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STUDENT DIGITAL NEWSLETTER ALAGAPPA INSTITUTIONS |
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Nicholas P. Jewell PhD
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Bienville erectile dysfunction ring buy 50 mg fildena amex, April 4 erectile dysfunction questionnaire uk discount fildena 50mg free shipping, 1862 erectile dysfunction drugs muse fildena 25 mg lowest price, Lake Pontchartrain erectile dysfunction cause of divorce cheap 25mg fildena mastercard, describing a naval action at the Rigolets along with a sketch of the defenses of New Orleans; and a letter from Thomas W impotence use it or lose it order fildena 100mg without a prescription. Describes camp life erectile dysfunction 7 seconds generic fildena 150 mg without prescription, marches, entertainment, morale, foraging expeditions, the condition and attitudes of whites and blacks in the South, Confederate morale, conditions in the Confederate Army, battles and skirmishes, and the devastation of war. Also contains a few details on the burning of Atlanta and the capture of Savannah, and a letter from Gen. Includes remarks on the destruction of public and private property and on conversations with Confederate prisoners. Provides information on camp life, training, marches, troop movements, discipline, morale, entertainment, supplies, disease, casualties, hospital care, depredations by Confederate soldiers, and battles and skirmishes. Lee, May 2, 1863, on the Chancellorsville Campaign; and postwar letters from Gens. Official and personal correspondence, diary, notebooks, legal and financial papers, and miscellaneous items concerning the War Department, military justice, the Lincoln assassination, and the trial of the assassination conspirators. Includes remarks on diet, deaths, burials, trade with Confederate guards, attempts by Confederate officers to recruit Union prisoners for service in the Confederate Army, and the exchange of prisoners at the end of the war. Also contains remarks on camp life, training, discipline, marches, casualties, and the devastation of war. Joseph Reynolds written during the battles of Lookout Mountain and Missionary Ridge. Includes information on medical procedures and supplies, disease, deaths, and routine naval affairs. Also includes a daybook containing records of patients treated by Horner aboard the U. Naval Academy, July 1864; names of candidates examined for appointments as engineers and warrant officers, July-Dec. Printed pamphlets and articles concern military hygiene, the diagnosis and treatment of various diseases and injuries, and the management of medical stores. General and family correspondence, diary and diary extracts, orders, battle reports, quartermaster reports, invoices and returns for engineering equipment, and miscellaneous notes relating to the Shenandoah Valley Campaign of 1862, the 2d Manassas, Peninsular, Antietam, Fredericksburg, Chancellorsville, Gettysburg, and Wilderness campaigns, the Battle of Cold Harbor, and operations in the Shenandoah Valley in the summer and fall of 1864. Includes information on strategy, camp life, morale, marches, the disposition of troops, depredations, the selection of officers, the draft, desertions, casualties, prisoners of war, equipment and supplies, battles and skirmishes, and the condition and attitude of noncombatants in Virginia. Letterbook, 1862-64, containing correspondence relating to the Index, a Confederate newspaper published in London, England, and to the London-based Confederate States of America Commercial Agency. Also letterbook, May 28, 1864-June 16, 1865, containing chiefly personal correspondence. Includes a few remarks on efforts to recruit British soldiers whose terms of service were about to expire for the Confederate Army. Bulloch, Edwin De Leon, George Eustis, George McHenry, Colin John McRae, Ambrose Dudley Mann, Matthew Fontaine Maury, William Preston, and John Slidell; a letter from Judah P. Letters written by Howe in late 1863 and 1864 describe his service and experiences as a convalescent in military hospitals in Mississippi and Missouri. Contains a few letters written by President Lincoln relating generally to the war. Contains a few letters to Vinnie Ream from wounded Union soldiers and Confederate prisoners of war, including Gen. Also contains a sketch of Union and Confederate positions before Chattanooga and a field map of northern Alabama and Georgia. Includes material relating to the activities of the Union Defense Committee in New York, the Southern Relief Committee, the New England Soldiers Relief Association, and various other patriotic and benevolent organizations. Also contains a few letters and documents found by McCurdy in the Senate chambers of the defunct C. Louis Blenker, and the organization, supply, condition, and disposition of New York troops. Letters from Hudson to his family written during campaigns in Tennessee, Alabama, and Georgia, Apr. Includes correspondence and notes concerning the sale, purchase, and repair of vessels for the U. Water Witch, plans for the construction and improvement of gunboats, and miscellaneous items. Also contains war news and the names of several refugees from Fairfax and Fauquier Counties. Chiefly official and personal correspondence, orders, vouchers, sketches, and printed matter relating to the Civil War. Muir, 1861 - 62, concerning the death of his son William, a captain in the 8th South Carolina Volunteers, and the health of his son Charles, also in the 8th South Carolina, and a letter from Inglis 131 to his daughter Carrie on Confederate prisoners of war and plans in South Carolina to employ blacks as soldiers. Four letters from Leonard Ives to his brother Joseph, aide to President Davis, Sept. Describes camp life, marches, morale, troop movements, discipline, entertainment, casualties, disease, hospital care, refugees, the attitude of noncombatants in the South, and the impressment of blacks. Also includes a description of Jefferson Davis as he appeared shortly after his capture. Lee, May 2, 1863, notifying Lee of his intentions to attack Federal positions near Chancellorsville, Va. Douglas to the Librarian of Congress, May 20, 1941, relating a story on the death of Jackson as told by T. Contains 17 letters from Jewett to his brother Dexter, 1862-65, concerning the Federal occupation of New Bern, N. Includes remarks on camp life, training, discipline, entertainment, the attitude of noncombatants in New Bern, black life, disease, and hospital care. Stickney (39th Massachusetts Volunteers), John Stafforce (47th Massachusetts Volunteers), Jonathan Blyth, John Harrington, Lebin Stetson, W. Includes a few letters, reports, and dispatches relating to the war in Tennessee during the period when Johnson served as military governor of Tennessee and as Vice President of the United States. Includes details on the Battle of Pea Ridge, and remarks on military organization, morale, discipline, depredations, foraging expeditions, casualties, supplies, and inflation. Describes camp life, marches, foraging expeditions, the devastation of war, skirmishes, the Battle of Bentonville, N. Provides details on the battles of Seven Pines, Malvern Hill, and Sharpsburg, devastation in the Shenandoah Valley, camp life, marches, and Unionist sentiment in Maryland. Contains a "Map of the Southern States, including Rail Roads, County Towns, State Capitals, County Roads, the Southern Coast from Delaware to Texas, showing the harbors, inlets, forts and position of blockading ships," Jan. Chiefly letters from Jones to his family written during campaigns in Kentucky, Tennessee, Mississippi, Louisiana, and Arkansas. Letters written during marches in southwest Louisiana describe skirmishes at Carrion Crow Bayou and New Iberia, Nov. Unpublished narrative of military operations along the coasts of South Carolina, Georgia, and Florida. Contains details on the Port Royal expedition; the capture of Forts Walker, Beauregard, and Pulaski; operations on Morris Island, S. Includes general and special orders, a diary, and a memoir-"Reminiscences of the Civil War," 1861-65. Contains information on the battles of Mechanicsville, Hanover Courthouse, and Malvern Hill during the Peninsular Campaign, skirmishes in Kentucky and Tennessee in 1863, the Knoxville Campaign, the pursuit and capture of Gen. Also includes comments on military organization and administration, 137 August Valentine Kautz the Cavalry Bureau, camp life, morale, black troops, rank disputes, refugees, Confederate deserters, and the generalship of Ambrose E. Also contains comments on the administration of the Army of the Potomac, military strategy, casualties, dissension among senior officers, the use of black troops, and the generalship of Nathaniel P. Also includes official correspondence; the headquarters letterbook of the 3d Brigade, 3d and 6th Army Corps, June 16,1863- June 20,1865; ordnance and paymaster records; a list of casualties in the 110th Ohio during the Battle of Winchester (1863) and the Mine Run Campaign; reports on the 110th and 122d Ohio in the Battle of Winchester and the pursuit of General Lee after Gettysburg; and reports on operations along the Rapidan and Rappahannock Rivers in late 1863, the Wilderness, Spotsylvania, Cold Harbor, Winchester, Petersburg, and Appomattox campaigns, and the Shenandoah Valley Campaign of 1864. Randolph Keim published in the New York Herald, New York Times, and Philadelphia Inquirer. Two versions (as told by Kenner to different people after the war) of his mission to England and France in 1864-65 to secure diplomatic recognition for the Confederacy. Includes details on his travel in the Northern States with the assistance 141 of Confederate sympathizers and his meeting with John Slidell and James Mason. McClellan, pay for black troops, and morale and casualties in the 54th and 55th Massachusetts. General order, May 25, 1864, concerning the defenses of Covington and Newport, Ky. Patapsco, South Atlantic Blockading Squadron, concerning a voyage from Philadelphia to South Carolina, activities of Federal ships along the coast of Georgia and South Carolina, attacks on Confederate batteries along the shore, and the bombardment of Forts Moultrie, Sumter, Wagner, and Gregg. Includes samples of Confederate States currency, 1861-64, and North Carolina currency, 1861. Cuvier Grover, July 20, 1863, 143 "Belle Alliance" plantation, complaining of depredations by Federal soldiers. Letters from Lair to his family, 1864-65, concerning the Atlanta and Savannah campaigns. Contains information on Federal strategy in the battles of Dalton, Resaca, Dallas, Kennesaw Mountain, Chattahoochee River, and Atlanta, and the Siege of Savannah. Also includes a list of officers and enlisted men in the 4th Ohio or Canton Zouaves. Official correspondence, dispatches, telegrams, orders, and miscellaneous items relating to military operations along the upper Potomac River. Also includes numerous newspaper clippings on the military career and death of General Lander. Chiefly letters from Landis to his family concerning the Fredericksburg, Gettysburg, and Spotsylvania campaigns, the Siege of Petersburg, and skirmishes in northern Virginia and West Virginia. Includes comments on camp life, morale, entertainment, marches, the draft, and military diet and pay. John Teed, 116th Pennsylvania Volunteers, on his exchange as a prisoner of war, Mar. Also contains information on the Antietam, Fredericksburg, Knoxville, Wilderness, Spotsylvania, Cold Harbor, and Petersburg campaigns; the pursuit of Gen. Rosecrans; and military organization, rank disputes, discipline, morale, marches, depredations, black life, black troops, entertainment, prisoners of war, foraging expeditions, disease, inflation, furloughs, military appointments, and the effect of the war on noncombatants in the South. Contains a few letters to Lathers concerning aid for Confederate prisoners of war held at Fort Delaware, the New York draft riots, the state of the war in July 1863, and the location and condition of Lt. McClellan, Joseph Mansfield, and Egbert Viele, Secretaries Edwin Stanton and Simon Cameron, and Col. Biddle Roberts, 1861-62, concern the release of political prisoners in southeast Virginia and the resumption of commerce at Norfolk. Steuart, Company C, 1st Missouri Cavalry, to his family from various camps in Virginia, 145 July 1864-Jan. Also, two military passes to members of the Latrobe family, 1862-63, to visit Latrobe while a prisoner of war at Fort McHenry, Md. Provides details on camp life, training, discipline, entertainment, disease, desertions, marches, casualties, troop movements, furloughs, courts-martial, depredations, black life, and civilian life in the South during the war. Report of Leale (the first physician to reach President Lincoln after he was shot) to the Congressional Assassination Investigation Committee (14 p. Describes troop movements, depredations, the attitude and suffering of noncombatants, and social life in and around Winchester during the war. Lawton extending his sympathy on the death of her brother-in-law; a letter from Lee to Gen. Breckinridge, May 16,1864, ordering Breck147 inridge to follow up on his victory over General Sigel, and Jan. Includes a few rough sketches of military camps, roads, and fortifications along the Potomac River, near Richmond, Va. Official, confidential, and squadron letterbooks, 1862-65; diary of signal officer Lt. Miller, May 5-June 14, 1864, concerning activities along the James River; letters of Gen. John Gray Foster, 1863, on coastal defenses and problems with smuggling and discipline in North Carolina and Virginia; letters (to Adm. Louis and Chicago, espionage by southern women, Confederate methods of communication with guerrillas, smuggling, and corruption among Federal officials at New Orleans, La. Mississippi, 1861-62; logbooks and log extracts of vessels in the North Atlantic Blockading Squadron, 1862-64; sketches 148 of roads and fortifications near Wilmington, Williamstown, and Roanoke Island, N. Sciota), May 20, 1862, to prevent the construction of Confederate batteries near Warrenton, Miss. Letters from Lester to his family in England concerning camp life, marches, morale, generalship, disease, prisoners of war, foraging expeditions, depredations, black life, and the attitude of noncombatants in the South. Provides some information on the Battle of Corinth, the Yazoo Pass expedition, the Siege of Vicksburg, and the Chattanooga and Atlanta campaigns. Describes camp life, marches, disease, foraging expeditions, discipline, depredations, and Confederate deserters. Includes a few details on the Battle of Cedar Creek and the capture of Petersburg, Va. Provides names or figures on casualties in the 3d Maine, 38th New York, and 40th New York regiments. Chocura, information on prizes taken by the Chocura, material on civilian arrests, and miscellaneous items relating to the administrations of Gens. Military and political correspondence, orders, plans, reports, telegrams, circulars, maps, muster rolls and returns, proclamations, petitions, affidavits, speeches, pamphlets, and miscellaneous items. Also contains newspaper clippings, photographs, and a map of the operations of the Army of the Potomac and the Army of the James in Virginia and Maryland. General and official correspondence, headquarters letterbooks, order books, battle reports, returns, telegrams, dispatches, and circulars relating chiefly to the Vicksburg, Atlanta, Savannah, and Carolinas campaigns. Provides information on reconnaissance expeditions, troop positions, enlistments and resignations, morale, promotions, disputes between officers, supplies, ordnance, depredations, courts-martial, prisoners of war, and the defense and operation of military railroads.
Critical Elements for Effective Collaborative Models in the Western Hemisphere Collaborative Model U which antihypertensive causes erectile dysfunction buy 100mg fildena mastercard. These collaborative models focus on the operational and preventive countermeasures to confront illicit actors and promote security and development erectile dysfunction under 30 cheap fildena 150 mg with mastercard. It has all the critical elements of a collaborative model: commitment erectile dysfunction causes medications 100mg fildena otc, institutions diabetic erectile dysfunction pump 25 mg fildena with mastercard, mechanisms impotence guilt purchase 50mg fildena visa, resources impotence ring generic 150mg fildena with visa, and metrics, as well as a strong interagency and international culture that has developed over its lifetime. All of these initiatives to combat illicit networks in the Americas are ongoing but appear to be executed in parallel. In this resource-constrained environment, greater donor coordination would ensure that all these security and development programs complement rather than duplicate each other. Globalization has benefited the private, public, and civic sectors of society over the past few decades. We have witnessed extraordinary rates of economic growth with significant advances in international trade, capital markets, science, and technology. Meanwhile, illicit networks have leveraged the processes and new opportunities arising from globalization and capitalized on weak institutions and gaps in governance around the world to expand their enterprises. In the Western Hemisphere, illicit networks have been increasingly engaged in drug, arms, counterfeiting, and human-trafficking activities that have been accompanied by 264 Collaborating to Combat Illicit Networks unprecedented levels of violence. Consequently, the threat of transnational organized crime and illicit networks has become a national security concern to the United States and its allies. Since illicit networks threaten citizen safety and economic security, governments must engage the public, private, and civic sectors to diminish and defeat the power and influence of transnational organized crime and illicit actors. As John Aquilla, at the Naval Postgraduate School, explains, "It takes a network to defeat a network. To ensure success, the initiatives undertaken to combat illicit networks must be supported by political commitment, institutions, mechanisms, financial and human resources, and measures of effectiveness to promote security and development. Disclaimer the views expressed in this chapter are those of the author and do not reflect the official policy or position of the Center for Hemispheric Defense Studies, the National Defense University, the Department of Defense, or the U. Realuyo, "Securing Global Supply Chains in an Age of Uncertainty: Focus on Food Safety," George Mason University Center for Critical Infrastructure and Homeland Security Critical Infrastructure Report 10, no. Caden, "National Debt Poses Security Threat, Mullen Says," American Forces Press Service, August 28, 2010, available at < Department of State, Bureau for International Narcotics and Law Enforcement Affairs, "International Narcotics Control Strategy Report 2011," vol. Meyer and Clare Ribando Seelke, "Central America Regional Security Initiative: Background and Policy Issues for Congress," Congressional Research Service, R41731, March 30, 2011, available at < Department of State, before the Senate Subcommittee on the Western Hemisphere, Peace Corps, and Global Narcotics Affairs, February 17, 2011. Department of State, Bureau of Public Affairs, "The Central America Regional Security Initiative: A Shared Partnership Fact Sheet," August, 5, 2010, available at < Southern Command, "Posture Statement before the 112th Congress House Armed Services Committee," March 30, 2011, available at < He received his education from the University of California, London School of Economics, and School for Advanced International Studies. Jacqueline Brewer is an analyst in the Center for Complex Operations, Institute for National Strategic Studies, at the National Defense University. She is responsible for a wide range of activities including research and project development targeted at preparing U. She has also worked with various Department of Defense educational organizations to coordinate and design curriculum for operational training programs. He advises the Office of the Deputy Assistant Secretary of Defense for Counternarcotics and Global Threats on policy and strategy issues related to transnational organized crime and illicit networks. Barnabo has supported clients in the Office of the Secretary of Defense, Department of Homeland Security, and the intelligence community by analyzing and designing policy approaches to complex national security challenges. He served with the Department of Defense in Baghdad, leading rule-of-law efforts by training Iraqi judges and prosecutors until sovereignty was transferred. He also held long-term posts in Moscow and Yerevan, Armenia, for the Justice Department. Deville is an Adjunct Professor of Law at Georgetown University, with graduate degrees from Oxford, Harvard, and the University of Denver, and an undergraduate degree from the University of Louisiana. His articles have appeared in the law reviews of Columbia University, the George Washington University, Harvard, Stanford, and University of Chicago, as well as in the Boston Globe, Moscow Times, the New York Times, Washington Times, and numerous business publications. Douglas Farah is a senior fellow at the International Assessment and Strategy Center and adjunct fellow at the Center for Strategic and International Studies. In his 18 years as a foreign correspondent and investigative reporter for the Washington Post, he covered the drug war in the Andean region, the Medellнn and Cali cartels, the Colombian and Mexican drug mafias, Russian organized crime in Latin America and the Caribbean, Mexican drug cartels in the United States, and drug-related banks in the Caribbean. As bureau chief in El Salvador for United Press International, he covered the civil war there and U. He wrote Blood from Stones: the Secret Financial Network of Terror (Broadway Books, 2004) and, with Stephen Braun, Merchant of Death: Money, Guns, Planes and the Man Who Makes War Possible (J. Vanda Felbab-Brown is an expert on international and internal conflict issues and their management, including counterinsurgency. Her research centers on the interaction between illicit economies and military conflict. Felbab-Brown is a fellow in foreign policy and a fellow in the 21st Century Defense Initiative at the Brookings Institution where she focuses on South Asia, Burma, the Andean region, Mexico, and Somalia. She is the author of Shooting Up: Counterinsurgency and the War on Drugs (Brookings Institution Press, December 2009), as well as numerous articles and reports on illicit economies, crime, insurgency, and state-building around the world. She has conducted field work in Afghanistan, Burma, Colombia, Mexico, Burma, Brazil, India, and Morocco. He has led projects on topics such as the security implications of climate change, diverse cultures of hackers, and the global narcotics trade. Gilman spent 6 years leading competitive intelligence and product marketing teams at enterprise software companies. He is the author of Mandarins of the Future (The Johns Hopkins University Press, 2003) and coeditor of Deviant Globalization (The Continuum International Publishing Group, 2011), which explores how globalized black market economies are challenging traditional state authority. Gilman is also coeditor of Humanity, an international journal of human rights, humanitarianism, and development. Jesse Goldhammer is a partner at the Monitor Group and the firm Monitor 360, where he helps public- and private-sector clients engage in strategic, analytic, organizational, and institutional transformation. Goldhammer has spent the past 20 years bringing together unique people, ideas, and approaches to devise lasting and effective solutions to vexing problems. These solutions include developing novel analytic approaches to understand and reframe client challenges, using human networks to leverage alternative and unorthodox perspectives, and designing training programs to propagate new strategies and tradecraft. Goldhammer is also an expert in scenario planning, has taught scenario-planning courses, and published "Four Futures for China Inc. Goldhammer is the author of the Headless Republic (Cornell University Press, 2005) and coeditor of Deviant Globalization (The Continuum International Publishing Group, 2011). Patrick Radden Keefe is a staff writer at the New Yorker and fellow at the Century Foundation where his research and writing focus on transnational crime, international security, and foreign affairs. He is the author of the Snakehead: An Epic Tale of the Chinatown Underworld and the American Dream (Knopf-Doubleday, 2009) and Chatter: Uncovering the Echelon Surveillance Network and the Secret World of Global Eavesdropping (Random House, 2005), along with numerous book chapters on espionage, national security, and illicit networks. From 2010 to 2011, he served as a special advisor in the Office of the Secretary of Defense for Policy where he focused on crime, corruption, and rule-of-law issues. Lindholm plays a strategic role in activities related to hybrid/transnational threats, including threat finance, illicit networks, and anti-money-laundering issues. She has also worked as country manager for 271 About the Contributors Middle East and North Africa regions for the U. Trade and Development Agency; special assistant to the Under Secretary of State for Economic, Business, and Agricultural Affairs; advisor for international economic policy at the National Economic Council; and senior policy advisor to a Congressman, responsible for financial services, national and homeland security, and foreign affairs. Lindholm was vice president for policy at Business Executives for National Security, where she worked with Treasury, the Defense Department, Drug Enforcement Administration, combatant commands, and the private sector to develop solutions and share information on potential vulnerabilities in the financial services sector. Luna helps coordinate diplomatic initiatives on national security that disrupt and dismantle transnational criminal networks. Naнm has written extensively on international economics and global politics, economic development, and the unintended consequences of globalization including books such as Illicit: How Smugglers, Traffickers, and Copycats Are Hijacking the Global Economy (Doubleday, 2006). He is the chairman of the board of both the Group of Fifty (G-50) and Population Action International and a member of the board of directors of the National Endowment for Democracy and the International Crisis Group. He has invented disruptive technologies that protect billions of products and documents from counterfeiting and tampering. Picard has written numerous papers and patents on document security, anticounter- 272 About the Contributors feiting, artificial intelligence, and illicit trade, and is a frequent speaker on anticounterfeiting technologies. Picard and his company were selected as a World Economic Forum Technology Pioneer. Since 2009, he has been a member of the World Economic Forum Global Agenda Council on Illicit Trade, and is also a member of the Evian Group. Realuyo is an assistant professor of national security affairs in the Center for Hemispheric Defense Studies at the National Defense University. She is an expert on geopolitical risks in the 21st century, global supply chains, international financial systems, terrorist financing, and money laundering. She is a member of the Council on Foreign Relations, International Institute for Strategic Studies, Women in International Security, and Professional Risk Managers International Association. Louise Shelley is a professor in the School of Public Policy at George Mason University. She is an expert on the relationship among terrorism, organized crime, and corruption as well as human trafficking. She is the author most recently of Human Trafficking: A Global Perspective (Cambridge University Press, 2010), as well as 10 other books. She has written numerous articles and book chapters on all aspects of transnational crime and corruption. Shelley has run large-scale programs in the former Soviet Union on organized crime and corruption for the last 15 years. She served on the Global Agenda Council on Illicit Trade of the World Economic Forum and was the first cochair of its Council on Organized Crime. Southern Command and has served as a strategic and long-range planner on the staffs of the Chief of Naval Operations and Chairman of the Joint Chiefs of Staff. He has served as the executive assistant to the Secretary of the Navy and the senior military assistant to the Secretary of Defense. His current research focus is the impact of transnational organized crime on sovereignty in Mexico and other countries. Steven Weber is a specialist in international relations with expertise in international and national security; the impact of technology on national systems of innovation, defense, and deterrence; and the political economy of knowledge-intensive industries. Trained in history and international development at Washington University and medicine and political science at Stanford, Mr. Their latest publication is the End of Arrogance: America in the Global Competition of Ideas (Harvard University Press, 2010). Wechsler is the deputy assistant Secretary of Defense for Special Operations and Combating Terrorism. Wechsler is the primary lead for Defense Department policies, plans, authorities, and resources related to special operations and irregular warfare, with special emphasis on counterterrorism, counterinsurgency, unconventional warfare, information operations, and sensitive special operations. Wechsler served for over 3 years as deputy assistant Secretary of Defense for Counternarcotics and Global Threats. Wechsler also served as special advisor to the Secretary of the Treasury, on the staff of the National Security Council, and as special assistant to the Chairman of the Joint Chiefs of Staff. Ridgway Center for International Security Studies at the University of Pittsburgh. Professor Williams has published extensively in the field of international security, including books on crisis management, the U. He has edited volumes on Russian organized crime, human trafficking, and combating transnational crime. From 2001 to 2002, he was a visiting scientist at the Community Emergency Response Teams program, where he worked on cybercrime and infrastructure protection. From 2007 to 2009, he was a visiting professor in the Strategic Studies Institute at the U. Army War College where he published two monographs: From the New Middle Ages to a New Dark Age: the Decline of the State and U. Strategy (2008), and Criminals, Militias and Insurgents: Organized Crime in Iraq (2009). In 2009, he coauthored (with James Cockayne) a study for the International Peace Institute titled the Invisible Tide: Towards an International Strategy to Deal with Drug Trafficking Through West Africa. The converged threats that pose the greatest danger to national security today require integrated responses that bring together disparate elements of government both domestically and internationally. Convergence provides research-driven insight and concrete and practical recommendations for how governments can best confront these emerging threats. National Coordinator for Security, Infrastructure Protection, and Counterterrorism "There are regrettably few studies that take a holistic look at the overlapping scourge of illicit networks. Miklaucic and Brewer have brought together an insightful, engaging collection of articles written by those on the frontlines of cutting-edge research. They are to be applauded for avoiding the typical siloed approach to targeting the challenge and making concrete recommendations for how the international community, led by the United States, should fight back. It was printed using vegetable oil-based ink on recycled paper containing 30% post consumer waste. To find a depository library near you, please go to the Federal depository library directory at catalog. The electronic text of this publication is available for public use free of charge at. Title: Style manual: an official guide to the form and style of federal government publications / U. Government edition of this publication and is herein identified to certify its authenticity. Crawford, Managing Director, Plant Operations Gregory Estep, Deputy Managing Director, Plant Operations Shelley N.
Consequently erectile dysfunction treatment exercises fildena 100 mg with amex, diagnostic and pathogen-detection devices will be key enabling technologies for disease management; the future accuracy of molecular diagnostics has the power to transform medicine erectile dysfunction treatment himalaya order 100 mg fildena mastercard. The targets of molecular diagnostics include genetic information on disease presence or predisposition erectile dysfunction drugs egypt safe fildena 150 mg, and the ability to monitor the physical manifestation of a disease erectile dysfunction caused by lipitor discount fildena 50 mg free shipping. Molecular diagnostic devices will revolutionize medicine by providing a rapid means of testing for both genetic and pathogenic diseases during surgeries erectile dysfunction see urologist discount 150 mg fildena otc. Readily available genetic testing will hasten disease diagnosis and help physicians decide on the optimal treatment for each patient erectile dysfunction what doctor to see cheap fildena 25 mg online. Theranostics, the combination of a diagnostic and a therapeutic Spanning a wide gamut of technologies, ranging from implants and prosthetics to powered exoskeletons, human augmentation enhances innate human abilities, global Trends 2030: AlternAtive Worlds GaMe-chanGers 96 or replaces missing or defective functions such as damaged limbs. Prosthetic limbs have now reached the stage where they offer equivalent or slightly improved functionality to human limbs. Brain-machine interfaces in the form of brain-implants are demonstrating that directly bridging the gap between brain and machine is possible. Military organizations are experimenting with a wide range of augmentation technologies, including exoskeletons that allow personnel to carry increased loads and psychostimulants that allow personnel to operate for longer periods. Human augmentation could allow civilian and military people to work more effectively, and in environments that were previously inaccessible. Elderly people may benefit from powered exoskeletons that assist wearers with simple walking and lifting activities, improving the health and quality of life for aging populations. Brain-machine interfaces could provide "superhuman" abilities, enhancing strength and speed, as well as providing functions not previously available. Owing to the high cost of human augmentation, it probably will be available in 15-20 years only to those who are able to pay for it. Such a situation may lead to a two-tiered society of an enhanced and non-enhanced persons and may require regulation. In addition, the technology must be sufficiently robust to prevent hacking and interference of human augmentation. Advances in synergistic and enabling technologies are necessary for improved practicality of human augmentation technologies. For example, improvements in battery life will dramatically improve the practicality of exoskeleton use. Progress in understanding human memory and brain functions will be critical to future brain-machine interfaces, while advances in flexible biocompatible electronics will enable better integration with the recipient of augmentations and recreate or enhance sensory experiences. Future retinal eye implants could enable night vision, and neuro-enhancements could provide superior memory recall or speed of thought. Neuro-pharmaceuticals will allow people to maintain concentration for longer periods of time or enhance their learning abilities. Augmented reality systems can provide enhanced experiences of real-world situations. Combined with advances in robotics, avatars could provide feedback in the form of sensors providing touch and smell as well as aural and visual information to the operator. Nevertheless, with the rapid rise of multiple other powers, the "unipolar moment" is over and Pax Americana-the era of unrivalled American ascendancy in international politics that began in 1945-is fast winding down. The graphic on page 103 shows a snapshot of the relative power and factors underlying leading countries in 2030. Secondary education is weak, with 15 year-old American students ranking only 31st of 65 countries in mathematics and 22nd in science in a survey that includes many developing countries. Even before 2008, the pressures on European security capabilities were apparent and Europe had begun a substantial defense retrenchment. In a multispeed economic world in which the West continues to experience severe fiscal constraints- which is the most likely development for the foreseeable future-the trend toward an increasingly disproportionate share of military spending by the non-G-7 will grow. However, spending for major entitlement programs- particularly Social Security, Medicare, and Medicaid- has grown rapidly over the past several decades. As a result, it is difficult to reverse the historic trend or increase the share in the future in the absence of a major emergency. With an aging population and the prospect of higher interest rates in the future, the rising entitlement costs will consume an increasing proportion of the Federal budget without major reform of the programs or substantially increased tax revenues. One study believes that an affordable long-term level for national defense would be between 1. Although incomes of the top 1 percent of Americans have soared, median household incomes have declined since 1999. Most other Western states have also suffered a stiff downturn, while developing states are accounting for a larger share of the global economy. Power has become more multifaceted-reflecting the diversity of issues- and more contextual- certain actors and power instruments are germane to particular issues. As mentioned earlier, leadership will increasingly be a function of position, enmeshment, diplomatic skill, and constructive demeanor. Historically many such powers have played a dominant role long after their economic or even military weight has lessened in relation to others. Many emerging countries seek to use their ties with the Us to advance their national interests, creating freedom for maneuver. Words like "humiliation" and "respect" cropped up repeatedly in the presentations and conversations, especially with experts from those regions. As emerging powers seek greater influence and recognition in the international order they are likely to clash diplomatically with the Us. For most emerging powers, it was clear from the discussions that participants saw significant barriers to emerging powers building the political, military, and diplomatic capacity necessary to project power and influence internationally. As countries enjoy a rapid increase in their power they will need to think about the world in new ways and overcome severe domestic constraints that can impede this transition. Participants saw China in a separate category: the Us and China will be in competition with one another but they will also be required to cooperate to solve common threats and challenges and to protect mutual interests. For China, the principal question is whether it can continue to operate within the existing international order or if it will eventually pursue a revisionist course. Average living standards would rise-almost 40 percent in this scenario-potentially engendering greater social mobility. Though its growth would slow sharply by 2030, China would still become the central player in world trade and the largest trading partner of most countries. Washington would have a stronger interest in world trade, potentially leading a process of World Trade Organization reform that streamlines new negotiations and strengthens the rules governing the international trading system. In that scenario, a large and dangerous global power vacuum would be created and in a relatively short space of time. The European Union might remain, but as an empty shell around a fragmented continent. Progress on trade reform as well as financial and monetary system reform would probably suffer. A weaker and less secure international community would reduce its aid efforts, leaving impoverished or crisis-stricken countries to fend for themselves, multiplying the chances of grievance and peripheral conflicts. The Middle East would be riven by numerous rivalries which could erupt into open conflict, potentially sparking oil-price shocks. This would be a world reminiscent of the 1930s when Britain was losing its grip on its global leadership role. All countries would want and need stability to ensure their continued internal development. Most experts see the usurpation of the dollar as unlikely in the next 15-20 years. How the replacement of the United States by another global power and erection of a new international order seems the least likely outcome in this time period. In all those cases, the transition was extended and re-balancing was partly a matter of trial and error. Domestic politics was an global Trends 2030: AlternAtive Worlds GaMe-chanGers 105 important factor shaping international outcomes. The transition away from unipolarity toward new global leadership will be a multifaceted and multilayered process, played on a number of different levels and driven too by the unfolding of events, both domestically and more broadly in the rest of the world. A long, general peace among the great powers prevailed, mostly because no one wanted to risk imposing its will on the others for fear of the larger consequences. We have sought here to delineate four archetypal futures that represent distinct pathways for future developments out to 2030. We believe the risks of interstate conflict will rise, but we do not expect bilateral conflict to ignite a full-scale conflagration. Moreover, unlike in the interwar period, the complete unraveling of economic interdependence or globalization would be more difficult-and therefore less likely-in this more advanced technological age with ubiquitous connections. Our modeling suggests that under this scenario total global income would be $27 trillion less than under Fusion, our most optimistic scenario. More nationalist, even nativist, parties rise to claim positions of influence in coalition governments. Economic growth continues in major emerging markets and accounts for approximately three quarters of global growth. Nonetheless, fundamental economic and political reforms remain elusive in China and India. Corruption, social unrest, weak financial systems, and chronically poor infrastructures slow their growth rates. As pressures grow everywhere for disengagement and protectionism, the global governance system is unable to cope with a widespread pandemic that triggers panic. Rich countries wall themselves off from many developing and poor countries in Asia, Africa, and the Middle East. By disrupting international travel and trade, the severe pandemic helps to stall out, but does not kill globalization. One of their members has asked the director of her "Strategic Vision" office to write a short paper describing the downward spiral, which is used as the basis for the discussion. Not only did our earlier inflated estimates fall victim to slower-than-anticipated technological improvements in extraction efficiency and deposits that proved to be at the lower end of initial forecasts, but we failed to factor in the costly series of lawsuits against the energy producers. It was a devastating defeat for the French Government and now a huge problem for everyone else. It is not clear that a new deal can be devised given the wide margin of defeat for the former treaty proposal. Fundamental economic and political reforms have stalled; corruption and social unrest is slowing growth rates, which perhaps explains why the government is fomenting nationalism and becoming more adventurist overseas. A Taliban coup recently occurred in which all the other factions-which had formed the government-were brutally suppressed. China recently completed a 38,000-megawatt dam on the Brahmaputra close to the disputed border with India and has begun building another. The global economy has suffered the consequences of the escalating tensions among the emerging powers. Poorer countries, particularly, are suffering: during bad harvest years, more countries are creating export bans, exacerbating food shortages and price spikes. Saudi Arabia and Iran-both hit by lower energy prices because of the global growth slowdown-have nevertheless increased tensions by launching a proxy war in Syria and Lebanon. Hizballah has also launched its first large-scale cyber attack against Israel and the United States. In China, however, the party is increasingly under fire for what many Chinese people view as gross mismanagement of the economy. No government stays in power long and there is a constant reshuffling of government posts among coalition partners. As with most ill fortune, troubles tend to come in waves: a deadly virus-which scientists had warned about repeatedly-has erupted in Southeast Asia. The virulent strain spread quickly outside Southeast Asia to South Asia and along the trade and travel routes to the Middle East and Africa. Now the new mental map shows a devastated Southeast Asia and portions of India, the Horn of Africa, and parts of the Gulf. This new mental map, created by what happened to the poor and destitute and their being shunned by the rich countries, including China, is widening the gulf between North and South and East and West. The new map will be what survivors in the developing world carry around in their minds and, consciously or not, will inform thinking for a generation on world affairs. Even in the rich, developed countries, which were spared the worst impact from the pandemic, the death toll reached several million-the youth were particularly susceptible. It was the coup de grace for many, sealing the case against what was seen as the rampant globalization earlier in the 21st century. Western multinationals have seen forced nationalization in Southeast Asia, India, and Africa. Governments there say that those businesses which ceased their operations during the pandemic lost their rights to resume their businesses afterward. Still, I noticed that Facebook is becoming more popular and that young people are also beginning to travel and study abroad. By end of scenario, however, it connections are source of renewal, preserving globalization. A Us withdrawal from Asia leaves india having to fend on its own against what it sees as an increasingly aggressive China. Brazil and the rest of south America are less affected by growing geopolitical tensions and the worldwide pandemic. Poorer states suffer enormously in this scenario from rising geopolitical tensions and food inflation. Pandemic deaths are greatest in poorer countries, and recovery will be difficult with the breakdown in global economic and technological cooperation. This scenario would only be possible through strong political leadership that overrules cautious domestic constituencies and forges stronger international partnerships. In a Fusion world, economic growth resumes as the initial collaboration on security is widened to include intellectual property and innovation to deal with resource issues and climate change. China, bolstered by the increasing role it is playing in the international system, begins a process of political reform. With the growing collaboration among major powers, global multilateral institutions are reformed and made more inclusive. Chinese per capita incomes also rapidly increase, ensuring that China avoids the middle-income trap.
Syndromes
There was a difference in the isolation of mycoplasma organisms between healthy and affected sheep erectile dysfunction medication for high blood pressure fildena 25 mg otc. Mycoplasma organ201 Table 2: Summary of the bacterial species isolated from 104 clinically affected and 116 unaffected sheep impotence treatment after prostate surgery 25mg fildena with visa. Bacterial isolates Affected sheep (n = 104) Total isolates Unaffected sheep (n = 116) n Acinetobacter lwoffi Actinobacillus actinomycetemcomitans Actinobacillus seminis Alcaligenes odorans Arcanobacterium pyogenes Corynebacterium pseudotuberculosis Corynebacterium renale Corynebacterium species Enterococcus faecalis Erysipelothrix rhusiopathiae Escherichia coli Flavobacterium multivorum Lactobacillus species Moraxella species Pasteurella multocida Rhodococcus equi Staphylococcus aureus Staphylococcus epidermidis Streptococcus agalactiae Streptococcus species Total 5 7 2 15 46 12 3 15 9 15 3 8 6 3 16 24 11 15 6 22 243 % 4 erectile dysfunction at age 33 buy 100 mg fildena fast delivery. This result points to an association of these mollicutes with ulcerative genital disease of sheep in South Africa erectile dysfunction age 80 generic 100 mg fildena mastercard. It confirms the suppositions expressed in earlier publications that mycoplasma organisms are important contributing pathogenic agents in ulcerative balanoposthitis and vulvovaginitis in sheep4 erectile dysfunction quick fix purchase fildena 50 mg mastercard,15 erectile dysfunction doctors fort worth order fildena 25mg fast delivery,36. Furthermore, the absence of viruses, Chlamydophila species and inconsistent isolation of different species of bacteria from clinically infected sheep indicates that these organisms are probably not responsible for the clinical signs observed. However, it seems probable that bacteria may contribute by initiating or aggravating the condition when present in association with mycoplasmas. Mycoplasmas are welldefined pathogens acting singly or in consort with other agents. Although it cannot be assumed with certainty, it is possible that on the basis of the results obtained in this investigation, the concurrent isolation of A. Arcanobacterium pyogenes is considered as the most pathogenic bacterium residing on mucosal surfaces as it can cause tissue damage by means of its virulence factor, the exotoxin pyolysin5. The organism has for example been isolated from 3 of 10 pus specimens taken from goats suffering from vulvitis in Nigeria17. It is therefore probable that these endotoxins can be held responsible for aggravating the cellular damage of the genital system of sheep colonised by this Mycoplasma species. In this study, Mycoplasma capricolum was isolated from 7 sheep with lesions of ulcerative balanitis and vulvitis (Table 3). This organism is usually associated with polyarthritis in sheep and goats19, but has also been isolated from the genital tract of sheep in England in an outbreak of vulvovaginitis and balanoposthitis 20. However, from the low isolation rate detected in the investigation reported here, it appears unlikely that M. Although Mycoplasma species group 7 was isolated from 23 % of affected sheep with an odds ratio of 5. Moreover, there are no reports in the literature which incriminate this organism as a causal agent of any disease. In the light of increasing evidence of the association of this organism with disease conditions there is a need for further assessment of its pathogenic potential. In this survey the prevalence of ureaplasmas in the apparently healthy sheep was higher than in affected sheep. These results are in agreement with earlier reports that many apparently healthy sheep carry ureaplasmas in their urogenital tract11,18,27. Therefore, it is possible that the ureaplasmas were either commensals within the vagina or prepuce of the sheep as suggested by Jones and Rae18, or alternatively, that no pathogenic serotypes were amongst them (H J Ball, Veterinary Research Laboratories, Belfast, Ireland, pers. Ball H J, McCaughey W J 1982 Experimental production of vulvitis in ewes with Ureaplasma isolates. Ball H J, Kennedy S, Ellis W A 1991 Experimental reproduction of ovine vulvitis with bacteria of the Haemophilus/Histophilus group. Billington S J, Songer J G, Jost B H 2001 Molecular characterization of the poreforming toxin, pyolysin: a major virulence determinant of Arcanobacterium pyogenes. Chima J C, Ojo M O, Adetosoye A I 1992 Association of mycoplasmas with genital tract infection of goats in Nigeria. Proceedings of the West African Commonwealth Veterinary Association/Ghana Veterinary Medical Association. Cottew G S, Lloyd L C, Parsonson I M 1974 Isolation of a mycoplasma from vulvovaginitis in sheep. Doig P A, Ruhnke H L 1977 Isolation of Ureaplasma from sheep with granular vulvitis. Gummow B, Staley G P 2000 A retrospective survey of ulcerative balanoposthitis and vulvovaginitis in South African Dorper sheep. Horner G W, Hunter R, Day A M 1982 An outbreak of vulvovaginitis in goats caused by a caprine herpesvirus. Jones G E, Rae A E, Holmes R G, Lister S A, Jones J M W, Grater G S, Richards N 1983 Isolation of exotic mycoplasmas from sheep in England. Kapoor S G, Pathak R C, Singh P P 1984 Prevalence of Mycoplasma/Acholeplasma in the genital tract of sheep. Kidanemariam A 2003 Identification and characterization of the primary infectious agents associated with ovine ulcerative balanoposthitis and vulvovaginitis in South Africa. In vitro antimicrobial susceptibility of Mycoplasma mycoides mycoides large colony and Arcanobacterium pyogenes isolated from clinical cases of ulcerative balanitis and vulvitis in Dorper sheep in South Africa. Livingstone C W, Gauer B B, Shelton M 1978 A specific ureaplasmal serotype associated with ovine uterine infections. McCaughey W J, Ball H J 1981 Distribution of ureaplasmas in the urogenital tract of ewes. Roberts D S 1967 the pathogenic synergy of Fusiformis necrophorus and Corynebacterium pyogenes. In Gyles C L, Thoen C O (eds) Pathogenesis of bacterial infections in animals (1st edn). Singh N, Rajyan B S, Mohanty G C 1974 Granular vulvovaginitis in goats associated with Mycoplasma agalactiae. Tiwana J S, Singh N 1982 Isolation of Acholeplasma oculi from genital lesions in sheep. Trichard C J V, Jordan P Prozesky L, Jacobsz, E P Henton M M 1993 the identification of, Mycoplasma mycoides mycoides Large Colony as the aetiological agent of balanoposthitis and vulvovaginitis in sheep in South Africa. Trichard C J V, Van Tonder E M 1994 Ulcerative balanoposthitis and vulvovaginitis in sheep and goats. In Coetzer J A W, Thomson G R, Tustin R C (eds) Infectious diseases of livestock with special reference to southern Africa (1st edn). By blocking immune checkpoints, immunotherapy puts the immune system into a state of hyperactivation that can cause immune-related adverse events. We present the clinical, pathological and molecular data of a patient with metastatic cervical cancer and progressive disease after second-line therapy. Case presentation: We report the case of a 62-year-old woman who was diagnosed with advanced squamous cell carcinoma of the cervix with paraaortic lymph node metastases. After an initial combined radio-chemotherapy with cisplatin, she developed local and nodal (supraclavicular) recurrence. Second-line chemotherapy with 6 cycles of carboplatin, paclitaxel, and bevacizumab resulted in a partial response for 6 months. Checkpoint inhibition with nivolumab was started due to progression, leading to persistent complete remission. Immunotherapy was well tolerated for 8 months until the patient presented with an immune-related isolated vulvitis, which was successfully managed with topical corticosteroids. Conclusions: the persistent complete response after third-line treatment for relapsed chemotherapy-resistant cervical cancer presented in this case highlights the potential of immunotherapy for patients with advanced cervical cancer impressively. To our knowledge, this is the first report of an isolated immune-related vulvitis under nivolumab. This adverse event might be underdiagnosed and mistreated, however, it is of importance due to its impact on quality of life, sexual wellbeing and compliance of patients. In the future, routine molecular tumour profiling is likely to aid in the stratification of cervical cancer patients for immunotherapy. Journal for ImmunoTherapy of Cancer (2019) 7:281 Page 2 of 7 Background Immunotherapy with immune checkpoint inhibitors has emerged as a novel option for many patients with advanced cancers whom previously had limited treatment options and experienced poor outcomes. While clinical studies have demonstrated survival benefits and durable responses in various cancer entities, immunotherapy of gynaecological cancers is still in relative infancy. Under physiological conditions, immune checkpoints play a crucial role in preventing autoimmunity [1]. Immune checkpoint inhibitors reduce the interaction between cancer cells and T cells so that re-activated lymphocytes can destroy their malignant targets. For the last 20 years, the standard of care for patients with recurrent or metastatic cervical cancer has been cisplatin-based chemotherapy combined with paclitaxel. However, despite the addition of other agents such as vinorelbine, gemcitabine or topotecan [3], most patients deteriorated rapidly, developing platinum resistance at recurrence [4]. Adding bevacizumab, an anti-vascular endothelial growth factor antibody, to chemotherapy became the standard of care since the Gynecologic Oncology Group 240 trial demonstrated a survival benefit of almost 4 months [5]. However, it remains challenging to select patients with a potential therapeutic response and to anticipate the magnitude of response. Last, immune responsiveness signatures based on methylation profiles, as already identified in lung cancer, are rapidly moving into clinical focus [10]. First-line treatment included combined radiochemotherapy with 6 cycles of cisplatin 40 mg/m2 weekly and lymph node irradiation, which was followed by intra-cervical brachytherapy with Iridium-192 resulting in a partial response. Three months later, progressive disease with a new palpable mass in a left supraclavicular lymph node and suspicion of pulmonary metastases (small nodules of 6 mm, not amenable to biopsy) was noted. A mixed response of the pelvic nodal metastases as well as a progression of the cervical mass was documented. However, bevacizumab had to be interrupted due to rectorrhagia and ensuing anaemia. The immunotherapy was well tolerated over the course of 8 months, then the patient presented with a well-delimited inflammation of the vulva and perianal region with ulceration and epidermolysis. Histology of a punch biopsy revealed a lichenoid interface dermatitis with a pronounced lymphocytic infiltrate along the dermoepidermal junction as well as intraepithelial. We observed the highest concordance with the methylation classes of squamous cell carcinomas, particularly of the cervix, head and neck, and oesophagus. Methylation array data were also analysed for copy number changes, revealing a relatively flat profile. Somatic mutations in both of these genes have been suggested to play a role in the pathogenesis of cervical squamous cell carcinoma [15]. Discussion We report on a patient with primary advanced cervical cancer with paraaortic lymph node metastases, which. Immunotherapy with checkpoint inhibitors is an emerging option for many types of solid cancers, including advanced cervical cancer for which data remain limited [6]. Pembrolizumab was evaluated in recurrent metastatic cervical cancer in the Keynote 028 phase Ib trial (n = 24) [18]. In addition, methylation profiling might represent an independent modality to predict response to immune checkpoint inhibitors as recently demonstrated for lung cancer [10]. To facilitate data comparison with other cases we have included the raw methylation data as Additional file 1. Journal for ImmunoTherapy of Cancer (2019) 7:281 Page 6 of 7 reactions, eczema, vitiligo, and pruritus. In the case of severe reactions, interruption of immunotherapy should be considered [11]. Given the broad range of potential differential diagnosis, clinicians should be aware of the importance of biopsies in determining the underlying aetiology. Early referral to a gynaeco-oncologist is crucial to ensure appropriate management. The diagnosis of immune-related vulvitis is also important to avoid the evolution of an untreated vulvopathy [22]. As in our patient, the vagina had been irradiated while the vulva was outside the irradiation field, a low dose radiotherapy effect on the vulvar skin cannot be excluded. In the literature, a case of nivolumab-induced StevensJohnson syndrome with striking enhancement at the site of radiation has been reported in a patient with metastatic squamous cell carcinoma of the oropharynx [23]. Clinical trials in patients with advanced solid tumours showed that treatment with nivolumab causes fewer and less severe adverse events in comparison to conventional chemotherapy [25]. Nevertheless, a vulvitis as reported in our case may impact on the quality of life, sexual wellbeing and compliance of patients. To our knowledge, this is the first report of an immunerelated vulvitis under immune checkpoint blockade. Furthermore, we supplement our article with the tumour methylome dataset in order to provide the base for identification of comparable responders. Supplementary information Supplementary information accompanies this paper at doi. Availability of data and materials the methylome data are included as an Additional file. All other datasets obtained during workup of this case are available from the corresponding author on reasonable request. Consent for publication Written informed consent for publication of their clinical details and clinical images was obtained from the patient. Author details 1 Department of Gynaecology and Obstetrics, Hфpital du Jura, Delйmont, Switzerland. Conclusions Immunotherapy has emerged as a new option for patients with advanced cervical cancer. We report the case of a patient with persistent complete response after third-line treatment with nivolumab for relapsed, chemotherapy-resistant cervical squamous cell carcinoma showing the promising potential of immunotherapy. Journal for ImmunoTherapy of Cancer (2019) 7:281 Page 7 of 7 Received: 15 June 2019 Accepted: 16 September 2019 References 1. Cervical cancer - state of the science: from angiogenesis blockade to checkpoint inhibition. Tumor mutational burden as an independent predictor of response to immunotherapy in diverse cancers. Development of tumor mutation burden as an immunotherapy biomarker: utility for the oncology clinic. Mutational burden, tumor immune checkpoint expression, and microsatellite instability in gynecologic malignancies: implications for immune therapy.
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