SPRINGFIELD, Mo. -- A Springfield laboratory finds itself on the frontlines of testing for COVID-19.

At first, patients found access to testing tough. Now that is access is easier with much faster results, since doctors can send tests to hospital labs and Dynamic DNA, a private Springfield lab.

Scientists at Dynamic DNA have tested patient specimens for nearly three weeks. The business normally does genetic testing, but had all the right equipment to do COVID-19 tests. When employees heard about delays and trouble with access, they wanted to help. So far, they have tested hundreds of patients.

While handling the specimens, lab workers use a biosafety cabinet and wear personal protective equipment. Couriers drop off new test specimens each day.

They analyze test samples for multiple health systems, including Mercy, Jordan Valley Health Clinic, Citizens Memorial Hospital and Ozark Valley Medical. The lab process itself takes about 4 to 5 hours.

"It's been really rewarding to know that we're able to decrease those turnaround times," said Rhy Norton, Dynamic DNA Laboratories lab manager. "So we're getting tests out in 24 hours. Honestly, if you get a test in the morning, it can be as short as eight hours. It feels good to be able to help things along."

Norton says it is still a little difficult to get all the testing supplies, but they have enough right now to do thousands more. The lab charges hospitals $100 for each test and is expecting to receive some funding soon from the Missouri Foundation for Health.

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Springfield's Dynamic DNA on the frontlines of testing for COVID-19 in Springfield - KY3

Recommendation and review posted by Bethany Smith

Dr. Concepcion is chief clinical urologist officer, Integra Connect, West Palm Beach, FL, and clinical associate professor of urology, Vanderbilt University School of Medicine, Nashville, TN.

Prostate cancer is a clinically heterogenous disease with variability in progression once diagnosed, ranging from the very indolent cases that may require no therapy to patients who present with de novo metastasis. In 2019, there were approximately 174,650 newly diagnosed prostate cancer cases in the United States and a cancer-specific mortality of 31,620 directly attributable to the disease or 5.2% of all cancer deaths.1

A number of newer therapies (all mechanistically different) and treatment regimens have been approved for the management of both patients with metastatic castration-sensitive prostate cancer (mCSPC) and metastatic castration-resistant prostate cancer (mCRPC). A unique dynamic progressive model estimates the incidence of these two subsets may approach 42,970 patients in 2020.2

Unfortunately, despite the availability of superior agents, optimal sequences or a combination of these oncolytics have yet to determined, as there are no predictive biomarkers to inform the provider what is the most ideal initial line of therapy (LOT) and as patients progress, what will be the most appropriate next LOT. What makes this situation even more challenging is that these newer therapies, as well as those that we anticipate will be approved in 2020 and beyond, are targeted for molecular drivers of prostate cancer. For the patient with mCSPC or mCRPC, how can we best determine the initial and subsequent LOTs, given the limitations of the monotherapy registration trials?

A number of key genomic mutations have been consistently identified in patients with prostate cancer (hormone naive and mCRPC). These mutations include gene fusion/chromosomal rearrangements (TMPRSS2-ERG), androgen receptor (AR) amplification, inactivation of tumor suppressor genes (PTEN/PI3-K/AKT/mTOR, TP53, Rb1), and oncogene activation (c-myc, RAS-RAF).3 More significantly, defects in DNA repair appear to be central in increasing ones susceptibility to malignant transformation.

Germline vs. somatic mutations

It is critical to patient management that we determine whether these mutations are inherited (germline) or acquired (somatic). Germline mutations are changes in DNA that are present in the patients reproductive cells (sperm or ovum) and are thus passed from generation to generation and will be identified in every cell of the body. Therefore, germline testing can be conducted with just a swab from the mouth, saliva, or blood from the patient. There are many companies in the United States that currently offer germline testing.

It is paramount that in order to obtain the most comprehensive analysis and report, genetic testing through next-generation sequencing in a diagnostic laboratory is mandatory. This type of testing should be compared with many of the direct-to-consumer tests that are currently marketed to patients. The testing platforms deployed by many of these companies are much less robust and often include a very limited number of known genetic mutations in their panels.

For example, thousands of identified BRCA mutations have been identified, but only a handful may be tested in some of these direct-to-consumer testing kits. This situation can lead to an unacceptable number of studies with false-negative results and should not be used for clinical decision-making.

Acquired or somatic mutations can be defined as any alteration in DNA that occurs after conception. These can occur in any cell of the body (except the reproductive cells) and usually arise as a result of exogenous or environmental exposures, such as tobacco smoking or UV radiation. Therefore, somatic testing requires next-generation sequencing of cells extracted from the tumor itself and cannot be performed by using a sample of saliva or blood.

Pritchard and colleagues were among the first to demonstrate the value of assessing inherited genetic changes in prostate cancer. Among 692 patients with metastatic prostate cancer, they examined the prevalence of mutations in 20 DNA repair genes.4 Mutations were identified in 82 men (11.8%) with significant geographic heterogeneity, even among these recognized cancer centers (prevalence of 8.8% in patients treated at the University of Washington and 18.5% in those treated at Memorial Sloan Kettering), potentially reflecting referral biases. Subsequently, Castro et al found a prevalence of germline DNA damage repair gene mutations of 16.2% in patients with mCRPC.5

Unlike other disease states in which commonly identified germline mutations may be actionable, actionable germline mutations are relatively uncommon in patients with prostate cancer. Nicolosi and colleagues found that actionable mutations were identified in 1.74% of their study cohort with a diverse patient population.6 In previous analyses, Robinson et al reported clinically actionable pathogenic germline mutations in 8% of 150 patients with mCRPC, in contrast to clinically actionable aberrations in the AR in 63% and aberrations in other cancer-related genes in 65% of patients.7 It is likely not surprising that actionable underlying germline mutations would be more common in a cohort with more advanced prostate cancer.

In patients with regional or metastatic prostate cancer, somatic tumor testing may also be considered on the basis of the observation that nearly 90% of men have potentially actionable mutations at the tumor level, whereas only a relatively small proportion of men would have actionable germline mutations (approximately 9% of patients with mCRPC, according to the National Comprehensive Cancer Network). In these patients, testing may be undertaken for somatic homologous recombination repair (HRR) gene mutations (eg, BRCA1, BRCA2, ATM, PALB2, FANCA, RAD51D, and CHEK2) and for microsatellite instability (MSI) or mismatch repair (MMR).7

In patients with advanced prostate cancer, identification of underlying germline mutations may guide treatment selection to determine the most appropriate next LOT, especially in those who have progressed through multiple lines of prior therapy, including AR signaling agents. Patients with identified MSI-high status, defects in DNA MMR genes, or CDK12 biallelic loss may respond to checkpoint inhibition therapy.8

Pembrolizumab (KEYTRUDA), an FDA-approved PD-1 inhibitor, is the first immunotherapy to win approval in a tumor-agnostic manner and not based on organ type. Further, patients with mutations in HRR genes (including BRCA1/2, CHEK2, and genes that cause Fanconi anemia) may be better suited for treatment with PARP inhibitors, many of which are in ongoing phase III trials with expected approval in 2020.

Finally, patients with DNA repair defects may have increased sensitivity to platinum-based chemotherapeutics.9 Given the uncertainty regarding optimal treatment selection and pending approval of current agents in trial, the National Comprehensive Cancer Network prostate cancer guideline panel recommends clinical trial enrollment for all men with prostate cancer and identified DNA repair gene mutations. In addition, somatic testing for specific gene variants may be undertaken.

For the most part, this approach is used in patients with advanced disease with the goal of identifying specific actionable targets. For example, mutations in HRR or MMR genes and identification of MSI-high versus MSI-low status may suggest certain treatments are more likely to be beneficial.

In addition to genetic testing of tumor tissue, assessing circulating tumor cells may offer important information. For example, testing of AR variant status can be performed using circulating tumor cells and may be predictive of disease.

Generally, genetic testing yields results that are unambiguous and will show that a gene mutation is present or absent. However, the reporting of the significance and association of that mutation relative to a disease state can be quite variable. Given that the coding sequence for a particular gene has been defined and the sequencing machines are fairly similar, what is considered positive or deleterious versus negative or favorable/no mutation relative to risk of disease is predicated on the number of patients tested.

As noted, a number of genes have been identified as associated with an increased susceptibility risk for prostate cancer. Multigene panels are becoming used more often, but the makeup of these panels is not uniform. A recent analysis looking at various commercially available multigene panels shows that the average number of genes tested is 12 (range, 4-16). BRCA1/BRCA2 are included in all the panels, but 20% did not include HOXB13 or MMR genes.10

The clinical experience and number of patients tested with BRCA1/2 is more extensive compared with other genes. More and more mutations continue to be discovered, but the significance to the patient has yet to be determined until even further samples are processed. These discoveries, classified as variants of unknown significance (VUS), represent a gray area in which there is a change in the genetic sequence; however, it is still unknown whether this change is associated with a deleterious or favorable prognosis. Among women with breast cancer, detection of a VUS is more common than identification of known pathogenic variants.11 Although ongoing work seeks to better delineate the importance of these VUS, the involvement of a genetic counselor is key to helping patients navigate this uncertain situation.

Conclusion

Urologists will need to incorporate comprehensive genomic testing, just as we embraced PSA testing back in the 1990s. A recent survey conducted among 52 single-specialty independent urology community practices identified the following three issues related to incorporation and development of a comprehensive testing program12:

medical/legal liability for unaddressed identified mutations

reimbursement concerns and cost of testing

complexity and time involved to enter a complete family history and pedigree into the electronic health record.

None of these considerations, however, is insurmountable if the practice has a commitment to enhance and deliver precision medicine for our patients with prostate cancer.

References

1. Siegel RL, Miller KD Jemal A. Cancer statistics, 2019. Cancer J Clin. 2019; 69:7-34.

2. Scher HI, Solo K, Valant J, Todd MB, Mehra M. Prevalence of prostate cancer clinical states and mortality in the United States: estimates using a dynamic progression model. PLoS ONE. 2015; 10:e0139440.

3. Rubin MA, Maher CA, Chinnaiyan AM. Common gene rearrangements in prostate cancer. J Clin Oncol. 2011; 29:3659-68.

4. Pritchard CC, Mateo J, Walsh MF, et al. Inherited DNA-repair gene mutations in men with metastatic prostate cancer. N Engl J Med. 2016; 375:443-53.

5. Castro E, Romero-Laorden N, Del Pozo A, et al. PROREPAIR-B: a prospective cohort study of the impact of germline DNA repair mutations on the outcomes of patients with metastatic castration-resistant prostate cancer. J Clin Oncol. 2019; 37:490-503.

6. Nicolosi P, Ledet E, Yang S, et al. Prevalence of germline variants in prostate cancer and implications for current genetic testing guidelines. JAMA Oncol. 2019; 5:523-8.

7. Robinson D, Van Allen EM, Wu YM, et al. Integrative clinical genomics of advanced prostate cancer. Cell. 2015; 161:1215-28.

8. Wu YM, Cielik M, Lonigro RJ, et al. Inactivation of CDK12 delineates a distinct immunogenic class of advanced prostate cancer. Cell. 2018; 173:1770-82.

9. Humeniuk MS, Gupta RT, Healy P, et al. Platinum sensitivity in metastatic prostate cancer: does histology matter? Prostate Cancer Prostatic Dis. 2018; 21:92-9.

10. Aldubayan SH. Considerations of multigene test findings among men with prostate cancerknowns and unknowns. Can J Urol. 2019; 26:14-6.

11. van Marcke C, Collard A, Vikkula M, et al. Prevalence of pathogenic variants and variants of unknown significance in patients at high risk of breast cancer: a systematic review and meta-analysis of gene-panel data. Crit Rev Oncol Hematol. 2018; 132:138-44.

12. Concepcion RS. Germline testing for prostate cancer: community urology perspective. Can J Urol. 2019;26:50-1.

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Role and rationale for molecular testing in advanced prostate cancer - Urology Times

Recommendation and review posted by Bethany Smith

Answers to questions regarding the availability of testing, new types of tests and how testing could help end the states shutdown.

Editors Note: This content is being provided for free as a public service to our readers during the coronavirus outbreak. Please support local journalism by subscribing to the Burlington County Times at burlingtoncountytimes.com/subscribenow.

As New Jersey and much of the country begin to emerge from the most intense surges of the coronavirus outbreak, attention is turning toward testing.

Public health officials say improvements and access to testing are crucial to ending shutdowns like New Jerseys, which has closed schools and most businesses, prohibited gatherings, and, generally, kept most people housebound for the last month.

But many questions about how testing works, and who is allowed to get tested, remain.

What improvements have been made to testing?

On Thursday, state officials announced a new saliva-based test developed by Rutgers University that is expected to allow for broader testing than currently possible with nose and throat swab tests.

Other benefits of the new test include not putting health care professionals at risk for infection by performing and allowing personal protective equipment to be reserved for use in patient care instead of testing.

Most importantly, perhaps, the new testing is faster, allowing for a significant increase in the number of people tested daily.

The testing could be particularly important for quarantined people especially health care workers who are unsure when it is safe to leave quarantine.

Rutgers also recently announced a genetic testing service that allows for an increase of thousands of tests daily. Combined with the new saliva test, New Jerseys testing capacity could increase to tens of thousands of samples daily, according to the university.

In addition, earlier this month New Jersey received 15 Abbott ID NOW Instruments, which can test and diagnose coronavirus in as little as five minutes.

How will New Jersey use testing to help end the shutdown?

Next week the state is to release an outline regarding how the state will conduct widespread testing and contact tracing.

Both are prerequisites to the state relaxing social distancing and reopening businesses, according to the state department of health.

To date, the state has tested about 2% of the population, and the vast majority of those tested have been for symptomatic patients.

Already though, the state is slowly expanding the scope of testing, according to Gov. Phil Murphy.

One such expansion is a plan, announced Thursday by Murphy, that would test all residents and staff at New Jerseys five developmental centers, including the New Lisbon Developmental Center in Woodland.

The state already has begun a widespread testing program of nursing homes and assisted living facilities in South Jersey.

The department of health, in coordination with Cooper University, on Wednesday tested 3,000 long term-care facilities patients and staff, according to health commissioner Judy Persichilli.

State epidemiologist Dr. Christina Tan repeatedly has emphasized testing is just the first part of the states strategy.

The testing strategy also involves the need to then take the next step. Once you get the results you have to be able to act upon those results, because otherwise whats the point to doing the testing, right, if youre not going to be able to take the next steps to isolate, to be able to do contact tracing, to be able to for example in the long-term care facilities to appropriately cohort and to do all the appropriate infection control measures that need to happen, Tan said at a news conference Wednesday.

To effectively perform contact tracing, the state needs about 81 dedicated health professional per 100,000 people, according to Persichilli. In New Jersey that would total 7,290 health professionals.

The state is developing a testing task force that will further refine testing strategy, according to Persichilli.

According to guidelines from the Centers for Disease Control and Prevention, after an individual tests positive, health officials then dive into evaluating persons considered to have been in close contact with the COVID-19 positive patient.

Individuals considered to have close contact could include members of a patients household; community members who spent at least 10 minutes within 6 feet of the patient; community members who were exposed to the patient in a health care setting; and health care personnel, according to the CDC.

People identified as having been in close contact then enter a 14-day monitoring period, which includes daily check-ins with local health department officials. Anyone who develops new or worsening symptoms is then deemed a person under investigation for COVID-19 and tested for the disease, according to the CDC.

Should any one these individuals test positive, health officials will once again start the contact tracing process.

Though Murphy has said at least a small rise in coronavirus cases is inevitable once the shutdown is lifted, contact tracing will significantly help to contain the spread, according to health officials.

Where can I get tested in Burlington County, and why are some sites limited to certain municipal residents?

There are three types of testing sites in New Jersey: Community-based testing sites which are open to all New Jerseyans experiencing symptoms of respiratory illness; county testing sites, which largely are restricted to residents or first responders of a specific county; and private testing sites, which usually require a referral from a health care provider.

Burlington County has a county site and a private sight.

The county testing site at the Burlington County Emergency Services Training Center, 695 Woodlane Road in Westampton, opened late last month and has since conducted about 1,500 tests.

The drive-through site is open only to symptomatic Burlington residents who have made an appointment. Hours are limited to Tuesdays and Thursdays 10 a.m.-1 p.m.

As of Thursday morning the county had conducted 1,432 tests, over eight total testing days, since it opened the site March 26. It tests about 180 people per testing day. Appointments are still available.

The countys private site, on the other hand, has only been open a few days.

Virtua on Monday began testing at Virtua Willingboro hospital, formerly Lourdes Medical Center of Burlington County, off Sunset Road. More than 50 people were tested within the first hour and Virtua officials expect to test about 100 people each day.

The free testing site is restricted to Willingboro residents, and patients who have a referral from a Virtua Health doctor. Those patients do not have to be from Willingboro, but do need a doctors order to be tested.

Virtua focused testing on Willingboro because the township has been the hardest hit community in Burlington County. As of Wednesday night, Willingboro had 336 cases and 10 deaths as of Friday, according to county data.

The next highest caseload is in adjoining Burlington Township, which reports 219 cases and 14 deaths as of Friday, county data shows.

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What you need to know about coronavirus testing in New Jersey - Burlington County Times

Recommendation and review posted by Bethany Smith

Demand for mental health tools and services skyrockets; SAMSHA crisis hotline reported 9 times the number of requests for mental health crisis support in March

Genominds mental health tools were shown to reduce emergency room visits by 40% and inpatient hospitalizations by 58% i

Recent health plan contracts provide in-network coverage and significant discounting of Genomind Professional PGx Express for almost 40 million subscribers

Genomind, the leading mental health company bringing precision medicine into mainstream mental health treatment, today announced that during a time of unprecedented mental health demand, it is working with providers, health plans, and employer groups to increase access to its mental health tools and services. Its flagship pharmacogenetics (PGx) product, Genomind Professional PGx Express, provides genetic guidance to reduce the process of mental health medication trial and error. A recent independent study showed that Genominds mental health tools and services can reduce the burden on the healthcare system by decreasing emergency room and in-patient hospitalizations by 40% and 58%, respectively.

Genomind confirmed five recent additional network coverage contracts for Genomind Professional PGx Express the most advanced and comprehensive mental health pharmacogenetic testing service available. With these new contracts, Genomind Professional PGx Express is now covered in-network at significantly discounted contracted rates with 26 health plans and organizations serving almost forty million members across the United States.

"At this critical point in our shared history, it is more important than ever to make sure that those with mental health conditions have access to the tools and services they need, and to stay out of the hospital whenever possible," said Shawn Patrick OBrien, Chief Executive Officer at Genomind. "We are going to be part of the solution. We applaud the commitment of these health plans to help their subscribers access mental health resources that reduce the burden on hospitals and providers, and look forward to continued work with other health plans to support broader access to mental health PGx testing."

Skyrocketing Demand for Mental Health Tools and Services

Even prior to the COVID-19 pandemic, mental health issues have been increasing. In April, the U.S. Centers for Disease Control and Prevention (CDC) reported a 35% increase in suicide rates between 1999 and 2018. Since the recent events related to the novel coronavirus have disrupted everyday life, leading advocacy and professional groups are reporting a sharp rise in mental health concerns.

"Even as our hospitals and health systems are being stretched to the limit, it is clear that mental health cannot wait. It is incumbent upon us as mental health professionals to do everything we can to provide tools and services that both help our patients and reduce the burden on our health systems," said Gisoo Zarrabi, M.D. Medical Director of Harbor Psychiatry & Mental Health. "Genominds PGx test and services are an important tool in my arsenal and I am pleased to see the company making these efforts to increase access to mental health technologies that can support my practice and benefit my patients."

Genomind has taken several steps to help mental healthcare providers work remotely and deliver quality care during the COVID-19 crisis. Genomind is providing:

About Genomind Professional PGx Express

Genomind Professional PGx Express, available by prescription, is the most advanced mental health genetic testing service available, analyzing variants on up to 24 genes selected for inclusion based on guidelines from expert consortia peer-reviewed studies due to their significance in mental health. Test results include information on patients genetic variants that are relevant for the treatment of conditions such as depression, anxiety, autism, schizophrenia, chronic pain, bipolar disorder, obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), and substance abuse.

Genomind Professional PGx Express bundles the test results with a suite of services, including:

About Genomind

Genomind is the leading mental health care company delivering the genetic testing tools that empower clinicians to make more informed treatment decisions and create better outcomes for patients with mental illnesses. As the scientific leader in genetic testing, Genominds flagship offering is Genomind Professional PGx Express the most advanced and comprehensive mental health genetic service available. Supported by a world-class genetics lab and unique consultative approach, Genomind is advancing a new paradigm of personalized medicine in mental health care.

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Genomind Coordinates With Multiple Health Plans to Expand Access to Its Pharmacogenetics Tools and Help Reduce Mental Health-Related ER and Hospital...

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In Global Direct-to-consumer Genetic Testing Market Research Report, the study analysis was given on a worldwide scale, for instance, present and traditional Direct-to-consumer Genetic Testing growth analysis, competitive analysis, and also the growth prospects of the central regions. The report gives an exhaustive investigation of this market provides an analysis of the industry trends in each of the sub-segments, from sales, revenue and consumption. A quantitative and qualitative analysis of the main players in Global and country level is introduced, from the perspective of sales, revenue and price.

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Product Type Coverage(Market Size & Forecast, Major Company of Product Type etc.):

Diagnostic ScreeningPrenatal, Newborn Screening, and Pre-Implantation DiagnosisRelationship Testing

Company Coverage(Company Profile, Sales Revenue, Price, Gross Margin, Main Products etc.):

23andMeMyHeritageLabCorpMyriad GeneticsAncestry.comQuest DiagnosticsGene By GeneDNA Diagnostics CenterInvitaeIntelliGeneticsAmbry GeneticsLiving DNAEasyDNAPathway GenomicsCentrillion TechnologyXcodeColor GenomicsAnglia DNA ServicesAfrican AncestryCanadian DNA ServicesDNA Family CheckAlpha BiolaboratoriesTest Me DNA23 MofangGenetic HealthDNA Services of AmericaShuwen Health SciencesMapmygenomeFull Genomes

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OnlineOffline

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North America (U.S., Canada, Mexico)Europe (Germany, U.K., France, Italy, Russia, Spain etc.)Asia-Pacific (China, India, Japan, Southeast Asia etc.)South America (Brazil, Argentina etc.)Middle East & Africa (Saudi Arabia, South Africa etc.)

At the upcoming section, this report discusses industrial policy, economic environment, in addition cost structures of the industry. And this report encompasses the fundamental dynamics of the market which include drivers, opportunities, and challenges faced by the industry. Additionally, this report showed a keen market study of the main consumers, raw material manufacturers and distributors, etc.

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Major Point of TOC:

Table of Content1 Industry Overview2 Industry Environment (PEST Analysis)3 Direct-to-consumer Genetic Testing Market by Type4 Major Companies List5 Market Competition6 Demand by End Market7 Region Operation8 Marketing & Price9 Research Conclusion

About us:Research is and will always be the key to success and growth for any industry. Most organizations invest a major chunk of their resources viz. time, money and manpower in research to achieve new breakthroughs in their businesses. The outcome might not always be as expected thereby arising the need for precise, factual and high-quality data backing your research. This is where MART RESEARCH steps in and caters its expertise in the domain of market research reports to industries across varied sectors.

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Global Direct-to-consumer Genetic Testing Market Analysis 2015-2019 and Forecast 2020-2026: Size, Share, Growth Rate, Revenue, Applications, Industry...

Recommendation and review posted by Bethany Smith

Identigene

Global Direct-To-Consumer (DTC) Genetic Testing Market Segmentation

This market was divided into types, applications and regions. The growth of each segment provides an accurate calculation and forecast of sales by type and application in terms of volume and value for the period between 2020 and 2026. This analysis can help you develop your business by targeting niche markets. Market share data are available at global and regional levels. The regions covered by the report are North America, Europe, the Asia-Pacific region, the Middle East, and Africa and Latin America. Research analysts understand the competitive forces and provide competitive analysis for each competitor separately.

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Global Direct-To-Consumer (DTC) Genetic Testing Market Regions and Countries Level Analysis

The regional analysis is a very complete part of this report. This segmentation highlights Direct-To-Consumer (DTC) Genetic Testing sales at regional and national levels. This data provides a detailed and accurate analysis of volume by country and an analysis of market size by region of the world market.

The report provides an in-depth assessment of growth and other aspects of the market in key countries such as the United States, Canada, Mexico, Germany, France, the United Kingdom, Russia and the United States Italy, China, Japan, South Korea, India, Australia, Brazil and Saudi Arabia. The chapter on the competitive landscape of the global market report contains important information on market participants such as business overview, total sales (financial data), market potential, global presence, Direct-To-Consumer (DTC) Genetic Testing sales and earnings, market share, prices, production locations and facilities, products offered and applied strategies. This study provides Direct-To-Consumer (DTC) Genetic Testing sales, revenue, and market share for each player covered in this report for a period between 2016 and 2020.

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Executive Summary: In this section, the report focuses on analysis of macroscopic indicators, market issues, drivers, and trends, competitive landscape, CAGR of the global Direct-To-Consumer (DTC) Genetic Testing market, and global production. Under the global production chapter, the authors of the report have included market pricing and trends, global capacity, global production, and global revenue forecasts.

Direct-To-Consumer (DTC) Genetic Testing Market Size by Manufacturer: Here, the report concentrates on revenue and production shares of manufacturers for all the years of the forecast period. It also focuses on price by manufacturer and expansion plans and mergers and acquisitions of companies.

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Tags: Direct-To-Consumer (DTC) Genetic Testing Market Size, Direct-To-Consumer (DTC) Genetic Testing Market Trends, Direct-To-Consumer (DTC) Genetic Testing Market Forecast, Direct-To-Consumer (DTC) Genetic Testing Market Growth, Direct-To-Consumer (DTC) Genetic Testing Market Analysis

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Direct-To-Consumer (DTC) Genetic Testing Market Overview by 2026: Verified Market Research - Cole of Duty

Recommendation and review posted by Bethany Smith

Yahoo Life is committed to finding you the best products at the best prices. We may receive a share from purchases made via links on this page. Pricing and availability are subject to change.

You may think you might know everything about Fidos life, especially if you raised him from a fur babybut that little rascal has plenty of mysteries hidden in his family tree. For instance, what breeds were his parents and grandparents? Is your pup really a purebred, or is she a mix? And the question every owner of a rescue pet is tired of hearing: what exactly is your dog a mix of?

Dog DNA kits are designed to help answer those burning questions and pinpoint your poochs originsjust like the kits designed for humans. Knowing more about your pups background is not only interesting, but it can help you better navigate current or future behavioral or health issues.

Right now, Chewy has a slew of pet DNA kits on sale. From basic ancestry to health profiles, these tests really run the gamut and thankfully, you wont have to pay full price for them.

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Embark tests for over 250 dog breeds including wolf, coyote and village dog ancestry. It also helps trace your pup's family tree back to great grandparents and connects you to other relatives that share similar DNA. However, the standout feature of this test is the comprehensive genetic testing for over 170 genetic health conditions.

This is by far the most accurate breed and health testing for dogs, one vet shares. I am a veterinarian and have had access to results by many of the companies out there - this is the one I will always recommend to my clients.

All the DNA My Dog kit requires is a simple, painless at-home cheek swab using the included sterile cotton applicator to determine your dog's complete breed and ancestry. Mail in the sample, and you'll receive a detailed report in two weeks or less listing specifics for every breed in your pets genetic profile, including a percentage breakdown of the levels found in your dogs DNA.

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I loved this experience!!! The kit came immediately with great instructions, one happy shopper shared. To find out his DNA has been the coolest experience! The description of the levels was most helpful. SO GLAD I DID THIS!! Never ever would have dreamed these breeds! It explains a lot. And the greatest part is that this Italian girl just discovered her dog is Italian!! As in Italian Greyhound. Love it!

The Wisdom Panel test can detect over 250 dog breeds, including 99 percent of American Kennel Club-recognized breeds. If youre testing a puppy, the test will determine how much he or she will weigh as an adult. It takes two to three weeks to see results after mailing your pups cheek swab to the lab.

We were very happy with the results, a happy shopper shared. The results were spot on! The tests were done very quickly and very accurately. One of our dogs has the MDR1, so THANK YOU for informing us. Very happy.

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Trimethylaminuria is a rare disorder in which the body is unable to break down the chemical trimethylamine.

Trimethylamine has a very strong smell, similar to that of rotting fish. In people with trimethylaminuria, trimethylamine builds up in the body, causing it to give off a strong fish-like odor.

Trimethylaminuria does not have any associated health problems, but the strong odor may affect people socially and psychologically.

Here, we look at the causes, symptoms, and treatment of trimethylaminuria.

Trimethylaminuria is a rare disorder that causes a person to have an excess of the chemical trimethylamine in the body.

People may also refer to trimethylaminuria as:

The intestines produce a chemical called trimethylamine when people eat certain foods, including:

Usually, an enzyme breaks down trimethylamine as part of the digestion process.

Some people have a mutation in the gene that controls this enzyme, which prevents it from breaking down certain chemicals properly. As a result, trimethylamine builds up in the body.

Trimethylamine has a strong fish-like odor. When people are unable to break trimethylamine down as usual, the body releases the chemical through bodily fluids.

Due to this, people with trimethylamine give off a strong fish-like odor.

The main symptom of trimethylaminuria is a strong fish-like odor. The body releases excess trimethylaminuria through:

People may have a strong odor all of the time or a milder odor that can change in intensity.

Certain factors, such as sweating, may increase the smell. People may find that the odor worsens with exercise or stress.

Trimethylaminuria seems to be more common in females than in males. Although there is not yet a clear reason for this, researchers suggest that female sex hormones, such as estrogen and progesterone, could play a role.

Females may have more severe symptoms:

Stress levels and diet may also play a part in triggering symptoms.

People with trimethylaminuria do not usually have any symptoms other than a fish-like odor, and the disorder does not cause any other physical health issues.

However, some people may find that the strong odor affects their mental, emotional, or social health. These individuals may socially isolate themselves or experience depression due to the condition.

Trimethylaminuria is usually an inherited condition that occurs due to an affected flavin-containing monooxygenase 3 (FMO3) gene.

A mutation in the FMO3 gene affects the FMO3 enzyme. This enzyme converts trimethylamine to trimethylamine N-oxide, which has no smell.

If the FMO3 enzyme does not work properly, the body is unable to break down trimethylamine, and the chemical builds up in the body. The body releases the strong-smelling chemical through bodily fluids, such as sweat and urine.

The symptoms of trimethylaminuria vary greatly among individuals. Researchers believe that different types of mutations in the FMO3 gene can affect the intensity of the symptoms.

In some cases, people may develop secondary trimethylaminuria from large doses of trimethylamine or products that trigger trimethylamine production.

This type of the condition can occur when the FMO3 enzyme in the liver becomes unable to break down the excess quantities of trimethylamine.

A doctor may be able to diagnose trimethylaminuria by asking a person about their symptoms and carrying out a few tests.

A urine test can show whether a person has high levels of trimethylamine in their urine.

A doctor may give the person an oral dose of choline first, as this causes the production of trimethylamine.

People may also undergo genetic testing, which can show whether there is a mutation in the FMO3 gene that causes trimethylaminuria.

There is currently no cure for trimethylamine, so treatment focuses on managing and reducing symptoms.

One of the main ways in which people can reduce the odor of trimethylamine is by avoiding certain foods that contain trimethylamine or choline, which triggers trimethylamine production.

The milk from wheat-fed cows contains trimethylamine, while foods that contain choline include:

Trimethylamine N-oxide is present in seafood, including fish, cephalopods (such as squid and octopus), and crustaceans (such as crabs and lobsters). It is also in freshwater fish at lower levels.

Other ways to reduce symptoms include:

Certain supplements may help reduce the amount of trimethylamine in the urine. The National Human Genome Research Institute recommend:

Riboflavin, or vitamin B-2, may help increase any existing FMO3 enzyme activity in the body. People can take the recommended intake of 3040 mg between three and five times a day with meals.

People can also avoid using alkaline soaps and body lotions with a high pH level. Using slightly acidic soaps or body lotions with a pH of 5.56.5 instead can help wash off trimethylamine more easily from the skin.

If trimethylaminuria has a psychological or social impact on a person, they should speak to a doctor or counselor. Family or relationship counseling may also be helpful.

If a person suspects that they have trimethylaminuria, they can see their doctor for a diagnosis.

A doctor can help put together a treatment plan that includes dietary and lifestyle changes.

They can also advise on any supplements and check that these will not interact with other medications that the person may be taking.

People who are avoiding certain foods and drinks to reduce their symptoms may benefit from working alongside a doctor or registered dietitian. These professionals can help them avoid any nutrient deficiencies and maintain a healthful lifestyle.

Trimethylaminuria is a rare condition that causes a buildup of the chemical trimethylamine in the body.

The body releases the excess trimethylamine through sweat, urine, breath, and reproductive fluids, giving off a strong fishy odor.

Many people with trimethylaminuria, particularly those with mild-to-moderate symptoms, will be able to reduce the fish smell with dietary and lifestyle changes.

Trimethylaminuria does not cause any other physical health problems, and people with the condition are usually in good health otherwise.

It is important that people seek help from a healthcare professional if trimethylaminuria causes social isolation, depression, anxiety, or any other psychological issues.

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(Reuters) Immunomedics Inc won an accelerated approval from the U.S. Food and Drug Administration for Trodelvy, its therapy for a form of invasive breast cancer that has worsened despite two prior rounds of treatment, the company said on Wednesday.

Trodelvy injection, approved to treat metastatic triple-negative breast cancer, comes with a boxed warning the FDAs harshest that flags risks of severe diarrhea and neutropenia, an abnormally low count of a type of white blood cell. (https://bit.ly/2XW5G3z)

The therapys label specified that its continued approval may depend upon verification of clinical benefit in supporting trials.

The FDA had declined to grant accelerated approval for the breast cancer therapy in January last year https://www.reuters.com/article/us-immunomedics-fda/immunomedics-cancer-treatment-fails-to-win-accelerated-approval-from-the-fda-idUSKCN1PC03G.

Patients with triple-negative breast cancer test negative for hormone receptors or HER2, meaning their tumors do not respond to hormone therapy or to therapies like Roches blockbuster Herceptin.

As per the U.S. Centers for Disease Control and Prevention, breast cancer is the second most common cancer among women in the United States with 41,487 women dying of female breast cancer in 2016 https://gis.cdc.gov/Cancer/USCS/DataViz.html, the latest year for which data is available. Triple-negative breast cancer accounts for about 10-15% of all breast cancers, according to the American Cancer Society.

(Reporting by Saumya Sibi Joseph and Shivani Singh in Bengaluru; Editing by Maju Samuel and Shailesh Kuber)

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FDA grants accelerated approval for Immunomedics breast cancer therapy - Physician's Weekly

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By Deborah J. Nelson

(Reuters) Scientists are baffled by how the coronavirus attacks the body killing many patients while barely affecting others.

But some are tantalized by a clue: A disproportionate number of patients hospitalized by COVID-19, the disease caused by the virus, have high blood pressure. Theories about why the condition makes them more vulnerable and what patients should do about it have sparked a fierce debate among scientists over the impact of widely prescribed blood-pressure drugs.

Researchers agree that the life-saving drugs affect the same pathways that the novel coronavirus takes to enter the lungs and heart. They differ on whether those drugs open the door to the virus or protect against it. Resolving that question has taken on new urgency after an April 8 report by the U.S. Centers for Disease Control and Prevention showed that 72% of hospitalized COVID-19 patients 65 or older had hypertension.

The drugs are known as ACE inhibitors and ARBs, broad categories that include Vasotec, Valsartan, Irbesartan, as well as their generic versions. In a recent interview with a medical journal, Anthony Fauci the U.S. governments top infectious disease expert cited a report showing similarly high rates of hypertension among COVID-19 patients who died in Italy and suggested the medicines, rather than the underlying condition, may act as an accelerant for the virus.

Efforts to understand how the virus uses the pathway to the heart and lungs, and the role of the medicines, are complicated by a lack of rigorous studies.

There are millions of Americans that take an ACE inhibitor or AR daily, said Dr Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness in Baltimore. This is one of the most important clinical questions.

An estimated 100 million U.S. residents suffer from high blood pressure, which increases the risk of heart disease, stroke and kidney failure. About four-fifths of them need to take prescription drugs to control it, according to the CDC. ACE inhibitors and ARBs are widely prescribed to patients with congestive heart failure, diabetes or kidney disease. The drugs account for billions of dollars in prescription sales worldwide.

The absence of clear answers on how the drugs impact COVID-19 patients has sparked rampant speculation in correspondence and editorials posted on medical journal websites and those where scientists share unreviewed, pre-publication study drafts.

Many patients are agonizing over whether their medicines will help or hurt them. Doris Kertzner, 88, of Redding, Conn., said she has carefully followed experts guidelines for preventing infection and keeps her distance from others in her retirement community. Now she has a new worry: She takes losartan, an ARB, and cant decide whether to stop.

Dropping the medicine presents its own problems in dealing with her high blood pressure.

Its gotten very complicated, she said.

Dr Carlos M. Ferrario a researcher at the Wake Forest University School of Medicine and co-author of widely cited studies on ACE inhibitors understands patients plight.

There is a lot of paranoia and a lot of speculation with very little fundamental, convincing information, he said.

The National Institutes of Health in the United States has put out a call seeking proposals for studies into the issue. An independent consortium of researchers has launched a global study to analyze health records for thousands of COVID-19 patients in the United States, Europe and Asia. That project is part of the Observational Health Data Sciences and Informatics program, an open-source research platform that enables large-scale studies.

Dr Marc Suchard a biostatistician at the University of California, Los Angeles who is leading the study said that it aims to determine whether the medicines make infections more likely or more severe or, by contrast, whether they help protect against the virus. Suchard said he expects a preliminary report within two weeks.

MORE TARGETS FOR THE VIRUS

There is evidence that the drugs may increase the presence of an enzyme ACE2 that produces hormones that lower blood pressure by widening blood vessels. Thats normally a good thing. But the coronavirus also targets ACE2 and has developed spikes that can latch on to the enzyme and penetrate cells, researchers have found. So more enzymes provide more targets for the virus, potentially increasing the chance of infection or making it more severe.

Other evidence, however, suggests the infections interference with ACE2 may lead to higher levels of a hormone that causes inflammation, which can result in acute respiratory distress syndrome, a dangerous build-up of fluid in the lungs. In that case, ARBs may be beneficial because they block some of the hormones damaging effects.

Novartis International AG and Sanofi SA are among the major drugmakers selling ACE inhibitors and ARBs.

Sanofi spokesman Nicolas Kressmann said that patients should consult their doctors on whether to continue taking the drugs but that the company has found insufficient evidence that they worsen COVID-19 through its own assessment of available scientific data.

The company reviewed several recent studies from China that came to conflicting conclusions about whether COVID-19 patients with hypertension fare worse than other patients, he said.

Novartis has not issued any guidance to clinicians or patients and defers to scientists studying the issue, said spokesman Eric Althoff.

Researchers and doctors generally agree that people with severe hypertension or heart failure should keep taking the drugs because of the high risks of stopping. The debate centers on how to advise the many patients with milder conditions who take the drugs. Two camps have emerged one calling for no action unless the drugs are proven dangerous, the other for some limits on their use until they are proven safe.

The Centre for Evidence-Based Medicine at University of Oxford in England has recommended that clinicians consider withdrawing the medicines in patients with mild hypertension if they are in a high risk group, such as medical workers and replacing them with alternative blood pressure-lowering drugs.

The New England Journal of Medicine (NEJM) took the opposite tack, highlighting the drugs potential in fighting coronavirus and recommending patients continue taking the drugs until more about the risks is known. Several of the scientists who co-authored it had done extensive, industry-supported research on antihypertensive drugs.

CONFLICTS OF INTEREST

Dr Kevin Kavanagh, founder of Health Watch USA, a patient advocacy organization, questioned whether scientists who are funded by the drug industry should be advising clinicians, given the high stakes.

You need to consider stepping back, and let others without a conflict of interest try to make a call, Kavanagh said.

His organization recommends that doctors temporarily avoid putting new patients on the drugs and warn those currently on them to take extreme precautions to avoid virus exposure.

Dr Scott David Solomon, a co-author of the NEJM article, conducts industry-financed research but said it has no influence on his position.

Not only is there no compelling evidence that we should be discontinuing those medications, but theres reason to think that doing so might actually cause harm, said Solomon, who is the director of noninvasive cardiology at Brigham and Womens Hospital in Boston.

The lack of consensus leaves doctors to navigate the issue patient by patient. Alexander, of Johns Hopkins, is trying to strike a balance in his own practice. Patients with more severe blood-pressure problems may need to keep taking the medicines, he said, while patients with milder or newly diagnosed cases could instead take one of the literally dozens of alternative hypertension treatments.

Rest assured, he said, there are dozens of scientific teams working feverishly to put this question to bed.

(Reporting by Deborah Nelson; Editing by Brian Thevenot)

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Photo illustration by Slate. Photo by Getty Images Plus.

Two emergency physicians, based at two different hospitals in the New York metropolitan area, are logging their days for Slate. At the end of each shift, they write a response to three questions: What was today like? How did it compare with yesterday? And how do you feel? We have offered them anonymity so that they can write freely about their experiences. Dr. Kelly Keene and Dr. Lauren Serino are pseudonyms. Read Week 1here, Week 2here, and Week 3 here.

Im not Jewish, but we had a Passover Seder with my boyfriends family over Zoom after my ER shift today. This was preceded by us watching the Rugrats Passover episode, both for a bit of lighthearted comic relief as well as for a quick refresher on the Ten Plagues.I am struck by how eerily some current events are mirroring some of the Ten Plagues: First, the snow turned red as blood at the North and South poles, then the hail in upstate New York, the swarms of Locusts in Africa, etc.Is this coronavirus but a form of pestilence, or is it causing the darkness in this modern day plague?

Having trained in an intense ER residency, Im used to seeing all sorts of critical situations. Ive delivered babies in the ER parking lot; Ive seen horrific trauma in which the entire inside of human anatomy was visible; I regularly deal with strokes, sepsis, heart attacks, broken bones, head bleeds, failing organ transplants, etc.Im used to handling acutely psychotic patients, severely demented patients, drunks, drug addicts; I have often been yelled at, cursed at, spit at, even hit and kicked.Yet nothing has compared to what we are seeing now with COVID. For the first time in my life, going to work scares me, and coming home from work scares me even morebecause of the concern that I might bring the infection home to my boyfriend.More and more colleagues (nurses, PAs, attending physicians, residents) are falling sick. Two young residents in NYC reportedly died from the coronavirus.

I can only imagine how this is affecting the residents across the country, the ones who are just starting out in hospitals, and are there to learn the ropes.Some have already been infected, others have sent their spouses and children away to avoid infecting them.They have all been working exhausting 12-hour back-to-back shifts, and the usual venues of decompression (e.g., bars, restaurants, movie theaters, friendly get-togethers) have all been shut down. But beyondthe devastating effects on their psyche, it has been detrimental to their education, too.This is supposed to be a time of training and learning, of honing their craft. But the chain of command has been upended by this: Medical students are being graduated early to start pitching in, residents are now acting as workhorses, and fellows have had their fellowships discontinued and asked to work as attendings. I worry about their well-being, yes, but I also worry about the future of the U.S. medical landscape as we practice wartime medicine.

If I had wanted to be in the military, I could have had my medical school paid for by thegovernment.

Speaking of wartime medicine Ive been reading the many articles and commentaries calling the ER and hospitals a war zone and referring to health care staff as heroes of the COVID war.I find the war metaphor both apropos and vexing. The number of projected COVID-related deaths, even with social distancing, is still projected to be between 100,000 and 240,000.By comparison, about 60,000 were killed on the battlefield in the Vietnam War.Navy ships have been deployed and Army field hospitals have been mobilized in multiple regions of the country.The hospital wards are filled with patients lined up on vents, not even a curtain between them for lack of space. There are refrigerated trucks parked outside hospitals serving as temporary morgues holding piles of dead bodies. It looks like a war.

But it is vexing to hear health care workers being compared to military personnel. Yes, we signed up to be front-line staff in treating illness and injuries.We did not sign up to be in combat, we did not sign up to go into battle against COVID without proper personal protective equipment, and we certainly did not sign up for endangering our loved ones.If I had wanted to be in the military, I could have had my medical school paid for by the government. Instead, I, along with many other physicians, chose to go hundreds of thousands of dollars in debt to go to medical school and sacrifice a decade of my life to train to be a civilian physician.Let me be clear:Soldiers are not sent to war without necessary equipment; firefighters do not rush into burning buildings without respirators.Why is this lack of PPE acceptable for the health care profession?

The health care system in the United States has been faulty for a long time.Front-line staff in hospitals have been asking for updated equipment for years.Instead, often our profit-driven system focused on improving Press Ganey (customer satisfaction) scores rather than upgrading supplies that would actually enable better health care.Will this COVID pandemic finally highlight the problems and help drive a proper response from the health care systems and the government?Or will it all fade away in short memory, with our dead colleagues counted as fallen heroes and collateral damage from the COVID war?

Dont get me wrong, I am proud to work alongside my ER family, andit is nice to be considered heroic. But that is not how I think of myself. I hope people realize that this is the job we have always donewe have always been front-line staff, treating the sick and injured, serving as the safety net for marginalized populations.I am heartened by the many reports of people coming together all over the world to help one another in this time of crisis. I just hope this moment lasts longer than the pandemic itself.

I woke up to three boxes on my doorstep filled with face shields and a text from NYCPPE saying that our GoFundMe money is stretching even farther, and to expect another delivery of 500 N95s this week. New York is starting to get what passes as a modicum of control over new COVID cases, but the long haul has only just started. Slightly less contagion is still vastly too much, and the supplies will have to stretch.

The newspaper reports a plateauing death toll, the accompanying graphic is that familiar stretched curve. I drink my still-terrible coffee, a reminder that Ill never have the option to quit medicine and become a barista. Ive been waking up to headlines about mortality and economic devastation caused by the coronavirus for over a month now, and it has started to feel mundane. I was already refilling my mug when I realized that my anxiety was absent, replaced by a sense of routine. What is the epidemiological equivalent of the banality of evil? Maybe, the prosaicism of pathology. I finished my breakfast, checked the mail, bleached the door handle, and watched a COVID treatment panel discussion about the utility of blood thinners in the acute phase of disease, all things that are starting to seem like second nature now.

What is the epidemiological equivalent of the banality of evil? Maybe, the prosaicism ofpathology.

On the panel, a few doctors from New York were discussing what theyve been seeing in terms of clinical picture and treatments that are workingor not. Two of the doctors described scenes that told very different stories.One told the story I have been watching unfoldERs crowded to the point of collapse, a crushing number of deaths, the shocking acuity and multi-organ-system derangement in even the younger patients. But the other spoke of an experience more in line with the overall datayes, far too many young in the ICU, but the elderly and comorbid older patients making up the bulk of the dying, the hospital strained, but able to keep up.

ProPublica has an interactive ZIP code map that updates daily with the number of cases in each NYC area. The first doctor worked in an area with 71 percent greater number of infections than the city average. The other? In an area with 60 percent less than the average. Even in the pandemic epicenter, eight miles made a vast difference.

Poverty is a terminal illness in itself, and its why the hardest hit neighborhoods, in the hospitals where Ive spent my career, report the highest piles of bodies. Bodies who had insufficient access to preventive medical care, healthy diets, and too many people squeezed into a tiny apartment. COVID can kill you no matter how much money you have. But not having it correlates closely with the risk factors that make it much more likely to kill you and the people you love.

Short of a vaccine, theres no way to immediately solve this entrenched problem just by recognizing its there. But that doesnt make it any less important to acknowledge and, maybe, to rememberif we are wise enough to learn from some of our myriad mistakes during the pandemic. The virus, more than anything, reminds us that the world is interconnected. None of us are separate. And devastation in one community is not only their loss but may set off a chain of contagion that affects people more broadly, whether thats a few miles or a continent away.

Before bed, I called a friend who wanted to congratulate me on the slowing of NYC deaths. I assured her it wasnt all my doing, but thanks. She laughed. She has an innate optimism Ive always been jealous of.

This too shall pass, I said, but it sounded dismissive and, more than that, untrue. Sometimes, the ghost of an experience sticks around simply because it enjoys the haunt. I wonder if COVID will be that way: One of my colleagues said shes going to take the next two weeks recovering from the last two weeks, and then repeat the process for the foreseeable future. Maybe, instead of passing, the realists alternative is, This too shall become normal.

Today was hard. I keep looking for a more evocative adjective, but I just keep coming back to this: Today was hard. I turned in my badge at the hospital that Ive worked at for the last five years. There has been mounting violence in the ER and not enough done to protect its workers. Things had become dangerous there, long before the presence of the virus. In a few days, I start at a new hospital. There will be some familiar faces there. Still, its hard.

A 73-year-old male patient is rushed in, his oxygen saturating reading 56 percent (normal is over 95 percent). He is visibly in respiratory distress, breathing shallowly and rapidly, able only to eke out one word at a time. We place a nonrebreather mask on him to give him maximal oxygen, but his saturation only improves to about 85 percent. Knowing time is limited,I had to ascertain his code status, specifically, whether he would want to be placed on a ventilator when he could no longer support his own breathing.He made it clear between labored breaths that intubation was something he would never want, understanding that he would die the minute he tired out from his puffing and panting.He told me of his wife of 45 years, now home alone, unable to be by his side because of the no-visitor rule that most NYC hospitals have instituted.

We have one iPad in the ER to allow patients to FaceTime with their loved ones, but it is currently being used in the next room by a 56-year-old man, also critically ill from COVID, telling his children in Chicago he loves them before being induced into a medical coma for intubation.I pull out my cellphone and helped my patient FaceTime his wife. I hold back tears as they exchanged what might be their last loving words to each other.Overhead on the PA system, I hear more calls of rapid responses for admitted patients who are decompensating on the hospital wards, and then upgrades to code blue, for patients who are dying on the wardsdying so utterly alone, with no one to hold their hand.Death has always been a sad part of my job, but now we are the ones saying goodbye for the patients. Having to do so remotely, over a phone or tablet, seems that much worse.

Hairdressers have a mafia, of which I knew next to nothing prior to the pandemic, and which Im intensely grateful to know now. Their magic is how, over the course of an hour, $500 could be amassed and, three days later, 5 gallons of barbicide and boxes upon boxes of gloves appeared at my doorstepjust in time to add them to my next PPE deliveries tomorrow night. Disinfectant online is still almost universally sold out. But, no worries, they know a guy.

Meanwhile, friends who have never cooked a day in their life have become master bread bakers. The clumsiest amongst us has taken a daily ballet class, and isnt half bad. Some are learning to program or play the guitar.

There have been a lot of unexpected things happening during the pandemic. But none have amused me more than this: My friends keep calling me for medical advice. This in itself isnt uncommon. Strangers will try showing me their rashes at dinner parties when they find out what I do. But this time, its couples who dont live together, each member contacting me separately, and all with the same question:

When can we have sex again?

Im almost positive, based on the conversation, that neither knows the other is calling to ask. Its romantic, really. Couples, isolated in different apartments, perhaps one or both sick, so concerned for the others welfare above their own animal needs that they arent willing to risk it without medical clearance.

Somehow, on my days out of the hospital, I have become the Dr. Ruth of the coronavirus.

And today, when the first of the couples who called me reached back out, each barely an hour aparthe to announce that he is now asymptomatic going on three weeks after being sick with COVID, and she to say she remained perfectly healthy and her roommate had chosen to move out and isolate back homeI was finally able to give someone medical advice they actually wanted to hear.

My contract at my new position was canceled today. The positionone requiring procedural experience, best filled by a critical care doc, i.e., an intensivist or someone like meis now going to be filled by hospitalists: doctors who only work on the hospital floor and dont have the procedural training I do. Apparently the people hiring think this can be taught in a pinch, and that other docs, possibly from specialties that dont usually do floor medicine, can take over for those hospitalists if needed.

Another contractthis one for per diem assistance in a busy systemwas supposed to start placing me on shifts to help during the peak of our crisis. The company offering me that contract told me to be prepared to start three days after I was hired, and then it never called. Another doc was also waiting for that same call. It never came.

Since the start of the pandemic, NYC has been asking doctors from other places to come help and fight the COVID crisis. It was akin to a call to arms during a war: Do you have or did you have a medical degree in any state? Are you able-bodied enough, even if you are sick or old? Are you willing to be a hero on the front lines? Theres honor to be won in a war, son, do your part.

Health care workers from all over the country were directed to a NYC Department of Health online portal for assistance with placement, so that doctors could be matched with the hospitals that needed them most.

Ive spent my career in NYC. I was prepared to jump in, so I reached out directly to the places that I knew were being hit hard to see if I could offer my services, forgoing the delays inherent in a bureaucratic government website. Friends, doctors Id trained with, doctors already living and working throughout the city who wanted to be of broader use, did the same.All of us were already familiar, in a way those out-of-towners were not, with what a 12-hour shift in a COVID-saturated urban ER was like.

But the hospitals seemed strangely uninterested; their rhetoric didnt match their actionsit was hard to get in contact with anyone. Getting in touch with someone at the VA took five calls, three emails, a week, and then finally I received the internal email address of the physician recruitment team. That address bounced back. Hospitals took my CV, my phone number, then never followed up. During this time, I received calls from recruitersmiddlemen hired at a high premium by hospitals during staffing shortagespromising jobs at some of these same hospitals. Companies that took my CV said they had immediate need, and then, again, went silent. Friends and colleagues mentioned they were in the same situation, even though we were in the thick of the patient crush.

Strange.

Days passed. Finally, two hospitals said they would start the credentialing process and would need us to start immediately. We opened our schedules. Committed and then

Crickets.

As this was happening, volunteers were placed through the city DOH website. Many physicians I spoke with directly, some retired with medical conditions in high-risk age groups, were volunteering to do what seemed to be the necessary thing and return to work, and many were placedwithout pay, in overcrowded ERs, without adequate PPE. Not shockingly, some began to get ill. Already, some health care workers had died.

Meanwhile, other doctor friends and I kept trying to work. We kept wondering, too, why werent we being hired?

Hospitals were willing to pay premiums in some situations: They offered large hourly rates to out-of-state physicians who were being asked to come live in hotels and be deployed wherever they were needed each day, to work 13-hour days, 14 days in a row without a day off, in physically and emotionally strenuous environments. Premiums one anonymous administrator told me they prefer to pay because offering hazard pay to local per-diem physicians sets a bad precedent, and wages are sticky. Its harder to reverse a temporary increase in rate or decrease the number of shifts for local new per-diems than it is to just spend more on doctors who will get on a plane and quietly leave at the end of their tenure. I rarely see the ER staffing agencies hospitals use to execute these callous strategies mentioned in news stories. Theyre an invisible part of the system.

Theres nothing like a pandemic to bring out the opportunists.

Most of us have been OK with living our lives as if taking care of others is more important than taking care of ourselves. Hospitals exploit this feeling.

Doctors learn the business of the body, not the business of medicine. But modern health care is an industry with a bottom line measured in dollars, not wellness. As we train, were told to stay in our lanean important lane, to be sureand just worry about being good healers. The rest, the pesky business of how the wheel turns, can be managed by the rapidly expanding pool of administrators. In staying in our lane, we dont feel the insidious ways the business of medicine has eroded the value of the doctor-patient relationship. Instead, patients have become a commodity and physicians a cog. Were blind to the chaos and danger around us. We might note how focused administrators are on metrics of efficiency and patient satisfaction scores, even if efficiency doesnt mean quality, and higher patient satisfaction scores are linked to higher overall mortality rate. But were hired to provide the services approved by the hospital, and insurers, which is frequently not to our own standards of patient care.

Doctors learn the business of the body, not the business of medicine. But modern health care is an industry with a bottom line measured in dollars, notwellness.

I see this dynamic continuing in the midst of the COVID crisis. As hospitals and politicians continue calling for help in public, the rhetoric has been that there are too few doctors to manage the crisis. They said this even as doctors were fired or told to leave midshift for wearing their own protective equipment. Colleagues who were pointing out dangerous practices for both employees and patients were asked or pressured into leaving. Colleagues who were lower risk and looking for fairly paid work were passed over because other health care workerswho were made to believe there were no other doctors available to workwere being brought in as unpaid labor. They were told there was no money to be found, despite high reported revenues and administrative salaries in the multimillions.

In writing this I wondered if this is the time to talk about how the business of health care is affecting us, as hospitals proclaim extreme need while not hiring available doctors. But there is no way to separate the business from the care anymore. Were no longer given the luxury of that separation, because it is the business and the bottom line that has created this situation where the sacrifice of health care lives is considered inevitable.

Even as our sense of purpose is being preyed upon, were afraid well be seen as selfish if we ask for reasonable compensation, even as administrative bloat continues to increase, and insurers continue to collect their premiums. We worry that society sees us as greedy opportunists, even as we must practice medicine in unsafe conditions, at the whims of insurers and hospital authorities who profit from our sense of obligation and decide how we provide care, and then sends us out to be the messenger, placing us between the patients and their policies. We know how much everyone loves the messenger.

It seems that I have inadvertently become the messenger. So here is my message: If hospital systems really cared about healthof their workers, their patients, their communitiesthey have been extremely good at hiding it from me and all the physicians who have been looking to work within their walls.

The language of war, or sacrifice, is used when you want to mentally prepare people for a certain amount of unavoidable front-line losses. The system leverages our sense of moral obligation to exploit us.

A robust 72-year-old man is sitting up on the stretcher, talking on the phone with his family member about having to be admitted for his new onset atrial fibrillation, an irregular heart rhythm. During his 3.5 hour ER stay, I saw the cardiology team come by his side four times, checking to see if a medication has successfully converted his rhythm back to normal. I look at my resident in disbeliefneither of us had ever seen cardiology swing by to see a stable patient in the ER so frequently.

Another man comes in requesting a urinary suprapubic catheter change, a fairly simple and quick procedure.But he demands that a urologist perform the exchange and refuses to let ER staff touch it.Apologetically, I explain the situation on the phone with the urology consultant and he replies, No problem, Ill come and take care of you. Im sure you guys have your hands full in the ER.

Next comes a 40-year-old female who returns to the emergency room for a repeat beta-HCG level, a pregnancy hormone we need to recheck because she might be having an ectopic pregnancy.Because she was seen by our OB-GYN team a couple days prior, I call the OB-GYN consult just to touch base, mostly to ensure the patient has follow up.To my surprise, the consultant comes by the ER to see the patient, even though I told her it was not necessary.Again, my resident and I exchange a lookour consultants have all been exceptionally nice and helpful during this whole time of COVID crisis.

Largely, I attribute this niceness to medical professionals coming together in solidarity, supporting each other in this pandemic.Across the country, many subspecialty health care providers (cardiology, gastroenterology, etc.) have been recruited to the ERs and to the inpatient units to assist with the influx of COVID patients.The rest of them, who have been experiencing a lower volume than usual, have been trying to pitch in any way they can. It is incredibly touching to feel the support of colleagues, to know we are there for each other, even if we may often have disagreements in normal times (e.g., surgical services often punting patients to medicine rather than admitting them to their own service).

But on a lighter note, I also think Ive been seeing consultants in the ER more frequently partly because they are bored, and partly because they are just excited to see patients with diseases that are non-COVID-related.

During a telemedicine consult this morning, my patient seemed apologetic and uncomfortable, as if he was speaking through gritted teeth.

Im having terrible abdominal pain, he said.

When did it start?

A week ago.

He described severe, acutely worsening lower abdominal pain, the inability to have a bowel movement for over five days, and a history of obstruction. He was vomiting. It didnt look right, like dark, wet coffee grounds. Every tiny movement to his trunk felt like knives in his abdomen. Im getting lightheaded, he said, quietly, as if he was confessing a secret. The tenor of his voice revealed that he knew this wasnt going to be solved with a phone call.

Sir, you

He cuts me off. I really dont want to go to the hospital

You have to.

I dont want to get the virus. He sounds like hes about to cry.

I think about the tally of COVID deaths being recently adjusted for presumed cases found deceased at home. I wonder how many all-causes of death are increasing because the fear of COVID outweighs the fear of their current illness. In fairness, the fear of COVID is the fear of dying alone, without your family, shrouded in wires. I get it.

We complain about the frustrations caused by patients who show up in the middle of a busy shift complaining of two years of back pain, or requesting a pregnancy test, or with a bug bite. But when the volume of non-COVID patients dropped precipitously, we knew the worried well didnt make up that large of our patient population.

I feel like there are only bad and less-bad options when it comes to managing health care right now, even as we fall back from the initial surge ofcases.

There are still appendicitis, heart attacks, and strokes happening in the community. There are broken bones, bleeding in pregnancy, and kidney stones. We have been asking where our patients went, but we know where they went. Or rather, where they didnt go. They remain the most adherent to the stay-at-home orders. They are delaying or forgoing care, simmering in their otherwise-treatable pathologies at home.

Finally, finally, I was able to convince him to go. He put on a fabric mask and a pair of ski goggles and let me call the ambulance because he was too weak to drive. I couldnt promise him that he wouldnt catch COVID in the ER. The oppositeIm worried that he will, and will be at increased risk of death because of his comorbidities. But while COVIDmightkill him, without treatment his obstruction, internal bleeding, and infection certainly will.

I feel like there are only bad and less-bad options when it comes to managing health care right now, even as we fall back from the initial surge of cases. I have to consider my advice carefully, leveraging as many outpatient and telemedicine treatment options as I safely canwhich is vastly more than I have ever used before.The number of people whose chronic and acute medical conditions will make it worse for them should they catch COVID are, of course, the same people whose conditions will be worsened by trying not to. COVID is a chameleon, constantly presenting in new and wildly varied ways. I wish we had planned for the ways it might kill a person without them ever catching it at all.

This afternoon I went to a party on Zoom hosted by a group out of London called the Co-Reality Collective. It was largehundreds of people, multiple roomsand most people were costumed, friendly, and eager to connect across time and miles. The theme was moon landing, and at midnight their time, we stopped to share a screen. The host cued up a movie that revealed our place in the universe: floating on a small blue dot in a mote of sunlight. This passage from Carl Sagans Pale Blue Dot was narrated:

Our planet is a lonely speck in the great enveloping cosmic dark. In our obscurity, in all this vastness, there is no hint that help will come from elsewhere to save us from ourselves. To me, it underscores our responsibility to deal more kindly with one another

Ive been struggling with feeling like the distance between where were at now in the pandemic timeline and the light at the end is as vast as that between Earth and sun. But as the movie ended and everyone shared how grateful they are for the support, even the online support of strangers, then got up to have a digital dance party, I realized that what were doing isnt socially distancing at all. Its only physically distancing.

I stopped by my old hospital tonight to drop off a surprise donation: a plexiglass intubation boxmeant to decrease COVID exposure during aerosol-producing procedures. My favorite senior resident was on the night shift. Ive known him since he was an intern and I was a relatively new attending. He was having a hard time then, and reminded me of myself when I felt like I didnt fit into the department my first year of residency. I hoped I could model myself after the attendings who supported me, in some small way, and be a nonjudgmental ear. A safe person to come to.

Hey, thanks for looking out for us, he said as I handed over the box.

No problem.

Youve been really vocal about the stuff that affects us even when we cant be. Its appreciated.

I nodded, hoping he knows that I wont stop feeling a responsibility toward them even if Im not there for shifts.

Oh, hey, you also still owe me that bottle of Champagne, so maybe dont forget that next time?

I laughed.

If a resident does a spinal tap and the lab reports that it has returned without a single drop of blood in it, we call it a Champagne tap. Its a demonstration of the residents skill. To congratulate them, you gift a bottle of Champagne. Its supposed to be a reward for thefirsttime they do it, not the hundredth. But, as he reminded me, these are unprecedented times.

I like Dom, but Veuve will do.

The guy in apartment 1A has a knack for walking by the laundry room in the brief moments just after I have stripped completely naked and am shoving my COVID-contaminated scrubs into the laundry, but before I have covered myself up with a robe. Prior to the pandemic we had only nodded congenially at each other if we passed the mailbox. Now we just sidestep one another and keep moving.

I was outside tonight, in the middle of the large complex of apartment buildings where I live, when the clapping started. Ive heard it some days at 7 p.m. when Im not at work, but today was the first time I wasnt inside from the vantage of my own room. I looked up and saw as windows burst open and bodies leaned out, clanging pots and pans, yelling thank you. The shouting is ostensibly for the health care workers, yes, but also for one another. I can feel how badly those bodies want to burst out of their apartments like the cherry blossoms on the branches of the trees in Prospect Park.

Even as the number of overall cases is decreasing, there is still a mounting number of colleagues and friends becoming ill. As time goes on, we are losing our degrees of separation between someone who has died or is critical.

My mom said on the phone today that she and my dad are going stir-crazy. I feel like we will never see you again! She said it in a jesting tone, but I know she means it. They live across the country. Theyre scared. Theyre worried about me. I also wonder how long its going to be. Its been on my mind since my friends mother passed away from COVID a few days ago. He cant go to the funeral. But worse, so much worse, he wasnt able to go hold her hand in the hospital as he knew she was dying. Forget the memorial, its what he couldnt do for her while she was alive that guts himand so many in his situationnow. I wish I could say I cant imagine that scenario, but I can, and it makes me wonder, not just when I will see my parents again, but what I will have to do to make visiting an 85- and 73-year-old safe.

The goal of curve-flattening was to give the health care system a chance to prepare. There was no way that we would have a vaccine by now, but Id hoped that we would have a better handle on the ever-evolving and truly baffling pathophysiology of virus. Or a medication we could rely on. Even just reliable access to PPE. The goal wasnt just to decrease the crush of initial patients, which, thank goodness, is starting to work. The problem is, unless our only goal was to delay the inevitable, we have to know what we are replacing lockdown with.

The WHO has outlined six conditions for any government that wants to start lifting restrictions:

1.Disease transmission is under control

2.Health systems are able to detect, test, isolate and treat every case and trace every contact

3.Hot spot risks are minimized in vulnerable places, such as nursing homes

4.Schools, workplaces, and other essential places have established preventive measures

5.The risk of importing new cases can be managed

6.Communities are fully educated, engaged, and empowered to live under a new normal

I find most of these infuriatingly vague, and its hard to imagine implementing No. 2 successfully in democratic societies. But they make a good pointother than controlling transmission with further lockdown, I dont see how we have made strides on Nos. 26. Even No. 1 could be easily reversed.

Im anxious for reliable antibody testing to actually be available, since weve been hearing rumors of it here in NYC for a while now. I called the DOH today to ask how, as a health care worker, I could get tested, but Im not optimistic, since the consultant didnt know any more than I did. I still put my hopes in vaccine challenge trials. Maybe the Plaquenil study Im in will show positive results. On an emerging expert panel I took part in the other day (experts on any novel pathogen being the people who are seeing enough cases that they can say, Here are all the weird things that Im witnessing, heres what didnt work, heres what did) we tried to put together a wish list of practical actions that would fulfill the WHO conditions. Without large-scale national coordination, local behavioral changes will only put out satellite fires. Theres no question that we will move forward somehow. Thats the only directiontogo. I just hope that the way forward comes with an actual, specific plan.

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Link:
For the First Time in My Life, Going to Work Scares Me - Slate

Recommendation and review posted by Bethany Smith

When one is struck by the coronavirus, symptoms can range from none to fatal. But for the many million in between who are infected by the novel pathogen and then recover, just how damaging are the lingering effects?

Medical researchers are on the quest to find out.

Anytime you get really sick, it is possible that it affects your different organ systems, leaving varying degrees of compromise, or you may have none at all, Dr. Eric Carter, physician and co-CEO of medical app DocClocker, told Fox News. We still dont fully understand the immune response and if recovery and immunity development offer any level of protection against reinfection and disease severity.

Thus, while the prognostic symptoms of coronavirus, formally called COVID-19, have been well-documented ranging from fevers and a loss of taste to breathing problems and pneumonia scientists are purporting to piece together what may happen to those who contract the illness and recover.HOW IS THE CORONAVIRUS MUTATING INTO DIFFERENT STRAINS?

Studies to date have shown that the vast majority of those who are infected are on the mild scale and should recover with no lasting effects. But for more serious cases, especially those who require a ventilator and/or ICU treatment which is around 20 percent of those hospitalized, the possibility of lasting lung damage or severe respiratory affliction is a very real threat.

For more than 80 percent of patients infected with the coronavirus, recovery is likely to be complete. However according to a recent study from Hong Kong, about 20-30 percent of hospitalized patients will have decreased lung capacity due to pneumonia and inflammation caused by the disease or by the ventilator treatment itself, explained Dr. Steven Berk, executive vice president and dean of Texas Tech Health Sciences Center School of Medicine.

He also noted that patients who develop acute respiratory distress syndrome and require long-term mechanical ventilation, sometimes a week or more, are most likely to have persistent shortness of breath, and evidence of scarring or pulmonary fibrosis.

A report published earlier this month in the medical publication journal Cellular & Molecular Immunology from researchers at Fudan University in Shanghai and the New York Blood Center noted that when researchers instituted contact between coronavirus and lab-grown T lymphocytes referred to as T cells the virus paralyzed these critical cells, which help identify and expel pathogens in the body. The researchers also found that SARS, a related coronavirus, could not infect T cells.

Disturbingly, the study also indicated that damage to the T lymphocytes paralleled that caused by HIV.

Moreover, preliminary studies out of China have also underscored that around 12 percent of survivors of severe cases endured protracted heart issues, and some showed signs of impaired liver function.

Given that the virus itself is only a few months old, having originated out of China at some point late last year, experts have only small-scale, immediate term studies to go on, and are mainly looking at data from related viruses SARS and MERS to gauge a more in-depth understanding.

Those with SARS pneumonia had shortness of breath and evidence of pulmonary fibrosis one month after infection. Most patients improved over time, Berk continued. Patients with SARS continued to excrete the virus, sometimes for more than 20 days. Those who had developed acute respiratory distress syndrome (ARDS) remained short of breath for months or for a lifetime.

Texas and Arizona-based hormone specialist Dr. Elizabeth Lee Vliet also pointed out that, in examining the long-term adverse effects of a variety of viral illnesses, problems include lungs illnesses, as well as issues with neurological systems showing cognitive and nerve dysfunction, heart damage viral cardiomyopathy that can lead to congestive heart failure as well as kidney impairment that in astringent cases can lead to progressive kidney failure.

We have known that severe viral illnesses can lead to severe fatigue that can become debilitating, she said. Those are the major organ systems we already know can be damaged by severe viral illnesses with known viruses, so I plan to be monitoring my patients for the emergence of such problems as we go forward.

From Vliets purview, long-term consequences will more commonly be seen in older patients who have pre-existing conditions such as heart disease, kidney disease and pulmonary fibrosis.

And for those just weeks or months in recovery with now negative test results, it is not only the enduring physical ramifications such as reported breathlessness, lung pain, or fatigue that plague, but the psychological distress, isolation and fear of a relapse that medical professionals are monitoring.

From the original SARS outbreak in 2003, we see that psychiatric illness is the most notable long-term outcome, said Dr. Melissa Nolan, an infectious disease expert, and professor at the University of South Carolina. Including post-traumatic stress disorder and depression.

Berk concurred that anxiety, depression, and muscle weakness were also common.

But if the novel pathogen has proven anything to date, it is that uncertainty and outliers are its hallmarks.

It will also be very important to determine the level of antibody developed to coronavirus, as investigators also determine the level of antibody that guarantees protection against a second infection, Berk added.

Go here to read the rest:
Coronavirus crisis: What are the potential long-term health impacts? - New York Post

Recommendation and review posted by Bethany Smith

Young girl watching as mother uses spoon to serve meal, vegetarian food, family dinner time, healthy ... [+] eating

The novel coronavirus pandemic is unleashing havoc on every aspect of society medical, cultural, financial. Zooming in from macro to micro, we see that the viral outbreak is clearly impacting our day-to-day living including our eating patterns. Environmental stressors often do. Who hasnt participated in emotional eating? I certainly have! At this unprecedented time, stress levels are exceedingly high, and being sustained at this level for an indefinite length of time, as COVID-19 does not appear to dissipate anytime soon.

Eating While Stressed

According to a study by Yale researchers, stress may contribute to an increased risk for obesity and other metabolic diseases. Uncontrollable stress, in fact, changes eating patterns and the consumption of hyperpalatable foods, like those late-night Oreo cookies or Cool Ranch Doritos.

Our good habits are being challenged by our natural tendencies to snack more while at home which can include comfort foods, explained W. Scott Butsch, MD, MSc, Director of Obesity Medicine, Bariatric and Metabolic Institute at the Cleveland Clinic. That, together with a baking pandemic, could add more calories to the day.

High-sugar, processed foods increase the risk of metabolic syndrome, diabetes, heart disease and ... [+] obesity which increase our risk for infections such as COVID-19

Not all eating patterns have been unhealthy. In the wake of the COVID-19 pandemic, were eating out less frequently. No more work lunches or social dinners to fill up on endless appetizers and booze. But the stressors of this sudden new normal are also changing our dietary habits for the worse.

Theres a well-documented relationship between stress and weight gain, according to Julius Wilder, MD, PhD, Assistant Professor of Medicine at the Duke Division of Gastroenterology. Increased stress levels lead to a rise in the stress hormone, cortisol, which can result in an increased appetite. Dr. Wilder continued: The weight gain in the current pandemic is further accentuated by a decrease in daily exercise and an increase in alcohol consumption.

Does Stay at Home Translate to Binge at Home?

Since the start of the pandemic, public health professionals have been advising us to avoid social gatherings by staying home. During daily White House press briefings and on nearly every major news outlet the nations top infectious disease physician, Dr. Anthony Fauci, in his delightfully-prominent Brooklyn accent, has explained the rationale of physical distancing in reducing transmission of this highly infectious coronavirus. But have public health pundits inadvertently triggered a different health problem overeating?

Food is medicine. Healthy foods can help us fight infection. A poor diet, in contrast, can increase ... [+] inflammation and the development of metabolic syndrome, cancer and other chronic illnesses.

I think several emotions are at play here, Dr. Butsch reflected. More stress, more fear, more boredom lead to comfort foods, more snacking, more carbs.

Some folks are combating their boredom and loneliness by watching TV and movies, but that can be associated with mindless snacking of chips and popcorn as well as consumption of alcohol, all of which can contribute to weight gain.

Seven Ways to Maintain a Healthy Food Regimen

1.Take an Emotional Break. In the midst of SO much uncertainty, give yourself permission to indulge on your favorite cheesecake, parmesan truffle fries or Pinot Grigio! But in moderation perhaps a glass of wine each night or a few cookies per week.

2.Make a Schedule. Heres a sample: prepare breakfast (maybe a fruit smoothie or scrambled eggs); do a zoom meeting or other work; exercise at noon (see #5); grab a healthy snack (see #3); squeeze in some more work; make dinner; watch TV/movie, read, wind down.

Snacks can be healthy and delicious! Berries are high in antioxidants which can boost the immune ... [+] system.

3.Prepare healthy snacks. Im always snacking between meals, and there are plenty of healthy options. My favorites include carrot sticks; apple slices or celery sticks with peanut butter; and roasted almonds. Its also okay to indulge in your favorite sweet/salty treat (e.g. Kit Kat and Pringles are often in my kitchen)see #1.

4.Portion control. While at home, its easy to consume an entire large bag of potato chips or 6-pack of beer which can contribute to unintentional weight gain. Try to measure out portions of food and transfer into smaller bowls or plates.

Running, jogging or brisk walking - while physically distanced - are effective means of staying ... [+] healthy

5.Regular physical activity. Moderate exercise releases endorphins which reduce stress and improve mood. Simply walking for 20-30 minutes, getting out of the house, breathing fresh air can help de-stress, says Dr. Butsch.But home exercises can be just as effective check out the many fun and free YouTube workout videos! (Mike Chang is one of my favorites)

6.Get plenty of sleep. Studies supported by the National Institutes of Health suggest an association between sleep deprivation, weight gain and obesity. Poor sleep alters the levels of endocannabinoid which affect appetite and the brains reward system.

7.Mindful practice. Daily meditation can reduce stress, improve attention and help us be more mindful of our food choices. According to Harvard Health, mindful eating means being fully attentive to your food as you buy, prepare, serve and consume it. Next time youre cooking, bring all your senses to the meal smell the onions and garlic, feel the ripe tomato, hear the pepper shaker and taste the spices in your turkey chili.

A healthy diet is essential to boosting the body's immune system and ability to fight off ... [+] infections.

For many, unfortunately, food choices arent choices at all. People living in food deserts have limited options for fruits, vegetables, whole grains and lean meats. We need to invest in public health programs that enable marginalized communities access to healthy foods and other support services (preparation, storage, etc.)

Common sayings in clinical nutrition circles are food is medicine and you are what you eat. Both phrases resonate when one considers that the leading causes death heart disease, diabetes, cancer are largely preventable by following a healthier diet. Good nutrition is essential to a strong immune system which in turn will help shield us from, say, an infectious pathogen like the COVID-19 virus. But its also okay to treat yourself to a snack or drink that puts a smile on your face.

Read more:
Fighting The COVID-15: 7 Ways To Maintain A Healthy Weight During Social Isolation - Forbes

Recommendation and review posted by Bethany Smith

LifeGaines Medical and Aesthetics in Boca Raton serves South Floridians with age management therapies. Dr. Gaines discusses NAD's role in keeping a vibrant immune system. He is also conducting Physician Telehealth Consultations for those who want to achieve health and beauty goals during this time.

BOCA RATON, Fla., April 24, 2020 /PRNewswire/ --Dr. Gaines recently sent a message to his patients about keeping a healthy immune system, which also needs to be shared with the greater South Florida community.

NAD+'s Role in Keeping A Healthy Immune System

As people continue to cope with the pandemic, most people have thought about their immune system but have not considered the role NAD+ plays and how it can affect their response to a deadly virus.

NAD+ (Nicotinamide Adenine Dinucleotide)is a critical coenzyme found in every cell of one's body and helps the immune system function at its best by repairing and remodeling cells.

A viral infection causes free radicals to form which causes DNA damage. In order to repair DNA, the body needs high levels of NAD+. When people are young, high levels of NAD+ are present in their cells, but as people age, those levels deplete and can make people more susceptible to infection.

NAD+ IV therapyis a good solution to replenish one's NAD+ levels in the fight against viruses but it has many additional benefits. It is usually recommended in a series of 3 weekly treatments by LifeGaines, but will be customized based on each patient's specific needs. The NAD+ IV therapy is a slow drip process, so it takes time to enter into your system, generally 3-4 hours per treatment. NAD+ IV therapy can;

For more information on NAD+ IV Therapy, call the office of LifeGaines at (561) 931-2430.

Also, LifeGaines advises its patients to maintain their goals of health and beauty by participating in a telehealth consultation with Dr. Gaines.

Issues that can be addressed in a telehealth consultation:

Complimentary aesthetics consultations can determine someone's needs for:

Any new patient virtual appointment will receive10% off a future in-office service! Inquire about Telehealth consultations. Call (561) 931-2430.

Dr. Richard Gaines is the Chief Medical Officer of LifeGaines Medical and Aesthetics, an age management medical practice located in Boca Raton, FL. His new practice offers a complete regenerative medicine program for men and women, including hormone optimization, sexual health, as well as facial rejuvenation.

LifeGaines Medical & Aesthetics is located at 3785 N. Federal Hwy, Suite 150 Boca Raton, FL 33431. Go to http://www.lifegaines.comto learn more. For any media inquiries, contact Kellie Keitel at kellie@lifegaines.com.

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inquire-about-telehealth.png Inquire about Telehealth consultations. Call (561) 931-2430. LifeGaines Medical & Aesthetics is located at 3785 N. Federal Hwy, Suite 150 Boca Raton, FL 33431. Go to http://www.lifegaines.com to learn more.

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Recommendation and review posted by Bethany Smith

In the 10 years since Caster Semenya won the 2009 World Championships at just 18 years old, the sports world has whittled her story down to one thing: her body.

Narrow hips. Wide shoulders. Pronounced jawline. Manly.

Based on the tones of disgust used to discuss her physicality, one might think that Semeya is the only runner to ever possess a body that so greatly differed from everyone elses in the field. It seems the sports world has forgotten the peculiarities of Ira Murchisons stocky, 54 frame, which earned him both the nickname Human Sputnik and an Olympic gold medal in the 4x100. Or that world record-holder Usain Bolt was taller with longer legs than any of his competitors.

Unlike those men, Semenyas body is often deemed unwanted and out of place, most notoriously by her sports governing body. Throughout her career, World Athletics, formerly the International Association of Athletics Federations, has insisted she undergo intrusive testing and hormone regulation, and ultimately banned her from competition after instituting rule changes that seemingly targeted her in 2019.

But Semenya is not alone. Burundian runner Francine Niyonsaba, one of Semenyas competitors in the 800-meter run, has since revealed she is one of a growing number of female athletes, mostly from the Global South, whose hyperandrogenism puts them directly in the crosshairs of World Athletics regulations. Former top junior-athlete Annet Negesa, an intersex runner from Uganda, recently disclosed that she underwent invasive surgery at the behest of World Athletics doctors to ensure she could continue competing. Complications from the procedure left her damaged both mentally and physically.

Underlying this harsh, discriminatory treatment is not simply an adherence to faulty biological metrics or antiquated, binary conceptions of gender, though these aspects have undoubtedly played a role. In fact, sex verification practices originated in the 1950s out of the as yet unfounded suspicion that some countries were allowing men to compete disguised as women, and involved little more than asking athletes to remove their undergarments. (Some of the athletes subjected to this scrutiny, like 1932 Olympic gold medalist Stella Walsh, were discovered to have genetic conditions resembling intersex characteristics.)

Semenyas treatment is rooted in something far more disturbing. As early as the 16th century, European explorers who made their way to the African continent began remarking on the anatomical features of the populations they encountered. To the Europeans, the dark skin, strong builds, and wide lips and noses they encountered resembled those of apes, so much so that they began perpetuating the idea that Africans regularly copulated with monkeys. Over time, such beliefs took on a more gendered tone, with comparisons made between African and European women that not only promoted arbitrary markers of racial difference and inferiority, but also justified the exclusion of African women from the category of woman altogether.

World Athletics remains committed to a centuries-old, white supremacist notion that defines womanhood in terms of the white, cisgendered female body, rendering everyone else, especially women of African descent, socially unacceptable abberations.

World Athletics describes its mission as fostering athletic excellence and enhancing sport to offer new and exciting prospects for athletes. Yet it has historically done so by enabling vile attitudes towards black women and the bodies they inhabit.

In 1897, just 15 years before World Athletics was founded, British missionary Sir Albert Cook, a medical doctor by training, wrote broadly and unabashedly about his ethically dubious biopsies of women in present-day Uganda, remarking:

Who has not been struck by the extraordinary narrowness of the Negroid hip? Viewed behind in the erect position at the level of hips the female Negroid body is narrow and round as compared with the broad beam of the average European woman, and when the dried pelvises of each are placed alongside each other the explanation is obvious, the Mugandas bone looks like that of a child in size and in the fineness of its structure.... The negroid races have a shape of pelvis which is intermediate between the protomorphean races and those of the higher civilised types.... The brim, as in the apes, is longoval in shape.

It is difficult to overemphasize how critical Cooks now-disproven studies were in the development of racialized ideas around femaleness and womanhood, and ultimately the dehumanization of black womens bodies. He would become a two-time president of the British Medical Association and was knighted by way of King George V after his studies of African womens anatomy became popular. Cook exemplified to the colonizing world the knowledge that could be seized upon through engagement with the African other.

Before Cook, Sarah Baartman, more commonly known by her derogatory nickname The Hottentot Venus, encompassed Western societys fixation on black womens bodies. Captured and enslaved in what is now South Africa (Semenyas home country), Baartman was brought to Europe in 1810 and exhibited in circuses and public squares until her death, when scientists assessed and dissected her elongated labia. That work was promoted as more evidence that black womens so-called deficiencies made them less womanly than their white counterparts.

The impact of such ideas can still be seen today within the medical community through widespread diagnoses of labial hypertrophy, a medical term for an elongated labia, despite the fact it is not a major (nor, for the most part, even minor) health concern. The rise of labiaplasties a procedure that shortens and reduces the overall length and size of the labia reifies the idea that the legitimacy of female genitalia should be defined by its distance from the physiology of the black, female body.

And while some might dismiss the relevance of these concepts today, chalking them up to a long-ago historical era of overt racism, they nonetheless helped Europeans institutionalize racism in areas like sports. As a result, the medical knowledge that informs society and World Athletics standard of womanhood is deeply rooted in racism, to the extent that black women like Semenya, Niyonsaba, and Negesa never really stood a chance.

Take sex hormones, for example. The idea that there are racial differences in testosterone and estrogen levels, particularly between black and white groups, is widely held yet highly controversial. The belief that black women are more masculine than just about every other race of women is rooted in the 17th and 18th centuries, and based on the notion that people of African descent are animalistic and aggressive. Fast forward to 1995, when popular psychologist J. Philippe Rushton argued that black people are less intelligent and more impulsive than white and Asian people, in large part due to their heightened levels of testosterone. Though Rushtons work has been subjected to criticism over the years, his book Race, Evolution, and Behavior is in its third edition. Rushton himself was elected to the prestigious Canadian Psychological Association, and received a one-time Guggenheim fellowship. Scientists have spent the last few decades refuting Rushtons claims, and ironically fanning the flames of racial pseudoscience.

Some studies suggest that among older women in the U.S., black women possess lower levels of estradiol, a form of the female sex hormone estrogen, than white women. On the surface, this may appear to be the source of World Athletics highly racialized policies. But it is important to note few studies have assessed racialized hormone disparities among women of different races, and even fewer studies with results that can actually be replicated. More common, as one might imagine, are studies that explore racial differences in sex hormones among men. Some show, contrary to popular belief, testosterone levels are quite similar between black and white men, while free estradiol levels are much higher in black men than men of other races. But even those results have been questioned by endocrinologists, biologists, and doctors due to conflicting studies in the field.

World Athletics relative lack of interest in variance in mens bodies illustrates, by contrast, just how disproportionately unfair it has acted towards women. In his 1996 book Darwins Athletes, historian John Hoberman argues this discrepancy is due to a fixation on black athletic aptitude that goes back centuries. In 1851, physician Samuel Cartwright wrote that, It is not only in the skin that a difference of color exists between the negro and the white man, but in the membranes, the muscles, the tendons, and in all the fluids and secretions. Cartwrights work, which Hoberman claims was read widely by slaveholders, gave (pseudo-) scientific, biological justification for maintaining racial hierarchy and slavery, even as moral opposition grew in other parts of the United States. Implicit in Cartwrights work was the idea that black mens physicality is acceptable only when it can be manipulated for profit.

Today, we see Cartwrights legacy in sports. Exceptional male bodies, often characterized by great strength and size, often inspire awe, and not ire, because for the last century sports institutions have forged and refined mechanisms to make money off of them. Strong womens bodies, however, havent yet been nearly as profitable, and thus have been much more easily derided.

From an interracial lens, black athletes are only considered worthy of wealth once theyve proven their value beyond any reasonable standard. Until then, they are denied the same fame, wealth, and recognition that white competitors more easily receive. In their analysis of the rise of Kenyan athletes in the middle and long distance winners circle, John Bale and Joe Sang show that, when confronted with the domination of African-American sprinters from the top of the 20th century onward, white sprinters from Europe quietly retreated to the longer distances while sports writers claimed black athletes lacked the stamina and strategic acumen to succeed in those races. Further, when black athletes began performing better than whites, race officials would either give white athletes another opportunity to run, or disqualify the faster times run by their black counterparts. Such was the case when African runners Humphrey Khosi and Bennett Makgamathe bested white runners in a 1962 meet held in Mozambique, but were denied victory by officials.

Now, World Athletics has established development centres throughout Africa and many other parts of the Global South, hoping to recruit and cultivate the very talent it once sought to restrict from success in competition. Some argue that regional development centres are actually a way to export these athletes to the West so that they can compete for nations like Britain and France. And still, these centres cater to the cultivation of male athletes, leaving women behind even in countries with more liberal attitudes towards womens participation in sports.

World Athletics simply sees little use in acknowledging and developing female talent, particularly black female talent in the Global South. As exemplifiers of a particular strain of racialized thinking, those women, to them, are not real women. And when World Athletics refuses to elevate the athletic prowess of a black woman, within a body that defies centuries of white supremacist, colonial, gender-essentialist myths, it chooses, instead, to humiliate her on every level.

In this era of sports and protest, perhaps a movement of solidarity from other runners could rise up, forcing World Athletics to reevaluate its stance. But track and field is still an intense, cutthroat competition. Many contestants instead see a chance to fill a void atop the podium, or worse, proliferate their own racism without fear of backlash. British middle-distance runner Jemma Simpson described racing with Semenya as literally running against a man. Australian Madeleine Pape recently defended Semenya, and expressed regret at having joined the chorus of voices condemning her performance as unfair. Black female athletes from sub-Saharan Africa occupy a position of heightened marginality; the chances of them receiving widespread support were miniscule from the jump. Ironically as some of the worlds fastest runners, they havent been able to garner the momentum needed to create a different outcome.

And yet, these women shouldnt need to advocate for themselves. As society continues to confront the racial legacies of social institutions in other ways, sports organizations like World Athletics have a clear opportunity to address the harm done as a result of the implementation of racist, sexist ideas. No more hiding behind biased science, doctors, and metrics. Semenya, Niyonsaba, Negesa, and other African female athletes with hyperandrogenism need not alter or manipulate themselves to fit ideals of womanhood that were constructed explicitly around their exclusion. Their bodies are simply not the problem.

They never were.

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Caster Semenya and the cruel history of contested black femininity - SB Nation

Recommendation and review posted by Bethany Smith

Dr. Lori Brotto and Dr. Peter Leung, professors in the UBC department of obstetrics and gynaecology, and Dr. Kendall Ho, professor in the department of emergency medicine, have been awarded the 2019 Faculty of Medicine Distinguished Researcher Awards. The annual awards recognize faculty who have made significant contributions in basic science research in the areas of health and life sciences, as well as clinical and applied research to improve health outcomes of populations.

Dr. Lori Brotto

Dr. Lori Brotto, the Canada Research Chair in Womens Sexual Health at UBC and executive director of the Womens Health Research Institute, was recognized for her contributions to the field of womens sexual health and mental health. Her research has influenced the assessment and treatment of sexual dysfunction around the world.

It is such an honour to receive this award because it recognizes the important contributions that psychology makes to the field of medicine, and I am proud that our evidence-based psychological treatments have been implemented in so many medical centres, Dr. Brotto said. Moreover, to be recognized for my research in womens health is so important because womens health continues to be misunderstood, misdiagnosed, and dismissed. In my mind, research is the route towards ending these gender-based biases, and I am happy that my research has played one small part in doing so.

Dr. Brottos research has also influenced local clinical practice through the introduction of psychological skills training for treating womens chronic genital pain in hospital-based programs. Her recommendations for mindfulness and psychological approaches to treating sexual dysfunction have also appeared in the International Consultation on Sexual Medicine. Dr. Brotto has published her research in more than 170 peer-reviewed publications, regularly participates in media interviews, and wrote Better Sex Through Mindfulness to translate her research to the public. Dr. Brotto is a Fellow of the Royal Society of Canada and the College of New Scholars, Artists and Scientists.

Dr. Peter C.K. Leung

Dr. Peter C.K. Leung, the faculty of medicines former associate dean of graduate and postdoctoral education, was recognized for his work in womens reproductive biology and medicine. Dr. Leungs research seeks to understand hormonal factors in womens reproductive health and improve the treatment of reproductive health and gynaecologic cancers

This honour is a recognition of the collective efforts of a great many postdoctoral researchers, graduate students, staff and visiting scholars who I have been privileged to work with, said Dr. Leung. Their talents and dedication to scientific pursuit are deeply appreciated.

Dr. Leung has received worldwide recognition for discovering and categorizing the human gene encoding the genadotrophin-releasing hormone receptor (GnRH), which is a key regulator of reproduction. His findings have influenced further research and clinical practice, including treatments and therapies for infertility, endometriosis and uterine fibroids, as well as prostate cancer. Dr. Leung has established international academic and research partnerships between UBC and top universities, and published more than 420 peer-reviewed papers in academic journals. He has received the Medical Research Council of Canada Scientist and Michael Smith Foundation for Health Research Distinguished Scholar awards among many others. Dr. Leung is a Fellow of the Royal Society of Canada and Canadian Academy of Health Sciences.

Dr. Kendall Ho

Dr. Kendall Ho, the lead investigator for Digital Emergency Medicine at UBC and an attending emergency physician at Vancouver General Hospital, was recognized for his contributions to research in digital health. Dr. Ho leads a research program integrating digital applications to enhance health outcomes of diverse patient populations.

I am very honoured and humbled to be selected for this award, Dr. Ho said. I feel very fortunate to be in the field of emergency medicine, being a member of the UBC faculty of medicine, and pursuing my vocation in Canada. All of these factors allow me to develop my scholarship and knowledge translation in digital health with strong clinical grounding, fertile innovative milieu, rich contexts of care, and meaningful partnerships across Canada and globally, so as to make positive impact to patient care. This award recognizes this diverse tapestry upon which I am nurtured and grow as a clinician-researcher.

Dr. Ho is a national leader in digital health with an extensive clinician-researcher career. His most recent project, TEC4Home, investigates home monitoring of patients with heart failure to help improve the lives of patients through digital health practices. Dr. Hos research regularly informs provincial and national health policy-making organizations, such as the B.C. Ministry of Health and Health Canada, on digital health. He has significantly impacted the training of health professionals in digital health, as well as published more than 100 articles in peer-reviewed journals. Dr. Ho is a Fellow of the Canadian Academy of Health Sciences and has received numerous awards and recognition, including, most recently, the Canadian Medical Association Physician Changemaker.

More here:
Three faculty members recognized for outstanding contributions to health research - UBC Faculty of Medicine

Recommendation and review posted by Bethany Smith

It was noticeable from the initial outbreak in Wuhan that Covid-19 was killing more men than women. By February, data from China, which involved 44,672 confirmed cases of the respiratory disease, revealed the death rate for men was 2.8%, compared to 1.7% among women. For past respiratory epidemics, including Sars, Mers and the 1918 Spanish flu, men were also at significantly greater risk. But why?

Much of the reason for the Covid-19 disparity was put down to mens riskier behaviours around half of Chinese men are smokers, compared with just 3% of women, for instance. But as the coronavirus has spread globally, its proved deadlier to men everywhere that data exists (the UK and US notably and questionably do not collect sex-disaggregated data). Italy, for instance, has had a case fatality rate of 10.6% for men, versus 6% for women, whereas the sex disparity for smoking (now a known risk factor) is smaller there than China 28% of men and 19% of women smoke. In Spain, twice as many men as women have died. Smoking, then, is unlikely to account for all of the sex disparity in Covid-19 deaths.

Age and co-morbidity (pre-existing health conditions, including diabetes, cardiovascular disease or cancer) are the biggest risk factors, and that describes more older men than women. There may also be a sex difference in how people fight infection, due to immunological or hormonal differences oestrogen is shown to increase the antiviral response of immune cells.

If women are mounting a more effective immune response to Covid-19, it could be because many of the genes that regulate the immune system are encoded on the X chromosome. Everybody gets one X chromosome at conception from their mother. However, sex is determined (for the vast majority) by the chromosome received from their father: females get an additional X, whereas males do not (they receive a Y). According to The Better Half by American physician Sharon Moalem, having this second X chromosome gives women an immunological advantage. Every cell in a womans body has twice the number of X chromosomes as a mans, and so twice the number of genes that can be called upon to regulate her immune response, he says. Only one of the X chromosomes in each cell will be active at any time, but having that diversity of options gives women a better immunological toolbox to fight infections.

Moalem describes the possession of XX chromosomes as female genetic superiority. In the case of Covid-19, for instance, the virus uses its spike protein as a key to unlock a receptor protein on the outside of our human cells, called ACE-2, and gain entry. As the ACE-2 protein is on the X chromosome, men will have identical versions of ACE-2 on all their cells if the virus can unlock one, it can unlock all, he wrote recently in a Twitter thread. Women, though, have two different ACE-2 genes on their two X chromosomes, which may make it harder for the Covid-19 virus to break into all their cells, as it has to unlock two different proteins. Furthermore, once the ACE-2 is unlocked, it cannot perform its function, which, in the case of lung cells, is to clear fluid buildup during infection. So males, with all of their ACE-2 proteins affected, will suffer this more than females, he says. Moalem believes this may be the crucial advantage that XX-carrying women have over XY-carrying men in Covid-19 infection mortality.

Its an intriguing theory, and in his provocative book (written before the Covid-19 outbreak) Moalem expands the XX advantage to explain a whole range of life factors, from womens increased longevity to their lesser incidence of autism. It is incontrovertible that women are far less likely to suffer from X-linked genetic disorders, which include everything from Hunter syndrome to colour-blindness, because they usually have an unaffected X chromosome to fall back on. Indeed, in the case of colour vision, Moalem posits that having a second X chromosome can give some women a visual superpower, enabling them to see 100 times the usual colour range due to the extra diversity of receptors they carry on their multiple Xs.

It is striking that Moalem barely references environmental and social factors in a book about sex differences in health outcomes

However, the evidence for other of Moalems claims for the protective role of a second X chromosome, such as in autism spectrum disorders or behavioural traits, is less convincing. A broad range of genes play complex roles in the workings of the brain, and attributing a simple chromosomal relationship is brave. (It should be noted that Moalem authored the questionable The DNA Restart: Unlock Your Personal Genetic Code to Eat for Your Genes, Lose Weight, and Reverse Ageing in 2016.)

Outside of inherited genetic disorders, such as haemophilia, most conditions are attributable to a range of factors, including cultural norms, behaviours and social and environmental aspects as well as a host of biological factors. For Covid-19, for instance, gender-based norms around smoking and hand-washing, collective or individualistic mindsets that affect compliance with social-distance requests, how polluted your city is, whether you are a caregiver, and poverty and nutrition level all play a part in determining your infection risk and disease outcome. And, as weve seen, a range of co-morbidities increase risk are they too made more likely by absence of a second X chromosome? In many cases, such as cancers and lung disease, Moalem believes so a fascinating theory that surely deserves more study.

It is striking, though, that Moalem barely references environmental and social factors in a book about sex differences in health outcomes. This is particularly problematic when discussing sex differences in the brain, given the history of prejudicial research in this area. Much as this reviewer enjoys the rare pleasure of being described as the stronger, better, and superior sex certainly it is a change from being described as the weaker sex, as women have throughout history it is nevertheless an uncomfortable valuation. Claims for significant innate cognitive or behavioural advantages between the sexes have largely been debunked in the past few years by a range of influential books and research, and while there are differences, in most cases these are at least as great between individuals of each sex as between the sexes.

This is, however, a book that openly champions women, and it is most enjoyable when giving centre stage to female scientists, who have been too often overlooked. Moalems point is that, just as womens discoveries have been ignored, so too has the importance of their second X chromosome. Even today, medical and pharmaceutical research overwhelmingly favours male subjects, blinding us to knowledge that could lead to breakthroughs, and disadvantaging women who suffer inappropriate treatments and dosing. As men continue to fill the Covid-19 morgues faster than women, Moalem is on a quest to draw the worlds attention to a chromosomal tool we might just need.

Originally posted here:
The Better Half: On the Genetic Superiority of Women review bold study of chromosomal advantage - The Guardian

Recommendation and review posted by Bethany Smith

In Global Male Breast Cancer Treatment Market Research Report, the study analysis was given on a worldwide scale, for instance, present and traditional Male Breast Cancer Treatment growth analysis, competitive analysis, and also the growth prospects of the central regions. The report gives an exhaustive investigation of this market provides an analysis of the industry trends in each of the sub-segments, from sales, revenue and consumption. A quantitative and qualitative analysis of the main players in Global and country level is introduced, from the perspective of sales, revenue and price.

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Snapshot:The global Male Breast Cancer Treatment market size is estimated at xxx million USD with a CAGR xx% from 2015-2019 and is expected to reach xxx Million USD in 2020 with a CAGR xx% from 2020 to 2025. The report begins from overview of Industry Chain structure, and describes industry environment, then analyses market size and forecast of Male Breast Cancer Treatment by product, region and application, in addition, this report introduces market competition situation among the vendors and company profile, besides, market price analysis and value chain features are covered in this report.

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HospitalsClinicsOthers

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At the upcoming section, this report discusses industrial policy, economic environment, in addition cost structures of the industry. And this report encompasses the fundamental dynamics of the market which include drivers, opportunities, and challenges faced by the industry. Additionally, this report showed a keen market study of the main consumers, raw material manufacturers and distributors, etc.

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Table of Content1 Industry Overview2 Industry Environment (PEST Analysis)3 Male Breast Cancer Treatment Market by Type4 Major Companies List5 Market Competition6 Demand by End Market7 Region Operation8 Marketing & Price9 Research Conclusion

About us:Research is and will always be the key to success and growth for any industry. Most organizations invest a major chunk of their resources viz. time, money and manpower in research to achieve new breakthroughs in their businesses. The outcome might not always be as expected thereby arising the need for precise, factual and high-quality data backing your research. This is where MART RESEARCH steps in and caters its expertise in the domain of market research reports to industries across varied sectors.

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Global Male Breast Cancer Treatment Market by Disease Overview, Trends, Symptoms, Etiology, Diagnostic Methods, Insight, Epidemiology, Drug &...

Recommendation and review posted by Bethany Smith

Scrolling through social media, reading your favorite magazine, or visiting popular websites exposes you to endless information about nutrition and health most of which is incorrect.

Even qualified health professionals, including doctors and dietitians, are to blame for spreading misinformation about nutrition to the public, adding to the confusion.

Here are 20 of the biggest myths related to nutrition, and why these antiquated beliefs need to be put to rest.

Though creating a calorie deficit by burning more energy than you take in is the most important factor when it comes to weight loss, its not the only thing that matters.

Relying solely on calorie intake doesnt account for the large number of variables that may prevent someone from losing weight, even when on a very low calorie diet.

For example, hormonal imbalances, health conditions like hypothyroidism, metabolic adaptations, the use of certain medications, and genetics are just some of the factors that may make weight loss harder for some people, even when theyre on a strict diet (1, 2).

This concept also fails to emphasize the importance of sustainability and diet quality for weight loss. Those following the calories in, calories out method typically concentrate solely on the calorie value of foods, not their nutrient value (3).

This can lead to choosing low calorie, nutrient-poor foods like rice cakes and egg whites over higher calorie, nutrient-dense foods like avocados and whole eggs, which isnt the best for overall health.

The calories in, calories out theory doesnt account for several variables that may prevent someone from losing weight. Many factors, such as genetics, medical conditions, and metabolic adaptations, make weight loss much harder for some.

Though this antiquated and incorrect theory is slowly being put to rest, many people still fear high fat foods and follow low fat diets in the hopes that cutting their fat intake will benefit their overall health.

Dietary fat is essential for optimal health. Plus, low fat diets have been linked to a greater risk of health issues, including metabolic syndrome, and may lead to an increase in insulin resistance and triglyceride levels, which are known risk factors for heart disease (4, 5).

Whats more, diets that are higher in fat have been proven just as effective or even more so than low fat diets when it comes to encouraging weight loss (6, 7).

Of course, extremes in either direction, whether it be a very low fat or very high fat diet, may harm your health, especially when diet quality is poor.

Many high fat foods are extremely nutritious and can help you maintain a healthy weight.

While it was once thought that eating breakfast was one of the most important factors in setting yourself up for a healthy day, research has shown that this might not be the case for most adults (8).

For instance, research indicates that forgoing breakfast may result in reduced calorie intake (9).

Moreover, partaking in intermittent fasting, during which breakfast is either skipped or consumed later in the day, has been linked to a plethora of benefits, including improved blood sugar control and reductions in inflammatory markers (10, 11, 12).

However, intermittent fasting can also be accomplished by consuming a regular breakfast then having your last meal earlier in the evening to maintain a fasting window of 1416 hours.

Keep in mind that this does not apply to growing children and teens or those with increased nutrient needs, such as pregnant women and those with certain health conditions, as skipping meals may lead to negative health effects in these populations (13, 14).

On the other hand, some evidence shows that eating breakfast and consuming more calories earlier in the day rather than at night, coupled with reduced meal frequency, may benefit health by reducing inflammation and body weight (15).

Regardless, if you enjoy breakfast, eat it. If youre not a breakfast person, dont feel the need to add it to your daily routine.

Eating breakfast is not necessary for everyone. Health benefits are associated with both eating breakfast and skipping it.

Eating small, frequent meals regularly throughout the day is a method used by many people to boost metabolism and weight loss.

However, if you are healthy, the frequency of your meals does not matter as long as you meet your energy needs.

That said, those with certain medical conditions, such as diabetes, coronary artery disease, and irritable bowel syndrome (IBS), as well as those who are pregnant, may benefit from eating more frequent meals.

Eating frequent meals throughout the day is not the best way to promote weight loss. Research shows that a regular meal pattern may be best for health.

The rising interest in low calorie, low carb, sugar-free foods has led to an increase in products that contain non-nutritive sweeteners (NNS). While its clear that a diet high in added sugar significantly increases disease risk, intake of NNS can also lead to negative health outcomes.

For example, NNS intake may increase your risk of type 2 diabetes by leading to negative shifts in gut bacteria and promoting blood sugar dysregulation. Whats more, regular NNS intake is associated with overall unhealthy lifestyle patterns (16, 17).

Keep in mind that research in this area is ongoing, and future high quality studies are needed to confirm these potential links.

Non-nutritive sweeteners may lead to adverse health outcomes, such as an increased risk of type 2 diabetes and negative changes to gut bacteria.

Although macro coaches may lead you to believe that the ratio of macronutrients in your diet is all that matters when it comes to weight loss and overall health, this narrow-minded take on nutrition is missing the bigger picture.

While tweaking macro ratios can benefit health in many ways, the most important factor in any diet is the quality of the foods you eat.

Though it may be possible to lose weight by eating nothing but highly processed foods and protein shakes, focusing solely on macronutrients discounts how eating certain foods can either increase or decrease metabolic health, disease risk, lifespan, and vitality.

Although tweaking macro ratios can be helpful in some ways, the most important way to promote overall health is to follow a diet rich in whole, unprocessed foods, regardless of the macro ratio.

Often labeled as unhealthy by those in the nutrition world, white potatoes are restricted by many people wanting to lose weight or improve their overall health.

While eating too much of any food including white potatoes can lead to weight gain, these starchy tubers are highly nutritious and can be included as part of a healthy diet.

White potatoes are an excellent source of many nutrients, including potassium, vitamin C, and fiber.

Plus, theyre more filling than other carb sources like rice and pasta and can help you feel more satisfied after meals. Just remember to enjoy potatoes baked or roasted, not fried (18, 19).

White potatoes are a nutritious carb choice just be sure to enjoy them in more healthful ways, such as roasted or baked.

Take a trip to your local grocery store and youll find a variety of products labeled diet, light, low fat, and fat-free. While these products are tempting to those wanting to shed excess body fat, theyre typically an unhealthy choice.

Research has shown that many low fat and diet items contain much more added sugar and salt than their regular-fat counterparts. Its best to forgo these products and instead enjoy small amounts of foods like full fat yogurt, cheese, and nut butters (20, 21).

Low fat and diet foods are typically high in sugar and salt. Unaltered higher fat alternatives are often a healthier choice.

While focusing on consuming a nutrient-dense, well-rounded diet is the most essential component of health, supplements when used correctly and in the right form can be beneficial in many ways.

For many, especially those with health conditions like type 2 diabetes, as well as those who take common medications like statins, proton pump inhibitors, birth control, and antidiabetic medications, taking specific supplements can significantly affect their health (22, 23, 24).

For example, supplementing with magnesium and B vitamins has been shown to benefit those with type 2 diabetes by enhancing blood sugar and reducing heart disease risk factors and diabetes-related complications (25, 26).

Those on restrictive diets, people with genetic mutations like methylenetetrahydrofolate reductase (MTHFR), people over the age of 50, and pregnant or breastfeeding women are other examples of populations that may benefit from taking specific supplements.

Supplements are useful and often necessary in many populations. The use of common medications, age, and certain medical conditions are just some of the reasons why supplements may be needed for some people.

While reducing calorie intake can indeed boost weight loss, cutting calories too low can lead to metabolic adaptations and long-term health consequences.

Though going on a very low calorie diet will likely promote rapid weight loss in the short term, long-term adherence to very low calorie diets leads to a reduction in metabolic rate, increased feelings of hunger, and alterations in fullness hormones (27).

This makes long-term weight maintenance difficult.

This is why studies have shown that low calorie dieters rarely succeed in keeping excess weight off in the long term (27).

Very low calorie diets lead to metabolic adaptations that make long-term weight maintenance difficult.

Obesity is associated with many health conditions, including type 2 diabetes, heart disease, depression, certain cancers, and even early death (28, 29).

Still, reducing your disease risk does not mean you have to be skinny. Whats most important is consuming a nutritious diet and maintaining an active lifestyle, as these behaviors often improve your body weight and body fat percentage.

Though obesity increases your risk of disease, you dont have to be skinny to be healthy. Rather, maintaining a healthy body weight and body fat percent by consuming a nutritious diet and maintaining an active lifestyle is most important.

Many people are told to pop calcium supplements to keep their skeletal system healthy. However, current research has shown that supplementing with calcium may do more harm than good.

For example, some studies have linked calcium supplements to an increased risk of heart disease. Additionally, research shows that they dont reduce the risk of fracture or osteoporosis (30, 31).

If youre concerned about your calcium intake, its best to focus on dietary sources of calcium like full fat yogurt, sardines, beans, and seeds.

Although medical professionals commonly prescribe calcium supplements, current research shows that these supplements may do more harm than good.

Many people struggle with getting adequate dietary fiber, which is why fiber supplements are so popular. Although fiber supplements can benefit health by improving bowel movements and blood sugar control, they should not replace real food (32).

High fiber whole foods like vegetables, beans, and fruit contain nutrients and plant compounds that work synergistically to promote your health, and they cant be replaced by fiber supplements.

Fiber supplements should not be used as a replacement for nutritious, high fiber foods.

Certain juices and smoothies are highly nutritious. For example, a nutrient-dense smoothie or freshly made juice composed primarily of non-starchy vegetables can be a great way to increase your vitamin, mineral, and antioxidant intake.

Yet, its important to know that most juices and smoothies sold at stores are loaded with sugar and calories. When consumed in excess, they can promote weight gain and other health issues like tooth decay and blood sugar dysregulation (33, 34, 35).

Many store-bought juices and smoothies are packed with added sugar and calories.

Probiotics are amongst the most popular dietary supplements on the market. However, practitioners generally overprescribed them, and research has demonstrated that some people may not benefit from probiotics like others do (36).

Not only are some peoples digestive systems resistant to probiotic colonization, but introducing probiotics through supplements may lead to negative changes in their gut bacteria.

Plus, bacterial overgrowth in the small intestine related to probiotic use can lead to bloating, gas, and other adverse side effects (37).

Additionally, some studies show that probiotic treatment following a course of antibiotics may delay the natural reconstitution of normal gut bacteria (38).

Instead of being prescribed as a one-size-fits-all supplement, probiotics should be more personalized and only be used when a therapeutic benefit is likely.

Current research suggests that probiotic supplements may not benefit everyone and should not be prescribed as a one-size-fits-all supplement.

Dont be fooled by the dramatic before and after pictures used by supplement companies and stories of rapid weight loss attained with little to no effort.

Weight loss is not easy. It requires consistency, self-love, hard work, and patience. Plus, genetics and other factors make weight loss much harder for some than others.

If youre struggling to lose weight, youre not alone. The best thing to do is drown out the weight loss noise that youre exposed to every day and find a nourishing and sustainable dietary and activity pattern that works for you.

Weight loss is difficult for most people and requires consistency, self-love, hard work, and patience. Many factors may influence how easy it is for you to lose weight.

Theres no need to obsess over your calorie intake and track every morsel of food that passes your lips to lose weight.

Although food tracking can be a useful tool when trying to lose excess body fat, its not right for everyone.

Whats more, being overly preoccupied with food by tracking calories has been associated with an increased risk of disordered eating tendencies (39).

Although tracking calories may help some people lose weight, its not necessary for everyone and may lead to disordered eating tendencies.

Cholesterol-rich foods have gotten a bad rap thanks to misconceptions about how dietary cholesterol affects heart health.

While some people are more sensitive to dietary cholesterol than others, overall, nutrient-dense, cholesterol-rich foods can be included in a healthy diet (40).

In fact, including cholesterol-rich, nutritious foods like eggs and full fat yogurt in your diet may boost health by enhancing feelings of fullness and providing important nutrients that other foods lack (41, 42, 43).

High cholesterol foods like eggs and full fat yogurt are highly nutritious. Although genetic factors make some people more sensitive to dietary cholesterol, for most people, high cholesterol foods can be included as part of a healthy diet.

Many people assume that eating disorders and disordered eating tendencies only affect women. In reality, adolescent and adult men are also at risk.

Whats more, over 30% of adolescent men in the United States report body dissatisfaction and the use of unhealthy methods to attain their ideal body type (44).

Its important to note that eating disorders present differently in men than women, and theyre more prevalent in adolescent and young adult men who are gay or bisexual, highlighting the need for eating disorder treatments that are better adapted to the male population (44, 45).

Eating disorders affect both men and women. However, eating disorders present differently in men than women, highlighting the need for eating disorder treatments that are better adapted to the male population.

Just as fat has been blamed for promoting weight gain and heart disease, carbs have been shunned by many people over fears that consuming this macronutrient will cause obesity, diabetes, and other adverse health effects.

In reality, eating a moderate amount of nutritious carbs that are high in fiber, vitamins, and minerals like starchy root vegetables, ancient grains, and legumes will likely benefit your health not harm it.

For example, dietary patterns that contain a balanced mix of high fiber carbs mainly from produce, healthy fats, and proteins, such as the Mediterranean diet, have been associated with a reduced risk of obesity, diabetes, certain cancers, and heart disease (46, 47).

However, carb-rich foods like cakes, cookies, sweetened beverages, and white bread should be restricted, as these foods can increase weight gain and disease risk when eaten in excess. As you can see, food quality is the main predictor of disease risk (48).

Including healthy carb choices in your diet wont make you gain weight. However, following unhealthy eating patters and overindulging in carb-rich sugary foods will lead to weight gain.

The nutrition world is rife with misinformation, leading to public confusion, mistrust of health professionals, and poor dietary choices.

This, coupled with the fact that nutrition science is constantly changing, makes it no wonder that most people have a warped view of what constitutes a healthy diet.

Although these nutrition myths are likely here to stay, educating yourself by separating fact from fiction when it comes to nutrition can help you feel more empowered to develop a nutritious and sustainable dietary pattern that works for your individual needs.

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The Top 20 Biggest Nutrition Myths - Healthline

Recommendation and review posted by Bethany Smith

Ligers (the offspring of a female tiger mixed with a male lion) or tigons (a female lion plus a male tiger) are unnatural crossbreeds that dont exist in the wild. They have no conservation value and usually suffer from health problems because of the inbreeding. As noted by National Geographic, the number of ligers and white tigers seen in the docuseries were examples of problematic overbreeding. Whatsmore, because ligers and tigons arent pure tigers, theyre not protected by endangered species regulations.

This is a problem because there is truly no regulatory body on the care, treatment, or management of tigers in captivity, and these privately bred tigers are considered generic tigers by the United States Fish and Wildlife Service, Cancellare said. As a result, they are currently exempt from the captive-bred wildlife registration program under the U.S. Endangered Species Act. There is talk of changing this exemption, thankfully, but until then, it means it's still really easy to get and breed tigers.

In general, Guynup said the overbreeding leads to poor care and living conditions for the captive tigers. She said issues have included rodent-infested enclosures, animals living in putrid standing water, uncared for injuries and illnesses, and inadequate food. The tiger cubs can legally only be used for petting until theyre about 12 weeks old, according to the U.S. Agriculture Department. That short window of time for petting also becomes an incentive for overbreeding. After that, they become too dangerous.

It presents a public safety issue because big cats are powerful predators who retain their natural instincts, Block said. They can and do injure and kill people, and they take every opportunity to escape. There have been many dangerous incidents involving privately owned big cats. Wild animals do not belong in captivity.

So, how can you know if a sanctuary is legit or just a roadside zoo using buzz words? It comes down to the venues goals.

A legitimate wildlife sanctuary or rescue center does not breed, buy, sell, offer any public contact with or take animals off-site for exhibition, Block said. Tigers and other wild animals have unique and complex needs. Providing decades of appropriate care requires substantial resources.

Additionally, tigers at sanctuaries are provided with proper nutrition and vet care. The animals at these facilities are also kept for life.

As Guynup puts it, venues accredited by the Big Cat Sanctuary Alliance the Global Federation of Animals meet the criteria for a true sanctuary. You can check a facilitys certifications for yourself by visiting their respective lists of sanctuaries or members. To qualify as a member of the Big Cat Sanctuary Alliance, establishments have to provide lifelong care for abused, neglected, unwanted, impounded, abandoned, orphaned, or displaced wild cats. The Global Federation of Animals requirements are even more extensive: Standards are spelled out depending on the breed but include specifications regarding the quality of the applicants enclosure, sanitation, temperature control, nutrition, veterinary care, and more.

Tiger Kings Carole Baskins Big Cat Rescue is certified by both groups, but that isnt mentioned throughout the series. Unlike the roadside zoos Baskins place is pitted against, Big Cat Rescue is a legitimate sanctuary, according to National Geographic and the Washington Post.

Read the rest here:
Tiger Sanctuaries and Roadside Zoos: The History You Wont See in Tiger King - Teen Vogue

Recommendation and review posted by Bethany Smith

MANHASSET, N.Y.--(BUSINESS WIRE)--Analyzing the electronic health records (EHR) of coronavirus disease 2019 (COVID-19) patients hospitalized at New York States largest health system, a team of researchers uncovered several comorbidities as a key factor in the acuity of the disease, according to a report in The Journal of the American Medical Association (JAMA).

The Northwell Health COVID-19 Research Consortium, with support from the Feinstein Institutes for Medical Research, described the clinical course and outcomes of 5,700 Northwell patients hospitalized with COVID-19 the largest hospitalized patient cohort to date from the United States between March 1 and April 4.

The Northwell Health Covid-19 Research Consortiums findings, published today in JAMA, demonstrate that hypertension (57 percent), obesity (41 percent) and diabetes (34 percent) were the most common comorbidities in the COVID-19 patients studied. Patients with diabetes were more likely to have received invasive mechanical ventilation, received treatment in the intensive care unit (ICU) or developed acute kidney disease.

Of the 2,634 hospitalized patients for whom outcomes were known, 14 percent were treated in the ICU, 12 percent received invasive mechanical ventilation and 3 percent were treated with kidney replacement therapy. Twenty one percent passed away while 88 percent of individuals receiving mechanical ventilation died. To read the JAMA paper for which Safiya Richardson, MD, MPH, assistant professor at the Feinstein Institutes, is the first author click here.

New York has become the epicenter of this epidemic. Clinicians, scientists, statisticians and laboratory professionals are working tirelessly to provide best care and comfort to the thousands of COVID-19 patients in our Northwell hospitals, said Karina W. Davidson, PhD, MASc, professor and senior vice president at the Feinstein Institutes. Through our consortium, we will share our clinical and scientific insights as we evolve the ways to care for and treat COVID-19 patients.

The majority of patients in the study were male, and the median age of all patients being treated was 63 years old. At triage, about of third of all patients (1,734) presented with a fever, 986 had a high respiratory rate and 1,584 patients received supplemental oxygen. On average, patients were discharged after four days. The mortality rates were higher for male patients than female at every adult 10-year age interval.

The data were collected from the enterprise electronic health record reporting database and also consisted of patient demographic information, home medications, triage visits, initial laboratory tests, initial electrocardiogram results, diagnoses during the hospital course, inpatient medications, treatments (including invasive mechanical ventilation and kidney replacement therapy), and outcomes (including length of stay, discharge, readmission, and mortality).

Dr. Davidson and the Northwell Consortium research team provide a crucial early insight into the front line response to the COVID-19 outbreak in New York, said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes. These observational studies and other randomized clinical trial results from the Feinstein Institutes will improve the care for others confronting Covid outbreaks.

Research conducted at the Feinstein Institutes would not be possible without philanthropic support. In this most challenging moment in health care, we rely on supporters to provide resources for physicians and scientists to better understand COVID-19 and conduct research that benefit our patients. To support our research efforts, please click here.

About the Feinstein Institutes

The Feinstein Institutes for Medical Research is the research arm of Northwell Health, the largest health care provider and private employer in New York State. Home to 50 research labs, 2,500 clinical research studies and 5,000 researchers and staff, the Feinstein Institutes raises the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health innovations and outcomes, and molecular medicine. We make breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and are the global scientific leader in bioelectronic medicine a new field of science that has the potential to revolutionize medicine. For more information about how we produce knowledge to cure disease, visit feinstein.northwell.edu.

About Northwell Health

Northwell Health is New York States largest health care provider and private employer, with 23 hospitals, about 750 outpatient facilities and more than 13,600 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 70,000 employees 16,000-plus nurses and 4,000 employed doctors, including members of Northwell Health Physician Partners are working to change health care for the better. Were making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Twitter, Instagram and LinkedIn.

See the article here:
Largest COVID-19 Study of Hospitalized Patients in US Links Comorbidities to Acuity - Business Wire

Recommendation and review posted by Bethany Smith

Theres been quite a lot in the news lately about men, women and their theoretically different and some have theorised womens superior approaches to leadership.

Some have even gone so far as to declare women the winners in the COVID 19 leadership stakes. An article in Forbes last week declared, What Do Countries with the Best Coronavirus Response Have in Common? Women Leaders.

Also last week, Tanja Kovac, the CEO of Gender Equity Victoria, highlighted on Linked In that of the 10 nations that have successfully flatted the curve, women lead 40 percent of them. This, despite the fact that women lead just 8 percent of UN recognised nation states. Save lives, elect women, Kovac declared.

Kovac is not the only one to have made such bold claims about womans supposed superior leadership qualities.

Last year, former US President Barack Obama told guests at an event in Singapore that, If more women were put in charge, there would be less war, kids would be better taken care of and there would be a general improvement in living standards and outcomes.

Theres also been a lot in the news lately about how men are the losers in the coronavirus pandemic, at least in terms of their likelihood of acquiring the virus and dying as a result of it. (Who is carrying the heavier load of the response, as well as the economic and social fallout of the pandemic thats debatable.)

This past weekend, The Ages Good Weekend prominently featured an article entitled, X marks the spot: why the weaker sex wins every stage of life. The article featured an interview with Canadian physician and scientist Dr. Sharon Moalem, who claims in her new book, The Better Half, that women live longer, have stronger immune systems, fewer developmental disabilities and higher cancer survival rates than men because of the extra X in every female cell.

I have to admit, after decades of hearing about everything thats supposedly wrong with women, including an ever expanding list of all the things we need to fix about them, particularly in the world of work and leadership, I have found it rather novel to read a number of articles in such short succession suggesting that in many ways women are better than men.

Have women finally won the so-called battle of the sexes? Some are certainly calling it. Game over. But I say, not so fast.

Generally speaking, I am not a huge fan of biologically deterministic theories about the sexes, in particular when it comes to leadership. While tempting, these tropes men are from Mars, women are bending the curve on Venus can, and often are, used as sticks to beat women with.

In that regard, I am in fierce agreement with Arwa Mahdawi, who wrote in The Guardian at the time of Obamas comments: Obamas sweeping statements about women arent just facile, theyre supremely unhelpful. They reinforce the myth that women and men are innately different; that women are biologically programmed to be more cooperative and compassionate than men. Were not. Were just socially conditioned to be people-pleasers. And, from day one, wereheld to higher standardsthan men; boys will be boys but girls are expected to be angels.

To my mind its not that women are necessarily better than men, and certainly not because they are gifted with superior genetics, though they are undeniably different. Its that we have a real problem with stereotypically male styles of leadership, which we, as a culture, have traditionally held up as the gold standard of leadership.

To quote Professor Higgins in My Fair Lady, Why cant a woman be more like a man, I suggest we challenge Professor Higgins and ask if that would really be a good thing. Weve spent decades trying to make women in leadership behave in ways our culture associates with masculinity and rewards, despite significant evidence that it is, Ill go ahead and use the word, toxic.

To illustrate that point, the Harvard Business Review recently featured the research of Jennifer Berdahl, Peter Glick and Marianne Cooper, sociologists and leadership experts who surveyed thousands of workers in the US and Canada and found that four stereotypical masculine norms which together define masculine contest culture (show no weakness, strength and stamina, put work first and dog eat dog ruthlessness) emerged as highly correlated with each other and with organisational dysfunction.

This pressure shifts the focus from accomplishing the organizations mission to proving ones masculinity, the authors wrote. The result is endless mines bigger than yours contests.

For an object lesson in that, I give you recent events in the US: Donald Trump, of course, but also some of his male colleagues in the various governors mansions, including the Democrat New York Governor Andrew Cuomo, who has been at the centre of the epidemic.

Rebecca Traister put it best in her essay for The Cut when she declared, Enough with the Dick Swinging.

These men have media cockfights, while people die, Traister wrote. Its not funny, its not hot. Its a travesty. And it tells us everything about power: how its distributed, how its communicated. How its understood. And how its mismanaged to tragic and malignant effect.

Im all for emotionally intelligent, and quite frankly collaborative and competent, leadership. I just hope that, as a culture, we can move away from the belief that such qualities are the sole preserve of a single sex. Diversity simply leads to better decisions. Full stop. Well all be better off when we value and reward these qualities in all leaders.

Kristine Ziwica is a regular contributor. She tweets @KZiwica

Here is the original post:
Are women better leaders than men? It's really not the point - Women's Agenda

Recommendation and review posted by Bethany Smith

But ProfGilbert maintainsthat she never meant to become a vaccine specialist.

I actually came to Oxford to work on a human genetics project, she told a newspaper. That highlighted the role of a particular type of immune response in protection against malaria and so the next thing to move on to was to make a vaccine that would work through that type of immune response - and thats how I got into vaccines.

One can't help but feel thankful she did. With worldwide coronavirus cases topping two million, and economists predicting a financial crash from extended periods of lockdown,the race to develop a vaccine is urgent.It is thought that 60-70 per centof people need to be immune to the virus in order to stop it spreading.

Can it be achieved?

As ever, ProfGilbert remained measured when discussing this. She has said in the media that "nobody can give any guarantees, nobody can promise its going to work and nobody can give you a definite date, but we have to do all we can as fast as we can.

She is also breath of fresh air in the science research industry, which still remains male dominated. According to the Women in Science and Engineering (Wise) campaigns latest analysis,women in science professional roles now make up to 45.7 per cent of the workforce. However, worldwide, less than 30 per cent of the worlds researchers are women.

Plus, the gender pay gap for UK scientists has widened. According to the the2019 edition of the annual salary survey carried out byNew Scientistand science recruitment specialists SRG, the average female scientist or engineer now earns 35,600, while the average for men is 45,800 a 22 per cent difference.

Although the gender balance is closing in, historically women at the forefront of pioneering research haven't got a fair deal.Katherine Johnson, the American mathematician who contributed calculations to the Apollo 11 mission, was overlooked for years in her vital role. Last year, Rosalind Franklin, the scientist who helped discover DNA but was overshadowed by her female colleagues, was finally granted recognition after a space robot was named after her.

But with the well-being of society - quite literally - in her hands, it seems fitting that Prof Gilbert should be honoured for her efforts far sooner. The Jenner Institute, where the coronavirus vaccine is being trialed, is named after Edward Jenner who helped develop a vaccination against Smallpox. Perhaps Gilberttoo could one day see an institute named after her.

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Meet Sarah Gilbert, the female scientist leading Oxford vaccine team - and about to make history - Telegraph.co.uk

Recommendation and review posted by Bethany Smith

CBD is a natural plant-derived molecule with truly versatile effects on human health, and one of these effects directly causes blood pressure to drop.

The complex legal status of cannabis and hemp continues to cripple CBD research on a global scale, and human studies remain very rare.

While research is still only performed on animals for the majority of conditions, a very important human study was specifically looking into the effects of CBD on blood pressure.

This groundbreaking placebo-controlled, double-blind 2017 research was the first to look into whether CBD reduces blood pressure in humans, and it was inspired by previous preclinical studies which hinted that CBD offers a multitude of cardiovascular benefits.

Nine healthy male volunteers participated in the research, and were given either a 600mg dose of CBD, or a placebo.

The results showed that the participants who received the 600mg CBD dose had:

The data also showed that the participants who were given the CBD dose had:

Finally, in response to cold stress, volunteers who were given 600mg of CBD had:

Researchers concluded that a single administration of CBD reduced resting blood pressure, but also reduced the blood pressure increase associated with stressful situations.

The participants in the study received a considerably large single dose of CBD (600mg), which could be considered as a very expensive treatment method for most people.

On the safety side of things, a 2011 scientific review stated that high doses of CBD are well tolerated in humans (up to 1,500mg per day), and a 2017 follow-up survey also corroborated this claim.

High blood pressure is a very serious health condition, so if youre planning to implement CBD in your regimen, the doses have to be greater compared to less-debilitating conditions such as anxiety or insomnia, for instance.

Not sure how to dose CBD? Download Droppy the app that calculates your perfect dosage based on research studies.

People react differently to CBD, mostly due to the difference in age, overall health, and genetics. These differences make finding the perfect dose of CBD a personal quest, which usually requires some fine-tuning.

For this particular condition, it would be better to start with an intermediate dose (around 60mg of CBD per day) and observe how you are responding. This dose can also be met by consuming two 30mg CBD capsules per day.

Its highly recommended to keep a CBD journal which will help you follow your daily intake and the precise effects of different CBD doses.

Some people feel the effects of CBD right away, while others dont seem to notice any difference whatsoever.

A debate about why exactly this happens still rages on, and as of yet there are no definitive answers.

One of the main hypotheses (and my personal favorite) is the endocannabinoid system deficiency.

The way CBD (and all other cannabinoids) produce their beneficial effects is by enticing the cells of the endocannabinoid system.

Imagine CBD molecules as keys, which upon entering the lock (receptor) of a specific cell trigger a specific reaction of that cell.

The endocannabinoid system is a vast collection of different cells located throughout the body, which is why CBD is able to help with such a large number of different conditions and disorders.

Due to differences in age, unique genetics, overall health, and a variety of other complex factors, some people have a malfunctioning endocannabinoid system.

This means that the cells of a malfunctioning endocannabinoid system wont react in the same way as the cells of a properly-functioning endocannabinoid system.

The theory also suggests that the endocannabinoid system can be restarted, by continually exposing its cells to cannabinoids like CBD. This process usually lasts for several weeks.

The entire endeavor requires some dedication and conviction, but as CBD is completely natural and very well tolerated in most people, its not much of a sacrifice to try it out.

Just like the percentage of people who dont experience relief from CBD right away, some individuals tend to have adverse effects from CBD, while most users dont have any noticeable issues.

This is also most likely due to age, overall health, personal chemistry, and genetic differences.

Luckily, most of the potential side effects of CBD are not too serious and can be considered only a nuisance. They include:

Unfortunately, this entire field of medicine is not yet well understood. The only way to determine which category of users you belong is to try using CBD.

Its important to understand that the potential side effects are not hazardous in any way.

Similarly to grapefruit juice, CBD interferes with the metabolization (the breakdown) of all medications that have a grapefruit warning on their packaging.

This is because CBD is metabolized by an enzyme called CYP3A4.

The CYP3A4 enzyme is also responsible for metabolizing a large percentage of prescription drugs, including some blood pressure medications.

This basically means that if your body is metabolizing both CBD and a different drug at the same time, the CYP3A4 enzyme will have to metabolize both substances at once, which is not a good thing.

The CBD in your system can diminish the metabolization of other drugs in your system, leaving elevated levels of the other drug for too long.

This process can also go the other way around, where the CYP3A4 enzyme focuses more on the other drug, which will leave the CBD molecules lingering in your body.

The interactions of other medications with CBD are very important, so please take them extremely seriously and do your homework by thoroughly researching the medication youre taking.

Some medications dont have a grapefruit warning on their packaging, so check the inserted information for any mention of the CYP3A4 enzyme.

You should also consult with your doctor, but they are still (in most cases) not adequately familiar with CBD and its drug interactions.

High blood pressure is a very serious condition, and its absolutely vital to perform rigorous research if you plan to add CBD to your existing treatment regimen.

Follow this link:
CBD and Blood Pressure: Can It Reduce High BP? - Greencamp

Recommendation and review posted by Bethany Smith

Induced pluripotent stem cells made to produce insulin and CRISPR, used to correct a genetic defect, cured Wolfram syndrome in mice.

Using induced pluripotent stem cells (iPSCs) produced from the skin of a patient with a rare, genetic form of insulin-dependent diabetes called Wolfram syndrome, researchers transformed the human stem cells into insulin-producing cells and used CRISPR-Cas9 to correct a genetic defect that had caused the syndrome. They then implanted the cells into lab mice and cured the unrelenting diabetes in those models.

The findings, from researchers at Washington University School of Medicine in St. Louis, US, suggest this CRISPR-Cas9 technique may hold promise as a treatment for diabetes, particularly the forms caused by a single gene mutation and it also may be useful one day in some patients with the more common forms of diabetes, such as type 1 and type 2.

This is the first time CRISPR has been used to fix a patients diabetes-causing genetic defect and successfully reverse diabetes, said co-senior investigator Dr Jeffrey Millman, an assistant professor of medicine and of biomedical engineering at Washington University. For this study, we used cells from a patient with Wolfram syndrome because, conceptually, we knew it would be easier to correct a defect caused by a single gene. But we see this as a stepping stone toward applying gene therapy to a broader population of patients with diabetes.

Wolfram syndrome is caused by mutations to a single gene, providing the researchers an opportunity to determine whether combining stem cell technology with CRISPR to correct the genetic error also might correct the diabetes caused by the mutation.

Researchers at Washington University School of Medicine in St. Louis have transformed stem cells into insulin-producing cells. They used the CRISPR gene-editing tool to correct a defect that caused a form of diabetes, and implanted the cells into mice to reverse diabetes in the animals. Shown is a microscopic image of insulin-secreting beta cells (insulin is green) that were made from stem cells produced from the skin of a patient with Wolfram syndrome [credit: Millman lab Washington University].

Millman and his colleagues had previously discovered how to convert human stem cells into pancreatic beta cells. When such cells encounter blood sugar, they secrete insulin. Recently, these researchers developed a new technique to more efficiently convert human stem cells into beta cells that are considerably better at controlling blood sugar.

In this study, they took the additional steps of deriving these cells from patients and using the CRISPR-Cas9 gene-editing tool on those cells to correct a mutation to the gene that causes Wolfram syndrome (WFS1). Then, the researchers compared the gene-edited cells to insulin-secreting beta cells from the same batch of stem cells that had not undergone editing with CRISPR.

In the test tube and in mice with a severe form of diabetes, the newly grown beta cells that were edited with CRISPR more efficiently secreted insulin in response to glucose. Diabetes disappeared in mice with the CRISPR-edited cells implanted beneath the skin and the animals blood sugar levels remained in normal range for the entire six months they were monitored. Animals receiving unedited beta cells remained diabetic. Although their newly implanted beta cells could produce insulin, it was not enough to reverse their diabetes.

We basically were able to use these cells to cure the problem, making normal beta cells by correcting this mutation, said co-senior investigator Dr Fumihiko Urano, the Samuel E. Schechter Professor of Medicine and a professor of pathology and immunology. Its a proof of concept demonstrating that correcting gene defects that cause or contribute to diabetes in this case, in the Wolfram syndrome gene we can make beta cells that more effectively control blood sugar. Its also possible that by correcting the genetic defects in these cells, we may correct other problems Wolfram syndrome patients experience, such as visual impairment and neurodegeneration.

Were excited about the fact that we were able to combine these two technologies growing beta cells from induced pluripotent stem cells and using CRISPR to correct genetic defects, Millman said. In fact, we found that corrected beta cells were indistinguishable from beta cells made from the stem cells of healthy people without diabetes.

Moving forward, the process of making beta cells from stem cells should get easier, the researchers said. For example, the scientists have developed less intrusive methods, making iPSCs from blood and they are working on developing stem cells from urine samples.

The study is published in Science Translational Medicine.

Read more here:
Induced pluripotent stem cells and CRISPR reversed diabetes in mice - Drug Target Review

Recommendation and review posted by Bethany Smith