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U.S. rural areas soon might be on front lines in COVID-19 pandemic

The COVID-19 pandemic has left a path of destruction in urban centers throughout the northeastern United States, but the next outbreak hotspots could have even deadlier effects in rural areas.




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U.S. ICUs could still be overwhelmed by COVID-19 patients, analysis says

Communities across the U.S. still need to expand hospital capacity to manage new COVID-19 cases, even as some states loosen social distancing restrictions, a study published Wednesday by JAMA Network Open says.




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Brain model links herpes virus to development of Alzheimer's disease

Bio-engineered models of the human brain infected with herpes simplex virus-1 develop many of the same characteristics found in Alzheimer's disease, according to a new analysis published by Science Advances.




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Study: Opioid overdose 14 times more likely in general public than cancer survivors

Cancer survivors have a lower risk for a fatal opioid overdose -- from prescription pain medications or illegal drugs -- than those without the disease, an analysis published Thursday by JAMA Oncology shows.




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Arthritis drug shows promise against respiratory distress caused by COVID-19

Anakinra, a drug developed to treat rheumatoid arthritis might help patients who have developed acute respiratory distress syndrome caused by COVID-19, a small study published by The Lancet Rheumatology has found.




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Johns Hopkins to launch trials of blood plasma treatment for COVID-19

Johns Hopkins University will start two clinical trials of convalescent blood plasma for treatment of COVID-19, the disease caused by the new coronavirus.




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Poverty, poorer health make some in the Bronx more vulnerable to COVID-19

New York City has been the epicenter of the COVID-19 outbreak in the United States, with immigrant populations in areas such as the Bronx "disproportionately" affected, a commentary in JAMA Internal Medicine says.




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15-minute COVID-19 test proves accurate at confirming infection

A new, point-of-care testing kit for COVID-19 that can deliver results in 15 minutes accurately diagnoses people more than 80 percent of time, an analysis has found.




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Combination of HIV, hepatitis C, MS drugs might resolve COVID-19 infection

Combination therapy with interferon beta-1b plus lopinavir-ritonavir and ribavirin appears to improve symptoms and shorten hospital stays for people with mild to moderate COVID-19.




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Performance of High-Sensitivity Cardiac Troponin Assays To Reflect Comorbidity Burden and Improve Mortality Risk Stratification in Older Adults With Diabetes

OBJECTIVE

Incorporation of comorbidity burden to inform diabetes management in older adults remains challenging. High-sensitivity cardiac troponins are objective, quantifiable biomarkers that may improve risk monitoring in older adults. We assessed the associations of elevations in high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) with comorbidities and improvements in mortality risk stratification.

RESEARCH DESIGN AND METHODS

We used logistic regression to examine associations of comorbidities with elevations in either troponin (≥85th percentile) among 1,835 participants in the Atherosclerosis Risk in Communities (ARIC) Study with diabetes (ages 67–89 years, 43% male, 31% black) at visit 5 (2011–2013). We used Cox models to compare associations of high cardiac troponins with mortality across comorbidity levels.

RESULTS

Elevations in either troponin (≥9.4 ng/L for hs-cTnI, ≥25 ng/L for hs-cTnT) were associated with prevalent coronary heart disease, heart failure, chronic kidney disease, pulmonary disease, hypoglycemia, hypertension, dementia, and frailty. Over a median follow-up of 6.2 years (418 deaths), both high hs-cTnI and high hs-cTnT further stratified mortality risk beyond comorbidity levels; those with a high hs-cTnI or hs-cTnT and high comorbidity were at highest mortality risk. Even among those with low comorbidity, a high hs-cTnI (hazard ratio [HR] 3.0 [95% CI 1.7, 5.4]) or hs-cTnT (HR 3.3 [95% CI 1.8, 6.2]) was associated with elevated mortality.

CONCLUSIONS

Many comorbidities were reflected by both hs-cTnI and hs-cTnT; elevations in either of the troponins were associated with higher mortality risk beyond comorbidity burden. High-sensitivity cardiac troponins may identify older adults at high mortality risk and be useful in guiding clinical care of older adults with diabetes.




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Incidence of Type 2 Diabetes in Patients With Chronic Hepatitis C Receiving Interferon-Based therapy




vi

Use of Glucagon-Like Peptide 1 Receptor Agonists and Risk of Serious Renal Events: Scandinavian Cohort Study

OBJECTIVE

To assess the association between use of glucagon-like peptide 1 (GLP-1) receptor agonists and risk of serious renal events in routine clinical practice.

RESEARCH DESIGN AND METHODS

This was a cohort study using an active-comparator, new-user design and nationwide register data from Sweden, Denmark, and Norway during 2010–2016. The cohort included 38,731 new users of GLP-1 receptor agonists (liraglutide 92.5%, exenatide 6.2%, lixisenatide 0.7%, and dulaglutide 0.6%), matched 1:1 on age, sex, and propensity score to a new user of the active comparator, dipeptidyl peptidase 4 (DPP-4) inhibitors. The main outcome was serious renal events, a composite including renal replacement therapy, death from renal causes, and hospitalization for renal events. Secondary outcomes were the individual components of the main outcome. Hazard ratios (HRs) were estimated using Cox models and an intention-to-treat exposure definition. Mean (SD) follow-up time was 3.0 (1.7) years.

RESULTS

Mean (SD) age of the study population was 59 (10) years, and 18% had cardiovascular disease. A serious renal event occurred in 570 users of GLP-1 receptor agonists (incidence rate 4.8 events per 1,000 person-years) and in 722 users of DPP-4 inhibitors (6.3 events per 1,000 person-years, HR 0.76 [95% CI 0.68–0.85], absolute difference –1.5 events per 1,000 person-years [–2.1 to –0.9]). Use of GLP-1 receptor agonists was associated with a significantly lower risk of renal replacement therapy (HR 0.73 [0.62–0.87]) and hospitalization for renal events (HR 0.73 [0.65–0.83]) but not death from renal causes (HR 0.72 [0.48–1.10]). When we used an as treated exposure definition in which patients were censored at treatment cessation or switch to the other study drug, the HR for the primary outcome was 0.60 (0.49–0.74).

CONCLUSIONS

In this large cohort of patients seen in routine clinical practice in three countries, use of GLP-1 receptor agonists, as compared with DPP-4 inhibitors, was associated with a reduced risk of serious renal events.




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Decreased Vagal Activity and Deviation in Sympathetic Activity Precedes Development of Diabetes

OBJECTIVE

The objective of this study was to examine whether altered heart rate variability (HRV) could predict the risk of diabetes in Asians.

RESEARCH DESIGN AND METHODS

A cohort study was conducted in 54,075 adults without diabetes who underwent 3-min HRV measurement during health checkups between 2011 and 2014 at Kangbuk Samsung Hospital. We analyzed the time domain (SD of the normal-to-normal interval [SDNN] and root mean square differences of successive normal-to-normal interval [RMSSD]) and the frequency domain (total power, normalized low-frequency power [LF], and normalized high-frequency power [HF] and LF/HF ratio). We compared the risk of diabetes until 2017 according to tertiles of heart rate and HRV variables, with tertile 1 serving as the reference group.

RESULTS

During 243,758.2 person-years, 1,369 subjects were diagnosed with diabetes. Both time and frequency domain variables were lower in the group with diabetes, with the exception of those with normalized LF and LF/HF ratio. In Cox analysis, as SDNN, RMSSD, and normalized HF tertiles increased, the risk of diabetes decreased (hazard ratios [95% CIs] of tertile 3: 0.81 [0.70–0.95], 0.76 [0.65–0.90], and 0.78 [0.67–0.91], respectively), whereas the risk of diabetes increased in the case of heart rate, normalized LF, and LF/HF ratio (hazard ratios [95% CIs] of tertile 3: 1.41 [1.21–1.65], 1.32 [1.13–1.53], and 1.31 [1.13–1.53), respectively) after adjusting for age, sex, BMI, smoking, drinking, systolic blood pressure, lipid level, CRP, and HOMA of insulin resistance.

CONCLUSIONS

Abnormal HRV, especially decreased vagal activity and deviation in sympathovagal imbalance to sympathetic activity, might precede incident diabetes.




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New Poll: How Do You Feel About the Level Of Education The School Provides Your Child

I will be starting a monthly poll to engage the readers of this blog and start some discussion. Feel free to comment on this topic. I'm sure many of you have a lot to say. At the end of the month, I'll share and discuss results in a blog post. I'm curious to see how the readers of this blog feel about your own schools. You can find the poll in the sidebar. Thanks for participating!




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Assessing Bilingual Individuals

Two years into my position in a culturally diverse school system has taught me many things that I never would have learned in my previous position in a school system with much less diversity. I had hoped to be bilingual by now, but I’m not even close to that goal. However, I do have the training to conduct assessments with bilingual students. Thanks to Samuel Ortiz, Ph.D. for his workshops, research, and books that we use so much in our system. Thanks to the other Psychologists in my system for mentoring me and helping me learn this process. It has helped us to better identify which students have a disability and which students only look like they have a disability because of their performance on tests that are not standardized on children with different cultural and linguistic backgrounds. Learning a second language is not a disability. Just because a student is struggling academically, does not mean he should qualify for special education.

What everyone involved in school needs to know:
It takes many years for a person learning a language to develop academic use of language to the same level as monolingual individuals. It does not always seem that way when a person has excellent conversational skills in English. However, social use of language is not as sophisticated as academic use of language. Students can appear to be fluent, when in actuality the language and vocabulary is not on grade level. If a student’s comprehension and expression of language is below grade level, academics will naturally be below grade level as well. This is not the same as having a disabling condition.

A child with good social use of language, but developing academic use of language often looks to teachers like a student with a disability, when in reality the student may be a typically developing second language learner. Special education is not the answer for this student; the answer comes through hard work, patience, and instruction through a high quality English as a Second Language Program. In the past (and currently in many systems) this child would be misidentified as a student with a disability and inappropriately put into special education programs.

What Parents need to know:
Traditional assessments are not standardized for use with culturally and linguistically diverse students, so typical interpretation of scores on these assessments are inappropriate. When school systems try to use these assessments in the traditional way and then apply the unreliable scores into eligibility criteria, it’s frankly scary.

If you are a parent of an English Language learner, insist that a bilingual assessment be administered. I recognize that the irony of this statement is that many parents of bilingual students are not reading this blog as it is in English only. I don’t really have a good answer for that at this time.

What Teachers need to know:
If you are a teacher, recognize that academic language competency takes time and it requires additional assessment tools to tease out if the difficulties are primarily the result of language and cultural differences or if it is the result of a disability.

What School Psychologists need to know:
If you are a School Psychologist and not using the Cattell-Horn-Carroll Cross-Battery Assessment, I strongly encourage you to take a look. Here is an article from the National Association of School Psychologists Website by Samuel Ortiz, Ph.D. on resources for cultural competency. http://www.nasponline.org/resources/culturalcompetence/ortiz.pdf Advocate that all School Psychologists in your system be trained to administer bilingual assessments or at least have someone competent on hand for these assessments. You can’t hire a School Psychologist in every possible language you might need, so it only makes sense for all School Psychologists to be trained to assess all students. It takes more time to do the assessment, interpret data, and write a report and it requires the use of hiring an interpreter for portions of the assessment, but it is well worth the time and money to properly identify these students. If your school system does not see it this way, bring it up as a solution to disproportionality.




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Teacher's Role in a Successful Behavior Plan

Over the last few years I have been very busy working with teachers to create individualized behavior plans for several different elementary school students. There have been amazingly successful plans where some of the most significant behavior problems in the school have turned it around. Children who made daily trips to the office are only there now to receive praise from the administration. Teachers previously brought to tears from the behaviors have stopped me in the hall to say "Oh my goodness, he's like a different kid!" Students who were close to being sent to a day placement school are now succeeding in a regular classroom. It's very encouraging if I focus on those students. However, there have also been some plans that have been revised and revised and revised and the student is still struggling and the teacher is still severely frustrated. I have been reflecting on why some behavior plans work and others don't. Of course one of the biggest factors is the student. All students are different and the motivation for the misbehavior or lacking skill is different in each student. While this is important to consider, this particular article does not focus on this. I'm going to focus today on the teacher's role in making the behavior plan successful.




  • Focus on the Positive!!! The behavior plans that have had the most dramatic success are plans that allow the teacher to focus on the positive. Classroom consequences are still in place, but are not connected to the plan. Here is an example: Johnny's teachers will offer positive reinforcement frequently in the classroom by giving Johnny a “warm fuzzy” pom pom when he is caught engaging in a desired behavior. Johnny will chose the bag to keep the “warm fuzzies” in and carry the bag with him to every class. Once the bag is full, he receives an immediate reward. There is no limit to how many “warm fuzzies” he can earn in a day. He does not loose “warm fuzzies” that he has already earned. All teachers and staff who work with Johnny can give him “warm fuzzies” for his bag. This plan works because Johnny who was used to receiving a lot of negative feedback, is now getting positive attention frequently throughout the day. He receives something tangible (the warm fuzzy) that he can put into his bag. This begins to change his perception of himself, which changes his behavior, which changes his teacher's perception of him, which can potentially change his future. Plans that offer positive rewards completely separate from the classroom consequences seem to have the most significant effects.



  • Be Consistent. Teachers who are able to be consistent and are able to follow through every time have the most success with the plan. Oppositional children are excellent at pushing limits to see how far they can push. Consistent teachers have more success because they don't offer the wiggle room.



  • Be Flexible. This is not the opposite of being consistent. This is having flexibility in your expectations and stating them upfront. If the student was able to behave like everyone else in the class she would be. She may need some flexibility in some areas. For example you may need to have area for her to work in the classroom for times she needs to cool down and get away from a stimulus. The teacher may need to allow her extra time to finish projects if it is the transition that sets her off. Being flexible and willing to make acceptable changes for the student sets everyone up for success.



  • Remember that all students are different. The behaviors may be exactly the same as a student you had two years ago. However, that doesn't mean that the motivation for the behavior or the lacking skills are the same. What works for one student may not work for the next. That is the reason for the individualized plan. I strongly recommend doing a formal Functional Behavioral Assessment and a Behavior Intervention Plan.

Teachers have a HUGE part in making the Behavior Plan sucessful. It is the teacher who has to follow through and implement it consistently every day. It is the teacher who has to push forward even when it appears it isn't working at first. It is the teacher who has a tremendous positive impact on the student when the behavior starts turning around. It is the teacher who does the work to change lives!




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The Blog is moving to School Psychologist Files

You can find all of the same articles in a more visually appealing Blog.  From now on use www.schoolpsychologistfiles.com/blog.  Thanks!




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The Diversity Visa Program Holds Lessons for Future Legal Immigration Reform

On paper, the Diversity Visa Program is not set up to bring in the highly skilled; applicants need only a high school diploma (or equivalent) or two years of mid-level work experience. Yet as this commentary explains, the green-card lottery has become a channel for entry of the highly skilled—with half of recipients coming to the United States in recent years having a college degree.




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Mexican Migration to Canada: Temporary Worker Programs, Visa Imposition, and NAFTA Shape Flows

Mexicans migrate to Canada in much smaller numbers than to the United States, yet over the last 30 years the country has become an increasingly attractive destination. Canada prioritizes highly skilled, educated Mexicans for permanent residency, but also attracts temporary workers from Mexico. This article examines Mexican migration to Canada and how it has been shaped by visa requirements, trade policy, and more.




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Federal judge declines to block COVID-19 abortion ban in Arkansas

A federal court on Thursday denied a motion to block an Arkansas directive preventing patients from receiving abortion care.




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House probe: Trump admin failed to adequately screen travelers from South Korea, Italy for COVID-19

The Trump administration failed to conduct effective screening of passengers from South Korea and Italy for the coronavirus when those countries were experiencing rapid expansion in COVID-19 cases.




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Pennsylvania, Texas, California among states lifting coronavirus restrictions Friday

California, Iowa, Pennsylvania and Rhode Island are among states that are loosening coronavirus restrictions Friday to gradually revive their economies.




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Supreme Court puts temporary block on release of evidence in Mueller probe

The Supreme Court on Friday granted a Justice Department request to temporarily block release of secret grand jury material from special counsel Robert Mueller's probe to Congress.




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U.S. copes with COVID-19 pandemic

The novel coronavirus, COVID-19, pandemic is spreading across the United States. People are discouraged (even banned in some places) from large gatherings, public spaces are closed, store shelves are empty, with long lines in grocery stores, and travel is limited. Here are some scenes from across America.




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Mars' magnetic field emerged earlier and lasted longer than previously thought

Mars' ancient magnetic field emerged earlier and persisted for longer than scientists previously thought, according to a new study.




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Researchers find honey bee gene that causes virgin birth

The Cape honey bee, a subspecies found along the southern coast of South Africa, reproduces without having sex. Now, scientists have identified the gene responsible for the bee's virgin births.




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Cannibalism helps comb jellies survive harsh conditions, invade new environs

The warty comb jelly is native to the western Atlantic, but in recent decades, it has invaded the waters of Eurasia. New research suggests cannibalism is key to the species' ability to move into new environs.




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Neanderthals preferred bovine bones for leather-making tools

When it came to selecting bones for leather-making tools, Neanderthals were surprisingly choosy. New archaeological analysis shows Neanderthals preferentially selected bovine rib bones to make a tool called a lissoir.




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Migration & Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed the state of play around the globe surrounding COVID-19 and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




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Crisis within a Crisis: Immigration in the United States in a Time of COVID-19

The global COVID-19 pandemic has brought into sharp focus the intersection of U.S. immigration and public health policy, and the unique challenges that immigrants face. This article analyzes the Trump administration’s introduction of some of the most stringent immigration restrictions in modern times, the often disparate fallout of the outbreak on immigrant communities, the status of federal immigration agency operations, and more.




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Side-by-Side Comparison of 2013 Senate Immigration Bill with Individual 2013 House Bills

This fact sheet offers a detailed review of the comprehensive immigration reform legislation approved by the U.S. Senate in June 2013 and compares its major provisions with those of the five targeted immigration bills approved by the House Judiciary Committee and the House Homeland Security Committee.




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A House Divided: Divergent Views in Congress Over Immigration Reform - A Video Chat

MPI experts participate in a video chat shortly after the Migration Policy Institute released an analysis comparing the major provisions of the Senate bill to those of the individual House bills considered to date in House committees. 




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Securing the Border: Defining the Current Population Living in the Shadows and Addressing Future Flows

Testimony of Marc Rosenblum before the Senate Committee on Homeland Security and Governmental Affairs for the March 26, 2015 hearing on the characteristics of unauthorized immigrants in the United States and how to address future flows.




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Leadership Visions: A Discussion with Mexican Foreign Minister Claudia Ruiz-Massieu

An MPI Leadership Visions discussion with the Foreign Minister of Mexico, Claudia Ruiz-Massieu, for her first public appearance in Washington, DC. 




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Ask Ariely: On Simple Savings, Better Bonuses, and Revised Resolutions

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, My partner and I are students,...




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Ask Ariely: On Healthy Handshakes, Bus Behaviors, and Diet Defenses

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, I know that because of the...




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Join Me Live to Talk about COVID-19

Hello, join me tomorrow, April 24th at 12pm EST for a live chat about the intersections of behavioral science and the coronavirus pandemic. There will be a live Q&A portion at the end! Here is the event link. See you there!




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White House press secretary Kayleigh McEnany: President Donald Trump can revive economy again

Presidential press secretary Kayleigh McEnany said Friday the Trump administration is confident in a major economic recovery after several weeks of closures due to the coronavirus pandemic.




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Andrew Cuomo says N.Y. has COVID-19 'on the run'; Mike Pence aide tests positive

Vice President Mike Pence's press secretary has tested positive for the coronavirus disease, the White House said Friday. In New York, Gov. Andrew Cuomo said the state is finally getting ahead of the virus.




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Navy adapts maintenance procedures, strategies for containing COVID-19

The Navy has been particularly hard hit by the coronavirus pandemic and is working to adapt its strategies for maintenance as well as containing outbreaks on ships.




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AAI Corp., a division of Textron, nabs $20.7M contract modification for Navy drone program

Textron was awarded a $20.7 million contract modification Friday for work on the Navy's Unmanned Influence Sweep System and Unmanned Surface Vehicle program.




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Ohio State University agrees to $10M settlement with abuse victims

Ohio State University will pay more than $40 million to 162 former students who said a team doctor abused them over two decades, the school announced.




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China offers to help North Korea respond to coronavirus pandemic

China's President XI jinping offered Saturday to help North Korean leader Kim Jong Un respond to the coronavirus pandemic.




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New Jersey nursing home with overwhelmed morgue fined for violations

Federal health officials fined a New Jersey nursing home where last month authorities discovered 17 bodies piled in a small morgue.




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Watch: Ariana Grande, Justin Bieber release at-home video for 'Stuck with U'

Ariana Grande and Justin Bieber released their music video for "Stuck With U."




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Watch: Pete Davidson says Bill Hader recommended him for 'SNL'

Pete Davidson discussed on "The Tonight Show" how Bill Hader helped him land a spot on "Saturday Night Live."




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Look: Brian May visits hospital after injuring buttocks while gardening

Queen guitarist Brian May is recovering after tearing his gluteus maximus during a moment of "over-enthusiastic" gardening.




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Look: Netflix shares teaser for 'Baby-Sitters Club' revival

Netflix shared a premiere date and teaser trailer for its "Baby-Sitters Club" series, based on the Ann M. Martin book series.




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'Community' cast reuniting for COVID-19 benefit live read

"Community" creator Dan Harmon and cast members Joel McHale, Donald Glover, Alison Brie, Yvette Nicole Brown, Gillian Jacobs, Danny Pudi, Jim Rash and Ken Jeong will perform a table read and Q&A for charity.




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Entertainer Roy Horn of Siegfried & Roy dies of COVID-19 complications at 75

German-born entertainer Roy Uwe Ludwig Horn, one half of the stage duo Siegfried & Roy, has died of complications from the coronavirus. He was 75.