Vaccine Supply Chain Distribution under Covid-19 Pandemic:Stressed, Resourceful and Resilient- Lesson Learned from the United States Experiences

Supply chain failed during the initial phase of the COVID-19 pandemic. Irrational consumer behaviour created a panic buying and led to bullwhip effects. The United States government response to the pandemic from manufacturing vaccines to distribution to consumers in a very short period of time created further uncertainty as the local authorities where vaccines were to be administrated were unprepared for implementing the vaccine supply chain. The federal pandemic supply chain, Operations Wrap Speed (OWS) actually contributed to confusion, uncertainty and the panic environment at the local level. Panic for the fear of virus and confusion ensued until the end of March 2021. Lack of communication and information sharing among stakeholders are to blame for such an inefficient and ineffective pandemic supply chain execution. Once information filtered through the local level, the pandemic supply chain functioned well as it should have performed. This study suggests that a pandemic supply chain infrastructure should be in place at the local level for future emergency deployment.

Jalur Sutra Kesehatan: Upaya China Mencapai Kepentingan Geopolitik Melalui Diplomasi Vaksin

In early April 2021, China had contributed a vital role in the Covid-19 vaccine export. With the national pharmaceutical company Sinovac and Sinopharm China capable of producing over 250 million doses of vaccine, 118 million have been successfully exported to 49 countries according to Airfinity. The world distribution of the covid-19 vaccine has been deemed a failure by the WHO, from 448 million global doses only 0.1 percent of the vaccine were administered to low-income countries, and rich countries which hold 16 percent of the world's population receiving nearly half a global dose. China is able to answer the world's frustration with the western nationalism vaccine issue, as the EU and USA failed to help low-income countries to provide vaccine access. The nationalism vaccine discourages equality, as 200 million doses of vaccine produced by the United States government had approximately exported only about 4 million doses to other countries. This paper will answer how China gains global geopolitics through vaccine diplomacy? What is the role of diplomacy in promoting China's influence? Currently China focuses on expanding its influence over Asia and South America through vaccine diplomacy, under the BRI initiative this policy is then called the Health Silk Road. Keywords: Health Silk Road, Vaccine Diplomacy, Sinovac, Sinopharm

Calibration of two validated SARS-CoV-2 pseudovirus neutralization assays for COVID-19 vaccine evaluation

Vaccine-induced neutralizing antibodies (nAbs) are key biomarkers considered to be associated with vaccine efficacy. In United States government-sponsored phase 3 efficacy trials of COVID-19 vaccines, nAbs are measured by two different validated pseudovirus-based SARS-CoV-2 neutralization assays, with each trial using one of the two assays. Here we describe and compare the nAb titers obtained in the two assays. We observe that one assay consistently yielded higher nAb titers than the other when both assays were performed on the World Health Organization’s anti-SARS-CoV-2 immunoglobulin International Standard, COVID-19 convalescent sera, and mRNA-1273 vaccinee sera. To overcome the challenge this difference in readout poses in comparing/combining data from the two assays, we evaluate three calibration approaches and show that readouts from the two assays can be calibrated to a common scale. These results may aid decision-making based on data from these assays for the evaluation and licensure of new or adapted COVID-19 vaccines.

Between Prohibitionism and Religious Freedom: The Legal Disputes Concerning an Ayahuasca Church and the United States Government

This article focuses on the legal disputes between the U.S. government and the Centro Espírita Beneficente União do Vegetal (UDV), as well as on the regulation of the religious use of ayahuasca by the Drug Enforcement Agency (DEA). Our aim is to present the main issues that were at stake throughout the dispute, especially the relationship between the limits of religious freedom when associated with the use of controlled substances.

Closed material procedure in civil proceedings

<p>"Items of historical significance of two wars Iraq and Afghanistan Significant Activity, Sigacts, between 0001 January 2004 and 2359 31 December 2009 extracts from CSV documents from Department of Defence and CDNE database…This is one of the most significant documents of our time removing the fog of war and revealing the true nature of 21st century asymmetric warfare…" ¹ This was part of the message sent along with the documents later known as Iraq and Afghanistan war logs from Chelsea Manning, a United States solider, to the website of WikiLeaks - an international, online, non-profit organisation which publishes secret and sensitive information. The release of the war logs was referred as “the largest leak of classified documents in its history” and the release of diplomatic cables exposed numerous unguarded comments and revelations regarding critiques and praises about the host countries of various United States embassies; United States intelligence and counterintelligence efforts and other diplomatic actions. These leaks put the United States in great controversy considering its actions in the Iraq and Afghanistan wars and caused quite an embarrassment due to its comments regarding diplomatic actions. Chelsea Manning was convicted and Julian Assange, the founder of WikiLeaks, is facing potential criminal prosecution, despite being granted political asylum. While WikiLeaks still works as an important role of exposing the “truth” to the public, it imposed great concerns to many of the governments around the world towards their government policies, national security and general reputation. The consequence of WikiLeaks releasing sensitive information about United States government rang the alarm of the importance of governments safeguarding secret information. The motivation of the United Kingdom government issuing the Justice and Security Act arguably comes from the concern of exposing sensitive information. The Introduction of the Act reads that the JSA is “to provide for oversight of the Security Service, the Secret Intelligence Service, the Government Communications Headquarters and other activities relating to intelligence or security matters; to make provision about closed material procedure in relation to certain civil proceedings; to prevent the making of certain court orders for the disclosure of sensitive information; and for connected purposes”. This Act, based on the objectives mentioned above, introduced closed material procedure to the civil proceedings, which is regarded as a response to the judgment of Al Rawi, undoubtedly generated huge discussions across boundaries as to the matter of security and liberty; security and due process; security and justice; the Act’s in relation to the common law as well as its relationship with Article 6 of the European Convention on Human Rights. While many of the scholars accused JSA of “turning off the light”, this paper would like to direct attention to the Wikileaks incidents and consider the views of both the British government and the promoters of human rights and common law. This paper will first introduce the effect of CMP in the criminal proceedings, and then look at Al Rawi and Tariq. It will conclude the conflicts when adopting CMP and by interpreting JSA to draw some concerns and the certain “light”, as well as some suggestions towards CMP in JSA. 1. Denver Nicks. 'Private: Bradley Manning, WikiLeaks, and the Biggest Exposure of Official Secrets in American History' (Chicago Review Press, Chicago, 2012) at 137-138.</p>

Closed material procedure in civil proceedings

<p>"Items of historical significance of two wars Iraq and Afghanistan Significant Activity, Sigacts, between 0001 January 2004 and 2359 31 December 2009 extracts from CSV documents from Department of Defence and CDNE database…This is one of the most significant documents of our time removing the fog of war and revealing the true nature of 21st century asymmetric warfare…" ¹ This was part of the message sent along with the documents later known as Iraq and Afghanistan war logs from Chelsea Manning, a United States solider, to the website of WikiLeaks - an international, online, non-profit organisation which publishes secret and sensitive information. The release of the war logs was referred as “the largest leak of classified documents in its history” and the release of diplomatic cables exposed numerous unguarded comments and revelations regarding critiques and praises about the host countries of various United States embassies; United States intelligence and counterintelligence efforts and other diplomatic actions. These leaks put the United States in great controversy considering its actions in the Iraq and Afghanistan wars and caused quite an embarrassment due to its comments regarding diplomatic actions. Chelsea Manning was convicted and Julian Assange, the founder of WikiLeaks, is facing potential criminal prosecution, despite being granted political asylum. While WikiLeaks still works as an important role of exposing the “truth” to the public, it imposed great concerns to many of the governments around the world towards their government policies, national security and general reputation. The consequence of WikiLeaks releasing sensitive information about United States government rang the alarm of the importance of governments safeguarding secret information. The motivation of the United Kingdom government issuing the Justice and Security Act arguably comes from the concern of exposing sensitive information. The Introduction of the Act reads that the JSA is “to provide for oversight of the Security Service, the Secret Intelligence Service, the Government Communications Headquarters and other activities relating to intelligence or security matters; to make provision about closed material procedure in relation to certain civil proceedings; to prevent the making of certain court orders for the disclosure of sensitive information; and for connected purposes”. This Act, based on the objectives mentioned above, introduced closed material procedure to the civil proceedings, which is regarded as a response to the judgment of Al Rawi, undoubtedly generated huge discussions across boundaries as to the matter of security and liberty; security and due process; security and justice; the Act’s in relation to the common law as well as its relationship with Article 6 of the European Convention on Human Rights. While many of the scholars accused JSA of “turning off the light”, this paper would like to direct attention to the Wikileaks incidents and consider the views of both the British government and the promoters of human rights and common law. This paper will first introduce the effect of CMP in the criminal proceedings, and then look at Al Rawi and Tariq. It will conclude the conflicts when adopting CMP and by interpreting JSA to draw some concerns and the certain “light”, as well as some suggestions towards CMP in JSA. 1. Denver Nicks. 'Private: Bradley Manning, WikiLeaks, and the Biggest Exposure of Official Secrets in American History' (Chicago Review Press, Chicago, 2012) at 137-138.</p>

Kikuchi-Fujimoto Disease: A Case Report

Kikuchi-Fujimoto: A Case Report Hickman, JD. MD LT MC USN and An, Joseph, DO. LCDR MC USN Naval Medical Center Portsmouth 620 Johns Paul John Cir, Portsmouth VA 757-953-2223 The views expressed in this abstract are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. We are military service members and employees of the U.S. Government. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that "Copyright protection under this title is not available for any work of the United States Government." Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person's official duties. Kikuchi-Fujimoto disease is a rare benign disorder often presenting with tender cervical lymphadenopathy, fever, and malaise. While first described in Japan, its distribution is worldwide and predominantly seen in young adults. Diagnosis is based on characteristic histopathologic findings of patchy necrosis occupied by karyorrhectic debris and abundant histiocytes on node biopsy. The origin is unclear but associated with a preceding viral illness as well as cutaneous lupus erythematosus. Treatment is generally supportive and focused on managing tender lymph nodes. We present a case of a 28-year-old female presenting with a 2 month history of night sweats, fever, and weight loss in the setting of painful neck swelling. CT and PET/CT imaging demonstrated numerous hypermetabolic and enlarged nodes in the bilateral cervical and axillary regions. Lab studies were notable for leukopenia, anemia, and elevated inflammatory markers. A COVID-19 screening was negative. Excisional biopsy of a cervical node revealed extensive cortical necrosis and apoptotic debris with scattered histiocytes and plasmacytoid dendritic cells in absence of neutrophils or a monoclonal B cell or T cell population. Treatment was initiated with NSAIDs and close monitoring. The patient exhibited a complete response after two months. Our case is an important reminder that lymphadenopathy, fever, and night sweats in a young adult are not pathognomonic for lymphoma. Nonetheless, a high suspicion for lymphoma should be maintained and followed with an expedited workup. Kikuchi-Fujimoto can certainly mimic Hodgkin lymphoma or other serious conditions like lupus erythematosus and tuberculosis. The diagnosis is largely one of exclusion following a careful examination of a lymph node histopathology and must be considered in young previously healthy adults to avoid misdiagnosis and unnecessary escalation of treatment. Disclosures No relevant conflicts of interest to declare.

A Precis on How Democracies Die as a Consequence of America’s, Failure of Government Working for the People while Serving the Interests of the Wealthy

This precis speaks to the failure of the United States government to sustain the wealth of the middle-class after the post-World War Two years’, while serving the wealthiest Americans. It will document how the country has become polarized and fractured along ideological and cultural lines. This situation has created a segmentation of the country that has competing visions, purpose and meaning which is tearing it apart.It will also focus on the inequality in the country that has emerged from the Oligarchy’s domination of the political and free market space-government of the 1%, by the 1% AND FOR THE 1%. Their mantra is to keep the government out of business and have business in the government.

The Historical and Contemporary Causes of «Survival Migration». From Central America’s Northern Triangle

Durante la última media década se han producido salidas masivas de refugiados procedentes del Triángulo Norte de América Central, es decir, de El Salvador, Guatemala y Honduras. Dichas salidas surgen de una serie de procesos históricos perversos, que se refuerzan mutuamente: la implementación profundamente defectuosa de acuerdos de paz igualmente defectuosos que puso fin a las guerras civiles de la región en la década de 1990; la búsqueda de la privatización neoliberal y las políticas económicas «amigables al mercado» que socavan el avance hacia una paz social sostenible; los acuerdos comerciales que infligieron un gran daño a la agricultura campesina; la búsqueda de inversión extranjera en sectores extractivos que desplazaron a pueblos rurales e indígenas y las políticas de las principales instituciones internacionales y del gobierno de Estados Unidos en particular, que profundizaron todas estas tendencias perversas que dejaron a la gente sin medios de vida. Las bandas criminales y la violencia vinculadas al narcotráfico son manifestaciones de estos procesos subyacentes que expulsan a las personas de la región en oleadas de «migración de supervivencia» forzada. The past half decade of massive refugee outflows from the Northern Triangle of Central America –that is, from El Salvador, Guatemala, and Honduras– emerge from a number of perverse and mutually reinforcing historical processes: the deeply flawed implementation of equally flawed peace accords that ended the region’s civil wars in the 1990s; the pursuit of neoliberal privatization and «market-friendly» economic policies that undercut advance toward sustainable social peace, including trade agreements that inflicted great damage to peasant agricultura; the pursuit of foreign investment in extractive sectors that displaced rural and indigenous peoples, and the policies of the major international institutions, and of the United States government in particular, which deepened all of these perverse trends that left people without livelihoods. The gang and criminal violence linked to the narcotics trade are manifestations of these underlying processes that expel people from the region in waves of forced «survival migration».