Myotonic dystrophy type I (DM1) is the most common type of adult-onset muscular dystrophy. DM1 is caused by mutations in the DMPK gene. A normal DMPK gene has 3 to 37 repetitions of the CTG sequence, while in DM1, there are hundreds to thousands of repetitions of this sequence. When a DMPK gene with too many CTG repeats is transcribed, the resulting RNA is too long. This abnormally long RNA is toxic to cells, and those affected experience progressive muscle wasting and weakness.

CRISPR-Cas9 is a technique increasingly used in efforts to correct the genetic defects that cause a variety of diseases. Now a research team from the University of California, San Diego (UCSD), School of Medicine, reports they redirected the technique to modify RNA in a method they call RNA-targeting Cas9 (RCas9), to eliminate the toxic RNA and almost fully reverse symptoms in a mouse model of myotonic dystrophy.

Their findings, The sustained expression of Cas9 targeting toxic RNAs reverses disease phenotypes in mouse models of myotonic dystrophy type 1, was published in Nature Biomedical Engineering and led by Gene Yeo, PhD, professor of cellular and molecular medicine at UCSD School of Medicine.

Myotonic dystrophy is part of a group of inherited disorders called muscular dystrophies. There are two major types of myotonic dystrophy: type 1 and type 2. The muscle weakness associated with type 1 particularly affects muscles farthest from the center of the body, such as those of the lower legs, hands, neck, and face. Muscle weakness in type 2 primarily involves muscles close to the center of the body, such as those of the neck, shoulders, elbows, and hips. The two types of myotonic dystrophy are caused by mutations in different genes.

Many other severe neuromuscular diseases, such as Huntingtons and ALS, are also caused by similar RNA buildup, explained Yeo. There are no cures for these diseases. Yeo led the study with collaborators at Locanabio and the University of Florida.

CRISPR-Cas9 works by directing Cas9 to cut a specific target gene, allowing researchers to inactivate or replace the gene. However, the Cas9 in the RCas9 method is guided to an RNA molecule instead of DNA. In a previous study, Yeo and his team established RCas9 as a means to track RNA in living cells in a programmable manner without genetically encoded tags. In a 2017 study, in lab models and patient-derived cells, the researchers used RCas9 to eliminate 95% of the abnormal RNA linked to myotonic dystrophy type 1 and type 2, one type of ALS and Huntingtons disease.

In the current study, the method goes further, by reversing myotonic dystrophy type 1 in a mouse model of the disease. Toxic RNAs expressed from such repetitive sequences can be eliminated using CRISPR-mediated RNA targeting, yet evidence of its in vivo efficacy and durability is lacking, noted the researchers. Here, using adult and neonatal mouse models of DM1, we show that intramuscular or systemic injections of adeno-associated virus (AAV) vectors encoding nuclease-dead Cas9 and a single-guide RNA targeting CUG repeats results in the expression of the RNA-targeting Cas9 for up to three months, redistribution of the RNA-splicing protein muscleblind-like splicing regulator 1, elimination of foci of toxic RNA, reversal of splicing biomarkers and amelioration of myotonia.

The researchers packaged RCas9 in a non-infectious virus. They then gave the mice a single dose of the therapy or a placebo. RCas9 reduced the abnormal RNA repeats by more than 50%, varying a bit depending on the tissue, and the treated myotonic dystrophy mice became indistinguishable from healthy mice.

To prevent the potential of the RCas9 proteins, developing an immune reaction in the mice, the researchers tried suppressing the mices immune systems briefly during treatment. As a result, they were surprised to see that they successfully prevented immune reaction and clearance. The researchers did not see signs of muscle damage, but found an increase in the activity of genes involved in new muscle formation.

Yeo believes the findings will open a new avenue of understanding and lead the way for treating other genetic diseases. This opens up the floodgates to start testing RNA-targeting CRISPR-Cas9 as a potential approach to treat other human genetic diseasesthere are at least 20 caused by buildup of repetitive RNAs, Yeo added.

Read the original here:
Muscular Dystrophy Condition in Mice Reversed by RNA-Targeting Cas9 - Genetic Engineering & Biotechnology News

Recommendation and review posted by Bethany Smith

CAMBRIDGE, Mass.--(BUSINESS WIRE)--Sherlock Biosciences, an Engineering Biology company dedicated to making diagnostic testing better, faster and more affordable, today announced the formation of The 221b Foundation, a nonprofit organization committed to addressing the global COVID-19 pandemic by enabling access to intellectual property associated with the companys SHERLOCK CRISPR-based technology. Proceeds from any company or third-party sales of SHERLOCK CRISPR COVID-19 products will support racial and gender diversity in science, technology, engineering, and mathdisciplines collectively known as STEM.

The 221b Foundations initial leadership includes board members Rahul Dhanda, co-founder, president and CEO of Sherlock Biosciences, and Mark Jefferson, assistant dean for community engagement and equity at Harvard Law School.

COVID-19 has undoubtably had a devastating impact on the world. At the same time, there are organizations such as Sherlock that have benefitted by rapidly responding to address the pandemic, which has accelerated our companys innovation and overall plans, said Dhanda. The 221b Foundation is our way of giving back, furthering our commitment to racial and gender diversity especially within the Black Community in STEM, while also sharing our progress with other organizations that can join in the fight against this global pandemic.

The Foundations first partner in this effort is Scratch, the programming language and online community designed for young people ages 8-16. Used in more than 150 countries and available in more than 40 languages, Scratch is committed to helping young people think creatively, reason systematically and work collaboratively. Scratch, which was originally developed at MIT, will dedicate this funding to programs that benefit the Black, Latinx and Native American communities, along with young women and girls.

We are excited to partner with The 221b Foundation to advance our efforts to further equity in computer science education, particularly supporting young people from communities that face systemic inequities and injustice, said Champika Fernando, acting executive director of Scratch. Our commitment to equity and justice throughout all of our work, from the design of our creative coding tools and online community to our outreach programs that support schools and educators, aligns perfectly with The 221b Foundations mission. We look forward to working together to further our shared goal of ensuring representation and equity in STEM throughout the world.

COVID-19 and diversity issues are major crises of our time, both of which are ravaging institutions throughout the world, said Jefferson. I am excited to help The 221b Foundation lead a proactive effort to alleviate the social and healthcare burden through scientific development, educational support and community outreach.

About SHERLOCK

SHERLOCK is a method for single molecule detection of nucleic acid targets and stands for Specific High Sensitivity Enzymatic Reporter unLOCKing. SHERLOCK utilizes CRISPR as a method for smart amplicon detection and can be adapted for use with existing diagnostic instruments, improving time to result due to the technologys large multiplex capacity. When a specific sequence of DNA or RNA is present, the CRISPR enzyme is activated and, much like a pair of scissors, starts cutting nearby genetic material, releasing a fluorescent signal that indicates a positive result.

About The 221b Foundation

The 221b Foundation was founded with the dual mission to assist in the eradication of COVID-19, while supporting racial and gender diversity in STEM. By providing support and intellectual property that enables both non-profit and for-profit entities to develop CRISPR-based diagnostic testing, The 221b Foundation seeks to aid in the fight against the global COVID-19 pandemic while furthering access and diversity in STEM industries. Led by industry experts in the fields of diagnostic testing, STEM and diversity, The 221b Foundation envisions a world where advances in CRISPR technology fuel the innovations that will put an end to the COVID-19 pandemic. For more information, please visit: 221bfoundation.org.

About Sherlock Biosciences

Sherlock Biosciences is dedicated to making molecular diagnostics better, faster and more affordable through Engineering Biology platforms. The company is developing applications of SHERLOCK, a CRISPR-based method to detect and quantify specific genetic sequences, and INSPECTRTM, a Synthetic Biology-based molecular diagnostics platform that is instrument-free. SHERLOCK and INSPECTR can be used in virtually any setting without complex instrumentation, opening up a wide range of potential applications in areas including precision oncology, infection identification, food safety, at-home tests, and disease detection in the field. In May 2020, the company received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) for its Sherlock CRISPR SARS-CoV-2 kit, the first FDA-authorized use of CRISPR technology. For more information visit Sherlock.bio.

Read more from the original source:
Sherlock Biosciences Launches The 221b Foundation to Address the COVID-19 Pandemic and Equity in STEM - Business Wire

Recommendation and review posted by Bethany Smith

Depression is a dark horse.

The disease often goes unnoticed, but affects work performance, social interaction and the ability to take pleasure in everyday life. According to theNational Center for Biotechnology Information, antidepressants only help around 50 percent of those who struggle with depression and anxiety and, even when they are effective, scientists have yet to understand how they work in the brain.

MSU associate professor of physiology A.J. Robison and his lab used new CRISPR-based technology to uncover pathways of depression-like behavior in the mouse brain. Credit: College of Natural Science

But groundbreaking research in the lab of Michigan State University scientistA.J. Robison, associate professor in theDepartment of Physiologyand MSUsNeuroscience Program, is directing some new rays of light onto the molecular, cellular and circuit-level mechanisms underlying depression-like diseases.

Theresultswere recently published inNature Communications.

In this paper, we perform the first ever CRISPR-based gene editing [a genetic engineering technique in molecular biology by which the genomes of living organisms may be modified] in a single circuit between two areas of the mouse brain, explained Robison about the culmination of five years of research funded by the National Institutes of Mental Health. We can reach into the mouse brain and manipulate specific genes in a circuit involved in depression and anxiety-like behaviors a critical advance on the road to genetic medicine for psychiatric diseases.

Scientists estimate there are roughly 80-100 billion neurons connecting regions of the brain. To accomplish the feat of locating and manipulating a single gene in a single circuit required new and sophisticated technology. With the expertise of co-author Rachael Neve, director of theGene Transfer Core at Massachusetts General Hospital, they developed it.

The key advance is that we designed a dual-vector system to manipulate a specific gene in the connections between two brain areas, and that has never been done before, Robison said.

Cross section of a mouse brain. The projections of the cells between the vHPC and NAc, shown here in neon green, are manipulated by the new CRISPR viral vector-based technology developed by Rachael Neve and the Robison Lab. Credit: Andrew Eagle

The neurons that Robison and his team zeroed in on originate in the ventral hippocampus (vHPC), a deep-seated structure that projects to regions in the brain important in stress susceptibility, mood and social avoidance. Neurons rooted in the vHPC reach out with branch-like structures called axons to connect with the nucleus accumbens, or NAc. The completed circuit is regulated by the star of the pioneering paper, the transcription factor known as DFosB.

Using the viral vector technology specifically designed and packaged by Neve, the team split the CRISPR system in half. Half of the system, inert on its own, was an enzyme that can mutate DNA in the vHPC. The other half, a guide RNA, was sent to all cells that project to the NAc and tells the enzyme where to bind and the specific gene to mutate. Only those cells specific to the circuit from the vHPC to the NAc got both halves, triggering the enzyme to bind with and turn off a single gene: FosB.

When the FosB gene was turned off in the neurons, we were able to get a circuit-specific behavioral effect relevant to a disease like depression, said Robison about the landmark discovery. When we put it back, or rescued it within the circuit, the effect was erased.

Claire Manning was a key contributor to the groundbreaking study and is now a postdoctoral researcher at Stanford University. Credit: Ken Moon

One of the most exciting findings from our investigations was the circuit-specific role of the FosB protein in conferring resilience to stress, Eagle said. We also discovered that FosB altered the excitability of hippocampal circuit neurons and may be affecting long-term downstream changes that lead to changes in the activity of this circuit. But removing DFosB permanently altered the expression of a suite of genes, in effect removing the conductor from the orchestra. To that end, the paper goes on to report in-depth experiments on DFosB largely done by the members of theRobison Labincluding co-first authorsClaire Manning, a 2019 neuroscience graduate, now a postdoc at Stanford University; andAndrew Eagle, a former postdoctoral researcher, now an assistant professor in the MSU Department of Physiology.

Andrew Eagle, shown here imaging a mouse brain, played a major role in conducting experiments to further probe the function of DFosB. Credit: Research@MSU.

Based on the findings in the paper, the Robison Lab will continue to develop highly collaborative and cutting-edge techniques, accelerated by MSUs newly completed Interdisciplinary Science and Technology Building. This work is important because it elucidates a potential mechanism, namely FosB, for how stress may contribute to depression, Eagle continued. Future clinical work may find ways to directly manipulate FosB, or more likely one of its gene targets, to provide resilience to stress and decrease the incidence of depression in vulnerable people.

The end of this paper, which shows us measuring the changes of expression in hundreds of genes when we remove DFosB, is only the beginning of years of work for our lab, Robison said. Which genes are important and what are they doing in the brain? This is the challenge of a lifetime for me and my lab.

This article is repurposed content originally featured on the College of Natural Sciences website.

View post:
Illuminating the opaque pathways of depression - MSUToday

Recommendation and review posted by Bethany Smith

The CRISPR and Cas genes market is projected to reflect stupendous growth with a 21.2% CAGR between the years 2020 and 2026. A Fact.MR study has found that that the coronavirus outbreak has generated key lucrative opportunities to participants in the market in the short term. Application of CRISPR technologies diagnosing covid-19 cases, and potential for a cure has is likely to contribute to market growth. Wide ranging field of applications will sustain the high growth for years to come.

CRISPR and Cas gene systems have attracted significant attention among researchers owing to cheaper, faster, and accurate, results in comparison to other existing processes for genome editing. In addition, rising investments in the field by the biotech companies will contribute substantially to the growth of the industry through the forecast period, says the FACT.MR report.

Request a sample of the report to gain more market insights at:https://www.factmr.com/connectus/sample?flag=S&rep_id=4823

CRISPR and Cas Genes Market- Key Takeaways

CRISPR and Cas Genes Market- Driving Factors

CRISPR and Cas Genes Market- Major Restraints

COVID-19 Impact on CRISPR and Cas Genes Market

CRISPR and CAS gene technology developers are likely to benefit from the coronavirus pandemic. Researchers have been studying these technologies as for potential in covid-19 diagnostic applications. In addition, CRISPR is also providing opportunities in terms of a cure through destroying the RNA structure of the virus. The market is expected to continue growing exponentially even in the post-pandemic era owing to applications in plant gene editing and drug development applications for the foreseeable future.

Explore the global CRISPR and Cas Genes market with 88 figures, 24 data tables, along with the table of contents of the report. You can also find detailed segmentation on:https://www.factmr.com/connectus/sample?flag=RM&rep_id=4823

Competitive Landscape

Thermo Fisher Scientific, Addgene, and Integrated DNA Technologies are some of the major players in the CRISPR and Cas gene market.

CRISPR and Cas gene researchers have been investing increasingly in tech innovations and diversification of potential applications for a growing number of end use verticals, supporting long term prospects.

For instance, Thermo Fisher Scientific has collaborated with BioEnergy Science Center to use CRISPR/Cas9 protein delivery for a non-GMO process to edit plant genes. Integrated DNA Technologies has engineered a new high-fidelity Cas9 nuclease through unbiased bacterial screen. Beam Therapeutics is collaborating with Addgene for the commercialization of base editing tools for laboratory use in the United States.

About the Report

This study offers readers a comprehensive market forecast of the CRISPR and Cas gene market. Global, regional and country-level analysis of the top industry trends impacting the CRISPR and Cas gene market is covered in this FACT.MR study. The report offers insights on the CRISPR and Cas gene market on the basis of product (Vector-based Cas and DNA-free Cas), application (genome engineering, disease models, functional genomes, knockdown/activation, and others), and end user (biotechnology & pharmaceutical companies, academic research institutes, and contract research organizations) across five regions (North America, Latin America, Europe, Asia Pacific, and MEA).

Media Release: https://www.factmr.com/media-release/1591/global-crispr-and-cas-genes-market

Visit link:
The Vector-Based Systems to be Highly Lucrative in CRISPR and Cas Genes Market, Fact.MR Study - The Cloud Tribune

Recommendation and review posted by Bethany Smith

Intellia Therapeutics Inc. [NASDAQ: NTLA] gained 8.59% or 1.66 points to close at $20.92 with a heavy trading volume of 1102470 shares. The company report on September 2, 2020 that Intellia Therapeutics to Present at Bairds 2020 Virtual Global Healthcare Conference.

Intellia Therapeutics, Inc. (NASDAQ:NTLA), a leading genome editing company focused on developing curative therapeutics using CRISPR/Cas9 technology both in vivo and ex vivo, will present at Bairds 2020 Virtual Global Healthcare Conference on Wednesday, September 9, 2020 at 10:50 a.m. ET.

A live webcast of Intellias presentation will be accessible through the Events and Presentations page of the Investors & Media section of the companys website at http://www.intelliatx.com. To access the webcast, please log on approximately 15 minutes prior to the start time, to ensure adequate time for any software downloads that may be required. A replay of the webcast will be available on Intellias website for approximately 14 days following the live event. About Intellia TherapeuticsIntellia Therapeutics is a leading genome editing company focused on developing proprietary, curative therapeutics using the CRISPR/Cas9 system. Intellia believes the CRISPR/Cas9 technology has the potential to transform medicine by permanently editing disease-associated genes in the human body with a single treatment course, and through improved cell therapies that can treat cancer and immunological diseases, or can replace patients diseased cells. The combination of deep scientific, technical and clinical development experience, along with its leading intellectual property portfolio, puts Intellia in a unique position to unlock broad therapeutic applications of the CRISPR/Cas9 technology and create a new class of therapeutic products. Learn more about Intellia Therapeutics and CRISPR/Cas9 at intelliatx.com and follow us on Twitter @intelliatweets.

It opened the trading session at $19.78, the shares rose to $21.44 and dropped to $19.78, the range by which the price of stock traded the whole day. The daily chart for NTLA points out that the company has recorded 121.56% gains over the past six months. However, it is still -127.89% lower than its most recent low trading price.

If we look at the average trading volume of 784.64K shares, NTLA reached to a volume of 1102470 in the most recent trading day, which is why market watchdogs consider the stock to be active.

Based on careful and fact-backed analyses by Wall Street experts, the current consensus on the target price for NTLA shares is $30.15 per share. Analysis on target price and performance of stocks is usually carefully studied by market experts, and the current Wall Street consensus on NTLA stock is a recommendation set at 2.10. This rating represents a strong Buy recommendation, on the scale from 1 to 5, where 5 would mean strong sell, 4 represents Sell, 3 is Hold, and 2 indicates Buy.

Oppenheimer have made an estimate for Intellia Therapeutics Inc. shares, keeping their opinion on the stock as Outperform, with their previous recommendation back on February 28, 2020. The new note on the price target was released on February 14, 2020, representing the official price target for Intellia Therapeutics Inc. stock.

The Average True Range (ATR) for Intellia Therapeutics Inc. is set at 1.32, with the Price to Sales ratio for NTLA stock in the period of the last 12 months amounting to 23.83. The Price to Book ratio for the last quarter was 3.17, with the Price to Cash per share for the same quarter was set at 7.56.

Intellia Therapeutics Inc. [NTLA] gain into the green zone at the end of the last week, gaining into a positive trend and gaining by 15.42. With this latest performance, NTLA shares gained by 1.97% in over the last four-week period, additionally plugging by 121.56% over the last 6 months not to mention a rise of 46.77% in the past year of trading.

Overbought and oversold stocks can be easily traced with the Relative Strength Index (RSI), where an RSI result of over 70 would be overbought, and any rate below 30 would indicate oversold conditions. An RSI rate of 50 would represent a neutral market momentum. The current RSI for NTLA stock in for the last two-week period is set at 54.55, with the RSI for the last a single of trading hit 59.58, and the three-weeks RSI is set at 53.42 for Intellia Therapeutics Inc. [NTLA]. The present Moving Average for the last 50 days of trading for this stock 20.56, while it was recorded at 19.08 for the last single week of trading, and 16.77 for the last 200 days.

Operating Margin for any stock indicates how profitable investing would be, and Intellia Therapeutics Inc. [NTLA] shares currently have an operating margin of -246.78. Intellia Therapeutics Inc.s Net Margin is presently recorded at -230.92.

Return on Total Capital for NTLA is now -37.57, given the latest momentum, and Return on Invested Capital for the company is -35.52. Return on Equity for this stock declined to -36.34, with Return on Assets sitting at -29.21. When it comes to the capital structure of this company, Intellia Therapeutics Inc. [NTLA] has a Total Debt to Total Equity ratio set at 6.81. Additionally, NTLA Total Debt to Total Capital is recorded at 6.37, with Total Debt to Total Assets ending up at 5.50. Long-Term Debt to Equity for the company is recorded at 4.68, with the Long-Term Debt to Total Capital now at 4.38.

Reflecting on the efficiency of the workforce at the company, Intellia Therapeutics Inc. [NTLA] managed to generate an average of -$368,641 per employee. Receivables Turnover for the company is 7.09 with a Total Asset Turnover recorded at a value of 0.13.Intellia Therapeutics Inc.s liquidity data is similarly interesting compelling, with a Quick Ratio of 7.50 and a Current Ratio set at 7.50.

With the latest financial reports released by the company, Intellia Therapeutics Inc. posted -0.49/share EPS, while the average EPS was predicted by analysts to be reported at -0.62/share. When compared, the two values demonstrate that the company surpassed the estimates by a Surprise Factor of 21.00%. The progress of the company may be observed through the prism of EPS growth rate, while Wall Street analysts are focusing on predicting the 5-year EPS growth rate for NTLA. When it comes to the mentioned value, analysts are expecting to see the 5-year EPS growth rate for Intellia Therapeutics Inc. go to 30.00%.

There are presently around $1,130 million, or 83.00% of NTLA stock, in the hands of institutional investors. The top three institutional holders of NTLA stocks are: ARK INVESTMENT MANAGEMENT LLC with ownership of 11,403,379, which is approximately 11.369% of the companys market cap and around 0.90% of the total institutional ownership; SUMITOMO MITSUI TRUST HOLDINGS, INC., holding 6,195,189 shares of the stock with an approximate value of $129.57 million in NTLA stocks shares; and NIKKO ASSET MANAGEMENT AMERICAS, INC., currently with $129.33 million in NTLA stock with ownership of nearly -12.8% of the companys market capitalization.

Positions in Intellia Therapeutics Inc. stocks held by institutional investors increased at the end of August and at the time of the August reporting period, where 100 institutional holders increased their position in Intellia Therapeutics Inc. [NASDAQ:NTLA] by around 10,206,052 shares. Additionally, 50 investors decreased positions by around 2,748,793 shares, while 30 investors held positions by with 41,050,254 shares. The mentioned changes placed institutional holdings at 54,005,099 shares, according to the latest SEC report filing. NTLA stock had 42 new institutional investments in for a total of 4,196,261 shares, while 18 institutional investors sold positions of 408,199 shares during the same period.

Link:
Intellia Therapeutics Inc. [NTLA] gain 42.57% so far this year. What now? - The DBT News

Recommendation and review posted by Bethany Smith

Bruce Power and BWXT Canada Ltd have announced that they are collaborating on several projects to advance the made-in-Ontario economic recovery programme, including an estimated $55 million contract for BWXT to perform fuel channel maintenance on unit 3 at Bruce nuclear power plant. BWXT has also begun to ship steam generators to Bruce Power for unit 6.

The Life Extension project is known as Extended West Shift Plus and is scheduled to be carried out in 2021. Once complete, it will extend the life of unit 3 to 2023, when Bruce Power is scheduled to start the units Major Component Replacement (MCR) Project. Extended West Shift Plus is the fourth major project of its kind to have been executed by BWXT in the past 12 years.

Todays announcement is exciting news for Ontarios nuclear industry and for the province as the work being done through our Life-Extension Programme is creating jobs and providing direct and indirect spending to support getting the economy back on track in the face of the COVID-19 health crisis, said Bruce Power President and CEO Mike Rencheck. BWXTs ability to execute on critical projects like Extended West Shift Plus extends the life of our reactors, which Ontarians count on to deliver affordable and reliable electricity.

BWXT is expanding its footprint in Saugeen Shores (where it opened an office in 2018) and is relocating to a larger facility, which will allow for training of staff to provide reactor inspection and maintenance services. BWXTs Owen Sound manufacturing facility also opened in 2018 and is manufacturing and delivering a supply of critical components to Bruce Power.

The two companies also announced that the first Made in Ontario steam generator, built by United Steel Workers, for the unit 6 MCR has been shipped from BWXTs plant in Cambridge to Bruce Power. BWXT, a member of the Retooling and Economic Council launched at the end of April by Bruce Power, will manufacture a total of 32 steam generators for Bruce Powers MCR projects. This manufacturing contract, originally awarded in 2016 and extending until 2030, represents the largest and longest-standing contract ever signed by BWXT Canada in the companys 175-year history.

In August, Bruce Power, Isogen a joint venture between Kinectrics and Framatome and BWXT signed a Memorandum of Understanding to advance feasibility work for a made-in-Ontario partnership for the production of medical isotopes to meet the growing demands of health-care providers in Canada and internationally.

Photo: The first Made in Ontario steam generator, built by United Steel Workers, for the Unit 6 MCR has been shipped from BWXTs plant in Cambridge to Bruce Power (Credity: Bruce Power)

Read the rest here:
Bruce Power and BWXT collaborate on life extension projects - Nuclear Engineering

Recommendation and review posted by Bethany Smith

Growing emphasis on the food safety and longer shelf life has played an important role in the development of ingredients that aid in food preservation. These ingredients vary from simple water content to salt or sugar to chemicals like antioxidants and are used to prevent growth of microorganisms, thereby delaying the spoilage process. In terms of origin, food safety and shelf life extension ingredients can be synthetic or natural in nature.

Food preserving ingredients have been an integral part of kitchen aisles in the form of lemon, ginger, vinegar, spices, salt and sugar. Their traditional utilization was replaced by synthetic ingredients with increasing commercialization of the food industry in past decades. However, with the dissemination of knowledge related to harmful effects of synthetic ingredients, currently, the industry is witnessing a prominent shift toward natural ingredients for food safety and shelf life extension.

Shelf Life Extension Ingredients Market Notable Developments

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Shelf Life Extension Ingredients Market Dynamics

Clean-Label Trend Fuels Synthetic to Natural Transition in Food Ingredient Landscape

Naturally sourced ingredients have gained significant traction as consumer preference for natural products continues to surge. In terms of effectiveness, natural preservatives are superior in delivering greater protection and longer shelf life. As they work with equivalent efficiency and are healthful in nature, adoption of naturally sourced ingredients is increasing consistently as compared to the synthetic options.

Natural ingredients such as antimicrobials or antioxidants have additional potential health benefits also. Well aware of the increasing consumer demand for natural food products that are without artificial ingredients, manufacturers in the food ingredient market are introducing bio-based or naturally sourced food safety ingredients.

Frozen Foods Drive Demand for Specialized Food Safety Ingredients

Ranging from salads to sauces or ready meals to rice, a plethora of food products are available in frozen forms. As the demand for fresh and frozen foods increase across the globe, food manufacturers are seeking innovative ways to introduce novel food safety ingredients to extend the shelf life of frozen foods.

Manufacturers in the food safety and shelf life extension ingredient market are introducing ingredients specific to refrigerated products. Along with providing safety, these ingredients are label friendly and help in reducing sodium content while enhancing consumers sensory experience.

Shelf Life Extension Ingredients Market Regional Outlook

North America presents lucrative opportunities for the Shelf Life Extension Ingredients Market on the back of buoyancy in regions the food and beverage industry and presence of leading F&B companies.

The market is likely to witness increasing opportunities in the developing countries of Asia pacific. These countries are witnessing huge demand for frozen foods, RTD food and beverages and processed food, thereby presenting higher potential for the market in the future.

Shelf Life Extension Ingredients Market Segmentation

The Shelf Life Extension Ingredients Market is segmented into following,

Based on type, Shelf Life Extension Ingredients Market can be segmented in,

Based in function, Shelf Life Extension Ingredients Market can be segmented in,

Based on application, Shelf Life Extension Ingredients Market can be segmented in,

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About TMR Research:

TMR Research is a premier provider of customized market research and consulting services to business entities keen on succeeding in todays supercharged economic climate. Armed with an experienced, dedicated, and dynamic team of analysts, we are redefining the way our clients conduct business by providing them with authoritative and trusted research studies in tune with the latest methodologies and market trends.

Original post:
Shelf Life Extension Ingredients Market Global Opportunity Analysis and Forecast 2018-2028 - The Market Correspondent

Recommendation and review posted by Bethany Smith

It's one thing to design and build reliable centrifugal pumps for severe applications. But it's quite another to deliver the right maintenance to the thousands of them that are already operating out there.

That's why Baker Hughes identifies supporting resources from top-notch, specialized organizations in key regions around the world. There's a rigorous qualification process involved so our Customers can rest assured they'll get expert OEM-approved support. They are Baker Hughes Channel Partners, and Houghton International just became our newest onefocusing on API 610 centrifugal pumps in the UK and Ireland. It's a comprehensive agreement enabling them to provide overhauls, repairs, parts, replacements, and more with the proven advantages of our OEM service processes and technologies.

This is a big deal for owners of the 150+ Baker Hughes pumps operating in the region (the agreement also covers full lifecycle services for other OEMs). This deal with Houghton International isn't just about repairs and regular maintenance, it's about injecting new technologies into old machines. Some of these pumps have been operating for 30-40 yearsso our ongoing knowledge and technology sharing with Houghton International will help improve pump efficiency and reduce energy consumption.

Houghton International is a well-known and trusted service provider with excellent resources and expertise not only in the region, but around the world. Specialising in the monitoring, maintenance, repair and life extension of rotating machines, it has a team of experts in pump repairs and maintenance to improve the performance of pumps across a range of applications. Operating from a 130,000 sqft, IECEx certified, facility in the North East of England, Houghton International works with customers to diagnose problems, improve performance and eliminate issues.

Houghton International and Baker Hughes will work together to use our combined knowledge and experience to ensure that the installed base of pumps remain fit for purpose, modifying the design and upgrading the components accordingly to improve efficiency, save energy and extend the mean time between failure (MTBF). As an authorised Channel Partner, Houghton International will also be able to support the specification and installation of new Baker Hughes pumps across a range of sectors.

Houghton International's core values align well with our own. Both companies encourage people to be their best and provide them with the resources to do so. We both see the exponential value possible through open collaboration, and we practice it every day. The thread of innovation runs through every inch of both our organizations, and we are equally focused on acting with integrity and providing customers with the best quality technologies and support possible.

We look forward to a long relationship with Houghton International continually working together to make sure pump customers in the UK and Ireland get the support they need to be more productive and efficient throughout the energy transition. Enrico Mangialardo (GM Pump)

Michael Mitten, CEO of Houghton International, added: We are delighted to have the opportunity to work with Baker Hughes to support the ongoing operation and performance improvement of its installed base of centrifugal pumps in the UK and Ireland.

With decades of proven experience in upstream and downstream processes, Baker Hughes pumps are known for exceptional performance in extreme conditions and we look forward to supporting customers in continuing to operate these pumps for many years to come.

Becoming an approved Baker Hughes Channel Partner marks the start of an exciting partnership between both companies which will offer an OEM backed service facility that combines extensive product knowledge and genuine OEM parts with a flexible and responsive service offering that meets the needs of the market.

See the original post:
Making centrifugal pumps more efficient for Baker Hughes Customers in the UK and Ireland - OilVoice

Recommendation and review posted by Bethany Smith

The documentary Hope Frozen: A Quest to Live Twice shows the journey of a Thai family as they embark on a quest to preserve their 2-year-old daughter cryogenically. In fact, the story of Matheryn Naovaratpong, also known as Einz by her family, gained international traction in 2015. In the documentary, some fundamental questions about life and death are explored through both a scientific and spiritual lens. Moreover, it actively discusses the extensive process of saving a body in such a manner. In this article, we take a look at the man who was responsible for conserving baby Einz cryogenically.

Aaron Drake is an expert in the field of cryogenics, and he completed his undergraduate studies from the University of Nebraska-Lincoln in 1986. According to his LinkedIn profile, he worked as a paramedic firefighter for almost 14 years in the city of Lincoln from 1992 to 2006. He then moved into the consulting domain, and at the time of the documentary, he was the Senior Medical Response Consultant for Alcor.

Dr. Sahatorn and Nareerat made the decision to cryogenically freeze their daughter as a last resort. The couple had, after all, tried everything that was medically and humanly possible to help their daughter. Einz was battling ependymoblastoma, a rare but malignant tumor that affects children. An intensive treatment commenced, but eventually, the parents, both of whom have a Ph.D. in engineering, understood that their daughter would not survive after her multiple surgeries. So, the family contacted the Alcor Life Extension Foundation with the hope that one day, when medical technology has advanced enough, she could be revived.

The initial plan was to fly out baby Einz to Arizona, where the company is located, for their services.But Aarontold Vice, It was hoped that this young 2-year-old girl was going to relocate to this hospital as her health declined so distance would be minimized. Unfortunately, her breathing declined more quickly than her doctors anticipated and two days before she was to fly to the US, she was placed on a ventilator, essentially eliminating the possibility for airline travel. So he, along with Dr. Jose Kanshepolsky (a retired neurosurgeon), flew out to Bangkok to carry out the procedure. The family was present in the room during the surgery.

Today, Aaron Drake operates in three roles, according to his LinkedIn profile. The first is as the Director of Research and Chief Specialist at the Yinfeng Institute for Biological Sciences, which is based in Shandong, China. He has also continued as a Senior Medical Response Consultant for Alcor. Lastly, he serves as the Managing Director for Arizona Medical Sciences. Apart from this, he has also been honored with many accolades in his professional life. He is the recipient of the Quancheng Friendship Award and QiLu Foreign Expert Award due to his work in China. He lives in Scottsdale, Arizona, and can speak English, Chinese, and French.

Read More: Where is Einzs Mother Now?

Read this article:
Aaron Drake Now: Where is Alcor's Cryogenic Expert Today? - The Cinemaholic

Recommendation and review posted by Bethany Smith

Oral Probitoics Market research is an intelligence report with meticulous efforts undertaken to study the right and valuable information. The data which has been looked upon is done considering both, the existing top players and the upcoming competitors. Business strategies of the key players and the new entering market industries are studied in detail. Well explained SWOT analysis, revenue share and contact information are shared in this report analysis.

Oral Probitoics Market is growing at a High CAGR during the forecast period 2020-2026. The increasing interest of the individuals in this industry is that the major reason for the expansion of this market.

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Top Key Players Profiled in this Report:

NatureWise, Now Foods, DS Healthcare, Higher Nature, NutriPreme, Candidabiotix, Hyperbiotics, Jarrow Formulas, Life Extension, Natren, UltraCruz, Aqua Flora

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Various factors are responsible for the markets growth trajectory, which are studied at length in the report. In addition, the report lists down the restraints that are posing threat to the global Oral Probitoics market. It also gauges the bargaining power of suppliers and buyers, threat from new entrants and product substitute, and the degree of competition prevailing in the market. The influence of the latest government guidelines is also analyzed in detail in the report. It studies the Oral Probitoics markets trajectory between forecast periods.

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Table of Contents:

Global Oral Probitoics Market Research Report 2020

Chapter 1 Oral Probitoics Market Overview

Chapter 2 Global Economic Impact on Industry

Chapter 3 Global Market Competition by Manufacturers

Chapter 4 Global Production, Revenue (Value) by Region

Chapter 5 Global Supply (Production), Consumption, Export, Import by Regions

Chapter 6 Global Production, Revenue (Value), Price Trend by Type

Chapter 7 Global Market Analysis by Application

Chapter 8 Manufacturing Cost Analysis

Chapter 9 Industrial Chain, Sourcing Strategy and Downstream Buyers

Chapter 10 Marketing Strategy Analysis, Distributors/Traders

Chapter 11 Market Effect Factors Analysis

Chapter 12 Global Oral Probitoics Market Forecast

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Comprehensive Report on Oral Probitoics Market 2020 | Size, Growth, Demand, Opportunities & Forecast To 2026 | NatureWise, Now Foods, DS...

Recommendation and review posted by Bethany Smith

The loss of a child, or a sibling, is something people never quite get over. Even after the initial heartbreak, the pain continues to resonate, in somewhat reduced form, from a locked-away part of ones mind (and heart) thats best accessed only at sporadic intervals. Grief is a gnawing virus, and it must eventually be contained lest it spread and consume. Unavoidable and unbearable, its an inherent component of life that has the potential to destroy.

Hope Frozen: A Quest to Live Twice is a story about such grief, and the unique path upon which it set a Thai family. Directed, produced and co-written by Pailin Wedel, the new Netflix documentary (premiering Sept. 15) concerns Sahatorn and Nareerat Naovaratpong, and their son Matrix, whose clan expanded with the birth of the couples young daughter Matheryin. Nicknamed Einz, the newborn girl was an immediate cause for merriment, her arrival so celebrated that it brought Matrix to literal tears. In home movies, we see Einz develop from a smiling infant to a boisterous and perpetually cheery 2-year-old, playing, laughing and radiating an innocent joy thats nothing short of infectious.

The Naovaratpongs happiness, however, was short-lived. After suddenly falling into a coma, Einz was diagnosed with ependymoblastoma, a rare and fatal brain tumor that no one has ever survived. Though she underwent 10 surgeries, 12 rounds of chemotherapy, 20 radiation treatments, and countless stays in the ICU, Einz succumbed to her illness before she reached the age of 3. That would be the end of her tale, if not for the fact that her fathera scientist by traderefused to let her slip away. Convinced that he could give her a chance at a new life, he began investigating cryonics, the practice of indefinitely freezing and preserving human bodies (and, sometimes, just heads) in the hope that future technological breakthroughs will allow for subjects resurrection, and for their lethal maladies to be cured. Even with the understanding that hed likely never see her again (since any reawakening would probably take place long after he was dead), Sahatorn made Einz the youngest person ever (as well as the first Asian of any age) to be cryogenically frozen.

Given that cryonics isnt exactly accepted as a legitimate procedure by the mainstream scientific community, many viewed Sahatorn and Nareerats plan with skepticism, if not outright condemnation, especially once the story went viral and Sahatorn was asked to defend his course of action on a variety of TV talk shows. Hope Frozen, though, cares less about what the outside world thinks about this unique decision than about the stew of motivations and justifications that drove the family to embark on their quest. That journey took them to Californias Alcore Life Extension Foundation, a tax-exempt nonprofit run by CEO Max More which charges a minimum of $200,000 to freeze an entire body, and which makes no promises about how, when or if these deceased individuals might ever be resurrected.

Faith and science collide and intermingle in Hope Frozen, as Sahatorn and Nareerat grapple with their Buddhist view of reincarnation (and critics worries that theyre trapping the soul of their daughter in a stasis-bound body) and their conviction in sciences capacity to solve all problemsthe latter of which is, of course, its own kind of faith. Sahatorn passes that pro-science dogma down to his son Matrix, whos soon following in his fathers footsteps and assuming his dads dreams. At the same time, Matrixs attempt to seek temporary solace from his heartache by becoming an ordained monk only further blurs the boundary between rational and religious belief.

Director Wedel evokes these intertwined forces through a combination of traditional non-fiction footage of Sahatorn and Matrix in their lab (and at Alcore), Nareerat showing off Einzs favorite white dress while standing next to her crib, and misty dusk and dawn imagery of the forest treetops and foliage surrounding their home. Plentiful clips of Einz from before she fell ill, and while stuck in a hospital, convey an empathetic impression of this upbeat little girl, who touched her familys life so profoundly that they refuse to simply let her go. Sahatorn says that what youre witnessing in those videos and photos are traces of Einzs soul, and to be sure, theres a potent sense of the spark that clearly enlivened her, and by extension, those around her.

Sahatorn says that what youre witnessing in those videos and photos are traces of Einzs soul, and to be sure, theres a potent sense of the spark that clearly enlivened her, and by extension, those around her.

The ultimate question posed by Hope Frozen is whether or not Sahatorns hope for a miracle rebirthhowever distant and fanciful it could beis a healthy means of keeping her memory alive (and of coping with unendurable tragedy), or whether its a mistake that denies everyone finality and, thus, a chance to move on. Sahatorn states outright, This is who I am. I cant let go, likens his late daughter to a machine (Its like we had manufactured a defective computer. So we have to put it on hold. We believe that the computer could work again), and opines that she might not return to the land of the living until humanity has developed interstellar travel and time machines. For all his dogged optimism, its hard not to see him as a man whos chosen to figuratively freeze himselfa notion that isnt totally erased by the late revelation that he and Nareerat subsequently had another daughter (whom they named Einz Einz).

There are no easy answers to these issues, and to its credit, Hope Frozen doesnt try to provide them, instead allowing Sahatorn, Nareerat and Matrix to explain the complicated thought process behind their unusual response to loss. After visiting a California researcher who successfully unfroze a rabbits braina breakthrough that suggests a remedy for Einz could be decades, rather than centuries, awayMatrix learns new information that seismically affects his own feelings about Einzs cryonic prospects. Yet regardless of that late development, Wedels film is an open-ended portrait of placing trust in both scientific facts and the vast, unknowable unknownall in an effort to contend with an anguish that, no matter what anyone does, can never be fully extinguished.

See more here:
They Didn't Want Their 2-Year-Old to Go. So They Froze Her. - The Daily Beast

Recommendation and review posted by Bethany Smith

Newswise A new study published in Circulation by University of Alabama at Birmingham researchers showed that Black heart failure patients have worse prognoses even after achieving biomarker-based treatment goals.

Vibhu Parcha, M.D., a clinical research fellow in the Division of Cardiovascular Disease, says prior studies have shown that those heart failure patients who take medications regularly and have their NT-proBNP levels a heart failure biomarker less than 1,000 pg/mL do better in terms of being admitted to hospital for worsening of heart failure or dying due to cardiac causes.

Heart failure affects nearly 5 million patients in the United States, and there are key racial differences in the disease pathophysiology and care of heart failure patients, according to Parcha. Therefore, it is important to understand the racial differences in the prognosis of heart failure patients who achieve the treatment goal of NT-proBNP levels of less than 1,000.

In this investigation, Parcha and his team analyzed the data from the heart failure patients enrolled in the NHLBI-sponsored Guiding Evidence-Based Therapy Using Biomarker-Intensified Treatment in Heart Failure trial.

The assessment of heart failure patients in the setting of a randomized clinical trial allowed us to look closely at the racial differences in the clinical characteristics and outcomes of heart failure patients, Parcha said.

Researchers found that, regardless of race, heart failure patients who achieve the treatment goal of NT-proBNP levels 1,000 pg/mL were less likely to be admitted with worsening heart failure or die due to cardiovascular reasons. Notably, they found that Black heart failure patients had worse prognoses compared to their white counterparts at any level of the NT-proBNP levels reached.

Heart failure is a serious medical condition, and all heart failure patients require close medical attention and care, said senior author Pankaj Arora, M.D., a physician-scientist in the UAB Division of Cardiovascular Disease. We have previously shown that even healthy Black individuals have lower levels of beneficial hormones produced by the heart called natriuretic peptides. The diseased heart in conditions like heart failure produces higher levels of these hormones. As heart failure worsens, the secretion of the hormone increases as a reflection of the activation of the neurohormonal system. Therefore these hormones act as a gold-standard biomarker for the status of heart failure. With appropriate treatment, we can improve the functioning of the heart, which in turn causes a reduction in this biomarker hormone.

Arora adds that it is important for patients to take their heart failure medications regularly and seek medical care to ensure that their medications are being changed adequately based on their clinical condition.

Both Black individuals and white individuals with heart failure have a good prognosis when they are receiving adequate medical care for their heart failure and also have their biomarker (NT-proBNP) levels less than 1,000, he said. However, Black heart failure patients had worse prognosis irrespective of attainment of the biomarker targets, which indicates that aggressive up-titration of goal-directed therapy must be done for these heart failure patients despite the attainment of biomarker goals. These racial differences in the care are important as Black individuals are at a greater risk of developing cardiovascular diseases such as heart failure and need to be treated adequately once the disease develops.

This work was supported by the National Institutes of Health grant, and the UAB Minority Health and Health Disparities Research Center research grant to Arora.

See original here:
Black heart failure patients have worse prognosis even after reaching treatment targets - Newswise

Recommendation and review posted by Bethany Smith

With upwards of 1 million licensed doctors in the United States, there have never been more caretakers to help you maintain perfect health. But nearly all patients would agree that finding the right Doc can be tricky. Yes, most doctors wear a white coat or a pair of scrubs, and can be found in hospitals or steely offices but the truth is that doctors are vastly different from one another, and most have an expertise in one particular area of medicine. There are hundreds of documented medical specialities and related certifications that physicians can pursue in their career, and there is often a special doctor for each affliction or illness, no matter how complex or rare that condition may be.

Where does one start when faced with a specific health issue? First step: It's a good idea to establish care with a primary care doctor, so that you have someone to oversee your healthcare treatment. They'll work with other doctors when the time comes, too: "Your primary care provider is an important first stop when receiving care, and they can help you to determine when you may need to see a specialist," says Craig Hersh, M.D., a board certified family medicine physician and the Chief Medical Officer for Empire BlueCross BlueShield.

"Think of your primary care provider as the front door to the healthcare system, who can also help you navigate and work with the specialist who best matches your needs," Dr. Hersh tells Good Housekeeping.

Sometimes, though, you might need direct access to a specialist say, if you've moved recently and don't have a primary care provider just yet. With the help of Dr. Hersh, we'll explore the most common types of doctors you'll likely turn to for help in your lifetime each of these 26 specialists can help address unique health concerns, and may finally get you the treatment you've been searching for.

This article generalizes the roles and descriptions of common doctors and specialists: It isn't intended to be a complete list, nor is it reflective of laws, statutes, regulations, license issues, or Medical Practice Acts by state. It is meant to be educational in nature and isn't a substitute for actual medical or treatment advice from a licensed professional. Remember: Always call 911 if you are experiencing a life-threatening emergency.

Primary care providers | Internist | Pediatrician | Geriatric specialists | Gynecologist, OB/GYN | Dermatologist | Allergist | Cardiologist | Ophthalmologist |Endocrinologist | Gastroenterologist | Geneticist| Hematologist | Neurologist | Otolaryngologist |Podiatrist |Pulmonologist| Nephrologist | Infectious disease specialists | Oncologist |Osteopath | Radiologists | Urologist | Plastic surgeons|Mental health care providers

Also known as a family physician, a primary care provider is in charge of handling your routine healthcare appointments, including annual physicals and vaccinations over time. Primary care doctors should always be your first call if you have a health concern that isn't an emergency, as they can help treat everything from the common cold to a physical injury. More often than not, they'll attempt to alleviate any symptoms you are experiencing; they may also refer you to another doctor or specialist.

A primary care provider can treat symptoms associated with conditions like:

These doctors work similarly to a primary care provider, in that they can see a patient routinely over their lifetime; unlike their counterparts, however, they usually have a background in internal medicine and spend their time in hospitals. Internists don't usually treat children or preteens, but care for anyone else from young adults to elderly patients, especially those who need help in diagnosing or managing chronic conditions or diseases. They may specialize in certain areas as well, like gastroenterology.

Pediatricians handle scheduled care and check-ins for infants, toddlers, younger children, adolescents, preteens, and most teenagers. They function like a primary care provider, designed for children specifically, but also keep kids' vaccinations up to date and do important screenings as they get older. Pediatricians are also a good point of contact to discuss any particular health concerns or questions about your child's physical or mental development.

Some elderly individuals may transition from a primary care doctor to what's know in the healthcare space as a geriatric specialist. Geriatricians take over primary care of people who are aging, and can help manage conditions that particularly impact the elderly, everything from severe arthritic pain to diabetes and dementia. These docs are on the other end of the family medicine spectrum from pediatricians!

Gynecologists, of course, handle preventative care for women in reproductive health, menopause, and hormone issues and you know that an obstetrician specifically looks after pregnant women and delivers their babies. An ob/gyn office (combining the two specialties) is also be a place where cervical cancer is tested and diagnosed, and where breast exams are performed.

Nearly everyone knows that dermatologists have the best information about routine skincare but they're also the specialist in charge of treating more serious skin issues, hair loss, or nail irregularities. Rashes or severe acne, rosacea or psoriasis, and skin cancer are treated; these specialists examine symptoms, help you manage them as best as possible, and provide a longterm treatment plan if possible.

These physicians are specially trained to determine if someone has an allergy, and they may also be referred to as an immunologist. If you're wondering if you have an allergy, an allergist is the doctor to see. In addition to diagnosing and managing allergies, these specialists may also help manage asthma, certain lung conditions, and immunodeficiency disorders. An allergist can give patients with allergies injections to help manage their allergies in the long run.

These physicians are in charge of taking care of your heart, but they'll most likely step in for direct care if you have high blood pressure, or experience heart failure or irregular heartbeats. Cardiologists often use physical stress tests and electrocardiography to diagnose, treat, and prevent other issues. You'll also have to be under their care after a heart attack, as your primary doctor may need screening done for future heart conditions.

These physicians look after your eyes, both medically and surgically, which is different from a optometrist, who is responsible for eye tests and corrective lenses as well as prescribing medication for some diseases. Opticians solely help you with the fit of your glasses and contacts overall.Ophthalmologists will also be needed if you develop a serious eye impairment, like glaucoma and cataracts as you age.

For those dealing with diabetes or a thyroid issue, an endocrinologist will help you pinpoint the source of trouble or help you troubleshoot longterm solutions. These specialists assess and treat internal glands that produce hormones and other bodily functions.

Digestive issues? If they're not clearing up whether it's diarrhea, bloating, acid reflux, or excessive flatulence it's time to ask for a gastroenterologist's help. Gastroenterologists who are licensed physicians, unlike gastrologists treat anything related to your digestive system (including bad breath!), and for longterm treatment, they help you control issues like irritable bowel syndrome or Crohn's disease. They may also screen you for issues later in life, like a colon cancer screening such as a colonoscopy.

Out of all doctors on this list, this may be one of the few that often require a referral; these doctors specifically look at whether a health issue has been inherited at birth, or if your genes are causing (or will cause) an issue in the future. They'll often help patients understand how genetic conditions could be passed along to a child preemptively, or they'll help to treat hereditary conditions that turn up.

If you're suffering an iron deficiency, or more serious conditions like anemia or hemophilia (inability to clot), a hematologist will step in to assess issues in your blood. They can be instrumental in preventing and treating cancers of the blood, such as leukemia.

Ah, the good brain doctor. But did you know that neurologists are also in charge of managing symptoms related to the nervous system, or anything that relates to your spine? Most often, neurologists tend to patients who have survived a stroke, or battle serious conditions like Parkinson's disease, multiple sclerosis (MS), and numbness or nerve pain caused by neuropathy. You may also seek them out for migraines and severe headaches that aren't going away.

These specialized surgeons also take care of your head and neck, but they focus on sinus, hearing, and throat disorders, among other issues. They are more commonly referred to as ENTs because they take care of your "ear, nose, and throat" primarily. You may visit an ENT for sinus issues, allergies and their side effects, as well as swallowing and hearing issues.

Ouch! You'll be heading to a podiatrist if you have foot, ankle, or lower leg pain or issues that can't be addressed by your primary care provider. While a visit to the podiatrist is often because someone has physically injured muscles, joints, or bones in their feet, these foot docs can also manage side effects from chronic conditions like diabetes.

Often mentioned in the same breath as a immunologist, these specialists are in charge of mitigating any pain or health concerns in your lungs and the entire respiratory system. You'll be referred to them for asthma often, but pulmonologists also diagnose and treat conditions like chronic obstructive pulmonary disease (COPD), emphysema, and lung cancer.

Believe it or not, this doctor is just focused on a singular organ in your body: The kidney. They are often called in for longterm treatment for serious chronic kidney diseases, of which there are many: They may also set up dialysis for those experiencing kidney failure.

These doctors may be known as virologists, or epidemiologists, but more routinely they're called infectious disease physicians. These targeted specialists treat ailments that are caused by viral bacteria or viruses themselves, including conditions like HIV/AIDS, tuberculosis, and malaria.

A referral to an oncologist might be terrifying for some, especially if they have yet to yield a positive result for any kind of cancer, but oncologists are often first examining your body, blood, or tissue samples beforehand. They may treat a benign tumor, which isn't cancerous by nature, but these specialist are still required. Oncologists are the point people for anyone who is living with cancer, and they'll draft treatment options, plus additional care when you reach remission.

These doctors are different from what's known as a naturopath, or a natural doctor. Osteopaths, titled as D.O.s in the field, receive similar training to a traditional M.D. but a greater emphasis is placed on treating a person for holistic health using elements of alternative medicine. Particularly, they often focus on relieving physical pain and tension in your body, especially in muscles and in joints.

These specialized care providers only see you for a short amount of time, and mainly for one thing only: Tests. Radiologists use imaging of all kinds to make an official diagnosis after another doctor or your primary care provider orders a test. The radiologist will make a detailed report to send back to your primary doctor or the specialist who ordered the test. Their testing services most commonly include:

Another highly targeted care provider, a urologist will treat pain and conditions related to the urinary tract (including bladders and urethra) for both men and women. They may troubleshoot issues like incontinence or help you pass a kidney stone; for men, they also deal with reproductive concerns.

A visit to a plastic surgeon's office isn't always for "craniofacial" adjustments. A bulk of a plastic surgeon's doesn't have to do with cosmetic procedures: They take care of the physical reconstruction of the body, and can help to repair your skin after a serious injury or burn, for example.

A special note on the following healthcare providers: They all address aspects of mental health in one way or another, with differences based on patients' needs. Each of them have different academic qualifications of various degrees, and they work in vastly different settings as well. "Only one type can prescribe medication and treat other medical conditions," Dr. Hersh explains.

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25 Different Types of Doctors - The Most Common Types of Doctors and Specialists - GoodHousekeeping.com

Recommendation and review posted by Bethany Smith

My paralegal, Anne, buzzed me. You have a couple on the phone who have Covid-19. They are very upset with their family doctor and want to talk with you about a possible lawsuit for malpractice.

Now, this sounded interesting.

Just diagnosed with COVID-19 doctor yelled at them

Mr. Beaver, our family was just diagnosed with COVID-19, and fortunately no one is sick enough to go to the hospital, but we feel very disrespected by how our family doctor reacted.

I wondered how long have they gone to this doctor, and why they feel so disrespected.

We have been his patients for several years and never had a problem until now. But when he called us and confirmed that we all had COVID-19, it is what he said that hurt our feelings terribly. He was so angry! We recorded it. (They played the recording.)

Whats wrong with you all? I told you months ago that you were dangerously obese and that you were not taking your blood pressure medication as prescribed. Dont you watch TV? Almost all of the faces of the people who died from COVID-19 who you see on the evening news are horribly obese and you are too, all of you, mom, dad and your four young kids! Dont you get it! You are sentencing yourselves to death because of being morbidly obese!

Mr. Beaver, we arent that much overweight and our kids are otherwise healthy, if a bit big.

Was the doctor correct? Were they all obese? Dr. Skype would answer that question, and so I askedand the family agreedto do a Skype video chat. As soon as their webcam was active, it was clear to me that I was looking at an entire family of morbidly obese people in complete denial of their own health status.

See original here:
You and the Law: Obese COVID patients and their angry doctor - Hanford Sentinel

Recommendation and review posted by Bethany Smith

Read the Full Video Transcript

Alicia Morgans: Hi. I'm so excited to talk today with Dr. Michael Morris, who is a Professor of Medicine at Memorial Sloan Kettering Cancer Center and a GU Medical Oncologist, and Dr. Chris Sweeney, who is a Professor of Medicine at Harvard Medical School and a GU Medical Oncologist at Dana-Farber Cancer Institute. Thank you both so much for talking with me today.

Michael Morris: Thank you, Alicia.

Chris Sweeney: You bet. Yeah.

Alicia Morgans: Wonderful. So I wanted to really pick your brains about the treatment of metastatic hormone-sensitive prostate cancer or some people say mCSPC, castration -sensitive prostate cancer, because I think that there has been a lot of data in this space. There's a lot of confusion. The first thing being that it's not always clear to everyone that the backbone of all treatment is really testosterone suppression with GnRH agonist or antagonist, or if you want to do bilateral orchiectomy, but these treatments to lower testosterone are actually critical.

But then we're really, I think, in the United States moving to a place where we need to combine, for all appropriate patients, which is most patients, use combination therapy. Whether that is ADT plus docetaxel or ADT plus an AR targeted agent, is actually something that we all need to work out. And I just want to talk to you both, about how you make those decisions and what your thoughts are. So maybe we can start with Chris. What are your thoughts when you see a new patient with metastatic hormone-sensitive prostate cancer, of course in addition to traditional ADT, what are you doing to help make that decision about that other treatment that you're adding on?

Chris Sweeney: I ask myself three questions. I think it's three, let's see how we go. One, what is their prognosis? And that's driven by, did they present with metastatic disease as their first presentation and the amount of cancer on a CAT scan or a bone scan. So when we're talking about metastatic disease, we're talking about the amount of cancer that we can see on conventional scans.

Alicia Morgans: Okay.

Chris Sweeney: So that's the first thing and second thing. And chemo fit, volume of disease, and the... How they relapsed or did they present de novo?

Alicia Morgans: Okay.

Chris Sweeney: Because they have very different prognosis and outcome and I think that's what's causing some variations in the trials that we're going to talk about in the outcomes and why one trial may be giving one signal and another trial may be giving another because of patient mix. We looked at the Dana-Farber data set of about 450 patients and it's published, about a third of patients are this high volume de novo metastatic and with just the ADT testosterone suppression, half of those patients would die by about the three-year mark.vWe've made major progress in that group of patients, with the drugs you've mentioned.

And the other spectrum, the other third, is the late relapsing person who years later, has a two bony metastases. You put them on testosterone suppression and their median survival is actually eight years, from the start of the hormones and then this is middle ground. De novo low volume, which is... has a median survival of about five years and some of them have a rapid progression and some of them would be slow. And then there's this very rare bird if somebody has surgery and then a year later they have a high burden of disease because they rapidly progressed after the radiation or their surgery. So I think the more we can annotate the patient in front of us, we can personalize the options for them and then look at all the treatment data sets that have come out. And I suspect Mike and I probably would actually offer the same treatments for the different groups of patients based on their chemo fitness, volume and the timing of the presentation with metastatic disease.

Alicia Morgans: Yeah. And how do you think about things Micheal because... And maybe comment too on the STAMPEDE trial, the CHAARTED trial, which we just got an update from for the STAMPEDE trial, in terms of thinking about volume of disease and sensitivity to docetaxel in addition to ADT, which was a little bit disruptive in a really interesting way to the paradigm that had been laid out by the prior STAMPEDE data and the CHAARTED data. So what, what are your thoughts there?

Michael Morris: Yeah, I'm not sure I see the update of the STAMPEDE data, which had suggested that perhaps the low volume patients actually did have a benefit. I'm not sure that that changes all that much in our landscape. In this case, we know a lot of what we don't know and we know we have one outright negative study. We know that we have CHAARTED, which was a positive study, but there was a readout that led us to believe that perhaps some patients benefit more from others and now we have a look back at a study that didn't initially separate patients by volume, which suggests that there's still more questions to be asked on this front. So it's an ambiguous situation. I think it's an ambiguity that has new information to inform what we're ambiguous about. I also think though, that there are unknown unknowns here that we have to consider.

So, for example, you know, for patients who are really high-risk patients, I do try to profile those patients, at least with germline sequencing, if not somatic as well. And germline for those patients who have high-grade disease at presentation for an initial diagnosis with a localized disease with a family history or anyone with metastatic disease is standard of care.

Alicia Morgans: Yes.

Michael Morris: So I know that volume isn't the great teller of who may respond and who may not. P53 and RB status, would probably make me think about even a low volume patient who I know is probably not going to respond particularly long to any of the AR directed therapies that may trump the volume of disease. So there are other factors here that we know that we don't have enough information about beyond disease distribution, which may be very informative, which are coming into their own as the... As we appreciate as well, that the DNA repair population has yet another set of options to be explored.

Alicia Morgans: Yes.

Michael Morris: That... I think that that's going to factor into our consideration as well. I think that there's some really basic fundamentals... Factors to consider. Even beyond data sets. Not everybody has access to the same drugs. Insurers won't necessarily reimburse for the same drugs. Chemotherapy has great advantages in terms of brevity, a limited course, and financial economy.

Alicia Morgans: Yes.

Michael Morris: So those factors are really important to patients because that really impacts their lives. Beyond distribution, beyond genomics, there's some real practical considerations even in choosing the AR inhibitor that you might be selecting. Different side effect profiles. Some of those drugs get along better with other drugs.

Alicia Morgans: Yes.

Michael Morris: So there are many factors to consider beyond an update on STAMPEDE or beyond a new analysis of the data of head to head, for example.

Alicia Morgans: Absolutely. Go ahead.

Chris Sweeney: So let me pick up on a couple of things there and I agree 100% it is not an easy conversation. This is one where you've got to sit the whole time and sit down and have the patient tell you what their interests are. Sometimes it may be, get the chemotherapy out of the way. Others may be saying, "I've got a lot going on. I just need the simple hormones approach." But two things I want to just pick up on. One is there's a fantastic collaboration that's developing between the ENZAMET team, the CHAARTED team and the STAMPEDE team where we're gene expression profiling, exome sequencing, all the patients, and we'll actually have some data at GU ASCO where we are starting to see some prognostic and predictive markers.

Alicia Morgans: Wonderful.

Chris Sweeney: So hopefully that'll get... We'll have everything ready and have some air time on that to make some progress on that. We've got the gene expression profiling, but we're now doing the whole exome sequencing. We're just pulling the DNA now to send that off from CHAARTED and we're going to train in CHAARTED and validate with the STAMPEDE and the ENZAMET, so we're on the case.

The second thing is just breaking down, thinking through this new information where, well, the high volume de novo we... You're absolutely right, your options are chemotherapy, or the new hormones. It's very unlikely that you wouldn't do something adding that. That's, there's no controversy there. This low-volume de novo metastatic, is one entity, and I just want to say the... If you look at the pattern of the studies, so if you pull out the low volume de novo metastatic from GETUG-12 they actually have a survival curve and European urology paper and they're overlapping, in their study for that patient population. When we look at it and CHAARTED, it's a hazard ratio of about 0.86 for docetaxel and it was 0.72 or something for the low volume. So the STAMPEDE data is a little bit of an outlier when you look at all the other data sets, granted this power issue and they're missing 25% of the scans because they've did it retrospectively.

But let's just take a step back and just look at the pattern across the data because this trials... We can see there's probably a subgroup in there and it's going to be our job to find what that biology is, who's got the rapid proliferating that may benefit from chemotherapy and who can we take a slower approach?

Alicia Morgans: Absolutely.

Chris Sweeney: But let's also recognize that low-volume de novo metastatic group has another really good option in addition to the hormones and that's radiation to the prostate that can be considered, which looks like it has as much as a treatment effect as the docetaxel. So if a patients and physicians sit down and think through those different options and what can you access and what's right for them. Let's also take another extreme. Is there a patient that you'd never had on these other agents?

Michael Morris: Yeah, I would say that that's the one, you know, in a problem created by an embarrassment of riches in this space, the main mistake that can be made, is not to do any of these options and just do some testosterone lowering agent alone. There aren't that many patients that I can think about except for those with significant comorbid disease.

Chris Sweeney: Exactly.

Michael Morris: So at the end of life.

Alicia Morgans: Or advanced dementia.

Michael Morris: Advanced dementia or for whom you'd think that just the prostate cancer is not their primary medical issue, but pretty much everybody else should be on ADT plus something.

Chris Sweeney:We'll annotate that patient, that rare patient. It's the 85... Depends on which practice you are. It's the 85-year-old patient with severe congestive heart failure. Maybe some memory disturbance, frail who's relapsed 20 years after their bony... With two bony metastases. And you could just maybe get away with some radiation and some hormones because you know they're going to live a long time and you can maybe just radiate the two spots as per the STOMP. Maybe give some hormones and just de-escalate in that rare scenario.

Alicia Morgans: Maybe, but I do think it's still going to be, you know, if there are things like repeated admissions for CHS and dementia, I think though what you've both said is it's a conversation and that each of these decisions is probably going to be a real negotiation and education process for both the patient and for the physician on what's going to be the right thing. And, and my 85-year-old be may be different than your 85-year-old. And I think that it's important for us as we see new patients to at least consider that the standard of care is combination therapy and potentially radiation to the prostate if it's low-volume disease, and we need to at least think what is the reason why I would not use this combination.

Chris Sweeney: Exactly.

Alicia Morgans: Before we just default to using single agent.

Michael Morris: Yes. And I just to pick up something that Chris said that we're going to explore much more deeply in a session that we're planning for a GU ASCO is this issue that for the patient for whom this standard of care is not appropriate, that creating a new standard of care that has no evidence of clinical benefit is appropriate. That is the SBRT. Is...

Chris Sweeney: Work in progress.

Michael Morris: Is cause presuming that the patient has no symptoms, there is no organ threatening, that there's not an impending fracture. There actually is no need to make that lesion disappear without some evidence that you're doing some benefit. And we don't really have that evidence. So I just put a little caveat into what Chris just said.

Chris Sweeney: Absolutely.

Michael Morris: That we don't know that ADT free survival is a beneficial thing, but we do know that ADT plus is a beneficial thing. So...

Chris Sweeney: I've got... I have to admit, I'm not a fan of the radiation alone, approach to the MDT. I always have some testosterone suppression with everything I do, including the radiation. Now the bigger question is what about the patient who is three, two years in, their PSA is less than 0.2, if you image them and there's nothing growing at all, and they've got significant quality of life impairment from this profound androgen deprivation and four pills a day.

Michael Morris: Yeah.

Chris Sweeney: We need to think about, can we actually revisit intermittent dosing or dose de-escalation?

Alicia Morgans: Yes. Well, lots of questions to be answered and just so that everyone understands these are questions that we should answer in a clinical trial. And so referral to clinical trials or consideration of clinical trials in your own center is always the way that we should go about trying these approaches and so many patients can benefit. So much work for us to do. But I so appreciate both of your perspectives and I hope that our conversation brings... Sheds some light on what has become a very murky, set of questions that it's really those physician, patient, caregiver, family conversations about practical and even molecular, potentially at some point and disease volume. All of these considerations are going to be important.

Chris Sweeney: And patient preference.

Alicia Morgans: Patient preference, of course.

Chris Sweeney:What... I don't think we've talked about it enough, but we need to start saying that every conclusion of every hormone-sensitive conversation.

Michael Morris: Especially when this murkiness or ambiguity is because you have so many good choices.

Alicia Morgans: Yes.

Michael Morris: That the patient's voice needs to be heard so that you can make the right choice for that patient.

Alicia Morgans: Absolutely. Well, we will definitely end on that high note, and I appreciate the time that you've both given to this. Thank you.

Michael Morris: Thank you, Alicia.

Chris Sweeney: Thank you.

Read the original post:
Standard of Care in the Treatment of Metastatic Hormone-Sensitive Prostate Cancer - Michael Morris & Christopher Sweeney - UroToday

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Hyperglycemia is when you have elevated blood sugar. Before a meal, or when you have not eaten in several hours, high blood sugar is defined as 130 mg/dL. Two hours after eating, hyperglycemia is when blood sugar levels are above 180 mg/dL.

By comparison, normal blood sugar levels are generally between 80 mg/dL and 130 mg/dL. Hyperglycemia is most common for people with diabetes, and essentially, it describes the high blood sugars that define the chronic condition.

In some cases, hyperglycemia can also occur as a result of stress or as a side effect of steroid medication. Here's how you can recognize the signs of high blood sugar and lower it quickly.

The most common symptoms of hyperglycemia include:

However, the only way to know for sure if you have hyperglycemia is with a blood draw, says Jordan Messler, MD, a hospitalist at Morton Plant Hospitalist group in Clearwater, Florida. This can confirm that your blood sugar levels are elevated, and by how much. In fact, symptoms often won't become severe until blood sugars rise above 200 mg/dL.

If left untreated, hyperglycemia can lead to diabetic ketoacidosis (DKA) within 24 hours in some cases. This condition, most common in people with type 1 diabetes, occurs when the body is not able to break down sugar properly for fuel, so it breaks down fats instead, Messler says. This naturally releases acids into the blood, and because the body cannot flush the acid quickly enough, it becomes toxic in the blood.

DKA is a medical emergency, and people with the following symptoms should visit the emergency room, especially if they have diabetes, Messler says:

Both type 1 and type 2 diabetes can cause hyperglycemia. But there are also other potential causes, like stress or steroid medications.

People with diabetes are not able to process blood sugar effectively, either because they do not produce insulin, the hormone that breaks down blood sugar (type 1), or because their body does not utilize insulin effectively (type 2).

Since the body cannot break down blood sugar, it builds in the bloodstream and is more likely to cause high blood glucose levels, or hyperglycemia.

Hyperglycemia can also occur occasionally in people who are being treated for diabetes. These spikes in blood sugar levels can be caused by:

Even people without diabetes can get hyperglycemia. For example, stress can cause insulin resistance a condition where your body doesn't utilize insulin effectively.

At the same time, the stress hormone cortisol encourages the release of hepatic glucose, or glucose stored in the liver, which further raises blood sugar. This so-called "stress hyperglycemia" can occur during acute medical situations, such as an infection or heart attack, Messler says.

Steroids, like Prednisone and methylprednisolone, can also cause hyperglycemia in up to 46% of patients without diabetes, but this usually resolves when the medication is stopped.

Like the effect of stress, these medications also increase hepatic glucose release and increase insulin resistance, and can cause hyperglycemia even if you don't have diabetes.

The goal of treatment for hyperglycemia is to lower blood sugar. For people with diabetes, this could mean adjusting your insulin dose, or following a plan that you and your doctor have created ahead of time for when you experience hyperglycemia.

People who have chronic hyperglycemia caused by diabetes should also work to lower their blood sugar over time, in addition to treating individual episodes of hyperglycemia.

"The best ways to begin lowering blood glucose, for someone who has diabetes, is through lifestyle changes, such as diet and exercise," Messler says.

People with type 1 diabetes will need insulin to lower blood sugar levels, while type 2 diabetics are often treated with oral medication like metformin, and possibly insulin as well, Messler says.

However, for people with stress or steroid-induced hyperglycemia, the condition usually resolves on its own, as soon as the stress dissipates, or about four to six hours after the medication is discontinued.

If hyperglycemia persists after the underlying health condition is addressed, the patient may be diagnosed with diabetes, Messler says.

Hyperglycemia is a serious condition, especially if left untreated. Since it can only be diagnosed by measuring blood sugar, it's important to talk to your doctor if you're concerned about hyperglycemia.

"If you are suffering from symptoms of increased thirst and frequent urination with weight loss, then you should discuss with your doctor and check your blood sugar," Messler says.

He also recommends that people who have risk factors for diabetes including being overweight, having a family history of diabetes, or being older than 45 have their blood sugar levels checked regularly.

Originally posted here:
The most common signs and symptoms of hyperglycemia, or high blood sugar - Insider - INSIDER

Recommendation and review posted by Bethany Smith

A small study in the U.K. says cases of Type 1 diabetes nearly doubled in children during the peak of the pandemic.

WASHINGTON We are learning more about how COVID-19 could affect kids. A recent study out of the U.K. said the virus could be linked to Type 1 diabetes in children after cases of the chronic condition nearly doubled. An expert at Childrens National Hospital weighed in on the research.

It is another mystery in the battle against the coronavirus as researchers discovered a possible link between the virus and Type 1 diabetes in children and adolescents.

The autoimmune disease destroys cells in the pancreas that make insulin. Insulin is a hormone that turns blood sugar into energy. Without it, complications occur since high blood sugar is damaging to the body.

A small study in the U.K. is raising questions about possible ties between COVID-19 and Type 1 diabetes after cases nearly doubled, compared to previous years, in children and teens during the height of the pandemic.

The study was done between March and June on patients as old as 16. When hospitals tested kids with Type 1 diabetes, some were COVID-19 positive while others had antibodies.

Pediatric Endocrinologist Dr. Brynn Marks tells WUSA9 that it is still not clear whether the virus can cause the autoimmune disease to develop or if children who have it are at greater risk of contracting COVID-19.

We still dont know what exactly causes Type 1, Dr. Marks said. Theres some evidence that a related virus, the SARS virus which is similar to COVID, can attack the cells and pancreas that makes insulin so there is still that possibility that COVID-19 may be linked to Type 1, but without larger-scale studies, we just dont know the answer right now."

Dr. Marks said it is important for parents to watch for symptoms that include: extreme thirst, frequent urination, weight loss, fatigue and bed-wetting in children that dont normally wet the bed.

Its better to ask that question and find out sooner by going to your pediatrician than waiting until things get more serious, Dr. Marks said. One of my big worries as a physician is that the kids who do come in with diabetes are more sick when they come in.

Dr. Marks also said kids with Type 1 diabetes are oftentimes asymptomatic. It is only detected due to screening.

Seventy percent of children in the study also exhibited a more serious complication to Type 1, Diabetic Ketoacidosis (DKA). It happens when blood insulin levels are too low and the body tries to make up for it by creating something called ketones, excess blood acids.

Between March 1 and Aug. 31, 109 cases of Type 1 diabetes have been diagnosed at Childrens National, according to Dr. Marks. On average, there are about 20 new cases each month or between 230-240 annually.

Dr. Marks said there have not been many variations as the number of cases ranged between 17 and 22. However, when compared to last year's total number, nearly 300 cases will be diagnosed.

Newer technology like "continuous glucose monitors," which are little devices about the size of your pinky finger that sends data to your smartphone, are available to help monitor blood sugar, according to Dr. Marks.

Originally posted here:
Study finds possible link between COVID-19 and Type 1 diabetes in children - 11Alive.com WXIA

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When it comes to healthy eating, one size does not fit all. Japanese cooking, with its emphasis on rice, fish, and vegetables, may not be the best diet for everyone, but it is marvelously suited to the physiology of the Japanese, writes physician and writer Okuda Masako.

The popularity of Japanese cuisine has soared in recent decades, and one reason is undoubtedly its healthful image. The average lifespan of the Japanese people climbed rapidly after World War II. By around 1980, Japan had the highest life expectancy of any country in the world, and it still ranks near the top. (The worlds oldest living person is also a Japanese woman.) Amid a slew of investigations into the secrets of Japanese longevity, attention quickly centered on the benefits of washoku, traditional Japanese cooking.

My research and experience have taught me that the optimal diet depends on a variety of hereditary and environmental factors. But there is no denying that washoku has contributed to the health and longevity of the Japanese people. Let us begin by examining how.

In terms of health and long life, the biggest physiological factor the Japanese have going for them is a low risk of atherosclerosis. Atherosclerosis occurs when fats and other substances build up along the walls of arteries, restricting or even blocking blood flow. In the brain, such a blockage is known as a cerebral infarction (stroke); in the heart, it is called a myocardial infarction (heart attack). The incidence of myocardial infarction in Japan is among the lowest in the world.

Scientists believe that both genetics and diet play a role in protecting Japanese arteries. One factor is a high level of good cholesterol, or HDL (high-density lipoproteins), in the blood. In a 2008 study, Japanese HDL levels were found to be roughly 10% higher than those of white Americans on average. Another reason is that fish is a big part of the traditional Japanese diet, and fish contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), two polyunsaturated fatty acids that help prevent hardening of the arteries. Since ancient times, the Japanese have been eating oily fish like mackerel, sardines, yellowtail tuna, and eel, which are abundant off the coast of Japan and are rich in EPA and DHA. In a 2015 study, the average concentration of DHA in Japanese maternal milk was determined to be up to six times that found in Western countries and about twice that found in China.

A second major contributor to Japanese health is the gut microbiota, the many and varied microorganisms living in the intestinal tract. A 2016 analysis of the intestinal microbiota of subjects from 12 countries found that the Japanese had the highest counts of beneficial bifidobacteria. (Interestingly, the gut microbiome of the Chinese subjects was closer to that of the Western subjects studied.) This can probably be attributed to the high fiber content of the traditional Japanese diet, with its emphasis on grains and vegetables. Dietary fiber provides a good nutritional environment for beneficial microbes and helps cleanse the gut of the harmful substances that unhealthy bacteria produce. Since it takes a generation or more to permanently alter the gut microbiota, todays Japanese probably owe their intestinal health to the dietary habits of their parents and grandparents.

All of this might lead one to the conclusion that eating washoku will automatically make one healthier. Unfortunately, it is not quite so simple. In general, the traditional diets that developed in various parts of the world were optimally adapted to the local environment and the needs of the native population. The physiology of the native population, in return, adapted to the diet.

There are obvious physical differences between Japanese people and Westerners. But the differences go beyond hair texture and eye color. There are also disparities in musculature, body fat, and body temperature, as well as various factors that affect digestion and metabolism of alcohol: hormone and enzyme secretion, the shape of the stomach, the composition of the gut flora, and so forth. Race is not just skin-deep.

The Japanese stomach is adapted to consumption of grain.

Figure 1 illustrates the stomach shapes typically found in Japanese people on the one hand and people of Westerners extraction on the other. The differences are the result of disparities in the traditional diet.

The Japanese have long relied on rice and other grains as their dietary staple. Grains are a good source of energy, but whole grains in particular take time to digest because of their high fiber content. The Japanese stomach is vertically elongated so as to store, mix, and break down such food before it continues on into the intestines. The intestines, in turn, are rich in the kinds of bacteria that help digest and extract nutrition from starchy foods.

By contrast, the traditional European diet, with its emphasis on meat and dairy products, is considerably higher in protein and fat. Since protein and fat are digested primarily in the intestines, the food needs to move more rapidly from the stomach to the gut. The digestive system evolved to deal with these demands. For example, a large quantity of stomach acid is produced so that the stomach can process the food quickly; comparatively thicker stomach muscles then push it smoothly into the intestines.Plenty of enzymes and other fluids are secreted to aid the digestion of fat and protein inside the intestines.

It has long been known that the ability of adults to digest milk varies by ethnicity and region. The bodys capacity to digest the lactose in milk hinges on continued production of the enzyme lactase. The map in figure 2 shows the global distribution of lactose-intolerant adults in various parts of the world, with higher concentrations indicated by darker shades. While most people in the British Isles and Scandinavia digest milk easily, close to 90% of adults in Southeast Asia and East Asia (including Japan) have trouble with it.

Darker shades indicate regions with higher rates of adult lactose intolerance.

Such differences in physiology can translate into serious health problems when people adopt different diets and lifestyles. One example involves vitamin D, which is essential to bone health, among other things. Vitamin D is produced inside the body when the skin is exposed to the suns ultraviolet rays, but it can also be obtained from dietary sources like oily fish. It has been suggested that Africans, who evolved in a part of the world where year-round UV exposure is high, may be less well equipped to absorb vitamin D from dietary sources, and this may be why African Americans tend to have relatively low vitamin-D levels. Some experts have warned that African Americans need to adjust their diets to avoid health problems resulting from vitamin D insufficiency. The optimum diet for any person depends on genetic makeup, as well as lifestyle and environment.

Genetics also influences the way our bodies accumulate fat. One characteristic of the Japanese constitution is the tendency to accumulate visceral adipose tissue, or fat inside the abdominal cavity, as opposed to the subcutaneous fat that collects under the skin. Unfortunately, visceral fat is the more worrisome kind.

Cross-sections showing the distribution of abdominal fat in representative Japanese (left) and Westerners (right) subjects.

This is a fairly recent phenomenon, mind you. In earlier times, obesity was relatively rare in Japan, and the incidence of chronic diseases associated with visceral fatincluding type 2 diabetes, along with other diseases like breast cancer and colon cancerwas correspondingly low. That began to change in the 1960s to 1980s, as the Japanese diet became increasingly westernized, leading to higher fat consumption and lower intake of fiber. And with more people doing deskwork and leading sedentary lifestyles, lack of exercise contributed to the rise of obesity and the accumulation of visceral fat. The result has been a significant increase in disease, raising concerns for the future.

Extensive studies have revealed that a traditional Japanese dietlow in meat and dairy products, high in soybeans and fish, and high in fiber from grains, vegetables, and seaweedis tied to very low accumulation of visceral fat. In other words, washoku is ideally suited to the physiological traits of the Japanese people, protecting them from their innate tendency to accumulate visceral fat. Without knowing the science, our forebears managed to develop, preserve, and pass down a dietary culture perfectly adapted to our own metabolism.

Washoku has other health benefits as well. Soybeans, green and yellow vegetables, and small fish eaten whole all help to build strong bones. Lifelong consumption of soy foods also contributes to the relativelylow incidence in Japan of diabetes, breast cancer, and colon cancer, all ailments linked closely to visceral fat levels, as compared with the West

One notable weakness of the Japanese diet as it has developed in the past two or three centuries is the overwhelming preference for polished rice. For the health-conscious, I would recommend brown rice, which has seven times the dietary fiber of white rice and contains substances that help the body burn visceral fat.

In recent years, science has made considerable progress in identifying genetic differences among ethnic groups. In 2016, a Japanese team of researchers released the first Japanese reference genome panel (JRG v1), a whole-genome assembly representing the genes of a typical healthy Japanese. Comparison with the human reference genome has revealed millions of single-nucleotide differences, many of which doubtless reflect significant differences in nutrition physiology. We need to abandon the one-size-fits-all approach to nutrition and consider what diet works best for each ethnic group.

Nowadays, the Japanese people are able to enjoy delicious cooking from every part of the world. That is a splendid thing, as long as we keep in mind that washoku is the bedrock of our much-admired health and longevity.

(Originally written in Japanese. Banner photo: Dairy and meat products figure heavily in the Western diet, while the traditional Japanese diet has much to offer in the area of human health. Pixta.)

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Nutrition and the Wisdom of Ethnic Cuisine: A Japanese Doctor's Perspective - Nippon.com

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This transcript has been edited for clarity.

Matthew F. Watto, MD: Welcome back to The Curbsiders. I'm Dr Matthew Watto, here with my great friend, Dr Paul Williams. Paul, can you tell us about today's video?

Paul N. Williams, MD: Thanks so much for asking I'm also thrilled to hear that I'm now a great friend. I feel we're getting closer with each video, so we'll be married soon, and I'm looking forward to it. I couldn't do better. Tonight we had the opportunity to talk with Dr Eve Bloomgarden about hyperthyroidism.

Watto: We covered every aspect of diagnosis, treatment, and complications that we could. We are going to start off by giving you three pearls that we thought were really great from this episode. Paul, I'll let you go first.

Williams: We took a delightful detour and ended up talking about Graves orbitopathy (not a word I've ever said before tonight), otherwise known as thyroid-associated eye disease. She talked about the pathophysiology behind each type, which I thought was fascinating. With hyperthyroidism or thyrotoxicosis, more properly the patient can have a thyroidal stare or, classically, a lid lag. You ask the patient to look down, and if you see sclera, that's abnormal. It's positive for lid lag. Those are both adrenergic features of thyrotoxicosis, as opposed to Graves orbitopathy, where you have a little bit of proptosis, or the patient may say they have some itchiness, almost like a sand-like sensation in their eye. Those patients should be referred fairly promptly to ophthalmology.

Differentiating the pathophysiology behind each of those things was super-interesting.

Watto: And Graves orbitopathy is caused by thyroid-stimulating immunoglobulins (TSI), as opposed to just the thyroid hormone levels being high. I had no idea that it can occur even if the thyroid hormone levels have normalized.

Williams: Right, because it's not thyroid hormone mediated; it's antibody mediated.

Watto: Speaking of Graves, the main treatment is methimazole. My question to Dr Bloomgarden was, why do patients have such poor adherence to it? Part of that was my own misunderstanding. I thought patients had to be on methimazole for the rest of their lives, but she said she follows the TSI level. When those levels drop off, you can taper the patient off methimazole. They might have recurrence, but some patients don't need to be on it for the rest of their lives.

She sees patients monthly until their levels have normalized, and she is constantly teaching them that they have to take the methimazole, and this is why. That's what you have to do to get people to stay on it. For some reason I've seen people have trouble adhering to this therapy.

Williams: That's a great point. The assumption is that patients are on methimazole in perpetuity, but some patients can actually come off of it. If you explain that at the outset, you might have better adherence.

Dr Bloomgarden has a whole set of rules and regulations that patients must adhere to when taking methimazole. One thing we have to be mindful of is agranulocytosis (which to me has been purely theoretical because I haven't encountered it yet), a potential side effect of the medication. Any time that a patient on methimazole has symptoms of pharyngitis, a sore throat, or a fever and it sounds like there is some urgency to it she tells the patient to go to the lab and get a complete blood count, and to call endocrinology while they are on the way to the lab. If it turns out that the patient has agranulocytosis, that's an indication for hospital admission. It's a drastic and severe consequence that needs to be taken very seriously, and I don't think I appreciated that before.

Watto: That's why, even as a primary care or generalist physician, you can start these medications and you probably should have these folks followed by an endocrinologist. They are going to help decide whether the patient needs a thyroid ablation or thyroidectomy.

This is a huge topic. We delved into so many great things with our guest, Dr Eve Bloomgarden. If this sounds interesting to you, you can click on the link below to hear our full conversation.

Click to hear the full episode Thyroid on Fire: Hyperthyroidism with Dr Eve Bloomgarden, or find The Curbsiders' podcasts oniTunes.

The Curbsiders is a national network of students, residents, and clinician educators from across the country, representing 15 different institutions. They "curbside" experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge, and bad puns. Learn more abouttheir contributorsand follow them onTwitter.

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Lid Lag or 'Sand in My Eyes' -- What Could They Mean? - Medscape

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J.K. Rowling is in hot water again.

It seems the Harry Potter author whose latest claim to fame has been getting accused by many of transphobia after wading into controversial discussions about gender and biological sex is once again the topic of criticism. This time, its due to just-revealed details about her new novel (for adults, written under her pseudonym Robert Galbraith), Troubled Blood.

J.K. Rowling's latest book, Troubled Blood, written under pseudonym Robert Galbraith, is pictured outside of a bookstore in London. Its plot, about a cross-dressing serial killer, is sparking backlash. (Photo: REUTERS/Peter Nicholls)

The meat of the book is the investigation into a cold case: the disappearance of GP Margot Bamborough in 1974, thought to have been a victim of Dennis Creed, a transvestite serial killer, wrote reviewer Jake Kerridge in the Telegraph. One wonders what critics of Rowlings stance on trans issues will make of a book whose moral seems to be: Never trust a man in a dress.

The response, so far, has been negative, with #RIPJKRowling trending on Twitter, as shes called out with a mix of anger and exasperation not only for using the well-worn and damaging trope of the transgender serial killer ( la Psycho, Dressed to Kill, Silence of the Lambs and more) in her new book, but for doing so on the heels of her most recent public row about transgender identity, which is being viewed by her critics as a bizarre doubling down.

Rowling sparked accusations of transphobia back in December 2019, when she tweeted in defense of a U.K. researcher, Maya Forstater, who had lost her job after expressing views on transgender people including the belief that it is impossible to change sex that were deemed not worthy of respect in a democratic society. After the woman filed a discrimination lawsuit and lost, Rowling came to her defense on Twitter, noting, Dress however you please. Call yourself whatever you like But force women out of their jobs for stating that sex is real?

That caused a huge uproar among many in the LGBTQ community, who called her comments everything from heartbreaking to TERF. The latter is an acronym that stands for trans-exclusionary radical feminist, a pejorative term used to describe a feminist who is considered to have transphobic beliefs. Still, others came to Rowlings defense, with feminist writer Julie Bindel, for example, noting, YOU ARE AMAZING.

Then, just when the angry buzz seemed to have died down a bit, Rowling returned to Twitter in June, when she shared an op-ed and apparently took issue with the headline: Opinion: Creating a more equal post-COVID-19 world for people who menstruate. With her tweet, she noted, People who menstruate. Im sure there used to be a word for those people. Someone help me out. Wumben? Wimpund? Woomud?

And there was more:

The tweets re-sparked rage, hurt and allegations of transphobia, including from a range of LGBTQ activists, and from organizations including the Trevor Project and GLAAD.

Then, shortly thereafter, Rowling published a lengthy piece on her website, tweeting it with the caption TERF Wars and adding even more fuel to the fire.

This isnt an easy piece to write, for reasons that will shortly become clear, but I know its time to explain myself on an issue surrounded by toxicity. I write this without any desire to add to that toxicity, shewrote, and then outlined five reasons for being worried about the new trans activism. Then came more tweets, in July, calling out the long-term health risks of hormone therapy used to facilitate gender transition. Yet another backlash followed.

Now, with this latest bit of news about Rowlings new book, the hurt has been stoked, say her detractors.

Still, some have come out in her defense most notably actor Robbie Coltrane, who played Hagrid in the Harry Potter films and told Radio Times of the outcry, I dont think what she said was offensive really. I dont know why but theres a whole Twitter generation of people who hang around waiting to be offended. Other defenders include journalist Kim Willsher, Atlantic staff writer Helen Lewis and writers Helen Dale and Andrew Doyle, as well as the U.K. group (which, too, has been called transphobic) LGB Alliance.

Still, many say their view of Rowling has been forever tainted, especially in light of the latest book. That includes USA Today culture critic Kelly Lawler, who wrote on Tuesday that, while shes been a longtime fan of all her fiction, ever since Rowling made headlines this summer for her comments on transgender rights that have been widely condemned as transphobic, I cant see any story she's written in the same light You can't separate the art from the artist. Not anymore, not when the tone of both author and novel is the same. Rowling maintains she supports trans people, but we can only judge her by her actions and words. After reading 927 pages of them, I'm not inclined to change my judgment.

Read more from Yahoo Entertainment

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J.K. Rowling is again facing allegations of transphobia. Here's what sparked it this time around. - Yahoo Entertainment

Recommendation and review posted by Bethany Smith

Most people dying of COVID-19 have chronic health problems, a fact that has generated endless skepticism as the number of deaths attributed to the disease climbs closer to 200,000 nationwide.

From the beginning, some have repeatedly noted that there are few pure COVID-19 deaths where no other contributing conditions present. The vast majority who have died are struggling with chronic health conditions such as hypertension, diabetes, heart disease and obesity.

There has also been a growing mantra that deaths said to be caused by COVID-19, because they occur so often among those with other serious health problems, were inevitable.

Ousted former Fox News host Bill OReilly, for example, said on a radio show in early April that many people who are dying, both here and around the world, were on their last legs anyway, suggesting that, had it not been for the coronavirus, their chronic illnesses would have done the job soon enough.

But the numbers tell a different story.

The National Center for Health Statistics tracks excess deaths associated with COVID-19, releasing weekly totals of all deaths observed in the United States alongside totals of the number that would be expected given the numbers observed during the same weeks in previous years.

Though the dataset is perennially incomplete due processing lags for the newly-issued death certificates that are the main data source, information listed through Aug. 29 shows that there were 2.1 million deaths observed compared to an expected number of roughly 1.9 million.

The difference is about 181,000 more deaths this year about 16,500 of them in California than would have been expected, a number that correlates closely with the number of deaths nationwide attributed to COVID-19. The excess number of deaths detected this year, statisticians say, strongly suggests that the virus is killing those who otherwise might have had a long time left to live despite their ongoing struggles with chronic diseases.

It makes sense to Dr. Rodney Hood, a respected San Diego primary care physician who has made it his lifes work to help those in some of the regions most disadvantaged communities cope with and prevent the kinds of conditions most often present in those who die after testing positive for the novel coronavirus.

Suggesting that those with chronic illnesses were soon to die regardless of their encounters with the novel coronavirus, and suggestions that those who die with chronic diseases as well as COVID-19 somehow should not count, he said, is simply flabbergasting.

I think its ridiculous. It doesnt make logical sense; it doesnt make scientific sense, Hood said.

Yet the narrative continues as recently as this month.

On Sept. 1, when the president retweeted a now-removed tweet from Q Anon leader Mel Q claiming that only about 6 percent of those listed as COVID-19 deaths actually died from COVID while the remainder had 2-3 other serious illnesses.

Whats missing from the COVID-related death conversation, physicians say, is a basic understanding of how chronic diseases increase the odds of death from any type of infection.

The virus now rampaging across the globe is known to attack the cardiovascular system, triggering serious inflammation in a minority of patients that makes it significantly more difficult for the body to move oxygen from the air, through the lungs and into the blood.

Surviving this scenario, noted Dr. Duane Pinto, an interventional cardiologist with Harvard University, amounts to a serious fight for all of the bodys systems.

Youre going into a battle that really is about you having to fight to breathe, you having to fight to clear the toxins from your blood, to metabolize the acids that are being built up, Pinto said.

Speaking during a recent media symposium on the cardiovascular effects of COVID-19 convened by the medical device company Abiomed, Pinto explained that the presence of chronic disease at the time of infection means many start this vital fight already behind.

These systemic illnesses leave you less prepared to deal with a very severe ailment, Pinto said. It is not that just having diabetes is making you sick. It is that having the diabetes meant that you came into this firing on five of your six cylinders when you need seven cylinders to get past this, and youre not going to do as well.

Hood, too, favors a good car metaphor when explaining the situation.

Even for otherwise-healthy people, he noted, the body becomes less robust with age. The human immune system becomes less powerful, making it tougher to fight off new infections, kidneys become less able to effectively filter the blood, muscle mass decreases, dropping the odds of surviving a long hospital stay.

As your tires wear down, you may drive over a nail and get a blow out. Had you had new tires, you might have driven over the same nail and not have even noticed it, Hood said.

Hypertension, the most common of the co-occurring health problems in those who die after coronavirus infection, is a good example, Hood said. Otherwise known as high blood pressure, the condition puts additional stress on the blood vessels of the body over many years, causing insidious damage that puts a person at a disadvantage when a viral fight for their life suddenly materializes.

Hypertension is an indication that you have underlying damage to your blood vessels and, as we know, one of the things that happens with COVID is that it can attack the blood vessels, Hood said.

Type two diabetes, another chronic condition at the top of the list of diseases present in those who die after pandemic coronavirus infection, involves an insufficiency of or resistance to insulin, the hormone the body needs to properly process glucose, a sugar in the blood that all cells need to function.

In addition to causing vascular damage that affects many organs, diabetes also is known to impair the immune system, making infection more likely and more difficult to fight off, Hood said.

Though there are similar direct links with the other co-occurring illnesses on the COVID-19 mortality list, some have continued to say that these deaths would have happened anyway.

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Numbers, experts refute narrative that COVID-19 deaths are inevitable among the chronically ill - The San Diego Union-Tribune

Recommendation and review posted by Bethany Smith

Brian Bradley, Special to San Angelo Standard-Times Published 1:21 p.m. CT Sept. 9, 2020

Normal testosterone levels in men are important for a variety of important functions. The older a man gets, it is typical for this hormone to decrease.(Photo: Zerbor / Getty Images)

SAN ANGELO Normal testosterone levels in men are important for a variety of important functions. The older a man gets, it is typical for this hormone to decrease.

Symptoms of low or absent testosterone include:

To help men combat low testosterone levels, doctors can prescribe hormone replacement therapy to regulate levels appropriate to each individual. The Shannon Urology Clinic is now offering a new replacement option in the form of hormone pellet therapy.

Hormone pellet therapy is a convenient way to steadily dose testosterone for hormone replacement in adult males. The slow-release hormones are designed to last 3 to 4 months and aid in certain conditions causing low or absent testosterone in the body. The consistencies in these hormones help promote a more active lifestyle with less of the hassle of other methods.

Testopel testosterone pellets are inserted just under the skin of the hip or other fatty area during a 10 minute in-office procedure. Each pellet is 10mm in size and dosed based off the recommendation of your doctor. The pellets are FDA-approved and covered by most insurance providers. All Shannon Urology Providers are able to offer this as a service to their patients.

Brian Bradley(Photo: Shannon Medical Center / Contributed)

In the past, the Shannon Urology Clinic has offered other methods of hormone replacement, such as shots and gels. While these methods may have worked for some individuals, they do not provide as much convenience as pellet therapy. Gels often transfer onto clothing or other people, and shots typically require administration either every 2 to 4 weeks for short-acting injections or every 10 weeks for long-acting injections. Pellets release a more consistent dose over a longer period of time without the risk of transference. This provides both convenience of regular dosage of hormones and fewer trips to the doctors office.

If you feel like you might be experiencing symptoms of low or absent testosterone, visit with your doctor about potential treatment options. For more information about testosterone replacement therapy, or to schedule an appointment, call the Shannon Clinic Urology Department at 325-481-2231.

Dr. Brian Bradley is part of the Shannon Clinic Urology team. He earned his medical degree from the University of Texas Medical Branch inGalveston and did his residency at the University of Florida.If you appreciate locally driven journalism, consider a digital subscription to GoSanAngelo.com. Follow us on Facebook, Twitter and Instagram for news updates. Submit news tips to News@GoSanAngelo.com.

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Originally posted here:
Shannon Medical Center offers new option for hormone replacement therapy - Standard-Times

Recommendation and review posted by Bethany Smith

So, flowing and holding poses in a heated room isnt your thing.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

Fair enough.

But dont give up on yoga quite yet. Did you know that theres a style of yoga that just involves relaxing on a mat, blanket or even your bed?

Interested now? Well keep going.

And the best part about this style of yoga is that a 45-minute session could leave you feeling like you indulged in a peaceful three-hour nap.

If youre ready for an easy, pose-free way to slow down and recover from the stressors in your life, read on to discover how yoga nidra could be the answer.

Yoga nidra involves slowing down and chilling out. So does meditation. While some people tend to lump them together, they really are two different practices.

Yoga nidra is like meditation, but yet its not, says yoga therapist and yoga program manager, Judi Bar. There are overlaps, but there also are key differences. With yoga nidra, you are lying down and the goal is to move into a deep state of conscious awareness sleep, which is a deeper state of relaxation with awareness. This state involves moving from consciousness while awake to dreaming and then to not-dreaming while remaining awake going past the unconscious to the conscious. Bar says that this practice is guided like some meditation practices, but its very structured.

With meditation, youre sitting and in a waking state of consciousness while focusing the mind and allowing thoughts to come and go. Meditation makes it possible for us to get to the theta state the state we go through to get to the delta state, which is the place of the deepest sleep cycle. The delta state is a deep healing state. Thats where were trying to get through yoga nidra. In this state, the body and mind rest and the consciousness is awake.

Bar says that yoga nidra works with the autonomic nervous system. The autonomic nervous system regulates processes of the body that take place without a conscious effort (heartbeat, breathing, digestion and blood flow). This system also includes the sympathetic and parasympathetic nervous systems.

Meditation helps us calm the sympathetic nervous system; mainly, our fight-or-flight response, explains Bar.We do a meditation practice to basically calm the sympathetic, or fight-or-flight and activate the parasympathetic more. Theres such a benefit when those are balanced overall for immunity, digestion and stress management. But in this deeper relaxation, the pineal gland is activated and that releases the hormone melatonin.

Melatonin is a powerful antioxidant. It can also help manage immune function, blood pressure, cortisol levels and induce restful sleep.

A recent study showed that while meditation and yoga nidra were both effective in reducing anxiety and stress, yoga nidra seemed to be more effective in reducing anxiety. The study also suggested that yoga nidra can be a useful tool in reducing both cognitive and physiological symptoms of anxiety.

Some yoga studios offer yoga nidra, but you can also do it at home with the help of YouTube or a meditation app. You dont need fancy equipment either. You can lie flat on your back on a yoga mat or a blanket with a bolster or pillow supporting your lower back, spine and your head. You can even put a blanket or pillow under your knees.

Bar says there are 10 stages of a yoga nidra practice. These steps are outlined by Richard Miller in his 10 Stages of Yoga Nidra.

While yoga nidra might seem much easier than traditional yoga, Bar says you still have to practice, especially if youre not used to meditation or quieting your mind. She recommends practicing away from distractions and in a darker room. You can use a sleep mask to block out light if you need to. Bar also recommends covering up with a blanket since the body tends to cool down when its at rest.

If lying on the floor for a while wouldnt be comfortable for you, you can practice yoga nidra in a recliner or even in bed. And you dont have to start with a long session. Start with 15 or 20 minutes and work your way up. You also dont have to do yoga nidra in the middle of the day. A nighttime practice can help you sleep tight through most of the night.

And like with most things, dont give up if you struggle with your first session. Quieting your mind and not doing anything is much harder than you think. So give yoga nidra a few tries. Youll get the hang of it in no time especially when your mind and body need time to rest and recover.

Read the rest here:
What Is Yoga Nidra? - Health Essentials from Cleveland Clinic

Recommendation and review posted by Bethany Smith

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He had that hair.

Curly and blond, it floated around his head like a cloud and set him apart from his swarthier, shaggier classmates. He had the bluest eyes. He was tall. He was confident, and when she saw him across the room at her little brothers Halloween carnival in 1975 she knew that he was the one she wanted as her boyfriend.

They were both 14, and she was right. From seventh grade at Taft Junior High to 11th grade at Valley High, Francisca Contreras and Jubal Bobb were together.

Then, as it does, life took them on different paths to different cities, different loves, different worlds in which their relationship was a distant memory.

................................................................

But it was a sweet one.

Jubal Bobb and Francisca Contreras were junior high sweethearts but only rekindled their romance this spring, 45 years after they met.

We were each others first everything, said Contreras, now 59. We were each others first love.

Now, in spite of the years and miles and the improbability between them they just may be each others last love.

Contreras calls it love in the time of COVID-19, a rekindling of a romance that blossomed anew 45 year after it began through an unexpected courtship hampered but not deterred by closures and travel restrictions.

It is, she said, love with the one who has known her past yesterday.

Hes the closest thing to being home again, she said.

Which is an interesting feeling for two people who have been married since June 17 but still maintain their separate domiciles hers in Palm Springs, California, his in Breckenridge, Colorado.

By air, thats a distance of 702 miles. By COVID-19 restrictions, it feels like many more.

When we talk, Contreras, who manages a bio-identical hormone clinic in Palm Springs, is in Breckenridge for the long Labor Day weekend. Bobb is off on his route for UPS.

Here, restrictions are more relaxed than in California. Restaurants are open to 50% capacity, Main Street and hiking trails are accessible to those who wear masks.

Earlier this year, there were no movies or places open for dinner, drinks or coffee.

We couldnt go on regular dates, but in a way we didnt have to because we already knew each other so well, Contreras said.

Jubal Bobb and Francisca Contreras dated from seventh grade until 11th grade. In 1977, they went to the Homecoming dance at Valley High School. (Courtesy of Francisca Contreras)

It reminded them of their younger days when money was tight.

He used to forego lunch because he saved his lunch money for gas to pick me up, she said. We never had real dates.

In high school, sports kept Bobb too busy for jobs. Contreras had several. She was ambitious, a straight A student with a focus on earning a college scholarship.

Thats why we broke up, she said. I wanted to be serious about academics, and he wanted to be a boy.

Contreras earned a presidential scholarship to the University of New Mexico after graduation in 1979. Bobb became a mechanic.

Both eventually married other people, had children, divorced, married again. Contreras moved to the West Coast; Bobb moved to the Western Slope.

They and their spouses attended Valley High Schools 10-year reunion, where Bobb won the Most Lost Hair award, his cloud of curl now coiffed in a less lofty style.

They saw each other again at the 20-year reunion but didnt converse much.

The 40-year reunion was held in the summer of 2019, and for Contreras it was a reminder of how much had changed in her life. Both her parents had died within months of each other. Her children were grown. She had been divorced for four years and flailing in a dating pool that had grown increasingly shallow.

In her head, she heard her mothers voice saying, Go to him, hes waiting. But she had no idea who he was.

From across the room at the reunion she saw Bobb. They raised their glasses in a silent toast.

They didnt speak. He left with his wife of 27 years.

And I was thinking, how I wish I could meet someone who knows me past yesterday, she said. But you realize you just go on in life.

Several weeks after the reunion, Bobb called her late one night. His wife had left him, leaving her farewell on a sticky note.

He was broken, and in need of a friend who had been down that divorce path, she said.

She never imagined then that the path would lead them back to each other.

For eight months, they talked and texted and Facetimed as old friends. It wasnt until April that they admitted that maybe they were more than old friends.

I could hear my mothers voice again, she said. And I realized he was someone who knew me past yesterday. We connected on every level. Being someones first everything is an undeniable connection.

For now, their paths connect through airports and long car drives. Both plan to retire in three years and settle down together, although Contreras said she is hopeful she can move her business to be closer to Bobb sooner.

If COVID-19 restrictions allow, they plan to meet up in Albuquerque Sept. 19 to share their joy with family and friends in that place where it all began for them home.

Bobs hair is gray and thinner now. But from across the room, he still stands out to her and she still knows he is who she wants.

UpFront is a front-page news and opinion column. Reach Joline at 730-2793, jkrueger@abqjournal.com, Facebook or @jolinegkg on Twitter.

Read more:
First loves overcome years to be together at last - Albuquerque Journal

Recommendation and review posted by Bethany Smith

While most patients with metastatic hormone-sensitive prostate cancer (mHSPC) will initially respond to androgen deprivation therapy (ADT) plus abiraterone acetate with prednisone (AA/P), the majority will develop castration-resistant disease. The ability to track early prostate-specific antigen (PSA) changes may alert clinicians to those more likely to progress and initiate subsequent therapies earlier before clinical or radiographic progression develops.

Historically with ADT alone or docetaxel-based chemotherapy, a non-detectable PSA at 7 months was considered a predictor of overall survival.1-2 However, there has not been a standard time frame established for patients treated with adrenal biosynthesis inhibitors.3-4 Our results showed a significant association between the degree of PSA decline at 3 months and serologic progression in mHSPC patients treated with ADT plus AA/P. Moreover, a PSA reduction < 98% from baseline and PSA > 3.0 ng/mL at 3 months were associated with a significantly shorter castration-resistant prostate cancer (CRPC)-free survival.

These findings support evaluating response to ADT plus AA/P for mHSPC as early as 3 months after initiation of therapy. Since castration-resistant disease is associated with high morbidity and mortality, it is important to identify patients with aggressive disease early to help maintain quality of life and prevent increased exposures to the healthcare system.

Written by: Iris Y Sheng, Jaleh Fallah, Ruby Gupta, Hong Li, Kimberly Allman, Allison Martin, Pedro Barata, Moshe C Ornstein, Timothy D Gilligan, Brian I Rini, Jorge A Garcia

Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA., Department of Hematology and Medical Oncology, Bellmunt Hospital, Troy, MI, USA., Department of Internal Medicine, Section of Hematology Oncology, Tulane University Medical School, New Orleans, LA, USA., Department of Internal Medicine, Section of Hematology Oncology, Vanderbilit University, Nashville, TN, USA., Department of Hematology Oncology, University Hospital Cleveland Medical Center, Cleveland, OH, USA.

References:

Go here to see the original:
Identifying Prostate Surface Antigen Patterns of Change in Patients with Metastatic Hormone Sensitive Prostate Cancer Treated with Abiraterone and...

Recommendation and review posted by Bethany Smith