Hunga Tonga volcano: impact on record warming

By Javier Vinos.

Here is the Link.

Climate Change: settled or unsettled?

Here are some excerpts.

The climate event of 2023 was truly exceptional, but the prevailing catastrophism about climate change hinders its proper scientific analysis. I present arguments that support the view that we are facing an extraordinary and extremely rare natural event in climate history.

1. Off-scale warming

Since the planet has been warming for 200 years, and our global records are even more recent, every few years a new warmest year in history is recorded. Despite all the publicity given each time it happens, it would really be news if it didn’t happen, as it did between 1998 and 2014, a period popularly known as the pause.

Since 1980, 13 years have broken the temperature record. So, what is so special about the 2023 record and the expected 2024 record? For starters, 2023 broke the record by the largest margin in records, 0.17°C. This may not sound like much, but if all records were by this margin, we would go from +1.5°C to +2°C in just 10 years, and reach +3°C 20 years later.

Moreover, to produce so much warming, almost the entire globe experienced above-average warming. 2023 was a year of real global warming, although most of the warming occurred in the Northern Hemisphere.
--------------------------
Gavin Schmidt, director of NASA’s climate monitoring institute, also uses the expression “uncharted territory” when he explains that the 2023 anomaly worries scientists, saying that climate models cannot explain why the planet’s temperature suddenly spiked in 2023. Not only was the temperature anomaly much larger than expected, but it occurred months before the onset of El Niño. In his own words: “The 2023 temperature anomaly has come out of the blue, revealing an unprecedented knowledge gap perhaps for the first time since about 40 years ago. It could imply that a warming planet is already fundamentally altering how the climate system operates, much sooner than scientists had anticipated.”[iii] According to Gavin, we could have broken the climate and the models would no longer work.

Instead of abandoning science for wild speculation let’s examine the possible factors responsible for the abrupt warming that Gavin Schmidt dismisses by saying they could explain at most a few hundredths of a degree, for which he has little evidence.

Dismissing natural warming

On the one hand, we have an absolutely unprecedented abrupt warming that the models cannot explain and that has scientists scratching their heads. Such anomalous warming cannot logically respond to the usual suspects, El Niño, reduced sulfur emissions, or increased CO₂, which have been going on for many decades.

On the other hand, we have an absolutely unprecedented volcanic eruption, the effects of which we cannot know, but which, according to what we know about the greenhouse effect, should cause significant and abrupt warming.

Of course, we cannot conclude that the warming was caused by the volcano, but it is clear that it is by far the most likely suspect, and any other candidate should have to demonstrate its ability to act abruptly with such magnitude before being seriously considered.

So why do scientists like Gavin Schmidt argue, without evidence or knowledge, that the Tonga volcano could not have been responsible? If the effect were cooling, the volcano would be blamed without a second’s hesitation, but significant natural warming undermines the message that warming is the fault of our emissions.

Doing Hard Things

The story of Master Sgt. Roddie Edmonds, by Will Dabbs, MD at American Handgunner.

 What exactly defines a person’s character? Why are some folks simply horrible, most monotonously average, and others frankly amazing? What is that ethereal secret sauce that drives certain rare personalities to, when faced with a true life-or-death circumstance, rise gloriously to the occasion? I have no idea, but Master Sergeant Roddie Edmonds had gobs of it.

 In late 1944, Roddie Edmonds was serving in Europe as an infantryman with the 422nd Infantry Regiment, 106th Infantry Division — the “Golden Lions.” The war was clearly over, and the Germans were all but beaten. There were rumblings that the troops might even be home in time for Christmas. And then Hitler launched Operation Wacht am Rhein.

Wacht am Rhein literally translates as “Watch on the Rhine.” The name was taken from a popular German military marching song. Watch on the Rhine was going to change everything.

 Order of Battle

 The Germans were indeed losing the war. The Allies had gained a foothold on D-Day some six months earlier and then had pressed relentlessly forward ever since. The Soviet Operation Bagration on the Eastern Front had ground the German Army Group Center into dog food. Overwhelming air superiority had left the vaunted Luftwaffe a shell of its former self.

 In mid-December of 1944, the Allies fielded 96 divisions in the West. There were a further 10 en route from the US. Facing this juggernaut were some 55 understrength German Wehrmacht and Waffen SS division-sized formations. However, the Allies were tired. The Germans had made them bleed for every inch of French soil. Then, on 16 December 1944, the Germans rolled west through the Ardennes with 410,000 men, 1,400 tanks and armored fighting vehicles, 2,600 artillery pieces, and over 1,000 combat aircraft. Surprise, both tactical and strategic, was utter, overwhelming and complete.

 I knew two veterans who were there. They said the Battle of the Bulge was horrifying up close. The SS vanguard slammed into the battered American defensive lines like a tidal wave, overrunning advanced positions and enveloping entire combat units. One of those was the American 442d Infantry Regiment.

 Dire Fortunes

 Tens of thousands of Americans were captured in that initial onslaught. One of those was Master Sgt. Roddie Edmonds. At the time of his capture, he had only been on the front for five days.

 The Germans placed Master Sgt. Edmonds in Stalag IX-A, a POW camp for enlisted troops outside Bonn. At age 25, Edmonds found himself the senior NCO in the camp. I wouldn’t trust most modern 25-year-olds these days unsupervised with string. By contrast, Edmonds was now responsible for the well-being of some 1,275 American POWs.

 With the benefit of hindsight, we now know how it all turned out. As December 1944 turned into January 1945, however, there was still an enormous amount of uncertainty on the ground in Europe. In few places were things less certain than in Stalag IX-A. On 27 January 1945, Edmonds’ first day at the camp, German Camp Commandant Siegmann ordered Master Sgt. Edmonds to identify all of the Jewish prisoners so they could be remanded to the death camps. Without hesitation, Edmonds mustered all 1,275 of the men under his charge and had them stand in formation.

 A Life-Defining Moment

 Siegmann was livid. Drawing his pistol, he placed the muzzle to Edmonds’ forehead and demanded he identify the Jews. Master Sgt. Edmonds, himself a devoted Baptist, responded, “We are all Jews here.”

 With a gun literally at his head, Edmonds calmly explained that if the Germans wanted to kill the Jews, they would have to kill them all. He further reminded the German officer that he would eventually be prosecuted for war crimes if he followed through with his plans. The young NCO then explained that captured troops were required to provide nothing more than their name, rank and service number, not their religion. The German camp commander holstered his pistol and walked away. Edmonds’ actions that frigid morning on the POW camp parade ground saved the lives of more than 200 Jewish prisoners.

 The Quiet Hero

 Master Sgt. Edmonds endured a total of 100 days in captivity before being repatriated. He never told anyone of his exchange with the German camp commandant. Edmonds later saw combat in Korea as well.

 Roddie Edmonds eventually came home to raise a family and make his living selling mobile homes and cable television. He passed away in 1985. As his son, a Baptist minister, was going through his things, he came across his father’s diary.

 Though his Dad had never mentioned the exchange with the German officer, Edmonds had documented everything. Edmonds’ son made inquiries, eventually tracking down some other POWs who were there. One of those was a Jewish-American veteran named Sonny Fox. After the war, Fox worked as an executive for NBC. Fox and several others came forward and attested that the events occurred exactly as I have described them here today.

Recognizing Greatness

 In 2015, Israel’s Yad Vashem, the official world Holocaust remembrance center, posthumously bestowed upon Master Sgt. Roddie Edmonds the honorific Righteous Among Nations. This is the highest honor Israel can confer on a non-Jew for sacrificing to save Jews during the Holocaust. Edmonds is one of only five Americans to be so designated.

 During WWII, the Germans systematically murdered some six million Jews. They killed a further 11 million other people they deemed to be inferior. However, on 27 January 1945, one brave American Baptist stood defiantly with a gun to his head and declared himself a Jew. In so doing, he saved the lives of more than 200 of his comrades. Righteous Among Nations indeed …

 Subscribe To American Handgunner 

How Retired Corrections Officer Defended His Life and Liberty Against Violent Attackers

I have not verified the following but did ascertain that there was such a court case.

An overzealous prosecution such as described is not unheard of.
------------------------------------------
Retired Corrections Officer Kirk Culik and his wife live in Hillsdale County, Michigan. Hillsdale County is the home of Hillsdale College, known for its strict adherence to the United States Constitution. It is also where Culik not only had to defend himself from three attackers but also had to defend himself from an overzealous prosecutor.

In May of 2022, Culik, a U.S. A. Hockey U18 coach, was unloading groceries with his wife from his car when a teenager approached him. According to Mr. Culik and evidence presented in court, the teenage chest-bumped Mr. Culik before another sucker punched him. A third teen came up from behind Culik and smashed a wine bottle over his head, giving Culik a concussion. The three teens repeatedly punched and kicked him as he was on the ground. Mr. Culik believed his life was in danger.

Mr. Culik stated he did not know the teens carrying out the seemingly random attack but believed they might be trying to steal his truck. He was not and still is unsure, but he knew he was in serious trouble. Mr. Culik had the great equalizer. He was armed, and having trained at MDFI, he knew what he had to do to possibly save his life. He managed to reach his gun, firing one shot and hitting and killing one of the attackers. The others fled the scene.

Earlier on, the three teens went on a crime spree. They stole a boat and a car. They also vandalized a park, all the while doing drugs and drinking. Mr. Culik told his wife to call 911 after defending himself. He thought his ordeal was over, but once police arrived from the small police force, they arrested Mr. Culik on the spot. He didn’t have to invoke his right to remain silent because the police didn’t ask any questions. Less than an hour later, he was indicted for murder.

The cancer survivor faced a long, hard road ahead of him, but he refused to plead guilty. He would fight for his freedom in court, but the ordeal would cost him. Mr. Culik was denied bond for 90 days and sent to jail, where he would be placed in solitary confinement for 102 days. In those 102 days, the lights were never turned off. He was told he was in solitary confinement because of “COVID.” The three-time cancer survivor was also denied medical treatment for the same excuse for 72 days

Eventually, the bond would be set, but to everyone’s shock, it was the highest in Hillsdale’s history. Mr. Culik’s bond was set to a mind-blowing $400,000. Not only that, but the judge demanded that it be paid in full in cash. Most bonds work by someone coming up with 10% of the bond value. The judge insisted every penny be put up in this case. Luckily for Culik, his family came through. His sister mortgaged her house to get the money, and after spending 703 days in jail, he was out and ready to fight back in court. That is, if he could get a fair trial, which was in doubt since he could not get even the speedy trial promised by the U.S. Constitution.

Shortly after the trial began, Mr. Culik’s lawyer was tipped off by someone in the Michigan State Police that law enforcement had given over evidence to the prosecution in the form of drone footage. The prosecution did not turn over evidence to the defense even though they were required to until the defense demanded it. Without the tip-off, it would have never seen the light of day. The drone footage not only showed what happened but also that the prosecution’s two star witnesses were not present during the attack.

It also came to light that the judge held ex parte meetings without the defense being present. A similar situation happened in the Young Thug case in Atlanta, leading many to believe that the case will be overturned if the rapper is convicted of murder. This situation was very similar.

While the case continued, Mr. Culik’s wife had to leave their home due to death threats. Their lives were being turned upside down. The ordeal would not be quick. Finally, on April 23, 2024, Mr. Culik heard the words he was waiting two years to hear, “Not guilty.”

The media covered the initial incident, but when the facts of the case started coming out, those same papers remained silent. When the narrative was about a 62-year-old man gunning down a teen, the media were interested in reporting the news, but when it became a clear-cut case of self-defense, the coverage dried up.

Mr. Culik was free, but the process of his punishment was costly. Culik did not have any concealed carry insurance and spent over $200,000 on his legal defense. An innocent man was forced to sell everything he owned to fight for his freedom, but the folks at MDFI are stepping up to help.

MDFI has a program called “Operation Skywalker.” It is an alum program that helps those in need, and Mr. Culik is one of those alumni. The goal is to raise $100,000 to help Mr. Culik get back on his feet, although that only covers half his legal bills. When there is injustice, we must help those affected.

If you would like to donate to help Mr. Culik, you can do so by donating at https://www.givesendgo.com/OPERATIONSKYWALKER

Jonathan Turley puts Presidential Immunity in perspective

No, President Biden, the Supreme Court Did Not Remove All Limits on the Presidency

President Joe Biden delivered an address from the White House last night on the presidential immunity decision by the Supreme Court. While pledging that he will defend the rule of law, President Biden misrepresented what that law is in the aftermath of Trump v. United States. While we have often discussed false constitutional claims by the President as well as other false statements, an address of this kind is particularly concerning in misleading citizens on the meaning of one of the most important decisions in history.

As I have previously written, I am not someone who has favored expansive presidential powers. As a Madisonian scholar, I favor Congress in most disputes with presidents. However, I saw good-faith arguments on both sides of this case and the Court adopted a middle road on immunity — rejecting the extreme positions of both the Trump team and the lower court.

One of the most glaring moments in the address came when President Biden declared that “for all…for all practical purposes, today’s decision almost certainly means that there are virtually no limits on what a president can do.”

That is not true.

The Court found that there was absolute immunity for actions that fall within their “exclusive sphere of constitutional authority” while they enjoy presumptive immunity for other official acts. They do not enjoy immunity for unofficial, or private, actions.

The Court has often adopted tiered approaches in balancing the powers of the branches. For example, in his famous concurrence to Youngstown Sheet & Tube Co. v. Sawyer, 343 U.S. 579 (1952), Justice Robert Jackson broke down the line of authority between Congress and the White House into three groups where the President is acting with express or implied authority from Congress; where Congress is silent (“the zone of twilight” area); and where the President is acting in defiance of Congress.

Here the Court separated cases into actions taken in core areas of executive authority, official actions taken outside those core areas, and unofficial actions. Actions deemed personal or unofficial are not protected under this ruling.

It is certainly true that the case affords considerable immunity, including for conversations with subordinates. However, this did not spring suddenly from the head Zeus. As Chief Justice John Roberts lays out in the majority opinion, there has long been robust protections afforded to presidents.

There are also a host of checks and balances on executive authority in our constitutional system. This includes judicial intervention to prevent violations of the law as well as impeachment for high crimes and misdemeanors.

President Biden’s hyper-ventilated response is crushingly ironic. He was vice president when President Barack Obama killed an American citizen without a trial or a charge. When former Attorney General Eric Holder announced the “kill list” policy (that included the right to kill any American citizen), he was met with applause, not condemnation.

The Obama-Biden administration then fought every effort by the family to sue the government. President Biden would have been outraged by any attempt of a Republican district attorney to charge him or President Obama with murder.

He would also be outraged by prosecutors pursuing criminal charges for the deaths associated with the deluge of undocumented persons over the Southern border.

In his address, President Biden also claimed that “the law would no longer” define “the limits of the presidency.”

That is also untrue. This case was remanded for the purpose of defining what of these functions would be deemed private as opposed to official. Even on official actions, former president Donald Trump could be prosecuted if the presumptive immunity is rebutted by prosecutors.

What was most glaring for many civil libertarians was President Biden’s portrayal of himself as a paragon of constitutional fealty. He declared that “I know I will respect the limits of the presidential powers as I have for the last three-and-a-half years.”

That was also untrue. President Biden has racked up an impressive array of losses in federal courts where he was found to have violated the constitution.

This includes rulings that his administration has exceeded his authority and engaged in racial discrimination in federal programs. Indeed, Biden has often displayed a cavalier attitude toward such violations.

For example, the Biden administration was found to have violated the Constitution in its imposition of a nationwide eviction moratorium through the Centers for Disease Control and Prevention (CDC). Biden admitted that his White House counsel and most legal experts told him the move was unconstitutional. But he ignored their advice and went with that of Harvard University Professor Laurence Tribe, the one person who would tell him what he wanted to hear. It was, of course, then quickly found to be unconstitutional.

Biden showed the same disregard over the unconstitutionality of his effort to unilaterally forgive roughly half a trillion dollars in student debt. Courts have already enjoined that effort as presumptively unconstitutional (though an appellate court in one of those cases relaxed aspects of the injunction).

The address was used to reinforce his “democracy is on the ballot” campaign theme. Pundits have repeated the mantra, claiming that if Biden is not elected, American democracy will perish.

While some of us have challenged these predictions, the other presidential candidates are missing a far more compelling argument going into this election. While democracy is not on the ballot this election, free speech is.

For many of us in the free speech community, President Biden has become the most anti-free speech president since John Adams. As discussed in my new book, “The Indispensable Right: Free Speech in an Age of Rage,” the Biden Administration has helped fund and maintain an unprecedented censorship system in the United States.

That record is hardly supportive for a president claiming to be the defender, if not the savior, of the Constitution.

Fasten your seatbelts

Patrick Veillette at aviationweek.com

Here is the link.

Here are some excerpts.

There is a common misperception that vortices are not a factor during cruise flight. While the majority of wake turbulence encounters occur during terminal phases of flight, a Flight Safety Foundation study by this author found that 13% of NASA Aviation Safety Reporting System (ASRS) wake turbulence reports occurred during high-altitude cruise flight.

The unique characteristics of a wake turbulence encounter at altitude can cause an elevated risk to the aircraft occupants as well as the structural integrity of the aircraft. The following ASRS report is indicative of a “Cross-Track Penetration.” This occurs when the trailing aircraft crosses another aircraft’s wake at a sharp angle.

“Our company’s Gulfstream IV departed Teterboro, New Jersey, on a routine night trip to Fort Myers (FMY), Florida, with a crew of three and two passengers, the company’s chairman and his wife. The trip was CAVU with smooth air… At approximately FL250 south of Sarasota on the arrival, Miami Center advised us we might see traffic crossing from right to left, 757 traffic enroute to Miami. We spotted the 757 cross so far ahead that we did not bother to acknowledge visual contract. Suddenly at about 15,000 feet and 300 knots, we hit what I thought was another aircraft, or we had an explosion on board the aircraft. The shock was something I have never experienced in my 19,964 hours of flight time or in any other physical encounter. It felt like we hit a 20-foot thick concrete wall at 300 knots.”

“Fortunately, we had completed the descent in range checklist. We were harnessed and the cabin seat belt sign was on. Everything in the cockpit that could move, did—manuals, clipboard, maintenance record, etc., even the steel approach plate holder secured on the yoke came up and hit me in the face. I thought we had a momentary total power failure, but that was not the case. We slowed to 200 knots because we were still unsure of damage to the Gulfstream. I went back to check on the cabin and passengers, and upon opening the door all the horror of total disaster was there. Debris was everywhere, broken china, smashed crystal glassware, silverware, even the stowed tray tables had lifted out of the side cabinets and traveled around the cabin. More importantly, the flight attendant was injured and the chairman’s wife lay on the floor in severe pain. Both had been jettisoned to the ceiling then slammed to the floor in a microsecond. I called ahead for an ambulance and asked approval for special handling priority for medical emergency. The chairman’s wife 12th and 14th vertebrae were broken and total recovery took a full year. The flight attendant was treated and released with severe bruises.” [NASA ASRS report no. 265754. December 1993.]

Recurrence Rate of Melanoma in Situ Excised With a 5-mm Excisional margin

 From jamanetwork.com.

 Here is the link.

Pistol malfunctions and how to clear them

 From American Handgunner.

 Very clear with pictures showing the procedures.

Here is the link.

 https://americanhandgunner.com/discover/malfunctions-you-are-going-to-have-them/

Age of Rage: America’s Anti-Free Speech Movement Forces Us Again To Choose Between Our Rights and Our Rage

 From Jonathan Turley.

 JT is on target.

------------------------------------------

As the nation heads into the July 4th holiday, we have rarely been more divided as a people. Ironically, we are still debating the core values that define us, particularly the right to free speech. Indeed, “debate” hardly captures the rising anger and animosity from campuses to Congress. That is also nothing new.

While I have called this “an age of rage,” it is not our first. The United States was born in rage.

Roughly 250 years ago, a group calling itself the Sons of Liberty boarded three ships and dumped almost 100,000 pounds of English tea into the Boston harbor. The “Boston Tea Party” is still celebrated as an act of defiance that helped spark the American Revolution.

It was also an act of rage, a key moment that is the focus of my book out this week, “The Indispensable Right: Free Speech in an Age of Rage.”

As a nation, we have gone through almost cyclic periods of unhinged rage, including periods of what I call “state rage.” The first victim has always been free speech, including in our current age of rage. Indeed, this is arguably the most dangerous anti-free speech period in our history.

“The Indispensable Right“ is a reference to the description of Justice Louis Brandeis of core value in our nation. It is also a reference that captures our inherent conflict with free speech. Brandeis and his colleague Oliver Wendell Holmes are enshrined as civil libertarians who became the “great dissenters,” arguing for rights that remained unrealized for decades.

Yet, these two jurists would support some of the most abusive denials of free speech in our history. Holmes would supply the single most regrettable line of any opinion: that free speech protections do not allow citizens to shout fire in a crowded theater. That paraphrasing of his decision in Schenck v. United States continues to be used today as a rationalization for censorship and limits on free speech.

On free speech, Brandeis and Holmes were no heroes. Our true heroes are detailed in this book, a collection of true dissenters — anarchists, unionists, communists, feminists and others who risked everything to fight for their right to speak.

George Bernard Shaw once said “a reasonable man adjusts himself to the world. An unreasonable man expects the world to adjust itself to him. Therefore, all progress is made by unreasonable people.”

These are stories of wonderfully unreasonable people like Anita Whitney, a feminist who left a family of privilege to fight for social and political justice. The descendent of a family on the Mayflower and niece of Supreme Court Justice Cyrus W. Field, Whitney defied threats of the police that she would be arrested if she spoke in California in 1919 in Oakland.

With police standing around on stage, she refused to be silent and spoke against the lynchings of Blacks occurring around the country. Her abusive conviction would ultimately go before the court (with Brandeis and Holmes) and they would vote to uphold it.

Time and again, this country has abandoned our free speech values as political dissidents were met with state rage in the form of mass crackdowns and imprisonments. It is an unvarnished story of free speech in America and for better or worse, it is our story.

Yet, we have much to learn from this history as this pattern now repeats itself. The book explains why we are living in the most dangerous anti-free speech period in our history.

In the past, free speech has found natural allies in academia and the media. That has changed with a type of triumvirate — the government, corporations, and academia — in a powerful alliance against free speech values.

Ironically, while these groups refer to the unprecedented threat of “fake news” and “disinformation,” those were the very same rationales used first by the Crown and then the U.S. government to crack down on free speech in the early American republic.

The difference is the magnitude of the current censorship system from campuses to corporations to Congress. Law professors are even calling for changing the First Amendment as advancing an “excessively individualistic” view of free speech. The amendment would allow the government to curtail speech to achieve “equity” and protect “dignity.”

Others, including President Biden, have called for greater censorship while politicians and pundits denounce defenders of free speech as “Putin lovers” and “insurrectionist sympathizers.”

Despite watching the alarming rise of this anti-free speech movement and the rapid loss of protections in the West, there is still reason to be hopeful.

For those of us who believe that free speech is a human right, there is an inherent and inescapable optimism. We are wired for free speech as humans. We need to speak freely, to project part of ourselves into the world around us. It is essential to being fully human.

In the end, this alliance may reduce our appetite for free speech but we will never truly lose our taste for it. It is in our DNA. That is why this is not our first or our last age of rage. However, it is not the rage that defines us. It is free speech that defines us.

A 2024 Mid-Priced Automobile Sells for the Same $300 Price Paid for a Model T Ford in 1924

From George Reisman.

An interesting perspective about inflation.

It really does, if you can pay for it in Gold dollars. Based on the present price of gold bullion, of approximately $2,000 per ounce, a twenty-dollar US gold coin, which contains not quite an ounce of gold, sells for just about $2,000. Put together 15 of these $20 gold coins and you have 300 gold dollars, which represents $30,000 paper dollars, which is the price of a new mid-range automobile.

Who says prices have gone up? The truth is that the price of our paper money has plunged. When we had a gold standard, the price of a paper dollar was a gold dollar. Today, the price of a paper dollar is just one gold cent. So it takes correspondingly more of this cheap money to buy anything.

Here’s how to stop this process. Just repeal whatever laws are in the way of merchants accepting gold and silver coins at their actual market bullion value, not their face value. Consider, for example, that the price of silver is now about $24 per ounce. An old pre-1964 dime contains .0715 ounces of silver, a quarter contains 2.5 times as much, and a half dollar contains 5 times as much. (A silver dollar contains more than 10 times as much.) The silver content of a dime, times its current price per ounce, gives it a market value on the order of $1.70, which means, for example, that a $10 meal in a fast-food restaurant costs less than 60 cents in silver coin.

If precious-metal coins could be used at their market value, Gresham’s so-called “Law” that “bad money drives out good money,” would be totally reversed. Good money, i.e., gold and silver, would drive out bad money, i.e., irredeemable paper money. People would see every day, when they went shopping, that prices were rising only in paper money, not in the precious-metal money (or paper money redeemable on demand in precious metal). They would turn against the paper, unless and until they could have confidence that it could easily be redeemed for precious metal.

Mohs surgery in the treatment of melanoma

 From the Journal of the American Academy of Dermatology.

Here is the link.

Here is the abstract.

---------------------------------

Mohs Micrographic Surgery (MMS) for treatment of melanoma offers several advantages over wide local excision (WLE), including complete histologic margin evaluation, same-day resection and closure, and sparing of healthy tissue in critical anatomic sites. Recently, a large volume of clinical data demonstrating efficacy in MMS treatment of melanoma was published, leading to emerging patient safety considerations of incurred treatment costs, risk of tumor upstaging, and failure of care coordination for sentinel lymph node biopsy (SLNB). MMS offers a safe, effective, and value-based treatment for both melanoma in situ (MIS) and invasive melanoma (IM), particularly with immunohistochemistry use on frozen sections. Compared to wide local excision, MMS treatment demonstrates similar or improved outcomes for local tumor recurrence, melanoma-specific survival, and overall survival at long-term follow-up. Tumor upstaging risk is low, and if present, alteration to clinical management is minimal. Discussion of SLNB for eligible head and neck IM cases should be done prior to MMS. Though challenging, successful multidisciplinary coordination of SLNB with MMS has been demonstrated. Herein, we provide a detailed clinical review of evidence for MMS treatment of cutaneous melanoma and offer recommendations to address current controversies surrounding the evolving paradigm of surgical management for both MIS and invasive melanoma (IM).