarkers and clues for useful therapeutic pathways to guide drug development. At present, rare cardiomyopathy can u buy viagra over the counter variants have clinical utility in predicting risk, especially arrhythmic risk. PGS analyses for HF or DCM progression are expected to come to clinical use, especially with the addition of broader GWAS-derived data. Combining genetic risk data with clinical and social determinants should help identify those at greatest risk, offering the can u buy viagra over the counter opportunity for risk reduction.In a Special Article entitled ‘Influenza vaccination.

A ‘shot’ at INVESTing in cardiovascular health’, Scott Solomon from the Brigham and Women’s Hospital, Harvard Medical School in Boston, MA, USA, and colleagues note that the link between viral respiratory and non-pulmonary organ-specific injury has become increasingly appreciated during the current erectile dysfunction disease 2019 (erectile dysfunction treatment) viagra.21 Even prior to the viagra, however, the association between acute with influenza and elevated cardiovascular risk was evident. The recently published results of the can u buy viagra over the counter NHLBI-funded INVESTED trial, a 5200-patient comparative effectiveness study of high-dose vs. Standard-dose influenza treatment to reduce cardiopulmonary events and mortality in a high-risk cardiovascular population, found no difference between strategies. However, the broader implications of influenza treatment as a strategy to reduce morbidity in high-risk patients remains extremely important, with randomized control trial and observational data supporting vaccination in high-risk patients with cardiovascular disease. Given a favourable risk–benefit profile and widespread availability at generally low cost, the authors contend that influenza vaccination should remain a centrepiece of cardiovascular risk mitigation and describe the broader context of can u buy viagra over the counter underutilization of this strategy.

Few therapeutics in medicine offer seasonal efficacy from a single administration with generally mild, transient side effects and exceedingly low rates of serious adverse effects. control measures such as physical distancing, hand washing, and the use of masks during the erectile dysfunction treatment viagra have already been associated with substantially curtailed incidence of influenza can u buy viagra over the counter outbreaks across the globe. Appending annual influenza vaccination to these measures represents an important public health and moral imperative.The issue is complemented by two Discussion Forum articles. In a contribution entitled ‘Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation and coexistent can u buy viagra over the counter atrial fibrillation’, Paolo Verdecchia from the Hospital S. Maria della Misericordia in Perugia, Italy, and colleagues comment on the recently published contribution ‘2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.

The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC)’.22,23 A response to Verdecchia’s comment has been supplied by Collet et al.24The editors hope that readers of this issue of the European Heart Journal will find it of can u buy viagra over the counter interest. References1Sorimachi H, Obokata M, Takahashi N, Reddy YNV, Jain CC, Verbrugge FH, Koepp KE, Khosla S, Jensen MD, Borlaug BA. Pathophysiologic importance of visceral adipose tissue in women with heart failure and preserved ejection fraction. Eur Heart can u buy viagra over the counter J 2021;42:1595–1605.2Omland T. Targeting the endothelin system.

A step towards a precision medicine approach in heart can u buy viagra over the counter failure with preserved ejection fraction?. Eur Heart J 2019;40:3718–3720.3Reddy YNV, Obokata M, Wiley B, Koepp KE, Jorgenson CC, Egbe A, Melenovsky V, Carter RE, Borlaug BA. The haemodynamic basis of lung congestion during exercise in can u buy viagra over the counter heart failure with preserved ejection fraction. Eur Heart J 2019;40:3721–3730.4Obokata M, Kane GC, Reddy YNV, Melenovsky V, Olson TP, Jarolim P, Borlaug BA. The neurohormonal basis of pulmonary can u buy viagra over the counter hypertension in heart failure with preserved ejection fraction.

Eur Heart J 2019;40:3707–3717.5Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, Edelmann F, Fu M, Guazzi M, Lam CSP, Lancellotti P, Melenovsky V, Morris DA, Nagel E, Pieske-Kraigher E, Ponikowski P, Solomon SD, Vasan RS, Rutten FH, Voors AA, Ruschitzka F, Paulus WJ, Seferovic P, Filippatos G. How to diagnose heart failure with can u buy viagra over the counter preserved ejection fraction. The HFA-PEFF diagnostic algorithm. A consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J 2019;40:3297–3317.6Hamdani N, Costantino S, Mügge A, Lebeche D, Tschöpe C, Thum T, Paneni F can u buy viagra over the counter.

Leveraging clinical epigenetics in heart failure with preserved ejection fraction. A call for individualized therapies can u buy viagra over the counter. Eur Heart J 2021;42:1940–1958.7Corrigendum to. 2018 ESC Guidelines for the can u buy viagra over the counter diagnosis and management of syncope. Eur Heart J 2018;39:2002.8Thorolfsdottir RB, Sveinbjornsson G, Aegisdottir HM, Benonisdottir S, Stefansdottir L, Ivarsdottir EV, Halldorsson GH, Sigurdsson JK, Torp-Pedersen C, Weeke PE, Brunak S, Westergaard D, Pedersen OB, Sorensen E, Nielsen KR, Burgdorf KS, Banasik K, Brumpton B, Zhou W, Oddsson A, Tragante V, Hjorleifsson KE, Davidsson OB, Rajamani S, Jonsson S, Torfason B, Valgardsson AS, Thorgeirsson G, Frigge ML, Thorleifsson G, Norddahl GL, Helgadottir A, Gretarsdottir S, Sulem P, Jonsdottir I, Willer CJ, Hveem K, Bundgaard H, Ullum H, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K.

Genetic insight can u buy viagra over the counter into sick sinus syndrome. Eur Heart J 2021;42:1959–1971.9Tomsits P, Claus S, Kääb S. Genetic insight into sick sinus can u buy viagra over the counter syndrome. Is there a pill for it or how far are we on the translational road to personalized medicine?. Eur Heart J 2021;42:1972–1975.10Hoffman EP, Fischbeck KH, Brown RH, Johnson M, Medori R, Loike JD, Harris JB, Waterston R, Brooke M, Specht L, Kupsky W, Chamberlain J, Caskey T, Shapiro F, Kunkel LM.

Characterization of dystrophin in muscle-biopsy specimens from patients can u buy viagra over the counter with Duchenne’s or Becker’s muscular dystrophy. N Engl J Med 1988;318:1363–1368.11Porcher R, Desguerre I, Amthor H, Chabrol B, Audic F, Rivier F, Isapof A, Tiffreau V, Campana-Salort E, Leturcq F, Tuffery-Giraud S, Ben Yaou R, Annane D, Amédro P, Barnerias C, Bécane HM, Béhin A, Bonnet D, Bassez G, Cossée M, de La Villéon G, Delcourte C, Fayssoil A, Fontaine B, Godart F, Guillaumont S, Jaillette E, Laforêt P, Leonard-Louis S, Lofaso F, Mayer M, Morales RJ, Meune C, Orlikowski D, Ovaert C, Prigent H, Saadi M, Sochala M, Tard C, Vaksmann G, Walther-Louvier U, Eymard B, Stojkovic T, Ravaud P, Duboc D, Wahbi K. Association between can u buy viagra over the counter prophylactic angiotensin-converting enzyme inhibitors and overall survival in Duchenne muscular dystrophy. Analysis of registry data. Eur Heart J 2021;42:1976–1984.12Owens AT, can u buy viagra over the counter Jessup M.

Cardioprotection in Duchenne muscular dystrophy. Eur Heart J 2021;42:1985–1987.13Semsarian C, can u buy viagra over the counter Ho CY. Screening children at risk for hypertrophic cardiomyopathy. Balancing benefits and can u buy viagra over the counter harms. Eur Heart J 2019;40:3682–3684.14Lafreniere-Roula M, Bolkier Y, Zahavich L, Mathew J, George K, Wilson J, Stephenson EA, Benson LN, Manlhiot C, Mital S.

Family screening for hypertrophic cardiomyopathy. Is it time to change practice guidelines? can u buy viagra over the counter. Eur Heart J 2019;40:3672–3681.15Marston NA, Han L, Olivotto I, Day SM, Ashley EA, Michels M, Pereira AC, Ingles J, Semsarian C, Jacoby D, Colan SD, Rossano JW, Wittekind SG, Ware JS, Saberi S, Helms AS, Ho CY. Clinical characteristics and outcomes in childhood-onset hypertrophic cardiomyopathy can u buy viagra over the counter. Eur Heart J 2021;42:1988–1996.16Kaski JP.

Childhood-onset hypertrophic cardiomyopathy research coming can u buy viagra over the counter of age. Eur Heart J 2021;42:1997–1999.17Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, Dubourg O, Kühl U, Maisch B, McKenna WJ, Monserrat L, Pankuweit S, Rapezzi C, Seferovic P, Tavazzi L, Keren A. Classification of the can u buy viagra over the counter cardiomyopathies. A position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2008;29:270–276.18Crea F can u buy viagra over the counter.

Machine learning-guided phenotyping of dilated cardiomyopathy and treatment of heart failure by antisense oligonucleotides. The future has begun. Eur Heart J 2021;42:139–142.19Garnier S, Harakalova M, Weiss S, Mokry M, Regitz-Zagrosek V, Hengstenberg C, Cappola TP, Isnard R, Arbustini E, Cook SA, van Setten J, Calis JJA, Hakonarson H, Morley MP, Stark K, Prasad SK, Li J, O’Regan DP, Grasso M, Müller-Nurasyid M, Meitinger T, Empana JP, Strauch K, Waldenberger M, Marguiles KB, Seidman CE, Kararigas G, Meder B, Haas J, Boutouyrie P, Lacolley P, Jouven X, Erdmann J, Blankenberg S, Wichter T, Ruppert V, Tavazzi L, Dubourg O, Roizes G, Dorent R, de Groote P, Fauchier L, Trochu JN, Aupetit JF, Bilinska ZT, Germain M, Völker U, Hemerich D, Raji I, Bacq-Daian D, Proust C, Remior P, can u buy viagra over the counter Gomez-Bueno M, Lehnert K, Maas R, Olaso R, Saripella GV, Felix SB, McGinn S, Duboscq-Bidot L, van Mil A, Besse C, Fontaine V, Blanché H, Ader F, Keating B, Curjol A, Boland A, Komajda M, Cambien F, Deleuze JF, Dörr M, Asselbergs FW, Villard E, Trégouët DA, Charron P. Genome-wide association analysis in dilated cardiomyopathy reveals two new players in systolic heart failure on chromosomes 3p25.1 and 22q11.23. Eur Heart J 2021;42:2000–2011.20Fullenkamp can u buy viagra over the counter DE, Puckelwartz MJ, McNally EM.

Genome-wide association for heart failure. From discovery to can u buy viagra over the counter clinical use. Eur Heart J 2021;42:2012–2014.21Bhatt AS, Vardeny O, Udell JA, Joseph J, Kim K, Solomon SD. Influenza vaccination can u buy viagra over the counter. A ‘shot’ at INVESTing in cardiovascular health.

Eur Heart J 2021;42:2015–2018.22Verdecchia P, Angeli can u buy viagra over the counter F, Cavallini C. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation and coexistent atrial fibrillation. Eur Heart J 2021;42:2019.23Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, Dendale P, Dorobantu M, Edvardsen T, Folliguet T, Gale CP, Gilard M, Jobs A, Jüni P, Lambrinou E, Lewis BS, Mehilli J, Meliga E, Merkely B, Mueller C, Roffi M, Rutten FH, Sibbing D, Siontis GCM. 2020 ESC Guidelines can u buy viagra over the counter for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021;42:1289–1367.24Collet JP, Thiele H.

Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation and coexistent atrial fibrillation – Dual versus triple can u buy viagra over the counter antithrombotic therapy. Eur Heart J 2021;42:2020–2021. Published on behalf of the can u buy viagra over the counter European Society of Cardiology. All rights reserved. © The Author(s) 2021 can u buy viagra over the counter.

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SALT LAKE viagra pictures before and after how to get viagra CITY, Sept. 09, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. ("Health Catalyst", Nasdaq viagra pictures before and after. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Patrick Nelli, Chief Financial Officer, and Adam Brown, Senior Vice President, Investor Relations, will participate in the 2020 Cantor Global Virtual Healthcare Conference on Tuesday, September 15, 2020, which will include a fireside chat presentation at 1:20 p.m.

ET. A live audio webcast and replay of this presentation will be available at https://ir.healthcatalyst.com/investor-relations.About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Investor Relations Contact:Adam BrownSenior Vice President, Investor Relations+1 (855)-309-6800ir@healthcatalyst.comHealth Catalyst Media Contact:Kristen BerryVice President, Public Relations+1 (617) 234-4123+1 (774) 573-0455 (m)kberry@we-worldwide.com Source.

Health Catalyst, Inc.SALT LAKE CITY, Sept. 8, 2020 /PRNewswire/ -- Health Catalyst, Inc. ("Health Catalyst," Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that it has completed its seventh annual and first ever virtual Healthcare Analytics Summit (HAS), with record registration of more than 3,500 attendees.

Keynotes included Dr. Amy Abernethy, Principal Deputy Commissioner and Acting CIO of the U.S. Food and Drug Administration, Michael Dowling, CEO of Northwell Health, Vice Admiral Raquel Bono, MD, and many others. Other business updates include:The Vitalware, LLC ("VitalWare"), transaction has closed, and integration is underway of the Yakima, Washington-based provider of revenue workflow optimization and analytics SaaS technology solutions for health organizations.

This is another example of Health Catalyst's ability to scale software on top of its cloud-based Data Operating System (DOS™). DOS will further enhance the analytics insights made available by Vitalware's technology by combining charge and revenue data with claims, cost, and quality data. Vitalware's flagship offering is a Best in KLAS chargemaster management solution that delivers results for the complex regulatory and compliance functions needed by all healthcare provider systems. "As announced on August 11, 2020, we entered into an acquisition agreement to acquire Vitalware and expected to close the acquisition in Q3 or Q4 of 2020.

We are pleased to announce that we closed the acquisition on September 1, 2020. We are thrilled to formalize the combination of our solutions for the benefit of our customers and the industry," said CEO Dan Burton. On its upcoming Q3 2020 earnings call, Health Catalyst will share the impact of Vitalware on its Q3 2020 financial performance, which will not be significant given the timing of the acquisition, as well as update its full year 2020 guidance to include the impact of Vitalware. Health Catalyst Co-Founder Steve Barlow has returned from his three-year full-time volunteer mission for the Church of Jesus Christ of Latter-Day Saints, having served as Mission President of the Ecuador Quito Mission.

He has rejoined Health Catalyst's companywide Leadership Team as a Senior Vice President, responsible for some of the company's largest customer relationships. Dan Burton said, "We couldn't be more excited about Steve's return to Health Catalyst. His energy, dedication and commitment to transforming healthcare launched our journey and will continue to make us better and stronger. Steve is leading and overseeing all aspects of our partnerships with some of our largest and longest-standing customers can u buy viagra over the counter.

Steve's extraordinary experience and capability enable him to be a critical partner and leader in enabling these customers' continued improvement and success." "My experience over the past three years in Ecuador reinforced for me how fortunate I am to be in a country with high-quality healthcare," said Barlow. "It has been invigorating to return to Health Catalyst and witness the incredible growth and expansion that has occurred over the past few years. We are better positioned than ever before to achieve our mission of being the catalyst for massive, measurable, data-informed healthcare improvement. I am grateful to be reunited with our longstanding team members and customers, and I'm thrilled to get to know and work alongside our new customers and teammates in this critical work." Effective October 1, 2020, Chief Technology Officer Dale Sanders will be transitioning to a Senior Advisor role with Health Catalyst, and the company is pleased to announce that one of Dale's longtime protégés and colleagues, Bryan Hinton, will serve as Health Catalyst's next Chief Technology Officer.

Hinton joined Health Catalyst in 2012 and currently serves as the Senior Vice President and General Manager of the DOS Platform Business. He will continue to lead this business in addition to assuming the responsibilities of CTO. He has been instrumental in the development and integration of DOS and has been working directly with Dale and other technology leaders at Health Catalyst for many years. His experience prior to joining Health Catalyst includes four years with the .NET Development Center of Excellence at The Church of Jesus Christ of Latter-Day Saints, where he established the architectural guidance of all .NET projects.

Previously, at Intel, he was responsible for the development and implementation of Intel's factory data warehouse product installed at Intel global factories. Hinton graduated from Brigham Young University with a BS in Computer Science. "Dale has been central to Health Catalyst's growth and success and we are grateful to him for his many years of service to our company and to the broader healthcare industry," said Dan Burton, CEO of Health Catalyst. "Thanks to Dale's vision, passion, innovative thinking and broad-based industry experience and perspective, Health Catalyst has grown from a handful of clients to a large number of organizations relying on us as their digital transformation partner, helping the healthcare ecosystem to constantly learn and improve.

Dale's technology leadership was critical to the company's overall maturation, and I am convinced that we could not have grown and scaled as we have without Dale's foundational leadership and contributions. We are grateful to continue our association with Dale in the months and years ahead in his next role as a Senior Advisor to the company." Burton added, "We are thrilled to see Bryan Hinton take on this added role after having demonstrated his technology leadership prowess during the course of his tenure at Health Catalyst and having been mentored by Dale for many years. Bryan is well-prepared and ready for this additional responsibility, and we extend our congratulations to him." "I feel like a parent saying goodbye to my kids at their college graduation," said Dale Sanders. "Many of the concepts we first developed and applied over 20 years ago at Intermountain and then later refined during my tenure as CIO at Northwestern had a big influence on our technology and products at Health Catalyst.

The vision of the Data Operating System and its application ecosystem originated in the real-world healthcare operations and research trenches of Northwestern. At Health Catalyst, I had the wonderful opportunity to lead the teams who made that vision a reality for the benefit of the entire industry. None of it would have been possible without Bryan Hinton leading the DOS team and Eric Just and Dan Unger leading the application development teams. We've been working side-by-side for many years to make the vision real.

Bryan is the consummate modern CTO from outside of healthcare that healthcare needs. I've always described Eric as having a manufacturing engineer's mindset with a healthcare data and software engineer's skills, with Dan Unger leveraging his deep domain expertise in financial transformation to oversee the development of meaningful applications and solutions so relevant for CFOs. I'm honored and thrilled to step aside and turn the future over to their very capable hands. Under their leadership, the best is yet to come for Health Catalyst's technology." About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations, and is committed to being the catalyst for massive, measurable, data-informed healthcare improvement.

Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Media Contact:Kristen BerrySenior Vice President, Public Relations+1 (617) 234-4123HealthCatalyst@we-worldwide.com View original content to download multimedia:http://www.prnewswire.com/news-releases/health-catalyst-completes-hosting-of-the-largest-ever-healthcare-analytics-summit-and-announces-the-close-of-the-vitalware-acquisition-301125125.htmlSOURCE Health Catalyst.

SALT LAKE can u buy viagra over the counter CITY, Sept http://www.karpfenkaviar.at/2016/08/20/lorem-ipsum-dolor-sit-2/. 09, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. ("Health Catalyst", Nasdaq can u buy viagra over the counter. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Patrick Nelli, Chief Financial Officer, and Adam Brown, Senior Vice President, Investor Relations, will participate in the 2020 Cantor Global Virtual Healthcare Conference on Tuesday, September 15, 2020, which will include a fireside chat presentation at 1:20 p.m. ET.

A live audio webcast and replay of this presentation will be available at https://ir.healthcatalyst.com/investor-relations.About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Investor Relations Contact:Adam BrownSenior Vice President, Investor Relations+1 (855)-309-6800ir@healthcatalyst.comHealth Catalyst Media Contact:Kristen BerryVice President, Public Relations+1 (617) 234-4123+1 (774) 573-0455 (m)kberry@we-worldwide.com Source. Health Catalyst, Inc.SALT LAKE CITY, Sept. 8, 2020 /PRNewswire/ -- Health Catalyst, Inc.

("Health Catalyst," Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that it has completed its seventh annual and first ever virtual Healthcare Analytics Summit (HAS), with record registration of more than 3,500 attendees. Keynotes included Dr. Amy Abernethy, Principal Deputy Commissioner and Acting CIO of the U.S. Food and Drug Administration, Michael Dowling, CEO of Northwell Health, Vice Admiral Raquel Bono, MD, and many others.

Other business updates include:The Vitalware, LLC ("VitalWare"), transaction has closed, and integration is underway of the Yakima, Washington-based provider of revenue workflow optimization and analytics SaaS technology solutions for health organizations. This is another example of Health Catalyst's ability to scale software on top of its cloud-based Data Operating System (DOS™). DOS will further enhance the analytics insights made available by Vitalware's technology by combining charge and revenue data with claims, cost, and quality data. Vitalware's flagship offering is a Best in KLAS chargemaster management solution that delivers results for the complex regulatory and compliance functions needed by all healthcare provider systems. "As announced on August 11, 2020, we entered into an acquisition agreement to acquire Vitalware and expected to close the acquisition in Q3 or Q4 of 2020.

We are pleased to announce that we closed the acquisition on September 1, 2020. We are thrilled to formalize the combination of our solutions for the benefit of our customers and the industry," said CEO Dan Burton. On its upcoming Q3 2020 earnings call, Health Catalyst will share the impact of Vitalware on its Q3 2020 financial performance, which will not be significant given the timing of the acquisition, as well as update its full year 2020 guidance to include the impact of Vitalware. Health Catalyst Co-Founder Steve Barlow has returned from his three-year full-time volunteer mission for the Church of Jesus Christ of Latter-Day Saints, having served as Mission President of the Ecuador Quito Mission. He has rejoined Health Catalyst's companywide Leadership Team as a Senior Vice President, responsible for some of the company's largest customer relationships.

Dan Burton said, "We couldn't be more excited about Steve's return to Health Catalyst. His energy, dedication and commitment to transforming healthcare launched our journey and will continue to make us better and stronger. Steve is leading and overseeing all aspects of our partnerships with some of http://jakkicarey.com/portfolio/video-time-off-intangible-rewinds/ our largest and longest-standing customers. Steve's extraordinary experience and capability enable him to be a critical partner and leader in enabling these customers' continued improvement and success." "My experience over the past three years in Ecuador reinforced for me how fortunate I am to be in a country with high-quality healthcare," said Barlow. "It has been invigorating to return to Health Catalyst and witness the incredible growth and expansion that has occurred over the past few years.

We are better positioned than ever before to achieve our mission of being the catalyst for massive, measurable, data-informed healthcare improvement. I am grateful to be reunited with our longstanding team members and customers, and I'm thrilled to get to know and work alongside our new customers and teammates in this critical work." Effective October 1, 2020, Chief Technology Officer Dale Sanders will be transitioning to a Senior Advisor role with Health Catalyst, and the company is pleased to announce that one of Dale's longtime protégés and colleagues, Bryan Hinton, will serve as Health Catalyst's next Chief Technology Officer. Hinton joined Health Catalyst in 2012 and currently serves as the Senior Vice President and General Manager of the DOS Platform Business. He will continue to lead this business in addition to assuming the responsibilities of CTO. He has been instrumental in the development and integration of DOS and has been working directly with Dale and other technology leaders at Health Catalyst for many years.

His experience prior to joining Health Catalyst includes four years with the .NET Development Center of Excellence at The Church of Jesus Christ of Latter-Day Saints, where he established the architectural guidance of all .NET projects. Previously, at Intel, he was responsible for the development and implementation of Intel's factory data warehouse product installed at Intel global factories. Hinton graduated from Brigham Young University with a BS in Computer Science. "Dale has been central to Health Catalyst's growth and success and we are grateful to him for his many years of service to our company and to the broader healthcare industry," said Dan Burton, CEO of Health Catalyst. "Thanks to Dale's vision, passion, innovative thinking and broad-based industry experience and perspective, Health Catalyst has grown from a handful of clients to a large number of organizations relying on us as their digital transformation partner, helping the healthcare ecosystem to constantly learn and improve.

Dale's technology leadership was critical to the company's overall maturation, and I am convinced that we could not have grown and scaled as we have without Dale's foundational leadership and contributions. We are grateful to continue our association with Dale in the months and years ahead in his next role as a Senior Advisor to the company." Burton added, "We are thrilled to see Bryan Hinton take on this added role after having demonstrated his technology leadership prowess during the course of his tenure at Health Catalyst and having been mentored by Dale for many years. Bryan is well-prepared and ready for this additional responsibility, and we extend our congratulations to him." "I feel like a parent saying goodbye to my kids at their college graduation," said Dale Sanders. "Many of the concepts we first developed and applied over 20 years ago at Intermountain and then later refined during my tenure as CIO at Northwestern had a big influence on our technology and products at Health Catalyst. The vision of the Data Operating System and its application ecosystem originated in the real-world healthcare operations and research trenches of Northwestern.

At Health Catalyst, I had the wonderful opportunity to lead the teams who made that vision a reality for the benefit of the entire industry. None of it would have been possible without Bryan Hinton leading the DOS team and Eric Just and Dan Unger leading the application development teams. We've been working side-by-side for many years to make the vision real. Bryan is the consummate modern CTO from outside of healthcare that healthcare needs. I've always described Eric as having a manufacturing engineer's mindset with a healthcare data and software engineer's skills, with Dan Unger leveraging his deep domain expertise in financial transformation to oversee the development of meaningful applications and solutions so relevant for CFOs.

I'm honored and thrilled to step aside and turn the future over to their very capable hands. Under their leadership, the best is yet to come for Health Catalyst's technology." About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations, and is committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Media Contact:Kristen BerrySenior Vice President, Public Relations+1 (617) 234-4123HealthCatalyst@we-worldwide.com View original content to download multimedia:http://www.prnewswire.com/news-releases/health-catalyst-completes-hosting-of-the-largest-ever-healthcare-analytics-summit-and-announces-the-close-of-the-vitalware-acquisition-301125125.htmlSOURCE Health Catalyst.

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Latest Infectious Disease News By buy viagra pill Dennis Thompson HealthDay ReporterTHURSDAY, over the counter viagra walgreens July 15, 2021 (HealthDay News) Antibiotic-resistant bacteria is causing deadly pneumonia s among large numbers of children in the South Asian nation of Bangladesh, a rising threat that could one day reach American shores, experts warn. Doctors found these "superbug" bacteria in more than three of four children with a positive blood culture for bacterial pneumonia while being treated at a major Bangladesh hospital, said researcher Dr. Jason Harris, division chief for over the counter viagra walgreens pediatric global health at MassGeneral Hospital for Children, in Boston. By comparison, most American kids stricken with bacterial pneumonia are infected with either Staphylococcus or Streptococcus, germs that usually respond well to antibiotic therapy, the researchers noted. Still, the potential threat to people worldwide is "kind of staggering," Harris said.

"This is a good hospital where this study was done, and 30% of the kids with bacteria in the blood over the counter viagra walgreens and pneumonia died, which is unheard of. These are lots of kids dying already." Pneumonia is an of the lungs that causes air sacs to fill with pus and fluid, and without treatment it can be fatal. This is the most common cause of death among young children, according to the World Health Organization. Smaller studies have shown that a growing number of pneumonia cases in South Asian countries appear to be caused by bacteria resistant to antibiotics, so researchers decided to look at a large group of more than 4,000 children treated for pneumonia at the Dhaka Hospital of over the counter viagra walgreens the International Center for Diarrheal Disease Research, in Bangladesh. Nearly half of the kids had a blood culture obtained.

Among those whose blood tested positive for bacteria, 77% were infected with antibiotic-resistant bacteria like Pseudomonas, E. Coli, Salmonella, and Klebsiella, over the counter viagra walgreens according to the results published July 15 in the journal Open Forum Diseases. Dr. Amesh Adalja is a senior scholar with the Johns Hopkins Center for Health Security, in Baltimore. He said, "It is especially remarkable to see the very different microbial ecology of over the counter viagra walgreens pediatric pneumonia in Bangladesh.

It appears that Gram-negative bacteria, which have a high proclivity for resistance and less treatment options, dominate. This makes it very difficult to choose an antibiotic that will have a positive effect." Nearly one-third of the kids with bacterial pneumonia died, the researchers reported. In fact, the researchers concluded that children with antibiotic-resistant bacterial pneumonia had a 17 times greater risk of dying than kids without a over the counter viagra walgreens bacterial . "If you look at some of these antibiotic-resistant bacteria, almost none of the kids survived. This is over the counter viagra walgreens already killing lots of kids in Bangladesh," Harris said.

Widespread use of antibiotics in Bangladesh likely has contributed to the rise of resistant bacteria there, he noted. "Antibiotics are very commonly available over-the-counter in Bangladesh. Most people may not be able to afford over the counter viagra walgreens to go to a doctor, so they just go to the local pharmacy around the corner," Harris said. Antibiotics are handed out to treat common ailments like colds and diarrhea, which leads to "rampant antibiotic resistance," he explained. Further, a lack of safe water and poor sanitation probably exposes a greater number of children to already dangerous bacteria made even more deadly by antibiotic resistance, Harris added.

These sort of antibiotic-resistant bacteria have already reached America, over the counter viagra walgreens Adalja noted, but they aren't causing pneumonia in children. He suspects that malnourishment or intestinal issues might be contributing to the pneumonia cases in Bangladesh. But Harris sees what's happening in Bangladesh as a warning for the United States. "Once these bacteria have established themselves more, they will ultimately replace the bacteria which are over the counter viagra walgreens more susceptible to antibiotics because they do have an advantage. Once they're established here, I think we'll be stuck with them," Harris said.

"It's like the erectile dysfunction treatment variants. The Delta variant didn't emerge here, but it's now the leading cause of erectile dysfunction treatment over the counter viagra walgreens in the U.S. Because it had an advantage," he noted. QUESTION Bowel regularity means a bowel movement every day over the counter viagra walgreens. See Answer The United States actually could help protect itself by helping improve health care and sanitation in Bangladesh, Harris suggested.

"As erectile dysfunction treatment has shown us, we're all really connected. The emergence of over the counter viagra walgreens these bacteria in one place, there's no perfect way to keep them out. They spread," he said. Adalja added that the situation also "underscores the pressing need to develop more antibiotics against Gram-negative bacterial pathogens and to improve diagnostic capacity to help guide antibiotic selection." Unfortunately, research in that area has progressed at a snail's pace, Harris said. "Finding new antibiotics over the counter viagra walgreens is hard," Harris said.

"The pace of finding new antibiotics has not been fast." More information The U.S. Centers for Disease Control and Prevention has more about antibiotic resistance. SOURCES. Jason Harris, MD, division chief, pediatric global health, MassGeneral Hospital for Children, Boston. Amesh Adalja, MD, senior scholar, Johns Hopkins Center for Health Security, Baltimore.

Open Forum Infectious Diseases, July 15, 2021 Copyright © 2021 HealthDay. All rights reserved. From Infectious Disease Resources Featured Centers Health Solutions From Our SponsorsLatest Heart News THURSDAY, July 15, 2021 (American Heart Association News) Liz Harris won't let anything stop her from walking. Three mornings a week, she descends three flights of stairs and heads to Anacostia Park. It's a 10-minute walk just to get there.

If none of her friends are available, she walks alone. But they worry about her when she does. "The community is known for crime, and you don't feel comfortable walking alone," said Harris, 72, who lives in southeastern Washington, D.C.'s Ward 8. But that's not her only concern. Unleashed dogs in the park make her wary.

The streets along the way are uneven and in disrepair. Heavy traffic can contribute to poor air quality. "For the most part, the neighborhood is just not conducive to getting exercise, especially for women," she said. Still, Harris walks because crime isn't all her neighborhood is known for. It also has some of the district's highest rates of obesity, heart disease and cognitive decline, according to DC Health Matters Collaborative, a coalition of hospitals and community health centers.

A 2018 report by the Metropolitan Washington Council of Governments spotlights other neighborhood disparities. Higher infant deaths, child poverty, unemployment, older housing and longer work commutes. "We're always at the lowest indicators," said Mustafa Abdul-Salaam, a longtime community activist who also lives in Ward 8. "We die 15 years earlier than Ward 3 (in northwest Washington). That says it all." There is a wealth of research underscoring how the conditions in which people live, work, learn and play affect their health, particularly the heart – and therefore the brain.

A basic element of these so-called social determinants of health is the neighborhood, with factors such as housing security. Access to healthy foods, transportation and health care. Opportunities for physical activity. And exposure to pollutants and noise. Lack of public safety, social disorganization and exposure to high levels of violent crime also have been associated with increases in stroke risk, which can potentially cause cognitive decline.

"All of those factors coming together increase a person's vulnerability to cardiovascular disease, especially in poorer neighborhoods," said Mustafa Hussein, an assistant professor at the Joseph J. Zilber School of Public Health at the University of Wisconsin-Milwaukee. Hussein led a 2017 study published in the American Journal of Epidemiology that found people with low socioeconomic status were 60% more at risk of having a heart attack or stroke as those with high socioeconomic status, with at least one-third of the extra risk attributable to neighborhood conditions. Other research in the journal Stroke suggests people living with three or more of these social determinants are nearly 2.5 times more likely to have a stroke. A 2020 report in the journal Circulation.

Cardiovascular Quality and Outcomes concluded just living in aging public housing raises heart disease risk. In its 2019 prevention http://www.ec-sainte-madeleine-strasbourg.site.ac-strasbourg.fr/wp/?p=1059 guidelines, jointly issued with the American College of Cardiology, the American Heart Association said these social inequities are "strong" determinants of risk and can have as big an impact on cardiovascular health as medications and lifestyle changes. Abdul-Salaam sees those impacts firsthand. Ward 8 has a lot of natural beauty and green space – important factors for keeping a neighborhood healthy, he said. But it lacks access to healthy and affordable groceries and shoulders a heavy burden of commercial and commuter traffic that makes streets less amenable to walking while creating more noise and pollution.

It's one of the scenarios organizations like the National Complete Streets Coalition is trying to address. The group is working to transform roads and design new ones across the country to make it easier and safer to walk, bike, use assistive devices such as walkers and access public transportation. The solutions include sidewalks, bike lanes or wider shoulders, bus lanes and more comfortable and accessible transportation stops. A 2020 AHA policy statement said such campaigns were vital to promote "increased physical activity regardless of age, income, racial/ethnic background, ability, or disability." QUESTION In the U.S., 1 in every 4 deaths is caused by heart disease. See Answer The work hits home especially in neighborhoods that historically haven't seen the same economic and infrastructure investment as others.

To date, 35 state governments and the District of Columbia have adopted Complete Street policies. In Washington, this has led to improvements, some in Ward 8, such as raised crosswalks and dedicated bike paths. But community members say much more is needed to help the area thrive. Abdul-Salaam is helping to lead and facilitate a planning process in Ward 8 to connect residents with government, business and health leaders to collaborate on solutions for southeast Washington, D.C. He is recruiting and training community members to map the neighborhood's assets and deficits, using a GPS-enabled app.

"Then we can identify what we need to add or remove." Involving residents is an important – and often overlooked – step in neighborhood revitalization, said Dr. Tiffany Powell-Wiley, chief of the Social Determinants of Obesity and Cardiovascular Risk laboratory at the National Heart, Lung, and Blood Institute. Too often, decisions in under-resourced communities are made without input from the people who live there, resulting in low-income residents being pushed out when neighborhood upgrades make it more appealing to outsiders – and more expensive. "There needs to be an element of racial equity in the work that's happening," she said. "If a new policy is coming into place around community development, we need to ensure that different racial and ethnic populations are benefiting equally." That doesn't mean people also can't take individual steps, said Powell-Wiley.

She works with community members like Harris to design and carry out research on culturally appropriate ways to increase physical activity and improve heart health among Black women living in areas with fewer resources. "There are ways to use the resources you do have," she said, particularly if women form social networks to support each other. "It's safer to walk as a group, for example." But strategies to reduce heart and brain health risks – such as promoting lifestyle change – can't fully benefit people in communities with insufficient resources until underlying structural challenges are addressed, Hussein said. "The whole idea of lifestyle choices as something everyone can tap into is misleading, when in fact that choice is constrained by what is available to people," he said. "This is where policy solutions or investments into these neighborhoods to make up for historical disinvestment becomes so important." American Heart Association News covers heart and brain health.

Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email [email protected] By Laura Williamson American Heart Association News Copyright © 2021 HealthDay. All rights reserved. From Healthy Heart Resources Featured Centers Health Solutions From Our SponsorsLatest Infectious Disease News FRIDAY, July 16, 2021 A man in China has been hospitalized with the H5N6 strain of avian flu, which is one of several potentially dangerous strains that can infect humans.

The 55-year-old man came down with a fever and tested positive for the viagra on July 6. He was hospitalized in Bazhong, a city in the province of Sichuan, according to the state-run China Global Television Network, The New York Times reported. In response to the case, local officials "activated an emergency response and sterilized the area," the broadcaster said. It added that unnamed experts said there was a low risk of large-scale transmission among humans, the Times reported. There was no mention of whether the man was involved in work handling pouy.

The H5N6 viagra was first detected eight years ago in Laos, later spreading to China and other countries. Since 2014, 32 cases of human with the viagra and 19 deaths in Asia have been reported to the World Health Organization, the Times reported. The last human case before this latest one had an onset date of May 13. Mutations are common in bird flu viagraes, so scientists strive to track them closely for indications they're becoming more deadly or contagious, the Times reported. Last year, a team of scientists reported that a new strain of the H1N1 swine flu viagra was spreading silently in workers on China's pig farms and should be "urgently" controlled to avoid another viagra, even though the strain had not caused disease in the people it infected, the Times reported.

More information Visit the U.S. Centers for Disease Control and Prevention for more on the avian flu. SOURCE. The New York Times Robert Preidt Copyright © 2021 HealthDay. All rights reserved.

QUESTION Bowel regularity means a bowel movement every day. See AnswerLatest erectile dysfunction News FRIDAY, July 16, 2021 (HealthDay News) Surging erectile dysfunction cases have prompted Los Angeles County to once again require people to wear masks indoors, even if they're vaccinated. The nation's largest county has had more than 1,000 new cases each day for a week, with more than 400 hospitalizations, the Associated Press reported. The new mask order will take effect just before midnight Saturday in "an all-hands-on-deck moment," public health officer Dr. Muntu Davis said during a virtual news conference.

He said the focus will be on education rather than enforcement, and that there will be some exemptions to the mandate, such as when people are actually eating and drinking at restaurants, the AP reported. California has seen a spike in erectile dysfunction cases since it fully reopened its economy on June 15. Many cases involve the highly transmissible Delta variant, and the vast majority of cases are among unvaccinated people, the AP said. In response to rising case numbers, the University of California system also said Thursday that students, faculty and staff must be vaccinated to return to campuses, the AP reported. "Vaccination is by far the most effective way to prevent severe disease and death after exposure to the viagra and to reduce spread of the disease to those who are not able, or not yet eligible, to receive the treatment," UC President Michael Drake wrote.

The return of mask mandates come after a winter where Los Angeles County experienced a massive surge in s and deaths, the AP reported. Hospitalizations in California are now above 1,700, the highest level seen since April. More than 3,600 cases were reported Thursday, the most since late February but a far cry from a winter peak that saw an average of more than 40,000 per day, the AP reported. More information Visit the CDC for more on mask guidance. SOURCE.

Associated Press Robert Preidt Copyright © 2021 HealthDay. All rights reserved.Latest Allergies News FRIDAY, July 16, 2021 (HealthDay News) Pfizer Inc. Has agreed to pay $345 million in a proposed settlement to resolve lawsuits over steep EpiPen price increases. EpiPens are auto-injectable devices that deliver the drug epinephrine for emergency treatment of a life-threatening allergic reaction called anaphylaxis. In 2016, a number of class-action lawsuits were filed against Pfizer and its subsidiaries Meridian Medical Technologies Inc.

And King Pharmaceuticals, alleging they engaged in anticompetitive conduct related to EpiPen, the Associated Press reported. Another company that is a defendant in the litigation is Mylan, which owns the EpiPen brand, even though the devices are made by Pfizer. Mylan acquired the right to market and distribute the devices in 2007, when an EpiPen package cost about $100. Now, it costs more than $650 without pharmacy coupons or manufacturer discounts, the AP reported. Court documents filed Thursday in federal court in Kansas City, Kansas, show that Pfizer and its two subsidiaries asked the court to give preliminary approval to the settlement, according to Kansas City's NPR station KCUR-FM.

Three weeks ago, most of the claims against Mylan were dismissed, but the judge allowed antitrust claims against the company to proceed to trial, scheduled to start on Sept. 7, the AP reported. Rex Sharp, a lawyer for the plaintiffs, said his clients were pleased that Pfizer had agreed to the settlement, noting it would still need the court's approval, the AP reported In an email to KCUR-FM, a Pfizer spokesperson denied any wrongdoing by the company and said the settlement was sought to avoid "the distraction of continued litigation and focus on breakthroughs that change patients' lives." More information The National Institute of Allergy and Infectious Diseases has more on food allergies. SOURCE. Associated Press Robert Preidt Copyright © 2021 HealthDay.

All rights reserved. QUESTION Allergies can best be described as. See Answer.

Latest Infectious buy viagra pill Disease News By Dennis Thompson HealthDay ReporterTHURSDAY, July 15, 2021 (HealthDay News) Antibiotic-resistant bacteria is causing can u buy viagra over the counter deadly pneumonia s among large numbers of children in the South Asian nation of Bangladesh, a rising threat that could one day reach American shores, experts warn. Doctors found these "superbug" bacteria in more than three of four children with a positive blood culture for bacterial pneumonia while being treated at a major Bangladesh hospital, said researcher Dr. Jason Harris, division chief for pediatric global health at MassGeneral can u buy viagra over the counter Hospital for Children, in Boston.

By comparison, most American kids stricken with bacterial pneumonia are infected with either Staphylococcus or Streptococcus, germs that usually respond well to antibiotic therapy, the researchers noted. Still, the potential threat to people worldwide is "kind of staggering," Harris said. "This is a good hospital where this can u buy viagra over the counter study was done, and 30% of the kids with bacteria in the blood and pneumonia died, which is unheard of.

These are lots of kids dying already." Pneumonia is an of the lungs that causes air sacs to fill with pus and fluid, and without treatment it can be fatal. This is the most common cause of death among young children, according to the World Health Organization. Smaller studies have shown can u buy viagra over the counter that a growing number of pneumonia cases in South Asian countries appear to be caused by bacteria resistant to antibiotics, so researchers decided to look at a large group of more than 4,000 children treated for pneumonia at the Dhaka Hospital of the International Center for Diarrheal Disease Research, in Bangladesh.

Nearly half of the kids had a blood culture obtained. Among those whose blood tested positive for bacteria, 77% were infected with antibiotic-resistant bacteria like Pseudomonas, E. Coli, Salmonella, and Klebsiella, according to the results published July 15 in the journal Open can u buy viagra over the counter Forum Diseases.

Dr. Amesh Adalja is a senior scholar with the Johns Hopkins Center for Health Security, in Baltimore. He said, can u buy viagra over the counter "It is especially remarkable to see the very different microbial ecology of pediatric pneumonia in Bangladesh.

It appears that Gram-negative bacteria, which have a high proclivity for resistance and less treatment options, dominate. This makes it very difficult to choose an antibiotic that will have a positive effect." Nearly one-third of the kids with bacterial pneumonia died, the researchers reported. In fact, the researchers concluded that children with antibiotic-resistant bacterial pneumonia can u buy viagra over the counter had a 17 times greater risk of dying than kids without a bacterial .

"If you look at some of these antibiotic-resistant bacteria, almost none of the kids survived. This is already killing lots can u buy viagra over the counter of kids in Bangladesh," Harris said. Widespread use of antibiotics in Bangladesh likely has contributed to the rise of resistant bacteria there, he noted.

"Antibiotics are very commonly available over-the-counter in Bangladesh. Most people may not be able to afford to go to a doctor, so they just go can u buy viagra over the counter to the local pharmacy around the corner," Harris said. Antibiotics are handed out to treat common ailments like colds and diarrhea, which leads to "rampant antibiotic resistance," he explained.

Further, a lack of safe water and poor sanitation probably exposes a greater number of children to already dangerous bacteria made even more deadly by antibiotic resistance, Harris added. These sort of antibiotic-resistant bacteria have can u buy viagra over the counter already reached America, Adalja noted, but they aren't causing pneumonia in children. He suspects that malnourishment or intestinal issues might be contributing to the pneumonia cases in Bangladesh.

But Harris sees what's happening in Bangladesh as a warning for the United States. "Once these bacteria have established themselves more, can u buy viagra over the counter they will ultimately replace the bacteria which are more susceptible to antibiotics because they do have an advantage. Once they're established here, I think we'll be stuck with them," Harris said.

"It's like the erectile dysfunction treatment variants. The Delta variant didn't emerge here, but it's now the leading cause of erectile dysfunction treatment in the can u buy viagra over the counter U.S. Because it had an advantage," he noted.

QUESTION Bowel regularity means a can u buy viagra over the counter bowel movement every day. See Answer The United States actually could help protect itself by helping improve health care and sanitation in Bangladesh, Harris suggested. "As erectile dysfunction treatment has shown us, we're all really connected.

The emergence of these bacteria can u buy viagra over the counter in one place, there's no perfect way to keep them out. They spread," he said. Adalja added that the situation also "underscores the pressing need to develop more antibiotics against Gram-negative bacterial pathogens and to improve diagnostic capacity to help guide antibiotic selection." Unfortunately, research in that area has progressed at a snail's pace, Harris said.

"Finding new can u buy viagra over the counter antibiotics is hard," Harris said. "The pace of finding new antibiotics has not been fast." More information The U.S. Centers for Disease Control and Prevention has more about antibiotic resistance.

SOURCES. Jason Harris, MD, division chief, pediatric global health, MassGeneral Hospital for Children, Boston. Amesh Adalja, MD, senior scholar, Johns Hopkins Center for Health Security, Baltimore.

Open Forum Infectious Diseases, July 15, 2021 Copyright © 2021 HealthDay. All rights reserved. From Infectious Disease Resources Featured Centers Health Solutions From Our SponsorsLatest Heart News THURSDAY, July 15, 2021 (American Heart Association News) Liz Harris won't let anything stop her from walking.

Three mornings a week, she descends three flights of stairs and heads to Anacostia Park. It's a 10-minute walk just to get there. If none of her friends are available, she walks alone.

But they worry about her when she does. "The community is known for crime, and you don't feel comfortable walking alone," said Harris, 72, who lives in southeastern Washington, D.C.'s Ward 8. But that's not her only concern.

Unleashed dogs in the park make her wary. The streets along the way are uneven and in disrepair. Heavy traffic can contribute to poor air quality.

"For the most part, the neighborhood is just not conducive to getting exercise, especially for women," she said. Still, Harris walks because crime isn't all her neighborhood is known for. It also has some of the district's highest rates of obesity, heart disease and cognitive decline, according to DC Health Matters Collaborative, a coalition of hospitals and community health centers.

A 2018 report by the Metropolitan Washington Council of Governments spotlights other neighborhood disparities. Higher infant deaths, child poverty, unemployment, older housing and longer work commutes. "We're always at the lowest indicators," said Mustafa Abdul-Salaam, a longtime community activist who also lives in Ward 8.

"We die 15 years earlier than Ward 3 (in northwest Washington). That says it all." There is a wealth of research underscoring how the conditions in which people live, work, learn and play affect their health, particularly the heart – and therefore the brain. A basic element of these so-called social determinants of health is the neighborhood, with factors such as housing security.

Access to healthy foods, transportation and health care. Opportunities for physical activity. And exposure to pollutants and noise.

Lack of public safety, social disorganization and exposure to high levels of violent crime also have been associated with increases in stroke risk, which can potentially cause cognitive decline. "All of those factors coming together increase a person's vulnerability to cardiovascular disease, especially in poorer neighborhoods," said Mustafa Hussein, an assistant professor at the Joseph J. Zilber School of Public Health at the University of Wisconsin-Milwaukee.

Hussein led a 2017 study published in the American Journal of Epidemiology that found people with low socioeconomic status were 60% more at risk of having a heart attack or stroke as those with high socioeconomic status, with at least one-third of the extra risk attributable to neighborhood conditions. Other research in the journal Stroke suggests people living with three or more of these social determinants are nearly 2.5 times more likely to have a stroke. A 2020 report in the journal Circulation.

Cardiovascular Quality and Outcomes concluded just living in aging public housing raises heart disease risk. In its 2019 prevention guidelines, jointly issued with the American College of Cardiology, the American Heart Association said these social inequities are "strong" determinants of risk and can have as big an impact on cardiovascular health as medications and lifestyle changes. Abdul-Salaam sees those impacts firsthand.

Ward 8 has a lot of natural beauty and green space – important factors for keeping a neighborhood healthy, he said. But it lacks access to healthy and affordable groceries and shoulders a heavy burden of commercial and commuter traffic that makes streets less amenable to walking while creating more noise and pollution. It's one of the scenarios organizations like the National Complete Streets Coalition is trying to address.

The group is working to transform roads and design new ones across the country to make it easier and safer to walk, bike, use assistive devices such as walkers and access public transportation. The solutions include sidewalks, bike lanes or wider shoulders, bus lanes and more comfortable and accessible transportation stops. A 2020 AHA policy statement said such campaigns were vital to promote "increased physical activity regardless of age, income, racial/ethnic background, ability, or disability." QUESTION In the U.S., 1 in every 4 deaths is caused by heart disease.

See Answer The work hits home especially in neighborhoods that historically haven't seen the same economic and infrastructure investment as others. To date, 35 state governments and the District of Columbia have adopted Complete Street policies. In Washington, this has led to improvements, some in Ward 8, such as raised crosswalks and dedicated bike paths.

But community members say much more is needed to help the area thrive. Abdul-Salaam is helping to lead and facilitate a planning process in Ward 8 to connect residents with government, business and health leaders to collaborate on solutions for southeast Washington, D.C. He is recruiting and training community members to map the neighborhood's assets and deficits, using a GPS-enabled app.

"Then we can identify what we need to add or remove." Involving residents is an important – and often overlooked – step in neighborhood revitalization, said Dr. Tiffany Powell-Wiley, chief of the Social Determinants of Obesity and Cardiovascular Risk laboratory at the National Heart, Lung, and Blood Institute. Too often, decisions in under-resourced communities are made without input from the people who live there, resulting in low-income residents being pushed out when neighborhood upgrades make it more appealing to outsiders – and more expensive.

"There needs to be an element of racial equity in the work that's happening," she said. "If a new policy is coming into place around community development, we need to ensure that different racial and ethnic populations are benefiting equally." That doesn't mean people also can't take individual steps, said Powell-Wiley. She works with community members like Harris to design and carry out research on culturally appropriate ways to increase physical activity and improve heart health among Black women living in areas with fewer resources.

"There are ways to use the resources you do have," she said, particularly if women form social networks to support each other. "It's safer to walk as a group, for example." But strategies to reduce heart and brain health risks – such as promoting lifestyle change – can't fully benefit people in communities with insufficient resources until underlying structural challenges are addressed, Hussein said. "The whole idea of lifestyle choices as something everyone can tap into is misleading, when in fact that choice is constrained by what is available to people," he said.

"This is where policy solutions or investments into these neighborhoods to make up for historical disinvestment becomes so important." American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.

If you have questions or comments about this story, please email [email protected] By Laura Williamson American Heart Association News Copyright © 2021 HealthDay. All rights reserved. From Healthy Heart Resources Featured Centers Health Solutions From Our SponsorsLatest Infectious Disease News FRIDAY, July 16, 2021 A man in China has been hospitalized with the H5N6 strain of avian flu, which is one of several potentially dangerous strains that can infect humans.

The 55-year-old man came down with a fever and tested positive for the viagra on July 6. He was hospitalized in Bazhong, a city in the province of Sichuan, according to the state-run China Global Television Network, The New York Times reported. In response to the case, local officials "activated an emergency response and sterilized the area," the broadcaster said.

It added that unnamed experts said there was a low risk of large-scale transmission among humans, the Times reported. There was no mention of whether the man was involved in work handling pouy. The H5N6 viagra was first detected eight years ago in Laos, later spreading to China and other countries.

Since 2014, 32 cases of human with the viagra and 19 deaths in Asia have been reported to the World Health Organization, the Times reported. The last human case before this latest one had an onset date of May 13. Mutations are common in bird flu viagraes, so scientists strive to track them closely for indications they're becoming more deadly or contagious, the Times reported.

Last year, a team of scientists reported that a new strain of the H1N1 swine flu viagra was spreading silently in workers on China's pig farms and should be "urgently" controlled to avoid another viagra, even though the strain had not caused disease in the people it infected, the Times reported. More information Visit the U.S. Centers for Disease Control and Prevention for more on the avian flu.

SOURCE. The New York Times Robert Preidt Copyright © 2021 HealthDay. All rights reserved.

QUESTION Bowel regularity means a bowel movement every day. See AnswerLatest erectile dysfunction News FRIDAY, July 16, 2021 (HealthDay News) Surging erectile dysfunction cases have prompted Los Angeles County to once again require people to wear masks indoors, even if they're vaccinated. The nation's largest county has had more than 1,000 new cases each day for a week, with more than 400 hospitalizations, the Associated Press reported.

The new mask order will take effect just before midnight Saturday in "an all-hands-on-deck moment," public health officer Dr. Muntu Davis said during a virtual news conference. He said the focus will be on education rather than enforcement, and that there will be some exemptions to the mandate, such as when people are actually eating and drinking at restaurants, the AP reported.

California has seen a spike in erectile dysfunction cases since it fully reopened its economy on June 15. Many cases involve the highly transmissible Delta variant, and the vast majority of cases are among unvaccinated people, the AP said. In response to rising case numbers, the University of California system also said Thursday that students, faculty and staff must be vaccinated to return to campuses, the AP reported.

"Vaccination is by far the most effective way to prevent severe disease and death after exposure to the viagra and to reduce spread of the disease to those who are not able, or not yet eligible, to receive the treatment," UC President Michael Drake wrote. The return of mask mandates come after a winter where Los Angeles County experienced a massive surge in s and deaths, the AP reported. Hospitalizations in California are now above 1,700, the highest level seen since April.

More than 3,600 cases were reported Thursday, the most since late February but a far cry from a winter peak that saw an average of more than 40,000 per day, the AP reported. More information Visit the CDC for more on mask guidance. SOURCE.

Associated Press Robert Preidt Copyright © 2021 HealthDay. All rights reserved.Latest Allergies News FRIDAY, July 16, 2021 (HealthDay News) Pfizer Inc. Has agreed to pay $345 million in a proposed settlement to resolve lawsuits over steep EpiPen price increases.

EpiPens are auto-injectable devices that deliver the drug epinephrine for emergency treatment of a life-threatening allergic reaction called anaphylaxis. In 2016, a number of class-action lawsuits were filed against Pfizer and its subsidiaries Meridian Medical Technologies Inc. And King Pharmaceuticals, alleging they engaged in anticompetitive conduct related to EpiPen, the Associated Press reported.

Another company that is a defendant in the litigation is Mylan, which owns the EpiPen brand, even though the devices are made by Pfizer. Mylan acquired the right to market and distribute the devices in 2007, when an EpiPen package cost about $100. Now, it costs more than $650 without pharmacy coupons or manufacturer discounts, the AP reported.

Court documents filed Thursday in federal court in Kansas City, Kansas, show that Pfizer and its two subsidiaries asked the court to give preliminary approval to the settlement, according to Kansas City's NPR station KCUR-FM. Three weeks ago, most of the claims against Mylan were dismissed, but the judge allowed antitrust claims against the company to proceed to trial, scheduled to start on Sept. 7, the AP reported.

Rex Sharp, a lawyer for the plaintiffs, said his clients were pleased that Pfizer had agreed to the settlement, noting it would still need the court's approval, the AP reported In an email to KCUR-FM, a Pfizer spokesperson denied any wrongdoing by the company and said the settlement was sought to avoid "the distraction of continued litigation and focus on breakthroughs that change patients' lives." More information The National Institute of Allergy and Infectious Diseases has more on food allergies. SOURCE. Associated Press Robert Preidt Copyright © 2021 HealthDay.

All rights reserved. QUESTION Allergies can best be described as. See Answer.

Viagra blood pressure

American Airlines Boeing 787-9 Dreamliner takes off http://www.jadetrading.net/about-us/ from Los Angeles international Airport on November 11, 2020 in Los Angeles, California.AaronP | Bauer-Griffin | GC Images | Getty ImagesAmerican Airlines and United Airlines are pausing plans to operate viagra blood pressure nonstop flights to Shanghai from the U.S. Following reports of lengthy waits facing airline crews upon arrival, limited local accommodations and restrictions on their movement in the country, according to people familiar with the matter.They will instead route the flights with a stop in South Korea, the people said, asking not to be named because they aren't authorized to talk about it.Airlines haven't resumed most of their China service after suspending it in February as the erectile dysfunction was spreading.American Airlines planned to begin nonstop flights carrying only cargo from Los Angeles to Shanghai this month but will continue to operate the flight with a stop in Seoul, South Korea, on the way to Asia, the people viagra blood pressure said. It will fly nonstop from Shanghai back to Los Angeles, however.

American is also continuing to include a stop in Seoul on its cargo-only flights from Dallas-Fort Worth and from Los Angeles to Beijing because of similar concerns, one of the people said.Long waits to enter the country and get viagra blood pressure to hotels are a problem for airlines because it can eat into federally mandated crew rest requirements.Last month, American resumed China service with flights between Dallas-Fort Worth International Airport and Shanghai with a stop in Seoul."We are pleased by that decision and look forward to continued dialogue to ensure that when we resume flying it's in the best interest of American and its pilots," said Dennis Tajer, an American Airlines Boeing 737 captain and spokesman for the Allied Pilots Association, which represents the carrier's pilots.United, for its part, said it has added a stop in Seoul on its San Francisco-Shanghai service."Due to changes in operating conditions, we adjusted service between San Francisco and Shanghai to now include a stop in Seoul, South Korea for a crew change as we did earlier this year," United said in a statement. Passengers booked to Shanghai stay on the plane during the stop.Delta Air Lines plans to offer nonstop flights viagra blood pressure to Shanghai from Seattle and Detroit starting this week."Delta has shared with us their plan and the logistics surrounding the initiation of nonstop service to Shanghai," Delta's pilots' union, the Air Line Pilots Association, said in a statement. "Right now, we are studying it to make sure that it is airtight."In addition to lengthy airport waits, airline labor unions have expressed concerns about the Chinese government-mandated airport hotel that flight crews would stay in and reported restrictions on crews leaving hotel rooms.The Chinese Embassy in Washington and the U.S.

Department of Transportation didn't immediately respond to requests for comment.A Centers for Disease Control and viagra blood pressure Prevention panel voted 13-1 on Tuesday to give health-care workers and long-term care facility residents the first erectile dysfunction treatment doses once it's cleared for public use.There are roughly 21 million health-care workers and 3 million long-term care facility residents in the United States, according to a presentation during the CDC's Advisory Committee on Immunization Practices, an outside group of medical experts that advises the agency. Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, said most states and local jurisdictions expect it to take three weeks to vaccinate all of their health-care workers.

Pfizer and Moderna's treatments require two doses about a month apart.The meeting comes as states prepare to distribute a treatment in as little as two weeks. Moderna and Pfizer have both requested emergency clearance from the Food and Drug Administration for their erectile dysfunction treatments last month. The reviews by the FDA are expected to take a few weeks, and the agency has scheduled a meeting for Dec.

10 to discuss Pfizer's request for authorization.Since the viagra began, scientists and infectious disease experts have debated who will get immunized first and how the limited first treatment doses will be distributed across the United States. Health and Human Services Secretary Alex Azar told CNBC on Nov. 16 that about 40 million doses of treatment will available by the end of this year, enough to inoculate about 20 million people since the Moderna and Pfizer treatments require two shots.Earlier Tuesday, Trump treatment chief Moncef Slaoui said the entire U.S.

Population of 331 million could be vaccinated against erectile dysfunction treatment by June, and there could be enough doses to immunize http://www.finedesigncontracting.com/?page_id=23 the rest of the nearly 8 billion people in the world by early to mid-2022.Read More. Trump erectile dysfunction treatment chief Slaoui says everyone in U.S. Could be immunized by JuneThe side effects from the treatment can lay people up for a day or so, company officials have said.

That's prompted officials to recommend that health-care facilities plan for workers to have time away from clinical care if they experience symptoms after getting vaccinated.About 10% to 15% of people report noticeable side effects from the treatments, according to Dr. Moncef Slaoui, who is leading the Trump administration's erectile dysfunction treatment program Operation Warp Speed. The people who've suffered from side effects have reported redness and pain at the injection site as well as fever, chills, muscle aches and headaches, he said Tuesday, adding most people have no noticeable side effects.Read More.

Trump erectile dysfunction treatment czar says side effects ‘significantly noticeable’ in 10% to 15% of recipientsMedical experts have previously advocated for health-care workers to get the treatment first, followed by vulnerable Americans, including the elderly, people with preexisting conditions and essential workers. Children and young adults are expected to get the treatment last.Although states don't have to follow the CDC's guidance, it gives them a framework to work with and that many states adopt, Dr. Karen Landers, spokeswoman for the Alabama Department of Public Health, said in a recent phone interview."This guidance will be extremely helpful because it will be science-based, and also will give us the framework to be able to ensure that our guidelines are consistent with what is recommended by support staff," she said.

"The Alabama Department of Public Health will follow those recommendations, and we'll certainly be following what ACIP recommends in terms of the treatment administration.The committee defined health-care workers as paid and unpaid people serving in health-care settings who have the potential for direct or indirect exposure to patients or infectious materials.The group defined long-term care facility residents as adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently. Residents and staff in long-term care facilities account for 6% of erectile dysfunction treatment cases but 40% of deaths in the U.S., according to the CDC.During the meeting Tuesday, CDC officials said there is currently no data on how pregnant women will respond to Pfizer and Moderna's treatments, which both use messenger RNA, or mRNA, technology. About 75% of health-care workers are women, according to a presentation during the meeting, and 330,000 of them are pregnant.

Officials said they plan to provide further guidance on pregnant women once phase three trial data has been fully reviewed.Drugmakers and states are gearing up to distribute the treatment starting in mid-December. The Federal Aviation Administration said it supported the "first mass air shipment" of treatments on Friday. United Airlines carried Pfizer's erectile dysfunction treatment from Brussels to Chicago O'Hare International Airport on Friday, people familiar with the matter told CNBC..

American Airlines Boeing 787-9 Dreamliner takes off from Los Angeles international Airport on November can u buy viagra over the counter 11, 2020 in Los Angeles, California.AaronP | Bauer-Griffin | GC Images | Getty ImagesAmerican Airlines and United Airlines are pausing plans to operate nonstop flights to Shanghai from the U.S. Following reports of can u buy viagra over the counter lengthy waits facing airline crews upon arrival, limited local accommodations and restrictions on their movement in the country, according to people familiar with the matter.They will instead route the flights with a stop in South Korea, the people said, asking not to be named because they aren't authorized to talk about it.Airlines haven't resumed most of their China service after suspending it in February as the erectile dysfunction was spreading.American Airlines planned to begin nonstop flights carrying only cargo from Los Angeles to Shanghai this month but will continue to operate the flight with a stop in Seoul, South Korea, on the way to Asia, the people said. It will fly nonstop from Shanghai back to Los Angeles, however.

American is also continuing to include a stop in Seoul on its cargo-only flights from Dallas-Fort Worth and from Los Angeles to Beijing because of similar concerns, one of the people said.Long waits to enter the country and get to hotels are a problem for airlines because it can eat into federally mandated crew rest requirements.Last month, American resumed China service with flights between Dallas-Fort Worth International Airport and Shanghai with a stop in Seoul."We are pleased by that decision and look forward to continued dialogue to ensure can u buy viagra over the counter that when we resume flying it's in the best interest of American and its pilots," said Dennis Tajer, an American Airlines Boeing 737 captain and spokesman for the Allied Pilots Association, which represents the carrier's pilots.United, for its part, said it has added a stop in Seoul on its San Francisco-Shanghai service."Due to changes in operating conditions, we adjusted service between San Francisco and Shanghai to now include a stop in Seoul, South Korea for a crew change as we did earlier this year," United said in a statement. Passengers booked to Shanghai can u buy viagra over the counter stay on the plane during the stop.Delta Air Lines plans to offer nonstop flights to Shanghai from Seattle and Detroit starting this week."Delta has shared with us their plan and the logistics surrounding the initiation of nonstop service to Shanghai," Delta's pilots' union, the Air Line Pilots Association, said in a statement. "Right now, we are studying it to make sure that it is airtight."In addition to lengthy airport waits, airline labor unions have expressed concerns about the Chinese government-mandated airport hotel that flight crews would stay in and reported restrictions on crews leaving hotel rooms.The Chinese Embassy in Washington and the U.S.

Department of Transportation didn't immediately respond to requests for comment.A Centers for Disease Control and Prevention panel voted 13-1 on Tuesday to give health-care workers and long-term care facility residents the first erectile dysfunction treatment doses once it's cleared for public use.There are roughly 21 million health-care workers and 3 million long-term care can u buy viagra over the counter facility residents in the United States, according to a presentation during the CDC's Advisory Committee on Immunization Practices, an outside group of medical experts that advises the agency. Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, said most states and local jurisdictions expect it to take three weeks to vaccinate all of their health-care workers.

Pfizer and Moderna's treatments require two doses about a month apart.The meeting comes as states prepare to distribute a treatment in as little as two weeks. Moderna and Pfizer have both requested emergency clearance from the Food and Drug Administration for their erectile dysfunction treatments last month. The reviews by the FDA are expected to take a few weeks, and the agency has scheduled a meeting for Dec.

10 to discuss Pfizer's request for authorization.Since the viagra began, scientists and infectious disease experts have debated who will get immunized first and how the limited first treatment doses will be distributed across the United States. Health and Human Services Secretary Alex Azar told CNBC on Nov. 16 that about 40 million doses of treatment will available by the end of this year, enough to inoculate about 20 million people since the Moderna and Pfizer treatments require two shots.Earlier Tuesday, Trump treatment chief Moncef Slaoui said the entire U.S.

Population of 331 million could be vaccinated against erectile dysfunction treatment by June, and there could be enough doses to immunize the rest of the nearly 8 billion people in the world by early to mid-2022.Read More. Trump erectile dysfunction treatment chief Slaoui says everyone in U.S. Could be immunized by JuneThe side effects from the treatment can lay people up for a day or so, company officials have said.

That's prompted officials to recommend that health-care facilities plan for workers to have time away from clinical care if they experience symptoms after getting vaccinated.About 10% to 15% of people report noticeable side effects from the treatments, according to Dr. Moncef Slaoui, who is leading the Trump administration's erectile dysfunction treatment program Operation Warp Speed. The people who've suffered from side effects have reported redness and pain at the injection site as well as fever, chills, muscle aches and headaches, he said Tuesday, adding most people have no noticeable side effects.Read More.

Trump erectile dysfunction treatment czar says side effects ‘significantly noticeable’ in 10% to 15% of recipientsMedical experts have previously advocated for health-care workers to get the treatment first, followed by vulnerable Americans, including the elderly, people with preexisting conditions and essential workers. Children and young adults are expected to get the treatment last.Although states don't have to follow the CDC's guidance, it gives them a framework to work with and that many states adopt, Dr. Karen Landers, spokeswoman for the Alabama Department of Public Health, said in a recent phone interview."This guidance will be extremely helpful because it will be science-based, and also will give us the framework to be able to ensure that our guidelines are consistent with what is recommended by support staff," she said.

"The Alabama Department of Public Health will follow those recommendations, and we'll certainly be following what ACIP recommends in terms of the treatment administration.The committee defined health-care workers as paid and unpaid people serving in health-care settings who have the potential for direct or indirect exposure to patients or infectious materials.The group defined long-term care facility residents as adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently. Residents and staff in long-term care facilities account for 6% of erectile dysfunction treatment cases but 40% of deaths in the U.S., according to the CDC.During the meeting Tuesday, CDC officials said there is currently no data on how pregnant women will respond to Pfizer and Moderna's treatments, which both use messenger RNA, or mRNA, technology. About 75% of health-care workers are women, according to a presentation during the meeting, and 330,000 of them are pregnant.

Officials said they plan to provide further guidance on pregnant women once phase three trial data has been fully reviewed.Drugmakers and states are gearing up to distribute the treatment starting in mid-December. The Federal Aviation Administration said it supported the "first mass air shipment" of treatments on Friday. United Airlines carried Pfizer's erectile dysfunction treatment from Brussels to Chicago O'Hare International Airport on Friday, people familiar with the matter told CNBC..

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International students in NSW will have access to a new digital mental health and wellbeing toolkit, as one of a number of programs that will enhance employability, entrepreneurship and research and development skills, thanks to $360,000 in funding from the NSW Government to support the sector.Deputy Premier and Minister for Trade and Industry John Barilaro said the Partner Project funding from Study NSW will support the future best online viagra of international education in NSW, an industry that has been hit hard during the erectile dysfunction treatment viagra."The international education sector remains one of the state's biggest exports, sustaining thousands of jobs across NSW," Mr Barilaro said."These co-funded projects are part of a range of measures viagra prank porn from the NSW Government to support almost 170,000 international students currently studying with NSW education providers both here and overseas."Between 2014 and 2021, Study NSW has invested more than $2.4 million across 61 partner projects and attracted $8.4 million in industry contributions. Minister for Mental Health, Regional Youth and Women Bronnie Taylor said the digital mental health and wellbeing toolkit for international students couldn't have come at a better time."Being isolated from friends and family for long periods is difficult for everyone and this is especially true for international students right now" Mrs Taylor said."I want each and every one to know that it is completely normal to feel stressed, overwhelmed or uncertain and there is specialist support available if they need it."The recipients for the 2021-22 round are:$100,000 for ISANA International Education Association to deliver the Lived Experience Toolkit$48,000 for the Academy of Entrepreneurs to deliver Masterclass for Impact, a series of workshops on employability and entrepreneurship $45,000 for Intersective to deliver the Research and Development Project Program where international students will assist a real NSW SME or start-up advance an R&D project$44,000 for Haymarket HQ to deliver a virtual entrepreneurship program FFWD. Ideate & viagra prank porn.

Accelerate$40,000 for The Lygon Group to deliver student sentiment tracker, The Student Source, which will analyse sentiment shifts and make recommendations for NSW based institutions using social media listening $33,000 for the University of Technology Sydney to deliver Aus LEAP which connects students with volunteering opportunities with charities, not-for-profits, and social enterprise organisations$30,000 for The FRANK Team to deliver INTERCHANGE 2022, a seven-week Work Integrated Learning program offered in collaboration with seven universities$20,000 for the International Student Education Agents Association Limited to deliver Unite and Recover Education Agent Sector, a research report on the impact of erectile dysfunction treatment on education agents, the ongoing effects this has on NSW international education sector, and a strategy on how to recoverRefer to Study NSW - Partner Projects, to find out more about this year's successful projects.Students can access information on available support at the Study NSW erectile dysfunction treatment Help Hub.Older people, the LGBTIQ community and people living in regional NSW are among the at-risk groups who will now have improved access to mental health support thanks to the NSW Government's Suicide Prevention Fund. Minister for Mental Health Bronnie Taylor said viagra prank porn that $8 million in funding has been allocated to six organisations committed to engaging with communities known to have higher rates of suicide. "We know that there are some groups of individuals who are at greater risk of suicide due to issues such as past trauma, stigma or isolation," Mrs Taylor said.

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ACON will also deliver a Suicide Prevention and Mental Health Online Hub for this community, their families, friends and other support networks, including health professionals. Anglican Community Services Older viagra prank porn people Delivery of online suicide prevention training for people who work with older people across NSW (including those in aged care, allied health and mental health). HealthWISE - New England North West Health People who have previously attempted suicide A suicide aftercare service in the New England North West region of NSW.

The service covers Mehi, Tablelands and Peel clusters of the New England North West region and provides outreach services viagra prank porn in smaller towns. Grand Pacific Health People who are experiencing suicidal crisis and require immediate support, and people who have previously attempted suicideA suicide aftercare service in Illawarra Shoalhaven and Southern NSW. The primary focus will be supporting people over the age of 16 years who have attempted suicide, are at significant risk of suicide or in suicidal crisis.

The locations of hubs in Illawarra Shoalhaven are Wollongong viagra prank porn and Nowra. The locations of hubs in Southern NSW are Goulburn, Queanbeyan, Bega and Moruya. All hubs can provide viagra prank porn outreach services to surrounding regions.

€‹Suicide Prevention Australia ​Men An evidence-informed public health campaign to break down the stigma of help-seeking among men, as well as promote safe conversations around suicide and suicidal behavior, and improve access to existing suicide prevention services. €‹Wellways Australia ​Young people Delivery of local and state-wide social media campaigns to viagra prank porn build awareness of support pathways available to young people in times of increased stress, suicide risk or isolation. This will include a range of culturally diverse video campaigns.

The $8 million investment is viagra prank porn in addition to the $87 million Towards Zero Suicides investment. Towards Zero Suicides is a NSW Premier's Priority. If you, or someone you know, is thinking about suicide or experiencing a personal crisis viagra prank porn or distress, please seek help immediately by calling 000 (Triple Zero).

For anyone who is struggling, you can call the below helplines for support and advice. Lifeline 13 11 14 | Kids Helpline 1800 55 1800 | NSW Mental Health Line 1800 011 511..

International students in NSW will have access to a new digital mental health and wellbeing toolkit, as one of a number of programs that will enhance employability, entrepreneurship and research and development skills, thanks to $360,000 in funding from the NSW Government to support the sector.Deputy Premier and Minister for Trade and Industry John Barilaro said can u buy viagra over the counter the Partner Project funding from Study NSW will support the future of international education in NSW, an industry that has been hit hard during the erectile dysfunction treatment viagra."The international education sector remains one of the state's biggest exports, sustaining thousands of jobs across NSW," Mr Barilaro said."These co-funded projects are part of viagra online canada a range of measures from the NSW Government to support almost 170,000 international students currently studying with NSW education providers both here and overseas."Between 2014 and 2021, Study NSW has invested more than $2.4 million across 61 partner projects and attracted $8.4 million in industry contributions. Minister for Mental Health, Regional Youth and Women Bronnie Taylor said the digital mental health and wellbeing toolkit for international students couldn't have come at a better time."Being isolated from friends and family for long periods is difficult for everyone and this is especially true for international students right now" Mrs Taylor said."I want each and every one to know that it is completely normal to feel stressed, overwhelmed or uncertain and there is specialist support available if they need it."The recipients for the 2021-22 round are:$100,000 for ISANA International Education Association to deliver the Lived Experience Toolkit$48,000 for the Academy of Entrepreneurs to deliver Masterclass for Impact, a series of workshops on employability and entrepreneurship $45,000 for Intersective to deliver the Research and Development Project Program where international students will assist a real NSW SME or start-up advance an R&D project$44,000 for Haymarket HQ to deliver a virtual entrepreneurship program FFWD. Ideate & can u buy viagra over the counter. Accelerate$40,000 for The Lygon Group to deliver student sentiment tracker, The Student Source, which will analyse sentiment shifts and make recommendations for NSW based institutions using social media listening $33,000 for the University of Technology Sydney to deliver Aus LEAP which connects students with volunteering opportunities with charities, not-for-profits, and social enterprise organisations$30,000 for The FRANK Team to deliver INTERCHANGE 2022, a seven-week Work Integrated Learning program offered in collaboration with seven universities$20,000 for the International Student Education Agents Association Limited to deliver Unite and Recover Education Agent Sector, a research report on the impact of erectile dysfunction treatment on education agents, the ongoing effects this has on NSW international education sector, and a strategy on how to recoverRefer to Study NSW - Partner Projects, to find out more about this year's successful projects.Students can access information on available support at the Study NSW erectile dysfunction treatment Help Hub.Older people, the LGBTIQ community and people living in regional NSW are among the at-risk groups who will now have improved access to mental health support thanks to the NSW Government's Suicide Prevention Fund.

Minister for Mental Health Bronnie Taylor said that $8 million in funding has been allocated to six organisations committed to can u buy viagra over the counter engaging with communities known to have higher rates of suicide. "We know that there are some groups of individuals who are at greater risk of suicide due to issues such as past trauma, stigma or isolation," Mrs Taylor said. "These experiences not only destabilise their mental health and sense of connectedness, they also make can u buy viagra over the counter it extremely hard to ask for support. "This is all about encouraging safe conversations around suicide and suicidal behaviour so people in these priority groups know how and where to access the help that is right for them." The NSW Government is also in the final stages of identifying an Aboriginal-owned organisation to deliver targeted suicide prevention activities to First Australians.

The funded services and activities are:ACON LGBTQ+/ People of diverse sexualities and/or genders can u buy viagra over the counter Expansion of ACON's Suicide Aftercare Service to provide a statewide service for people of diverse sexualities and/or gender who have attempted suicide. ACON will also deliver a Suicide Prevention and Mental Health Online Hub for this community, their families, friends and other support networks, including health professionals. Anglican Community can u buy viagra over the counter Services Older people Delivery of online suicide prevention training for people who work with older people across NSW (including those in aged care, allied health and mental health). HealthWISE - New England North West Health People who have previously attempted suicide A suicide aftercare service in the New England North West region of NSW.

The service covers Mehi, Tablelands and Peel clusters of the New England North West region and provides outreach services in can u buy viagra over the counter smaller towns. Grand Pacific Health description People who are experiencing suicidal crisis and require immediate support, and people who have previously attempted suicideA suicide aftercare service in Illawarra Shoalhaven and Southern NSW. The primary focus will be supporting people over the age of 16 years who have attempted suicide, are at significant risk of suicide or in suicidal crisis. The locations of can u buy viagra over the counter hubs in Illawarra Shoalhaven are Wollongong and Nowra.

The locations of hubs in Southern NSW are Goulburn, Queanbeyan, Bega and Moruya. All hubs can provide outreach services to can u buy viagra over the counter surrounding regions. €‹Suicide Prevention Australia ​Men An evidence-informed public health campaign to break down the stigma of help-seeking among men, as well as promote safe conversations around suicide and suicidal behavior, and improve access to existing suicide prevention services. €‹Wellways Australia ​Young people Delivery of local and state-wide social media campaigns can u buy viagra over the counter to build awareness of support pathways available to young people in times of increased stress, suicide risk or isolation.

This will include a range of culturally diverse video campaigns. The $8 million investment can u buy viagra over the counter is in addition to the $87 million Towards Zero Suicides investment. Towards Zero Suicides is a NSW Premier's Priority. If you, or someone you know, is thinking about suicide can u buy viagra over the counter or experiencing a personal crisis or distress, please seek help immediately by calling 000 (Triple Zero).

For anyone who is struggling, you can call the below helplines for support and advice. Lifeline 13 11 14 | Kids Helpline 1800 55 1800 | NSW Mental Health Line 1800 011 511..

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GREAT FALLS, viagra walgreens Mont. €” For months, the jail in central Montana’s Cascade County was free of the erectile dysfunction, 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 viagra were arrested. By the time Paul Krogue, the jail’s medical director, realized there was a problem, nearly 50 inmates were infected in viagra walgreens the jail, where some had been sleeping on mats on an overcrowded floor.

After several weeks, Mr. Krogue got a call that s were spreading to a side of the jail that had been viagra-free.He hung up the phone and put his head in his hands.“I just kind viagra walgreens 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 viagra, 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 other week of the viagra. 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 viagra walgreens 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 August, is averaging more than 500 cases per day.In Cascade County, more than 300 inmates and staff members have viagra walgreens been infected in a facility meant to hold 365 people, the county’s first major outbreak in a region where the viagra is suddenly surging.The county seat, Great Falls, is seeing its worst case numbers yet. The local hospital and its 27-bed erectile dysfunction treatment unit is at capacity. The county health department is racing to hire new contact tracers.

And Mr viagra walgreens. 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 viagra walgreens going more quickly than prisons.

Jails can 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 viagra’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.A New York Times database has tracked clusters of at least 50 erectile dysfunction cases in a viagra walgreens dozen rural jails in Montana, Idaho, Utah and New Mexico during the viagra. Among them.

The Purgatory Correctional Center in Hurricane, Utah, with 166 s. The jail in Twin Falls, viagra walgreens 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 viagra cases in the county.

Health authorities say that the jail’s outbreak, which began in mid-August, viagra walgreens 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 viagra 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 viagra walgreens 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 viagra walgreens 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, viagra walgreens 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 viagra, said Mr. Krogue, the jail’s medical director, can be traced to a spring and early summer when almost no one in Cascade viagra walgreens 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 viagra walgreens 1,261 cases and six deaths during the viagra, 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 viagra walgreens authorities said. Three inmates shared cells designed for two. At night, men slept viagra walgreens 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 viagra. He said he had been unable to eat for three days, had intensive body aches and suffered from a headache so powerful it viagra walgreens 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 viagra walgreens the way the viagra 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,” viagra walgreens 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 viagra walgreens staff members, were hospitalized. No one from the jail has died from the viagra, 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 viagra walgreens basement, away from his wife and children.

He remains healthy but says he fears bringing the viagra home. The viagra 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 viagra walgreens.

€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 viagra walgreens 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 viagra walgreens funding opportunity. The erectile dysfunction Disease 2019 (erectile dysfunction treatment) 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 erectile dysfunction treatment.

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, viagra walgreens as well as enhance the mobility of transit users affected by the erectile dysfunction treatment 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 erectile dysfunction treatment 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 erectile dysfunction treatment 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 erectile dysfunction treatment 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 erectile dysfunction treatment Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA erectile dysfunction treatment 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 erectile dysfunction treatment 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. No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report.

B. erectile dysfunction treatment Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985.

A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request. Start Signature K.

Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20.

GREAT FALLS, Mont can u buy viagra over the counter where can i buy viagra over the counter. €” For months, the jail in central Montana’s Cascade County was free of the erectile dysfunction, 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 viagra 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, can u buy viagra over the counter where some had been sleeping on mats on an overcrowded floor.

After several weeks, Mr. Krogue got a call that s were spreading to a side of the jail that had been viagra-free.He can u buy viagra over the counter 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 viagra, 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 other week of the viagra. And the spread through sparsely populated areas of rural America has created problems in small towns that lack critical resources — including doctors — even in can u buy viagra over the counter 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 August, is averaging more than 500 cases per day.In Cascade County, can u buy viagra over the counter 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 viagra is suddenly surging.The county seat, Great Falls, is seeing its worst case numbers yet. The local hospital and its 27-bed erectile dysfunction treatment unit is at capacity. The county health department is racing to hire new contact tracers.

And Mr can u buy viagra over the counter. 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 can u buy viagra over the counter coming and going more quickly than prisons.

Jails can 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 viagra’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.A New York Times database has tracked clusters can u buy viagra over the counter of at least 50 erectile dysfunction cases in a dozen rural jails in Montana, Idaho, Utah and New Mexico during the viagra. Among them.

The Purgatory Correctional Center in Hurricane, Utah, with 166 s. The jail in Twin Falls, Idaho, can u buy viagra over the counter 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 viagra cases in the county.

Health authorities say that the jail’s outbreak, which began in mid-August, was not believed can u buy viagra over the counter 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 viagra 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 can u buy viagra over the counter 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 can u buy viagra over the counter 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 can u buy viagra over the counter. 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 viagra, 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 can u buy viagra over the counter 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 can u buy viagra over the counter viagra, 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 can u buy viagra over the counter 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, can u buy viagra over the counter 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 viagra. He said he had been unable to eat for three days, had intensive body aches and suffered from a headache so powerful can u buy viagra over the counter 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 viagra was being handled by refusing to leave their living areas and by can u buy viagra over the counter 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 can u buy viagra over the counter 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, can u buy viagra over the counter were hospitalized. No one from the jail has died from the viagra, 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 can u buy viagra over the counter basement, away from his wife and children.

He remains healthy but says he fears bringing the viagra home. The viagra 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 can u buy viagra over the counter.

€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 can u buy viagra over the counter 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 can u buy viagra over the counter funding opportunity. The erectile dysfunction Disease 2019 (erectile dysfunction treatment) 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 erectile dysfunction treatment.

In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to can u buy viagra over the counter 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 erectile dysfunction treatment 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 erectile dysfunction treatment 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 erectile dysfunction treatment 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 erectile dysfunction treatment 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 erectile dysfunction treatment Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA erectile dysfunction treatment 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 look at here 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 erectile dysfunction treatment 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. No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report.

B. erectile dysfunction treatment Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985.

A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request. Start Signature K.

Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20.