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Castration was performed not only as a punishment but also as a prerequisite for entering imperial service. Towards the end of the Ming Dynasty in the mid-17th Century some 70,000 eunuchs were employed to serve the emperor.

In an entirely different context, castration has also been carried out on young boys before puberty to prevent their voices from breaking

Men castrated before puberty retain an unusual high-pitched singing voice broadly comparable to that of a soprano, mezzo-soprano, or contralto, but covering a strikingly wide range.

the effects of castration, including strikingly long limb-bones, incomplete bone fusion and low bone density (osteoporosis

With Italy as its epicentre, enthusiasm for musical performances of castrati prevailed for over three hundred years,

The reported incidents range from verbal harassments to physical altercations.

As a man in his late 20s, Kim is not the typical victim of anti-Asian attacks. Chung Joe said that most attacks target the more vulnerable members of the Asian American community.

"Women are targeted more than twice as often as men," she said, and "we are seeing a spate of hate and violence targeted at our seniors."

Nearly 44% of all incidents reported to Stop AAPI Hate have come from California. Asian Americans account for roughly 15% of California's estimated 40 million people, according to the U.S. Census Bureau.

"The Federal Government must recognize that it has played a role in furthering these xenophobic sentiments through the actions of political leaders, including references to the COVID-19 pandemic by the geographic location of its origin," Biden said. "Such statements have stoked unfounded fears and perpetuated stigma about Asian Americans and Pacific Islanders and have contributed to increasing rates of bullying, harassment, and hate crimes against AAPI persons."

The figures "really bring to the fore how widely prevalent this problem already was" even prior to the pandemic, said WHO's Dr. Claudia Garcia-Moreno, one of the report's authors.

She says researchers won't know the pandemic's true impact on violence against women until they can conduct new population-based surveys again in the future.

According to the report, intimate partner violence was the most prevalent form – and it starts early. Nearly 1 in 4 girls and women who'd been in a relationship have already experience physical and/or sexual violence by age 19, the report found.

Globally, 6% of women reported being sexually assaulted by someone other than a husband or partner

In a statement, he called it a problem "endemic in every country and culture that has been exacerbated by the COVID-19 pandemic."

We can only fight it with deep-rooted and sustained efforts – by governments, communities and individuals – to change harmful attitudes, improve access to opportunities and services for women and girls, and foster healthy and mutually respectful relationships

U.N. Women Executive Director Phumzile Mlambo-Ngcuka called violence against women "the most widespread and persistent human rights violation" in the world.

While the problem of violence against women is pervasive globally, it is not distributed equally. Social and economic inequities are a leading risk factor, and women in low- and lower-middle-income nations and regions are disproportionately affected, the report found.

The disparities are particularly startling when it comes to recent violence: The analysis found 22% of women living in countries designated as "least developed" had been subject to intimate partner violence in the previous 12 months before being surveyed – much higher than the world average of 13%.

She says the data will provide a baseline that the United Nations can use to track future progress.

The report calls for interventions such as reforming laws that discriminate against women's education, employment and legal rights, and improving women's access to health care, including post-rape care. Prevention also includes challenging gender stereotypes, starting with how we educate children from a very young age, said WHO Assistant Director-General Dr. Princess Nothemba Simelela.

"Gender-based violence is part of what needs to be addressed as we come out of the pandemic," she said. "It is an integral part of building back better."

The charge of double standards points to a steep learning curve for a party that has struggled to keep pace with shifting public attitudes towards gender roles, power dynamics and sexual boundaries.

Just as the instant deification then instant demonisation of Cuomo has left many crying out for nuance and complexity, so it can be said that no two cases of sexual harassment in politics are quite the same.

This time, although Gillibrand said Cuomo’s alleged conduct was “completely unacceptable”, she stopped short of demanding he resign before the investigation is done

“The vice-president’s view is that she believes all women should be treated with respect. Their voices should be heard. They should tell their story. There’s an independent investigation that is happening now, being overseen by the New York attorney general, and she certainly supports that.”

But this puts Democratic leaders out of step with groups such as Women’s March, which was born out of the January 2017 protests against Donald Trump, who faced numerous allegations of sexual assault and harassment

“We share the view that there should be an independent investigation but Cuomo himself has not even denied many of the harassment allegations and, for us, it’s about behaviour that is disqualifying. It could be illegal, but it also could not be illegal.”

That same year, Gillibrand became the first Democratic senator to call for her Minnesota colleague Al Franken to quit over allegations of sexual misconduct. She was joined by others including Kamala Harris, who tweeted: “Sexual harassment and misconduct should not be allowed by anyone and should not occur anywhere. I believe the best thing for Senator Franken to do is step down.”Franken did just that, but some critics now believe that he was the victim of a rush to judgment and should have been allowed to wait for the results of an investigation.

In 2018 Eric Schneiderman, an attorney general of New York lauded as a liberal advocate of women’s rights, resigned after being accused of physically abusing four women. Cuomo was among those who were quick to call for him to step down.

Trump’s nominee to the supreme court, Brett Kavanaugh, was nearly derailed by allegations from Dr Christine Blasey Ford that he sexually assaulted her

In 2019 several women accused Biden of making unwanted physical contact.

Last year Tara Reade, a former Senate staffer, alleged that Biden sexually assaulted her in 1993. He vehemently denied the claim, which remained unsubstantiated and faded from the election race. Biden picked a woman – Harris – as his running mate and often highlighted his work as lead sponsor of the Violence Against Women Act.

Larry Jacobs, the director of the Center for the Study of Politics and Governance at the University of Minnesota, said: “In hindsight, a number of the Democrats in the Senate who had pushed him to step down later expressed regret. They realised they moved too quickly, they didn’t know enough and the punishment didn’t really fit what they later learnt to be the misbehaviour.”

sexual

“I don’t think the Republican party is in any position to be lecturing anyone about how to handle sexual harassment. They seem to have actually gotten real expertise on how to evade it.”

“Just because we fire Andrew Cuomo and Bill Cosby and Harvey Weinstein, that doesn’t alone solve the problem. The bigger problem is still there, which is that harassment is seen as an acceptable part of our culture. That’s why so many of these people in power are doing it. So yes, we need to respond and uproot harassment wherever it lies but we also need to keep our eye on the ball.”

The CDC defines people who are fully vaccinated as those who are two weeks past their second dose of the Moderna or Pfizer/BioNTech Covid-19 vaccines or two weeks past a single dose of the Johnson & Johnson vaccine.

"That was a determination made by the CDC. It wasn't driven by or directed by the White House," Psaki said of the CDC guidelines when asked if Biden agreed on not issuing new guidance on travel for people who are fully vaccinated.

Wen, who is also a CNN medical analyst, added that she thinks people who are fully vaccinated should be able to travel "and that's one of those incentives that we can give as a way for restoring freedoms" for those who get vaccinated.

The Biden administration is ramping up vaccination efforts, and as of Wednesday afternoon nearly 93.7 million vaccines had been administered, according to the CDC. About 9.7% of the population is fully vaccinated, the CDC says.

With such a huge food supply, food marketing got better and restaurants got cheaper. The low cost of food fueled the growth of the fast-food industry. If food were expensive, you couldn’t have fast food.

The epidemic was caused by the overproduction of food in the United States. Beginning in the 1970s, there was a change in national agricultural policy. Instead of the government paying farmers not to engage in full production, as was the practice, they were encouraged to grow as much food as they could. At the same time, technological changes and the “green revolution” made our farms much more productive. The price of food plummeted, while the number of calories available to the average American grew by about 1,000 a day.

Well, what do people do when there is extra food around? They eat it! This, of course, is a tremendously controversial idea. However, the model shows that increase in food more than explains the increase in weight.

There’s no magic bullet on this. You simply have to cut calories and be vigilant for the rest of your life.

Americans are wasting food at a progressively increasing rate. If Americans were to eat all the food that’s available, we’d be even more obese.

What new information did your equation render? That the conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one. Also, there’s a time constant that’s an important factor in weight loss. That’s because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new “steady state.” Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds — if you don’t cheat. Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.

People don’t wait long enough to see what they are going to stabilize at. So if you drop weight and return to your old eating habits, the time it takes to crawl back to your old weight is something like three years. To help people understand this better, we’ve posted an interactive version of our model at bwsimulator.niddk.nih.gov.

we should stop marketing food to children.

weight change, up or down, takes a very, very long time. All diets work. But the reaction time is really slow: on the order of a year.

I could see the facts on the epidemic were quite astounding. Between 1975 and 2005, the average weight of Americans had increased by about 20 pounds

People think that the epidemic has to be caused by genetics or that physical activity has gone down. Yet levels of physical activity have not really changed in the past 30 years. As for the genetic argument, yes, there are people who are genetically disposed to obesity, but if they live in societies where there isn’t a lot of food, they don’t get obese. For them, and for us, it’s supply that’s the issue.

I think childhood obesity is a major problem. And when you’re obese, it’s not like we can suddenly cut your food off and you’ll go back to not being obese. You’ve been programmed to eat more. It’s a hardship to eat less. Michelle Obama’s initiative is helpful. And childhood obesity rates seem to be stabilizing in the developed world, at least. The obesity epidemic may have peaked because of the recession. It’s made food more expensive.

I think the food industry doesn’t want to know it. And ordinary people don’t particularly want to hear this, either. It’s so easy for someone to go out and eat 6,000 calories a day.

Editors’ PicksBallet Is Hard Enough. What

“The importance of this test goes beyond the gender issue,” Senator Richard Blumenthal, a Connecticut Democrat who has focused on the area for years, said in an interview. “It raises the issue of how to attract different kinds of skills and talent to the military. We need to make sure the test does not exclude doctors, cyberwarriors and others whose physical fitness is important but maybe not in the same exact way as a man or woman going into combat.”

Not all women in uniform agree that the standards should be lowered.

California's public health directives have kept the parks closed since last March. But under new guidance released last week, red-tier counties — the second-highest level of risk — can open theme parks to in-state visitors, at 15% capacity, starting April 1.

The parks will operate under a new reservation system designed to enforce capacity limits and promote physical distancing

Face coverings will be required, and the facilities will adopt enhanced cleaning procedures and modify certain experiences in order to reduce contact.

"Beloved characters will pop up in new ways and sometimes in unexpected places as they remain mindful of physical distancing,"

"Certain experiences that draw large group gatherings – such as parades and nighttime spectaculars – will return at a later date."

The resort is moving to reopen in phases. Disney's Grand Californian Hotel & Spa plans to reopen with limited capacity starting April 29, followed by Disney Vacation Club Villas at Disney's Grand Californian Hotel & Spa on May 2.

"We've seen the enthusiasm, the craving for people to return to our parks around the world," Chapek said.

Disneyland and Disney's California Adventure were initially planning to open their doors on July 17 — Disneyland's 65th anniversary — but delayed their reopening indefinitely pending state guidance. Employees had also raised safety concerns and questions about the availability of COVID-19 testing.

Disney announced in September it was laying off 28,000 workers from its Parks, Experiences and Products division, with 67% of those part-time employees.In their announcement on Wednesday, officials said more than 10,000 employees will be returning to work.

The “Build Back Better” plan that his economic advisers recommended Mr. Biden pursue this week would lead with those physical investments: a combination of spending and tax incentives on traditional infrastructure, high-growth industry cultivation and carbon-reducing energy investment that documents suggest could top $2 trillion

At the same time, Democratic leaders will most likely prepare to move at least one part of Mr. Biden’s plans quickly through the budget reconciliation process, which allows senators to skirt the filibuster and pass legislation with a bare majority, as they did for the coronavirus relief bill. Senator Ron Wyden of Oregon, the chairman of the Finance Committee, said in an interview that he is drawing up legislative text for tax increases to fund the Biden spending: “I’m going to start rolling out specific proposals so that people can have ideas about how they might proceed,” he said.

"As a result, it affects the health of our entire nation. Racism is not just the discrimination against one group based on the color of their skin or their race or ethnicity, but the structural barriers that impact racial and ethnic groups differently to influence where a person lives, where they work, where their children play, and where they worship and gather in community. These social determinants of health have life-long negative effects on the mental and physical health of individuals in communities of color."

Walensky has charged all of the offices and centers under the CDC to develop interventions and measurable health outcomes in the next year, addressing racism in their respective areas

The site notes that racism, in both its structural and interpersonal forms, has a negative effect on mental and physical health.

including biology, botany, chemistry, ethics, history, logic, metaphysics, rhetoric, philosophy of mind, philosophy of science, physics, poetics, political theory, psychology, and zoology.

some of his work remained unsurpassed until the 19th century.

But he is, of course, most outstanding as a philosopher.

Within the Academy, however, relations seem to have remained cordial. Aristotle always acknowledged a great debt to Plato; he took a large part of his philosophical agenda from Plato, and his teaching is more often a modification than a repudiation of Plato’s doctrines.

Aristotle was born on the Chalcidic peninsula of Macedonia, in northern Greece.

Many of Plato’s later dialogues date from these decades, and they may reflect Aristotle’s contributions to philosophical debate at the Academy.

It is possible that two of Aristotle’s surviving works on logic and disputation, the Topics and the Sophistical Refutations, belong to this early period.

During Aristotle’s residence at the Academy, King Philip II of Macedonia (reigned 359–336 bce) waged war on a number of Greek city-states.

His writings in ethics and political theory as well as in metaphysics and the philosophy of science continue to be studied,

When Plato died about 348, his nephew Speusippus became head of the Academy, and Aristotle left Athens.

While in Assus and during the subsequent few years when he lived in the city of Mytilene on the island of Lesbos, Aristotle carried out extensive scientific research, particularly in zoology and marine biology.

The scope of Aristotle’s scientific research is astonishing.

The myriad items of information about the anatomy, diet, habitat, modes of copulation, and reproductive systems of mammals, reptiles, fish, and insects are a melange of minute investigation and vestiges of superstition.

In 343 or 342 Aristotle was summoned by Philip II to the Macedonian capital at Pella to act as tutor to Philip’s 13-year-old son, the future Alexander the Great.

By 326 Alexander had made himself master of an empire that stretched from the Danube to the Indus and included Libya and Egypt.

Most of Aristotle’s surviving works, with the exception of the zoological treatises, probably belong to this second Athenian sojourn.

Aristotle’s works, though not as polished as Plato’s, are systematic in a way that Plato’s never were.

Aristotle divided the sciences into three kinds: productive, practical, and theoretical.

When Alexander died in 323, democratic Athens became uncomfortable for Macedonians, even those who were anti-imperialist.

Aristotle’s writings fall into two groups: those that were published by him but are now almost entirely lost, and those that were not intended for publication but were collected and preserved by others.

Time cannot be composed of indivisible moments, because between any two moments there is always a period of time.

Motion (kinesis) was for Aristotle a broad term, encompassing changes in several different categories.

For Aristotle, extension, motion, and time are three fundamental continua in an intimate and ordered relation to each other.

Change, for Aristotle, can take place in many different categories.

Largely an office procedure when widespread screening was first recommended, colonoscopies have moved into surgery centers — which were created as a step down from costly hospital care but are now often a lucrative step up from doctors’ examining rooms — where they are billed like a quasi operation.

The high price paid for colonoscopies mostly results not from top-notch patient care, according to interviews with health care experts and economists, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.

While several cheaper and less invasive tests to screen for colon cancer are recommended as equally effective by the federal government’s expert panel on preventive care — and are commonly used in other countries — colonoscopy has become the go-to procedure in the United States. “We’ve defaulted to by far the most expensive option, without much if any data to support it,”

Hospitals, drug companies, device makers, physicians and other providers can benefit by charging inflated prices, favoring the most costly treatment options and curbing competition that could give patients more, and cheaper, choices. And almost every interaction can be an opportunity to send multiple, often opaque bills with long lists of charges: $100 for the ice pack applied for 10 minutes after a physical therapy session, or $30,000 for the artificial joint implanted in surgery.

Even doctors often do not know the costs of the tests and procedures they prescribe. When Dr. Michael Collins, an internist in East Hartford, Conn., called the hospital that he is affiliated with to price lab tests and a colonoscopy, he could not get an answer. “It’s impossible for me to think about cost,” he said

The more than $35,000 annually that Ms. Yapalater and her employer collectively pay in premiums — her share is $15,000 — for her family’s Oxford Freedom Plan would be more than sufficient to cover their medical needs in most other countries. She and her husband, Jeff, 63, a sales and marketing consultant, have three children in their 20s with good jobs. Everyone in the family exercises, and none has had a serious illness.

A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.

“In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. ”But it is a very weird market, riddled with market failures.”

Consumers, the patients, do not see prices until after a service is provided, if they see them at all. And there is little quality data on hospitals and doctors to help determine good value, aside from surveys conducted by popular Web sites and magazines. Patients with insurance pay a tiny fraction of the bill, providing scant disincentive for spending.

The United States spends about 18 percent of its gross domestic product on health care, nearly twice as much as most other developed countries. The Congressional Budget Office has said that if medical costs continue to grow unabated, “total spending on health care would eventually account for all of the country’s economic output.”

Instead, payments are often determined in countless negotiations between a doctor, hospital or pharmacy, and an insurer, with the result often depending on their relative negotiating power. Insurers have limited incentive to bargain forcefully, since they can raise premiums to cover costs.

“People think it’s like other purchases: that if you pay more you get a better car. But in medicine, it’s not like that.”

The group’s reopening recommendations include widespread testing, contact tracing and isolation of people who are infected or exposed.

One important factor in transmission is that seemingly benign activities like speaking and breathing produce respiratory bits of varying sizes that can disperse along air currents and potentially infect people nearby.

Health agencies have so far identified respiratory-droplet contact as the major mode of Covid-19 transmission. These large fluid droplets can transfer virus from one person to another if they land on the eyes, nose or mouth. But they tend to fall to the ground or on other surfaces pretty quickly.

Proper ventilation—such as forcing air toward the ceiling and pumping it outside, or bringing fresh air into a room—dilutes the amount of virus in a space, lowering the risk of infection.

An estimated 10% of people with Covid-19 are responsible for about 80% of transmissions, according to a study published recently in Wellcome Open Research. Some people with the virus may have a higher viral load, or produce more droplets when they breathe or speak, or be in a confined space with many people and bad ventilation when they’re at their most infectious point in their illness

that is only a rule of thumb, he cautioned. It could take much less time with a sneeze in the face or other intimate contact where a lot of respiratory droplets are emitted, he said.

When singing, people can emit many large and small respiratory particles. Singers also breathe deeply, increasing the chance they will inhale infectious particles.

Similar transmission dynamics could be at play in other settings where heavy breathing and loud talking are common over extended periods, like gyms, musical or theater performances, conferences, weddings and birthday parties.

The so-called attack rate—the percentage of people who were infected in a specific place or time

additional protocols to interrupt spread, like social distancing in workspaces and providing N95 respirators or other personal protective equipment, might be necessary as well, she said.

Another factor is prolonged exposure. That’s generally defined as 15 minutes or more of unprotected contact with someone less than 6 feet away

The attack rate for Covid-19 in households ranges between 4.6% and 19.3%, according to several studies. It was higher for spouses, at 27.8%, than for other household members, at 17.3%, in one study in China.

The 37-year-old stay-at-home mother was hospitalized with a stroke on April 18 that her doctors attributed to Covid-19, and was still coughing when she went home two days later.

She pushed to get home quickly, she said, because her 4-year-old son has autism and needed her. She kept her distance from family members, covered her mouth when coughing and washed her hands frequently. No one else in the apartment has fallen ill, she said. “Nobody went near me when I was sick,” she said.

Being outside is generally safer, experts say, because viral particles dilute more quickly. But small and large droplets pose a risk even outdoors, when people are in close, prolonged contac

No one knows for sure how much virus it takes for someone to become infected, but recent studies offer some clues

In one small study published recently in the journal Nature, researchers were unable to culture live coronavirus if a patient’s throat swab or milliliter of sputum contained less than one million copies of viral RNA.

“Based on our experiment, I would assume that something above that number would be required for infectivity,” said Clemens Wendtner, one of the study’s lead authors

He and his colleagues found samples from contagious patients with virus levels up to 1,000 times that, which could help explain why the virus is so infectious in the right conditions: It may take much lower levels of virus than what’s found in a sick patient to infect someone else.

Current CDC workplace guidelines don’t talk about distribution of aerosols, or small particles, in a room, said Lisa Brosseau, a respiratory-protection consultan

overall, “the risk of a given infected person transmitting to people is pretty low,” said Scott Dowell, a deputy director overseeing the Bill & Melinda Gates Foundation’s Covid-19 response. “For every superspreading event you have a lot of times when nobody gets infected.”

Some scientists say while aerosol transmission does occur, it doesn’t explain most infections. In addition, the virus doesn’t appear to spread widely through the air.

“If this were transmitted mainly like measles or tuberculosis, where infectious virus lingered in the airspace for a long time, or spread across large airspaces or through air-handling systems, I think you would be seeing a lot more people infected,” said the CDC’s Dr. Brooks.

High-touch surfaces like doorknobs are a risk, but the virus degrades quickly so other surfaces like cardboard boxes are less worrisome,

“It tells people, cops can kill you in the sanctity of your own home,” Linda Sarsour, a Palestinian-American activist, said as she wiped tears from her face.

After protesters marched loudly but peacefully through the streets for more than two hours, they were stopped by a line of officers in riot gear in the Highlands section of town.

2a”If anyone can get killed how Breonna got killed by the police, there’s no way we should live in a society where that’s possible,” he said.

“our criminal justice system is fundamentally broken.”

Under Kentucky law, a person is guilty of the crime when “under circumstances manifesting extreme indifference to the value of human life, he wantonly engages in conduct which creates a substantial danger of death or serious physical injury to another person.”

For months, Ms. Taylor’s death has been a rallying cry. Michelle Obama and Kamala Harris, the Democratic vice-presidential nominee, called out her name during the Democratic National Convention. Oprah Winfrey paid for billboards demanding the officers be charged, writing in her magazine, “We have to use whatever megaphone we can.”

Scientists have detected the virus in places that can be reached only by air, such as ductwork; asymptomatic transmission is occurring, meaning people are spreading this without coughing or sneezing large droplets; and basic aerosol physics shows that people shed an entire continuum of particles when they cough, sneeze or talk, including large particles that settle out quickly and smaller ones that stay afloat for hours.

Why is airborne transmission so important? One reason: super-spreader events. Covid-19 does not spread from one person to the next equally.

one recent paper found that 10 percent of cases led to about 80 percent of the spread.

Such super-spreader events appear to be happening exclusively indoors, where airborne transmission is more likely.

when people sing, they emit as many aerosol particles as they do when they’re coughing. The practice also happened from 6:30 to 9 p.m., when most buildings turn off their ventilation systems.

Just looking at these next few statistics will tell you everything you need to know about where we need to target our intervention efforts

To do that, we need to do two things. First, maintain physical distancing. Six feet is good, but 10 feet is better

Second, we must deploy healthy building strategies, such as refreshing stale indoor air.

We do this by opening windows in our homes and cars and by increasing the outdoor air ventilation rate in buildings with HVAC systems

We also have to make sure places such as bathrooms and rooms with infected patients have enough exhaust, and are negatively pressurized relative to common areas, so any airborne virus is confined to limited areas.

Florence Nightingale said, "Cleanliness and fresh air from open windows, with unremitting attention to the patient are the only defence a true nurse either asks or needs."

it also requires that we minimize exposure to airborne pathogens, especially indoors.

One in 3 deaths nationally are workers or residents of senior homes; nine of the top 10 clusters in the United States occur in meatpacking plants and prisons; the death rate in hot spots is 10-fold higher in areas with lower incomes; and communities of color have nearly five times the odds of infection.

“We have an [obesity] epidemic in the midst of a pandemic.”

And it is associated with a wide range of comorbidities, from heart disease to diabetes, that increase vulnerability to the worst impacts of the infection.

A constellation of factors can influence a patient’s outcome: Fat can physically compress parts of the lungs, impeding respiration. In the hospital, it can make calculating medication doses, inserting intravenous tubes and moving patients more difficult. It can stimulate parts of the body’s hormonal system, worsening covid-19, a disease that often provokes a powerful inflammatory response itself.

The Centers for Disease Control and Prevention lists 5,614 covid-19 deaths where obesity was a contributing factor, but this is probably a sharp undercount

More than 42 percent of U.S. residents are obese, defined as a body mass index of 30 or greater, and more than 9 percent are severely obese, with BMIs of 40 or more

A 5-9 person weighing 203 pounds has a BMI of 30. The same person would weigh 271 pounds if his BMI were 40.

For some groups, conditions are worse: 56 percent of African American women, for example, are obese,

Early analyses point to obesity itself — rather than the comorbidities it creates — as a separate precursor to poor outcomes.

Sara Tartof, a Kaiser Permanente research scientist who led the analysis, speculated that large amounts of visceral fat — the fat stored in the abdomen around body organs — may play a role in producing severe covid-19.

Fat is not inert; it secretes chemicals that can influence bodily systems. It may affect the angiotensin system that helps regulate blood pressure and blood flow, leading to more severe symptoms,

Lighter said people with obesity seem to have more ACE2 receptors, the gateway the virus uses to invade cells. “So there are more opportunities to attack,

people under age 60 are two to three times more likely to be admitted to the hospital for covid-19 if they are obese

“Obese people have more androgens and male hormones. Maybe that’s impacting the virus affecting the cells,

At times, there was not enough staff for the delicate task of turning him onto his stomach — a procedure called “proning” that helps open airways — or returning him to his back, Zymet said. Five people were needed to accomplish the task because of Place’s weight and the medical devices he was attached t

“Instead of needing four people to do it, you might need six or eight people to do it.”

Intubating very obese people also can be more complex because fat deposits around the neck can make proper positioning more difficult,

Place lost 49 pounds during his hospital stay while he was being fed through a tube and on a ventilator, leaving at 199 pounds. But the physical cost was enormous. When he awoke, the only part of his body he could move was his left arm, from the elbow to his fingers.

He has insisted that the 12 jurors were given “all of the evidence” and were free to pursue additional charges.

As is customary in the recording of Grand Jury proceedings, juror deliberations and prosecutor recommendations and statements were not recorded, as they are not evidence,

The audio files do not include statements or recommendations from prosecutors about which charges they think should be brought against the officers. Mr. Cameron has said that jurors were told that the two officers who shot Ms. Taylor were justified in their actions. Ultimately, the jurors indicted a former officer last week on three charges of endangering Ms. Taylor’s neighbors by firing into their home during a raid of her apartment in March, but did not charge either of the officers who shot her.

Grand jurors are given broad powers to request evidence, call witnesses and determine which charges to pursue, but prosecutors often closely guide the jurors, presenting them with certain charges and telling them about their own roles. The process almost always remains secret.

grand jurors indicted Brett Hankison, a former detective, on three counts of “wanton endangerment” last week, saying Mr. Hankison had recklessly fired his gun during the raid after Ms. Taylor’s boyfriend — who has said he thought intruders were entering the apartment — shot an officer in the leg.

Mr. Hankison’s rounds did not hit anyone, investigators have said, but some of them flew into an apartment behind Ms. Taylor’s, leading to the three charges.

Detective Myles Cosgrove, who the F.B.I. said fired the shot that killed Ms. Taylor, described a disorienting scene of flashing lights as officers breached the door and seemed to suggest uncertainty about exactly what happened.

But, he added, “It’s like a surreal thing. If you told me I didn’t do something at that time, I’d believe you. If you told me I did do something, I’d probably believe you, too.”

Detective Cosgrove said he also saw a shadow of a person, a “larger than normal human shadow,” when they raided the apartment and he saw flashing lights.

The first witness was an investigator for the Attorney General’s office, who presented photos and videos of the scene, including the body camera videos of three officers who arrived after the shots were fired

Grand jurors asked whether Kenneth Walker, Ms. Taylor’s boyfriend, had been named in the search warrant (he had not), what exactly the officers saw when the apartment door opened, and whether the officers executing the warrant were aware that the police had already found Jamarcus Glover, who was the target of an illegal drug investigation.

Mr. Glover was Ms. Taylor’s ex-boyfriend, and he was in custody by the time they raided her apartment. At times, the jurors’ questions suggested they were skeptical of what they were being shown: one asked about the time stamps on the video. Another asked why they had not seen the room where the gun was found; the investigator said that would be shown in a different video.

Grand jurors heard at least two Louisville police officers who were at the raid on Ms. Taylor’s apartment say the group knocked and announced their presence several times before breaking down the door, according to a recording of the proceedings released on Friday.Those accounts, which have been questioned by several of Ms. Taylor’s neighbors and her boyfriend, were included among roughly 15 hours of audio filed by the attorney general on Friday, which includes interviews heard by the grand jury over several days last week.

The unidentified neighbor yelled at them, “something about leave her alone, there was some girl there,” Detective Cosgrove said in an interview with police investigators last month that was played for the grand jury.

He said officers were outside knocking for 90 seconds, and that the volume escalated from “gentle knocking” to “forceful pounding” to pounding while yelling “police.”

Detective Nobles, who held the battering ram that broke through Ms. Taylor’s door, said he stood at the door, knocking and announcing himself as police for one or two minutes before he used the battering ram to force his way into Ms. Taylor’s apartment. His interview was also played for grand jurors. He said it took three knocks with the battering ram to break down the door completely.The first blow hit the handle, he said. The second broke the door, but left it still on the hinges. The third broke down the door completely. When he entered, Mr. Nobles said it was “pitch black,” and that Sgt. John Mattingly, one of the officers who shot Ms. Taylor, was quickly shot in the leg after the team entered the building.

In previous interviews with The Times, 11 of 12 of Ms. Taylor’s neighbors said they never heard the police identify themselves. One neighbor said he heard the group say “Police,” just once.

Grand jurors were played recordings of radio calls from Mr. Hankison, the detective who fired blindly from outside the apartment and has been charged with wanton endangerment, as well as 911 calls that came in after the shooting began.

The calls suggest that Mr. Hankison, who was fired after the shooting for violating department procedure, believed that Sgt. Jonathan Mattingly had been wounded by someone with an “A.R.” who was “barricaded” inside the apartment. Mr. Hankison’s reference to an “A.R.” on the call appears to be a reference to either an assault rile or the AR-15, a type of a military-style semiautomatic rifle.

The only charges brought by the grand jury were three counts of “wanton endangerment in the first degree” against Mr. Hankison for his actions during the raid.

Under Kentucky law, a person commits that crime when he or she “wantonly engages in conduct which creates a substantial danger of death or serious physical injury to another person,” and does so “under circumstances manifesting extreme indifference to the value of human life.” Other states may use terms like “reckless endangerment” for an equivalent offense.

But the charges against Mr. Hankison are not for killing Ms. Taylor. None of the 10 shots he fired are known to have struck her. Instead, the Kentucky attorney general said the former detective was charged by the grand jury because the shots he fired had passed through Ms. Taylor’s apartment walls into a neighboring apartment, endangering three people there.

The crime is a Class D felony in Kentucky, which means it can carry a sentence of up to five years in prison and a fine on conviction for each count.

A person can be guilty of wanton endangerment even if they did not intend to harm anyone or to commit a crime; it is sufficient to recklessly disregard the peril that one’s actions create.

Mr. Hankison was fired from the force. During the raid, he fired into her apartment from outside, through a sliding glass patio door and a window that were covered with blinds, in violation of a department policy that requires officers to have a line of sight.

The name Breonna Taylor has echoed across the nation for months as demonstrators demanded the police be held accountable for her death.

The police killing of George Floyd, a Black man who died in May after being handcuffed and pinned to the ground by a white police officer’s knee, brought renewed attention to deadly episodes involving the police, including Ms. Taylor’s death, and fueled Black Lives Matter protests that persisted throughout the summer.

In September, when the grand jury announced no charges against the officers who killed Ms. Taylor, protesters poured into the streets of Louisville with renewed strength and anger, demanding stronger charges. The protesters called for all three officers, who are white, to be held to account for Ms. Taylor’s death. Ms. Taylor’s family, too, has pleaded for justice, pushing for criminal charges against the officers. Ms. Taylor’s case has also been the center of campaigns from several celebrities and athletes, some of whom have dedicated their seasons to keeping a spotlight on her case.

Unfortunately, this development doesn’t mean we can all relax and start doing more things. It means we need to tighten up even further until the vaccine becomes available.

The goal is now no longer to learn to live indefinitely with the virus. It’s to get as many people through the winter as possible without getting sick.

It’s always been hard to convince people to make good choices when considering sacrifices. Uncertainty around when we’d get an effective vaccine made it even harder. Cutting off in-person interactions for an uncertain stretch of time was excruciating. But it may be more palatable to hunker down if it’s only for a defined period.

And the costs are not just financial; mental health is at risk as well as physical health as people forgo care, including self-care, to remain free from infection. All of that becomes easier to swallow if it’s for a shorter period of time.

To make the situation concrete, let’s consider the upcoming Thanksgiving holiday. With cases growing rapidly around the country, especially in the northern Midwest, indoor social gatherings are more dangerous than at any point since the spring. Thanksgiving dinners are ideal settings for “superspreader” events: They crowd people from all over around a table to talk, laugh and drink, often in poorly ventilated rooms. Many families stuff themselves into houses for an entire long weekend.

The calculus is very different, however, if a vaccine is around the corner. While Pfizer’s still needs to be approved, manufactured and distributed, the company estimates that 50 million doses could be distributed before the end of the year. Another 1.3 billion would come in 2021. If other vaccines also show success, relief could come as soon as the spring.

While Pfizer’s still needs to be approved, manufactured and distributed, the company estimates that 50 million doses could be distributed before the end of the year. Another 1.3 billion would come in 2021. If other vaccines also show success, relief could come as soon as the spring.

The point generalizes. Without question, the sacrifices required to keep us safe from Covid-19 are costly. And the costs are not just financial; mental health is at risk as well as physical health as people forgo care, including self-care, to remain free from infection. All of that becomes easier to swallow if it’s for a shorter period of time.

Cutting off in-person interactions for an uncertain stretch of time was excruciating. But it may be more palatable to hunker down if it’s only for a defined period.

Pfizer’s announcement strengthens the case for federal financial support. Covid-19 is still going to hurt some businesses disproportionately, either because they’ll be forced to close again or because people have stopped going out as much. But Congress no longer needs to write a blank check to support them. It just needs to provide a lifeline for a number of months, a much more palatable prospect.

It’s a bad idea for restaurants and bars to be open for indoor dining this winter. Temporarily closing them down would be easier to stomach if these establishments are given the wherewithal to reopen next year.

The Pfizer announcement is unmitigated good news. But it would be a tragic mistake to relax our vigilance. Instead, continue to mask up, stay home and consider canceling or limiting your Thanksgiving plans. This is still a marathon, but the end is much closer than before.

On Facebook, you have to endure anonymous abuse of this nature with absolutely no recourse other than to hit the “report” button and hope that some community standards drone, somewhere, suspends the offending account for a couple days.

In a real town square, you can see people’s faces and usually you know them already.

On Facebook, you’re dumped into a group of “friends” you’ve never met, or interacted with—many of whom might not even be actual human beings. And the only help you get in determining social context is a combination of text, emojis, and gifs.

On Facebook, you may be arguing with hired Russian trolls who are actively employed by Vladimir Putin to sow discord in the world.

In a real town square, if someone claims they plan to assault you and your family you can punch their physical face with your physical fist.

In a real town square, you can fit, at most, a few hundred people. If you’re in the square of a giant, world-historic city in Russia or China, you might be able to squeeze in 600,000 people. On Facebook, you have . . . everyone on planet Earth!

In a real town square, people who insist that COVID vaccines are filled with mind control nanobots and that the Jews are enslaving children are relegated to the fringes.

Facebook follows you everywhere—like a psychotic ex. It’s always hiding in the bushes and you have no choice but to wonder what the heck it’s up to right now,

In a real town square, if the entire town became convinced that their mayor is the Christ risen and decided that they needed to stockpile AK-47s in preparation for the apocalypse then visitors to the town would quietly leave (and warn the authorities).

On Facebook, those folks get a guest pass to every other Town Square—again in the world—and are free to go around preaching their lunacy to others without being constrained by space, time, or economics.

In a real town square, the town doesn’t benefit financially by attracting the stupidest/craziest/most pernicious townfolk to the soapbox and then doing everything in their power to make sure the residents of the town are afraid to leave the square for fear of missing something truly terrible.

Facebook makes approximately all its money by getting you to rubber-neck through your day as you slow-roll past trainwreck after trainwreck.

In the real world, the Town Square stays (as the name suggests) in TOWN!

On Facebook, they are brought together into powerful collectives, afforded megaphones, and algorithmically ushered into everyone’s sphere of influence to corrupt otherwise rational and healthy discourse.

But in fairness, there is one aspect of the town square metaphor where Facebook is a pretty decent facsimile of the real thing. It’s the one where we used to drag innocent people to a gallows, accuse them of something completely insane, like “witchcraft,” and then either ruin or end their lives.

Facebook is pretty good at that because its fortunes are made by making sure that you keep coming back—it doesn’t matter if you’re sharing pics of kitties, contributing to a genocide, or part of an angry mob that’s destroying someone’s livelihood or reputation on some fanciful whim.

What’s another real-world concept where a private unregulated enterprise gets to make a fortune running psychological experiments on the population of the world, which leads to a slow collapse of civil and civic order and drives everyone insane? I’m actually drawing a blank—but it sure as hell isn’t a “town square.”

crossing the Rubicon. Schnurer argues that this is more than just a familiar phrase. And he says that a U.S. Rubicon moment is in view—which would be triggered by a possible indictment of Donald Trump.

Crossing the Rubicon: If the United States, in recent years, has been tracking the decline and fall of Republican Rome, when do we pass the point of no return? By Eric B. Schnurer

How did a wealthy, powerful, and successfully self-governing people—proud of their frontier origins, piety and traditional values, and above all their origin story in throwing off monarchical rule—essentially commit democratic suicide and settle, more-or-less willingly, for a half-millennium of dictatorship?

From rising economic inequality, political violence, and governmental dysfunction on through the generally lackadaisical reaction of the Senate to a losing chief-executive candidate’s conspiracy to murder many of them, overthrow the government, and thereby block certifying his defeat, events in ancient Rome have remarkably paralleled some you might recognize more recently

What might signal the end of democracy as we know it?  There is, it turns out, an easy answer at hand.

While there is no precise end date to the Republic, there was a bright-line occurrence generally recognized as the irreversible beginning of the end for participatory government.

there is indeed an event looming—probably before the end of this year— that poses almost precisely the same situation as what provoked Caesar’s crossing of the Rubicon: the possible indictment of former president Donald J. Trump.

January 6th. It is no coincidence that insurrectionists that day carried banners urging Trump to “Cross the Rubicon” and declaring “The Die Is Cast”— Caesar’s words upon alighting on the Italian side of the river—or that they will be with him to storm the forces of the Republic and ignite a civil war over Trump’s potential indictment:

Avoiding criminal prosecution is precisely why Caesar crossed the Rubicon with his army and ignited a civil war 21 centuries ago.

Caesar’s ultimate rise had begun with the Cataline conspiracy a decade or so earlier, which, as noted, bears a familial resemblance to Trump’s attempts to overturn the recent election and, both literally and figuratively, decapitate the government.

Senate conservatives, known as the optimates (i.e., “the Best People”),  chose largely to shrug off both the immediate assault on the state and the long-term threat Caesar in particular posed to republicanism.  They soon lived to regret it.

The patricians who ruled Rome, however, had long resisted fundamental economic reforms to benefit the great mass of the population, making only such concessions as necessary when times grew tense. This simply increased the internal tensions within society as the economy globalized, making those with the means richer and richer, hollowing out the middle class, and leaving more and more Romans at the edge of desperation.

Will the Trumpist party similarly ultimately prevail once they cross the Rubicon? I have been predicting for years that something resembling a civil war will arise and something like Trumpists likely will carry the day in the short-term

three of these—Caesar, of course, plus Marcus Licinius Crassus, known as “the richest man in Rome,” and Gnaeus Pompeius (Pompey the Great), the undisputedly dominant figure of the era—formed a Triumvirate and became, between them, the sole possessors of real power. The only real question was which one would prevail as the sole autocrat,

Caesar thus hoped to temporize, reach some sort of cohabitation arrangement with Pompey, and eventually prevail in the long term. But his enemies forced his hand with the threat of imminent criminal prosecution.

Caesar paused with his army on the Gaul side of the Rubicon.

His only path was forward. As he crossed, he uttered the famous phrase, “Alea iacta est”: “The die is cast.” The phrase has taken on the meaning of an inevitability, but Caesar meant quite the opposite: that, while he was committed and could not turn back, the outcome was far from inevitable but, rather, a tremendous gamble. At least for him.

The outcome for the Republic itself, however, was indeed at that point already cast as if in iron rather than in tumbling dice. Whatever the outcome of the ensuing war, whether Caesar or Pompey prevailed as dictator, the Republic—a system of self-government in which disputes were settled by politics rather than force, where power was dispersed rather than concentrated—was dead.

The defenders of the Republic folded more quickly than the French Army in World War II and left Rome open to Caesar.

Rome was now—and ever would remain—a dictatorship.

When Trump’s supporters urge him to cross the Rubicon and cast the die—events that become highly likely if he, like Caesar, faces indictment—that is what they contemplate.

What did all this mean for Rome?  And what might it mean for us?

Augustus essentially achieved the settlement of unreconcilable political, social, and economic strains within Republican Rome that even his uncle Julius could not attain. The Augustinian settlement was essentially to substitute peace and prosperity for politics, and to impose the veneer of traditional piety and moral values over the reality of an increasingly heterodox and heterogenous society.

The Augustinian Settlement had something for everyone. Augustus, ultimately the canniest politician, was himself outwardly pious, dutiful, traditional, and respectful of republican forms—thus appealing to conservatives—while he presided over a cultural efflorescence fueled by a liberality in everything except political expression

The concentration of power in the Emperor allowed Rome to mobilize its economic and military resources in a way that the Republic had not, leading to five centuries of expanding geopolitical power and economic opulence the likes of which the world had never seen before.

Politics essentially ended for half a millennium—all government was the will of one man—and so did freedom of political speech and thought. But Romans, at least if they were lucky, were free, safe and wealthy beyond imagination in every other way. It was a trade-off they were more than happy to accept.

By Caesar’s time, however, the populares were no longer so much true “Tribunes of the People” like the Gracchi, as ambitious patricians with an authoritarian bent who recognized anti-elite appeals to the disaffected mob as their pathway to power

But a reactionary philosophy that rejects fact in favor of fantasy, is economically retrograde and socially repugnant to the majority of Americans, can impose its rule for only so long.

Governments as we know them today will be left to fill the role solely of the traditionalist “night watchman state”—maintaining physical order and extracting a “protection” fee in return—much like the ancient Roman state. The demise of liberal democracy, the end of virtually all politics, and perhaps a little performative traditionalism and a destructive civil war, may all be coming, anyway. But, in return, Blue America, like Rome, will be able to carry on pretty much as it wishes, rising to new heights of wealth and global power.

Will highly-educated Americans really be willing to settle for physical security and financial success beyond anything now imaginable, in return for abandoning the American Republic for an enlightened dictatorship?

The Roman experience isn’t very encouraging on that score—but neither are contemporary Democrats.

When the crisis came, it was the optimates (i.e., “the Best People”) who were the last defenders of the Republic.

Why? Because the status quo worked for them, whereas the plebeians had long-since lost faith in “the system.” The supporters of the Republic were the cream of Roman society, those who, as the saying went, “had Greek” (world-class educations), married amongst themselves, and passed these advantages on to their children.

The republican structures they defended—elections, limited and dispersed powers, rule of law—in turn supported the rest of their existing order: an increasingly globalized economy exacerbating distributional divides but benefiting their own class.

The optimates were tone deaf to the needs of those struggling to make a living, while the insurrectionists played to the working class in order to destroy what passed for democracy and impose their personal rule.

Rich, out-of-touch, socially liberal democrats versus rich, demagogic authoritarians masquerading as the party of the working class—not far off from today. The difference is that progressives don’t recognize that they’re the new optimates.

Increasingly-illiberal “progressives” are slowly losing not just the white working class but also Black and Latino workers, those for whom they think they speak.

Meanwhile, time grows short. As aggrieved souls are forced from their dying communities and traditional social structures, into a metropolitan economy that has no place for them, the army on the Rubicon draws closer every day to the city’s walls.