Abemaciclib (Verzenio) in combination with fulvestrant and trastuzumab (Herceptin) demonstrated significant improvement in progression-free survival (PFS) and tolerable safety compared with standard of care chemotherapy combined with trastuzumab in patients with hormone receptor (HR)-positive, HER2-positive advanced breast cancer, according to published results from the monarcHER trial (NCT02675231).

Patients in the study were randomized 1:1:1 depending on the number of prior systemic regimens and their disease status. Patients in group A received abemaciclib, trastuzumab, and fulvestrant. In group B, patients received abemaciclib plus trastuzumab. In group C, patients received chemotherapy of the physicians choice plus trastuzumab.

Baseline screening showed that the median age for groups A, B, and C was 55 years (range 47-61 years, 54 years (range, 47-62 years), and 57 (range, 47-62 years), respectively. The majority of patients across the treatment arms were European (n = 111), but there were also 38 patients from Asia, 61 from North America, and 27 from South America.

Disease characteristics were sorted by metastatic site and measurable disease status. The most common site of metastasis in the study was visceral, which was the case for 73% of group A, 71% of group B, and 61% of group C. Respectively, 89%, 86%, and 87% of these patients had measurable disease.

In terms of prior systemic therapy, most patients had 3 or more. Overall, 80% of group A, 76% of group B, and 76% of group C had prior endocrine therapy. In addition, 97% of patients in group A, 96% in group B, and 100% in group C received prior trastuzumab.

In total, 78 from group A, 77 from group B, and 72 from group C received at least 1 dose of treatment during the study. However, at data cutoff, only 20% of the patients in group A remained on the study (n = 16), 11% in group B (n = 9), and 15% in group C (n = 10). Most patients discontinued treatment due to progressive disease, including 51 patients in group A, 58 in group B, and 62 in group C. Additionally, there were 11 deaths across the 3 study arms, and 4 treatment withdrawals based on physicians decision.

In the intention-to-treat population, there were 169 PFS events at the time of data cutoff. Of the PFS events, 56 (33%) occurred in group A, 61 (36%) in group B, and 52 (31%) in group C. At a median follow-up of 19.0 months (interquartile range [IQR], 14.7-25.1 months), the median PFS was 8.3 months (95% CI, 5.9-12.6) in group A compared with 5.7 months (range, 5.4-7.0 months) in group C (HR 0.67; 95% CI, 0.45-1.00;P=.051). PFS in the subgroup analysis of prior systemic treatment was consistent with the overall analysis.

Overall survival data have not yet matured in this study and will be reported at a later date.

In terms of response, group A was superior to group C in the overall analysis and the post-hoc analysis, which evaluated response based on disease status.

To our knowledge, this trial is the first randomized study to report positive results for a CDK4 and CDK6 inhibitor in combination with fulvestrant and trastuzumab versus standard-of-care chemotherapy and trastuzumab. The endocrine combination of abemaciclib plus fulvestrant and trastuzumab showed significant improvements in both progression-free survival and overall response compared with chemotherapy plus trastuzumab and was generally well-tolerated, wrote Sarah M. Tolaney et al. The current study is noteworthy as it directly compared an

the endocrine-based regimen with standard-of-care chemotherapy in combination with trastuzumab, potentially offering a chemotherapy sparing treatment option.

There were multiple post-hoc analyses in monarcHER. First, the patients were assessed according to Blinded Independent Central Review in a post-hoc exploratory analysis. The assessment showed no significant difference in PFS between group A, which had a median PFS of 7.1 months versus group C, which had a PFS of 6.9 months (HR, 0.883; 95% CI, 0.565-1.380; two-sidedP=.56 stratified). The median PFS for groups B versus C were 7.9 months versus 6.9 months (HR, 0.876; 95% CI; 0.5601.368; two-sidedP=.56 stratified), which also showed no significant difference, respectively.

Among patients with brain metastases, another post-hoc analysis was inconclusive based on the fact that 11% of the patient population had progressive disease.

In terms of safety, at least 1 grade 1 to 4 treatment-emergent adverse event (TEAE) was observed in 94% of patients in group A (n = 73), 97% in group B (n = 72), and 93% in group C (n = 72). Grade 3/4 TEAEs were seen in all groups, with a higher percentage observed in group A (68%). The most frequent TEAE in patients was grade 3/4 neutropenia, which occurred in 27% of patients in group A, 22% in group B, and 26% in group C.

In higher than 1% of the safety population of monarcHER, the most common serious AEs in group A were pyrexia (4%), diarrhea (3%), urinary tract infection (3%), and acute kidney injury (3%). In group B, the most common serious AEs were diarrhea (3%), and pneumonitis (3%). Finally, in group C, the most common serious AEs were neutropenia (6%) and pleural effusion (3%).

A total of 6 patients from group A, 11 from group B, and 6 from group C discontinued treatment due to AEs. Across the 3 treatment arms, dose reductions were required for 50% of group A, 42% of group B, and 28% of group C. Mostly, diarrhea was the AE that led to treatment discontinuation.

MonarchHER is an ongoing phase 2, randomized, multicenter, open-label study. Participants of monarchHER received 150 mg of abemaciclib every 12 hours on a 21-day cycle, along with 8 mg/kg of intravenous trastuzumab, and 500 mg of intramuscular fulvestrant. Trastuzumab is administered for 90 minutes on day 1 of cycle 1 and then at 6 mg /kg on day 1 of all subsequent cycles. Fulvestrant is administered on days 1 and 12 of cycle 1 and on day 8 of cycle 2, followed by once every 4 weeks. All study treatments were continued until disease progression as per RECIST v 1.1. criteria or unacceptable toxicity.

MonarchHER was conducted based on prior research from the MONARCH-1 (NCT02102490), MONARCH-2 (NCT02107703), and MONARCH-3 (NCT02246621) clinical trials, which provided evidence of activity with CDK4/CDK6 inhibition in combination with endocrine therapy and chemotherapy.

This study provides clinical validation of the preclinical hypothesis suggesting that treatment with a CDK4 and CDK6 inhibitor might overcome acquired resistance to trastuzumab. Furthermore, together with previously published data, abemaciclib has now shown activity in both HR-positive, HER2-negative and hormone receptor-positive, HER2-positive advanced breast cancer, Tolaney et al concluded in the published report.

Reference:

Tolaney SM, Wardley AW, Zambelli S, et al. Abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with hormone receptor-positive, HER2-positive advanced breast cancer (monarcHER): a randomised, open-label, phase 2 trial. Lancet Oncol. 2020. Published Online April 27, 2020. doi: 10.1016/S1470-2045(20)30112-1

More:
Abemaciclib Triplet Improve PFS in HR+, HER+ Advanced Breast Cancer - Targeted Oncology

Recommendation and review posted by Bethany Smith

SMITHSONIANMAG.COM | June 10, 2020, 10:56 a.m.

More patients than ventilators. Understaffed hospitals. A snowballing pandemic. Seven decades before COVID-19, a similar crisis strained the city of Copenhagen. In August 1952, the Blegdam Hospital was unprepared and overwhelmed. A 12-year-old victim, Vivi Ebert, lay paralyzed before anesthesiologist Bjrn Ibsen, gasping for air and drowning in her own secretions. Seven years after liberation from Nazi occupation, a new shadow darkened the streets: the poliovirus. With his hands, a rubber bag, and a curved metal tube, Ibsen reset the boundary between life and death and taught the world how to breathe.

We were very afraid, remembers Ibsens daughter Birgitte Willumsen of the 1952 outbreak, everyone actually knew somebody affected by polio. Waves of young people with fever, headache, upset stomach and stiff neck heralded the arrival of the summer plague in cities throughout the United States and Europe. Masquerading as a common stomach virus, the infection established itself in the gut before spreading to the brain and spinal cord. The clinical picture ranged from a self-limited stomach bug to paralysis, shock and asphyxia. Some recovered, but lasting disability, or death, was typical. At the time, the best way to treat respiratory complications of polio was with the "iron lung," a tank that encased polio victims but allowed them to breathe with the help of a vacuum pump. Researchers understood that the virus was contagious, but they could not yet agree on its manner of spreading. Recalls Willumsen, We really learned to wash our hands. Nonetheless, the modern sanitation, water supply, housing and medical infrastructure of Western cities offered little protection. A vaccine was not yet available.

Blegdamshospitalet was the designated fever hospital for treating infectious diseases among the 1.2 million citizens of Copenhagen. During the summer of 1952, the staff treated more children with severe polio than they had in the previous decade. At the peak of the epidemic, up to 50 new patients limped, wheeled and wheezed onto the wards each day. With higher attack rates than preceding outbreaks in the U.S. and Sweden, the Copenhagen epidemic was the worst polio crisis that Europeand perhaps the worldhad ever seen. During these months we have in fact been in a state of war, wrote Henry Cai Alexander Lassen, Blegdams chief physician. We were not nearly adequately equipped to meet an emergency of such vast proportions. Hundreds of patients with bulbar polio. One state-of-the-art iron lung ventilator, and a few older, mostly impotent, devices. Concluded Lassen: Thus the prognosis of poliomyelitis with respiratory insufficiency was rather gloomy at the outbreak of the present epidemic in Copenhagen.

The prognosis was especially gloomy for young Vivi Ebert, who was dying in front of Ibsen and his colleagues on August 27, 1952, at the height of the epidemic. Vivi suffered from the bulbar variant of polio infection; in addition to causing paralysis, the virus disrupted brainstem control centers for swallowing, breathing, heart rate and blood pressure. At the time, about 80 percent of bulbar polio patients died comatose in the iron lung.

Physicians had long implicated overwhelming brain damage as the cause of bulbar polio deaths. A methodical problem-solver who logged even his music consumption (on November 24, 1997, for example, he listened to Arthur Rubensteins rendition of Fantaisie in F Minor by Chopin), Ibsen doubted the prevailing theory; he suspected that paralyzed chest muscles compromised respiration. The lungs themselves could sustain life if stronger mechanical muscles could be found. A world war and a chance encounter would lead him to the solutionand to an ethical dilemma that spurred accusations of murder.

Ibsen had been thinking about breathing for years. After completing medical school in 1940, he trained in Denmark's remote northern peninsula, where, according to his son Thomas, the healthcare system consisted of three persons: the doctor, the pharmacist and the priest. Ibsen delivered babies, assisted with surgery, spent long hours with the sick and raised his young children. Isolated by geography and Nazi occupation, opportunities for advanced medical training remained scant, even after the wars end. Ibsen and his peers looked abroad to the United States and United Kingdom.

In February 1949, Ibsen relocated his growing family to Boston so he could train in anesthesiology at the Massachusetts General Hospital, the institution credited with the first surgical administration of ether. In Boston, Ibsen fused ruffle-shirted Harvard medicine with Danish pragmatism. Accustomed to the privations of postwar Europe, the young Danes earned a reputation for medical creativity. This spirit would leave a lasting mark on medicine, as young Danes like Ibsen followed other pioneers to the United States and Great Britain to study.

In Boston, Ibsen learned the art of baggingthe use of a hand-squeezed rubber bag to breathe for anesthetized patients during surgery; the practice was foreign to Danish physicians at the time. He also learned to bag ventilate patients with tracheostomy tubesbreathing conduits placed in the windpipe through an incision in the neck. Although seemingly rudimentary, this technique became a crucial element of Ibsens answer to the bulbar polio crisis of 1952.

Ibsens bagging, known as positive pressure ventilation, was not widely used at the time, as it contradicted human physiology. Normally, air is instead drawn into the lungs by negative pressurethe vacuum created by diaphragm and chest muscle contraction. Outside of the operating room, negative pressure ventilators, such as Blegdams iron lung, were the sole means of artificial respiration.

Originally intended to treat victims of industrial accidents, the modern iron lung was developed at Harvard in 1928 by Philip Drinker and Louis Agassiz Shaw. Its nickname derived from the airtight cylindrical tank that enclosed the patients body. The head and neck protruded through a snug rubber collar. Electric pumps cycled air in and out of the tank to mimic normal breathing. John Emersonhigh school dropout, self-taught inventor and distant relative of Ralph Waldofashioned a rival model in 1931 that was cheaper, quieter and more adaptable. However, even Emerson tank ventilators remained prohibitively expensive for most hospitals and served as little more than a costly and claustrophobic deathbed for eight out of ten patients with bulbar polio. A better treatment was needed.

The breakthrough came in 1949 at the Los Angeles County Hospital, but few realized it at the time. For centuries, healers attempted positive pressure ventilation, using mouth-to-mouth resuscitation or even a fireplace bellows to treat victims of drowning, opioid overdose and other misfortunes. Physician Albert Bower and engineer Vivian Ray Bennett, supplemented the Emerson-style tank ventilator with an invention that simultaneously inflated the lungs through a tracheostomy. Their new positive pressure ventilator, modeled on an oxygen-supply system for World War II pilots, increased airflow to the lungs. The device decreased the mortality of severe polio from 79 to 17 percent. In 1950, the Bower-Bennett team published their results in an obscure medical journal. The article passed unnoticed by many, but Ibsen, who had returned to Denmark in February 1950 after completing his one-year fellowship in Boston, read it and immediately understood its significance. A reprint of Bower and Bennetts report in hand, Ibsen met with Lassen, Mogens Bjrneboe (a physician who worked with Lassen at Copenhagens fever hospital) and other senior physicians on August 25, 1952, as the bodies of Denmarks children were stacking high at Blegdam. Positive pressure ventilation, Ibsen argued, was the key to Bower and Bennetts success, and spare parts from the operating room could deliver Blegdam from catastrophe.

The following day, young Vivi Ebert arrived at Blegdam Hospital with headache, fever and a stiff neck. By morning, bulbar polio was manifest and death inevitable. Lassen agreed to let Ibsen proceed. At 11:15 a.m., at Ibsens direction, a surgeon placed a tracheostomy tube in her windpipe, but she deteriorated further. Oxygen levels fell.

Ibsen attached, to Vivis tracheostomy tube, a rubber bag filled with an oxygen supply. Air filled her lungs with each squeeze of the bag, but, agitated and drowning in mucus, she bucked and fought the breaths of the junior anesthesiologist. In desperation, to settle her, he administered a large dose of sodium thiopental. The assembled onlookers lost interest and left the room, figuring that the demonstration was culminating in a semi-intentional and lethal barbiturate overdose. However, as the sedative took hold, Vivis gasping ceased. Her struggling muscles relaxed, allowing Ibsen to breathe on her behalf. Her lungs cleared, and her condition stabilized. When the thiopental wore off, the team stopped bagging, but she again gasped and floundered. Primitive sensors, repurposed from U.S. Army Air Force and anesthesia applications, signaled falling blood oxygen and rising carbon dioxide. Ibsen and colleagues re-administered the sedative and resumed bag-ventilation, and, as before, she improved.

Vivi would live if they could keep squeezing the bag.

Standing on the shoulders of Bower, Bennett and unsung fireplace bellows-squeezers, Ibsen improvised the first practical treatment for bulbar polio. His breakthrough shepherded Vivi Ebert and the city of Copenhagen through the grimmest days of the outbreak, and cemented his reputation as a founding father of intensive care medicine. But later that afternoon, Ibsen and Lassen needed to find extra hands.

***

Over the next eight days, the leadership of Blegdam Hospital organized bag ventilation for every patient with respiratory failure. The effort consumed 250 ten-liter breathing gas cylinders each day. It was an unprecedented logistical challenge; up to 70 patients required simultaneous, around-the-clock ventilation at the height of the epidemic. In this manner we avoided being placed in the dreadful situation of having to choose, wrote Lassen. They recruited approximately 1,500 medical and dental students to assist. It was simply necessary and there were not enough physicians with these skills, remembered Ibsen. As young as 18 years old, the volunteers were but able-bodied reflections of the peers they were ventilating. Perhaps nothing but chance separated patient from practitioner. Amazingly, not a single bag-squeezer would catch polio while on duty at Blegdam.

The students assignment began with a few hours of instruction, and they were soon sent to the wards. They bagged in shifts, pausing for meals and cigarettes. The young students read to their patients and played games. They learned to read their lips. And they were heartbroken when their patients died. Uffe Kirk was 25 years old when he helped to organize the medical student response in 1952. In a letter to a colleague, he recalled: At worst, the patients died during the night. The light in the wards was dimmed in order not to disturb the patients in their sleep. But the faint light and the fact that the students were not able to tell anything from the ventilation made it impossible for the students to know that their patient had died. It was therefore a shock for the student when morning came and he/she realized that the patient had been dead for a while.

Few medical innovations would be so immediate and definitive. In one week, the mortality of bulbar polio fell from 87 to barely 50 percent. By November, the death rate dropped again to 36 percent. As the embers of the Copenhagen outbreak cooled in March 1953, only 11 percent of patients who developed bulbar polio died.

Healers from different specialties buttressed the mission of bag ventilation. The polio wards swarmed with internists, anesthesiologists, head and neck surgeons, physical therapists, experts in laboratory medicine and nurses. The team addressed nutrition and bedsore prevention. A comprehensive triage system facilitated recognition of impending respiratory failure. Ibsen and colleagues even ventured to outlying communities to collect stricken patients and ventilate them en route to Copenhagen. The Bledgam team cared for the mind as they cared for the body: The polio wards featured teachers, books and music.

The coordinated response was prescient. Decades before cross-functionality became a management buzzword, the leaders of the respective medical specialties gathered regularly at the Ibsen home for dinner and discussion. Detailed records on every polio admission to Bledgdam Hospital, compiled at Ibsens suggestion, facilitated clinical research. Even in 1952, the junior anesthesiologist sought answers in big data.

One-by-one, despite blood clots, pneumonias, bladder infections and other inevitable consequences of prolonged illness, victims weaned from ventilation as their muscle strength improved. There remained, however, a group of patients who were still unable to breathe on their own. In October 1953, well past the one-year anniversary of Vivi Eberts rescue, 20 of the original 318 patients treated by Ibsens method still required around-the-clock ventilation at Blegdam Hospital. By 1956, 13 patients remained dependent. As the first clinicians to practice modern intensive care medicine, Ibsen, Lassen, Bjrneboe and colleagues encountered the chronic respirator patient, an individual that medicine still struggles to serve nearly 70 years later.

at the beginning of intensive therapy it was a problem to keep the patient alivetoday it has become a problem to let him die.

-Bjrn Ibsen, 1975

Although the fundamentals had been practiced for centuries, the new discipline of critical care medicine blossomed in the wake of the 1952 Copenhagen polio outbreak. Lessons from Copenhagen bore fruit in Stockholm one year later during the next European polio epidemic. Engineers and physicians scrambled to build the first generation of positive pressure ventilators, applying declassified wartime insight on lung physiology and oxygen systems for pilots and sailors. Machines replaced bag-squeezing students.

Modern intensive care units or shock wards emerged in Copenhagen at the Kommunehospitalet, at the Los Angeles County General Hospital and at the Baltimore City Hospital. Mechanical ventilators, operating by positive pressure, improved survival for once-hopeless conditions such as shock, drug overdose and cardiac arrest. Temporary breathing tubes placed through the mouth soon obviated surgical tracheostomy. This technique of intubation made intensive care more accessible.

Of those patients ventilated in early I.C.U.s, many recovered, some died and others walked a path in between. Ibsens persistence in the summer of 1952 gave Vivi Ebert another chance at life. But the incomplete resurrection of many of the eras intensive care patients sparked new questions. What happens if the patient cannot be weaned from the ventilator? What happens when the body recovers and the mind does not? Does life support benefit all patients? Should intensive care be offered to everyone? The ethical and social weight of these concerns saddled Ibsen with somewhat conflicting roles as proud father and emerging conscience of this new brand of medicine.

In August 1974, he met with Christian Stentoft, a Danish radio journalist, and was presented with the question, Who helps when a human being is going to pass away? As related by Preben Berthelsena Danish anesthesiologist, intensive care physician and Ibsen scholarthe interview included this exchange:

Stenthoft: Do we prolong the death process?

Ibsen: Yes and often times it would be much more humane to give morphine, peace and comfort to patients with no hope of surviving.

Stentoft: Have you done that?

Ibsen: Yes I have.

Effectively, Ibsen confessed to removing patients from the ventilator when their illness was, in his opinion, insurmountable. He did not consult the next of kin. It serves no purpose that no one can die without having spent at least three months hooked up to a respirator. A risky admission, even for a national hero.

Newsmen pounced. Published excerpts of the interview, as Berthelsen explains, implied that Ibsen sought to euthanize the hopelessly ill. Patients beyond reach are helped to die! announced Danish headlines. Ibsen was suspended from hospital duties. Tabloids proclaimed him the first physician who openly supports and participates in active euthanasia. Jens Mller, the leader of the conservative Christian Peoples Party, cried murder. Others echoed his call for criminal charges.

Copenhagens chief medical officer, Hans Erik Knipschildt, summoned Ibsen to dissect fact from rumor. The anesthesiologist confirmed that he had removed dying patients from the ventilator and treated them with morphine. But the main aim, says Berthelsen, was to alleviate pain and secure comfort even if it hastened the demise of the patient. Knipschildt concluded that Ibsen acted reasonably and that his remarks had been interpreted out of context. Its of my understanding that if this conversation was provided in its original form, the whole havoc about Bjrn Ibsens business could have been avoided, Knipschildt told the media. Prosecutors declined to press charges. Though stoked by sensationalist journalism, the controversy surrounding the 1974 Ibsen-Stenthoft interview joined a growing international dialogue, including an address from the Pope on life support ethics, scientific acceptance of brain death, and landmark legal decisions that collectively recast traditional constructs of life and death in the age of the ventilator.

George Anesi, an intensivist and expert in intensive care utilization at the University of Pennsylvania, emphasizes: It took us a while to come to the conclusion that active withdrawal and passive declination, in the face of futility, are ethically equivalent events. This was a turning point that allowed for a more normalization of the idea of withdrawing support. If someone was sick enough that you would not put them on a ventilator if they were not on one, they were sick enough to justifiably remove a ventilator.

In his later years, Ibsen told his children, I am not afraid of dying, I am only afraid of how.

***

According to her medical chart, Vivi Ebert required continuous mechanical ventilation until January 1953. Quadriplegic, but alive, she left Blegdam in 1959 after a seven-year convalescence. After discharge, she moved with her mother, Karen, and a devoted rough collie named Bobby to an apartment complex for polio survivors. She relied on Karen for most daily needs like eating and toileting. Every evening, Vivi was wheeled to a penthouse unit where she slept on a ventilator under medical supervision.

Despite her condition she was a very positive person, says distant cousin Nana Bokelund Kroon Andersen. Optimistic and known for her smile, Vivi eventually completed her education from a wheelchair. Andersens mother, Sussi Bokelund Hansen, recalls that Vivi could turn pages in a book, type on a typewriter and paint with a long stick held in her mouth. She married her driver. She was beloved by generations of relatives.

Spirit alone could not shield Vivi from the complications of polio and critical illness. Like most survivors, her life was pockmarked by setbacks. Vivi and her husband eventually separated; not long thereafter, in 1971, she was readmitted to the fever hospital. Pneumonia and sepsis, determined the doctors, though her mother suspected a broken heart. She died a few days later at the age of 31. It is not clear whether Ibsen maintained contact with his most famous patient; he never spoke to his family about Vivi after their initial encounter in 1952.

In hindsight, Vivi Eberts journey after polio was as noteworthy as her August resurrection. Having endured the infection, she lived her remaining days dependent on people and machines to sustain her: too sick to survive on her own, but too well to surrender hope. Before intensive care, this manmade purgatory did not exist. Now termed chronic critical illness, this syndrome arises when recovery from catastrophe stops short. Patients with chronic critical illness often develop muscle wasting and weakness, fluid retention, neurologic dysfunction, anxiety, depression, post-traumatic stress disorder, hormone imbalances and increased susceptibility to infection. Its shadow may be life-long and, in retrospect, was visible in polio survivors like Vivithe worlds first graduates of intensive care.

Today, five to ten percent of all respiratory failure patients, about 100,000 Americans annually, share a similar fate. Of those discharged from the I.C.U. to specialized long-term ventilator rehabilitation facilities, about at least half will die within the year, and fewer than one in ten will ever return home able to walk, eat or dress independently. Older patients or those with a greater number of medical problems may face even tougher odds. Sadly, these statistics have not improved over the last 20 years, though not for lack of trying.

Faced with this understanding, modern critical care physicians must balance hope with reality when counseling the sick. An overly actuarial discussion of I.C.U. outcomes may alienate the patient and engender suspicion that the doctor is prematurely giving up. Conversely, skirting altogether the issue of prognosis risks more catheters, more needles and more setbacks, for little prospect of a life independent of machines and hospital walls. And even when physicians do begin these conversationstime pressure, prognostic uncertainty and fear of undermining patient trust are common barriersnot everyone is ready to listen.

Seven decades of scientific and historical examination defused the mystery of the poliovirus. As Ibsen and colleagues learned to bag ventilate, laboratory researchers unraveled the biology of viral growth and transmission. Arrival of the Salk vaccine in 1955 and the Sabin oral vaccine in 1961 halted epidemic polio in the West and laid the foundation for global eradication efforts.

By their disturbing and upsetting effects, writes the medical historian G.L. Wackers, epidemics, like wars, force the display of strengths and weaknesses in the political order of the infested societies. The events of August 27, 1952, bore the thumbprint of war, urbanization and centuries of biomedical innovation. Out of plague and disastermore patients than ventilatorsemerged a new lifesaving tactic, predicated on applied science and engineering, practiced in real time. The active approach and the fighting spirit in medicine are wonderful, Ibsen would remark in the 1970s. But Copenhagen also emphasizes how advances in medicine often trade one problem in the present for another in the future. Even prior to COVID-19, the healthcare system strained under the ethical and financial burdens of this active approach.

Over Ibsens career, intensive care became a victim of its own success. Bioethical reforms of the latter 20th century, justified and overdue, replaced the physician as arbiter of the ventilator switch with an unflinching commitment to patient autonomy. On the whole, medicine is more humane for it. But with its buffet of tubes and machines, sampled with insufficient consideration of risks versus benefits, intensive care lays bare one disquieting legacy of this transition. The nuance and complexity of this science, vastly evolved since 1952, challenge the expectation that laypersons can make dispassionate, informed decisionsand weigh the implications of incomplete recoveryamid gasping, weakening pulse and the need for immediate action. Bjrn Ibsen recognized this before most.

Many will benefit from intensive care medicine, but its ongoing availability in times of personal or global crisis hinges on careful identification of those who have the most to gain, and the least to lose, from this approach. Improved education and counseling could empower our sickest patients, or their surrogates, to weigh more fully the benefits and risks of medicines most heroic therapies. Increased patient and surrogate autonomy was an appropriate response to paternalistic medical abuses in the 20th century, Anesi explains, but true autonomy requires both the freedom to make ones own decision and the tools to make it an informed decision. Weve done better with the freedom part than the tools partmost notably, weve been short on education to put options in context and limiting options to those that may truly provide benefit and that align with the patients values.

To this end, an effective response to COVID-19and the inevitable next pandemicdemands grassroots conversations about the realities of life support and the journey after. Nations must also rebuild critical supply chains for ventilators, drugs, protective equipment and healthcare workers, which were undermined by years of myopic cost-cutting and lean management practices often by those who will themselves never be asked to face a contagious patient without an N95 mask or to improvise to save a human life. Just-in-time allocation of men and material is never more than one misfortune away from shortages and patient harm. Only those nave to history can expect otherwise.

In this origin story of the modern ventilator, the duality of intensive care medicine comes through: Its defining strength is also its weakness. Through Bjrn Ibsen and the breath-givers who preceded him, pandemic polio taught the first lesson: Actually, it does not matter what is the source of the patients gasping. You simply have to bring his breathing back in order.

Bradley M. Wertheim is a pulmonary and critical care physician and scientist at Brigham and Women's Hospital and Harvard Medical School. He has written for The Atlantic, the Los Angeles Times and peer-reviewed medical journals.

Read more:
The History of the Ventilator | Innovation - Smithsonian.com

Recommendation and review posted by Bethany Smith

Before you rush to the store or add the supplementsto your online checkout cart to combat COVID-19, it's important to know if you are vitamin D deficient.

Although vitamin D is called a vitamin, it's actually more of ahormone. When ultraviolet rays from sunlight strike your skin, the rays trigger vitamin D synthesis. You canbuild up your vitamin D levels through certain foods and supplements.

Genetics and age can play a big role in how muchvitamin D you have:

If you are worried that you are at risk of vitamin D deficiency, ask your physician to check your blood work.

It'sbeen known for years that vitaminD is essential formaintaining healthy bones and teeth. Without it, bones can become thin, brittleor misshapen.

Vitamin D also plays an important role in helping immune systems function. Low levels can lead to autoimmunity when the immune system attackshealthy cells and increase the chance of infection.

The immune system is like an army that prevents invaders, such as viruses and bacteria, from taking over the homeland your body.It is composed of the innate and adaptive immune systems.

Let's say a virus is present in a patient's lungs, specifically in the air sacs (alveoli), which can lead toacute respiratory distress syndrome (ARDS).

The first line ofdefenseis the innate immune system:Itcomes into play immediately or within hours of antigen detection.Antigens areproteins on the surfaces ofbacteria, fungi and viruses that the body doesnt recognize as its own.

Natural killer cells and macrophages, along with other immune cells, recognize, engulf and destroy pathogens.The main purpose of these cells is to prevent the spread and movement of harmful substancesthroughout the body. They are akin to soldiers shooting indiscriminately all over the enemy's camp.

Although the exact role of vitamin D in the immune system is not fully understood, studies have shown it may influence both innate and adaptive immune systems.

When the innate immune system is activated, its cells turn certain genes on to become more efficient at killing pathogens. Vitamin D binds to these cells and enhances this transformation, helping the innate immune system kill viruses.

If the pathogen manages to dodge the innate immune system, adaptiveimmunity kicks in.

The second line of defense is the adaptive immune system: Itrelies on B cellsandT cellsto carry out its tasks. These cells produce billions of antibodies.Antibodiesrecognize antigens and bind to them. They are like high-ranking officers thatconduct specific missions targeting only certain enemies. Antibodies makefuture responses against a specific antigen more efficient.

The problem with infections such as COVID-19, is that most of us are believed to be naive to the infection. So we don't have memory B cells ready, which means that adaptive immunity, even though it might be super powerful, can't recognize the pathogen, says Vadim Backman, professor of biomedical engineering at Northwestern University.

Cells of the adaptive immune system produce cytokines. These small proteins attract more immune cells and trigger inflammation. Sometimes, cytokines become too abundant and create a cytokine storm when immune cells spread beyond infected body parts and attack healthy tissue.

The way our immune system responds to the virusmay be a big part of this puzzle, Backman says. What does seem to be critical is acute respiratory distress syndrome. ARDS is caused by an overreaction of the immune system called a cytokine storm, which seems to be induced by the adaptive immune system, Backman says.

Backman saysVitamin D binds to the cells of the adaptive immune system and turnssome genes on while switching others off. This causes cells to produce fewercytokines, reducing inflammation and the possibility of cytokine storm.

When activated immune cells surge into the lungs as a result of a cytokine storm, the lungs can become inflamed. Fluid from the smallest blood vessels leaks into the tiny air sacs, resulting in acute respiratory distress syndrome (ARDS). The fluid prevents the lungs from filling with enough oxygen, so less reaches the bloodstream, causing organs to fail.

Many COVID-19-infected patients develop ARDS. Researchers in China examined risk factors for 191 coronavirus patients who died while being treated in two hospitals in Wuhan. The study showed50 of the 54 patients who died had developed ARDS; only nine of the 137 survivors developed ARDS.

A study in 2015showed that patients with ARDS and those at risk of developing it had vitamin D deficiency. Researchers demonstrated that vitamin D canreduce damage to capillaries that connect the alveoli to larger blood vessels that may prevent ARDS. In another study, Vitamin D was shown to have a protective effect on the lungs.

Another mystery of COVID-19 is why fewer children are seriously affected.

"Mortality and complications keep going up and up and up as age increases,"Backman says. Young children don't have mature adaptive immunity. They primarily rely on the antibodies that they have from their mother.

"There are always exceptions, but most children don't tend to overactivate their adaptive immune system. They don't develop cytokine storms because they just don't have the mechanisms, Backman says.

The research is in the early stages. According to a preprint studyBackman co-wrote, countries with low average vitamin D blood levels in the population had higher numbers of COVID-19 cases and deaths. A study from the U.K. looked at the nearly 450 patients diagnosed with COVID-19 and did not finda link between vitamin D concentrations and risk of COVID-19 infection.

In apaperpublished in theBritish Medical Journal,21 experts from the U.K., Ireland and the USA concludes that although vitamin D is essential for good health and may bolster the immune system, itcanbe dangerous in high doses.

Worldwide, about 1 billion people have inadequate levels of vitamin D in their blood, andinsufficiency affectsalmost 50% of the population. Most commonly, low levels of vitamin D are caused by insufficient exposure to sunlight.

In Louisiana, African Americans account for more than 50% of COVID-19 deaths despite representing only 32% of the population.

African Americans are at greater risk for vitamin D deficiency because they havehigher presence of melanin.Melanin reduces the bodys ability to produce vitamin D.PeoplefromSouth Asian backgroundsalso may not get enough vitamin D from sunlight in the summer.

Studies also have shown that African American adults have higher rates of hypertension, which isassociated with more severe cases of COVID-19.

"Vitamin D may simply correlate with some factor x, which for all we know has not been identified yet," Backman says."And that's factor x which causes or prevents complications."

Vitamin D deficiency can be caused by obesity.A body mass index greater than 30 is associated with lower vitamin D levels.The skin's ability to make vitamin D decreaseswith age.People who are homebound or rarely outside may have low levels of vitamin D as a result ofnot being able to getsun exposure.

If your levels are within normal ranges,here are some foods that will help with maintaining daily recommended value.

How much vitamin D you need depends on many factors, including age, race, latitude, season, sun exposure, clothing and more. The U.K.'s National Health Service recommends consuming 400 international units (10 micrograms) of vitamin D daily for adults.

"Let's say I knew that I'm vitamin D deficient," Backman says."It's something that is important for health. There are no benefits of vitamin D deficiency.So it's really guilt-free, risk-free to expose yourself to the sun for 20 minutes, get supplementation, get your levels within the normal level."

According to the NHS, people shouldn't take more than 4000 IUs (100 mcg)of vitamin Da day as it could be harmful.Children under 10 shouldn't have more than 2000 IUs(50 mcg) a day.

Taking too many vitamin D supplements over a long period of time can causetoo much calcium to build up in the body potentially weakening bones and damaging kidneys and heart.

Nutritionists say sticking to a healthy diet that includes a variety of nutrient-rich foods can boost the immune system.

"Ahealthy diet means eating food that is as close to its natural form is possible," says TamaraWard,a specialist in oncology nutrition at the University of Cincinnati Cancer Center."I don't say just eat real food. Because to a lot of folks, a box of Kraft macaroni and cheese is real because you can touch it, but it is highly processed. That little packet of flavoring isn't real food."

Other nutrients along with vitamin D aidtheimmune system. Consuming foods high in vitamin C, such as grapefruits and oranges, may increase white blood cell productionkey to fighting infection.

Adding carrots, spinach or kale to yourdiet mightbe a good idea. They containbeta-carotene that converts into vitamin A an anti-inflammation vitamin that enhances immune function.

Vitamin B-6 is essential in the formation of healthy red blood cells and is present in chicken, turkey and bananas. Garlic contains compounds that stimulatecertain immune cellsand helpregulate the immune system. Vitamin E and zinc are beneficial for fighting off diseases.

Ward recommends foods containing probiotics, such as yogurt:

"Once your gut is functioning really well, then that helps your gut to absorb all of the other nutrients that are in these foods, like zinc, vitamin B-6, vitamin D, the beta carotene," she says.

Go here to read the rest:
Can vitamin D help with symptoms of COVID-19? Possibly, it's key to helping your immune system function - USA TODAY

Recommendation and review posted by Bethany Smith

But if youre experiencing sudden weight gain that just doesnt seem to make sense to you (and it doesn't seem to have to do with normal life changes), then it may be a sign that something odd is going on with your bod. Think: out of whack hormones or other sneaky health conditions that are causing your metabolism to misfire.

Ultimately, you'll need to work with your doc to get a clear explanation for your unexplained weight gain. Before visiting the doc, keep a log of everything you eat as well as your exercise habits (including activity outside of your workouts) for at least a few days if not a week or two, says Melina Jampolis, MD, an internist and physician nutrition specialist. Maybe youre eating more calories now, or youve spent weeks sitting down more than usual thanks to a heavier workload.

Your doc can help you get to the bottom of whether any lingering health issues might be causing the weight gain. And there are tons of reasons for unexplained weight gain that have nothing to do with eating more and moving less.

Ahead, a list of conditions that could be causing your sudden weight gain, and how to tell if its time to see a doctor.

When a young woman walks into a docs office with unexplained weight gain, the thyroid is the first place most physicians will investigate, says Dr. Jampolis. And for good reason: A whopping one in eight women will develop athyroiddisorder in her life, according to theAmerican Thyroid Association.

That butterfly-shaped gland in the neck is responsible for secreting a hormone that regulates the metabolism, and if youve got an under-active thyroid (called hypothyroidism) the metabolism may slow down, triggering weight gain.

Women with hypothyroidism may also suffer from low energy levels or fatigue, dry skin, hair loss, hoarseness, or constipation, says Dr. Jampolis. Notice any of them and you should book a chat with your doc who can check on your thyroid with a simpleblood testif necessary.

Researchshows that as many as one in five women havepolycystic ovary syndrome(PCOS)an endocrine disorder that throws off the balance of reproductive hormones estrogen and testosterone, and can trigger a number of unpleasant symptoms like wacky periods, facial hair growth, and migraines.

PCOS can also muck up the way your body uses insulin (the hormone that helps turn sugars and starches into energy), which means (womp, womp) unexplained weight gain around the mid-section is common, says Dr. Jampolis.

If your menstrual cycles are off, a gyno will likely take a peek at your hormones to diagnose this one.

When you'restressed, you're thrown into fight-or-flight mode and get a surge of adrenaline, along with a heavy dose of the hormone cortisol, which is supposed to help you restore energy reserves and store fat. Because, hello, you just sprinted three miles from a tiger (okay, dramatic example)you're starving.

The problem? Lots of us getchronicallystressed sitting at our desk all day or just living a crazed life, says Dr. Jampolis. When your cortisol levels stay elevated for a prolonged period, then your body continues storing fat, which can lead to weight gain.

If youve persistently felt down in the dumps or anxious, have trouble sleeping, feel fatigued, or youve lost interest in the stuff that used to make you tick, talk with an MD or mental-health pro who can make suggestions for getting back on track if stress seems to be the culprit behind your sudden weight gain.

Theres nothing like a busted night ofsleepto make a girl crave sugar and fat (anything to survive at work the next day, right?). That's because missed shuteye does a number on your hunger hormones and metabolism: Sleeping too little raises ghrelin, the hormone that signals its time to eat, while lowering your levels of leptin, the hormone that conveys the Im full feeling, says Dr. Jampolis. The result: a totally unsatisfying chow-fest the next day.

Putting off sleep to watch just one more episode? That hour could be contributing to sudden weight gain. A2018 study in the journalSleepfound that people who slept just one hour more per week lost more fat than those who slept an hour less. The people who slept less lost lesseven though everyone in the study ate the same number of calories, proportionate to their weight at the start of the study.

The gut relies on good bacteria to function well (probiotics, anyone?), but theres also bad bacteria chilling in your digestive tract. When that balance of good to bad gets thrown off, small intestinal bacterial overgrowth (SIBO, for short) can take place, triggering extra gas in your GI tract along withbloating, abdominal pain, diarrhea, andyou guessed itsudden weight gain.

Docs arent entirely sure how SIBO may trigger those extra pounds, says Dr. Jampolis, but treatment for SIBO typically includes antibiotics to treat the bacterial overgrowth, according to theU.S. National Library of Medicine.

The transition period to menopause (a.k.a. perimenopause, which can start in women as early as their mid-30s, but usually starts in your 40s) triggers hormones like estrogen to rise and fall unevenly, which can cue weight gain in some women, says Dr. Jampolis. (Othersigns of perimenopauseinclude irregular periods, hot flashes, mood swings, and a change in your libidosymptoms your doc can usually suss out with her eyes closed.)

Compound perimenopause with the other inevitable body changes that happen with age (like a loss of muscle mass and increase in body fat), and it may feel like the scales tipping fast. Talk to your doctor to manage "the change" in stride.

There's a laundry list of both prescription and over-the-counter meds that can trigger sudden weight gain or water retention that shows up on the scale as extra poundage. Antidepressantsmost commonly the selective-serotonin reuptake inhibitors (SSRIs) such as Paxil, Lexapro and Prozacmay affect the appetite centre in the brain, says Roco Salas-Whalen, MD, an endocrinologist at theMedical Offices of Manhattan.

Meanwhile, beta-blockers (meds that reduce blood pressure) can slow your metabolism, and certain steroids (like prednisonean anti-inflammatory that causes water retention and an increase appetite) can add on pounds. Even OTC antihistamines like Benadryl, which can disrupt an enzyme in the brain that helps regulate food consumption, can trigger noticeable weight gain, says Dr. Salas-Whalen.

A word to the wise: Dont stop taking any pills cold-turkeychat with your doctor, who may be able to find a more waist-friendly substitute.

RELATED:8 Times Your Weight Gain Is A Sign Of A Bigger Health Problem

A super-rare condition called Cushings disease (only 10 to 15 people per million are affected, but 70 percent of those diagnosed are women) causes excess cortisol production and can trigger excessive weight gain just around the abdominal area (the legs and arms usually stay lean) and the back of the neck, says Reshmi Srinath, MD, assistant professor of diabetes, endocrinology, and bone disease at the Icahn School of Medicine at Mount Sinai.

Cushings typically presents with significantly low energy and complications like diabetes, high blood pressure, and high cholesterol. But the telltale sign is very large, red stretch marks on their belly, she says. If this sounds eerily familiar, talk to your doctor asap.

Theres a reason behind the bloat, and it may have just as much to do with the water you forgot to drink as the food that you ate.

Kristen Neilan, RD, a dietitian at University of Florida Health, says most of us arent drinking nearly enough water. Thats because many of us mistake the feeling of thirst for the feeling of hunger. Confusion, tiredness, and lightheadedness are all signs of even mild dehydration, she says. Sounds a lot like how we feel when were hankering for a snack.

Mixed signals arent the only possible culprits behind your unexplained weight gain. Adequate hydration increases mitochondrial functionwhat that basically means is that it increases your metabolism, says Neilan. Without enough water, your cells cant do their thing (namely, convert your food into energy) quickly and efficiently.

In rare cases, an expanding belly is the result of an ovarian tumour and fluid buildup associated with it, saysSanaz Memarzadeh, MD, PhD, a gynecologic cancer surgeon at UCLA Health. Patients come in with abdominal bloating, and their usual pants are not fitting, she says. Sometimes the tumour is so large it can cause distention of the abdomen, says Dr. Memarzadeh.

Women are more likely to be diagnosed with ovarian cancer after menopause. But its important for women at every age to look out for this symptom, as well as feeling full too quickly, pain in the lower stomach area, and extra pressure on the bladder. See your doc if the bloating persists, especially if your family has a history of ovarian cancer.

Smoking can often act as an appetite suppressant, so when you quit, the cravings can hit strong.Pouya Shafipour,MD, a weight-loss specialist atPaloma Health, explains that smoking can lead to a rise in dopamine, the neurotransmitter responsible for instant pleasure. It's the same kind of pleasure you get when you eat a sweet snack, like ice cream.

Quitting smoking causes that dopamine level drop, but your cravings for it still remain, and this craving for a dopamine hit can sometimes lead to eating something satisfying, and more than usual. "When one quits smoking, the body still has cravings for dopamine and often people get this craving from excess intake of refined sugar and starch (i.e., candy and other starchy snacks) and gain weight," says Dr. Shafipour.

To counteract the lower levels of dopamine once you quit smoking, it's important to engage in other behaviours, like exercise or meditation, that help release feel-good endorphins and also provide a nice distraction and healthy new habit.

Type 1 and type 2 diabetes both require insulin management in order to keep blood sugar levels regulated. In people with type 1, the pancreas essentially isn't producing enough insulin, so those that have it need to regularly insert themselves with the hormone. Insulin allows the body to absorb glucose (or sugar) and use it for energy.

Type 2 diabetes is associated with insulin resistance from a poor diet, a sedentary lifestyle, and unhealthy eating behaviours. That can usually contribute to weight gain in itself, explains Dr. Shafipour. Type 2 diabetics have a higher baseline insulin level which by itself causes more weight gain, typically around the belly," says Dr. Shafipour.

But an increase in insulin from external hormone treatments can also lead to weight gain. Insulin lets glucose into your blood cells so that it can be stored for energy, but if you're eating more calories than your body needs, your cells will take what they need leaving the remaining glucose to be stored as fat.

To counteract weight gain, it's important to closely monitor your diet and avoid eating too much fast food or foods high in refined sugar, Dr. Shafipour says.

Most cancers in their early stages will result in weight loss, instead of weight gain, unless it's a cancer that causes the release of cortisol, like a tumour in the adrenal gland.

However, as cancer progresses it can cause weight gain. "This weight gain can be due growth of the size of the tumor itself or [if it spreads] to other organs like the liver, which can cause fluid build-up in the stomach or the stomach cavity," says Dr. Shafipour.

But don't be too alarmed, as this is usually a worst-case scenario. Most cancers will cause other symptoms that may cause you to see a doctor while it's still in an early stage.

First, you should take a look at what your lifestyle's like. If your diet is poor, it's normal to gain between 1/4kg to 1/2 a kg a week. Your menstrual cycle can also caught your weight to fluctuate between 2-2.5kg depending on what stage of your cycle you are.

But when is weight gain a cause for concern? If you're gaining one to two pounds or more a week, and you don't see the numbers going down, then it might be time to see a doctor. "If one notices that they're gaining weight rapidly, more than 1kg a week, and it's not related to your menstrual cycle, poor sleep, anxiety or depression, or snacking or overeating, then they should probably see their primary care physician, who will do a thorough history and physical as well as some appropriate laboratory work-up to find the causes of weight gain," says Dr. Shafipour.

A doctor can work with you to determine whether an underlying condition is determining your weight gain, and find appropriate remedies to help you maintain a weight that makes you feel good.

This article originally appeared on Women's Health US.

RELATED:Snacking On Nuts Found To Help Prevent Weight Gain

View original post here:
13 Common Causes Of Sudden, Unexplained Weight Gain - Women's Health

Recommendation and review posted by Bethany Smith

Heather Lanier, a registered nurse from San Jose, California, received a diagnosis of triple-negative breast cancer just weeks before the COVID-19 pandemic began in the United States.

Despite the rapid spread of the new coronavirus nationwide, Lanier never once considered stopping or delaying her chemotherapy.

I just wanted to get through it and get on with my life, Lanier, 49, told Healthline.

Lanier has continued to work during her treatment and has one final chemotherapy infusion left. Shell have surgery next month to remove one of her breasts.

Lanier knew there were risks involved in continuing treatment during the pandemic.

But she insists theyve been risks worth taking.

COVID-19 is scary because I am immunocompromised. I know I have to be careful. But I was more scared in the beginning than I am now, said Lanier, who strictly follows physical distancing guidelines.

I wear my mask religiously and I wash my hands a lot. I feel pretty safe. Its just my personality. I do not want to live in a bubble. I want to live my life, she said.

People being treated for cancer face a difficult dilemma when deciding when, where, and how to treat their disease in the age of COVID-19.

New studies announced last week at the annual American Society of Clinical Oncologists (ASCO) ASCO20 Virtual Scientific Program include new information about the high-risk relationship between COVID-19 and cancer.

The COVID-19 and Cancer Consortium (CCC19) registry presented at ASCO and published in The Lancet show that people with progressive cancer were five times more likely to die within 30 days of a COVID-19 diagnosis compared to people in remission or people with no evidence of disease.

The risk for death was 1.79 times greater for those with stable cancer compared to people who had no evidence of disease.

Dr. Jeremy L. Warner, MS, a lead author of the study and an associate professor of medicine and biomedical informatics at Vanderbilt University in Tennessee, and his colleagues assessed data on 928 patients for 30-day all-cause mortality.

In a press statement, Warner said his team is working to identify the factors that affect disease severity and death.

Warner says hes also interested in the effects of specific cancer treatments that are being used to treat people with cancer who have COVID-19.

The researchers say theres more to learn about the relationship between cancer and COVID-19.

How we improve the care we provide these patients and reduce the number of deaths and severe consequences associated with this disease are among the top questions, Dr. Howard A. Burris III, FACP, FASCO, the president of ASCO, said in a press statement.

Another study announced at the ASCO conference showed that people with lung and other thoracic cancers who were treated with chemotherapy within 3 months of their COVID-19 diagnosis had an increased risk for death compared to other treatment methods.

In an analysis of data on 400 cancer patients, researchers concluded that only the patients treated with chemotherapy, either alone or in combination with other therapies, had a significantly increased risk (64 percent) of dying from the virus compared to people who didnt receive chemo.

In a presscast, the registrys lead author, Dr. Leora Horn, a cancer researcher and director of the thoracic oncology program at Vanderbilt University Medical Center, said that research on COVID-19 and cancer death continues to evolve.

In a press release, Burris added that there are still more questions than answers, but that these findings give us some insights into outcomes for patients with cancer who develop COVID-19.

Dr. Matthew Cook, the founder of BioReset Medical, an integrative clinic that specializes in regenerative and functional medicine, says the interplay between COVID-19 and cancer inevitably involves the bodys immune system.

Chemotherapy, radiation, immunotherapy, and the cancer itself can all have a suppressing effect on the immune system, said Cook, whose medical approach is to use the most noninvasive, natural, and integrative ways possible to achieve optimal health.

Cook told Healthline that he works in cooperation with oncology to get best results for his cancer patients.

We take a fairly traditional approach. We are looking at all the bodys systems to see if there are problems that we can optimize, he said.

For example, he notes that the gastrointestinal system and the immune system are intimately connected, and that the traditional medical world is beginning to embrace this concept.

I think the oncology community is evolving into accepting some modalities that are integrative. Our goal is to try to take all that into consideration and then develop a treatment plan that supports their immune systems, Cook said.

While people with cancer are between a rock and a hard place when it comes making decisions about treatment, Cook says, the relative risk of a cancer patient getting an infection with the new coronavirus remains low.

Patients with these conditions just need to have a very careful approach and limit their exposure and risk of infection, he said.

In broad terms, I would say that people are generally well served by following their physicians guidance and, in most cases, moving forward with their cancer therapy, depending on their circumstances in life, Cook said.

Cancer patients and physicians have actually known about these risks for a long time. Patients with cancer who are on chemotherapy are already immunocompromised. We already know how to give them the best ways of protecting themselves, he added.

Binzee Gonzalvo, 47, a university lecturer in Tokyo, Japan, whos currently receiving treatment for marginal zone lymphoma, is being careful and using common sense.

Hes read the new statistics on cancer death and COVID-19. And while it does give him pause, hes decided to move forward with his treatment.

Its not the best timing to have a cancer diagnosis or relapse. Im just dealing with it the best way forward given the circumstances, Gonzalvo told Healthline. I had to be proactive and consider that in my decision making process. I have stayed indoors at home the whole time, with the exception of treatment days.

He adds that he wears a mask thats used for medical staff, and he purchased protective glasses to wear when using public transportation to his cancer center.

So far, so good and on schedule regarding treatment, Gonzalvo said.

He notes that COVID-19 has affected communication with his hematologist.

He was assigned to a COVID-19 task force, and so for my appointments in May for my second treatment, I had to talk with another hematologist who covered for him, Gonzalvo said.

However, he added on a positive note, Im staying strong with hope.

People with cancer and survivors of the disease are also finding it increasingly difficult to get necessary healthcare as the COVID-19 pandemic persists.

Many are experiencing financial stress and mental health issues as they try to navigate the difficult health and economic environment.

A survey by the American Cancer Society Cancer Action Network (ACS CAN) of cancer patients and survivors found that 87 percent of respondents have had their healthcare affected by the COVID-19 pandemic in some manner. That was up from 51 percent in an April survey.

Of those in active treatment, 79 percent reported delays to their healthcare, including 17 percent of patients who reported delays to cancer therapies such as chemotherapy, radiation, or hormone therapy.

The most commonly reported effects for those in active treatment were for changes to in-person cancer provider appointments (57 percent) as well as delays in access to imaging services (25 percent) and surgical procedures (15 percent).

About 20 percent reported delayed access to supportive services, including physical therapy or mental healthcare.

Nearly 1 in 4 patients surveyed say the pandemic has made it more difficult to contact their providers with questions about their healthcare needs.

And 1 in 5 say theyre worried their cancer could be growing or returning due to delays and interruptions caused by the COVID-19 outbreak.

The situation is getting worse, not better for cancer patients during this pandemic, Lisa Lacasse, president of the ACS CAN, said in a statement.

Health practitioners continue to work to balance safety for an immunocompromised population at increased risk for contracting COVID with timely treatment to prevent the spread of cancer. Unfortunately, this results in delays in treatment for many cancer patients, she said.

Amid the fear and anxiety caused by COVID-19, theres also good news for people receiving cancer treatment.

At the annual ASCO conference, a variety of new data on treatments for numerous types of cancer showed promise in clinical trials.

For example, the Food and Drug Administration has given the fast track designation to ME-401, an oral treatment from MEI Pharma for people with relapsed or refractory follicular non-Hodgkins lymphoma (NHL).

Follicular NHL is the most common subtype of low-grade (indolent) lymphoma, making up as much as 30 percent of all non-Hodgkins lymphomas.

Follicular lymphoma is treatable but doesnt have a current cure. For cases that dont respond to two prior treatments, next steps can be difficult to decide. There are few viable options.

MEI Pharma is conducting an ongoing phase II clinical trial called TIDAL thats evaluating ME-401 for cases of follicular lymphoma that havent responded to at least two prior systemic therapies, including chemo and an anti-CD20 antibody.

Daniel Gold, PhD, president and CEO of MEI Pharma, said in a press statement hes excited to continue expanding the opportunity that ME-401 represents for cancer patients.

We are particularly encouraged that the follicular lymphoma patients in the Phase 1b study the focus of our ongoing Phase 2 TIDAL study now have a median time on therapy in excess of 1 year with responses that are durable to date while remaining generally well-tolerated, he said.

Here is the original post:
People with Cancer Have to Choose Between Treatment and COVID-19 Risks - Healthline

Recommendation and review posted by Bethany Smith

Save your business while saving lives, reads the website of Because Health, a Seattle tech startup selling two types of tests to employers willing to pay $350 a pop to learn whether their workers have been infected with COVID-19.

The Workplace Health plan includes not only nasal swab tests to detect infection, but also blood tests aimed at indicating whether workers have developed antibodies to the virus and, possibly, future protection.

Theres a tremendous consumer demand, said Dr. Lars Boman, the Boston-based medical director for the firm. Can they return to work? Can they return to life?

What the website does not make clear, however, is that public health officials have explicitly warned that antibody tests should not be used to make decisions about workplace staffing.

This is a personal choice of the business, of the consumer, Boman said.

Across America, untold numbers of employers, employees and ordinary citizens are turning to a slew of sometimes pricey new COVID-19 blood tests. Knowing whos already been infected could have important implications for understanding the spread of the disease, scientists say. But serious questions about the accuracy of some of the serology tests and the usefulness of the results they provide have prompted the federal Food and Drug Administration to try to rein in what several infectious disease experts described as the wild, wild West of antibody testing.

It does look as if companies sprang up overnight both importing these tests and distributing them, said Dr. Michael Busch, director of the nonprofit Vitalant Research Institute in San Francisco. Its outrageous that people were trying to make money off of this fear.

More than 200 tests have flooded the market in a matter of weeks, promising to detect antibodies, which are proteins that develop in the blood as part of the bodys immune response to an invading virus. These are different from the molecular tests, typically done with nasal swabs, used to diagnose infection.

As of June 1, only 15 antibody tests had received FDA emergency-use authorizations, which allow tests that havent been fully vetted to be used in a crisis. Even that standard has become a selling point for some large companies, such as LabCorp and Quest Diagnostics, which emphasize that they rely on tests that have received the FDA nod.

In late May, the FDA removed more than 30 serology tests from a list of commercially available kits, saying they should not be distributed for sale. Removal could result from a manufacturer not submitting an emergency-use authorization request within a reasonable period of time, or if the test shows significant problems that cannot be or have not been addressed in a timely manner, the agency said. The manner of enforcement remains unclear.

Last month, the CDC issued new guidelines warning that, given the low prevalence of the virus in the general population, even the most accurate tests could be wrong half of the time.

Serologic test results should not be used to make decisions about grouping persons residing in or being admitted to congregate settings, such as schools, dormitories, or correctional facilities, the guidelines state. Serologic test results should not be used to make decisions about returning persons to the workplace.

Such tests are most useful for understanding the epidemiology of the virus, not for making individual decisions, said Dr. Mary Hayden, director of the division of clinical microbiology at Rush Medical Laboratories in Chicago. Even the best tests cant yet answer the crucial question about whether antibodies confer immunity from future COVID infections, Hayden said.

The best possible scenario is that people get infected and they have protective immunity for a long time, she said. That would be awesome. But we just dont have that right now.

But a plethora of tests being pitched to consumers explicitly promise results aimed at allowing a return to work, school and other social arenas.

The tests offered by Because Health are among hundreds churned out since March, ranging from those offered by commercial labs and academic research centers to small developers seeking a toehold in the lucrative market spurred by a global pandemic. Because Health is using two antibody tests in tandem, one of which received emergency-use authorization on May 29; the other is still pending.

Anders Boman, the son of the medical director and co-founder of Because Health, said that until the COVID crisis occurred, the company, which launched in Seattle last year, was focused on a niche of integrative care and sexual health, including hormone treatments for men and women.

Consumers are not concerned about sexual health right now, Boman said, explaining the change in focus. Theyre concerned about how to get back to work, how to return to normal and are they safe?

The FDA normally follows a stringent approval process for tests to detect diseases, often a costly effort that can take months or years. That typically requires independent validation of the accuracy of the tests. But after being criticized for the fumbled rollout of diagnostic tests during the start of a global pandemic, the FDA swung hard in the other direction, waiving its usual requirements and letting firms rush self-validated tests into the market.

They sort of relaxed all regulatory oversight, Hayden said.

Several experts interviewed by Kaiser Health News said the FDA faced tremendous political pressure to make antibody tests available.

It was really a single pressure and that was the fact that the original inability to get a [diagnostic] test on the market in the U.S. as the outbreak escalated means they were trying to do basically everything they could to get these out, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The relaxed rules drew concern from Congress, where a subcommittee of the Committee on Oversight and Reform detailed the FDAs failure to police the test market. Groups such as the Association of Public Health Laboratories also raised questions. Scott Becker, the APHLs chief executive, said he spoke to top officials at the U.S. Department of Health and Human Services in early April.

We just let loose and we said, This is a really bad policy, Becker said. Were going to get flooded and were going to lose control of quality. Were not going to know what to do with the results.

Thats exactly what has happened, said Osterholm. The FDA needs to bring much more discipline to this area and they need to articulate it clearly, he said.

A key issue is the accuracy of the tests, which rely on measures known as sensitivity and specificity. A highly sensitive test will capture all true positive results. A highly specific test would identify all true negative results.

In April, researchers at the University of California-San Francisco, led by immunologist Dr. Alexander Marson, analyzed 14 COVID-19 serology tests on the market and found that all but one turned up false-positive results, indicating that someone had antibodies to the coronavirus when they actually did not. False-positive rates reached as high as 16% in the study, which has not yet been peer-reviewed.

Unreliable results worry Dr. Jeff Duchin, the public health officer for Seattle and King County, Washington, where the first surge of COVID cases emerged in the U.S. A person who tests positive for antibodies that dont exist may mistakenly believe he or she is free to ignore guidance about preventing infection, potentially spreading the disease. Regardless of whether you test positive or negative, the workplace still needs to take steps, he said. They shouldnt think a testing program in any way relieves them of that responsibility.

FDA officials said theyre working now with the National Cancer Institute to independently validate serology tests on the market. Until that list is public, users must rely on the relatively few that have received the emergency-use authorizations to date. More than 190 others have asked for that authorization, pending FDA review.

But consumers may have little control, because they are most likely getting tests from their employers or doctors, with little understanding of why those products were chosen.

There isnt a national standard, there isnt a one-stop shop or a Consumer Reports for antibody tests, Becker said. I dont expect a member of the public is going to be able to figure this out.

Even savvy physicians can have trouble. US Acute Care Solutions, a physician-owned medical services group, was trying out a Chinese-made test supplied by Minneapolis-based Premier Biotech, with plans to test its staff of more than 3,500 doctors and employees, said the groups chief medical officer, Dr. Amer Aldeen. That test has been widely used, including in recent controversial serology surveys conducted by Stanford University and the University of Southern California.

When USACS used it, the Premier test failed to detect antibodies in several employees who had been ill and tested positive for the coronavirus on diagnostic tests, Aldeen said. The results could have been caused by faulty instructions rather than flaws in the test itself, he said. Still, the Premier test has not received FDA authorization and the results gave him pause.

It does no good to select a test that isnt FDA-approved, he said.

In a statement, Premier Biotech officials said they anticipate exceeding FDA standards, which call for tests that are at least 90% accurate in identifying positive antibodies in a sample and 95% accurate in identifying samples that contain no antibody.

Some might ask why the FDA didnt just identify several reliable antibody tests and require their use to avoid the chaos. An FDA official said making that type of choice would be outside the scope of the agencys responsibilities.

FDAs lane is to review these tests and make sure that they are safe and accurate for the American people, said spokesperson Emma Spaulding. It wouldnt be within our lane to say which test must be used.

Although health officials understand the desire for a test that could provide comfort amid the uncertainty of COVID-19, Duchin advised employers and consumers to wait a little longer.

There are costs to testing with unvalidated tests that might outweigh the benefits of satisfying your curiosity, he said.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

by

JoNel Aleccia, Kaiser Health News and Anna Maria Barry-Jester

Kaiser Health News

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

Visit link:
Hype Collides With Science As FDA Tries To Rein In Wild West of COVID Blood Tests - Physician's Weekly

Recommendation and review posted by Bethany Smith

The treatment landscape for thyroid cancers has been enriched by several FDA approvals of targeted therapies, underscoring the importance for conducting genetic testing on patients with thyroid cancer before making treatment decisions.

Larotrectinib (Vitrakvi) was approved by the FDA in 2019 for the treatment of patients with solid tumors harboring an NTRK gene fusion. Entrectinib (Rozlytrek) was approved in 2019 for the treatment of patients with solid tumors harboring an NTRK gene fusion as well. While these fusions may be rarer in select cancer types, it is still important to test for this gene because both larotrectinib and entrectinib have been associated with more tolerable toxicity profiles compared with other available treatments.

Outside of TRK fusions, a RET inhibitor was also approved by the FDA, selpercatinib (LOXO-292), as treatment of patients with lung cancer or thyroid cancer harboring RET alterations. In thyroid cancer, this indication is specified for patients with advanced or metastatic RET-mutant medullary thyroid cancer or those with advanced or metastatic RET fusion-positive thyroid cancer who require systemic therapy and are radioactive iodine-refractory.

The approval of these targeted therapies in thyroid cancer suggests that physicians should be testing their patients for potential gene fusions or alterations. More therapies are under review in clinical trials or by the FDA for different therapies in thyroid cancer that will also rely on results from genetic testing. The highly selective RET inhibitor pralsetinib (BLU-667), for example, is under investigation now and has shown encouraging findings in thyroid cancer.

In an interview with Targeted Oncology, Marcia Brose, MD, PhD, director of the Center for Rare Cancers and Personalized Therapy, director of the Thyroid Cancer Therapeutics Program, associate professor of Otorhinolaryngology: Head and Neck Surgery at the Hospital of the University of Pennsylvania, and associate professor of Medicine at Penn Medicine, discussed the role of genetic testing in patients with thyroid cancer and the current treatment landscape.

TARGETED ONCOLOGY: How frequently areNTRKgene fusions observed in thyroid cancer?

Brose:NTRK gene fusions can be anywhere from extremely rare, less than 1% in a certain cancer to quite common in over 25% [with another cancer]. One of the things we know is that it is a little more common in both papillary thyroid cancer and metastatic colorectal cancer, which has microsatellite instability-high (MSI-H). MSI-H is 1 of the markers we check regularly in colon cancers, but it is probably in many other cancers as well.

TARGETED ONCOLOGY: What does prognosis look like for these patients?

Brose: For patients who have metastatic colorectal cancer that has not been responsive to other agents or metastatic thyroid cancer and no matter what therapies are available, they inevitably work for only so long. At that time, the prognosis starts to become quite grim. For patients with metastatic disease who are not cured, the prognosis depends on whether they have just been diagnosed or had not been diagnosed, had a lot of disease or not a lot of disease. The bottom line is they will not be cured. Even with all the therapies that we have, including the ones that work, they do not work forever. For that reason, we need to keep finding additional therapies that will help.

TARGETED ONCOLOGY: How often should physicians be conducting genomic testing for their patients with thyroid cancer? Do you think we are doing this enough right now?

Brose: We have enough targeted therapies now for thyroid cancer that we should know what the genetic and genomic landscape is for our patients before we even start any systemic therapy. The reason for that is 2-fold. First of all, this has to do with treatment planning. You may want to sequence the different therapies that are available in a certain way based on what you know is going to be available for the patient. The second very important thing is all the approved agents are not the same when it comes to tolerability. If a patient has access to a more tolerable agent because of a genetic marker in the tumor, you would want to know that because perhaps you would start with that and not have to deal with maybe quite as high a side effect profile.

TARGETED ONCOLOGY: Do you want to discuss these targeted therapies?

Brose: Currently for TRK fusion cancers, there are 2 FDA-approved agents. The first is larotrectinib, and the second is called entrectinib. Both of these agents target the TRK fusion, and the TRK fusion is the TRK gene that is stuck together with another gene. When things are stuck together, that activates that pathway, so much so that we think it caused that cancer to begin with. What we do is we test for those, and if we can actually target that abnormal pathway with an agent, we have a chance of directly getting at the cause of cancer. Both larotrectinib and entrectinib do a good job at inhibiting the TRK fusion gene. As a result, they do a good job at stopping these cancers from growing. In many cases, it causes quite a significant amount of shrinkage, so much so that sometimes the shrinkage is so great you cannot even find the disease anymore. I would never say the word cure because we dont have any data to say people are cured, but getting the disease burden down to be so small that we cannot find it on a CAT scan, that is a new level of response we have not been able to achieve with other agents.

TARGETED ONCOLOGY: How do you sequence agents in patients with thyroid cancer?

Brose: We look at treating these patients. We say if you find a patient who has a TRK fusion, when we start them on therapy, they have a choice of starting with the TRK gene with either larotrectinib or entrectinib or starting on the FDA-approved lenvatinib (Lenvima) or sorafenib (Nexavar). Both lenvatinib and sorafenib, while they have been very useful and active agents, they do have a side effect profile. Larotrectinib and entrectinib have better side effect profiles, so patients do not experience as many issues with high blood pressure, skin issues, or even fatigue. For that reason, if I have that option and they do have a TRK gene fusion, I am likely to choose that in the first place. I would use [larotrectinib or entrectinib] as first-line therapy.

I will point out that TRK fusions are still the minority of these patients. It is important to know if they have it or not, so we probably will not be using this in a lot of people. However, it is 1 of those instances where we have a really good therapy that you dont want to miss in 1 of your patients.

TARGETED ONCOLOGY: Besides these fusions, are there other fusions or mutations physicians should be testing for now?

Brose: Interestingly, a RET inhibitor, selpercatinib, was recently approved by the FDA. In metastatic differentiated thyroid cancer, there is a small population of patients who have RET fusions. In addition, patients with medullary thyroid cancer have RET-point mutations. In my opinion, given the ability, I would prefer to check both genetic and genomic.

TARGETED ONCOLOGY: Are there any other new treatments coming down the pipeline in thyroid cancer?

Brose: The most exciting thing happening right now are the RET inhibitors. Selpercatinib was approved recently by the FDA, and pralsetinib is another that is probably going to become approved in the coming year. This has been a game changer for patients with metastatic medullary thyroid cancer, as well as the subtype of differentiated thyroid cancer. Those are exciting the most.

We are still finding out whether immunotherapy has a role. At this point, the data has not lived up to what I had hoped, so I do not feel that right now we have a big immunotherapy combination Im excited about. However, Im still waiting on some more data in the coming year, and hopefully there will be some good combinations of immunotherapy with the kinase inhibitors that are already approved.

TARGETED ONCOLOGY: What is your key takeaway on the treatment landscape right now?

Brose: I personally feel that all patients with solid tumors who have metastatic disease and are not curable, they should all have genetic testing done to find if they have any point mutations or gene fusions. At a minimum, many of the mutations we find by doing genetic testing has a prognostic indication, meaning knowing a genetic mutation may change what we expect as far as how well a patient will do. In many cases, more than just being prognostic, it can also predict responses to some of these new agents that are a new level of agents that can create a very good response with really tolerable, if any, side effects. I think it is exciting because we have not had these agents up until now. As a physician, this is something I think we all need to know about.

Here is the original post:
Genetic Testing Becomes Vital in Sequencing Treatments for Patients With Thyroid Cancer - Targeted Oncology

Recommendation and review posted by Bethany Smith

DUBLIN--(BUSINESS WIRE)--The "Genetic Testing. Global Market Forecasts for Applications and Technologies. Updated for COVID-19 Pandemic impact with Executive and Consultant Guides 2020 to 2024" report has been added to ResearchAndMarkets.com's offering.

This report explores how the large genetic testing cancer segment has been impacted by COVID-19. Genetic Blizzard is creating a confusing array of new tests. Will all newborns receive Whole Genomic Sequencing at birth? What has happened to Direct to Consumer?

The role of genetics in health and disease is just now being understood. This new knowledge, combined with lower pricing is driving the Genetic Testing industry to record growth. New drugs may only work for people with a certain genetic makeup, and this too is driving the Genetic Testing Industry. The traditional genetic testing market is growing in volume and growing in the breadth of tests creating a new life for the industry. The report forecasts the market size out to 2024. The report includes detailed breakouts for 14 countries and 5 regions.

Predictive Diagnostics? Pharmacogenomic Testing? Direct to Consumer? Find out about the technology in readily understood terms that explain the jargon. What are the issues? Find the opportunities and pitfalls. Understand growth expectations and the ultimate market forecasts for the next five years.

Key Topics Covered:

1. Introduction and Market Definition

1.1 Genetic Testing Definition in This Report

1.2 The Genomics Revolution

1.3 Market Definition

1.4 U.S. Medical Market and laboratory Testing - Perspective

2. Market Overview

2.1 Market Participants Play Different Roles

2.2 Genetic Tests -Types, Examples and Discussion

2.3 Industry Structure

2.4 Market Shares of Key Genetics Players - Analysis

3. Market Trends

3.1 Factors Driving Growth

3.2 Factors Limiting Growth

3.3 Instrumentation and Automation

3.4 Diagnostic Technology Development

4. Genetic Testing Recent Developments

5. Profiles of Key Companies

6. Global Market Size

6.1 Global Market by Country

6.2 Global Market by Application

6.3 Global Market by Technology

7. Market Sizes by Application

7.1 Newborn Testing Market

7.2 NIPT Market

7.3 Predictive Testing Market

7.4 Oncology Testing Market

7.5 DTC Testing Market

7.6 Other Testing Market

8. Global Genetic Testing Market by Technology

9. The Future of Genetic Testing

For more information about this report visit https://www.researchandmarkets.com/r/jp4uin

About ResearchAndMarkets.com

ResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

Read more:
Global Genetic Testing Market Forecasts for Applications and Technologies 2020-2024, Updated in Light of Impact of COVID-19 Pandemic -...

Recommendation and review posted by Bethany Smith

The latest on the coronavirus in the U.S. and around the world.

Research from genetic-testing giant 23andMe Inc. found differences in a gene that influences a persons blood type can affect a persons susceptibility to COVID-19.

Scientists have been looking at genetic factors to try to determine why some people who contract the new coronavirus experience no symptoms, while others become gravely ill. In April, 23andMe launched a study that sought to use the millions of profiles in its DNA database to shed light on the role genetics play in the disease.

Preliminary results from more than 750,000 participants suggests type O blood is especially protective against SARS-CoV-2, the virus that causes COVID-19, the company said on Monday. The findings echo other research that has indicated a link between variations in the ABO gene and COVID-19.

Many other groups, including 23andMe competitor Ancestry Inc., are combing the genome to help make sense of the virus. It is known that factors such as age and underlying health conditions can determine how people fare once theyve contracted COVID-19. But those factors alone dont explain the wide diversity of symptoms, or why some people contract the disease and others dont. Studying the genetics of the people who are more susceptible to SARS-CoV-2 could help identify and protect those more at risk, as well as help speed treatment and drug development.

Several other studies looking at both severity of illness and susceptibility to disease have also suggested blood type plays a role.

Research published last week prior to peer review suggested blood type may play a role in the severity of patients reactions to SARS-CoV-2. That study looked at the genes of more than 1,600 patients in Italy and Spain who experienced respiratory failure and found that having type A blood was linked to a 50 percent increase in the likelihood a patient would require a ventilator. An earlier Chinese study turned up similar results regarding a persons susceptibility to COVID-19.

Read the full story about blood type and the coronavirus here.

World Bank forecasts worst recession in 8 decades amid pandemic

The global economy will contract the most since World War II this year and emerging nations output will shrink for the first time in at least six decades due to the COVID-19 pandemic, reducing incomes and sending millions of people into poverty, the World Bank said.

Global gross domestic product will probably shrink 5.2 percent in 2020, the Washington-based development organization said in its semi-annual Global Economic Prospects report Monday. Emerging and developing economies will shrink 2.5 percent, their worst performance in data that starts in 1960, it said.

Per-capita output will contract in more than 90 percent of countries, the biggest share since 1870. This decline may push 70 million to 100 million people into extreme poverty, Ceyla Pazarbazioglu, the World Banks vice president of equitable growth, finance and institutions, told reporters by phone.

The forecast for a global contraction compares with a January projection for a 2.5 percent expansion and would be the fourth-deepest recession of the past 150 years after 1914, 1930-32 and 1945-46, the World Bank said.

This is the first recession since 1870 triggered solely by a pandemic, and it continues to manifest itself, Pazarbazioglu said. Given this uncertainty, further downgrades to the outlook are very likely.

Advanced economies will shrink 7 percent, led by a 9.1 percent contraction in the euro area, the lender said.

Emerging economies with limited health-care capacity, deeply integrated global value chains, heavy dependence on foreign financing and extensive reliance on international trade, commodity exports and tourism are likely to be the hardest hit.

The economy will rebound in 2021, growing 4.2 percent, the lender said.

The World Bank presents two alternative scenarios. In one, where the COVID-19 outbreak persists for longer than expected, requiring the continuation or reintroduction of restrictions on movement, the global economy would shrink almost 8 percent this year. If control measures can be largely lifted in the near term, the contraction would be 4 percent still more than twice as deep as the global financial crisis of 2009.

New Yorks rate of virus infections at its lowest, Cuomo says

Only 1.2 percent of New Yorkers tested Sunday were infected with the new coronavirus, the lowest rate since the pandemic began, Gov. Andrew Cuomo, D, said.

Why are we reopening? Because these numbers say we can, Cuomo said at a news conference in Manhattan.

On Sunday, 58,054 tests were done statewide, and 702 people were found to be positive for COVID-19, Cuomo said.

The positive rate was higher in New York City, at 2 percent, but the governor said the citys Monday reopening would continue apace. The revival of the nations capital of commerce and culture comes after months of quarantine that ended with an explosion of street protests over police violence that some worry may set off another wave of disease.

As the city returns to life, Cuomo rode a conspicuously clean subway car to boost confidence.

Masks are mandatory for those riding buses and trains, Cuomo said. The state is sending 1 million masks and 25,000 gallons of hand sanitizer to the Metropolitan Transportation Authority, as well as 500,000 2-ounce bottles.

When asked whether an increase in subway ridership would cause a spike in cases, Cuomo said that the trains have been running throughout the pandemic.

If theyre using the sanitizer, if theyre using the masks, it will be OK, Cuomo said. If were going to have a problem, the variable here is: Did the protests have an effect? I dont know, and I dont want to speculate. Thats why Im asking them to actually get tests.

Swedens PM rebuked as coronavirus deaths ignite political anger

The prime minister of Sweden was forced to defend his covid-19 strategy after opposition parties mounted a scathing attack on his government amid signs its handling of the pandemic has been fatally flawed.

With more than 4,500 Swedes now dead as a result of the coronavirus, and Swedens chief epidemiologist admitting mistakes, Prime Minister Stefan Lofven was the target of a series of rebukes during a debate among party leaders broadcast on Sunday night.

Ulf Kristersson, the leader of the main opposition party known as the Moderates, said there have been obvious, fundamental failures in Swedens response to covid-19.

Read the rest of the story here.

Travelers to Britain must quarantine for 2 weeks

LONDON Travelers to Britain are now being required to go into quarantine for two weeks a sweeping measure meant to halt the further spread of COVID-19.

Starting Monday, all passengers will be asked to fill in a form detailing where they will self-isolate, with only a few exceptions. Those who fail to comply with the quarantine rules could be fined.

Ryanair chief executive Michael OLeary says the quarantine will cause untold devastation for the countrys tourism industry not just on the airlines.

He told the BBC that hotels, visitor attractions and restaurants will also be hurt, and thousands of jobs will be lost.

Shutdowns prevented mass death, study finds

Shutdown orders prevented about 60 million novel coronavirus infections in the United States and 285 million in China, according to a research study published Monday that examined how stay-at-home orders and other restrictions limited the spread of the contagion.

A separate study from epidemiologists at Imperial College London estimated that the shutdowns saved about 3.1 million lives in 11 European countries, including 500,000 in the United Kingdom, and dropped infection rates by an average of 82 percent, sufficient to drive the contagion well below epidemic levels.

The two reports, published Monday in the journal Nature, provide fresh evidence that aggressive and unprecedented shutdowns, which caused massive economic disruptions and job losses, were necessary to halt the exponential spread of the novel coronavirus.

Read the rest of the story here.

Moldova registers record number of new cases

CHISINAU, Moldova The government of Moldova says it has registered a record number of new cases of the new coronavirus during the first week of June, as a former health minister described the pandemic situation in the country as out of control.

One of the poorest countries in Europe and plagued by corruption and political turmoil, Moldova confirmed 1,449 new cases of COVID-19 during June 1-7, nearly 300 more than the previous week, according to data from the Ministry of Health. It was the fourth consecutive week with more than 1,000 new cases.

Since its first confirmed case on March 7, Moldova population 3.5 million has registered 9,700 cases and 346 deaths.

Former Health Minister Ala Nemerenco was very critical of the governments handling of the pandemic.

You dont have to be an epidemiologist, a virologist, or even a doctor to understand that the situation has gotten out of control, Nemerenco said in a Facebook post in reference to the rising number of cases.

Poland closing 12 coal mines after outbreak

WARSAW, Poland Polish authorities have ordered the closure of 12 coal mines for three weeks after hundreds of workers were infected with COVID-19.

The measure announced on Monday comes as coal mines in Polands southern mining region of Silesia have become hot spots for the transmission of the novel coronavirus.

Deputy prime minister Jacek Sasin said that the measure will take effect on Tuesday and is aimed at suppressing the epidemic. He added that the miners will continue to receive their full pay.

It is very important for us not to punish the miners economically for the infections at mines that have made us take this decision, Sasin told reporters.

In some other earlier cases, miners told not to work because of the epidemic saw their wages reduced, increasing their frustration ahead of a presidential election that is crucial to Polands governing conservatives.

Poland has so far recorded about 27,000 cases of coronavirus, which is far less than many other European countries. Yet nearly 5,000 of the confirmed cases are coal miners. That is an extremely high infection rate in the sector given that there are just 82,000 miners in the nation of 38 million people.

Turkish Airlines offers discount for health care workers

ANKARA, Turkey Turkish Airlines says it is offering a 40 percent discount on airfares for health care workers across the globe.

The national flag carrier said Monday the campaign was aimed at people who are working selflessly to combat the COVID-19 pandemic. Up to three people traveling with a health care worker would be able to benefit from the discount, the airline said.

The tickets must be purchased before Aug. 1 for flights before May 31, 2021.

Turkish airline companies resumed domestic flights last week. International flights are scheduled to resume gradually as of June 10.

Moscow ends tight lockdown after 2 months

MOSCOW The Russian capital is ending a tight lockdown that has been in place for more than two months, citing a slowdown in the coronavirus outbreak.

Moscow Mayor Sergei Sobyanin said that starting Tuesday residents will no longer be required to obtain electronic passes for travel and can walk, use public transport and drive without any restrictions.

Hairdressers and beauty salons will be allowed to reopen Tuesday, and cafes and restaurants will be able to open outdoor terraces starting June 16.

Under the lockdown imposed in late March, all nonessential businesses were closed and residents were only allowed to shop at nearby stores and pharmacies, visit doctors and walk their dogs.

The restrictions have been gradually eased. Industrial plants and construction sites were allowed to start working on May 12 and non-food retailers were permitted to reopen last Monday.

The number of daily infections in Moscow has dropped from a peak of about 6,700 to about 2,000 recently. Overall, Russia has registered over 476,000 infections, the worlds third-highest caseload after the United States and Brazil, including 5,971 deaths.

Moscow has accounted for nearly half of the nations infections and coronavirus deaths. Many of Russias 85 regions already have eased their lockdowns.

Armenian prime minister recovers from virus

YEREVAN, Armenia Armenian Prime Minister Nikol Pashinian says he and his family have recovered from the coronavirus.

Pashinian said on Facebook that he and his family members tested negative Monday for a second time in as many days.

Pashinian announced that he was infected a week ago, adding that he probably contracted the virus from a waiter who brought him a glass a water at a meeting without wearing gloves and later tested positive for the virus.

Armenia has so far reported over 13,000 infections, including 211 deaths, among its population of nearly 3 million.

China sends doctors to Bangladesh

DHAKA, Bangladesh China has sent a 10-member team of physicians to Bangladesh to help hospitals and doctors fight coronavirus as the South Asian nations total infections are nearing 70,000.

The team consists of 10 respiratory physicians selected by the Hainan Provincial Health Commission in China, according to the Chinese Embassy in Dhaka.

Bangladeshi Foreign Minister A.K. Abdul Momen was in Dhakas international airport to receive the team. He said the country was seeking cooperation and partnership to deal with the pandemic.

On Monday, the Health Directorates senior official said another 42 people died of coronavirus and 2,735 people were infected in the previous 24-hour period, raising the total infections to 68,504.

A total of 930 people have died since the first positive case was confirmed on March 8.

Officials in Cyprus continue to stress social distancing rules

NICOSIA, Cyprus Cypriot officials are warning against undue complacency in enforcing social distancing rules after video emerged of an open-air nightclub at a popular seaside resort jam-packed with patrons.

Cyprus police spokesman Christos Andreou told The Associated Press on Monday that the nightclubs owner faces a charge of flouting maximum capacity limits set out under a Health Ministry order.

Andreou said police are taking the owner to court because he was repeatedly warned over the weekend not to exceed the allowable capacity. Andreou said police will also seek a court order to temporarily shut down the Ayia Napa establishment.

Justice Minister George Savvides posted on his official Twitter account on Sunday that the nightclub acted inconceivably irresponsibly for the sake of profit.

Earlier, Health Minister Constantinos Ioannou also tweeted that such behavior could make a return to lockdown measures inevitable.

Cyprus is eager to get its key tourism sector back on track after a two-month lockdown, but officials say they wont allow anyone to cut corners on what they need to do to protect against the spread of COVID-19.

Commercial flights from a limited number of countries resume on Tuesday. Cyprus has lifted almost all restrictions, but a ban on indoor bar and nightclub openings remains in force.

Bars reopen today in Greece

ATHENS, Greece Bars, nightclubs and internet cafes are allowed to reopen from Monday in Greece, where an early lockdown is credited with keeping the number of coronavirus deaths and serious illnesses at low levels.

Nearly all lockdown measures have now been lifted in a phased reopening, with regulations in place for businesses to maintain limits on the number of customers allowed and distances to be maintained.

Most bars, nightclubs and restaurants operate outdoors in Greece during the summer months, which has helped authorities in allowing their reopening.

However, government and health authorities warn local lockdowns could be imposed if violations in social distancing regulations lead to outbreaks.

Indian begins reopening even as virus cases grow

NEW DELHI India is reopening its restaurants, shopping malls and religious places in most states even as the number of coronavirus cases and deaths in the country grows.

The Health Ministry reported another 9,983 cases Monday, raising Indias count past 256,000 to fifth most in the world. The 206 fatalities reported Monday were the highest single-day rise and takes the countrys death toll to 7,135.

New Delhi is also reopening its state borders, allowing interstate movement of people and goods.

India already partially restored train services and domestic flights and allowed shops and manufacturing to reopen.

Schools remain closed.

The number of new cases has soared since the government began relaxing restrictions. There has also been a surge in infections in Indias vast countryside following the return of hundreds of thousands of migrant workers who left cities and towns after losing their jobs.

Number of infections spirals upward in Pakistan

Link:
The Latest: Genetic testing offers more evidence that blood type plays role in effects of virus - Press Herald

Recommendation and review posted by Bethany Smith

At the consumer genetics giant 23andMe, CEO Anne Wojcicki last week issued a remarkable statement calling her product euro-centric and saying her company is part of the problem.

Competitor Ancestry put out its own statement saying it has a long, long way to go to make our product experience as inclusive as it can possibly be for everyone. And the DNA testing startup Nebula Genomics published a blog post about the lack of diversity in their field a post that was drafted months ago, but which the company held off on publishing because of concerns about how it would be received.

The reflections in the consumer genetics industry were triggered by the anti-racism protests following the killing of George Floyd. But the underlying issues are not new. The field of genetics has long been seen as too white in its leadership, its data, and its products.

advertisement

Geneticists have been grappling for years some more urgently than others with the underrepresentation of Black individuals and other people of color in genetic studies, databases, and the reference genome. While theres been some halting progress, these problems have resulted in tests that only work for people of European ancestry and have undermined hopes that everyone might benefit from personalized medicine.

STAT asked five experts in genetics and in health disparities to weigh on what 23andMe and its competitors should do to address these problems. Heres what they had to say:

advertisement

In 23andMes statement last week, Wojcicki said she was ashamed to say I do not have a single black employee who is at Director level or above. She also said her companys management team, board, and employee base need to be more diverse.

Lack of diversity among employees and executives at a company like 23andMe can send a message to potential customers and potential hires from underrepresented groups that theyre neither welcome nor represented, said geneticist Tshaka Cunningham.

How can you foster trust with me as an African American if I dont see any African Americans on your team? said Cunningham, co-founder and chief scientific officer of TruGenomix, a startup thats working on recruiting diverse cohorts to develop a test to gauge genetic risk for developing post-traumatic stress disorder.

Addressing inequities in hiring, promoting, and retaining employees is important on a fundamental level, Cunningham said. But a diverse team might also help a company avoid missteps such as the ad from Ancestry that was pulled last year after being widely condemned as racist; it depicted a romance between a white man and a Black woman in the antebellum South without addressing the unequal power dynamics and exploitation involved in such relationships of that era.

Having a broader range of perspectives at the table could also help companies better navigate the shortcomings of polygenic risk score tests analyses that gather multiple genetic variants that, together, are used to predict someones chance of developing a disease. So far, many commercial tests have come with warnings that theyre not very accurate or are even useless in people who are not of European ancestry. Thats due to the disproportionately low representation of other populations in the datasets used to build the tests. 23andMes polygenic risk score test for type 2 diabetes, introduced last year, had lower predictive power in African Americans than in any other group.

By the time they get to posting the statement on the website that the polygenic risk score is not going to be of any use to Black people but were still going to take your money for it, there are many other decisions that have been made and plenty of places where that discussion should have been halted to have a deeper conversation and thought about what to do, said Consuelo Wilkins, a physician who serves as vice president for health equity at Vanderbilt University Medical Center.

Before the pandemic, Cunningham traveled widely to speak at Black churches about the value of genetic research. It was part of his role as executive director and science advisory board member of the nonprofit Faith Based Genetic Research Institute.

As I go around the country talking to people of color about genomics and encouraging them to participate and get sequenced, the questions I get are: What are they going to do with that information, and how are they going to use it to hurt me? And then why would I give my information so somebody else can make money off of it? Cunningham said.

23andMe spells out its privacy policies online. Its customers must opt in to any of its research and it promises not to sell peoples individual-level data, though it does reserve the right to sell data that are aggregated and anonymized. But those disclosures may not be enough to build trust in communities of color that have been betrayed by medical researchers many times before.

Thats why 23andMe and other genetics researchers must go above and beyond when it comes to being transparent with minority communities about how theyre using their data, said KyEra Actkins, a Ph.D. student who studies human genetics at Meharry Medical College, a historically Black institution in Nashville, Tenn.

Another key step: Try to show people the benefits of what the science community is doing in terms of helping different minority populations or diverse populations and those who may not have always been very represented in the research that has been done historically, Actkins said.

But complicating such communication is the fact that 23andMe and other genetic testing companies arent making the same pitch to minority communities as, say, the National Institutes of Healths All of Us data-gathering program, which is meant to advance precision medicine for everyone in the U.S. While these companies do have a mission to advance scientific research, theyre also trying to sell spit kits and make money. Its not always clear that people of color will benefit from buying a 23andMe test or participating in one of the companys research studies any more than they would from engaging with some other consumer product.

The question is why would someone want to participate. Its a for-profit program, and for a for-profit company.

Consuelo Wilkins, vice president for health equity at Vanderbilt University Medical Center

When it comes to 23andMe, the question is why would someone want to participate. Its a for-profit program, and for a for-profit company. Why would people who are ethnic minorities want to pay for services that they may benefit less from than people of European descent? Wilkins said.

Its critical for 23andMe to demonstrate the value of its spit kits to communities of color, Wilkins said. The company should address whether it plans to take steps that would make the decision to hand over genetic data to the company more valuable over time, she said. That might include developing more robust reference datasets, reinterpreting genetic variants currently classified as being of unknown significance, and expanding its ancestry data to be more precise for people who are of African and Asian descent, she said.

The experts consulted by STAT called on 23andMe to prioritize recruiting underrepresented populations to enroll in its research studies an endeavor that, to the companys credit, its been working on for years.

In 2011, the company launched its Roots into the Future program, a genetic study of more than 10,000 African Americans. In 2016, 23andMe started its African Genetics Project, a study recruiting first- or second- generation emigrants from several countries in sub-Saharan Africa. 2018 saw the launch of 23andMes Global Genetics Project, which aims to expand the companys population reference data by collecting data from individuals with recent heritage from dozens of countries in Africa, Oceania, Asia, and the Americas.

23andMe has also received funding from the NIH to try to address disparities in genetic research, such as a project to create a reference panel of information to help scientists develop studies that benefit the African American community. The NIH has also funded 23andMes effort to develop a new way to detect disease-causing genetic variants among ethnically diverse populations.

These projects have made a dent in the problem. But the people of color recruited through these initiatives still represent only a tiny fraction of the millions of people in 23andMes databases.

Joyce Tung, 23andMes vice president of research whos been at the company for more than a decade, acknowledged in a statement to STAT that her company and the broader scientific community still have a long way to go in diversifying genetic research. There is no silver bullet to solve this problem, and it will require prioritizing multiple efforts now and into the future in order to ensure that we help everyone benefit from the human genome, Tung said.

Separate from concerns about diversity, some experts and startups have questioned the idea that people should be asked to pay for genetic tests and reports about their health and ancestry from commercial companies. 23andMe, after all, benefits enormously from the genetic data that people pay $100 or more to share and the scarcity of data from people from underrepresented groups makes their samples all the more valuable.

All of which raises the question: Should 23andMe pay people Black communities and other underrepresented populations for their data?

Cunningham thinks so. He pointed to the example of LunaDNA a platform which offers ownership shares to people who contribute their DNA and called for 23andMe to adopt a revenue-sharing model with communities of color.

The current model just doesnt work for many folks, Cunningham said.

Not all the experts agreed. They said they worried that offering money to give up genetic data, particularly given the economic crisis caused by Covid-19, could be considered coercive or might be frowned upon by the institutional review boards that decide whether to green-light studies.

With the current unemployment rate, how do you incentivize that in a way that would not be judged by an institutional review board as being coercive in some sense? said Nancy Cox, who directs the genetics institute at Vanderbilt University Medical Center.

Cox did not see an easy answer.

Experts consulted by STAT emphasized that the blame for the whiteness of genetics and the responsibility for diversifying it should not lay entirely at the feet of 23andMe.

Along with academic researchers and other genetics companies, other players in the ecosystem around genetic data have a responsibility to take steps that could incentivize more equitable genetic research, the experts said.

For example: Drug companies that purchase aggregated and de-identified genetic data from companies like 23andMe could commit to prioritizing purchasing diverse datasets or to paying more for them, said Robert Green, a medical geneticist and physician at Harvard and Brigham and Womens Hospital. Green advises several genetic testing companies and has worked closely with Cunningham and others to try to recruit diverse populations for his teams genetic studies.

Green added: We all have to take some responsibility at every level for this.

Read the rest here:
Geneticists weigh in on how 23andMe can tackle racial inequity in the field - STAT

Recommendation and review posted by Bethany Smith

Dive Brief:

FDA granted emergency use authorization to Phosphorus'unsupervised, at-home saliva test for COVID-19, the medical genetic testing company disclosedMonday.

Most test kits that allow at-home sample collection still use nasal swabs.But the agency previously OK'd a saliva-based test developed at Rutgers University, which is being distributed by a number of telemedicine providers,and one from Little Rock, Arkansas-based P23 Labs.

In the case of genomics startup Phosphorus, individuals can access the saliva-based test without using an outside telemedicine platform. Individuals requesta test online, complete a medical questionnaire, follow the instructions that come with the sample collection kit that arrives via mail and use a prepaid pack to send the saliva for analysis.

Phosphorus has marketed in the COVID-19 testing space since April, when it launched an IgG and IgM antibody test. In mid-May, the company announced it had viral and antibody COVID-19 tests available for home delivery in the New York City metro area, in which tests could be ordered online and then administered by licensed, in-home healthcare providers.

The company is aiming to further expand its COVID-19 testing reach with direct online ordering of its saliva-based test, now authorized by FDA for emergency use.

FDA greenlit the use of the Phosphorus and RUCDR tests after seeing data showing they deliver results consistent with the analysis of samples taken with nasopharyngeal swabs.

In eliminating the need for healthcare professionals to supervise the collection process, Phosphorus has removed one constraint on testing capacity. RUCDR, the Rutgers entity behind the first saliva-based test allowed by FDA for home collection,faces that constraint, but has partnered with companies like Vault Health to help.

Vault Health has an existing telemedicine platform to provide health services to men. Working with RUCDR, the startup is applying those capabilities amid COVID-19, enabling patients to log in to Zoom to provide samples under the supervision of a healthcare provider.

After talking to management at Vault Health on Monday afternoon, analysts at Jefferies called the company's direct-to-consumer test offering "surprisingly successful," noting just 2% of tests have come back as inconclusive.

"While the $150 price tag (reflective of Vault's cost per test) is higher than the $100 Medicare reimbursement for PCR and significantly higher than the cost per test at labs like [Quest Diagnostics,LabCorp and Opko Health], Vault has identified potential savings opportunities through expansion of scale with capacity currently at only 50k tests/day," the analysts wrote in a note to investors.

Go here to read the rest:
FDA expands at-home, saliva-based coronavirus testing with nod to Phosphorus - MedTech Dive

Recommendation and review posted by Bethany Smith

A new market report by Market Research Intellect on the Direct-Access Genetic Testing Market has been released with reliable information and accurate forecasts for a better understanding of the current and future market scenarios. The report offers an in-depth analysis of the global market, including qualitative and quantitative insights, historical data, and estimated projections about the market size and share in the forecast period. The forecasts mentioned in the report have been acquired by using proven research assumptions and methodologies. Hence, this research study serves as an important depository of the information for every market landscape. The report is segmented on the basis of types, end-users, applications, and regional markets.

The research study includes the latest updates about the COVID-19 impact on the Direct-Access Genetic Testing sector. The outbreak has broadly influenced the global economic landscape. The report contains a complete breakdown of the current situation in the ever-evolving business sector and estimates the aftereffects of the outbreak on the overall economy.

Get Sample Copy with TOC of the Report to understand the structure of the complete report @ https://www.marketresearchintellect.com/download-sample/?rid=174200&utm_source=COD&utm_medium=888

The report also emphasizes the initiatives undertaken by the companies operating in the market including product innovation, product launches, and technological development to help their organization offer more effective products in the market. It also studies notable business events, including corporate deals, mergers and acquisitions, joint ventures, partnerships, product launches, and brand promotions.

Leading Direct-Access Genetic Testing manufacturers/companies operating at both regional and global levels:

Sales and sales broken down by Product:

Sales and sales divided by Applications:

The report also inspects the financial standing of the leading companies, which includes gross profit, revenue generation, sales volume, sales revenue, manufacturing cost, individual growth rate, and other financial ratios.

The report also focuses on the global industry trends, development patterns of industries, governing factors, growth rate, and competitive analysis of the market, growth opportunities, challenges, investment strategies, and forecasts till 2026. The Direct-Access Genetic Testing Market was estimated at USD XX Million/Billion in 2016 and is estimated to reach USD XX Million/Billion by 2026, expanding at a rate of XX% over the forecast period. To calculate the market size, the report provides a thorough analysis of the market by accumulating, studying, and synthesizing primary and secondary data from multiple sources.

To get Incredible Discounts on this Premium Report, Click Here @ https://www.marketresearchintellect.com/ask-for-discount/?rid=174200&utm_source=COD&utm_medium=888

The market is predicted to witness significant growth over the forecast period, owing to the growing consumer awareness about the benefits of Direct-Access Genetic Testing. The increase in disposable income across the key geographies has also impacted the market positively. Moreover, factors like urbanization, high population growth, and a growing middle-class population with higher disposable income are also forecasted to drive market growth.

According to the research report, one of the key challenges that might hinder the market growth is the presence of counter fit products. The market is witnessing the entry of a surging number of alternative products that use inferior ingredients.

Key factors influencing market growth:

Reasons for purchasing this Report from Market Research Intellect

Customized Research Report Using Corporate Email Id @ https://www.marketresearchintellect.com/need-customization/?rid=174200&utm_source=COD&utm_medium=888

Customization of the Report:

Market Research Intellect also provides customization options to tailor the reports as per client requirements. This report can be personalized to cater to your research needs. Feel free to get in touch with our sales team, who will ensure that you get a report as per your needs.

Thank you for reading this article. You can also get chapter-wise sections or region-wise report coverage for North America, Europe, Asia Pacific, Latin America, and Middle East & Africa.

To summarize, the Direct-Access Genetic Testing market report studies the contemporary market to forecast the growth prospects, challenges, opportunities, risks, threats, and the trends observed in the market that can either propel or curtail the growth rate of the industry. The market factors impacting the global sector also include provincial trade policies, international trade disputes, entry barriers, and other regulatory restrictions.

About Us:

Market Research Intellect provides syndicated and customized research reports to clients from various industries and organizations with the aim of delivering functional expertise. We provide reports for all industries including Energy, Technology, Manufacturing and Construction, Chemicals and Materials, Food and Beverage and more. These reports deliver an in-depth study of the market with industry analysis, market value for regions and countries and trends that are pertinent to the industry.

Contact Us:

Mr. Steven Fernandes

Market Research Intellect

New Jersey ( USA )

Tel: +1-650-781-4080

Read more:
Direct-Access Genetic Testing Market 2019 Break Down by Top Companies, Countries, Applications, Challenges, Opportunities and Forecast 2026 - Cole of...

Recommendation and review posted by Bethany Smith

A new market report by Market Research Intellect on the Breast Cancer Predictive Genetic Testing Market has been released with reliable information and accurate forecasts for a better understanding of the current and future market scenarios. The report offers an in-depth analysis of the global market, including qualitative and quantitative insights, historical data, and estimated projections about the market size and share in the forecast period. The forecasts mentioned in the report have been acquired by using proven research assumptions and methodologies. Hence, this research study serves as an important depository of the information for every market landscape. The report is segmented on the basis of types, end-users, applications, and regional markets.

The research study includes the latest updates about the COVID-19 impact on the Breast Cancer Predictive Genetic Testing sector. The outbreak has broadly influenced the global economic landscape. The report contains a complete breakdown of the current situation in the ever-evolving business sector and estimates the aftereffects of the outbreak on the overall economy.

Get Sample Copy with TOC of the Report to understand the structure of the complete report @ https://www.marketresearchintellect.com/download-sample/?rid=230278&utm_source=COD&utm_medium=888

The report also emphasizes the initiatives undertaken by the companies operating in the market including product innovation, product launches, and technological development to help their organization offer more effective products in the market. It also studies notable business events, including corporate deals, mergers and acquisitions, joint ventures, partnerships, product launches, and brand promotions.

Leading Breast Cancer Predictive Genetic Testing manufacturers/companies operating at both regional and global levels:

Sales and sales broken down by Product:

Sales and sales divided by Applications:

The report also inspects the financial standing of the leading companies, which includes gross profit, revenue generation, sales volume, sales revenue, manufacturing cost, individual growth rate, and other financial ratios.

The report also focuses on the global industry trends, development patterns of industries, governing factors, growth rate, and competitive analysis of the market, growth opportunities, challenges, investment strategies, and forecasts till 2026. The Breast Cancer Predictive Genetic Testing Market was estimated at USD XX Million/Billion in 2016 and is estimated to reach USD XX Million/Billion by 2026, expanding at a rate of XX% over the forecast period. To calculate the market size, the report provides a thorough analysis of the market by accumulating, studying, and synthesizing primary and secondary data from multiple sources.

To get Incredible Discounts on this Premium Report, Click Here @ https://www.marketresearchintellect.com/ask-for-discount/?rid=230278&utm_source=COD&utm_medium=888

The market is predicted to witness significant growth over the forecast period, owing to the growing consumer awareness about the benefits of Breast Cancer Predictive Genetic Testing. The increase in disposable income across the key geographies has also impacted the market positively. Moreover, factors like urbanization, high population growth, and a growing middle-class population with higher disposable income are also forecasted to drive market growth.

According to the research report, one of the key challenges that might hinder the market growth is the presence of counter fit products. The market is witnessing the entry of a surging number of alternative products that use inferior ingredients.

Key factors influencing market growth:

Reasons for purchasing this Report from Market Research Intellect

Customized Research Report Using Corporate Email Id @ https://www.marketresearchintellect.com/need-customization/?rid=230278&utm_source=COD&utm_medium=888

Customization of the Report:

Market Research Intellect also provides customization options to tailor the reports as per client requirements. This report can be personalized to cater to your research needs. Feel free to get in touch with our sales team, who will ensure that you get a report as per your needs.

Thank you for reading this article. You can also get chapter-wise sections or region-wise report coverage for North America, Europe, Asia Pacific, Latin America, and Middle East & Africa.

To summarize, the Breast Cancer Predictive Genetic Testing market report studies the contemporary market to forecast the growth prospects, challenges, opportunities, risks, threats, and the trends observed in the market that can either propel or curtail the growth rate of the industry. The market factors impacting the global sector also include provincial trade policies, international trade disputes, entry barriers, and other regulatory restrictions.

About Us:

Market Research Intellect provides syndicated and customized research reports to clients from various industries and organizations with the aim of delivering functional expertise. We provide reports for all industries including Energy, Technology, Manufacturing and Construction, Chemicals and Materials, Food and Beverage and more. These reports deliver an in-depth study of the market with industry analysis, market value for regions and countries and trends that are pertinent to the industry.

Contact Us:

Mr. Steven Fernandes

Market Research Intellect

New Jersey ( USA )

Tel: +1-650-781-4080

Read the original here:
Breast Cancer Predictive Genetic Testing Market 2019 Break Down by Top Companies, Countries, Applications, Challenges, Opportunities and Forecast 2026...

Recommendation and review posted by Bethany Smith

A new market report by Market Research Intellect on the Direct-To-Consumer (DTC) Genetic Testing Market has been released with reliable information and accurate forecasts for a better understanding of the current and future market scenarios. The report offers an in-depth analysis of the global market, including qualitative and quantitative insights, historical data, and estimated projections about the market size and share in the forecast period. The forecasts mentioned in the report have been acquired by using proven research assumptions and methodologies. Hence, this research study serves as an important depository of the information for every market landscape. The report is segmented on the basis of types, end-users, applications, and regional markets.

The research study includes the latest updates about the COVID-19 impact on the Direct-To-Consumer (DTC) Genetic Testing sector. The outbreak has broadly influenced the global economic landscape. The report contains a complete breakdown of the current situation in the ever-evolving business sector and estimates the aftereffects of the outbreak on the overall economy.

Get Sample Copy with TOC of the Report to understand the structure of the complete report @ https://www.marketresearchintellect.com/download-sample/?rid=248561&utm_source=COD&utm_medium=888

The report also emphasizes the initiatives undertaken by the companies operating in the market including product innovation, product launches, and technological development to help their organization offer more effective products in the market. It also studies notable business events, including corporate deals, mergers and acquisitions, joint ventures, partnerships, product launches, and brand promotions.

Leading Direct-To-Consumer (DTC) Genetic Testing manufacturers/companies operating at both regional and global levels:

Sales and sales broken down by Product:

Sales and sales divided by Applications:

The report also inspects the financial standing of the leading companies, which includes gross profit, revenue generation, sales volume, sales revenue, manufacturing cost, individual growth rate, and other financial ratios.

The report also focuses on the global industry trends, development patterns of industries, governing factors, growth rate, and competitive analysis of the market, growth opportunities, challenges, investment strategies, and forecasts till 2026. The Direct-To-Consumer (DTC) Genetic Testing Market was estimated at USD XX Million/Billion in 2016 and is estimated to reach USD XX Million/Billion by 2026, expanding at a rate of XX% over the forecast period. To calculate the market size, the report provides a thorough analysis of the market by accumulating, studying, and synthesizing primary and secondary data from multiple sources.

To get Incredible Discounts on this Premium Report, Click Here @ https://www.marketresearchintellect.com/ask-for-discount/?rid=248561&utm_source=COD&utm_medium=888

The market is predicted to witness significant growth over the forecast period, owing to the growing consumer awareness about the benefits of Direct-To-Consumer (DTC) Genetic Testing. The increase in disposable income across the key geographies has also impacted the market positively. Moreover, factors like urbanization, high population growth, and a growing middle-class population with higher disposable income are also forecasted to drive market growth.

According to the research report, one of the key challenges that might hinder the market growth is the presence of counter fit products. The market is witnessing the entry of a surging number of alternative products that use inferior ingredients.

Key factors influencing market growth:

Reasons for purchasing this Report from Market Research Intellect

Customized Research Report Using Corporate Email Id @ https://www.marketresearchintellect.com/need-customization/?rid=248561&utm_source=COD&utm_medium=888

Customization of the Report:

Market Research Intellect also provides customization options to tailor the reports as per client requirements. This report can be personalized to cater to your research needs. Feel free to get in touch with our sales team, who will ensure that you get a report as per your needs.

Thank you for reading this article. You can also get chapter-wise sections or region-wise report coverage for North America, Europe, Asia Pacific, Latin America, and Middle East & Africa.

To summarize, the Direct-To-Consumer (DTC) Genetic Testing market report studies the contemporary market to forecast the growth prospects, challenges, opportunities, risks, threats, and the trends observed in the market that can either propel or curtail the growth rate of the industry. The market factors impacting the global sector also include provincial trade policies, international trade disputes, entry barriers, and other regulatory restrictions.

About Us:

Market Research Intellect provides syndicated and customized research reports to clients from various industries and organizations with the aim of delivering functional expertise. We provide reports for all industries including Energy, Technology, Manufacturing and Construction, Chemicals and Materials, Food and Beverage and more. These reports deliver an in-depth study of the market with industry analysis, market value for regions and countries and trends that are pertinent to the industry.

Contact Us:

Mr. Steven Fernandes

Market Research Intellect

New Jersey ( USA )

Tel: +1-650-781-4080

Read more from the original source:
Direct-To-Consumer (DTC) Genetic Testing Market 2019 Break Down by Top Companies, Countries, Applications, Challenges, Opportunities and Forecast 2026...

Recommendation and review posted by Bethany Smith

A new study examining genetic diversity within dog breeds encourages dog breeders to consider the exchange of dogs between countries. Jaakko Pohjoismki, corresponding author of the study, takes us through the new analysis of breeding practices.

Jaakko Pohjoismaki 10 Jun 2020

In our study Variation in breeding practices and geographic isolation drive subpopulation differentiation, contributing to the loss of genetic diversity within dog breed lineages, published in Canine Medicine and Genetics, we used commercially obtained genomic data to study subpopulation differentiation in six popular dog breeds, Belgian Shepherd, English Greyhound, Finnish Lapphund, Italian Greyhound, Labrador Retriever and Shetland Sheepdog.

We found strong subpopulation differentiation in all of these breeds, which corresponded either to the geographic origin or the specialized breed lineages within the breeds. While we were expecting to see some differentiation, especially as the populations in some countries are based on a rather small number of founders, it was surprising to see how distinct these subpopulations were genetically and how rapid the genetic differentiation in some breeds had been. For example, the so-called herding lineage of the Finnish Lapphund has differentiated from the companion lineage in mere three decades without any geographic barriers, just driven by diverging kennel preferences.

Breed type differentiation in Belgian Shepherd and Finnish Lapphund. Pohjoismki et al.

Our observations have both practical as well as more philosophical outcomes for kennel practices. Breeding dogs to fulfill given breed ideals will, by definition, result in loss of unwanted variation and is the basis for breeding in all domesticated animals. In general, breed differentiation and uniformity is not bad as such, but many breeds are small by default and are in danger of suffering from the accumulated effects of inbreeding depression over the generations. Specialized lineages do not need to be abolished, but the breed organizations should be more proactive in mixing the dogs between the lineages or between closely related breeds. While the maintenance of specialized lineages might be justified in, for example, working breeds, the majority of phenotypic differentiation of breeds serves only our desire to create specialty. Furthermore, many of these specialty characteristics, such as coat color or type, are recessive single-gene traits. The recessive phenotypes can be obtained from planned crossings of heterozygous individuals, which can be identified with the help of genetic testing. It needs to be kept in mind that dog breeds result from man-made criteria, whose justifications for breeding should be critically evaluated and diverse breeding options preferred over narrow ideals.

In contrast to the wide-spread ideals of discrete, tightly defined breeds, there are some breeds such as the Nordic Spitz or Norrbottenspets, whose breeding attempts to mimic the natural selection operating in feral dogs and can be seen as an example of a paradigm change in kennel practices. This small hunting breed is maintained in Finland by strict limits on inbreeding, limiting the number of pups per sire to 30, having an open stud book and emphasizing working hunting dogs over looks or qualifications in dog shows, while requiring compulsory health checks for the breeding dogs. Despite being once close to extinction, it is at the moment one of the most genetically diverse dog breeds in the world.

Our study is also an example how commercially obtained genome data can be utilized to provide valuable information on subpopulation differentiation and genetic diversity of dog breeds. Data helps us also to understand the genetic relationships and ancestral gene flow among the contemporary dog breeds, which are often speculated among the breed enthusiasts.

Lineage purpose differentiation in English Greyhound and Labrador Retriever. Pohjoismki et al.

From a more general perspective, the combined effect of population bottlenecks and selection on genetic differentiation are amazing to see in action. Although widely known, the fact that most dog breeds with their amazing phenotypic variation have emerged mostly during the last 200 years is perhaps still an under appreciated example of evolutionary forces in action. Understanding of the genetic differentiation in dog breeds might provide interesting insight into the evolution of natural populations, such as adaptive radiation of species or speciation from a few founder individuals on remote island habitats. Similarly, the rapid differentiation of dog breed subpopulations, accompanied by the loss of genetic diversity, underscores the impact of habitat loss and fragmentation on the population genetics of endangered species. The dog subpopulations with relatively few breeding individuals emulate closely the situation of many spatially dispersed populations of endangered species. Dogs could also offer practical, controlled models to study the effects of genetic rescue of endangered populations and help to device practices regarding the number of transferred individuals and required genetic differences to achieve the desired goals for the rescue.

Directional breeding is a powerful tool, which humans have applied for millennia to sculpt animals and plants alike. However, with power comes the responsibility to not do harm. Our greatest animal companions deserve us to see them in a broader view.

Read more:
What do the dog breeds tell about the makings of our best friends and us? - On Biology - BMC Blogs Network

Recommendation and review posted by Bethany Smith

A new market report by Adroit Market Research on the Preimplantation Genetic Testing Market has been released with reliable information and accurate forecasts for a better understanding of the current and future market scenarios. The exploration report comprised with market data derived from primary as well as secondary research techniques. The solicitation of proposals by the governments and publicprivate companies across the world to mitigate the impact of the COVID-19 pandemic is considered to be market forces. The aim is to get premium insights, quality data figures and information in relation to aspects such as market scope, market size, share, and segments including Types of Products and Services, Application / end use industry, SWOT Analysis and by various emerging by geographies.

Get Sample Copy of this Report: https://www.adroitmarketresearch.com/contacts/request-sample/1483

The report also emphasizes the initiatives undertaken by the companies operating in the market including product innovation, product launches, and technological development to help their organization offer more effective products in the market. It also studies notable business events, including corporate deals, mergers and acquisitions, joint ventures, partnerships, product launches, and brand promotions.

Some of the profiled players in Preimplantation Genetic Testing Market

Thermo Fisher Scientific, Inc., Agilent Technologies, Inc., PerkinElmer, Inc., CooperSurgical, Inc., Beijing Genomics Institute (BGI), Abbott Laboratories, Natera, Inc., Genea Limited, Rubicon Genomics, Inc. and Oxford Gene Technology

Read complete report with TOC at: https://www.adroitmarketresearch.com/industry-reports/preimplantation-genetic-testing-market

The report discusses the competitive landscape of the Global Preimplantation Genetic Testing Market. All the existing large, as well as small players which are functioning in the market, covered in the report. The report analyzes the market share and new orders of market share by the company. Information obtained from various companies is added covering their product portfolio and pricing strategy. Further, it covers the business overview and financial overview of each of the companies. An in-depth analysis of all the payers with their company profile, their sale and revenue analysis and competitive landscape in the industry has been delivered in the report.

The Preimplantation Genetic Testing Market has its impact all over the globe. On Global Preimplantation Genetic Testing Industry is segmented on the basis of product type, applications, and regions. It also focusses on market dynamics, Preimplantation Genetic Testing Market growth drivers, developing market segments and the market growth curve is offered based on past, present and future market data. The industry plans, news, and policies are presented at a Global and regional level.

Global Preimplantation Genetic Testing market is segmented based by type, application and region.

Based on Type, the market has been segmented into:

by Test Type (Aneuploidy, Structural Chromosomal Abnormalities, Single Gene Disorders, X-linked Disorders, HLA Typing, Gender Identification) and Technology (Next Generation Sequencing, Polymerase Chain Reaction, Fluorescent In-Situ Hybridization, Comparative Genomic Hybridization, Single Nucleotide Polymorphism)

Implementing Marketing Tactics:1. Numerous marketing strategies implemented by the renowned shareholders with respect to product marketing are presented in the report.2. Information related to the sales channels that companies select is also included in the report.3. Along with the dealers of these products, it also presents a summary of the top customers4. Data related to the Global Preimplantation Genetic Testing Market share of each product application as well as estimated revenue that each application registers for is given in the report.

Customization of the Report:This report can be customized to meet the clients requirements. Please connect with our sales team ([emailprotected]), who will ensure that you get a report that suits your needs. You can also get in touch with our executives on +1 972-362 -8199 to share your research requirements.

For Any Query on the Preimplantation Genetic Testing Market: https://www.adroitmarketresearch.com/contacts/enquiry-before-buying/1483

About Us :

Adroit Market Research is an India-based business analytics and consulting company. Our target audience is a wide range of corporations, manufacturing companies, product/technology development institutions and industry associations that require understanding of a markets size, key trends, participants and future outlook of an industry. We intend to become our clients knowledge partner and provide them with valuable market insights to help create opportunities that increase their revenues. We follow a code Explore, Learn and Transform. At our core, we are curious people who love to identify and understand industry patterns, create an insightful study around our findings and churn out money-making roadmaps.

Contact Us :

Ryan JohnsonAccount Manager Global3131 McKinney Ave Ste 600, Dallas,TX 75204, U.S.APhone No.: USA: +1 972-362 -8199 / +91 9665341414

Read the rest here:
Global Preimplantation Genetic Testing Market Share 2020 Industry Size, Types and Application, Regions, Manufacturers and Growth Opportunities by 2025...

Recommendation and review posted by Bethany Smith

Predictive Genetic Testing and Consumer/Wellness Genomics Market: Snapshot

Genetic testing comprises examination of ones DNA. The term DNA refers to the chemical database that is responsible for conveying the instructions for functions that need to be performed by the body. Genetic testing is capable of revealing changes or mutations in the genes of living beings, which might result in any kind of disease or illness in the body.

Get Exclusive PDF Sample Copy Of This Report:https://www.tmrresearch.com/sample/sample?flag=B&rep_id=1274

Predictive genetic testingrefers to the utilization of genetic testing methods in an asymptomatic individual to make a prediction about risk of contacting particular disease in future. These tests are regarded as representation of emerging class of medical tests, which differ in fundamental ways from the usual diagnostic tests.

The global predictive genetic testing and consumer/wellness genomics marketis likely to gather momentum owing to the benefits offered by predictive genetic testing.

The benefits of predictive genetic testing are

The global predictive genetic testing and consumer/wellness genomics marketis influenced by reducing cost of genetic sequencing and technological advancement in the field of genetics. North America is expected to emerge as a prominent region for the global predictive genetic testing and consumer/wellness genomics market in years to come due to high adoption rates of latest technologies in all fields.

Over centauries human DNA has undergone tremendous alteration due to evolutionary and lifestyle changes. They have led to both, advantages and disadvantages over the years. Some have given the mankind a deserving edge over other creatures while the others have led to disorders and diseases. Predictive genetic testing and consumer/wellness genomics market thrives on the growing demand for understanding the lineage of a certain gene pool to identify disorders that could manifest in the later or early stage of a human life. The surging demand for understanding the family history or studying the nature of certain diseases has given the global market for predictive genetic testing and consumer/wellness genomics market adequate fodder for growth in the past few years.

This new class of medical tests are aimed at reducing the risk of morbidity and mortality amongst consumers. The thorough surveillance and screening of a certain gene pool can allow an individual to avoid conditions that disrupt normal existence through preventive measures. The clinical utility of these tests remains unassessed. Therefore, increasing research and development by pharmaceutical companies to develop new drugs by understanding diseases and disorders is expected to favor market growth.

Unlike conventional diagnostic testing, predictive genetic testing identifies the risk associated with potential conditions. In certain cases it is also capable of stating when the disease may appear and the how severe will it be. Thus, this form of testing is expected to allow consumers to take up wellness measurements well in time to lead a life of normalcy, characterized by good health.

Buy This Report @https://www.tmrresearch.com/checkout?rep_id=1274<ype=S

Global Predictive Genetic Testing and Consumer/Wellness Genomics Market: Overview

Predictive genetic testing are used to identify gene mutations pertaining to the disorders that surface at a considerably later stage in life after birth. These tests are particularly beneficial for people from a family with a history of genetic disorder, although they themselves show no symptoms of the disorder at the time of testing. Genetic testing promises to revolutionize the healthcare sector, providing crucial diagnostic details related to diverse verticals such as heart disease, autism, and cancer. As the healthcare sector touches new peaks, the global predictive genetic testing and consumer/wellness genomics market is projected to expand at a healthy growth rate during the forecast period of 2017 to 2025.

This report on the global market for predictive genetic testing and consumer/wellness genomics analyzes all the important factors that may influence the demand in the near future and forecasts the condition of the market until 2025. It has been created using proven research methodologies such as SWOT analysis and Porters five forces. One of the key aspect of the report is the section on company profiles, wherein several leading players have been estimated for their market share and analyzed for their geographical presence, product portfolio, and recent strategic developments such as mergers, acquisitions, and collaborations.

The global predictive genetic testing and consumer/wellness genomics market, on the basis of test type, can be segmented into predictive testing, consumer genomics, and wellness genetics. The segment of predictive testing can be sub-segmented into genetic susceptibility test, predictive diagnostics, and population screening programs, whereas the segment of wellness genetics can be further divided into nutria genetics, skin and metabolism genetics, and others.

By application, the market can be segmented into breast and ovarian cancer screening, cardiovascular screening, diabetic screening and monitoring, colon cancer screening, Parkinsons or Alzheimers disease, urologic screening or prostate cancer screening, orthopedic and musculoskeletal screening, and other cancer screening. Geographically, the report studies the opportunities available in regions such as Asia Pacific, Europe, North America, and the Middle East and Africa.

Global Predictive Genetic Testing and Consumer/Wellness Genomics Market: Trends and Opportunities

Increasing number of novel partnership models, rapidly decreasing cost of genetic sequencing, and introduction of fragmented point-solutions across the genomics value chain as well as technological advancements in cloud computing and data integration are some of the key factors driving the market. On the other hand, the absence of well-defined regulatory framework, low adoption rate, and ethical concerns regarding the implementation, are expected to hinder the growth rate during the forecast period. Each of these factors have been analyzed in the report and their respective impacts have been anticipated.

Currently, the segment of predictive genetic cardiovascular screening accounts for the maximum demand, and increased investments in the field is expected to maintain it as most lucrative segment. On the other hand, more than 70 companies are currently engaged in nutrigenomics, which is expected to further expand the market.

Global Predictive Genetic Testing and Consumer/Wellness Genomics Market: Regional Outlook

Owing to robust healthcare infrastructure, prevalence of cardiovascular diseases, and high adoptability rate of new technology makes North America the most lucrative region, with most of the demand coming from the country of the U.S. and Canada. Several U.S. companies hold patents, which further extends the outreach of the market in the region of North America.

Companies mentioned in the research report

23andMe, Inc, BGI, Genesis Genetics, Illumina, Inc, Myriad Genetics, Inc, Pathway Genomics, Color Genomics Inc., and ARUP Laboratories are some of the key companies currently operating in global predictive genetic testing and consumer/wellness genomics market. Various forms of strategic partnerships with operating company and smaller vendors with novel ideas helps these leading players maintain their position in the market.

To know more about the table of contents, you can click @https://www.tmrresearch.com/sample/sample?flag=T&rep_id=1274

About TMR Research

TMR Research is a premier provider of customized market research and consulting services to busi-ness entities keen on succeeding in todays supercharged economic climate. Armed with an experi-enced, 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.

Read more:
Predictive Genetic Testing and Consumer/Wellness Genomics Market to Record Ascending Growth by 2025 - Cole of Duty

Recommendation and review posted by Bethany Smith

Digital Genome Market is expected to exceed USD 50.4 billion by 2025. The rising prevalence of chronic disorders across the globe is leading toward adoption of digitalized genomic solutions.

Some major findings of digital genome market report include:

The demand for digital genome is increasing across the globe due to various benefits such as mounting advances in biotechnology sector and augmented inventive digital genome products

Advancements in field of genomics and development of next generation DNA sequencing techniques have reduced costs and increased the speed of DNA sequencing

Shift in plant and animal sciences from traditional to molecular systematics for classification of organisms and understanding their evolution will propel market growth

Major players operating in digital genome market are Becton, Dickson and Company, F. Hoffmann-La Roche Ltd., and PerkinElmer Inc. Companies are delivering advanced technologies including Preimplantation Genetic Screening to gain competitive edge over the rivals.

Request sample copy of this report @ https://www.gminsights.com/request-sample/detail/1219

Technological advancements in the field of genomics and biotechnology resulting in rapid DNA sequencing at comparatively low costs would prove to be a high impact rendering factor. Rising incidence of chronic diseases due to unhealthy lifestyle, lack of physical activity and consumption of harmful substances will drive the market growth. The escalating use of personalized medicines for clinical diagnosis would fuel growth of digital genome market. In addition, several government organizations such as the National Institute of Health, European Commission, and Genome Canada are putting efforts to streamline volunteering process in the research genomics-based clinical trials essential for advancement of new tests & treatment of chronic diseases.

Developed countries are implementing genome-based technologies in numerous areas of healthcare, leading to industry progression. The Genome Russia project will serve to be a high impact rendering driver for the Russian digital genome market. However, factors such as high costs of personalized medicines, lack of expertise regarding digital genome in developing economies, data safety issues and imprecise findings are certain factors likely to impede the market growth during the projection period.

The evolution in epigenetic studies have created more demand for ChIP-seq. Sequencing Chip is mainly utilized to understand how phenotypic mechanisms are influenced by transcription factors and other chromatin associated proteins. The applications of next generation sequencing & ChIP provides better understanding of events of gene regulation and also its relation to various genetic & metabolic disorders. The increasing research for epigenetics to treat chronic metabolic disorders will fuel the demand for DNA/RNA sequencing chip. The adoption of advanced sequencing chIP coupled with Computer Aided Insilco Drug Discovery (CADD) will positively influence market for sequencing chips to grow at a high pace over forecast period.

Get In-depth table of contents @ https://www.gminsights.com/toc/detail/digital-genome-market

The agriculture and livestock industry are gaining huge popularity due to high adoption rate of genetic testing technologies. Moreover, dairy industry is getting highly benefitted by genetic testing technologies that will eventually raise the competitive bar in genomic market. Bovine genetic test is done on animals such as beef, cattle and dairy cow. Farming animals that display required traits, such as high yield of milk, faster weight gain, tenderness of meat, efficient nutrient utilization and disease resistance are economically useful for food production, eventually leading to market size expansion. Animals that are free from disease has ability to produce good quality food and utilize nutrients in a better way that will drive digital genome market over the forecast period.

In near future, genomics is expected to transform way of treating infectious and rare disease. Advanced gene editing techniques such as next generation sequencing, bio-python, computer aided drug delivery is essentially used by physicians to tailor precision medicines that considers individual genetic variability. Hospitals are also using DNA sequencing for testing organ for rejection before transplanting. The aforementioned applications of genomics in diagnosis, drug development, transplanting and preventing adverse drug reactions in hospitals will drive progress of digital genomic market.

At present, various firms have developed sequencing and analysis instruments. The companies are carrying out advanced research for more advanced technologies such as chain terminator DNA sequencing and next generation sequencing. The key players are integrating DNA sequencing with bioinformatics that will create high demand for these products. For instance, some of the most advanced sequencing technologies in market are Roche 454 sequencing, Illumina (Solexa) sequencing, Ion torrent: proton/ PGM sequencing & SOLiD (sequencing by Oligonucleotide Ligation and Detection) sequencing. The leading companies such as GE Healthcare, Illumina, Thermo Fisher Scientific and Roche are making large investments to enter emerging markets such as Brazil, India, and Saudi Arabia.

Read the original post:
Digital Genome Market drivers of growth analyzed in a new research report - Cole of Duty

Recommendation and review posted by Bethany Smith

The Preimplantation Genetic Testing market report by Reports and Data provides an extensive overview of the vital elements of the Preimplantation Genetic Testing market and factors such as the drivers, restraints, latest trends, supervisory scenario, competitive landscape, technological advancements, and others. The report proposes a full-fledged solution for all your business needs and helps to understand the overall dynamics of the market. The market report offers an in-depth evaluation of all aspects that are expected to impact the growth of the market in a constructive way.

Market Size USD 347.7 million in 2018, Market Growth CAGR of 10.1%, Market Trends Product launches and research for advanced preimplantation genetic testing

This is the latest report covering the current COVID-19 scenario. The coronavirus pandemic has greatly affected every aspect of the worldwide industry. It has brought along various changes in market conditions. The rapidly changing market scenario and the initial and future assessment of the aftereffects are covered in the research report. The report discusses all the major aspects of the market with expert opinions on the current status along with historical data.

Get a sample PDF copy of the Report @ https://www.reportsanddata.com/sample-enquiry-form/2244

The geographical regions mapped in the report are:

The market research report sheds light on both macro- and micro-economic factors. The report also highlights the regulatory framework that will play a vital role in shaping the future of the global Preimplantation Genetic Testing market. Additionally, the report studies the prevailing pricing structure, emerging areas of applications, and prominent investment opportunities that exist in the global market. It delivers extensive analysis of how the projected growth factors will be shaping the overall market dynamics in the upcoming years. Moreover, it also provides meaningful and actionable insights on the latest trends that are developing in the current market scenario and which will prove to be helpful for the future of the global Preimplantation Genetic Testing market.

The report on the global Preimplantation Genetic Testing market also includes an in-depth analysis of the competitive landscape. It analyzes key marketing and promotional strategies that are being adopted by key companies in the market. It also takes into account the existing development, historical events, and latest trends to provide the readers with a detailed understanding of the strategies adopted by leading companies. The market report mentions all factors and events impacting the growth of the market, such as mergers, acquisitions, joint ventures, strategic alliances, takeovers, and others. It also studies the overall intensity of the competition prevailing in the global Preimplantation Genetic Testing business.

To get a discount on the report, click @https://www.reportsanddata.com/discount-enquiry-form/2244

Some key players mentioned in the research report are:

Natera, Inc.; CooperSurgical, Inc.; F. Hoffmann-La Roche AG; Illumina, Inc.; IGENOMIX; and others

The global Preimplantation Genetic Testing market can be segmented into:

Test Type (Revenue, USD Million; 20162026)

Type (Revenue, USD Million; 20162026)

Application(Revenue, USD Million; 20162026)

Browse the full report @ https://www.reportsanddata.com/report-detail/preimplantation-genetic-testing-market

The Preimplantation Genetic Testing Market report delivers the principle locale, latest economic situations with the item value, benefits, production capacity, demand and supply, market growth rate, and others. Additionally, the report performs SWOT analysis, speculation attainability investigation, and venture return investigation.

Thank you for reading our report. For further details or to inquire about customization, please let us know and we will offer you the report as per your needs.

The rest is here:
Global Impact of Covid-19 on Preimplantation Genetic Testing Market to Witness Promising Growth Opportunities During 20202027 with Top Leading...

Recommendation and review posted by Bethany Smith

The growth of the market is driven by factors such as, growing awareness about hereditary cancer and favorable reimbursement scenario. However, market growth is likely to slow down due to the gender gap in cancer genetic testing in the region.

Register for a free trial today and gain instant access to our market research reports at https://www.businessmarketinsights.com/TIPRE00006806/request-trial

The Business Market Insights subscription helps clients understand theongoingmarket trends,identifyopportunities, and make informed decisions through the reports in the Subscription Platform. The Industry reports available in the subscriptionprovidean in-depth analysis on various market topics and enable clients to line up remunerative opportunities. The reportsprovidethe market size & forecast, drivers, challenges, trends, and more.

Personalized medicines is a comparatively new idea that allows doctors to select medication based on a patients hereditary profile; it is a developing area in the healthcare sector. The method not only reduces adverse side effects but also manages to produce strong results in a short period. For instance, mutations in BRCA1 and BRCA2 lead to breast cancer. However, identifying the type of variation in the breast cancer patient provides crucial information for the kind of treatment. Hence, personalized medicines allow right treatment at the right time, which reduces the mortality rate. On the back of these advantages, the personalized medicine approach is likely to create many opportunities for the hereditary cancer testing market players.

Business Market Insights reports focus upon clientobjectives, use standard research methodologies and exclusive analytical models, combined with robust business acumen, which providesprecise and insightful results.

Business Market Insights reports are usefulnot only forcorporate and academic professionalsbut also forconsulting, research firms,PEVCfirms, and professional services firms.

Company Profiles:

Business Market Insights provides affordable subscription with pay as per requirement at https://www.businessmarketinsights.com/TIPRE00006806/checkout/basic/single/monthly

(30-day subscription plans proveto beverycost-effectivewith no compromise on the quality of reports)

Benefits with Business Market Insights

About Business Market Insights

Based in New York, Business Market Insights is a one-stop destination for in-depth market research reports from various industries including Technology, Media & Telecommunications, Semiconductor & Electronics, Aerospace & Defense, Automotive & Transportation, Biotechnology, Healthcare IT, Manufacturing & Construction, Medical Device, and Chemicals & Materials. The clients include corporate and academic professionals, consulting, research firms,PEVCfirms, and professional services firms.

For Subscription contact

Business Market Insights

Phone :+442081254005E-Mail :[emailprotected]

Read this article:
North America Hereditary Cancer Testing Market to 2027: Business Market Insights Starts Cheaper, Monthly/Yearly Subscription Plan for Market Research...

Recommendation and review posted by Bethany Smith

FORT LAUDERDALE, Fla., June 10, 2020 /PRNewswire/ --When it comes to choosing the right vitamin, 74 percent of Americans are concerned that the advertised or promised benefits of vitamins and supplements are not backed by trustworthy research. As Americans begin to focus more on overall health and wellness, Life Extension, the health solutions expert translating scientific research for over 40 years into premium, clinically studied vitamins and supplements, wants to help consumers take away the guesswork when selecting the right vitamins and supplements to maintain their whole health, self-care.

To highlight the importance of choosing the best options, a new survey conducted by Life Extension revealed there is a clear crisis in confidence with Americans when it comes to their vitamin and supplement options. While nearly all supplement users (92 percent) believe that ingredients are important when purchasing a vitamin, two-fifths (42 percent) do not research the ingredients when considering which product to choose.

"Better health and quality of life are the biggest motivators when taking vitamins and supplements, but unfortunately, many people don't know where to start and how to find a trusted resource," said Michael Smith, MD and Life Extension Education Director. "That's why at Life Extension we make it easy to find high quality, research-backed vitamins and supplements. We offer free Wellness Specialists to answer questions prior to taking a vitamin or supplement and laboratory panel testing to help personalize supplement choices."

Additional survey highlights include:

The survey found that while Americans want their vitamins to work, they are not putting in the work to find the right ones for them. Roughly three-quarters of supplement users do not research factors that determine or contribute to the overall effectiveness of the products they are spending their money on, such as third-party testing (75 percent), industry certifications (73 percent) or where the product is made (72 percent). Life Extension researches, test and retest every ingredient in all of their products, and pride themselves on their quality clinical research to substantiate ingredient benefits and the efficacy of their formulations. Constant scrutiny of published scientific findings is used to establish optimal dosages for maximum benefit.

Find out more about the Vitamin and Supplement Buyer Confidence and Knowledge Survey

Survey Methodology

These highlights present the findings of an online survey conducted among a nationally representative sample of 1,500 Americans 18 years of age and older, who live in the United States and take a vitamin or supplement at least 2-3 times a week. The total sample data is nationally representative based on age, gender, ethnicity, region, household income and educational attainment. The online survey was conducted by Lucid and completed between January 28th and February 4th, 2020. The margin of error for the total sample at the 95% confidence level is +/- 2.53 percentage points.

About Life Extension

Life Extension is the health solutions expert that is translating scientific research into everyday insights for people wanting to live their healthiest lives. For nearly 40 years, Life Extension has pursued innovative advances in health, conducting rigorous clinical trials and setting some of the most demanding standards in the industry to offer a full range of quality nutritional vitamins and supplements and blood-testing services. Life Extension's Wellness Specialists provide personalized counsel to help customers choose the right products for optimal health, nutrition and personal care. To learn more, visit LifeExtension.com.

SOURCE Life Extension

https://www.lifeextension.com

See original here:
New Survey Reveals 74 Percent of Americans are Concerned that Vitamins and Supplements are not Backed by Trustworthy Research - PRNewswire

Recommendation and review posted by Bethany Smith

(WZAW) -- The disruption to everyday life has impacted our mental and physical health. Focusing on ones health is more important than ever, and now is the right time to evaluate and improve your diet and learn more about what vitamins and supplements are needed and where to get them.

A new survey conducted by Life Extension reveals 39% of American supplement takers are motivated to take vitamins because they believe their diet is lacking and vitamins and/or supplements help them make up for it, but while nearly 92% of the users believe the ingredients are important when purchasing, 42% dont research the ingredients when considering which product to choose. Additionally, many respondents 74% are concerned the benefits of supplements are not backed by trustworthy research.

On Tuesday, registered dietitian Maya Feller joined NewsChannel 7 at 4 to share tips to help Americans live their healthiest lives, including supplement recommendations for specific deficiencies.

The best ways to get your nutrients from food is to really look to foods that are in whole or minimally processed form. So, things like fruits, vegetables, whole grains, with limited added sugars, salt and synthetic fat, Feller explained. Its going to give your body a plethora of access to vitamins and minerals.

If you arent eating those foods, Feller said its important to fill those nutrient gaps. Thats when you can introduce supplements.

When were thinking about supplementation, safe supplementation is key.

She said people can learn if a nutrient or supplement is right for them by is to get a lab test done.

They can go to lifeextension.com and request a lab panel right there. They can then take that result back to a Life Extension wellness expert, or they can take it to their primary care provider or dietician, Feller explained. That way the supplementation can really be individualized, so that people are taking the correct dosage at the right frequency in intervals over the right period of time.

See original here:
Maintaining health and nutrition while staying at home - WSAW

Recommendation and review posted by Bethany Smith

A B-2 Spirit stealth bomber, 2013. Photo credit: Tech. Sgt. Shane A. Cuomo for US Defense Department.

As the novel coronavirus pandemic continues to exact a terrible human and economic toll on the United States, Americans are adjusting how they view national security. There also appears to be agreement, even within the senior leadership of the Defense Department, that the military budget, which has seen significant growth during the Trump administration, is likely to be pared back in the coming years as federal deficits soar.

So it should be no surprise that the havoc wrought by the virus has also fanned the flames of an ongoing debate about the Trump administrations aggressive and costly plans to sustain and upgrade the US nuclear arsenal.

But some supporters of the status quo will not countenance any challenge to business as usual. In an April 17 conversation hosted by the Mitchell Institute for Aerospace Studies, Frank Miller, a distinguished former US government official, argued that it is illegitimate and irresponsible to cite the current public health and economic crisis as a rationale to rethink US nuclear weapons spending priorities. A close examination reveals, however, that his reasoning is deeply flawed.

The unsustainable nuclear budget. At the Arms Control Association, where I am the director for disarmament and threat reduction policy, we have long argued that the administrations approach is unnecessary, unsustainable, and unsafe. The financial and opportunity costs have steadily grown and the biggest nuclear weapons modernization bills are just beginning to arrive. Government officials in charge of the nuclear weapons enterprise warn about the pervasive and overwhelming risk facing the current nuclear modernization program.

The danger posed by the plans is on full display in the administrations fiscal year 2021 budget request.

The Defense and Energy Departments are requesting$44.5 billion for next year to sustain and modernize US nuclear delivery systems and warheads and their supporting infrastructure, a larger-than-anticipated increase of about $7.3 billion, or 19 percent, from the fiscal year 2020 level. Meanwhile, the administration is recommending a lower overall national defense budget than Congress provided last year.

The combination of a decreased topline budget but an increased nuclear budget means that other defense programs would have to be cut. Some programs on the chopping block include the Navys planned second Virginia class submarine, the Energy Departments efforts to clean up nuclear waste leftover from US nuclear weapons production during the Cold War, and the Pentagons Cooperative Threat Reduction program, which supports global efforts to detect and secure dangerous pathogens such as the coronavirus.

And this was all before the coronavirus began its deadly march across the country and before Congress spent several trillion dollars trying to save the US economy from complete collapse.

Although Pentagon officials insist that nuclear weapons should be shielded from possible future defense budget cuts, the pressure on the federal budget imposed by the response to the virus is likely to exacerbate the affordability and execution challenges confronting the administrations nuclear spending plans. If great power competition with China is the Pentagons top priority, is it prudent to sacrifice a Virginia class submarine every year for the next 10 to 15 years to attempt to keep an excessive and overburdened nuclear modernization effort on track? The answer should be no, especially in light of the quantitative and qualitative superiority of the US nuclear arsenal over Chinas.

In the view of many, the Trump administrations proposal to expand spending on nuclear weapons is a sad and dangerous illustration of wildly misplaced federal spending priorities. As it proposed a 19 percent increase for nuclear weapons next year, the White House initially planned to slash the budgets for the Centers for Disease Control by 19 percent and the National Institutes of Health by 7 percent. The Pentagons proposal to cut the budget for the Cooperative Threat Reduction program in order to fund weapons modernization amid a global pandemic is shockingly reckless.

How can we prepare and arm ourselves so completely for wars that may never come, wrote Tyler Rogoway, editor of The Drive, in March, but we are so ill-prepared for one that we knew was more likely around the corner than not?

Inexplicably, the unprecedented economic crisis facing the nation hasnt stopped some Trump administration officials from raising the prospect of even greater spending on nuclear weapons above and beyond what is already planned. Marshall Billingslea, President Trumps special envoy for arms control, said recently that if Russia and China dont agree to US demands for talks on new trilateral arms control to replace the 2010 New Strategic Arms Reduction Treaty (New START), Washington could win a new arms race if necessary. We know how to win these races, and we know how to spend the adversary into oblivion, he said.

More US spending on nuclear weapons wont force the current Russian and Chinese leadership to capitulate and would be fraught with peril. The administrations desire to pursue a more ambitious arms control agreement is the right goal, but it cant be achieved before New START is slated to expire next February. A new quantitative arms race that could follow the collapse of New START would further undermine stability between the United States and Russia, the health of the global nonproliferation regime, and the US militarys emphasis on competition with China.

Our new post-pandemic reality should make it all the more obvious that the current modernization plans need to be reconsidered in a way that eliminates the most excessive and destabilizing elements, saves taxpayer dollars for other pressing national and health security needs, and is in sync with a revitalized and realistic strategy to cap and reduce global nuclear stockpiles.

A debate on nuclear weapons policy. In an article published on the Arms Control Association website in March, Shannon Bugos and I criticized the 2021 budget request for nuclear weapons and made the case for a different approach. The critique apparently struck a nerve with supporters of the Trump plans.

In his remarks for the Mitchell Institute event, Miller alleged that our organization is part of a nefarious disarmament cabal and attempted a point-by-point rebuttal of the purported body of lies and dangerous recommendations contained in our article. He claimed that our critique comes from a group of people who have never felt the burden of public responsibility and public office in defense of this nation and our allies. (In reality, nearly half of the Arms Control Associations 17-member board of directors has served in government in some capacity, including several board members who have served at the Defense Department.)

Miller published an expanded version of his remarks earlier this month in Real Clear Defense.

But a review of what we actually wrote reveals that Miller either did not read our article or deliberately chose to distort its contents. Below I respond to each of his assertions.

The growing costs. Millers claim: The projected cost of the [nuclear] modernization program as a percentage of the defense budget is not growing.

Response: The projected cost of nuclear weapons, both in actual dollars and as a percentage of the national defense budget, is clearly growing, and doing so more quickly than anticipated.

The Pentagon request for 2021 of $28.9 billion to sustain and modernize the triad of nuclear delivery systems and supporting command and control infrastructure is a large increase above this years appropriated level of $24.8 billion. As we noted, the requested amounts are consistent with the projected spending levels for these programs contained in previous budget submissions.

The request for the semiautonomous National Nuclear Security Administration nuclear weapons program, however, is far larger than anticipated. The submission calls for $15.6 billion, an astonishing increase of $3.1 billion, or 25 percent, above the fiscal 2020 appropriation, and $2.8 billion more than the projection for 2021 contained in the fiscal year 2020 budget request. Over the next five years, the National Nuclear Security Administration is planning to request over $81 billion for weapons activities, a nearly 24 percent increase over what it planned to seek over the same period as of last year.

Miller, echoing arguments often made by Pentagon officials, claims that even at its projected peak in 2029, spending on nuclear weapons will consume no more than 6 to 7 percent of total Pentagon spending. But this is misleading, unless you think a credible deterrent can be maintained without having actual warheads.

The 6 to 7 percent figure doesnt include spending at the National Nuclear Security Administration. When that is included, nuclear weapons already account for 6 percent of the total 2021 national defense budget request and will rise to 7 percent by 2024. Given the rate at which that agencys budget is exploding, probable future cost overruns in the delivery system modernization programs, and the likelihood of flat overall defense budgets (at best) for the foreseeable future, it is conceivable that spending on nuclear weapons could approach 10 percent of national defense spending by the late 2020s.

Miller can claim that the growing modernization bill is worth the price. But he cant claim that the price tag isnt growing.

A bigger stockpile. Millers claim: You can search the 2018 [Nuclear Posture Review] from cover to cover without finding any policy which supports expanding the US nuclear warhead stockpile.

Response: It is true that the Trump administration is not currently planning to grow the size of the arsenal. But we never claimed otherwise. Instead, the 2018 Nuclear Posture Review contains several proposed initiatives that support preparing the United States to grow the size of the stockpile in the event of a future decision to do so. Examples include: providing the enduring capability and capacity to produce plutonium pits at a rate of no fewer than 80 pits per year by 2030; exploring approaches for rapid [warhead] prototyping; assessing the potential for retired warheads and components to augment the future hedge stockpile; and reducing the time required to design, develop, and initially produce a warhead, from a decision to enter full-scale development.

According to Madelyn Creedon, former deputy administrator at the National Nuclear Security Administration during the Obama administration, the Nuclear Posture Review lays out a long-term plan to prepare the United States to develop, test, and deploy new nuclear weapons and to increase the size of the nuclear stockpile. In short, prepare for a new arms race.

The National Nuclear Security Administrations needs. Millers claim: There should be no cause for uncertainty about the crying need for increased funding for [the National Nuclear Security Administration].

Response: For 2021, the National Nuclear Security Administration has requested a large unplanned increase, totaling $15.6 billion for weapons activities. To many, such an increase was surprising: The agencysaidonly last year that its 2020 budget plan was fully consistent with the 2018 Nuclear Posture Review and affordable and executable. Under that proposal, the agency did not plan to request more than $15 billion for weapons activities until 2030!

So, what changed? Lisa Gordon Hagerty, head of the National Nuclear Security Administration, was asked to explain the rationale for such a large unplanned increase at a Congressional hearing in March, but her attempt at an answer hardly cleared up the situation. Perhaps there is a clearer explanation for why the agency so badly misjudged its funding needs for 2021, but if so the agency has yet to provide it.

Plutonium pit production. Millers claim: The comment that building 80 pits per year is unprecedented just doesnt even work within their own circles.

Response: At no point did we claim that the National Nuclear Security Administrations effort to build at least 80 pits per year is unprecedented. What we actually wrote, citing an Institute for Defense Analyses report published last year, is that there is no historical precedent for the agencys plan to go from the current production level of zero pits per year to 80 pits per year by 2030. The Institute for Defense Analyses report could not be clearer: No available option can be expected to provide 80 pits per year by 2030.

The right size for the arsenal. Millers claim: Its also absurd in the extreme to argue that the size of the current arsenal is more than is required for deterrence.

Response: Its not at all absurd to argue that the size of the current US nuclear arsenal is more than is required for deterrence of adversaries and assurance of allies.

In 2013, the Obama administration determined that deterrence requirements could be met with one-third fewer deployed New START-accountable strategic nuclear forces. Yet Obama did not immediately reduce the size of Americas nuclear force, despiteconcludingthat deterrence could be achieved by even a unilateral reduction.

Miller is of course free to argue that further reductions in the arsenal should only occur bilaterally with Russia (or trilaterally with Russia and China) or that the current security environment is such that further reductions arent advisable. But in that case the burden of proof is on him to explain the logic that presumes Moscow and Beijing would not be deterred by 1,000 nuclear warheads deployed on hundreds of delivery systems but are deterred by the 1,550 warheads deployed today.

The burden is also on him to explain why the current modernization plans should be funded next year at the expense of the Navys conventional shipbuilding account, defense environmental cleanup, and the Cooperative Threat Reduction programand likely at the expense of similar such cuts in future years. A Virginia class submarine would seem to be far more relevant to great power competition with China than a one-year increase in funds for an agency that said last year it didnt need those funds and is unlikely to be able to spend them.

Nuclear war fighting. Millers claim: There is that old canard, the ever-popular bloody flag that US policy is based on nuclear war fighting, not on deterrence.

Response: In our article and elsewhere we advocate for a nuclear strategy that deemphasizes nuclear war fighting by opposing the Trump administrations proposal to double the number of low-yield nuclear options in the US nuclear arsenal. Miller and other supporters of expanding the number of such options claim that doing so would strengthen deterrence and raise the nuclear threshold.

But the purported deterrent value of additional low-yield options is premised on the concern that adversaries might think the United States would be self-deterred from a more difficult to use higher-yield response. Indeed, Pentagon officials repeatedly argue that policy makers cannot simply assume that a possible nuclear conflict will inevitably escalate to massive nuclear use. They assert that the United States must plan and prepare to be able to prevail in a limited nuclear conflict.

While we do not advocate for the elimination of low-yield weapons from the US nuclear arsenal, we reject the notion that heightening their role is necessary or stabilizing. Placing greater emphasis on low-yield options risks spawning more planning for their use and belief, including by our adversaries, that such use can be controlled, thereby risking a lowering of the threshold for nuclear use.

The future nuclear submarine fleet. Millers claim: The idea that the size of the Columbia class should be cut, betrays either complete dishonesty, and theres a lot of that in their pitch, or total ignorance of industrial reality. Cutting boats 11 and 12 and possibly 13 and 14 wont solve the fiscal problem the [Arms Control Association] has raised with regard to coronavirus.

Response: At no point have we ever claimed that eliminating two to four submarines from the planned Columbia class purchase would solve the fiscal challenges facing the Pentagon. In fact, we clearly stated in our article that pressure on the defense budget cannot be relieved solely by reducing nuclear weapons spending.

What we argue is that changes to the nuclear replacement effort, including the Columbia class program, could make the effort easier to execute and ease some of the hard choices facing the overall defense enterprise, choices that are likely to get even harder amid constrained defense budgets. According to the Congressional Budget Office, eliminating two to four boats at the back end of the planned 12-boat Columbia class purchase would save during the 2030s between $17 and $36 billion in fiscal year 2017 dollars. Buying two additional boats as suggested by Miller would cost an additional $16 billion.

Land-based forces. Millers claim: The idea of extending the Minuteman [III] force has been studied and studied and studied. You just cant do this safely.

Response: We disagree that it is not possible to further extend the life of the Minuteman III, as explained in detail in an article in War on the Rocks. A 2014 Air Force study and a 2014 RAND Corporation study both concluded that extending the life of the Minuteman III would be possible. The latter suggested that delaying the development of a new missile by 20 years could save nearly $40 billion dollars through the mid-2030s.

Air-launched cruise missiles. Millers claim: The absurd notion that nuclear tipped cruise missiles are uniquely destabilizing is a notion unique to American disarmers. Abandoning the [Long Range Stand Off weapon] will also condemn the B-21 to fly directly into advanced enemy defenses in the decades to come.

Response: We also disagree with Miller about the case for building a new fleet of nuclear air-launched cruise missiles via the Long Range Stand Off program.

Concerns about the escalation risks associated with weapons systems that have both conventional and nuclear variants is hardly a concern unique to American disarmers. As Gen. Curtis M. Scaparrotti, former commander of US European Command, warned in 2017: One of the things that you see that is disturbing is the fact that [the Russians] are using similar weapon systems that can either be conventional or nuclear, which then makes it difficult for us to clearly understand what they have employed.

Miller worries that attempting to drop a nuclear gravity bomb (the B61-12) over a heavily defended target is too risky and might not succeed. But if the Air Force believes the stealth capabilities of the B-21 (which is still under development) could be compromised soon after it is deployed, then it is reasonable to question the services strategy for buying the bomber and retaining nuclear gravity bombs in the first place. For its part, US Strategic Command does not appear concerned about the long-term survivability of the B-21. As Gen. Hyten told Congress in July 2017, Its not the survivability of the bombers, its the ability of the bombers to access targets. By this Hyten meant that while bombers armed with nuclear gravity bombs can only attack one target at a time, the Long Range Stand Off weapon provides each bomber the ability to attack multiple targets at one time.

It is not surprising that military planners would want many different ways of attacking a target. But the weapons associated with the other two legs of the nuclear triadthe sea- and land-based forcescan also penetrate air defenses and strike targets anywhere on the planet with high confidence.

New warheads. Millers claim: Calling for a halt to upgraded US ballistic missile warheads and abandoning the ability to build new nuclear pits reveals a gross ignorance.

Response: We did not call for the United States to abandon this ability. On the contrary, we suggested that the National Nuclear Security Administration aim for a less ambitious pit production capacity of 30 to 50 pits per year by 2035. So long as the United States remains a nuclear-armed state, it needs and should have the ability to produce plutonium cores for nuclear warhead refurbishment. But the current goal of producing 80 pits per year by 2030 is almost certainly unachievable. And it is unnecessary. As American Universitys Sharon Weiner has noted, assessing the underlying assumptions makes clear there are credible alternatives to the scale and planned start date for pit production.

The need for increased pit production could be reduced by pursuing less technically ambitious warhead life extension programs. For example, a near-term driver of establishing a production capacity of 80 pits annually is to support the replacement of the W78 warhead with the new W87-1. But there are alternatives that would not require a new pit for the W87-1, or at least not as many new pits as currently planned. These alternatives include a smaller intercontinental ballistic missile force, a less ambitious upgrade for the W78, or storing or retiring the W78 and relying on just one warhead for the land-based missile force.

In addition, there is no need to accelerate the development of a newly-designed submarine-launched ballistic missile warhead, known as the W93, as proposed in the fiscal 2021 budget request. The existing W76-1 submarine-launched ballistic missile warhead just completed a major life extension program that prolonged its service life until at least 2040. The existing W88 submarine-launched ballistic missile warhead, which is the youngest warhead in the stockpile, is undergoing a significant upgrade and is not expected to require further refurbishment until at least the late 2030s. It is also highly unlikely that the National Nuclear Security Administration will be able to support three major submarine-launched ballistic missile warhead modernization programs in the 2030s.

Modernization as leverage. Millers claim: Finally, it must be noted that the disarmament communitys call to reduce the US nuclear modernization program paradoxically jeopardizes the achievement of one of the communitys highest priority goals:achieving a new arms control treaty with Russia and potentially also with China.

Response: The notion that changes to the modernization program would undermine Americas ability to bring Russia and China to the negotiating table is unconvincing. First, even if the modernization program were an effective bargaining chip, the chip cant be cashed in anytime soon. The program wont produce any new delivery systems until the late 2020s at the earliest. Second, there is little evidence to suggest that the Obama administrations support for an extensive modernization program provided the administration with leverage during its second term to convince Moscow to join talks on nuclear reductions below New START. Third, Moscow has identified constraints on US non-nuclear weapons, such as missile defense and advanced conventional strike capabilities, as priority conditions for further Russian nuclear cuts. Fourth, the United States has long had a superior nuclear arsenal to China, but China has refused to participate in arms control.

In a democracy, national defense and nuclear policy plans, options, and trade-offs warrant scrutiny. We welcome serious debate; not distortions about our analysis and recommendations.

See original here:
Debating US nuclear spending in the age of the coronavirus - Bulletin of the Atomic Scientists

Recommendation and review posted by Bethany Smith

There is also the possibility that future nuclear-powered Coast Guard icebreakers could find themselves in aggressive confrontations with Russian or other countries' ships, especially in the Arctic region. This is what is certainly driving the demand to explore potential defensive armament for America's next icebreakers.

Trump's memorandum doesn't mention any specific armament options for the Coast Guard to consider, but its own requirements for its latest heavy icebreaker have included keeping space available for the possible inclusion of weapons of some kind in the future. In 2017, Admiral Paul Zukunft, then-Commandant of the Coast Guard, also told members of Congress that his service was looking at adding both defensive and offensive armament, including anti-ship cruise missiles, onto future icebreakers.

While talk of Coast Guard cutters of any kind, icebreaking or not, armed with anti-ship missiles might seem unusual, the service did upgrade at least three Hamilton class cutters in the 1980s to be able to fire RGM-84 Harpoons. By the mid-1990s, following the collapse of the Soviet Union, these ships had lost this capability, which you can read more about in this past War Zone piece. The entire class, of which two remain in U.S. service, also received additional defenses in the form of 20mm Mk 15 Phalanx Close-in Weapon Systems (CIWS) and Mk 38 25mm automatic cannon mounts.

Much of the rest of Trump's memorandum covers things the Coast Guard already appears to be doing or has done. The required assessments will examine fleet mixes to include at least three heavy icebreakers. The service has long said that it wants to acquire three medium icebreakers after it gets its trio of heavy types. The difference between the two categories is the thickness of ice they can plow through, with heavy designs being able to get through ice up to 10 feet thick, while the fulls of medium types can manage up to eight feet of ice.

"Use cases in the Arctic that span the full range of national and economic security missions (including the facilitation of resource exploration and exploitation and undersea cable laying and maintenance) that may be executed by a class of medium PSCs [Polar Security Cutters], as well as analysis of how these use cases differ with respect to the anticipated use of heavy PSCs for these same activities," the memo notes. "These use cases shall identify the optimal number and type of polar security icebreakers for ensuring a persistent presence in both the Arctic and, as appropriate, the Antarctic regions."

The Coast Guard, at present, only has one operational heavy icebreaker, the USCGC Polar Star, which is aging and prone to major breakdowns, and one newer medium one, the USCGC Healy, that is still decades-old now.

"Based on the determined fleet size and composition, an identification and assessment of at least two optimal United States basing locations and at least two international basing locations," the memo adds. "The basing location assessment shall include the costs, benefits, risks, and challenges related to infrastructure, crewing, and logistics and maintenance support for PSCs at these locations. In addition, this assessment shall account for potential burden-sharing opportunities for basing with the Department of Defense and allies and partners, as appropriate."

The Coast Guard's plan, as it stands now, is to hopefully have taken delivery of all three conventionally-powered heavy icebreakers by 2026. Polar Star could also undergo a service life extension upgrade to keep it in service through at least 2025. There is no firm schedule yet for acquiring the additional medium icebreakers. Trump's memo says there needs to be "a ready, capable, and available fleet of polar security icebreakers that is operationally tested and fully deployable by Fiscal Year 2029," by which time Polar Star and Healy are both expected to be retired.

Trump's memorandum requires the Department of Homeland Security and the Coast Guard to submit their respective reports to the President, by way of the Director of OMB and the Assistant to the President for National Security Affairs, within the next 60 days. So, it may not be long before we learn whether America's icebreaker plans have changed to include the purchase of its first-ever nuclear-powered types.

Contact the author: joe@thedrive.com

Read more:
Trump Orders Coast Guard To Look Into Building Nuclear-Powered Icebreakers Like Russia - The Drive

Recommendation and review posted by Bethany Smith

Nichols Martin June 9, 2020News, Technology

USAF/NNSA

TheNational Nuclear Security Administration (NNSA), under the Department of Energy (DoE), partnered with the U.S. Air Force (USAF) to test the weapon systems of aB61-12modified for extended service life. Two flight tests for theB61-12 Life Extension Program took place in March 2020 at theNevada-basedTonopah Test Range, the Department of Energy said Monday.

USAF and the NNSA demonstrated the aircraft's compatibility with theF-15E during the final weapon system demonstration. The modified B61-12 features a new Boeing-made tail kit assembly. The Air Force plans to replace aging B61 bombers with the new extended-life variant for part of the U.S. nuclear force.

The success of these tests is a major milestone on the path to full rate production and the B61-12s initial operation capability on the F-15E in the coming years, said Brig. Gen. Ty Neuman, principal assistant deputy administrator for military application at the NNSA.

Check Also

The Department of Homeland Security's science and technology (DHS S&T) directorate has awarded 26 contracts to 23 small businesses through the first phase of the Small Business Innovation Research Program to explore proofs-of-concept that may respond to homeland security technology concerns.

Read the original here:
DOE-USAF Partnership Tests Compatibility, Weapon Systems of Extended B61 Bomber - ExecutiveGov

Recommendation and review posted by Bethany Smith