title: Blood transfusion

text: On rare occasions, blood products are contaminated with bacteria. This can result in a life-threatening infection known as transfusion-transmitted bacterial infection. The risk of severe bacterial infection is estimated, , at about 1 in 50,000 platelet transfusions, and 1 in 500,000 red blood cell transfusions. Blood product contamination, while rare, is still more common than actual infection. The reason platelets are more often contaminated than other blood products is that they are stored at room temperature for short periods of time. Contamination is also more common with longer duration of storage, especially if that means more than 5 days. Sources of contaminants include the donor's blood, donor's skin, phlebotomist's skin, and containers. Contaminating organisms vary greatly, and include skin flora, gut flora, and environmental organisms. There are many strategies in place at blood donation centers and laboratories to reduce the risk of contamination. A definite diagnosis of transfusion-transmitted bacterial infection includes the identification of a positive culture in the recipient (without an alternative diagnosis) as well as the identification of the same organism in the donor blood.


title: Blood transfusion

text: Since the advent of HIV testing of donor blood in the mid/later 1980s, ex. 1985's ELISA, the transmission of HIV during transfusion has dropped dramatically. Prior testing of donor blood only included testing for antibodies to HIV. However, because of latent infection (the "window period" in which an individual is infectious, but has not had time to develop antibodies) many cases of HIV seropositive blood were missed. The development of a nucleic acid test for the HIV-1 RNA has dramatically lowered the rate of donor blood seropositivity to about 1 in 3 million units. As transmittance of HIV does not necessarily mean HIV infection, the latter could still occur at an even lower rate.


title: Blood transfusion

text: The transmission of hepatitis C via transfusion currently stands at a rate of about 1 in 2 million units. As with HIV, this low rate has been attributed to the ability to screen for both antibodies as well as viral RNA nucleic acid testing in donor blood.


title: Blood transfusion

text: Other rare transmissible infections include hepatitis B, syphilis, Chagas disease, cytomegalovirus infections (in immunocompromised recipients), HTLV, and Babesia.


title: Blood transfusion

text: Transfusion inefficacy or insufficient efficacy of a given unit(s) of blood product, while not itself a "complication" "per se", can nonetheless indirectly lead to complications – in addition to causing a transfusion to fully or partly fail to achieve its clinical purpose. This can be especially significant for certain patient groups such as critical-care or neonatals.


title: Blood transfusion

text: For red blood cells (RBC), by far the most commonly transfused product, poor transfusion efficacy can result from units damaged by the so-called storage lesion – a range of biochemical and biomechanical changes that occur during storage. With red cells, this can decrease viability and ability for tissue oxygenation. Although some of the biochemical changes are reversible after the blood is transfused, the biomechanical changes are less so, and rejuvenation products are not yet able to adequately reverse this phenomenon. There has been controversy about whether a given product unit's age is a factor in transfusion efficacy, specifically about whether "older" blood directly or indirectly increases risks of complications. Studies have not been consistent on answering this question, with some showing that older blood is indeed less effective but with others showing no such difference; these developments are being closely followed by hospital blood bankers – who are the physicians, typically pathologists, who collect and manage inventories of transfusable blood units.


title: Blood transfusion

text: Certain regulatory measures are in place to minimize RBC storage lesion – including a maximum shelf life (currently 42 days), a maximum auto-hemolysis threshold (currently 1% in the US, 0.8% in Europe), and a minimum level of post-transfusion RBC survival "in vivo" (currently 75% after 24 hours). However, all of these criteria are applied in a universal manner that does not account for differences among units of product. For example, testing for the post-transfusion RBC survival "in vivo" is done on a sample of healthy volunteers, and then compliance is presumed for all RBC units based on universal (GMP) processing standards (RBC survival by itself does not guarantee efficacy, but it is a necessary prerequisite for cell function, and hence serves as a regulatory proxy). Opinions vary as to the "best" way to determine transfusion efficacy in a patient "in vivo". In general, there are not yet any "in vitro" tests to assess quality or predict efficacy for specific units of RBC blood product prior to their transfusion, though there is exploration of potentially relevant tests based on RBC membrane properties such as erythrocyte deformability and erythrocyte fragility (mechanical).


title: Blood transfusion

text: Physicians have adopted a so-called "restrictive protocol" – whereby transfusion is held to a minimum – in part because of the noted uncertainties surrounding storage lesion, in addition to the very high direct and indirect costs of transfusions. However, the restrictive protocol is not an option with some especially vulnerable patients who may require the best possible efforts to rapidly restore tissue oxygenation.


title: Blood transfusion

text: Although transfusions of platelets are far less numerous (relative to RBC), platelet storage lesion and resulting efficacy loss is also a concern.


title: Blood transfusion

text: In the United States, blood transfusions were performed nearly 3 million times during hospitalizations in 2011, making it the most common procedure performed. The rate of hospitalizations with a blood transfusion nearly doubled from 1997, from a rate of 40 stays to 95 stays per 10,000 population. It was the most common procedure performed for patients 45 years of age and older in 2011, and among the top five most common for patients between the ages of 1 and 44 years.


title: Blood transfusion

text: According to the "New York Times": "Changes in medicine have eliminated the need for millions of blood transfusions, which is good news for patients getting procedures like coronary bypasses and other procedures that once required a lot of blood." And, "Blood bank revenue is falling, and the decline may reach $1.5 billion a year this year [2014] from a high of $5 billion in 2008." Job losses will reach as high as 12,000 within the next three to five years, roughly a quarter of the total in the industry, according to the Red Cross.


title: Blood transfusion

text: Beginning with William Harvey's experiments on the circulation of blood, recorded research into blood transfusion began in the 17th century, with successful experiments in transfusion between animals. However, successive attempts by physicians to transfuse animal blood into humans gave variable, often fatal, results.


title: Blood transfusion

text: Pope Innocent VIII is sometimes said to have been given "the world's first blood transfusion" by his physician Giacomo di San Genesio, who had him drink (by mouth) the blood of three 10-year-old boys. The boys subsequently died. The evidence for this story, however, is unreliable and considered a possible anti-Jewish blood libel.


title: Blood transfusion

text: The first reported successful blood transfusions were performed by the Incas as early as the 1500s. Spanish conquistadors witnessed blood transfusions when they arrived in the sixteenth century. The prevalence of type O blood among Indigenous people of the Andean region meant such procedures would have held less risk than blood transfusion attempts among populations with incompatible blood types, which contributed to the failures of early attempts in Europe.


title: Blood transfusion

text: Working at the Royal Society in the 1660s, the physician Richard Lower began examining the effects of changes in blood volume on circulatory function and developed methods for cross-circulatory study in animals, obviating clotting by closed arteriovenous connections. The new instruments he was able to devise enabled him to perform the first reliably documented successful transfusion of blood in front of his distinguished colleagues from the Royal Society.


title: Blood transfusion

text: According to Lower's account, "...towards the end of February 1665 [I] selected one dog of medium size, opened its jugular vein, and drew off blood, until its strength was nearly gone. Then, to make up for the great loss of this dog by the blood of a second, I introduced blood from the cervical artery of a fairly large mastiff, which had been fastened alongside the first, until this latter animal showed ... it was overfilled ... by the inflowing blood." After he "sewed up the jugular veins", the animal recovered "with no sign of discomfort or of displeasure".


title: Blood transfusion

text: Lower had performed the first blood transfusion between animals. He was then "requested by the Honorable [Robert] Boyle ... to acquaint the Royal Society with the procedure for the whole experiment", which he did in December 1665 in the Society's "Philosophical Transactions".


title: Blood transfusion

text: The first blood transfusion from animal to human was administered by Dr. Jean-Baptiste Denys, eminent physician to King Louis XIV of France, on June 15, 1667. He transfused the blood of a sheep into a 15-year-old boy, who survived the transfusion. Denys performed another transfusion into a labourer, who also survived. Both instances were likely due to the small amount of blood that was actually transfused into these people. This allowed them to withstand the allergic reaction.


title: Blood transfusion

text: Denys's third patient to undergo a blood transfusion was Swedish Baron Gustaf Bonde. He received two transfusions. After the second transfusion Bonde died. In the winter of 1667, Denys performed several transfusions on Antoine Mauroy with calf's blood. On the third account Mauroy died.


title: Blood transfusion

text: Six months later in London, Lower performed the first human transfusion of animal blood in Britain, where he "superintended the introduction in [a patient's] arm at various times of some ounces of sheep's blood at a meeting of the Royal Society, and without any inconvenience to him." The recipient was Arthur Coga, "the subject of a harmless form of insanity." Sheep's blood was used because of speculation about the value of blood exchange between species; it had been suggested that blood from a gentle lamb might quiet the tempestuous spirit of an agitated person and that the shy might be made outgoing by blood from more sociable creatures. Coga received 20 shillings () to participate in the experiment.


title: Blood transfusion

text: Lower went on to pioneer new devices for the precise control of blood flow and the transfusion of blood; his designs were substantially the same as modern syringes and catheters. Shortly after, Lower moved to London, where his growing practice soon led him to abandon research.


title: Blood transfusion

text: These early experiments with animal blood provoked a heated controversy in Britain and France. Finally, in 1668, the Royal Society and the French government both banned the procedure. The Vatican condemned these experiments in 1670. Blood transfusions fell into obscurity for the next 150 years.


title: Blood transfusion

text: The science of blood transfusion dates to the first decade of the 20th century, with the discovery of distinct blood types leading to the practice of mixing some blood from the donor and the receiver before the transfusion (an early form of cross-matching).


title: Blood transfusion

text: In the early 19th century, British obstetrician Dr. James Blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe. In 1818 following experiments with animals, he performed the first successful transfusion of human blood to treat postpartum hemorrhage. Blundell used the patient's husband as a donor, and extracted four ounces of blood from his arm to transfuse into his wife. During the years 1825 and 1830, Blundell performed 10 transfusions, five of which were beneficial, and published his results. He also invented a number of instruments for the transfusion of blood. He made a substantial amount of money from this endeavour, roughly $2 million ($50 million real dollars).


title: Blood transfusion

text: In 1840, at St George's Hospital Medical School in London, Samuel Armstrong Lane, aided by Blundell, performed the first successful whole blood transfusion to treat haemophilia.


title: Blood transfusion

text: However, early transfusions were risky and many resulted in the death of the patient. By the late 19th century, blood transfusion was regarded as a risky and dubious procedure, and was largely shunned by the medical establishment.


title: Blood transfusion

text: Work to emulate James Blundell continued in Edinburgh. In 1845 the Edinburgh Journal described the successful transfusion of blood to a woman with severe uterine bleeding. Subsequent transfusions were successful with patients of Professor James Young Simpson after whom the Simpson Memorial Maternity Pavilion in Edinburgh was named.


title: Blood transfusion

text: Various isolated reports of successful transfusions emerged towards the end of the 19th century. The largest series of early successful transfusions took place at the Edinburgh Royal Infirmary between 1885 and 1892. Edinburgh later became the home of the first blood donation and blood transfusion services.


title: Blood transfusion

text: Only in 1901, when the Austrian Karl Landsteiner discovered three human blood groups (O, A, and B), did blood transfusion achieve a scientific basis and become safer.


title: Blood transfusion

text: Landsteiner discovered that adverse effects arise from mixing blood from two incompatible individuals. He found that mixing incompatible types triggers an immune response and the red blood-cells clump. The immunological reaction occurs when the receiver of a blood transfusion has antibodies against the donor blood-cells. The destruction of red blood cells releases free hemoglobin into the bloodstream, which can have fatal consequences. Landsteiner's work made it possible to determine blood group and allowed blood transfusions to take place much more safely. For his discovery he won the Nobel Prize in Physiology and Medicine in 1930; many other blood groups have been discovered since.


title: Blood transfusion

text: George Washington Crile is credited with performing the first surgery using a direct blood transfusion in 1906 at St. Alexis Hospital in Cleveland while a professor of surgery at Case Western Reserve University.


title: Blood transfusion

text: Jan Janský also discovered the human blood groups; in 1907 he classified blood into four groups: I, II, III, IV. His nomenclature is still used in Russia and in states of the former USSR, in which blood types O, A, B, and AB are respectively designated I, II, III, and IV.


title: Blood transfusion

text: Dr. William Lorenzo Moss's (1876–1957) Moss-blood typing technique of 1910 was widely used until World War II.


title: Blood transfusion

text: William Stewart Halsted, M.D. (1852–1922), an American surgeon, performed one of the first blood transfusions in the United States. He had been called to see his sister after she had given birth. He found her moribund from blood loss, and in a bold move withdrew his own blood, transfused his blood into his sister, and then operated on her to save her life.


title: Blood transfusion

text: While the first transfusions had to be made directly from donor to receiver before coagulation, it was discovered that by adding anticoagulant and refrigerating the blood it was possible to store it for some days, thus opening the way for the development of blood banks. John Braxton Hicks was the first to experiment with chemical methods to prevent the coagulation of blood at St Mary's Hospital, London in the late-19th century. His attempts, using phosphate of soda, however, proved unsuccessful.


title: Blood transfusion

text: The Belgian doctor Albert Hustin performed the first non-direct transfusion on March 27, 1914, though this involved a diluted solution of blood. The Argentine doctor Luis Agote used a much less diluted solution in November of the same year. Both used sodium citrate as an anticoagulant.


title: Blood transfusion

text: The First World War (1914-1918) acted as a catalyst for the rapid development of blood banks and transfusion techniques. Canadian doctor and Lieutenant Lawrence Bruce Robertson became instrumental in persuading the Royal Army Medical Corps to adopt the use of blood transfusion at the Casualty Clearing Stations for the wounded. In October 1915, Robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds. He followed this up with four subsequent transfusions in the following months, and his success was reported to Sir Walter Morley Fletcher, director of the Medical Research Committee.


title: Blood transfusion

text: Robertson published his findings in the "British Medical Journal" in 1916 and, with the help of a few like-minded individuals (including the eminent physician Edward William Archibald (1872–1945), who introduced the citrate anticoagulant method), was able to persuade the British authorities of the merits of blood transfusion. Robertson went on to establish the first blood-transfusion apparatus at a Casualty Clearing Station on the Western Front in the spring of 1917.


title: Blood transfusion

text: Oswald Hope Robertson, a medical researcher and U.S. Army officer, was attached to the RAMC in 1917, where he became instrumental in establishing the first blood banks in preparation for the anticipated Third Battle of Ypres. He used sodium citrate as the anticoagulant; blood was extracted from punctures in the vein and was stored in bottles at British and American Casualty Clearing Stations along the Front. Robertson also experimented with preserving separated red blood cells in iced bottles. Geoffrey Keynes, a British surgeon, developed a portable machine that could store blood to enable transfusions to be carried out more easily.


title: Blood transfusion

text: The secretary of the British Red Cross, Percy Oliver, established the world's first blood-donor service in 1921. In that year, Oliver was contacted by King's College Hospital, where they were in urgent need of a blood donor.


title: Blood transfusion

text: Alexander Bogdanov founded an academic institution devoted to the science of blood transfusion in Moscow in 1925. Bogdanov was motivated, at least in part, by a search for eternal youth, and remarked with satisfaction on the improvement of his eyesight, suspension of balding, and other positive symptoms after receiving 11 transfusions of whole blood. Bogdanov died in 1928 as a result of one of his experiments, when the blood of a student with malaria and tuberculosis was given to him in a transfusion. Following Bogdanov's lead, Vladimir Shamov and Sergei Yudin in the USSR pioneered the transfusion of cadaveric blood from recently deceased donors. Yudin performed such a transfusion successfully for the first time on March 23, 1930, and reported his first seven clinical transfusions with cadaveric blood at the Fourth Congress of Ukrainian Surgeons at Kharkiv in September. However, this method was never used widely, even in the Soviet Union. Nevertheless, the Soviet Union was the first to establish a network of facilities to collect and store blood for use in transfusions at hospitals.


title: Blood transfusion

text: Frederic Durán-Jordà established one of the earliest blood banks during the Spanish Civil War in 1936. Duran joined the Transfusion Service at the Barcelona Hospital at the start of the conflict, but the hospital was soon overwhelmed by the demand for blood and the paucity of available donors. With support from the Department of Health of the Spanish Republican Army, Duran established a blood bank for the use of wounded soldiers and civilians. The 300–400 mL of extracted blood was mixed with 10% citrate solution in a modified Duran Erlenmeyer flask. The blood was stored in a sterile glass enclosed under pressure at 2 °C. During 30 months of work, the Transfusion Service of Barcelona registered almost 30,000 donors, and processed 9,000 liters of blood.


title: Blood transfusion

text: In 1937 Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, established the first hospital blood-bank in the United States. In setting up a hospital laboratory that preserved, refrigerated and stored donor blood, Fantus originated the term "blood bank". Within a few years, hospital and community blood-banks were established across the United States.


title: Blood transfusion

text: Frederic Durán-Jordà fled to Britain in 1938 and worked with Dr Janet Vaughan at the Royal Postgraduate Medical School at Hammersmith Hospital to establish a system of national blood banks in London. With the outbreak of war appearing imminent in 1938, the War Office created the Army Blood Supply Depot (ABSD) in Bristol, headed by Lionel Whitby and in control of four large blood-depots around the country. British policy through the war was to supply military personnel with blood from centralized depots, in contrast to the approach taken by the Americans and Germans where troops at the front were bled to provide required blood. The British method proved more successful in adequately meeting all requirements, and over 700,000 donors were bled over the course of the war. This system evolved into the National Blood Transfusion Service established in 1946, the first national service to be implemented.


title: Blood transfusion

text: Stories tell of Nazis in Eastern Europe during World War II using captive children as repeated involuntary blood-donors.


title: Blood transfusion

text: A blood-collection program was initiated in the US in 1940 and Edwin Cohn pioneered the process of blood fractionation. He worked out the techniques for isolating the serum albumin fraction of blood plasma, which is essential for maintaining the osmotic pressure in the blood vessels, preventing their collapse.


title: Blood transfusion

text: Gordon R. Ward, writing in the correspondence columns of the "British Medical Journal", proposed the use of blood plasma as a substitute for whole blood and for transfusion purposes as early as 1918. At the onset of World War II, liquid plasma was used in Britain. A large project, known as "Blood for Britain", began in August 1940 to collect blood in New York City hospitals for the export of plasma to Britain. A freeze-dried plasma package was developed by the Surgeons General of the Army and Navy, working with the National Research Council, which reduced breakage and made transportation, packaging, and storage much simpler.


title: Blood transfusion

text: The resulting dried plasma package came in two tin cans containing 400 mL bottles. One bottle contained enough distilled water to reconstitute the dried plasma contained within the other bottle. In about three minutes, the plasma would be ready to use and could stay fresh for around four hours. Dr. Charles R. Drew was appointed medical supervisor, and he was able to transform the test-tube methods into the first successful technique for mass production.


title: Blood transfusion

text: Another important breakthrough came in 1937–40 when Karl Landsteiner (1868–1943), Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rhesus blood group system, which was found to be the cause of the majority of transfusion reactions up to that time. Three years later, the introduction by J.F. Loutit and Patrick L. Mollison of acid–citrate–dextrose (ACD) solution, which reduced the volume of anticoagulant, permitted transfusions of greater volumes of blood and allowed longer-term storage.


title: Blood transfusion

text: Carl Walter and W.P. Murphy Jr. introduced the plastic bag for blood collection in 1950. Replacing breakable glass bottles with durable plastic bags made from PVC allowed for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood.


title: Blood transfusion

text: In the field of cancer surgery, the replacement of massive blood-loss became a major problem. The cardiac-arrest rate was high. In 1963 C. Paul Boyan and William S. Howland discovered that the temperature of the blood and the rate of infusion greatly affected survival rates, and introduced blood warming to surgery.


title: Blood transfusion

text: Further extending the shelf-life of stored blood up to 42 days was an anticoagulant preservative, CPDA-1, introduced in 1979, which increased the blood supply and facilitated resource-sharing among blood banks.


title: Blood transfusion

text: To ensure the safety of blood transfusion to pediatric patients, hospitals are taking additional precautions to avoid infection and prefer to use specially tested pediatric blood units that are guaranteed negative for Cytomegalovirus. Most guidelines recommend the provision of CMV-negative blood components and not simply leukoreduced components for newborns or low birthweight infants in whom the immune system is not fully developed. These specific requirements place additional restrictions on blood donors who can donate for neonatal use.


title: Blood transfusion

text: A "massive transfusion protocol" is used when significant blood loss is present such as in major trauma, when more than ten units of blood are needed. Packed red blood cells, fresh frozen plasma, and platelets are generally administered. Typically higher ratios of fresh frozen plasma and platelets are given relative to packed red blood cells.


title: Blood transfusion

text: Because blood type O negative is compatible with anyone, it is often overused and in short supply. According to the Association for the Advancement of Blood and Biotherapies, the use of this blood should be restricted to persons with O negative blood, as nothing else is compatible with them, and women who might be pregnant and for whom it would be impossible to do blood group testing before giving them emergency treatment. Whenever possible, the AABB recommends that O negative blood be conserved by using blood type testing to identify a less scarce alternative.


title: Blood transfusion

text: Although there are clinical situations where transfusion with red blood cells is the only clinically appropriate option, clinicians look at whether alternatives are feasible. This can be due to several reasons, such as patient safety, economic burden or scarcity of blood. Guidelines recommend blood transfusions should be reserved for patients with or at risk of cardiovascular instability due to the degree of their anaemia. In these cases parenteral iron is recommended.


title: Blood transfusion

text: Thus far, there are no available "oxygen-carrying" blood substitutes, which is the typical objective of a blood (RBC) transfusion; however, there are widely available non-blood "volume expanders" for cases where only volume restoration is required. These are helping doctors and surgeons avoid the risks of disease transmission and immune suppression, address the chronic blood donor shortage, and address the concerns of Jehovah's Witnesses and others who have religious objections to receiving transfused blood.


title: Blood transfusion

text: The research in this area is ongoing. A number of blood substitutes have been explored, but thus far they all have serious limitations. Most attempts to find a suitable alternative to blood thus far have concentrated on cell-free hemoglobin solutions. Blood substitutes could make transfusions more readily available in emergency medicine and in pre-hospital EMS care. If successful, such a blood substitute could save many lives, particularly in trauma where massive blood loss results. Hemopure, a hemoglobin-based therapy, is approved for use in South Africa.


title: Blood transfusion

text: Minor blood transfusions are used by a minority of nyaope drug addicts in South Africa to economically share the high the drug induces in a practice colloquially known as "Bluetoothing", named after the wireless technology of the same name.


title: Blood transfusion

text: Veterinarians also administer transfusions to other animals. Various species require different levels of testing to ensure a compatible match. For example, cats have 3 known blood types, cattle have 11, dogs have 13, pigs have 16, and horses have 34. However, in many species (especially horses and dogs), cross matching is not required before the "first" transfusion, as antibodies against non-self cell surface antigens are not expressed constitutively – i.e. the animal has to be sensitized before it will mount an immune response against the transfused blood.


title: On the Basis of Sex

text: On the Basis of Sex is a 2018 American biographical legal drama film based on the life and early cases of Ruth Bader Ginsburg, who was the second woman to serve as an Associate Justice of the United States Supreme Court. Directed by Mimi Leder and written by Daniel Stiepleman (Ginsburg's real-life nephew), it stars Felicity Jones as Ginsburg. Armie Hammer, Justin Theroux, Jack Reynor, Cailee Spaeny, Sam Waterston, and Kathy Bates feature in supporting roles.


title: On the Basis of Sex

text: The film had its world premiere at the AFI Fest on November 8, 2018, and was theatrically released in the United States on December 25, 2018, by Focus Features. "On the Basis of Sex" received generally favorable reviews from critics, who praised Jones' performance, the film's intricacy and its pacing at a dramatic level. Other critics felt the biopic was predictable, over-packaged and hagiographic. Made on a $20 million budget, "On the Basis of Sex" grossed $38.8 million at the box office.


title: On the Basis of Sex

text: In 1956, Ruth Bader Ginsburg is a first-year student at Harvard Law School, when her husband Martin Ginsburg, a second-year student, is diagnosed with testicular cancer. She attends both her classes and his, taking notes and transcribing lectures while caring for Martin and their infant daughter Jane. Two years later, Martin's cancer is in remission and he is hired by a firm in New York City. Ruth petitions Harvard Law School Dean Griswold to allow her to complete her Harvard law degree with classes at Columbia Law School in New York, but he insists on following Harvard University policies at the time and denies her request, so she transfers to Columbia. In spite of graduating at the top of her class, she is unable to find a position with a law firm because none of the firms she applies to want to hire a woman. She takes a job as a professor at Rutgers Law School, teaching "Sex Discrimination and the Law".


title: On the Basis of Sex

text: In 1970, Martin brings "Moritz v. Commissioner", a tax law case, to Ruth's attention. Charles Moritz is a man from Denver who had to hire a nurse to help him care for his aging mother so he could continue to work. Moritz was denied a tax deduction for the nursing care because at the time Section 214 of the Internal Revenue Code specifically limited the deduction to "a woman, a widower or divorcée, or a husband whose wife is incapacitated or institutionalized". The court ruled that Moritz, a man who had never married, did not qualify for the deduction. Ruth sees in this case an opportunity to begin to challenge the many laws enacted over the years that assume that men will work to provide for the family, and women will stay home and take care of the husband and children. She believes that if she could set a precedent ruling that a man was unfairly discriminated against on the basis of sex, that precedent could be cited in cases challenging laws that discriminate against womenand she believes that an appellate court composed entirely of male judges would find it easier to identify with a male appellant.


title: On the Basis of Sex

text: Ruth meets with Mel Wulf of the ACLU to try to enlist their help, but he turns her down. Ruth flies to Denver to meet with Moritz, who agrees to let the Ginsburgs and ACLU represent him "pro bono" after Ruth convinces him that millions of people could potentially benefit. After reading the draft of the brief, Dorothy Kenyon, who was cold to the idea at first, meets with Wulf in his office and convinces him to sign on. The Ginsburgs and Wulf file an appeal of Moritz's denial with the Tenth Circuit Court of Appeals. Department of Justice Attorney James H. Bozarth asks to be the lead counsel for the defense. Bozarth does a computer search to find all of the sections of the US Code that deal with sex. His defense will contend that, if section 214 is ruled unconstitutional, that will open the door to challenge all of America's sex-based laws. Ruth, having no courtroom experience, does poorly in a moot court, and Wulf convinces her to let Martin lead off arguing the tax law, with Ruth following up with equal protection arguments.


title: On the Basis of Sex

text: The government offers Moritz a settlement of one dollar. Ruth makes a counter-proposal: the government will pay Moritz the sum he claimed as a deduction and make a declaration that he did nothing wrong, and also enter into the record that the sex-based portion of section 214 is unconstitutional. The government declines this proposal because of the constitutionality element. During oral argument at the Court of Appeals, Martin takes more of their side's allotted time than he had intended. Ruth is nervous but makes several key points and reserves four minutes of her time for rebuttal. Bozarth frames his side's argument as defending the American way of life, implying that the Ginsburgs and ACLU want "radical social change" and maybe Moritz "just doesn't want to pay his taxes". In her rebuttal, Ruth is much more confident. She states that societal roles that existed one hundred years ago, or even twenty years ago, no longer apply. She does not ask the court to change society, but for the law to keep up with societal changes that have already taken place. To a judge's objection that the Constitution does not contain the word "woman", she responds vigorously that neither does it contain the word "freedom".


title: On the Basis of Sex

text: Outside the courthouse, judgment being reserved, Wulf, Moritz, and the Ginsburgs celebrate that, win or lose, Ruth has finally found her voice as a lawyer. Titles over the closing scene indicate that the Court of Appeals found unanimously in Moritz's favor. Ruth went on to co-found the Women's Rights Project at the ACLU, which struck down many of the sex-based laws Bozarth identified, and in 1993 the Senate voted 96 to 3 for her to become an associate justice of the United States Supreme Court. The final scene shows the real-life Ginsburg walking up the steps of the Supreme Court building.


title: On the Basis of Sex

text: Robert W. Cort produced the film through Participant Media. On July 18, 2017, "Deadline" reported that the film would be directed by Mimi Leder. Production started in late 2017 in Montreal, Quebec.


title: On the Basis of Sex

text: The film's script, written by Daniel Stiepleman who is Ginsburg's nephew, had made the 2014 blacklist of the best unproduced screenplays of the year.


title: On the Basis of Sex

text: Natalie Portman had previously been linked to the role of Ginsburg. On July 18, 2017, "Deadline" reported that Jones would play the role of Ginsburg in the film. On September 7, 2017, Hammer was cast to play Ruth's husband Martin. The cast was completed by Justin Theroux, Kathy Bates, Sam Waterston, Jack Reynor, Stephen Root and Cailee Spaeny in October as filming commenced. In April 2018, it was announced that Ginsburg would appear in a small role.


title: On the Basis of Sex

text: The film was scheduled to be released by Focus Features on November 9, 2018, but was pushed back to a limited release on December 25, 2018, with a wide release on January 11, 2019. It had its world premiere at the AFI Fest on November 8, 2018.


title: On the Basis of Sex

text: The first trailer for the film debuted on July 16, 2018. The trailer was criticized for a scene in which Ginsburg tells a judge that the word "freedom" does not appear in the United States Constitution; it appears in the First Amendment. Screenwriter Daniel Stiepleman, in response to the criticism, stated that the point of the dialogue was to show that the Constitution, like the country as a whole, was always open to improvement.


title: On the Basis of Sex

text: On September 21, 2018, pop rap recording artist Kesha released the song "Here Comes the Change" as a standalone single, however it was not included in the film's soundtrack.


title: On the Basis of Sex

text: "On the Basis of Sex" grossed $24.6 million in the United States and Canada, and $14.1 million in other territories, for a total worldwide gross of $38.7 million.


title: On the Basis of Sex

text: The film grossed a "solid" $442,000 from 33 theaters on its first day of release, December 25. It went on to gross $690,000 in its first weekend, a total of $1.5 million over its first six days. During January 11–13, its first weekend of wide release, the film made $6.2 million from 1,923 theaters, finishing sixth at the box office. In its second weekend of wide release, the film fell 35% to $4 million, finishing 10th.


title: On the Basis of Sex

text: On the review aggregator website Rotten Tomatoes, the film holds an approval rating of based on reviews, with an average of . The website's critical consensus reads, ""On the Basis of Sex" is nowhere near as groundbreaking as its real-life subject, but her extraordinary life makes a solid case for itself as an inspirational, well-acted biopic." On Metacritic, the film has a weighted average score of 59 out of 100, based on 40 critics, indicating "mixed or average reviews". Audiences polled by CinemaScore gave the film an average grade of "A" on an A+ to F scale, while PostTrak reported filmgoers gave it an overall positive score of 94% and a "definite recommend" of 62%.


title: On the Basis of Sex

text: A. O. Scott of "The New York Times" noted that the film stays close to the true story of Ginsburg's emergence as a leading women's rights attorney: "That the movie may leave you wanting more — more history, more personality, more complicated emotion, more ideological contention — doesn't necessarily count against it. Historical narratives are best when they pique curiosity as well as satisfy it..."


title: I Am that I Am

text: "I Am that I Am" is a common English translation of the Hebrew phrase (; )– also "I am who (I) am", "I will become what I choose to become", "I am what I am", "I will be what I will be", "I create what(ever) I create", or "I am the Existing One". The traditional English translation within Judaism favours "I will be what I will be" because the imperfective aspect in Modern Hebrew is normally used for future tense and there is no present tense with direct object of the verb "to be" in the Hebrew language.


title: I Am that I Am

text: () is the first of three responses given to Moses when he asks for God's name in the Book of Exodus. The word () is the first person singular imperfective form of (), 'to be', and owing to the peculiarities of Hebrew grammar means 'I am' and 'I will be'. The meaning of the longer phrase is debated, and might be seen as a promise ('I will be with you') or as statement of incomparability ('I am without equal').


title: I Am that I Am

text: Biblical Hebrew did not distinguish between grammatical tenses, it has instead an aspectual system in which the perfect denoted any actions that have been completed, and imperfect denoted any actions that are not yet completed. Because these aspects had such general ambiguity on the time and placement of an action, the "past tense" would be represented by a verb conjugated in the imperfect and prefixed by ("wa-"), the "future tense" would represented by a verb conjugated in the perfect and prefixed by , and the "present tense", generally, would be represented by a verb conjugated in the imperfect "without" the prefix . The word () is the first-person singular imperfect form of , 'to be', which in Modern Hebrew indicates the future tense 'I will be'; however, it lacks the prefix which would necessitate this reading in Biblical Hebrew. It therefore may be translated as 'I am', but also as a modal form such as 'I may be', 'I would be', 'I could be', etc. Accordingly, the whole phrase can be rendered in English not only as 'I "am" that I am' but also as 'I "will be" what I will be' or 'I will be who I will be', or 'I shall prove to be whatsoever I shall prove to be' or even 'I will be because I will be'. Other renderings include: Leeser, 'I Will Be that I Will Be'; Rotherham, 'I Will Become whatsoever I please', Greek, (), 'I am The Being' in the Septuagint, and Philo, and the Book of Revelation or, 'I am The Existing One'; Latin, , 'I am Who I am'.


title: I Am that I Am

text: The word () is a relative pronoun whose meaning depends on the immediate context, so that 'that', 'who', 'which', or 'where' are all possible translations of that word.


title: I Am that I Am

text: An application of this phrase used in the New Testament has "But by the grace of God I am what I am ..." (1 Corinthians 15:10).


title: I Am that I Am

text: According to the Hebrew Bible, in the encounter of the burning bush () Moses asks what he is to say to the Israelites when they ask what gods ('Elohiym) have sent him to them, and Yahweh replies, "I am who I am", adding, "Say this to the people of Israel, 'I am has sent me to you. It is somewhat remarkable that despite this exchange, the Israelites never ask Moses for the name of God. Then there are a number of probably unanswerable questions, including who it is that does not know God's name, Moses or the Israelites (most commentators take it that it is Moses who does not know, meaning that the Israelites will ask him the name in order to prove his credentials), and just what the statement means.


title: I Am that I Am

text: In the Hindu Advaita Vedanta, the South Indian sage Ramana Maharshi mentions that of all the definitions of God, "none is indeed so well put as the biblical statement 'I am that I am. He maintained that although Hindu scripture contains similar statements, the Mahavakyas, these are not as direct as given in Exodus. Further the "I am" is explained by Sri Nisargadatta Maharaj as an abstraction in the mind of the Stateless State, of the Absolute, or the Supreme Reality, called Parabrahman: it is pure awareness, prior to thoughts, free from perceptions, associations, memories. Parabrahman is often considered to be a cognate term for the Supreme Being in Hinduism.


title: I Am that I Am

text: Victor P. Hamilton suggests "some legitimate translations ...: (1) 'I am who I am'; (2) 'I am who I was'; (3) 'I am who I shall be'; (4) 'I was who I am'; (5) 'I was who I was'; (6) 'I was who I shall be'; (7) 'I shall be who I am'; (8) 'I shall be who I was'; (9) 'I shall be who I shall be'."


title: Sonya Curry

text: Sonya Alicia Curry (née Adams; born May 30, 1966) is an American educator. She is the mother of basketball players Stephen Curry and Seth Curry.


title: Sonya Curry

text: Sonya Alicia Adams was born in Radford, Virginia, to Cleive and Candy Adams. They lived in extreme poverty and frequently had racist experiences with the Ku Klux Klan. In high school, Adams played volleyball, track and field, and basketball. She matriculated at Virginia Tech as a student athlete, where she played volleyball, earning all-conference honors in the Metro Conference as a junior. She received a degree in education. According to her best friend and college roommate, the volleyball team was popular largely due to Adams.


title: Sonya Curry

text: Adams met her future husband, Dell Curry, at Virginia Tech. During her official recruiting visit to the school, she was watching the men's basketball practice when Adams and Curry noticed each other.


title: Sonya Curry

text: Curry is president of the Christian Montessori School of Lake Norman in Huntersville, North Carolina, which she founded in 1995. Her children attended the school.


title: Sonya Curry

text: Curry's elder son, Stephen, plays for the Golden State Warriors and holds the all-time NBA record for three-pointers. He has won four NBA championships with the team. Her younger son, Seth, plays for the Brooklyn Nets. Her daughter, Sydel, played volleyball at Elon University. Curry has six grandchildren.


title: Sonya Curry

text: Starting when Stephen was in college playing with Davidson during the 2008 NCAA tournament, Curry began being a favorite shot for college basketball television producers. When Seth was playing college ball with Duke, her celebration of his three-point field goal against North Carolina in February 2013 had her trending on Twitter. She remained popular on the Internet during the Blue Devils' run in the 2013 NCAA tournament.


title: Sonya Curry

text: As she often receives camera time in the audience of Golden State games, Curry has been called NBA "royalty". She is often interviewed about how she successfully raised professional athletes, including two-time NBA Most Valuable Player Stephen. She shares how the family has been successful over time, including how they have dealt with their sons' success in the NBA.


title: Sonya Curry

text: Stephen and Seth Curry became the first brothers to ever compete against each other in an NBA Conference Finals in 2019, when Golden State played Portland. That postseason, Curry and Dell had been on the road since March, watching their sons' games from the stands. Stephen and Seth never played competitively against each other until they reached the NBA.


title: Sonya Curry

text: On August 23, 2021, Curry and her husband, Dell, announced that they were divorcing after 33 years of marriage.


title: Abdulmanap Nurmagomedov

text: Abdulmanap Magomedovich Nurmagomedov (; 10 December 1962 – 3 July 2020) was a Russian military veteran, former judoka and combat sports coach.


title: Abdulmanap Nurmagomedov

text: In September 2019, he was named by the "Russian Book of Records" as the most successful combat sambo coach in the country. He was the father and coach of retired UFC lightweight champion Khabib Nurmagomedov, and coach of current UFC Lightweight Champion Islam Makhachev.


title: Abdulmanap Nurmagomedov

text: An ethnic Avar, Nurmagomedov was born in 1962 in the village of Sildi, Tsumadinsky District. In 1987 he graduated from the Poltava University of Economics and Trade with a degree in accounting and economics. He had two sons, Magomed and Khabib, and one daughter, Amina. He started his sporting career with freestyle wrestling, which he, like many Dagestani children, had practiced from a young age. While serving in the Soviet Army, he began to practice judo and sambo.


title: Abdulmanap Nurmagomedov

text: His first big success as a coach came when his brother, Nurmagomed Nurmagomedov, won at the World Sambo Championship for Ukraine's national team in 1992. He trained a total of 18 world champions through his coaching career.


title: Abdulmanap Nurmagomedov

text: At the end of April 2020, during the COVID-19 pandemic in Russia, Nurmagomedov was hospitalized in the 2nd city hospital of Makhachkala with bilateral pneumonia caused by COVID-19. Having been taken to Moscow in early May on a private jet, his condition rapidly worsened, and he died there on 3 July 2020, from COVID complications. He was 57 years old. On 4 July, he was buried in his native village. Following his death, his son Khabib announced his retirement from mixed martial arts following his victory over Justin Gaethje at UFC 254, a fight which he dedicated to the memory of his father.


title: Plano, Texas

text: Plano ( ) is a city in Collin County and Denton County, Texas, United States. It had a population of 285,494 at the 2020 census. It is a principal city of the Dallas–Fort Worth metroplex.


title: Plano, Texas

text: European settlers came to the area near present-day Plano in the early 1840s. Facilities such as a sawmill, a gristmill, and a store soon brought more people to the area. A mail service was established, and after rejecting several names for the nascent town (including naming it in honor of then-President Millard Fillmore), residents suggested the name "Plano" (from the Spanish word for "flat") in reference to the local terrain, unvaried and devoid of any trees. The post office accepted the name.


title: Plano, Texas

text: In 1872, the completion of the Houston and Central Texas Railway helped Plano grow, and it was incorporated in 1873. By 1874, the population was over 500. In 1881, a fire raged through the business district, destroying most of the buildings. Plano was rebuilt and business again flourished through the 1880s. Also in 1881, the city assumed responsibility for what would eventually become Plano Independent School District (PISD), ending the days of it being served only by private schools.


title: Plano, Texas

text: At first, Plano's population grew slowly, reaching 1,304 in 1900 and 3,695 in 1960. By 1970, Plano began to feel some of the boom its neighbors had experienced after World War II. A series of public works projects and a change in taxes that removed the farming community from the town helped increase the population. In 1970, the population reached 17,872, and by 1980, it had exploded to 72,000. Sewers, schools, and street development kept pace with this massive increase, largely because of Plano's flat topography, grid layout, and planning initiatives.


title: Plano, Texas

text: During the 1980s, many large corporations, including J. C. Penney and Frito-Lay, moved their headquarters to Plano, spurring further growth. By 1990, the population reached 128,713, dwarfing the county seat, McKinney. In 1994, Plano was recognized as an All-America City. By 2000, the population grew to 222,030, making it one of Dallas's largest suburbs. Plano is surrounded by other municipalities and so cannot expand in area, and there is little undeveloped land within the city limits. But as of July 2012, one large tract of land was being developed: Turnpike Commons at the intersection of Renner Road and the George Bush Turnpike (also bordered by Shiloh Road to the east). The development is expected to feature apartments, medical facilities, restaurants, a Race Trac gas station, and a hotel.


title: Plano, Texas

text: On June 15, 2015, after five years of disuse, a 178-foot water tower built in 1985 was demolished to make room for Legacy West.


title: Plano, Texas

text: According to the United States Census Bureau, Plano has an area of 71.6 square miles (185.5 km). Plano is about from Downtown Dallas.


title: Plano, Texas

text: Plano is in the humid subtropical climate zone. The highest recorded temperature was 118 °F (48 °C) in 1936. On average, the coolest month is January and the warmest is July. The lowest recorded temperature was –7 °F (–22 °C) in 1930. The maximum average precipitation occurs in May.


title: Plano, Texas

text: As of the 2020 United States census, there were 285,494 people, 107,320 households, and 76,211 families residing in the city. , Plano had 259,841 people, 99,131 households and 69,464 families, up from 80,875 households and 60,575 families in the 2000 census. The population density was 3,629.1 people per square mile (1,400.8/km). There were 103,672 housing units at an average density of 1,448.6 per square mile (559.3/km).


title: Plano, Texas

text: In 2010, the racial makeup of the city was 67% White (58.4% non-Hispanic white), 7.5% Black, 0.36% Native American, 16.9% Asian (6.5% Asian Indian, 5.2% Chinese, 1.2% Vietnamese, 1.2% Korean, 0.6% Filipino, 0.2% Japanese, 1.9% Other), 0.1% Pacific Islander, 3.86% from other races, and 3.0% from two or more races. Hispanic or Latino made up 14.7% of the population (10.6% Mexican, 0.5% Puerto Rican, 0.2% Cuban, 3.5% Other). By 2020, the racial makeup was 46.3% non-Hispanic white, 8.77% Black or African American, 0.3% Native American, 24.08% Asian, 0.05% Pacific Islander, 0.47% some other race, 4.0% multiracial, and 16.04% Hispanic or Latino of any race, reflecting nationwide trends of greater diversification.


title: Plano, Texas

text: Of the 99,131 households in 2010, 35.8% had children under the age of 18. Married couples accounted for 56.7%; 9.7% had a female householder with no husband present, and 29.9% were non-families. About 24.4% of all households were individuals, and 5.3% had someone living alone who was 65 years of age or older. The average household size was 2.61, and the average family size was 3.15. Data indicates that 28.7% of Plano's population was under the age of 18, 7.0% was 18 to 24, 36.5% was 25 to 44, 22.9% was 45 to 64, and 4.9% was 65 years of age or older. The median age was 34. For every 100 females, there were 99.3 males. For every 100 females age 18 and over, there were 97.2 males.


title: Plano, Texas

text: According to a 2007 estimate, the median income for a household in the city was $84,492, and the median income for a family was $101,616. About 3.0% of families and 4.3% of the population were living below the poverty line, including 4.6% of those under age 18 and 7.8% of those 65 or older. In 2007, Plano had the United States' highest median income among cities with a population exceeding 250,000, at $84,492. As of 2010, Plano had a median income of $103,913 annually. According to crime statistics, there were four homicides in Plano in 2006, the lowest rate of all U.S. cities of 250,000 or more people.


title: Plano, Texas

text: , of the foreign-born residents, 17% were from China, 9% from India, and 4% from Vietnam; a total of 30% of foreign-born residents came from these three countries. That year, 22% of Plano's foreign-born originated in Mexico.


title: Plano, Texas

text: Along with Houston, Plano has one of Texas's two major concentrations of Chinese Americans. According to the 2010 U.S. census, there were 14,500 ethnic Chinese in Plano. Of cities with 250,000 or more residents, Plano has the sixth-largest percentage of ethnic Chinese, making up 5.2% of the city's population. Charlie Yue, the executive vice president of the Association of Chinese Professionals, estimated that about 30,000 Plano residents are Chinese and that many "don't participate in government activities, like the census".


title: Plano, Texas

text: Chinese professionals began to settle Plano by 1991. As of 2011, DFW's Chinese restaurants catering to ethnic Chinese are mainly in Plano and Richardson. Most of the DFW-area Chinese cultural organizations are headquartered in Plano and Richardson. Plano has six Chinese churches and supermarkets, including 99 Ranch Market and zTao Marketplace.


title: Plano, Texas

text: According to the Plano Economic Development 2017 Leading Employers Report, Plano's top 10 employers were:


title: Plano, Texas

text: About 80% of Plano's visitors are business travelers, due to its close proximity to Dallas and the many corporations headquartered in Plano. The city also has a convention center owned and operated by the city. Plano has made a concerted effort to draw retail to its downtown area and the Legacy West in an effort to boost sales tax returns. It has two malls, The Shops at Willow Bend and The Shops at Legacy. Collin Creek Mall closed in 2019. There is an area that has apartments, shops, and restaurants constructed with the New Urbanism philosophy. An experimental luxury Walmart Supercenter is at Park Boulevard and the Dallas North Tollway.


title: Plano, Texas

text: Some of the country's largest and most recognized companies are headquartered in Plano. Legacy Drive in ZIP Code 75024, between Preston Road and Dallas North Tollway, has many corporate campuses. The following companies have corporate headquarters (Fortune 1000 headquarters) or major regional offices in Plano:


title: Plano, Texas

text: In 2014 Toyota Motor North America announced its U.S. headquarters would move from Torrance, California, to Plano. In 2015, Liberty Mutual announced its plans to build a new corporate campus just a few blocks east of Toyota's, bringing an estimated 5,000 jobs to the community. In January 2016, JP Morgan Chase and mortgage giant Fannie Mae announced they would move their regional operations to Plano, bringing a combined 7,000 new jobs to the community.


title: Plano, Texas

text: The Plano Public Library System (PPLS) consists of the W.O. Haggard, Jr. Library, the Maribelle M. Davis Library, the Gladys Harrington Library, the Christopher A. Parr Library, the L.E.R. Schimelpfenig Library, and the Municipal Reference Library. The Haggard Library houses the system's administrative offices.


title: Plano, Texas

text: The Plano Symphony Orchestra is partially funded by the city, performing regularly at St. Andrew United Methodist Church and the Charles W. Eisemann Center for Performing Arts in nearby Richardson.


title: Plano, Texas

text: Although Plano is named for the flat plains of the area, large trees abound in the city's many parks. One such tree, estimated to be over 200 years old, is in Bob Woodruff Park, near Rowlett Creek on the city's east side.


title: Plano, Texas

text: There are two main open space preserves: Arbor Hills Nature Preserve (200 acres) which contains a pond in honor of Vasil Levski and Oak Point Park and Nature Preserve (800 acres). Bob Woodruff Park and Oak Point Park and Nature Preserve are connected by biking trails, making the green space one large uninterrupted park space larger than New York City's Central Park (840 acres). Go Ape, a family-friendly place with outdoor activities like ziplining and Tarzan swings, is at Oak Point Park and Preserve. The Plano Balloon Festival, which happens every September, also takes place at Oak Point Park and Preserve. Another open space is Haggard Park, which hosts the annual Plano AsiaFest in May. Acreage of all spaces the Parks Department manages totals 3,830.81. The Plano Master Plan has the acreage growing to 4,092.63 when complete.


title: Plano, Texas

text: There are five recreation centers: Tom Muehlenbeck Recreation Center, Carpenter Park Recreation Center, Oak Point Recreation Center, Liberty Recreation Center, and Douglass Community Center. Carpenter Park Recreation Center, Oak Point Recreation Center, and Tom Muehlenbeck Recreation Center have an indoor pool, while Liberty Recreation Center has an outdoor pool. Plano Senior Recreation Center is a recreation center dedicated to seniors. There are three swimming pools owned by Plano Parks & Recreation: Harry Rowlinson Community Natatorium, Jack Carter Pool, and Plano Aquatic Center. All the pools are indoor except Jack Carter Pool. Douglass Community Center houses the Boys & Girls Club of Collin County. For pet owners, there are The Dog Park at Jack Carter Park, The Dog Park at Bob Woodruff, and Dog Park at Windhaven Meadows Park.


title: Plano, Texas

text: The City of Plano also owns and operates four performing arts venues and a conference center under the auspices of the Parks and Recreation Department: the Courtyard Theater, the Cox Playhouse, the Amphitheater at Oak Point Park, McCall Plaza, and the Oak Point Park Nature and Retreat Center.


title: Plano, Texas

text: Plano has a council-manager form of government, with a part-time city council that sets city policy and a city manager responsible for city operations. The Plano City Council has eight members elected on a nonpartisan basis in staggered odd-year elections every other May. Council members and the mayor are elected by and serve the city at large. Council members serving in places one, two, three, and four must reside in that district, and the mayor always serves in place six. The mayor receives a yearly stipend of $8,400, and each council member receives $6,000.


title: Plano, Texas

text: All council members, including the mayor, serve a maximum of two consecutive four-year terms. The mayor and city council members could serve for a maximum of three consecutive three-year terms until voters approved changes to the city charter in 2011.


title: Plano, Texas

text: The 38th mayor of Plano was businessman Harry LaRosiliere, who was elected the first African-American mayor of Plano in 2013. Plano elected its first African-American city council member, David Perry, in 1990.


title: Plano, Texas

text: On December 8, 2014, the city council passed an amendment to its civil rights act to include sexual orientation and gender identity as protected. The ordinance drew the ire of conservative groups such as the Liberty Institute, which argued that it infringed on business owners' religious rights. Many civil rights organizations were not supportive either, such as the Human Rights Campaign, which argued that the policy's exclusion of transgender individuals from being able to use bathrooms and locker rooms that align with their gender identity rendered the ordinance not worth defending.


title: Plano, Texas

text: In the 2008 fiscal year Comprehensive Annual Financial Report, Plano reported $194 million in revenue, $212 million in expenditures, $278 million in total assets, $31.4 million in total liabilities, and $337 million in cash and investments.


title: Plano, Texas

text: Plano is a voluntary member of the North Central Texas Council of Governments association, the purpose of which is to coordinate individual and collective local governments and facilitate regional solutions, eliminate unnecessary duplication, and enable joint decisions.


title: Plano, Texas

text: In 2020, Police Chief Ed Drain announced the Plano Police Department would no longer make arrests for possession of small amounts of marijuana.


title: Plano, Texas

text: Dallas's wealthy northern suburbs were solidly Republican and in 2005, the Bay Area Center for Voting Research ranked Plano, the largest of them, the United States' fifth-most conservative city. It has become more competitive in national elections as its population has diversified, shifting toward the Democratic Party since 2016, when Donald Trump won the city by a narrow margin. In 2018, Beto O'Rourke became the first Democrat to win the city in a statewide election in the 21st century, and in 2020, Joe Biden won the city by an even larger margin. But in local and state elections, Plano still leans Republican, voting to reelect Governor Greg Abbott in 2018 and narrowly reelecting Republicans to the Texas House of Representatives and Texas Senate in 2018 and 2020.


title: Plano, Texas

text: Plano is split between the 66th and 67th Districts in the Texas House of Representatives, and is wholly contained in Texas Senate District 8.


title: Plano, Texas

text: Republican Matt Shaheen represents Texas House District 66, and Republican Jeff Leach has represented Texas House District 67 since 2013. Republican Angela Paxton represents Texas Senate District 8.


title: Plano, Texas

text: Republican Congressman Van Taylor has represented Texas's 3rd congressional district since 2019. Plano is represented in the United States Senate by Republicans Ted Cruz and John Cornyn.


title: Plano, Texas

text: Plano has 70 public schools, 16 private schools, and two campuses of the Collin County Community College District (Collin College).


title: Plano, Texas

text: The Plano Independent School District serves most of the city. Student enrollment has increased dramatically over the past few decades. Plano has a unique high school system, in which grades 9–10 attend a high school and grades 11–12 attend a senior high. There are three senior high schools (grades 11–12) in PISD: Plano East, Plano, and Plano West. Small portions of Plano are served by the Lewisville Independent School District, Frisco Independent School District, and Allen Independent School District (Commercial Only for Allen ISD).


title: Plano, Texas

text: Plano schools graduate more of their students than comparable districts. In 2010, 93% of Plano Independent Student District students graduated from high school, 18 percentage points higher than Dallas ISD's rate. In 2012, Plano Independent School District announced that 128 seniors were selected as National Merit Semifinalists.


title: Plano, Texas

text: Plano has given $1.2 billion in property tax revenue to other school districts through Texas's "Robin Hood" law, which requires school districts designated as affluent to give a percentage of their property tax revenue to other districts outside the county. In 2008, PISD gave $86 million. Controversy erupted when the salaries of teachers in less affluent districts—such as Garland ISD—exceeded the salaries of teachers in districts that had to pay into "Robin Hood".


title: Plano, Texas

text: In the 2013–14 school year, Plano ISD opened two four-year high school academies, one focusing on STEAM (STEM education plus Media Arts) called Plano ISD Academy High School, and the other on health science. Additionally, the district modified its International Baccalaureate program to allow freshmen and sophomores in the program to be housed at Plano East Senior High School.


title: Plano, Texas

text: In addition to Catholic primary and middle schools, the Roman Catholic Diocese of Dallas operates John Paul II High School in Plano. Non-Catholic private schools in Plano include Great Lakes Academy, Spring Creek Academy, Yorktown Education, and Prestonwood Christian Academy. In addition, the Collin County campus of Coram Deo Academy is in the One Church (previously Four Corners Church) facility in Plano.


title: Plano, Texas

text: Plano is the home to two campuses of Collin College, one at the Courtyard Center on Preston Park Boulevard and the larger Spring Creek Campus on Spring Creek Parkway at Jupiter. DBU North, a satellite campus of Dallas Baptist University, is in west Plano, and offers undergraduate and graduate courses and houses the admissions and academic counseling offices.


title: Plano, Texas

text: Plano is one of 12 suburbs of Dallas that opt into the Dallas Area Rapid Transit (DART) public transportation system. During its early membership in DART, Plano was lightly served by bus lines, but in 2002, the Red Line of the DART Light Rail project opened stations in Downtown Plano and at Parker Road, which provide access to commuters traveling to work elsewhere in the Dallas area. The Orange Line traverses the same route for selected weekday/peak hour trips. The Silver Line is also planned to run through Southern Plano. Approximately 1% of the city's population uses DART. The Parker Road station charged for parking for non-member city residents from April 2, 2012, to April 3, 2014, as a part of the Fair Share Parking initiative. Two DART park-and-ride bus facilities, separate from the rail lines, are in Plano: Jack Hatchell Transit Center and Northwest Plano Park & Ride.


title: Plano, Texas

text: Plano was the first city in Collin County to adopt a master plan for its road system. The use of multi-lane, divided highways for all major roads allows for higher speed limits, generally , but sometimes up to on the northern section of Preston Road. Plano is served directly by several major roadways and freeways. Central Plano is bordered to the east by U.S. Highway 75, the west by Dallas North Tollway, the south by President George Bush Turnpike (Texas State Highway 190 (east of Coit Road)), and the north by Sam Rayburn Tollway (Texas State Highway 121). Preston Road (Texas State Highway 289) is a major thoroughfare that runs through the city. Plano is Texas's largest city without an interstate highway.


title: Plano, Texas

text: Plano opened a new interchange at Parker Rd. and U.S. 75 in December 2010. The single-point interchange is the first of its kind in Texas. The design is intended to reduce severe congestion at this interchange. According to reports, traffic congestion has been reduced by 50-75%.


title: Plano, Texas

text: Plano is roughly 30 miles northeast of Dallas/Fort Worth International Airport, the primary airport serving Plano residents and visitors.


title: Plano, Texas

text: The Plano Police Department is an accredited agency and Plano's principal law enforcement agency. The department is led by Chief Ed Drain. The department has authorized staff of 414 sworn officers, 178 full-time civilian employees, and 79 civilian part-time employees. It is a member of the North Texas Crime Commission and uses the Crime Stoppers program.


title: Plano, Texas

text: Plano is part of the North Texas Municipal Water District, headquartered in Wylie, Texas. Lake Lavon is the district's principal source of raw water. Plano's water distribution system includes:


title: Jessi Combs

text: Jessica Combs (July 27, 1980 – August 27, 2019) was an American professional racer, television personality, and metal fabricator. She set a women's land speed class record (four wheels) in 2013 and broke her own record in 2016. She was known as "the fastest woman on four wheels".


title: Jessi Combs

text: She co-hosted the Spike TV show "Xtreme 4x4" for more than 90 episodes from 2005 to 2009. Other television shows on which she appeared include "Overhaulin'", "Mythbusters", "The List: 1001 Car Things To Do Before You Die", "All Girls Garage", and Science Channel's "How to Build... Everything" in 2016.


title: Jessi Combs

text: Combs died after crashing a jet-powered high-speed race car at the Alvord Desert in southeastern Oregon while attempting to beat her four-wheel land speed record. She was posthumously awarded the female land-speed world record by Guinness World Records in June 2020.


title: Jessi Combs

text: Combs was born in Rockerville, South Dakota, on July 27, 1980, the daughter of Jamie Combs and Nina Darrington. The family moved to Piedmont, South Dakota, when she was two years old. She had two siblings, Kelly Combs and Danielle Theis, and three step-siblings, Rebekah Hall, Arielle Hall, and Austin Darrington. Combs' great-grandmother was Nina DeBow, a jazz pianist who raced Stanley Steamers.


title: Jessi Combs

text: She graduated from Stevens High School in 1998. Combs graduated from WyoTech in 2004, where she attended the Collision and Refinishing Core Program, the Street Rod Fabrication and Custom Fabrication, and High-Performance Powertrain programs. Following her graduation, Combs' first professional job came after the WyoTech marketing department hired another student and her to build a car from the ground up in six months to debut at the Specialty Equipment Marketing Association's show.


title: Jessi Combs

text: On October 9, 2013, Combs drove the North American Eagle Supersonic Speed Challenger at the Alvord desert, claiming the women's four-wheel land speed record with an official run of 398.954 mph (632 km/h) and a top speed of 440.709 mph (709 km/h). In doing so, she broke the 48-year-old women's land speed record, a run average set by Lee Breedlove in "Spirit of America - Sonic 1" in 1965. On September 7, 2016, Combs set a new top speed of driving the other American Eagle.


title: Jessi Combs

text: Combs was also a 2014 Ultra 4 Spec Class National Champion with Falken Tire. In 2016, she took first place in King of the Hammers with the Savvy Off Road team in the EMC Modified Class and a 2017 12th-place finish in the Unlimited Class driving the same Stock Mod car.


title: Jessi Combs

text: Combs hosted the SpikeTV television show "Xtreme 4x4", a part of the "Powerblock", for four years. Following an on-set accident, Combs announced in February 2008 that she would leave the show.


title: Jessi Combs

text: In 2009, Combs appeared in 12 episodes of the seventh season of "MythBusters" while Kari Byron was on maternity leave. She also appeared on "Overhaulin'".


title: Jessi Combs

text: Starting in 2011, Combs hosted the Autoblog series, "The List: 1001 Car Things To Do Before You Die", alongside co-host Patrick McIntyre.


title: Jessi Combs

text: From 2011 to 2014, Combs served as one of the hosts of "All Girls Garage" on Velocity (now Motor Trend network). The basis of the show was women repairing and upgrading new and classic automobiles.


title: Jessi Combs

text: In 2012, Combs became a co-host with Chris Jacobs for the sixth season of "Overhaulin's" relaunch on the Velocity and Discovery channels.


title: Jessi Combs

text: Also in 2018, Combs appeared on an episode of "Jay Leno's Garage" as Jay Leno's guest driver of a Bugatti Chiron.


title: Jessi Combs

text: Released in 2022, "The Fastest Woman on Earth" details her career and land speed record attempt, filmed for seven years beginning in 2013.


title: Jessi Combs

text: Combs died on August 27, 2019, after crashing a jet-powered car while setting a land speed record as part of the North American Eagle Project on a dry lake bed in the Alvord Desert, Oregon. The crash was caused by a failure of a front wheel, likely caused by hitting an object in the desert, which caused the front wheel assembly to collapse at a speed nearing . The official cause of death was determined to be "blunt-force trauma to the head" occurring prior to the fire that engulfed the race vehicle after the crash.


title: Jessi Combs

text: Combs' final run across Oregon's Alvord Desert on August 27 reached , before her crash, which broke the existing women's land speed record of , set in 1976 by Kitty O'Neil at the same location. This record was verified by Guinness World Records in June 2020.


title: Gastroparesis

text: Gastroparesis (gastro- from Ancient Greek γαστήρ – gaster, "stomach"; and -paresis, πάρεσις – "partial paralysis"), also called delayed gastric emptying, is a medical disorder consisting of weak muscular contractions (peristalsis) of the stomach, resulting in food and liquid remaining in the stomach for a prolonged period of time. Stomach contents thus exit more slowly into the duodenum of the digestive tract. This can result in irregular absorption of nutrients, inadequate nutrition, and poor glycemic control.


title: Gastroparesis

text: Symptoms include nausea, vomiting, abdominal pain, feeling full soon after beginning to eat (early satiety), abdominal bloating, and heartburn. The most common known mechanism is autonomic neuropathy of the nerve which innervates the stomach: the vagus nerve. Uncontrolled diabetes mellitus is a major cause of this nerve damage; other causes include post-infectious and trauma to the vagus nerve.


title: Gastroparesis

text: Diagnosis is via one or more of the following: barium swallow X-ray, barium beefsteak meal, radioisotope gastric-emptying scan, gastric manometry, and esophagogastroduodenoscopy (EGD). Complications include malnutrition, fatigue, weight loss, vitamin deficiencies, intestinal obstruction due to bezoars, and small intestine bacterial overgrowth.


title: Gastroparesis

text: Treatment includes dietary modifications, medications to stimulate gastric emptying, medications to reduce vomiting, and surgical approaches.


title: Gastroparesis

text: Vomiting may not occur in all cases, as those affected may adjust their diets to include only small amounts of food.


title: Gastroparesis

text: Transient gastroparesis may arise in acute illness of any kind, as a consequence of certain cancer treatments or other drugs which affect digestive action, or due to abnormal eating patterns. The symptoms are almost identical to those of low stomach acid, therefore most doctors will usually recommend trying out supplemental hydrochloric acid before moving on to the invasive procedures required to confirm a damaged nerve. Patients with cancer may develop gastroparesis because of chemotherapy-induced neuropathy, immunosuppression followed by viral infections involving the GI tract, procedures such as celiac blocks, paraneoplastic neuropathy or myopathy, or after an allogeneic bone marrow transplant via graft-versus-host disease.


title: Gastroparesis

text: Gastroparesis present similar symptoms to slow gastric emptying caused by certain opioid medications, antidepressants, and allergy medications, along with high blood pressure. For patients already with gastroparesis, these can make the condition worse. More than 50% of all gastroparesis cases are idiopathic in nature, with unknown causes. It is, however, frequently caused by autonomic neuropathy. This may occur in people with type 1 or type 2 diabetes, about 30–50% among long-standing diabetics. In fact, diabetes mellitus has been named as the most common cause of gastroparesis, as high levels of blood glucose may effect chemical changes in the nerves. The vagus nerve becomes damaged by years of high blood glucose or insufficient transport of glucose into cells resulting in gastroparesis. Adrenal and thyroid gland problems could also be a cause.


title: Gastroparesis

text: Gastroparesis has also been associated with connective tissue diseases such as scleroderma and Ehlers–Danlos syndrome, and neurological conditions such as Parkinson's disease and multiple system atrophy. It may occur as part of a mitochondrial disease. Opioids and anticholinergic medications can cause medication-induced gastroparesis. Chronic gastroparesis can be caused by other types of damage to the vagus nerve, such as abdominal surgery. Heavy cigarette smoking is also a plausible cause since smoking causes damage to the stomach lining. Idiopathic gastroparesis (gastroparesis with no known cause) accounts for a third of all chronic cases; it is thought that many of these cases are due to an autoimmune response triggered by an acute viral infection. Gastroenteritis, mononucleosis, and other ailments have been anecdotally linked to the onset of the condition, but no systematic study has proven a link.


title: Gastroparesis

text: People with gastroparesis are disproportionately female. One possible explanation for this finding is that women have an inherently slower stomach emptying time than men. A hormonal link has been suggested, as gastroparesis symptoms tend to worsen the week before menstruation when progesterone levels are highest. Neither theory has been proven definitively.


title: Gastroparesis

text: On the molecular level, it is thought that gastroparesis can be caused by the loss of neuronal nitric oxide expression since the cells in the GI tract secrete nitric oxide. This important signaling molecule has various responsibilities in the GI tract and in muscles throughout the body. When nitric oxide levels are low, the smooth muscle and other organs may not be able to function properly. Other important components of the stomach are the interstitial cells of Cajal (ICC) which act as a pacemaker since they transduce signals from motor neurons to produce an electrical rhythm in the smooth muscle cells. Lower nitric oxide levels also correlate with loss of ICC cells, which can ultimately lead to the loss of function in the smooth muscle in the stomach, as well as in other areas of the gastrointestinal tract.


title: Gastroparesis

text: Gastroparesis can be diagnosed with tests such as barium swallow X-rays, manometry, and gastric emptying scans. For the X-ray, the patient drinks a liquid containing barium after fasting which will show up in the X-ray and the physician is able to see if there is still food in the stomach as well. This can be an easy way to identify whether the patient has delayed emptying of the stomach. The clinical definition for gastroparesis is based solely on the emptying time of the stomach (and not on other symptoms), and severity of symptoms does not necessarily correlate with the severity of gastroparesis. Therefore, some patients may have marked gastroparesis with few, if any, serious complications.


title: Gastroparesis

text: In other cases or if the X-ray is inconclusive, the physician may have the patient eat a meal of toast, water, and eggs containing a radioactive isotope so they can watch as it is digested and see how slowly the digestive tract is moving. This can be helpful for diagnosing patients who are able to digest liquids but not solid foods.


title: Gastroparesis

text: Dietary treatment involves low fiber diets and, in some cases, restrictions on fat or solids. Eating smaller meals, spaced two to three hours apart has proved helpful. Avoiding foods like rice or beef that cause the individual problems such as pain in the abdomen or constipation will help avoid symptoms.


title: Gastroparesis

text: Metoclopramide, a dopamine D receptor antagonist, increases contractility and resting tone within the GI tract to improve gastric emptying. In addition, dopamine antagonist action in the central nervous system prevents nausea and vomiting. Similarly, the dopamine receptor antagonist domperidone is used to treat gastroparesis. Erythromycin is known to improve emptying of the stomach but its effects are temporary due to tachyphylaxis and wane after a few weeks of consistent use. Sildenafil citrate, which increases blood flow to the genital area in men, is being used by some practitioners to stimulate the gastrointestinal tract in cases of diabetic gastroparesis. The antidepressant mirtazapine has proven effective in the treatment of gastroparesis unresponsive to conventional treatment. This is due to its antiemetic and appetite stimulant properties. Mirtazapine acts on the same serotonin receptor (5-HT3) as does the popular anti-emetic ondansetron. Camicinal is a motilin agonist for the treatment of gastroparesis.


title: Gastroparesis

text: In specific cases where treatment of chronic nausea and vomiting proves resistant to drugs, implantable gastric stimulation may be utilized. A medical device is implanted that applies neurostimulation to the muscles of the lower stomach to reduce the symptoms. This is only done in refractory cases that have failed all medical management (usually at least two years of treatment). Medically refractory gastroparesis may also be treated with a pyloromyotomy, which widens the gastric outlet by cutting the circular pylorus muscle. This can be done laparoscopically or endoscopically. Vertical sleeve gastrectomy, a procedure in which a part or all of the affected portion of the stomach is removed, has been shown to have some success in the treatment of gastroparesis in obese patients, even curing it in some instances. Further studies have been recommended due to the limited sample size of previous studies.


title: Gastroparesis

text: In cases of postinfectious gastroparesis, patients have symptoms and go undiagnosed for an average of 3 weeks to 6 months before their illness is identified correctly and treatment begins.


title: Gastroparesis

text: Cases of post-infectious gastroparesis are self‐limiting, with recovery within 12 months of initial symptoms, although some cases last well over 2 years. In children, the duration tends to be shorter and the disease course milder than in adolescent and adults.


title: Gastroparesis

text: Post-infectious gastroparesis, which constitutes the majority of idiopathic gastroparesis cases, affects up to 4% of the American population. Women in their 20s and 30s seem to be susceptible. One study of 146 American gastroparesis patients found the mean age of patients was 34 years with 82% affected being women, while another study found the patients were young or middle aged and up to 90% were women.


title: Gastroparesis

text: There has only been one true epidemiological study of idiopathic gastroparesis which was completed by the Rochester Epidemiology Project. They looked at patients from 1996 to 2006 who were seeking medical attention instead of a random population sample and found that the prevalence of delayed gastric emptying was fourfold higher in women. It is difficult for medical professionals and researchers to collect enough data and provide accurate numbers since studying gastroparesis requires specialized laboratories and equipment.


title: Steny Hoyer

text: Steny Hamilton Hoyer (born June 14, 1939) is an American politician and attorney serving as the U.S. representative for since 1981 and as House Majority Leader since 2019. A Democrat, Hoyer was first elected in a special election on May 19, 1981. As of 2022, he is in his 21st term as a member of the House. The district includes a large swath of rural and suburban territory southeast of Washington, D.C. Hoyer is the dean of the Maryland congressional delegation and the most senior Democrat in the House.


title: Steny Hoyer

text: Since 2003, Hoyer has been the second-ranking Democrat in the House of Representatives behind Nancy Pelosi. He is a two-time House majority leader, having previously served in the post from 2007 to 2011 under Speaker Pelosi. During two periods of Republican House control (2003–2007 and 2011–2019), Hoyer served as House minority whip, both times under Minority Leader Pelosi. Following the 2018 midterm elections in which the Democrats took control of the House, Hoyer was re-elected majority leader in January 2019 upon the opening of the 116th Congress; he remains the number two House Democrat behind Speaker Pelosi. He announced on November 17, 2022 that he, along with Pelosi, would not seek a leadership position in the 118th Congress, although he would remain a member of the House of Representatives.


title: Steny Hoyer

text: Hoyer was born in New York City but grew up in Mitchellville, Maryland, the son of Jean (née Baldwin) and Steen Theilgaard Høyer. His father was Danish and a native of Copenhagen; "Steny" is a variant of his father's name, "Steen". His mother was an American, with Scottish, German, and English ancestry, and a descendant of John Hart, a signer of the Declaration of Independence. He graduated from Suitland High School in Suitland, Maryland.


title: Steny Hoyer

text: In his early years at the University of Maryland College Park, Hoyer held a 1.9 grade point average. His attitude towards school and politics changed after hearing a speech from then Senator John F. Kennedy before his election in 1960. In 1963, Hoyer received his B.A. degree "magna cum laude" and graduated Omicron Delta Kappa from the University of Maryland, College Park. He was also a member of the Sigma Chi fraternity. He earned his J.D. degree from Georgetown University Law Center in Washington, D.C., in 1966.


title: Steny Hoyer

text: For four years, from 1962 to 1966, Hoyer was a member of the staff of United States Senator Daniel Brewster (D-Maryland); also on Senator Brewster's staff at that time was Nancy Pelosi, who would later become a leadership colleague of Hoyer's.


title: Steny Hoyer

text: In 1966, Hoyer won a newly created seat in the Maryland State Senate, representing Prince George's County–based Senate district 4C. The district, created in the aftermath of "Reynolds v. Sims", was renumbered as the 26th district in 1975, the same year that Hoyer was elected President of the Maryland State Senate, the youngest in state history.


title: Steny Hoyer

text: In 1978, Hoyer sought the Democratic nomination for Lieutenant Governor of Maryland as the running mate of then acting Governor Blair Lee III, but he lost to Samuel Bogley 37%–34%. In the same year, Hoyer was appointed to the Maryland Board of Higher Education, a position he served in until 1981.


title: Steny Hoyer

text: Fifth district Congresswoman Gladys Spellman fell into a coma shortly before the 1980 election. She was reelected, but it soon became apparent that she would never regain consciousness, and Congress declared her seat vacant by resolution in February 1981. Hoyer narrowly won a crowded seven-way Democratic primary, beating Spellman's husband Reuben by only 1,600 votes. He then defeated a better-funded Republican, Audrey Scott, in the May 19 special election by 56%–44%, earning himself the nickname of "boy wonder". In the 1982 general election, Hoyer won reelection to his first full term with 80% of the vote. He has faced only one relatively close contest since then, when he defeated future Governor of Maryland Larry Hogan with just 53% of the vote in 1992. His second lowest margin of victory was his 1996 bid against Republican State Delegate John Morgan, when he won reelection with 57% of the vote. Hoyer has been reelected 14 times with no substantive opposition, and is the longest-serving House member ever from southern Maryland.


title: Steny Hoyer

text: Hoyer supports and has led on the "Make It In America" plan linking domestic manufacturing industry and overall US economic success.


title: Steny Hoyer

text: Hoyer is pro-choice on abortion rights. He voted against the Partial-Birth Abortion Ban Act in 2003. (However, at the height of national polarization after the Supreme Court's intention to overturn "Roe v. Wade" had been leaked, Hoyer controversially endorsed an anti-abortion incumbent House member over his pro-choice primary challenger.) Hoyer supports affirmative action and LGBT rights. Hoyer is rated F by the NRA, indicating a pro-gun-control voting record.


title: Steny Hoyer

text: In 2008, Hoyer said he opposed providing immunity to telecom companies, but then negotiated a bill, described by Senators Patrick Leahy and Russ Feingold as a "capitulation", that would provide immunity to any telecom company that had been told by the Bush administration that their actions were legal. "No matter how they spin it, this is still immunity," said Kevin Bankston, a senior lawyer for the Electronic Frontier Foundation, a privacy rights group that has sued over President George W. Bush's wiretapping program. "It's not compromise, it's pure theater."


title: Steny Hoyer

text: In a 2009 "USA Today" opinion piece regarding healthcare reform, Steny Hoyer wrote that "[d]rowning out opposing views is simply un-American."


title: Steny Hoyer

text: In June 2010, Hoyer brought up the idea that Congress would extend only temporarily middle-class tax cuts that were set to expire at the end of the year, suggesting that making them permanent would cost too much. President Obama wanted to extend them permanently for individuals making less than $200,000 a year and families making less than $250,000.


title: Steny Hoyer

text: Hoyer voted against the impeachment of President Bill Clinton in 1999. In 2019, Hoyer voted for the impeachment of President Trump. In 2021, Hoyer voted for the second impeachment of President Trump.


title: Steny Hoyer

text: In February 2021, Hoyer made a passionate speech in Congress which has been viewed online more than two million times, criticising an incendiary Facebook post by new Republican congresswoman Marjorie Taylor Greene. The post featured a gun-toting Greene next to three members of the "Squad"—congresswomen Ilhan Omar, Alexandria Ocasio-Cortez and Rashida Tlaib, with the caption "Democrats' Worst Nightmare".


title: Steny Hoyer

text: In his speech he compared Greene's words with those of Republican Congressman Steve King, who was removed from the Judiciary and Agriculture Committees in 2019 after comments he made to the New York Times questioning why white supremacy was considered offensive. Hoyer made the point that Taylor Greene's words both in that post and other posts she had made promoting baseless conspiracy theories, were far more offensive and incendiary than the comment which led Republicans to strip King of his committee roles. He asked his colleagues to on both sides of the aisle to "do the decent thing" and strip Taylor Greene of her committee roles. The eventual vote succeeded, but only eleven Republicans joined Democrats to pass the motion by 230–199 to remove.


title: Steny Hoyer

text: Hoyer initially supported the Iraq War and was even recognized by the DLC for his vocal leadership on this issue. After the war became publicly unpopular, Hoyer said he favored a "responsible redeployment". However, he has repeatedly supported legislation to continue funding for the war without deadlines for troop withdrawal, most recently in return for increased funding of domestic projects.


title: Steny Hoyer

text: Hoyer is a supporter of Israel, and has often been allied with American Israel Public Affairs Committee (AIPAC). In September 2007, he criticized Rep. Jim Moran for suggesting that AIPAC "has pushed (the Iraq) war from the beginning", calling the comment "factually inaccurate". In January 2017, Hoyer voted for a House resolution condemning the UN Security Council Resolution 2334, which called Israeli settlement building in the occupied Palestinian territories a flagrant violation of international law and a major obstacle to peace. Hoyer supported President Donald Trump's decision to recognize Jerusalem as Israel's capital.


title: Steny Hoyer

text: In January 2019, Hoyer opposed President Donald Trump's planned withdrawal of U.S. troops from Syria and Afghanistan as "impulsive, irresponsible, and dangerous". Hoyer supports former President Obama's call for authorizing limited but decisive military action in response to the Assad regime's alleged use of chemical weapons.


title: Steny Hoyer

text: On February 28, 2014, Hoyer introduced the bill to amend the National Law Enforcement Museum Act to extend the termination date (H.R. 4120; 113th Congress) into the United States House of Representatives. The bill would extend until November 9, 2016, the authority of the National Law Enforcement Officers Memorial Fund, a nonprofit organization, to construct a museum on federal lands within the District of Columbia honoring law enforcement officers.


title: Steny Hoyer

text: Hoyer is a prolific fundraiser for House Democrats. He has been the top giver to fellow party members in the House. In the 2008 election cycle, he contributed more than $1 million to the party and individual candidates as of July 14, 2008.


title: Steny Hoyer

text: Hoyer has served as chairman of the Democratic Caucus, the fourth-ranking position among House Democrats, from 1989 to 1994; the former co-chair (and a current member) of the Democratic Steering Committee; and as the chief candidate recruiter for House Democrats from 1995 to 2000. He also served as Deputy Majority Whip from 1987 to 1989.


title: Steny Hoyer

text: When David E. Bonior resigned as Minority Whip in early 2002, Hoyer ran but lost to Nancy Pelosi. After the 2002 midterm elections, Pelosi ran to succeed Dick Gephardt as Minority Leader, leaving the Minority Whip post open again. On November 14, 2002, Hoyer was unanimously elected by his colleagues in the Democratic Caucus to serve as the Minority Whip, the second-highest-ranking position among House Democrats.


title: Steny Hoyer

text: Pelosi became the Speaker of the House in January 2007. Hoyer was elected by his colleagues to be House Majority Leader for the 110th Congress, defeating John Murtha of Pennsylvania by a vote of 149–86 within the caucus, despite Pelosi endorsing Murtha. Hoyer is the first Marylander to become Majority Leader. and became the highest-ranking federal lawmaker in Maryland history. In this post, Hoyer was the floor leader of the House Democrats and ranked second in the leadership after the Speaker who is the actual head of the majority party in the house.


title: Steny Hoyer

text: The day after the 2010 midterm elections in which the Democrats lost control of the House, Hoyer had a private conversation with Pelosi and stated that he would not challenge her bid for Minority Leader (for Pelosi to remain Democratic House Leader). He ran for minority whip, but was challenged by outgoing Majority Whip Jim Clyburn (the top House Democrats wanted to remain in the leadership, but the minority party in the House has one less position). Hoyer is moderate while Pelosi and Clyburn are more liberal, and a significant number of Hoyer's would-be supporters in the House who were moderate and conservative Democrats had been defeated for reelection. The Congressional Black Caucus backed Clyburn, while 30 House Democrats have supported Hoyer, and Hoyer has also raised money and campaigned for many candidates. Hoyer received further support from outgoing Foreign Affairs Committee Chairman Howard L. Berman, Financial Services Committee Chairman Barney Frank, and outgoing Energy and Commerce Committee Chairman Henry A. Waxman Pelosi intervened in the contest by supporting Hoyer as Minority Whip, while creating an "Assistant Leader" position for Clyburn which would keep him as the third-ranking Democrat in the House behind Pelosi and Hoyer (the existing "Assistant to the Leader" post formerly held by Chris Van Hollen is not officially part of the House leadership and was directly appointed by the Minority Leader).


title: Steny Hoyer

text: Hoyer and the DCCC have been criticized for picking their preferred candidates through an undemocratic process. In 2018, it was reported that Hoyer sought to influence the primary race in Colorado's 6th congressional district. Hoyer was recorded urging progressive candidate Levi Tillemann to drop out of the race. Hoyer acknowledged that the DCCC had already identified its choice candidate and discouraged a candid discussion about his weaknesses. On November 28, 2018, Hoyer was selected to return as House Majority Leader.


title: Steny Hoyer

text: Hoyer has three daughters, Anne, Susan, and Stefany, from his marriage to Judy Pickett Hoyer, who died of cancer in February 1997. In June 2012, after Hoyer announced his support of same-sex marriage, his daughter Stefany Hoyer Hemmer came out as a lesbian in an interview with the "Washington Blade".


title: Steny Hoyer

text: His wife was an advocate of early childhood education, and child development learning centers in Maryland have been named in her honor ("Judy Centers"). She also suffered from epilepsy, and the Epilepsy Foundation of America sponsors an annual public lecture in her name. Hoyer, too, has been an advocate for research in this area, and the Epilepsy Foundation presented him in 2002 with their Congressional Leadership Award.


title: Steny Hoyer

text: Hoyer serves on the board of trustees for St. Mary's College of Maryland and is a member of the board of the International Foundation for Electoral Systems, a nonprofit that supports international elections. He is also an Advisory Board Member for the Center for the Study of Democracy.


title: Steny Hoyer

text: In July 2018, Hoyer was hospitalized at George Washington University Hospital for pneumonia. He is a member of a Baptist church.


title: Oromo people

text: The Oromo ( Oromo: "Oromoo") are a Cushitic ethnic group native to the Oromia region of Ethiopia and parts of Northern Kenya, who speak the Oromo language (also called "Afaan Oromoo" or "Oromiffa"), which is part of the Cushitic branch of the Afroasiatic language family. They are the largest ethnic group in Ethiopia and represent a large portion of Ethiopia's population.