GREEN BAY, Wis. (WBAY) - Wisconsin's Safer at Home order is set to expire on April 24, but there's a possibility it could be extended. The order prohibits all non-essential business and travel in the state during the coronavirus outbreak.

Gov. Tony Evers has said he may consider extending the order. We talked to Prevea Health President & CEO Dr. Ashok Rai about what needs to happen before Wisconsin reopens for business.

Watch the videos attached to this story for all three segments from Wednesday.

SHOULD SAFER AT HOME BE EXTENDED?

"It's a lot easier to turn things off than to turn things on in a situation like this. So there's a few things that are necessary to make sure we're safe to turn things on," says Dr. Rai.

"Number one, you want to make sure hospitals and health care overall has the capacity to take care of COVID-19 patients going forward. And we'll probably see more as people are out in public. So can we take care of that increased number of people? Remember, the stay at home being lifted doesn't mean COVID-19 is gone. It means it's still there, and we're going to have some spread. We may even have some more spread. So do we have the capability? The capability means having the beds, the ICUs, the physicians, the ventilators and more importantly, that personal protective equipment. We also need to make sure that we can test people on a more broad level. As people go back to work, we hope employers screen them. Ask them questions, take their temperature. If someone screens positive, they need to be tested right away and quarantined. That's part of a successful strategy to getting back to any kind of normalcy, is to be able to identify somebody who has risk factors or symptoms, be able to test them, and be able to isolate them.

"Even more on top of that, what the governor's asking for and what we're all asking for, is the ability to do what's called contact tracing. Having people--public health officials--find somebody who's positive, figure out everybody they've been in contact with--close contact, not going to the store kind of contact--and be able to test them and isolate them. That's how you actually continue to control those hotspots as we call them, and be able to return to normal and not have to rewind to the beginning of March, end of February.

"It's going to be a constellation of things for the governor to make his decision on. And I don't know what resources he has available to him to actually pick a date. But the things we need to see from local government and state government is definitely a lot more into public health. For us to be successful, we need to be able to effectively screen the population, test the population and isolate them. That last step, that isolation part, the contact tracing we talked about, that takes public health officials--a lot more than we have today. So the governor's going to need to make an investment there. He's going to have to tell health care where we can get our tests from. They've been diverted to other states. We need those here. And personal protective equipment--not only for hospitals and clinics--but for nursing homes, for law enforcement. We definitely need to see that supply chain come into Wisconsin.

"Once those things are accomplished and we know we can trace people, we know we can protect people, we know that the hospitals have capacity--that's when you can make a decision to say this is how we can get back online.

"But if you're going to tell employers to mask, if you're going to tell employers to shift differently, to spread people apart, the employers are going to need resources, too. You can't just tell everybody to put a mask on and make sure they can't get one. I think getting those state resources, funding for employers to help them get back to work, is going to be really important for us to see a return to normalcy."

WISCONSIN PEAK

"When we look at any kind of modeling situation, it's only as good as the data that's being put into it. Certain things, certain environmental changes, certain laxes, if we were to get rid of stay safe at home the peak could change. Those are all factors that go into that University of Washington modeling. It did change a day or two. Two weeks ago it was April 27. Then it got narrowed down to April 12. Then it went back to April 14. We really hope that is the peak. How do you know it's the peak? You have to have a downward turn to know that you've hit your peak. You don't know you're at the top of the mountain until you start walking down. Hopefully we start to see a downward turn in hospitalizations and death rates to really justify that that was the peak," says Dr. Rai.

WEARING MASKS AT WORK

"This might actually come back as part of our normal life as we give some government advice to it. Even Dr. [Anthony] Fauci said as we get back to normal maybe part of that is people wearing masks. For it to be successful you need both sides of the party to wear the mask--the employee and the customer--to do that. We also have to look at the practicality. These businesses have not had a lot of time to educate their employees on how to wear a mask, acquire masks for them. We have to give that time for employers to be able to get their supply chain going to get masks. And even more importantly, educate their employees how to use them, how not to take them on and off throughout the day. Those are things we need to give employers time to adapt to," says Dr. Rai.

"From a health care prospective, if you're a patient and you're coming into a clinic or hospital, be prepared to ask those questions, possibly have your temperature checked, and we're likely going to put a mask on you. If you refuse to put one on, there's a chance you may not be put into a health care facility for that visit. Soe people have to understand we are doing those rules in health care, and employers are doing those rules not only to keep you safe, but to keep our employees safe and to make sure we don't take a backslide where we have to shut everything down again.

"They're inconvenient. You may not like what we're asking you to do, but they're there for a purpose."

GLOVES

"You think about health care when we wear gloves, we wear them for a single interaction. I go into a patient's room and I put gloves on, and before I leave that room, I've taken my gloves off in a very safe manner where I may not even touch the outside of them--and then I'm using a trash can where I put my foot down and I'm throwing those away and then I'm leaving the room. You'd never think it would be normal for me to examine a patient with one set of gloves, go into the next room and touch the door handles, go into the next room and examine another patient with the same set of gloves on. That's the equivelant of what we're talking about here every time we touch something with gloves on. We're taking bacteria and viruses from one object and transferring it to the next without washing our hands. The most important thing we need to be able to do is between interactions with people, between interactions with separate sets of items, is being able to wash our hands. Whether that's 20 seconds with soap or water or the second best thing would be hand sanitizer. When you're using gloves, all you're doing is propagating that spread. You know, that doesn't make sense in that situation if what you're trying to do is prevent the spread of the virus or for you getting it," says Dr. Rai.

ARE WE FLATTENING THE CURVE?

"It's not unexpected to see an increase in cases. I'm worried people will look at those numbers and get concerned. Really, you have to understand why those numbers are there. First of all, some of those tests were done seven-to-ten days before the result was given because of the turn around time with some of the commercial labs. The state actually expanded who we can test on a faster track. So we're testing more people. So we're going to get more positives. We expect that. Those numbers are important to look at, but we're not testing enough people to actually really know if that's an upward trend, or if it's just that we're testing more people that we think are going to be positive, so we're going to have more positives. The numbers that we really should be looking at, unfortunately, is the death rate and making sure that's going down. That's what we want to happen. And the hospital utilization of patients. So do we have six COVID patients in a hospital in Brown County? Do we have 20? Is that number flat? Is it going down? And those are the things we should be paying attention to. And so far over the weekend and over the week, we saw a small increase in the number of hospitalizations, but it is relatively stable for now. Those are the things we should be focusing on. We're going to see a lot more positives. That's expected because hopefully we're going to test a lot more people," says Dr. Rai.

SALIVA TEST

"From a health care prospective, any way we can test is exciting, especially if it can be validated. When we do that nasal swab of your nose, we're looking for genetic material of the virus to test positive. So if you think of the saliva test, many people have done a saliva test lately to see who they're related to, or what diseases they may be at risk for, through some national companies. It's using that same technology, spitting into a vial multiple times, and then submitting that for genetic testing for the virus. It's awesome to see that come forward, but it's in a single situation in the university in New Jersey at Rutgers. Excited for them. Hopefully it will continue to work. But right now, it's still in that phase where it's got that emergency use authorization based on testing 60 people with swabs. And 60 people is not a huge number when it comes to health care. So we want to see them do a lot more of this. And how can they ramp that up and make it commercially available? Those are the things we'll be watching for. But it's really exciting because you're not going to have to be limited by a nasal swab. We've talked about how those are really hard to get right now. And there's a lot less interaction with the health care worker so everybody stays safer. So in a drive up testing environment, a saliva test is something we have a lot of hope for now," says Dr. Rai.

SUMMER HOME AND CABIN VISITS

"I think everybody's situation is different. If you're able to stay at home safe in that environment, bring food with you, not interact with multiple people--and we'll get to a point where we're interacting with people again--but safely doing that, maintain that physical distance. If the town there is welcoming you back, I don't see a problem with that right now," says Dr. Rai.

HOTSPOTS

"Any time that we start to see multiple cases in any kind of setting--whether that be a nursing home, a prison, a school, a specific company, or any kind of environment where people are constantly interacting with each other, where one is positive and two are positive and six are positive--those are areas where the public health department has some concern and they go in and they advise and they help quarantine people. That's going to happen everywhere. That's going to happen in multiple companies, in multiple environments, as we start to come out of stay safer at home. It's not atypical. What's really important is that public health has the resources to go into that environment, quickly help the employer or the school or the nursing home at that point, quarantine, identify, clean and then get back to normal," says Dr. Rai.

SMITHFIELD FOOD OUTBREAK

More than 400 people tested positive for COVID-19 after an outbreak at a Smithfield Foods plant in Sioux Falls, South Dakota.

"Number one the way you prevent significant outbreaks like that is to stay safer at home. Unfortunately that state chose not to have one, so they're going to see breakouts like that. We've got a stay safer at home policy so essential workers like food packaging can go to work, and then we need to be able to control those situations very closely. But when you don't have a stay safer at home order, public health will get quickly overwhelmed, and not be able to handle a situation like happened in South Dakota," says Dr. Rai.

DOCTORS WHO TEST POSITIVE

"Health care workers are under the same guidelines from the CDC as everyone else. It's seven days from your first symptom, plus three days of having no fevers or significant symptoms without medications to help with that. So in other words, three days without Tylenol, I haven't had a temperature, and it's been a week or seven days since my first symptom. Then you can work with your employee health department and come back to work," says Dr. Rai.

See the original post here:
Dr. Rai on what needs to happen before we can safely return to normal - WBAY

Recommendation and review posted by Bethany Smith

LEAH Messers daughter Ali Simms had a long road of tests and procedures to diagnose her with muscular dystrophy, leaving the Teen Mom 2 star with unbearable pain.

Leah, 27, detailed Alis struggle with muscular dystrophy, a genetic disease that causes weakness and loss of muscle mass, in her memoir, Hope, Grace & Faith, which is out May 5.

7

The MTV star wrote that she knew the moment Ali was born that there was something more going on than what doctors told her and baby daddy Corey Simms.

During her C-section, Corey asked about his newborn daughter: Whats wrong with her? There something wrong with her legs.

Leah explained how Alis legs were stuck up over her head and her hands were hyperextended back towards her elbows.

Leah was told this was fairly common among breech babies and that was likely her position as the bottom baby in the womb.

7

She explained how while twin sister Aleeah was reaching developmental milestones, Ali, now 10, just didnt seem to have the strength.

The older Ali got, the more she kept falling further and further behind.

By her first birthday, she couldnt bear any weight on her legs.

Leah wrote: For the first three years of Alis life, I felt like I was holding my breath. She was tested for everything from a spinal injury to skeletal and neuromuscular disorders.

"We met with so many different specialists it made our heads spingeneticists, neurologists, orthopedists, and neuromuscular specialists."

7

She said her daughter underwent X-rays, bloodwork, genetic testing, muscle biopsies and multiple MRIs.

The reality star wrote: My maternal instinct was screaming that there was more going on with her than just a developmental delay, but none of the doctors we took her to seemed to be able to tell me why she wasnt reaching those early milestones.

She claimed one doctor, without any testing, thought she could have dwarfism, down syndrome or spina bifida.

Leah explained how the road to finding a diagnosis was long and lonely, as family, including Corey, insisted she stop putting Ali through testing.

7

But after Dr. Tsao, who has appeared on Teen Mom 2, gave Ali a muscle biopsy, he diagnosed her with Titin Myopathy.

She explained in the book: At the time, there were only a handful of adults around the world with the same type of muscular dystrophy, and Ali was the first child ever to be diagnosed.

"With adults, they know that Titin MD can lead to heart and lung failure, but for Ali, we have no idea what to expect as she gets older because she is the research.

Leah, who is also mom to daughter Adalynn with ex-husband Jeremy Calvert, called the process to get the diagnosis unbearable, and she was angry that there is no cure.

7

She wrote: Every time we had to have Ali tested, it was like having our hearts ripped out of our bodies, especially when she had to be sedated for the MRIs and the muscle biopsy. In those first few years of her life, I just remember feeling helpless all the time."

Leah explained how Aleeah began acting out, as their focus was on Ali.

She would throw fits, hit and be mean to Ali.

The twins are doing a lot better now, it is still a daily struggle for both of them.

7

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She wrote: "I worry all the time that theyre not as close as other twins because of everything they have to go through.

Ali will see her sister running and doing all the things I have to hold her back from (for her own safe-ty), which is so hard on her. At the same time, Aleeah sees me spending all this time with Ali, taking her to physical therapy and driving to all her doctors appointments, which can leave her feeling left out and neglected.

Leah said all she could do is try to find a balance where they know they are loved.

As The Sun exclusively reported, Leah also revealed her suicide attempt by driving off a cliff, her sexual abuse as a child, her abortion secret and her battle with drug use in the memoir.

Do you have a story for The US Sun team?

Email us at exclusive@the-sun.com or call 212 416 4552.

Like us on Facebook at http://www.facebook.com/TheSunUS and follow us from our main Twitter account at @TheSunUS.

Originally posted here:
Teen Mom Leah Messer says daughter Alis road to muscular dystrophy diagnosis was lonely and the pain was u - The Sun

Recommendation and review posted by Bethany Smith

The Most Recent study on the Preimplantation Genetic Testing Market Research provides a profound comprehension of the various market dynamics like trends, drivers, the challenges, and opportunities. The report further elaborates on the micro and macro-economic elements that are predicted to shape the increase of the Preimplantation Genetic Testing market throughout the forecast period (2019-2029).

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Original post:
Preimplantation Genetic Testing Market: Study provides in-depth analysis of market along with the current trends and future estimations (2019 2025) -...

Recommendation and review posted by Bethany Smith

Los Angeles, United States, April, 2020, The new report has been added by qyresearch.com to provide detailed insight into the global Direct-To-Consumer (DTC) Genetic Testing market. The study will help to get a better understanding about the Direct-To-Consumer (DTC) Genetic Testing industry competitors, a channel for the distribution, Direct-To-Consumer (DTC) Genetic Testing growth potential, potentially disruptive trends, Direct-To-Consumer (DTC) Genetic Testing industry product innovations, market size value/volume (regional/country level, Direct-To-Consumer (DTC) Genetic Testing industry segments), market share of top players/products.

Due to the pandemic, we have included a special section on the Impact of COVID 19 on the Direct-To-Consumer (DTC) Genetic Testing Market which would mention How the COVID-19 is Affecting the Direct-To-Consumer (DTC) Genetic Testing Industry, Market Trends and Potential Opportunities in the COVID-19 Landscape, COVID-19 Impact on Key Regions and Proposal for Direct-To-Consumer (DTC) Genetic Testing Players to Combat COVID-19 Impact.

QY Research has acquired great experience in market research and has been producing reports offering critical analysis of various markets with quality and accuracy. Our market analysts utilize various research methodologies to offer precise and reliable information to the market players to effectively design new growth strategies with an aim to strengthen their presence in the market. They also provide various SWOT and PESTLE analyses that act as a useful tool for the market participants to evaluate different scenarios of the concerned market and take further decision.

The insight has been added in the report to provide realistic overview of the industry, consist of Direct-To-Consumer (DTC) Genetic Testing manufacturers data, i.e. shipment, price, revenue, gross profit, business distribution, etc., SWOT analysis, consumer preference, recent developments and trends, drivers and restrain factors, company profile, investment opportunity, demand gap analysis, forecast market size value/volume, services and product, Porters Five Models, socioeconomic factors, government regulation in Direct-To-Consumer (DTC) Genetic Testing industry. Market players can use the report to peep into the future of the global Direct-To-Consumer (DTC) Genetic Testing market and bring important changes to their operating style and marketing tactics to achieve sustained growth.

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The report reviews the competitive landscape scenario seen among top Direct-To-Consumer (DTC) Genetic Testing Sales players, their company profile, revenue, sales, business tactics and forecast Direct-To-Consumer (DTC) Genetic Testing Sales industry situations. According to the research, Direct-To-Consumer (DTC) Genetic Testing Sales market is highly competing and disparate due to global and local vendors. The global Direct-To-Consumer (DTC) Genetic Testing Sales market report chiefly includes following manufacturers-

Keyplayers:AncestryColor GenomicsEasy DNAFamilytreeDNA (Gene By Gene)Full Genome CorporationHelix OpCo LLCIdentigeneKarmagenesLiving DNAMapmygenomeMyHeritagePathway GenomicsGenesis Healthcare23andMe

Types:Carrier TestingPredictive TestingAncestry & Relationship TestingNutrigenomics TestingOthers

Applications:Online PlatformsOver-the-Counter

Market Competition

The competitive landscape of the global Direct-To-Consumer (DTC) Genetic Testing market is broadly studied in the report with large focus on recent developments, future plans of top players, and key growth strategies adopted by them. The analysts authoring the report have profiled almost every major player of the global Direct-To-Consumer (DTC) Genetic Testing market and thrown light on their crucial business aspects such as production, areas of operation, and product portfolio. All companies analyzed in the report are studied on the basis of important factors such as market share, market growth, company size, output, sales and income.

Highlights of Report

Distribution channel assessment

Innovation trends

Sustainability strategies

Niche market trends

Market entry analysis

Market sizing and forecasts

The geographical division offers data that gives you an idea of the revenue of the companies and sales figures of the Direct-To-Consumer (DTC) Genetic Testing For Electrical Meters growth business. Here are highlights of the Geographical divisions: North America (United Statess, Canada and Mexico), Europe (Germany, Spain, France, UK, Russia and Italy and more), Asia-Pacific (China, Japan, Korea, India and Southeast Asia and more), South America (Brazil, Argentina, Colombia), Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa) and ROW.

Table of Content

Market Overview: This is the first section of the report that includes an overview of the scope of products offered in the global Direct-To-Consumer (DTC) Genetic Testing market, segments by product and application, and market size.

Market Competition by Player: Here, the report shows how the competition in the global Direct-To-Consumer (DTC) Genetic Testing market is growing or decreasing based on deep analysis of market concentrate rate, competitive situations and trends, expansions, merger and acquisition deals, and other subjects. It also shows how different companies are progressing in the global Direct-To-Consumer (DTC) Genetic Testing market in terms of revenue, production, sales, and market share.

Company Profiles and Sales Data: This part of the report is very important as it gives statistical as well as other types of analysis of leading manufacturers in the global Direct-To-Consumer (DTC) Genetic Testing market. It assesses each and every player studied in the report on the basis of the main business, gross margin, revenue, sales, price, competitors, manufacturing base, product specification, product application, and product category.

Market by Product: This section carefully analyzes all product segments of the global Direct-To-Consumer (DTC) Genetic Testing market.

Market by Application: Here, various application segments of the global Direct-To-Consumer (DTC) Genetic Testing market are taken into account for the research study.

Market Forecast: It starts with revenue forecast and then continues with sales, sales growth rate, and revenue growth rate forecasts of the global Direct-To-Consumer (DTC) Genetic Testing market. The forecasts are also provided taking into consideration product, application, and regional segments of the global Direct-To-Consumer (DTC) Genetic Testing market.

Upstream Raw Materials: This section includes industrial chain analysis, manufacturing cost structure analysis, and key raw materials analysis of the global Direct-To-Consumer (DTC) Genetic Testing market.

Marketing Strategy Analysis, Distributors: Here, the research study digs deep into behavior and other factors of downstream customers, distributors, development trends of marketing channels, and marketing channels such as indirect marketing and direct marketing.

Research Findings and Conclusion: This section is solely dedicated to the conclusion and findings of the research study on the global Direct-To-Consumer (DTC) Genetic Testing market.

For Further Detailed insights and Any Query About Direct-To-Consumer (DTC) Genetic Testing Market, Place your Query Here!- https://www.qyresearch.com/customize-request/form/1639883/global-direct-to-consumer-dtc-genetic-testing-market

The report answers important questions that companies may have when operating in the global Direct-To-Consumer (DTC) Genetic Testing market. Some of the questions are given below:

What will be the size of the global Direct-To-Consumer (DTC) Genetic Testing market in 2025?

What is the current CAGR of the global Direct-To-Consumer (DTC) Genetic Testing market?

What products have the highest growth rates?

Which application is projected to gain a lions share of the global Direct-To-Consumer (DTC) Genetic Testing market?

Which region is foretold to create the most number of opportunities in the global Direct-To-Consumer (DTC) Genetic Testing market?

Which are the top players currently operating in the global Direct-To-Consumer (DTC) Genetic Testing market?

How will the market situation change over the next few years?

What are the common business tactics adopted by players?

What is the growth outlook of the global Direct-To-Consumer (DTC) Genetic Testing market?

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Direct-To-Consumer (DTC) Genetic Testing Market Analysis 2020 Growth by Top Companies and Trends by Types, Treatment, Diagnosis and Application ...

Recommendation and review posted by Bethany Smith

Even before Texas first case of the novel coronavirus landed in March in Fort Bend County, Mrudula Rakhade was preparing how her clinical laboratory in a northwest Houston business park could accommodate the testing to come.

Anticipating the need in February to test for the rapidly-spreading virus back when international travel was the leading source Rakhade took the lead in ordering COVID-19 supplies for Altru Diagnostics, where she works as the chief scientific officer. She also made the lab one of the few statewide to be registered with the U.S. Food and Drug Administration to identify positive traces of the virus.

By the time her boss of two years, Dr. Jesse Howard, suggested the lab take on COVID-19 testing in March she had news for him.

I told him, Youre going to get COVID testing in a week because I had already been working on it, Rakhade proudly said.

As Howard, who opened the lab with his late father in 2016, walked by her office Monday afternoon, he said I trust her blindly.

CORONAVIRUS UPDATES: Stay informed with accurate reporting you can trust

Now, the 25-employee operation off the Katy Freeway is analyzing more than 1,000 specimens a day, mostly for local medical providers, including four United Memorial Medical Center drive thru-testing sites. Increases in testing have doubled the number of specimens they started with on March 19. Since then, they have analyzed an estimated 20,000 tests or more, Howard said.

Rakhade and her team of molecular technologists are pulling 12-hour shifts in cramped rooms to meet the growing demand. Social distancing is not an option. Some workers wear N-95 masks, while others, like Rakhade, choose at times not to.

I havent gotten anything yet, she said, adding that employees are tested every week for the novel coronavirus out of precaution. We dont go and touch anything without gloves on.

A meticulous assembly line starts the moment a courier arrives and couriers with coolers packed with tests routinely pop into the lab.

Specimens are packed into one-time use plastic plates designed to hold 96 biological samples which are then injected with a magnetic solution to isolate any trace of the coronavirus ribonucleic acid, also known as RNA.

Another machine identifies how much novel coronavirus if any is in a sample, using a predetermined range for a positive result. A lower range of a positive could mean the nasal swab was not administered properly.

Some people dont go that deep, she said.

Undetermined values mean the sample is negative.

For each batch, the process can take up to four hours. As of Monday, the turnaround time, which includes contacting patients with their results, can be anywhere from 24 to 48 hours.

It is difficult to fulfill everyones expectations at this point, she continued.

And then the patients themselves start calling.

We just have to be patient with them, Rakhade said. Sometimes they get frustrated wondering why their results are not yet in. What can I do, they ask. Im quarantined.

CORONAVIRUS IN HOUSTON: All of the latest news, numbers and analysis to keep you up-to-date, only on HoustonChronicle.com

On Sunday, for the first time in a month, Rakhade took the day off.

Up until then, she had spent several sleepless nights at the lab. She worked exhaustively in mid-March to finalize their COVID-19 certification with a positive patient sample supplied by the Centers for Disease Control to base their review.

I stayed up two nights continuously getting that done, Rakhade said. The night before I finished, we went home around 2 a.m. and I came back at 6 a.m. to finish.

During their research for certification, the lab stumbled across what appeared to be Laredos first case, she said. Without federal registration, which she finalized on March 18, the lab was unable to consider it official and recommended the patient an elementary school teacher be retested. According to Laredo officials, the San Antonio Metro Laboratory handled her test and her case was confirmed on March 17. Two days later, Altru Diagnostics first official positive arrived amid an estimated batch of 500 samples. That lone specimen was followed by about three more positives.

It was very rare to see a positive. It had just started, Rakhade said. After that it became routine because we had been testing so many samples.

Despite all her preparation, the lab ran into a similar problem plaguing hospitals and the Houston and Harris County-operated drive-thru testing sites: supply shortages.

On Friday, the lab used up all its plastic plates designed to hold COVID-19 samples. The plates can only be used once and the manufacturer was also out.

Rakhade resorted to old-school bartering to get what they needed. Another lab in Houston, which does not do COVID-19 testing, had a stash of unused plates. And she had what they needed micro fluiditcs chips for genetic testing.

All the manufacturers are focusing on COVID-19 supplies, she said. They needed something they couldnt get because its not COVID-19.

nicole.hensley@chron.com

See the article here:
Inside the Houston lab tackling thousands of COVID-19 tests - msnNOW

Recommendation and review posted by Bethany Smith

The times are strange. We began the year raging into this new decade with an untamable pace, adding quite a bit of stress, we might add. Three months into 2020 and we find ourselves cooped up inside our home, again, with elevated levels of stress. The fact remains, ones mental wellness directly impacts their physical being. As a result, this mental unrest will take a toll on your body, inside and out. While pale skin, outbreaks, and hair fall are some of the first and most visible problems you may face with, the problem goes much deeper.

That said, let this pause act as that much-needed stress buster. Taking care of yourself at this time and investing in your physical well-being will significantly shape how you feel. Dr Simal Soin, founder of AAYNA clinic, says, Under these exceptional circumstances, it is easy to slip into despair and depression because of a lack of routine. Remaining healthy is of topmost priority, and this is the time to develop a self-care regime.

Soin adds, Having a good skin and hair care routine can boost your self-confidence, apart from helping you to productively utilise your time. In fact, this is the ideal time to try all those DIY home remedies that could otherwise never be a part of your routine because of your busy schedule. As these efforts give you refreshing, supple skin, and your precious mane truly becomes healthy and gorgeous, you will naturally feel positive and happy about taking the time out for yourself.

Also Read: 5 Self-Care Practices You Need To Incorporate In 2020

Also Read: Meditation techniques to help reduce stress

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Self-Care In Testing Times: An Expert Guide - Femina

Recommendation and review posted by Bethany Smith

The single biggest threat to mans continued dominance on the planet is thevirus. Joshua Lederberg, Nobel Prize in Physiology or Medicine, 1958

One of the most terrifying aspects of the COVID-19 pandemic is that we dont know what makes one person die, another suffer for weeks, another have just a cough and fatigue, and yet another have no symptoms at all. Even the experts are flummoxed.

Ive been puzzled from the beginning by the sharp dichotomy of who gets sick. At first it was mostly older people with chronic disease, and then a young person with low risk would show up. It can be devastating and rapid in one individual but mild in another, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease on a media webinar.

What lies behind susceptibility to COVID-19? Gender? Genetics? Geography? Behavior? Immunity? All of these factors may be at play, and they overlap.

Comedian Bill Maher blames poor immunity on eating too much sugar, and a thriving industry pitches immune-boosters, but much of the strength or weakness of an individuals immune response arises from specific combinations of inherited gene variants. Thats my take as a geneticist, and Dr. Faucis. Perhaps genetics and the immune response play a role in why one person has a mild response, yet another rapidly deteriorates into viral pneumonia and respiratory failure, he said.

During the first weeks of the pandemic, the observation that many victims were either older, had certain chronic medical conditions, or both, fed a sense of denial so widespread that young people flocked to Spring Break beaches as older folks boarded cruise ships in Florida as recently as early March. And then the exceptions began to appear among the young people.

While clinicians on the front lines everywhere are saving as many lives as possible, researchers are racing to identify factors that the most vulnerable, and the most mildly affected, share, especially the asymptomatic carriers. And as the numbers continue to climb and more familiar possible risk factors are minimized or dismissed age, location, lifestyle habits genetics is emerging as an explanation for why otherwise young, strong, healthy people can die from COVID-19.

Following are possible genetic explanations for why some people become sicker than others. These are hypotheses, the language of science: ideas eventually fleshed out with observations and data. Proof is part of mathematics; in science, conclusions can change with new data. The public is getting a crash course in the scientific method.

The most obvious genetic risk factor in susceptibility to COVID-19 is being male. The details of disease demographics change daily, but males are about twice as likely to die if theyre infected as are women: 4.7% versus 2.8%.

At first people blamed the sex disparity on stereotypes, like the riskier habits of many a male compared to females. But the sex difference comes down to chromosomes.

In humans, a gene, SRY, on the X chromosome determines sex. Males have one X and a puny Y; females have two Xs. Fortunately, nature takes care of this fundamental inequality of the sexes, which I detailed hereand in every biology textbook Ive ever written.

To compensate for the X deficit of the male, one X in every cell of a female is silenced beneath a coating of methyl groups, an epigenetic change. But which X is silenced differs, more or less at random. In a liver cell, the turned off X might be the one that the woman inherited from her father; in a skin cell, the silenced X might be the one inherited from her mother.

The immune system seems to benefit from the females patchwork expression of her X-linked genes, with a dual response. Gene variants on one X may recognize viruses, while gene variants on the other X may have a different role, such as killing virally-infected cells.

Women also make more antibodiesagainst several viral pathogens. But some of us pay the price for our robust immune response with the autoimmune disorders that we are more likely to get.

People with type O blood may be at lower risk, and with type A blood at higher risk, of getting sick from SARS-CoV-2, according to results of a recent population-based study. But the idea of type O blood protecting against viral infections goes back years.

We have three dozen blood types. Theyre inherited through genes that encode proteins that dot red blood cell (RBC) surfaces, most serving as docks for sugars that are attached one piece at a time. The RBCs of people with type O blood do not have an extra bit of a sugar that determines the other ABO types: A, B, or AB.

The unadorned RBCs of people with type O blood, like me, are less likely to latch onto norovirus (which explains why I rarely throw up), hepatitis B virus, and HIV.

An investigation of ABO blood types from the SARS epidemic of 2002 to 2003 provides a possible clue to the differences. People with blood types B and O make antibodies that block the binding of the SARS viruss spikes to ACE2 receptors on human cells growing in culture. Since the novel coronavirus enters our cells through the same receptors, are people with type O blood less likely to become infected?

Thats what researchers from several institutions in China have found in the new study. They compared the blood types of 2,173 patients with COVID-19 from three hospitals in Wuhan and Shenzhen to the distribution of blood types in the general population in each area.

People with type A blood were at higher risk than people with type 0 blood for both infection and severity of the illness.

In the general population 31% of the people are type A, 24% are type B, 9% are type AB, and 34% are type O. But among infected individuals, type A is up to 38%, type B up to 26%, AB at 10%, and type O way down to 25%.

The researchers conclude that the findings demonstrate that the ABO blood type is a biomarker for differential susceptibility of COVID-19. I think thats a bit strong for a trend, considering the exceptions. But the researchers suggest that their findings, if validated for more people, can be used to prioritize limited PPE resources and implement more vigilant surveillance and aggressive treatment for people with blood type A.

Immunity and genetics are intimately intertwined. Links between mutations both harmful and helpful and immunity to infectious diseases are well known.

Mutations in single genes lie behind several types of severe combined immune deficiencies (SCIDs), like bubble boy disease. Sets of human leukocyte antigen gene variants (HLA types) have long been associated with increased risk of autoimmune conditions such as celiac disease, type 1 diabetes, and rheumatoid arthritis, and were for many years the basis of tissue typing for transplants.

In HIV/AIDS, two specific mutations in theCCR5 gene remove a chunk of a co-receptor protein to which the virus must bind to enter a human cell. The mutation has inspired treatment strategies, including drugs, stem cell transplants, and using CRISPRto recreate the CCR5 deletion mutation by editing out part of the gene.

Might variants of the gene that encodes ACE2, the protein receptor for the novel coronavirus, protect people in the way that a CCR5 mutation blocks entry of HIV? The search is on.

Another clue to possible genetic protection against the novel coronavirus may come from the SARS experience from years ago and parasitic worm diseases in Africa. (This hypothesis I came up with on my own so Im prepared to be shouted down.)

In a human body, the SARS virus disrupts the balance of helper T cells, boosting the number of cells that fight parasitic worms (the Th2 response) while depleting the cells that protect against bacteria and viruses (the Th1 response). The resulting Th2 immune bias, in SARS as well as in COVID-19, unleashes the inflammatory cytokine storm that can progress to respiratory failure, shock, and organ failure.

In subSarahan Africa alone, a billion people have intestinal infections of parasitic worms, the most common of which is schistosomiasis. Its also called snail fever because the worms are released into fresh water from snails and burrow into peoples feet when they wade in the water.

The worms mate inside our blood vessels, releasing eggs that leave in urine and feces into the water supply. Remaining eggs can inflame the intestines and bladder. The infection begins with a rash or itch, and causes fever, cough, and muscle aches in a month or two. A drug treatment is highly effective.

Genetics determines susceptibility, or resistance to, schistosomiasis. And thats what got me thinking about COVID-19.

People who resist the flatworm infection have variants of eight genes that ignite a powerful Th2 immune response that pours out a brew of specific interferons and interleukins. Could the Th2 immune bias of the novel coronavirus SARS-CoV-2 not be as devastating to people who already have the bias, to resist schistosomiasis? If so, then places in Africa where many people are immune to schistosomiasis might have fewer cases of COVID-19.

So far parts of Africa have reported low incidence of the new disease. On April 7, the World Health Organization reported approximately 10,000 cases in all of Africa. Thats similar to the number of deaths in New York City, although Africa could be on track for the exponential growth seen elsewhere. But if the lower number in Africa persists, then maybe those eight genes are protecting people. Adding to the evidence is that the 8-gene set varies more between West Africans and Europeans than do other sets of genes.

Like the ABO blood type study, if the 8-gene signature that protects against schistosomiasis protects against COVID-19, then the signature should be overrepresented among those exposed to the virus who do not get very sick, and underrepresented among those who do. However, its possible that Africa is just behindthe rest of the world in reporting COVID-19 cases. So, a thought experiment for now.

Before researchers zero in on a highly predictive genetic signature of COVID-19 risk, we can think about how the information would best be used:

I hope that discovery of a genetic basis for COVID-19 vulnerability or resistance will not inspire discrimination unfortunately, genetic information has had a legacy of misuse.

Ricki Lewis is the GLPs senior contributing writer focusing on gene therapy and gene editing. She has a PhD in genetics and is a genetic counselor, science writer and author of The Forever Fix: Gene Therapy and the Boy Who Saved It, the only popular book about gene therapy. BIO. Follow her at her website or Twitter @rickilewis

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Can genetics explain the degrees of misery inflicted by the coronavirus? - Genetic Literacy Project

Recommendation and review posted by Bethany Smith

The premise of my latest novel, Virgin & Child, will no doubt be seen as so outrageous and provocative that it calls for some explanation.

Its a novel that arose out of a thought experiment, which I wrapped up as a literary thriller. It was long in the writing and brings together all the different aspects of my own life and work, and yet the idea came to me in one instant, more than 10 years ago.

I was studying for my masters in theology, having come to faith after a long struggle between my head and my heart, wanting to understand it better. We had a task: to review the then Pope Benedicts first encyclical, Deus Caritas Est (God is Love). What was praised by the Catholic Church and many commentators for what Ruth Gledhill called its beautiful and passionate writing and theological rigour seemed to me to set up such an idealised nature of love that no human being could possibly come close to it.

An encyclical is addressed to the world, not just the Catholic Church, and this one had nothing to say to anyone who doesnt support the churchs position that only in a heterosexual marriage and when open to procreation can sex be approved.

The encyclical failed to address any of the new approaches to gender, embodiment, sexuality and sexual orientation in our postmodern or transmodern world. There was nothing either to help or offer guidance with all the difficult and complex moral and ethical dilemmas faced in the modern age by us imperfect beings in an imperfect world. In short, it was an epic fail.

I had spent a great deal of my early career involved in womens reproductive rights. I worked for various charities and sat on the Committee to Defend the 1967 Abortion Act, and worked with Spanish groups trying to set up contraception and abortion services after Francos death.

I saw at first hand the very real pain and suffering and the struggles faced by women who found themselves unwantedly pregnant, and the moral conflicts they faced. The language used by the Catholic Church around abortion, as well as on issues such as homosexuality and transgender, is dismissive and horrible.

What could happen to shake these popes and cardinals in the Vatican, wrapped in their dogma, surrounded by medieval walls and completely divorced from the reality of peoples ordinary lives, desires and problems? How, in particular, could they ever understand a womans lived experience, what it is like to be unwantedly pregnant, or the lives of those who feel different?

And then the idea came to me. It was only if one of them became mysteriously pregnant, I thought, if they desired to end it and were afraid of childbirth, if they discovered that they were not male as they had thought, that they would understand. And I liked the idea that they could be intersex, since I had been a tomboy as a child and had felt frustrated with the gender roles in our society when I was growing up, especially since my then ambition was to become an astronaut.

Yes, this seemed an absurd idea for a novel. Was this even possible? Could I make it convincing? Happily, my first degree was in biochemistry, which included a module in molecular genetics. I looked at scientific papers and found that a rare condition exists where two early embryos fuse, one male and one female, and then go on to develop as one individual, but with a random distribution of male and female cells and characteristics.

One case study caught my eye a person with one ovary and one testis, who appeared to be male. And there had been 11 live births to such people. So, while of course it was extremely unlikely, it was indeed possible and so it neednt be a miracle, though of course people would suspect that it was.

My Pope, Patrick, is the first Irish Pope. I chose an Irish Pope because there has never been one, so I felt that he couldnt be thought to be based on anyone specific; and because I have always identified as a Celt rather than English, as my Welsh, Scottish, and distant Irish ancestry far outweighs my English blood.

It also seemed appropriate in terms of the enormous changes that have taken place in Irish society in the last few years, with the diminishing power of the church, tarnished by child abuse scandals, and the legalisation of abortion, which happened towards the end of the writing of the novel.

At first, it was hard to like my Pope Patrick. He started off as dogmatic, rigid, fussy, a bit like Benedict himself. And then Benedict resigned and we had Pope Francis a different kind of character altogether. My Pope changed too as I recreated his childhood.

As I wandered round Cork where my cousin lives, and where it was therefore convenient for Patrick to have grown up, he began to become human. I realised that as a child he had been mocked for being different, something I had always felt at school. He was desperate for human love and connection, and found himself in a position where this was impossible to achieve.

This human love is of course mediated through touch, something withheld from him by his mother and father; his difficult relationship with his parents rested on secrets which he uncovered only after his fathers death.

As the cardinals in my novel opposed him and threatened his position, even took steps to remove him, I felt more and more sympathy with his predicament. And as the story unfolded, and his faith was shaken, it reflected my own struggles with Christianity, something which as a scientist I had always found hard to believe, and yet which constantly tugged at my heart till I could no longer resist it.

I tried to write the book with humanity, and respect. I dont have any wish to denigrate religion, and indeed, there are passages in the book based on my own experience of prayer and Gods presence. The Catholic Church today is torn, as is my novel, between those who want things to stay as they are and those who want to make the faith more relevant in the modern world. My novel is a way of engaging with this debate, asking questions and inviting people to share in the experience, rather than giving any definitive answers.Virgin & Child is published by Barbican Press, priced 16.99

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Meet Pope Patrick Irish, intersex and pregnant - The Irish Times

Recommendation and review posted by Bethany Smith

THE number of people dying from coronavirus across the world is continuing to rise every day - with just under 130,000 deaths in 210 countries.

And in the UK alone,the total of deathspushed past the 12,000 barrier yesterday - with the grim total expected to be 15 per cent higher than reported due to people dying outside of hospital.

4

However, scientists have now revealed that there are some key factorsthat people who pass away from Covid-19have in common.

A team of researchers from eight institutions in China and the United States including the Chinese Peoples Liberation Army General Hospital in Beijing, and the University of California Davis recently looked at the data of 85 patients who died of multiple organ failure after having received care for severe Covid-19.

All individuals whose data the study used received care at either the Hanan Hospital or the Wuhan Union Hospital between January 9 and February 15, 2020.

And the researchers who conducted the study,that appears in the American Journal of Respiratory and Critical Care Medicine,uncovered a series of factors that the majority of these patients shared.

Here, we outline these key factors...

The killer new coronavirus appears to be posing a particularly deadly threat to men.

In fact, the researchers found that 72.9 per cent of those who died from the new coronavirus were male.

Experts believe there are a few reasons for more men dying than women, including some biological and other lifestyle choices.

Hand washing is one of the best ways to prevent infection - but multiple studies show that women are much more likely to wash their hands and use soap than men.

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Akiko Iwasaki, a professor of immunology at Yale University, told the New York Times that men may have a "false sense of security" about coronavirus.

Meanwhile, Chinese men are much more likely to smoke than women, which can lead to a weaker immune system.

In fact China has the largest population of smokers in the world - accounting for nearly a third of the world's smokers - but just two per cent of them are women.

Meanwhile, in the UK 16.5 per cent of men - around 3.9 million - and 13 per cent of women - around 3.2 million - reported being current smokers.

Chinese men also have higher rates of high blood pressure, Type 2 diabetes and chronic obstructive pulmonary disease than women.

All of these conditions can increase the risk of complications following infection of coronavirus.

Then new strain of deadly coronavirus doesn't discriminate and can infect anyone of any age.However, it's older adults - aged 60 and upwards - who are more likely to get seriously ill from it - with the scientists discoveringthat those who died from Covid-19 had amedian age of 65.8 years.

Medics say it's because our immune systems weaken with age, meaning an older person's body is less able to fight Covid-19.

Dr Sarah Jarvis, GP and Clinical Director of Patient Access, told The Sun: "We know that as you get older, your immune system becomes less efficient thats why older people are at higher risk of serious complications of coronavirus infection.

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"If your immune system isnt strong, its more likely that the virus can multiply deep inside your lung, causing inflammation and scarring.

"Your immune system will try and fight it off, and will often destroy healthy lung tissue in the process.

"This makes you more prone to get secondary infections like pneumococcal pneumonia."

In fact, evidence from China, where the deadly virus originated, shows one in seven of those over 80 known to have contracted coronavirus have died.

Those who died from Covid-19 in the study mostly had underlying chronic conditions, such as heart problems or diabetes.

The greatest number of deaths in our cohort were in males over 50 with noncommunicable chronic diseases, the researchers said.

We hope that this study conveys the seriousness of Covid-19 and emphasizss the risk groups of males over 50 with chronic comorbid conditions, including hypertension (high blood pressure), coronary heart disease, and diabetes, they added.

4

In fact, another study recently revealed that your risk of dying from coronavirus is 80 per cent higher if you have just one underlying health issue.

For those with two pre-existing conditions or more, the chances of being admitted to intensive care are even higher, experts warned.

Some of the chronic conditions said to heighten the risk among patients are asthma, cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD), diabetes and HIV and AIDS.

People who are obese or seriously overweightfall into the high risk category for coronavirus.

This is because being overweight or obese can weaken the bodys immune system which could make people more likely to catch coronavirus and makes it harder for the body to fight the bug.

The NHS has said people with a BMI of 40 or above have a greater risk of developing complications if they catch the virus.

More than 60 per cent of patients in intensive care with the virus were overweight or classed as morbidly obese, arecent NHS survey found.

Those who were overweight, with a BMI of 25 to 40, made up 64 per cent of the 194 coronavirus patients who were in ICU at the time, while seven per cent were classed as obese with a BMI over 40.

BMI is a measure of whether youre a healthy weight for your height, you can calculate yours on the NHS website.

In the past, studies have shown overweight and obese people are at greater risk of serious complications or death from infections, like flu.

The extra weight on obese people's diaphragms puts pressure on lungs and makes it harder to breathe, starving them of oxygen.

Clogged up arteries can also make it harder for blood carrying immune cells to circulate and travel to fight infection around the body.

In terms of other potentially relevant information, the research team found that 81.2 per cent of those who died from Covid-19 in the study had very low eosinophil counts on admission to the hospital."

This is a type of white blood cells, which are specialised immune cells that help fight infection.

The medics suggested that having abnormally low levels of eosinophils a condition known as eosinophilopenia may correlate with a greater risk of severe outcomes in people who have contracted Covid-19.

While the scientists hope that their current findings may help other doctors better understand and prepare for fighting coronavirus, the researchers nevertheless urge other experts to keep on recording all possible information about people receiving care for this new illness.

Our study, which investigated patients from Wuhan, China, who died in the early phases of this pandemic, identified certain characteristics, the researchers said.

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"Yet as the disease has spread to other regions, the observations from these areas may be the same, or different.

They added: Genetics may play a role in the response to the infection, and the course of the pandemic may change as the virus mutates, as well.

"Since this is a new pandemic that is constantly shifting, we think the medical community needs to keep an open mind as more and more studies are conducted.

We pay for your stories and videos! Do you have a story or video for The Scottish Sun? Email us at scoop@thesun.co.uk or call 0141 420 5300

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The 5 factors people who die of coronavirus have in common - The Scottish Sun

Recommendation and review posted by Bethany Smith

Would you like to be involved in cutting edge research to develop novel solutions for smart resorbable bone implants for controllable and fast bone restoration, and to testa new generation acellular scaffold with bone-like architecture? Are you interested in acquiring and/or developing your skills to develop new tissue engineering solutions for in vitro reprogramming of adult stem cells for embedding into the smart implant?

Applications are invited for a Postdoctoral Fellow position working with Prof Peter Giannoudis and Dr Elena Jones on the Horizion 2020project SBR Smart Resorbable Bone and a small industry funded project Greenbone. Based on the St. James Campus, you will co-ordinate projects related to several SBR Work Packages (WPs).

More specifically you will be working on the WPs 6 with the aims to:

You will also be responsible for delivering Greenbone project to assess the biological support that GreenBone scaffold can provide for MSCs and endothelial cells.

Reporting to Dr Jones, your work will be carried out in collaboration with consortium members based in Patras, Greece and Munich, Germany.

Capitalising on the infrastructure and samples collected through the Leeds Institute of Rheumatic and Musculoskeletal medicine based across St Jamess University Hospital and LGI, you will generate primary MSC cells to be used by other consortium partners. You will develop and validate assays to assess the behaviour of MSCs on electrospun biocompatible scaffolds, as well as optimise the MSCs uptake of several bioactive DDRs. In collaboration with partners in Greece and Germany, you will also develop and validate assays for the assessment of MSC functionality on bioactive implants. In Greenbone project, you will be testing the attachment and growth of human bone marrow cells onGreenBone scaffold, as well as the endothelial cell-MSC interactions on the scaffold surface.

The post holder will also liaise with the research group, specifically dedicated to this project, and based in the School of Chemical and Process Engineering, as required.

To explore the post further or for any enquiries you may have, please contact:

Dr Elena Jones, Associate Professor (Non-Clinical)

Tel: +44 (0)113 2065647; email:e.jones@leeds.ac.uk

OR

Professor Peter Giannoudis, Professor of Orthopaedic Surgery

Tel + 44 (0) 113 0113-20-67068; email:P.Giannoudis@leeds.ac.uk.

Further Information

The University of Leeds is committed to providing equal opportunities for all and offers a range offamily friendly policies. The University is a charter member of Athena SWAN and holds the Bronzeaward. The School of Medicine holds theGoldaward. We are committed to being an inclusive medical school that values all staff, and we are happy to consider job share applications and requests for flexible working arrangements from our employees.

Location:Leeds - St James University HospitalFaculty/Service:Faculty of Medicine & HealthSchool/Institute:Leeds Institute of Rheumatic & Musculoskeletal Medicine (LIRMM)Section:Section of Experimental RheumatologyCategory:ResearchGrade:Grade 7Salary:33,797 to 40,322 p.a.Working Time:100% FTEPost Type:Full TimeContractType:Fixed Term (Available immediately on a fixed term basis for 27 months or until 31 December 2023 (wichever is sooner))ClosingDate:Tuesday 21 April 2020Reference:MHLRM1130Downloads:CandidateBrief

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Horizon Research Fellow job with UNIVERSITY OF LEEDS | 203439 - Times Higher Education (THE)

Recommendation and review posted by Bethany Smith

SUZHOU, Chinaand SHANGHAI, April 13, 2020 /PRNewswire/ -- Gracell Biotechnologies Co., Ltd. ("Gracell"), a clinical-stage immune cell and gene therapy company, is pleased to announce that their first-in-human phase I data of Universal TruUCAR GC027 in relapsed or refractory (R/R) T-cell acute lymphoblastic leukemia (T-ALL) was accepted for plenary oral presentation at the America Association for Cancer Research (AACR) Annual Meeting.

Gracell Logo (PRNewsfoto/Gracell)

This year's AACR presentations are moved to be held virtually to allow sharing the data in a timely fashion. A series of online sessions featuring presentations will be provided. Gracell will report the clinical safety and efficacy of GC027, an off-the-shelf CAR-T product based on Gracell's TruUCAR technology, for treatment of adult T-ALL patients.

"We are very pleased that AACR has accepted the phase I results of GC027, a first-in-human off-the-shelf TruUCAR product for plenary oral presentation. Gracell's proprietary TruUCAR platform was protected with patents of novel designs and unique features. Remarkably, GC027 derived from HLA unmatched donor's cells, is a monotherapy without co-administration of other immunosuppressive drug." said Dr. William CAO, founder and CEO of Gracell. "We are pleased to share thefirst-in-human phase I data with the scientific community."

Presentation: Safety and efficacy clinical study of TruUCART GC027: the first-in-human, universal CAR-T therapy for relapsed/refractory T-cell acute lymphoblastic leukemiaAbstract #9564Online live section: Apr. 27-28, EDT

About GC027GC027 was manufactured fromT cells of human leukocyte antigen (HLA) unmatched healthy donors using TruUCAR technology. TruUCAR allows the allogeneic CAR-T cells to proliferate and persist in HLA-unmatched patients (recipients) with minimized risk of graft-versus-host-disease (GvHD). GC027 is currently being developed as an investigational, off-the-shelf CAR-T cell therapy for treatment of T cell malignancies. The use of HLA unmatched healthy donor's cells may improve efficacy and reduce production time, available for off-the-shelf use in a timely manner.

About TruUCARTruUCAR is Gracell's proprietary and patented platform technology, with selected genes being edited to avoid GvHD and immune rejection without using strong immunosuppressive drugs. In addition to T-ALL antigen, the platform technology can also be implemented for other targets of hematological malignancies.

About T-ALLT - Lymphoblastic Leukemia (T-ALL) is an aggressive form of acute lymphoblastic leukemia, with a diffuse invasion of bone marrow and peripheral blood. In 2015, T-ALL affected around 876,000 people globally and resulted in 110,000 deaths worldwide. T-ALL compromises about 15%-20% of all children and adult acute lymphoblastic leukemia[1].Current standard of care therapies for T-ALL are chemotherapy and stem cell transplantation. 40-50% of patients will experience relapse within two years following front line therapy with limited treatment options available[2] [3]. Treatment of relapsed and refractory T-ALL remains a high unmet medical need.

About GracellGracell Biotechnologies Co., Ltd. ("Gracell") is a clinical-stage biotech company, committed to developing highly reliable and affordable cell gene therapies for cancer. Gracell is dedicated to resolving the remaining challenges in CAR-T, such as high production costs, lengthy manufacturing process, lack of off-the-shelf products, and inefficacy against solid tumors. Led by a group of world-class scientists, Gracell is advancing FasTCAR, TruUCAR (off-the-shelf CAR), Dual CAR and Enhanced CAR-T cell therapies for leukemia, lymphoma, myeloma, and solid tumors.

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Gracell to Present the First-in-human, Universal TruUCAR GC027 Therapy for Relapsed or Refractory T-cell Acute Lymphoblastic Leukemia at the AACR...

Recommendation and review posted by Bethany Smith

Following is a transcript of the video.

Narrator: Depending on the stallion, horse semen is one of the most expensive liquids on the planet.

Matson: So, we collected about 80 mils, and this is gonna be worth in excess of $100,000.

Narrator: That means that a gallon of this horse's semen is worth $4.7 million. And that's nowhere near the most expensive. Once it's collected, horse semen can be separated and sold in small tubes called straws.

Matson: One of these straws is worth about $1,200. We're putting about 150 million to 200 million sperm cells in each individual straw. Big Star's produced about 60 or 70 of them here.

Narrator: Super-fertile stallions like Big Star can ejaculate once a day. Theoretically, this means he could produce over $20 million worth of semen during an eight-month stud season. And if a stallion's semen is high quality, it can be frozen in straws for future use.

Matson: So, in this room is the heart of really Stallion AI Services. This room's built like actually a nuclear bunker in here. This is where all the semen is now kept. We've got hundreds and hundreds of thousands of straws in here. We've got over 1,200 different stallions. So, in here, stored at minus 196 degrees, is hundreds of millions of dollars' worth of semen ready to be used to inseminate mares.

Narrator: In the horse-breeding world, genetics is king. Wealthy investors are willing to pay high prices for proven winners' semen, hoping that the resulting foal provides a large return on investment.

Matson: Big Star is one of the most prolific show jumpers of all time. He's a double-gold-medal-winning stallion, which, there's very few of them out there. He's got the perfect genetics, really, to go on to show jumping. So you mix that with another genetic line on the female side and cross those two together. You can pay $1,200 for a single straw, you can have a foal, and maybe three or four years later, you can sell that foal for sometimes $100,000. In Big Star's case, he's hit those bells. He had the highest-price foal in the UK, and that sold for in excess of $100,000.

Narrator: Even though most stud farms offer guarantees on producing a live foal, commercial and competitive success is still a gamble, even with strong genetics. In fact, the bloodline of all stallion horses is closer than you might think. According to an international team of scientists who studied the Y chromosomes of 52 horses from 21 breeds, practically all modern horses descended from just a few original stallions, from carriage horses hauling tourists in the streets right through to champion racehorses like Galileo, the world's most expensive sire. Even more surprisingly, 95% of all thoroughbred racehorses, like him, can be traced back to just a handful of ancestors, who are all linked to one single superstud: the Darley Arabian, born in 1700. But the value of thoroughbred semen is a little harder to quantify, since breeding must occur naturally for racehorses.

Matson: In the sport-horse world, we're very lucky. We can use artificial insemination to breed our mares with, as opposed to the thoroughbred world, everything's got to be done naturally. They've got to literally cover the mare naturally. Their concern with their gene pool, if they would allow AI into the thoroughbred world, it would mean the gene pool would shrink because one horse could then cover thousands of mares.

Narrator: And anyone wishing to naturally cover their mare with Galileo needs serious financial backing. Even though his price is listed as private, it's widely reported that his stud fee sits at around $650,000, comfortably the world's highest. But because thoroughbred horses must be bred naturally, and therefore a collection of sperm cannot be purchased, equating the cost of Galileo's semen requires some extrapolation. Assuming that during the course of a natural covering, Galileo ejaculates the average of 50 mil of semen, and assuming that the semen is high-enough quality to impregnate a mare successfully, and assuming that a breeder paid $650,000 for that service, then we can deduce that a gallon of Galileo's semen could be worth a whopping $49 million, making it the most expensive liquid on earth. But is it worth it?

Matson: Like anything, there's a lot of work, there's a lot of luck in it. But you've got to make your luck, and you've gotta start off with the right genetics. The chances, obviously, you need to breed a lot to get that particular horse, but with the right genetics, you've got a much better chance.

Narrator: Galileo's position as the top sire is cemented by the achievements of his offspring. He has sired no less than 84 winners, including Frankel, who himself has now been put to stud, commanding the second-highest stud fee in the UK of around $220,000. In turn, he has sired a further 10 winners. Like father, like son.

Despite generally being safer for both stallion and mare, artificial insemination is criticized for its ethics around science and nature. But the analysis of thoroughbred-racehorse genetics has added to the controversy surrounding horse breeding. Roughly 10% experience orthopedic problems, and the majority suffer exercise-induced bleeding in the lungs. PETA investigators captured video from inside the breeding barns at Darley in Kentucky, one of the world's most expensive thoroughbred-breeding facilities, where stallions were goaded to cover more than 100 mares each in a breeding season. Some thoroughbreds were even sold for slaughter at a horse meat market.

With so much money to be made in racing, show jumping, dressage, and more, the price of horse semen will remain stable.

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Why thoroughbred horse semen is the world's most expensive liquid - Business Insider - Business Insider

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Its not unusual to crave a cold glass of water on a hot summer day or after youve eaten something particularly spicy. But there are multiple reasons why you may suddenly find yourself thirsty and some are more serious than others.

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One of the most common reasons youre probably thirsty is dehydration. Overheating is one of the biggest causes of dehydration. Whether youve been rigorously exercising or just resting in the sun at the beach, your body needs water to keep from overheating.

When you exercise, your muscles generate heat. To keep from burning up, your body needs to get rid of that heat. The main way the body discards heat in warm weather is through sweat. As sweat evaporates, it cools the tissues beneath. Lots of sweating reduces the bodys water level, and this loss of fluid affects normal bodily functions.

According to the American College of Sports Medicine, to avoid dehydration, active people should drink at least 16 to 20 ounces of fluid one to two hours before an outdoor activity. After that, you should consume 6 to 12 ounces of fluid every 10 to 15 minutes that you are outside. When you are finished with the activity, you should drink more. How much more? To replace what you have lost: at least another 16 to 24 ounces (2 to 3 cups).

One way to make sure you are properly hydrated is to check your urine. Matthew Goldman, MD, says, The goal is to keep the urine clear. If it starts to become yellow, then youre getting dehydrated.

Certain foods are also great at helping you stay hydrated thanks to being heavy on water content. And many have added benefits of including other essential nutrients your body needs. Vegetables such as cucumbers and celery arent just high in water content, theyre also low in calories, making for a perfect snack.

If youre looking for fruits, both watermelon and strawberries are excellent choices with 91% water content and make for great, sweet treats, especially in hot weather.

Drinking water is one of the best ways to stay hydrated but some sports drinks can also assist in replacing not just fluids but electrolytes such as sodium and potassium. But try to avoid alcohol and caffeinated beverages, such as coffee and sodas, as these fluids tend to pull water from the body and promote dehydration.

Increased urination and excessive thirst are two telltale signs of the onset of type 2 diabetes. It can also be an indicator of hyperglycemia, a condition where there is too much sugar in the blood, most often experienced by those with diabetes.

According to the CDC, Eating too much food, being less active than usual, or taking too little diabetes medicine are some common reasons for high blood glucose (aka hyperglycemia). Your blood glucose can also go up when youre sick or under stress.

Normally, the amount of sugar leaving the body through the urine is not detectable, explains Dr. Goldman. However, if someones blood sugar level is elevated enough, sugar begins to leave the bloodstream through the kidneys and enters the urine.

The glucose (sugar) molecules are small enough to leak out through the filtration system of the kidneys. As the excessive glucose molecules enter the urine, the glucose draws water with it like a sponge. As a result, the amount of urine formed and frequency of urination increases. As we lose those excess fluids, we eventually become dehydrated.

This is why patients who have elevated blood sugar levels for too long often become dried up and may end up in the emergency department or intensive care unit. Once they arrive, they often require a lot of fluids (through IV) as well as vitamins and medications to get their sugar levels under control in a safe manner.

Dehydration could also be a sign of a condition known as diabetes insipidus. According to Dr. Goldman, Antidiuretic hormone (ADH) is a hormone that allows the body to reabsorb water from urine that is forming in the kidneys. This reabsorption tends to occur most when we are becoming dehydrated, such as while we sweat.

If the body isnt producing enough ADH or the kidneys arent responding appropriately to ADH, then the body doesnt retain as much water as it may need; this may result in more frequent urination and possibly dehydration.

Patients should speak to their provider about sugar levels and what is considered a normal blood sugar level for themselves as well as what to do if these levels become abnormal, suggests Dr. Goldman.

In general, patients should avoid drinking fluids to have excessive amounts of sugar in them because this may eventually lead to uncontrolled blood sugar levels and cause the amount of urination to worsen, Dr. Goldman says.

One reason patients should take in some extra sugar is if their blood sugar level is too low. Patients should speak to their provider further about what is considered a normal as well as low sugar for themselves, he adds.

Certain medications your doctor prescribes may cause certain side-effects, including thirst.

Lithium is a medication that is widely known to possibly result in excessive urine output and therefore increased thirst, according to Dr. Goldman. Over time, it may eventually block the activity of antidiuretic hormone (ADH) in the kidneys, which leads to excess urination and thirst, he says. A number of other medications antipsychotics, antidepressants, anticonvulsants, anticholinergics and alpha agonists can cause dry mouth and, therefore, trigger thirst.

Dr. Goldman also notes that SGLT2 inhibitors (a kind of diabetes medication) as well as steroids can also cause thirst since SGLT2 inhibitors increase the release of glucose from the blood into the urine to lower blood sugar levels and steroids often raise sugar levels as a side effect.

This is why, when someone is placed on steroids (whether short or long term), they may be encouraged by their provider to monitor their blood sugar or accommodate the higher sugar levels by taking more diabetic medications.

Dr. Goldman says you should talk to your provider about these side-effects and see if there are alternative medications available.

Until you and your provider can discuss alternatives, continue taking your medication as directed.

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3 Reasons Why You May Be Feeling Really Thirsty - Health Essentials from Cleveland Clinic

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For continuing coverage of how COVID-19 is affecting reproductive health,check out our Special Report.

Four years ago, I needed an abortion in Texas while HB2, Republicans sweeping anti-abortion law, was still in effect. I wondered if Id have to continue a pregnancy for which I wasnt ready.

It took me two weeks to access care that I needed immediately. Im struggling today knowing that as a result of the COVID-pandemic, countless others are facing similar barriers I had faced. Millions have lost their job and are without childcare, and some anti-choice government officials have used the crisis to outright ban abortiondirectly violating our rights under Roe v. Wade.

Weve known that our right to an abortion means nothing if we cant access it. Even though it feels hard right now, you should know advocates have worked for decades to ensure people always have access to abortion care, especially in times like these.

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If youre seeking abortion care during the pandemic, I want to help you learn about the same network that helped me access an abortion whenit felt impossible. Here are some tips that might help you navigate the state of abortion access during COVID-19.

How to get an abortion in a state that has deemed abortion nonessential

If youre seeking an abortion in a state thats attempting to or have already restricted access during the pandemic, youve probably experienced a delay in your appointment at least once. But if you have the capacity, you should call clinicsincluding thosein surrounding areasfrequently for updates because circumstances can change day to day.

Some clinics may be scheduling appointments for the future, and if legal action changes abortion access, scheduling an appointment allows the clinic to contact you to tell you about appointment availability. Providers are working closely with advocates to ensure access to abortion care continues, and theyre one of the first to know when services can resume.

Clinics can also connect people with resources for out-of-state abortion care. Providers are already prepared with this information for people over the legal limit to have an abortion in certain states, and who are forced to travel to one of the statesthat provide later abortions.

If youre considering traveling, youre not alone. Fund Texas Choice, a practical support organization providing Texans with travel assistance, told Rewire.News last month that pregnant people with varying gestational ages have reached out for assistance to go out of state since Texas Gov. Greg Abbott (R) banned abortion under COVID-19. The Brigid Alliance, a practical support organization that helps people traveling to clinics providing second- and third-trimester abortions, told Rewire.Newsthat the organization has recently helped people with pregnancies of earlier gestations, as well as families who are forced to travel together as a result of a lack of childcare.

Because of shelter-in-place orders, some state officials are preventing drivers from crossing state lines and subjecting non-residents to 14-day quarantines, which could increase the logistical costs pregnant people face. Some methods of transportation have been affected too. But the Brigid Alliance says it hasnt encountered drivers being turned away when crossing state lines, and the organization is letting folks flying to New Mexico know that in order to be exempt from the state quarantine, they can only travel between the clinic and hotel where theyre staying.

Brigid Allianceis also seeing the impacts that are surging for those providing and needing practical support.

Bus lines have closed down, airlines have spontaneously canceled flights, hotels have closed down entirely or reduced capacitywe had to move people from hotel to hotel in the middle of a three- to four-day process [to get an abortion], and were hearing from partners that there are some Greyhound lines that are doing temperature checks, Odile Schalit, executive director of the Brigid Alliance, said.

Schalit wants people to know support is available for those seeking care amid the ever-changing landscape of abortion access.

While the obstacles to your health care may appear numerous today, please know that there is a network of good people, volunteers, and resources that exist to support you. Tap into our network and, as much as possible, your own, Schalit said. Take your time, break down your plan and needs, and take stock of your unique physical and emotional safety and comfort. For many, accessing abortion care now means having to travel out of your home town, city, and state. While this may seem impossible, we and many others are here to help you construct safe plans for getting to your care.

If youre thinking about traveling out of state for abortion access, consider going to one of the 23 states that dont have a mandatory waiting period to limit the number of times you have to visita clinic before the procedure.

How to get an abortion if you need help paying for an abortion, traveling to a clinic, or other logistical support

Abortion funds and practical support organizations help alleviate the high costs associated with paying for an abortion and traveling in or out of state. Funds generally help with the cost of an abortion, while practical support organizations cover travel-related costs; some do both. Below are some organizations that may be able to help you access the care you need:

To find other local abortion funds and practical support organizations in your area, visit the National Network of Abortion Funds to search for groups by state.

You can also ask abortion clinics to screen you for financial assistance. Unlike assistance from abortion funds and practical support organizations, in-clinic funding can be income-based, but you arent required to show proof of how much money you earn.

How to get an abortion in a state that allows telemedicine

Eighteen states prohibit the use of telemedicine for abortion care. If you live in one of the states that allow it, medical abortions can be obtained up to ten weeks into pregnancy through video conference with an abortion provider.

While U.S. Food and Drug Administration (FDA) restrictions prevent the medication from being mailed to your home, patients can avoid traveling long distances to an abortion clinic while protecting their health during the pandemic by visiting a nearby health center to receive the medication under guidance of a doctor.

TelAbortion, however, can send the medication to your home if youre eligible. TelAbortion is a study run by reproductive and maternal health research group Gynuity, and the evaluation is offered over the internetso you can access it on your own phone or computer. But the FDA requires people participating in the study to visit a health clinic in order to have an ultrasound or pelvic exam, according to Dr. Elizabeth Raymond, senior medical associate for Gynuity Health Projects.

You will need video conference access in one of the 13 states participating in the study, and have a mailing address in the state where the medication can be sent.

If a person encounters barriers in accessing an ultrasound or pelvic examespecially barriers compounded by the COVID-19 pandemicthey can call a TelAbortion site, as the provider may be able to accommodate their situation.

If youre eligible for a TelAbortion, youll be sent a package containing the necessary medications and an instruction sheet by mail. Afterward, the TelAbortion provider follows up with study participants to ensure the abortion was successful, and to address any side effects and complications. According to their data, the TelAbortion model is just as effective as an in-person abortion.

In the past two months, Gynuity expanded its TelAbortion study to include Maryland and Illinois, and the hope is to continue to expand during the pandemic,as telemedicine abortion care will be critical. In the past few weeks, Gynuity has had a significant increase in traffic to the TelAbortion site.

Weve been doing this study since 2016, [and] now its right there [and] ready, Raymond said. Its gratifying to be able to help in this crisis.

What you need to know about self-managed abortion

Self-managed has proven to be extremely safea 0.3 percent risk of major complications, according to an analysis byAdvancing New Standards in Reproductive Health. Interest in it is also rising.

Self-managed abortion canincludeusing mifepristone and misoprostol, or misoprostol alone, to end a pregnancy. Mifepristone blocks the hormone essential to advancing pregnancy, whereas misoprostol empties the uterus.

Plan C provides a report card on online retailers that offer the medications, resources about how the process works, and the legal risks surrounding it.Some states have laws that could be used against people ending their own pregnanciesat least 21 people have been arrested since 2005, Jill E. Adams, executive director of If/When/How: Lawyering for Reproductive Justice, told Rewire.News.

In states without such laws, Adams said some have faced charges as a result of prosecutors misapplying parts of the criminal codes that were never intended for people ending their own pregnancies. In most cases, the judge determines the law doesnt apply, but at that point, people have already been arrested, lost their job, and face public scrutiny as a result of private records being released.

The risk is highest for populations and communities under surveillance and on the receiving end of disproportionate state violencecommunities of color, especially Black and African American people, immigrants, and trans and gender nonconforming people, are all more at risk of criminalization, and [theyre] also more likely to need self-managed abortion due to barriers to clinic-based care and bans on coverage, Adams said.

Mandatory reporters, like health-care professionals, can also feel obligated to report people should they seek follow-up care from a doctor, even though Adams said the American Congress of Obstetrics and Gynecology and the American Medical Association recommends against it.

No state requires mandatory reporting for suspected or confirmed self-managed abortion, including when the person is a minor, Adams said. If people do report, they are likely violating patient privacy laws.

When seeking follow-up care, people arent legally required to disclose their situation to a doctor. If/When/How: Lawyering for Reproductive Justices legal helpline offers information on a persons rights when talking to law enforcement officialsor doctors involving self-managed abortion. According to the website, no one has been arrested for buying abortion pills online.

The right to abortionself-managed or provider-directedstill exists throughout the United States, Adams said. But laws have been misused and power abused in unjustly criminalizing people for ending their own pregnancies.

The helpline offers free, confidential legal information topeople concerned with being investigated or arrested for self-managing an abortion, as well as legal advice from an attorney when necessary.

But Adams said if there were ever a time to eliminate the sources of criminalization, that time is now. Their legal helpline has received double the number of inquiries they usually get.Local, state, and federal officials should make it clear that no one will be arrested, charged, or detained for ending their pregnancy, or for helping someone else end their pregnancyand not just during the pandemic, but always, Adams said.

If you need an abortion without parental consent

In the 37 states that have forced parental involvement laws for young people seeking abortion care, teenagers are forced to go through the overwhelming process of obtaining a judicial bypass, or permission from a judge to have an abortion. As a result of the pandemic, shelter-in-place orders and school closures prevent teens from discreetly leaving home to go to court, or even obtaining resources that may be able to support them.

Other things to know when seeking abortion care during COVID-19

Be aware that crisis pregnancy centers (CPCs), or anti-choice clinics, are still operating, but they dont provide abortion care. Even if they offer to talk to you about your options, they wont refer you to an abortion clinic or provide the necessary resources to obtain one. Reach out to any of the aforementioned organizations for information about the next steps.

The Online Abortion Resource Squad, a group of volunteers who respond to abortion-related questions on Reddit with compassionate, accurate answers, developed a resource site in response to the confusion and uncertainty around abortion during this health crisis.The site offers up-to-date information on clinic operations in states that have deemed abortion as nonessential health care, as well as connecting with local resources for financial and logistical assistance, and locating clinics in your state and nearby states.

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How to Get an Abortion During the COVID-19 Pandemic - Rewire.News

Recommendation and review posted by Bethany Smith

People with hypothyroidism who choose desiccated thyroid extract (DTE) over levothyroxine alone perceive that it works better but patients may not be aware of the risks, new research suggests.

Those were among the findings from qualitative analyses of nearly 700 online posts from three popular online hypothyroidism forums, which found that 75% of patients felt they fared better on DTE than the standard therapy of levothyroxine (LT4).

The results were to be presented at the Endocrine Society's annual meeting in late March, but the meeting was canceled because of the COVID-19 pandemic. They were subsequently published online April 3 in Medicina by Freddy J.K. Toloza, MD, a postdoctoral research fellow at the University of Arkansas for Medical Sciences, Little Rock, and a research collaborator at the Mayo Clinic, Rochester, Minnesota, and colleagues.

Made from desiccated pig thyroid glands, DTE is not approved by the US Food and Drug Administration because it pre-dates the agency, but it was grandfathered in and is sold legally by prescription under the names Nature Thyroid, Thyroid USP, and Armour Thyroid.

DTE is currently used by an estimated 10% to 29% of patients with hypothyroidism, despite concerns about the risk for hyperthyroidism-associated side effects.

"Current [American Thyroid Association] guidelines strongly suggest the use of levothyroxine over DTE as thyroid replacement therapy. We agree with this recommendation given concerns about DTE's side effects," Toloza told Medscape Medical News.

"Nevertheless, additional research should be conducted to understand if this recommendation applies to all hypothyroid patients," he added, and for those patients who are taking DTE, more research is required to determine who is at risk of side effects and methods to prevent these.

Toloza said that patients with hypothyroidism who take DTE frequently described a lack of individualized treatments and a feeling of not been listened to as issues influencing their choice.

"These findings reinforce the need for patient-centered approaches in current clinical practices. Clinicians need to carefully listen to their patients and consider their individual needs and the context of every patient," he noted.

Asked to comment, endocrinologist Rachel Pessah-Pollack, MD, of New York University Langone Health, told Medscape Medical News, "Animal-derived desiccated thyroid hormone contains both T4 and T3. We typically do not recommend using this because it can vary in concentration, meaning that the actual preparation is not physiologic."

Pessah-Pollack,a coauthor of the 2012 joint clinical practice guidelines on hypothyroidism by the American Thyroid Association and American Association of Clinical Endocrinologists, added that one of the major concerns about using DTE is the risk for iatrogenic hyperthyroidism, potentially leading to atrial fibrillation and fractures.

"That is one of the main factors that drive many professional societies to really use caution regarding DTE. That's also why major societies recommend against using DTE...based on the evidence to date," she said.

The whole issue of "combination therapy" in hypothyroidism is contentious, however. Physicians can also prescribe a "combination" of synthetic levothyroxine (LT4) and triiodothyronine (LT3) treatment; this, along with use of DTE products, has been a subject of debate for many years.

The current (2014) American Thyroid Association guidelines do not specifically rule out use of synthetic LT4/LT3 therapy, rather they "recommend only against theroutineuse of combination therapy." And although they don't expressly endorse use of DTE, they removed a statement saying it "should not be used."

"There is definitely a select group of patients who do better on combined T4/T3 treatment, and we're still trying to delineate who that population is," Pessah-Pollack told Medscape Medical News.

"As long as these patients are closely monitored and aware of the risk of hyperthyroidism and have their levels followed to ensure that they're not hyperthyroid, in select cases this is appropriate."

"But, first-line is ensuring that a good evaluation occurs...Clearly this helps us understand that we do need more studies in this area well-designed, blinded studies to really help us get to the bottom of this controversy."

Toloza and colleagues analyzed 673 posts from three online forums, WebMD (Medscape's parent company), PatientsLikeMe, and Drugs.com, selected from an initial 1235 posts because they included more complete information.

About half (51%, n = 257) of patients had primary hypothyroidism/Hashimoto's thyroiditis, 25% (n = 126) had postsurgical hypothyroidism, and 16% (n = 81) had postablation hypothyroidism. Among the 172 posts in which DTE dose information was available, the mean dose was 84.1 mg/day. Treatment duration ranged widely, from 2 weeks to 45 years.

Among the posts describing the source of the DTE prescription, the initial interest was driven mainly by the patient in 54% (n = 88), while 46% (n = 74) said that a clinician drove their interest in trying DTE. (The type of clinician was not reported.)

Among posts mentioning thesource of DTE, local pharmacies were the most common (63%, n = 75), followed by pharmacies outside the United States (31%, n = 37), and online (6%, n = 7).

Previous thyroid treatments were mentioned in 300 posts, of which 93% mentioned LT4 monotherapy.

Among the reasons for changing to DTE were no improvement in clinical symptoms (47%, n = 75), development of side effects (24%, n = 38), no change in overall well-being (22%, n = 36), and no changes in laboratory workup (7%, n = 12).

Perceived benefits of DTE included improvement in clinical symptoms (56%, n = 155), change in overall well-being (34%, n = 94), possibility of reaching previous health status (7%, n = 19), and low cost compared with previous treatment (3%, n = 8).

Specific symptoms reported to have improved included fatigue (28%, n = 43), weight gain (17%, n = 26), and neurocognitive symptoms (5%, n = 8). The average time to notice benefits with DTE was about 30 daysbut ranged widely from 2 days to 4 months.

The majority of posts (77%, n = 99) stated that DTE was more effective than their previous therapy, while 13% (n = 17) described it as equally effective and 10% (n = 13) said it was less effective.

Side effects of DTE were described by 20% (n = 136), including weight loss (15%), fatigue (11%), palpitations (11%), heat intolerance (11%), sleep disturbances (10%), high blood pressure (7%), and hair loss (5%).

A qualitative analysis of the posts yielded five major themes: experience with previous therapies before starting DTE, perceived effectiveness and benefits of DTE, DTE side effects, need for individualized therapy for hypothyroidism, and barriers to obtaining DTE.

One patient posted: "Synthroid [levothyroxine] did not help...and gives me bad side effects...my endocrinologist blamed all side effects on everything except the Synthroid."

Another wrote, "It [Armour] changed my life...I'm glad I found a medication that makes me feel normal again...all have improved; moods, skin (no itching), no headaches, goiter is down."

Others cited the lower cost of Armour compared with Synthroid.

However, some expressed negative experiences with DTE, such as, "My doctor expected that this medication would help me with brain fog, energy, and tiredness. I experienced the opposite."

And some couldn't obtain it. One wrote, "Doctors think they know how u feel and do not even tell you about Armour. I asked my doctor and was told there was not enough studies on it to show its effectiveness."

Pessah-Pollack pointed out that the study data don't address whether patients' initially prescribed levothyroxine doses were optimal, and noted that sometimes changes are needed, such as during pregnancy, following weight gain, or if the patient is taking other certain medications.

"It's unclear from patient-reported symptoms whether or not they actually had an evaluation of their thyroid levels to ensure that their dose of thyroid hormone was correct before switching over to T4/T3 replacement...There are many factors that need to be taken into account before we decide that the medication itself isn't working."

What's sorely needed, she said, are "well-designed, blinded studies that look at this controversy."

"Here, we don't know why patients are feeling better...We need to do additional work including validated symptom questionnaires and comparing thyroid levels of patients who are on Armour thyroid with those on levothyroxine monotherapy."

Toloza agrees:"It is not possible to say that DTE is working better for the user due to the limitations and the nature of the data used in our study."

"However, our findings are in-line with previously published research, which has shown that a subset of patients may prefer DTE to levothyroxine and have higher satisfaction with this treatment. Nevertheless, the reason behind this is still not well understood," and it should be further investigated.

Pessah-Pollack has reported being an advisor for Boehringer Ingelheim-Eli Lilly and Radius Health, and a moderator for Sanofi.

Medicina. Published online April 3, 2020. Abstract

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Patients Say Desiccated Thyroid Better Than Standard Therapy - Medscape

Recommendation and review posted by Bethany Smith

Study group

The study group was differentiated by several sociodemographic factors, most importantly age of the participants, as it ranged from 45 to 65years. Obviously, it was due to the inclusion criteria adopted in this study, which referred not to the chronological age, but to the time which lapsed since the last menstrual period, and also due to quite large time span (between 2 and 10years of the menopause) accepted for the study. Participants of this study went through menopause between the age of 40 and 60. This is consistent with population studies concerning Poland [26] and other highly developed countries [27, 28].

The diversity concerning the place of living provides, according to some authors, the possibility of identifying beneficial as well as adverse aspects of living in urban and rural areas [29, 30]. It is worth emphasizing that the differences between these areas are becoming less and less noticeable. In this study the number rural residents was significant (40.4%). The vast majority of the respondents (75.5%) declared to have completed secondary education. Study groups in similar studies conducted by other authors also comprised women with similar educational background [31], however some other authors noted a higher percentage of participants with basic vocational education [32]. According to broad population studies, middle aged women are characterized by a lower level of education than the study group in the presented material [33].

Hormone replacement therapy was used by 10.6% of respondents at the time of the study. In the light of reports from literature, this percentage should be considered as relatively low, because, as some authors claim, climacteric syndrome symptoms appear in 75% of perimenopausal women, and 25% of them require treatment [34]. Hormone replacement therapy is effective in relieving menopausal symptoms, i.e. hot flushes, night sweats, dyspareunia, sexual dysfunction and insomnia, as well as in the prevention of osteoporosis [34, 35]. However, there are some contraindications to the use of this therapy [36].

In the presented material, an attempt was made to define the concept of being healthy as understood by the postmenopausal women. The obtained results proved that the respondents perceived health primarily as a feature (to have all parts of the body functioning well and not to feel any physical discomfort) and/or condition (to experience happiness most of the time). These results are similar to the results obtained in other studies which were carried out on groups of elderly people [37, 38]. There are also studies showing that health is perceived as a feature also by younger people, i.e. over 40years of age [39], and by chronic patients [40].

The analysis of the presented results showed that the definition of health was related to the self-assessment of health. The study proved that women with low self-assessment of their health more frequently understood health instrumentally. Interestingly, these participants selected the statements which defined health as a feature of a body (to take medications only occasionally, not be sick or only suffer from flu, cold or indigestion, not need to make appointments with a doctor and/or hardly ever go to the doctor). On the other hand, those who assessed their own health better were more likely to choose claims that corresponded to the definition values of the result (to eat properly) or purpose (to accept oneself, to know your capabilities and deficiencies). In his study, Juczyski noted that low self-assessment of health was associated with attaching greater importance to the physical criteria of health [25]. Moreover, there are differences in the way health is understood in the case of loss of health or the occurrence of chronic illness [3]. Thus, health self-assessment is gaining popularity in the field of epidemiological research where is employed to assess the health condition of entire populations [41]. Additionally, some authors notice a correlation between health self-assessment and the results of laboratory tests and the prevalence of various civilization diseases [42]. In this study self-assessment of health proved to be surprisingly high. It was rated as good by more than half of the respondents, even though they were undergoingcontinuous treatment for various chronic diseases. The literature review shows that hypertension, coronary heart disease and atherosclerosis are the main medical problems in the postmenopausal period [43, 44].

The overall rate of health behaviours of the women in the studied group was average (M=86.18, SD=13.08). The results proved to be comparable with the normalized results of Juczyski (M=85.98, SD=12.70) who observed that the postmenopausal women exhibit more behaviours that have a positive effect on health than younger women. Juczyski claims that the only exception to this observation are the younger women who are affected by some chronic diseases [25]. Recent years indicate a fairly constant tendency among older women to improve their health behaviours. According to some authors, seniors may even show above-average results [45]. However, the study by Kurowska and Kierzenkowska [32] shows the opposite trend women over 60 have worse results in the area of pro-health behaviours. The results of the present study indicate that prevailing pro-health activities encompass prophylactic behaviours. Postmenopausal women should be under a regular care of a gynaecological clinic, just like younger women, and the frequency and type of appointments should be agreed individually, depending on the needs [46]. Nevertheless, gynaecological check-ups should take place at least once a year [14].

Our study revealed that slightly more than a half of the respondents regularly had a prophylactic gynaecological examination, and only 32.0% of them did so in line with the above-mentioned recommendations. In addition, the study confirmed that some women (11.7%) had never had a prophylactic gynaecological examination performed. It is probable they would never see a doctor without a serious reason, which could be considered a risky behaviour once they reached the postmenopausal period. According to literature, the frequency of women reporting for gynaecological examinations decreases with age, and women between 41 and 60 report to the gynaecologist less frequently than every 20months [47]. This situation should be considered as both worrying and requiring improvement. This study shows that in many cases (37.3%) the only reason for making an appointment with a gynaecologist was the appearance of disturbing symptoms. Such appointments do not have a prophylactic character. Some authors claim that such appointments are perceived by many women as a compulsion or an indispensable duty. They feel exempt from this duty if there are no disturbing symptoms [14]. Sometimes even when symptoms do show up (including the climacteric syndrome), it does not increase the regularity of gynaecological check-ups [48]. Breast self-examination is the first step in the secondary prophylactics of breast cancer. It is a simple, inexpensive, fast and non-invasive examination and all women should be encouraged to be more actively responsible for their own health [49]. It is the self-examination of breast that increases the number of early detections of breast cancers and therefore women should be encouraged to perform this self-check on a regular basis [14]. Our study indicated that 72.4% of women perform breast self-examination, although only a few (13.8%) did it regularly on a monthly basis. Similar trend was observed by other researchers [50]. One of the possible manifestations of womens concerns for their own health is taking advantage of free prophylactic examinations. According to the National Health Fund (NFZ), in 2015 only one in five women took part in the Population-Based Breast Cancer Early Detection Program, and in 2018 nearly two times more women participated. The Population-Based Cervical Cancer Screening Program attracted even fewer women-9.34 and 17.89%, respectively [51]. Our study indicated that 72.4% of the respondents declared undergoing regular mammography examinations and 69.4% confirmed they undergo regular smear tests of the cervix. However, it is not known to what extent this was a participation in a population-based screening programme. Perhaps some of them decided to undergo these examinations on their own initiative, i.e. without an invitation. What is more, some women sign up for test in private clinics. Anyway, the attendance rate is still unsatisfactory [52]. The reasons for such low attendance rate may be numerous and include a lack of faith in their effectiveness, ignoring the problem of cancer, the fear of pain and nudity associated with the examination, as well as fear of detecting the disease [53].

As regards health behaviours concerning positive mental attitude (PMA), the following categories were taken into account: avoidance of upsetting and depressing situations, avoidance of excessive emotions and tensions, and social life. The analysed material showed quite high psychometric properties of this factor (M=3.60; SD=0.70), which can be considered beneficial for the mental health of postmenopausal women. This is good news, as in this age group the incidence of various mental disorders, especially depression and anxiety, is generally on the increase [9]. These women, when compared to younger women, feel more negative emotions, such as anxiety, sadness and exhaustion [49].

Proper eating habits (PEH) are the third important health criterion and a number of factors were taken into account including the frequency of consumption of fruit, vegetables and wholegrain bread, and decrease in the consumption of animal fats, sugar, salt and heavily salted foods. The literature emphasizes the importance of following the principles of healthy nutrition and proper diet in the prophylaxis of diseases typical for the postmenopausal period (metabolic syndrome, ischemic heart disease, diabetes, malignant tumors, osteoporosis and depressive disorders) [14, 54].

It is worth noting that Juczyski [25] presented an identical distribution of results for all categories of health behaviours in his study. It is undeniable, however, that the results obtained by the authors of this study as well as the results obtained by other authors show that women are not sufficiently concerned about their own health. The average results which were obtained in reference to health-related behaviours cannot be considered satisfactory, due to the fact that women in this period are more susceptible to various psychophysical disorders [9, 14, 55, 56].

Choosing pro-health behaviours is usually characteristic of people who are satisfied with their health [57]. In the presented material higher self-assessment of health was significantly associated with a higher general indicator of health-related behaviours. In addition, in both age groups women who regularly performed prophylactic gynaecological examinations obtained higher score of the general indicator of health-related behaviours, proper eating habits (PEH), prophylactic behaviours (PBs) and health activities (HA). Moreover, women over 55years of age, who achieved higher scores in prophylactic behaviours (PBs) had mammography screening and preformed self-examination of breasts more regularly.

The obtained results concerning the concept of health, health self-assessment and the type of health behaviours undertaken by postmenopausal women may be further used in broadly defined health promotion programs, including new prophylactic programs. Most of these programs are aimed at convincing women that the proposed health-related behaviours will not only improve their lives but also they will be beneficial for their families and society. However, the programs need to be constantly improved and adapted to changing needs.

This study has several important limitations that may affect the obtained results. First and foremost, the selection of the study sample using convenience sampling methodology. Next, the broad age range of women included in the study. Therefore, for the purpose of statistical analysis, the study group was divided into two age groups. This way it was possible to show in more detail any possible differences in health behaviours and in the undertaken prophylactic activities. Another limitation is connected with the inclusion of women who had reported that they were undergoing continuous treatment for chronic diseases at the time of the study, which could have modified their health behaviours. However, due to the age of the participants, it is difficult, if at all possible, to include only women without any ongoing health problems. Therefore, to minimize this limitation, a statistical analysis was performed to check any potential differences in health behaviours presented by women in these two groups (with and without chronic diseases). The analysis showed that there is no statistically significant difference between these women in terms of health behaviours. It has to be noted that the claim of an undergoing treatment for a chronic disease was made subjectively by the participants. Their health history was not examined to objectify the results, neither were their former health behaviours investigated. Therefore, it was impossible to compare and analyse any changes, which could have occurred in this regard. It would be advisable to carry out such analyses in the future using a mix-method methodology, supplementing the collected material with qualitative research, which would allow for a more in-depth analysis of the issue.

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Perception of health, health behaviours and the use of prophylactic examinations in postmenopausal women - BMC Blogs Network

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When Dr Phil McGraw was 29, he had a vasectomy. At the time his wife was pregnant and he had made up his mind that he didnt want more children. Six years later, he would walk back into the clinic and demand for a reversal. Six months later, his wife was expectant.Having the procedure at such a young age was the biggest mistake I ever made.It is for this reason that doctors advice that when going for some long term family planning measures, you need to be absolutely sure. Vasectomy offers 99 per cent effectiveness and is suitable for men who are certain that they do not want any more children. According to Marie Stopes Kenya, this male sterilisation surgical procedure takes approximately 15 minutes and its failure rate is about 1 in 2,000 men. The Kenya Obstetrical and Gynecological Society reports that only one per cent of Kenyan men have undergone vasectomy despite its high effectiveness and surgical simplicity. However, since most vasectomies are performed in private facilities rather than in the public health system, the statistics could be an underestimation.It is estimated that 40 per cent of pregnancies globally are unplanned. In addition, most women are shunning hormonal contraceptives due to associated side effects. The modern man has grown more aware of the struggles their female partners go through and is more willing to take up family planning options. The options are nevertheless limited for men. Condoms, withdrawal (coitus interruptus and vasectomies are the most readily available artificial methods men can use. A man produces over 1,500 sperms per second which makes it challenging to come up with the most suitable reversible family planning method for men. But not to worry, there are options in the pipeline that will give the man more options and power over how many children he can have.WATCH OUT FOR:1. The Contraceptive gel

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Fluvastatin Sodium Drug Industry Size 2019, Market Opportunities, Share Analysis up to 2025 By Market Study Report

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The coronavirus pandemic has caused strain and hardship in so many ways and for so many peoplebut one demonstrable effect is that it has made the vulnerable more vulnerable. If it was already difficult to be an LGBTQ youth whose parents or caretakers dont understand or accept their sexuality/gender identity, that stress is magnified during a time when we, as a society, have been advised to stay indoors. The situation can effectively trap these people between the forces of a global pandemic outside and virulent bigotry inside.

The New York-based Ali Forney Center (AFC) continues to serve homeless LGBTQ youth, even during a global pandemic, providing housing, mental health support, meals, and a transitional living program that teaches youth to live independently. Though the AFC has been impacted by covid-19 in several ways, it is largely meeting the increased demands, according to executive director Alex Roque, who talked to Jezebel last week about the AFCs operation in the midst of a crisis. The organizations drop-in center, which serves new clients with no place to go, remains open (though it has moved to the organizations Bea Arthur Residence in Manhattans East Village). Theres been an increased demandin part because many of their former clients who were in college have been sent home, which means needing to return to one of the 18 AFC facilities around the city. Despite this, AFC has managed to increase its meal budget and spending for its recentlyout-of-work clients. (An info sheet sent out by AFCs communications department says that 90 percent of the organizations housed clients have lost their jobs as a result of the pandemic). Further, salaries of AFCs essential workers have increased by almost 50 percent. We really felt strongly that we needed to recognize how critical and how valued our essential workers are, Roque told me.

In our conversation, Roque explained how AFC has managed to do it, and how it is managing in general. Our interview has been edited and condensed.

JEZEBEL: Overall, how as the Ali Forney Center been managing during this pandemic?

ALEX ROQUE: AFC is in a unique because we are an essential services provider thats caring for a largely disenfranchised, uncared for population of young people who are rejected by their families because of their LGBTQ identity. Around the country and across the world, people have been asked to stay home and to shelter in place and find safety in their homes, and comfort in their families. Our young people dont have any of that, so its kind of a punctuation to what their realities are that even in these dark days and awful circumstances, they have nowhere to go.

Things are pausing. Pollution is down. Wild animals are running free. Critical care hospitalizationlike, heart attacks and strokeshave also declined significantly, according to the New York Times. I thought that maybe homophobia and transphobia would also just take a little pause. That hasnt been the case. Were seeing an increase in young people in our care and a demand for our work. A lot of it has to do with young people who were in our care before who went off to college and then were sent back because of shut-downs and we were their home before college. Some of it has been with young people who left their homes at younger ages because of homophobia and transphobia and were employed and have lost their jobs and now have no family to rely on. And another part of it is that a number of youth services providers have shut down in the city. A number of the shelters have shut down as a result of staffing issues, a number of community spaces and things like that have closed their doors. Thats increased the demand for our work. But theres this understanding that covid-19 is disproportionately affecting communities of color, disproportionately affecting communities struggling with poverty and lacking access to care. Its true for our young people. Among the most marginalized communities, our young people are still marginalized. Among LGBT youth, our young people are homeless LGBT youth.

Are you able to provide the same services that you were providing pre-coronavirus?

The drop-in center was moved to the Bea Arthur Residence at the recommendation of our medical provider. We have an onsite medical clinic and when covid started, we retained our medical provider to advise us on how to operate following CDC protocol. The CDC protocol was that there should be no more than 10 people congregating in a space. Thats difficult for us to do at the drop-in center, especially because we had on average anywhere between 60 and 80 young people coming there a day. We moved to a smaller facility where we can structure it more: housing referrals, offering meals, and offering crisis intervention for young people at Bea Arthur, and then more importantly, making sure were getting them into a stable bed as we work through this. Initially, it was a big increase and then when the new protocols came into place on March 23 about stay at home and 10 people or less, we moved it to Bea Arthur. A bulk of our services that were drop-in related were moved online. About 70 percent of our counseling, mental health, psychotherapy, medical, and educational services moved online. Were offering those online to young people and were still doing a structured drop-in program.

So, if someone is sheltering in place with a homophobic or transphobic parent, they still can leave and come to you?

Correct. They can come and access a meal, they can come and access support, and they can come and access solutions to housing options. We have 18 sites throughout New York City, and so we have beds at all those sites, except for the drop-in center. So if a young person is unstably housed, they can come to us, have the crisis de-escalation, have the intervention they can offer, and then have a housing referral to our program, which is preferred, or to another program that we work with.

What is the process in place for someone who comes in and has been potentially exposed to covid, and could expose other people? Is there any sort of quarantine?

Young people across all of our sites are assessed twice a day for their symptoms: temperature and a health check-in. Similarly, for clients that were intaking, were following a protocol. Outside of covid, when a young person would come into our care, they would have a medical evaluation and a check-in. Part of that evaluation now also includes covid, but also assessing them on their experiences and other health issues. We do have an isolation option at each of our housing sites. We have an isolation protocol at all of our sites so were not rejecting anyone from housing regardless of their exposure. Were working with the citys Department of Youth and Community Development on running a hotel to service isolation. If a young person is needing isolation, instead of isolating at our site, they will be picked up by a transportation service that will bring them to the hotel. At the hotel, they will be given a room. There will be 24-hour staff on site, like there is in our housing sites, and there will also be medical staff on sitea nurse and a medical doctor providing care.

You have increased demandare you able to meet it? Is it stretching your resources?

The increased demand has been largely from clients who were accessing care in other places, like meals and group activities and access to employment or employment help. Right now, were facing a lot of applications for unemployment. There are young people that we work with that are facing immigration issues, legal services. Young people are very resilient and resourceful, so typically wed piece together different resources throughout the city they could go to. And now because all of those have closed, weve had to increase our access to meals, consultation, mental health services and therapy, medical care, and also just access to a person. Were one of the few providers that are providing access to in-person care. So its an increase in volume, but not to the extent that we have to bring in a new staff team for that. We have the staff in place.

Youve been able to manage this extra demand?

We have.

Was it a challenge to get the youth on board with sheltering in place?

Yeah. Its been a challenge for most people around the world and our young people are no different. We definitely have struggled and had to rethink our work. We started having conversations with young people that went: What can we do to keep you here? We heard some really awesome things. When we really had to start to enforce the stay at home order, which came about a week after we started the covid response, they had some great ideas. They wanted more groups online, they wanted to be able to see their friends and they needed technology for that. They wanted to have pizza parties and ice cream socials and taco nights. They all wanted their own Hulu accounts. We had experiences with young people who lost employment and young people who didnt have conventional employment and needed help getting money because they still want to buy their own things.

We came up with a way of offering incentives. If you are covid compliant, you get a weekly stipend for staying at home and following those protocols. The reality is this is what families are dealing with across the country. I have a five-year-old and Im having these conversations about staying at home and why were here and why he cant see his friends. I think any supportive or loving environment is going to creatively brainstorm around that. So now we do Zoom dates with our friends and are playing more video games and he has all the junk food he wants, which he never has before. Were embracing it. Were all in this together and were going to do everything we can to keep you happy and support that. Whats different for us than a traditional family is that we are dealing largely with young people who are traumatized by their family rejection, who are dealing with some really, really awful backgrounds related to living on the streets and what theyve had to do to survive. This is retraumatizing, so were also infusing this approach to being creative during covid with a host of mental health services, a host of direct care and support groups and activities that are clinically based to help cope.

Youve increased spendingwhere did that money come from?

Fortunately, a number of agencies have come together to help. The city is offering help for their programs. We have city, state, and federal programs. Our meal program is largely unfunded. We serve over 220,000 meals a year and thats a largely unfunded program so weve had to shoulder that ourselves. Weve been able to petition to get more funding in those areas. Weve also reached out to our community, thats helping. We reached out to restaurants that sent food. We reached out to other partners who are meal providers. A lot of that has been helpful in getting food to our clients. The reason the number went up so much is because in our transitional living program, which is a graduating part of our work, the people in that program learn to buy their own groceries, the learn to cook for themselves, theyre required to have a job or being in school. And with them losing their jobs, weve had to increase our food expense, which is already difficult to meet. Weve been reaching out and securing meals. Were okay this week. Its kind of like Groundhog Day in many ways: Okay, here we go again. How are we finding meals this week? But were getting through it.

It sounds like youre doing well, all things considered.

Were very fortunate. Were a very young and scrappy organization thats also very mighty and driven by an incredible staff team. Many have the lived experiences of many of our clients, many come from communities that represent our clients, and many understand this calling, that we are these young peoples family. We are their comfort. We are their safety. Theres a lot of unity and compassion in the work and its something that were very proud of. Were stable. We have over 200 employees, and at any given time the average has been 30 staff members out because of covid, either because theyre at higher risk or because theyve had covid. The number of staff members whove had covid is much, much lower but its been rotating. Staff will be out for a two-week period and then theyll come back around and someone else is out. What struck me is the commitment of our team to being there. Our call-outs having to fill slots hasnt been out of the ordinary. Its been what we typically see, and we thought we were going to see a big decline in staff being able to show up for work. Weve been very fortunate and as a result weve been reaching out to providers and offering help because so many of them are not as fortunate as we are.

With staff members out and new clients coming in, are you secure in your ability to keep everyone safe from infection?

Weve had no shortage of young people who have been symptomatic and who have been put in isolation. We havent had outbreaks. Were following the protocols closely, were following the isolation closely, were following the cleaning. Were making sure the young person is cared for in a way that theyre not exposing [anyone else]that theres ventilation, theres a number of protocols in place. Were a month in, knock on wood, and we havent had an outbreak. Whats also to our benefit is that were in small, home-like environments and we have the same staff working our sites mostly, so its kind of like a family.

Can you give me a sense of what the increasing of staff salaries has looked like, in terms of a percentage?

Theres been a 44 percent or almost 50 percent increase in our pay for this period. We really felt strongly that we needed to recognize how critical and how valued our essential workers are, and thats 90 percent of our staff team is essential workers, frontline workers. So weve increased that in appreciation and support and recognizing that they are doing the extraordinary. At any given time, we have over 70 to 85 people on site, on staff, working around the clock. Theyre showing up for our young people and we really needed to recognize that. Theres so much gratitude across the board, and there is that moment of unity and this abundance of love that were feeling and a call to humanity right now. It definitely feels that way.

Do you have a sense of the morale among the youth?

Its gone up and down. Initially, there was a shock in seeing other programs close, in watching this starting to happen. There was a big moment of fear. Theres some restlessness right now. For some young people, theres been an increase in depression. This is isolating. The homeless population is largely isolated from the world and we work really hard so that people dont have that isolation. We mitigate and disrupt these feelings of isolation and now were re-isolated. Were doing meditation and yoga.

Has there been any change in your trans youths access to hormones?

During Week 2, after the stay at home order and we started to move our services to teleservices, we introduced a protocol to address hormone replacement therapy. We have a transgender housing site that has 18 young TG and T individuals. Our medical provider offers a guided live session with a staff person and a young person, so theres two people helping a young person with the administration of HRT.

What can people do who want to help?

Visit our website. It doesnt have to be money. Money is obviously needed, its helping us make the decisions for the purchases we need, but obviously thats not available to everyone and some people want to help in a different way. We have set up an [Amazon] wishlist, which allows you to understand the unique needs of an individual young person and also we have a way to sign up to engage in other ways. You can interact with a young person in a safe and secure way, or if you want to write a card, if you want to host a yoga session or talk about meditation or your job. Were open to connecting. At the core of our work is demonstrating to young people that theres nothing wrong with them, that there are people in our world who care about them, who value them, and who wish nothing but the best for them in spite of what their parents contend. So connecting with people is so important.

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How One Center for Vulnerable LGBTQ+ Youth Is Helping Its Clients During the Pandemic - Jezebel

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One thing that everyone can agree on right now is that the times we are living through are full of stress.

The worldwide outbreak of COVID-19, or coronavirus disease 2019, has resulted in abrupt and shocking changes to our lifestyles that we had little warning about and time to plan for and little to no control over.

We are living in confusion and fear as we try to avoid contagion and deal with the new social and economic realities. Considerable uncertainty exists about the future.

If any combination of factors leads to stress, the current times are full of them. Not only is the situation surrounding the virus causing stress, but that stress can impact how our bodies respond to the virus if we are exposed.

Some health-care experts warned that stress is contributing to complications and fatalities for those who become infected.

Many factors can affect an individuals response to illness, including age, gender, other medical conditions, lifestyle, genetics, socio-economic status and access to health care. These factors can generally be identified and measured to some degree.

However, defining stress is totally subjective, an individual factor that is not only hard to quantify but one for which experts do not have a common definition.

The National Institutes of Health of the U.S. Department of Health and Human Services describes stress as a physical and emotional reaction that people experience as they encounter changes in life. The changes we react to are called stressors.

Stress is normal, and the American Institute of Stress noted that some degree of stress is beneficial. It activates the fight or flight response whereby humans react to threats in their environment. A real-time example would be the immediate reaction to the sound of a fire alarm, causing a response to take quick action to extinguish the fire or escape.

The stress associated with a positive life changes, for example, a promotion at work, can be motivational and challenging.

However, when stress becomes overwhelming and persistent, it can negatively impact a persons health. People may perceive stressors differently. A change that one person may take completely in stride or consider a challenge may be perceived as a dire threat by another.

Many times, people dont realize the effects that situations are having on their health.

Some typical physical reactions to stress that people may experience include accelerated heartbeat, shortness of breath, tense muscles, headache, upset stomach and insomnia. Emotional reactions may include anxiety, depression, moodiness, irritability, feeling overwhelmed and loneliness.

Research shows that intense and prolonged stress can weaken the immune system. For example, the substance gamma interferon, which is produced in the body to activate the immune system, can be reduced by stress. Corticosteroid, a stress hormone, can lower the number of lymphocytes, which are infection-fighting cells.

People can become more prone to illnesses and less able to fight them off. In addition, the immune system becomes weaker with age, and older people cannot fight infections as well as the young can. Older people are also more likely to become infected, and the infection is more likely to be fatal.

Studies also show that once an infection, such as the influenza virus, takes hold, it can suppress the immune response and allow a secondary infection to move in. Often, a bacterial infection like pneumonia will follow a viral infection like influenza.

Just about every bodily system can be affected by stress. Stress can cause the airway between the nose and lungs to constrict, leading to rapid breathing (hyperventilation) and shortness of breath.

These respiratory changes can be deadly in someone infected with COVID-19, especially if the patient has a condition like asthma or emphysema. This makes hospital ventilators critical because ventilators move oxygen into and out of the lungs of people who cannot breathe sufficiently on their own.

Physicians have long recognized that stress plays a role in a patients recovery.

Audrius Plioplys, M.D., a retired pediatric neurology specialist with over 45 years of experience, has served as medical director for several pediatric skilled-nursing facilities and was on the staff of Michael Reese and Mercy hospitals.

The longtime resident of North Beverly shared some insights on the subject.

Certainly, stress can produce or contribute to many illnesses, said Plioplys. I have seen quite a few patients with epilepsy where stress clearly exacerbates their seizures.

My medical expertise is neurology. In clinical practice, I have many cases where stress will exacerbate, or even cause, headaches, both tension headaches and migraine headaches.

Plioplys said it would be no surprise to learn that stress is contributing to the prevalence, severity and fatality rates of the coronavirus pandemic.

Even before this pandemic, concern has grown about rising levels of stress in the U.S.

At a 2017 conference, former U.S. Surgeon General Vivek H. Murthy, M.D., gave a presentation on the public-health consequences of stress. He cited such factors as a 24/7 work culture; fewer supportive, in-person social connections; financial challenges; relationship/family issues; and health problems.

For years, public-health professionals have offered advice on flu stress to get through annual flu outbreaks. The precautions that are being instituted nowwashing hands, avoiding crowds, etc.have been shared numerous times before.

Mental-health professionals have also studied and written about the increased stress that can develop from watching or listening to hours of bad news on subjects such as terrorist bombings, school shootings, natural disasters and, now, the virus pandemic.

Studies conducted after the 9/11 attacks on the World Trade Center showed that excessive following of media coverage caused some people to experience post-traumatic stress symptoms even though they were nowhere near ground zero.

Fortunately, helpful coping mechanisms for dealing with stress are available. First and foremost, it is important for people to learn to recognize how their body and mental states are reacting to stressors, such as working from home or missing church. They may not be able to control the situation, but they can control their response.

In his presentation, Murthy recommended several buffers, including getting enough sleep, increasing social connections and practicing meditation or other contemplative activities. The beneficial results of these buffers for individuals also positively affect families, workplaces and society.

Plioplys also recommended meditation.

One of my standard recommendations for treating headache patients, said Plioplys,is meditation, specifically for the purpose of decreasing stress.

Indeed, of the many therapies suggested to deal with stress that have been studiedfrom relaxation techniques to yoga to aromatherapymeditation has shown the most positive results.

Advice for news consumers is to be informed without becoming overwhelmed; watch, read or listen to objective news services that offer helpful advice and limit exposure, especially before going to bed at night. Avoid repetitive, sensational coverage that only heightens negative emotions.

Coping mechanisms to avoid include those that lead to unhealthy habits like over-eating and over-imbibing in alcohol. Ultimately, these reactions lead to more problems than to solutions. The same is true for self-medicating. Taking any kind of over-the-counter or natural supplement should always be first discussed with a physician.

Isolation, feelings of loneliness or loss of control can increase stress, which is not good news given the current shelter-at-home directives. This is especially true for the elderly and the poor who have less access to computers and less technological know-how to reach out to others via the internet and social media. Family, friends and caregivers should be aware of this and help as they can.

Many good websites are available with information on stress and how to deal with it. Look for those connected to government and professional health-care organizations and to sites affiliated with hospitals and medical centers.

Although many physicians offices and clinics are temporarily closed for non-emergency in-person visits, these practitioners are still available by phone or videoconference. They can help with advice and referrals.

On April 11, Gov. J. B. Pritzker acknowledged that this is a time of crisis and announced a new service, Call4Calm, that will be available through the state to allow Illinois residents to speak for free with mental-health professionals about issues related to the coronavirus pandemic.

We are living in a deeply unprecedented moment, and holding the emotional ramifications of that inside will only be harder on you, Pritzker said. Please know that you dont have to feel it all alone. I want you to know that were here to help.

Residents can text the word TALK, or for service in Spanish the word HABLAR, to 552-220.

They will be asked for their first name and ZIP code, which will be used to connect callers with a health-care provider in their area. People can also seek information for other pandemic-related issues by entering key words such as shelter and unemployment.

By taking a positive approach to dealing with negative situations, we can all get through the stress of these troubling times.

Link:
Stress plays big role in people's reaction to pandemic - The Beverly Review

Recommendation and review posted by Bethany Smith

People with hypothyroidism who choose dried thyroid extract (DTE) over levothyroxine alone perceive that it works better, but patients may not be aware of the risks, new research suggests.Those were some of the findings from the qualitative analyzes of nearly 700 online posts from three popular online hypothyroid forums, which found that 75% of patients felt they did better with DTE than standard levothyroxine therapy (LT4). .

The results were due to be presented at the Endocrine Society annual meeting in late March, but the meeting was canceled due to the COVID-19 pandemic. They were subsequently published online April 3 in Medicine by Freddy J.K. Toloza, MD, a postdoctoral researcher at the University of Arkansas for Medical Sciences, Little Rock, and a research collaborator at the Mayo Clinic, Rochester, Minnesota, and colleagues.Made from dried pork thyroid glands, DTE is not approved by the U.S. Food and Drug Administration because it predates the agency, but it was protected and is legally sold by prescription under the names of Nature Thyroid, Thyroid USP and Armor Thyroid.

DTE is currently used in 10-29% of hypothyroid patients, despite concerns about the risk of side effects associated with hyperthyroidism.

"Current guidelines (American Thyroid Association) strongly suggest the use of levothyroxine over DTE as thyroid replacement therapy. We agree with this recommendation due to concerns about the side effects of DTE," Toloza told Medscape Medical News."However, additional research needs to be done to understand if this recommendation applies to all hypothyroid patients," he added, and for those patients taking DTE, more research is required to determine who is at risk for side effects and the methods to prevent them. .Toloza said hypothyroid patients taking DTE frequently described the lack of individualized treatments and the feeling of not being heard as problems influencing their choice.

"These findings reinforce the need for patient-centered approaches in current clinical practice. Physicians must listen carefully to their patients and consider their individual needs and the context of each patient," he noted.A select group of patients improves in combination with T4 / T3When asked to comment, endocrinologist Rachel Pessah-Pollack, MD, of New York University Langone Health, told Medscape Medical News: "Animal-derived desiccated thyroid hormone contains both T4 and T3. We generally do not recommend use this because it can vary in concentration, which means that the actual preparation is not physiological. "Pessah-Pollack, co-author of the 2012 American Thyroid Association and American Association of Clinical Endocrinologists Joint Clinical Practice Guidelines on Hypothyroidism, added that one of the main concerns about the use of DTE is the risk of iatrogenic hyperthyroidism, which could lead to atrial fibrillation and fractures

"That is one of the main factors that drives many professional societies to really use caution with regard to DTE. That is also the reason why large societies recommend not using DTE based on the evidence to date." , He said.

However, the whole question of "combination therapy" in hypothyroidism is debatable. Doctors may also prescribe a "combination" of synthetic levothyroxine (LT4) and treatment with triiodothyronine (LT3); This, along with the use of DTE products, has been a topic of debate for many years.

The current guidelines (2014) of the American Thyroid Association do not specifically rule out the use of synthetic LT4 / LT3 therapy, but "recommend only against routine use of combination therapy." And while they do not expressly endorse the use of DTE, they did delete a statement that "should not be used."

"There is definitely a select group of patients who do better on T4 / T3 combination therapy, and we are still trying to delineate who that population is," Pessah-Pollack told Medscape Medical News.

"As long as these patients are closely monitored and aware of the risk of hyperthyroidism and their levels are followed to ensure that they are not hyperthyroid, in selected cases this is appropriate."

"But the first line is to ensure that a good evaluation is done Clearly, this helps us understand that we do need more studies in this area, well-designed and blinded studies to really help us get to the bottom of this controversy."

Those taking DTE cite improved symptoms, well-beingToloza and colleagues analyzed 673 posts from three online forums, Medscape's parent company WebMD, PatientLikeMe, and Drugs.com, selected from an initial 1235 post because they included more comprehensive information.

Approximately half (51%, n = 257) of the patients had primary hypothyroidism / Hashimoto's thyroiditis, 25% (n = 126) had postsurgical hypothyroidism, and 16% (n = 81) had postablation hypothyroidism. Among the 172 publications in which DTE dose information was available, the mean dose was 84.1 mg / day. The duration of treatment varied widely, from 2 weeks to 45 years.

Among the publications describing the source of the DTE prescription, initial interest was primarily patient-driven in 54% (n = 88), while 46% (n = 74) said a physician fueled their interest in try the DTE. (Type of clinician not reported.)

Among the publications that mentioned the source of DTE, local pharmacies were the most common (63%, n = 75), followed by pharmacies outside the United States (31%, n = 37) and online (6%, n = 7).

Previous thyroid treatments were mentioned in 300 publications, of which 93% mentioned monotherapy with LT4.

Among the reasons for switching to DTE, there were no improvements in clinical symptoms (47%, n = 75), development of side effects (24%, n = 38), no change in general well-being (22%, n = 36). ), and without changes in laboratory work (7%, n = 12).

The perceived benefits of DTE included an improvement in clinical symptoms (56%, n = 155), a change in general well-being (34%, n = 94), the possibility of reaching a previous state of health (7%, n = 19) and a low cost compared to the previous treatment (3%, n = 8).

Specific symptoms reporting improvement included fatigue (28%, n = 43), weight gain (17%, n = 26), and neurocognitive symptoms (5%, n = 8). The average time to notice the benefits with DTE was approximately 30 days, but it varied widely from 2 days to 4 months.

Most publications (77%, n = 99) stated that DTE was more effective than their previous therapy, while 13% (n = 17) described it as equally effective and 10% (n = 13) said it was less effective.

DTE side effects were described in 20% (n = 136), including weight loss (15%), fatigue (11%), palpitations (11%), heat intolerance (11%), sleep disorders (10%), high blood pressure (7%) and hair loss (5%).

"Doctors think they know how you feel"A qualitative analysis of the publications yielded five main themes: experience with previous therapies before starting DTE, perceived effectiveness and benefits of DTE, side effects of DTE, need for individualized therapy for hypothyroidism, and barriers to obtaining DTE.

One patient posted, "Synthroid (levothyroxine) did not help and gives me negative side effects my endocrinologist attributed all side effects to everything except Synthroid."

Another wrote: "(The armor) changed my life I'm glad I found a medication that makes me feel normal again everyone has improved; the mood, the skin (no itching), no pain head, goiter is depressed. "

Others cited the lower cost of armor compared to Synthroid.

However, some expressed negative experiences with DTE, such as: "My doctor hoped this medication would help with brain fog, energy, and tiredness. I experienced the opposite."

And some were unable to obtain it. One wrote: "Doctors think they know how you feel and don't even tell you about Armor. I asked my doctor and they said there weren't enough studies to show its effectiveness."

Better evaluation, more data neededPessah-Pollack noted that the study data does not address whether the patients' initially prescribed doses of levothyroxine were optimal, noting that changes are sometimes needed, such as during pregnancy, after weight gain, or if the patient is taking other certain medications.

"It is unclear from the symptoms reported by the patient whether they actually had an evaluation of their thyroid levels to ensure that their thyroid hormone dose was correct before switching to T4 / T3 replacement There are many factors that they should be taken before deciding that the drug itself is not working. "

What is urgently needed, he said, are "well-designed, blinded studies that look at this controversy."

"Here, we don't know why patients feel better We need to do additional work that includes validated symptom questionnaires and comparing the thyroid levels of patients on armored thyroid with those on levothyroxine monotherapy."

Toloza agrees: "It cannot be said that DTE works better for the user due to the limitations and nature of the data used in our study."

"However, our findings are in line with previously published research, which has shown that a subset of patients may prefer ETD to levothyroxine and have greater satisfaction with this treatment. However, the reason behind this has not yet been established. understands well, "and should be further investigated.

Pessah-Pollack has reported being an advisor to Boehringer Ingelheim-Eli Lilly and Radius Health, and moderator for Sanofi.

Medicine Published online April 3, 2020. Summary

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. (tagsToTranslate) hypothyroidism (t) thyroid disorder (t) goiter (t) hyperthyroidism (t) chronic lymphocytic thyroiditis (t) adverse effects (t) side effects (t) patient safety (t) thyroid (t) Endocrine Society

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Patients say dissected thyroid is better than standard therapy - NewsDio

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We've all been talking about Sandra Bullock's beauty for several years now, and we still aren't sure how she manages to look stunning in every single photo of hers. Although she dismissed the idea of having plastic surgery, she does affirm that just like almost every Hollywood celebrity, the Bird Box actress uses natural remedies and a particular treatment which even surprised Ellen Degeneres!

Apparently, yes. In 2018, The Oceans 8 star revealed on The Ellen Show that she gets her foreskin facial also famously known as EGF serum by New York-based celebrity beautician, Georgia Louise who also treats stars like Katy Perry, Cate Blanchett, and Emma Stone.

The480 treatment which has the stem cells from foreskin Korean babies is what makes her skin to look younger and fuller. Approved by the state Department for control over products and medicines, Louise wanted to give Sandra something that would prevent her from undergoing any needles or lasers.

Related:Even Kim Kardashian Has Big Beauty Regrets

"I wanted to give Sandra something that would change her skin without having to go through the lasers and would provide long-term results," George Louise told to People. "In her case, the effect of the procedure seems to work great."

"It's this way in which one forces through micro-needlingit's a little roller, I think many of you know it," She said. "It pushes through the skin, ruptures the collagen and boosts it and you look like a burn victim for a day."

Apart from using the strange serum, Bullock also practices wipes her face with slices of fruits that leaves her skin looking fresh and toned. She uses anti-aging cosmetics as well to smooth out those fine lines and conceal the dark circles but avoids using it heavily on her face.

In fact, the one thing which she never forgets is quality cleansing, and she achieves that by using a sponge made of flannel fabric.

Related:10 Weird Beauty Techniques From Around The World

The 55-year-old actress refrains from using bright shades but instead opts for natural skin tones that make her look more elegant and quintessential. All she uses is a moisturizing cream, a neutral eye shadow, lip gloss, blush and, mascara, and she's good to go.

According to Popsugar, Sandra Bullock often consumes lean proteins in her diet and her menu usually consists of salads, steamed rice, tea and, fresh juices. Emirates Woman reports that Bullock sticks to her lean diet for six days a week but gives her body the freedom to indulge in the things that make her (everyone) happy such as chocolates and sweets.

CBS News reports that Bullock enjoys chicken and turkey meals that are sugar and gluten-free and that she eats throughout the day to maintain her metabolism.

Related:Anna Hathaway Reveals These Simple Yet Stunning Beauty Secrets

Apart from all that, the Speed actress's main beauty secret is apples! She eats apples and honey to overcome her sweet cravings.

"I start Friday night and I end Saturday night." She told InStyle.

She has a simple mantra to keep her healthy and young and that's to eat 5 times a day, eat in small portions, drink a lot of water and to avoid eating after 6 pm.

"There's always cardio like dance, jump roping or rebounding," Bullock told Women's Health. "Then we alternate between 10-minute intervals of high-intensity cardio and strength training moves that focus on different body parts."

Well, it's not easy for a Hollywood Star to maintain their health in between their sleepless nights and busy schedules but Bullock does it all with a strong mindset.

"I never did anything according to what anyone else wanted. That's why I think I am happy," She continued, adding. "I know when I'm getting ready to mess up, I'm going to do it full-on. I now know that anything sweet, really sweet, that I have was nothing that I planned."

And that's about all the hacks we know about the mother of two's everlasting beauty.

Next:Here Are 15 Things Sandra Bullock Has Been Up To Since Bird Box

Ellen DeGeneres Tries To Go From Bad Joke To Good Deed

Aaliyah Salia is the author of the 13: We all Start as Strangers, a poet, freelance writer, Vlogger, Travel Enthusiast, Script Writer, Proofreader, and Gamer. She has written many fanfictions on the online writing platform called Wattpad and is a Level 2 Seller on Fiverr.

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All The Hacks You Need To Know About Sandra Bullock's Beauty - TheThings

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One key to stopping the spread of Covid-19 is knowing who has it. A delay in reliable tests and Covid-19 diagnostics in the United States has painted an unreliable picture of just how many people are infected and how the epidemic is evolving. But new testing options are now becoming available and the information from these diagnostics will help guide decisions and actions important for public health.

McGovern Institute research scientists Omar Abuddayeh and Jonathan Gootenberg have been developing CRISPR technologies to rapidly diagnose Covid-19 and other infectious diseases. They recently described the current state of Covid-19 testing.

Q: How do Covid-19 tests work?

A: There are three main types of tests. The first uses the detection of nucleic acid. These tests directly test for the RNA genome of the virus in a variety of sample types, such as nasopharyngeal swabs or sputum. These tests are most commonly performed using polymerase chain reaction (PCR), which can amplify a small part of the virus RNA sequence billions-of-fold higher to allow detection with a fluorescence measuring instrument. These types of tests are highly sensitive, allowing for early detection of the virus days after infection. PCR tests require complex instrumentation and are usually performed by skilled personnel in an advanced laboratory setting. An alternative method is SHERLOCK, a nucleic acid-based test developed here at MIT stemming from the CRISPR gene editing tool that does not need complex instrumentation and can be read out using a paper strip akin to a pregnancy test, without any loss of sensitivity or specificity. The test is also low-cost and can be performed in less than an hour. Because of these features, we are hoping to gain FDA approval that allows deployment at the point of care or at home testing with our Covid-19 SHERLOCK test kit.

The second type of Covid-19 test detects viral proteins. Some tests use a paper strip that have antibodies against Covid-19 proteins. These allow for easy detection of the virus in less than an hour but are at least a million-fold less sensitive than nucleic acid-based tests because there is no amplification step. This makes them less ideal for screening purposes, as many patients will not have enough viral load in sputum or swabs and will receive false negative results.

The third category is serology tests that detect antibodies against the virus. These tests can also be used as a paper strip with antibodies that detect other antibodies that develop in someones blood in response to Covid-19 infection. Antibodies do not show up in blood until one to two weeks after symptoms present, so these tests are not great for catching infection at early stages. Serology tests are more useful for determining if someone has had the infection, recovered, and developed immunity. They may serve a purpose for finding immune people and deciding whether they can go back to work, or for developing antibody-based therapies.

Q: Why arent there more Covid-19 tests available?

A: The difficulties in getting nucleic acid detection tests stem from a confluence of multiple factors, including limited supplies of tests, limited supplies of other consumables needed for testing (such as nasal swabs or RNA purification kits), insufficient testing bandwidth at sites that can perform tests (often due to bottlenecks in labor or instruments), and complications behind the logistics of assigning tests or reporting back results. As a result, just producing more testing material would not solve the issue outright, and either more instrumentation and labor is required, or newer, more rapid tests need to be developed that can be performed in a more distributed manner with reduced dependence on equipment, centralized labs, or RNA purification kits.

Q: What kind of Covid-19 test are you developing now?

A: We are working on a nucleic acid-based test that does not require complex instrumentation, rapidly returns results (with a goal of under one hour), and can be performed at a point-of-care location without trained professionals. We hope to accomplish this using a combination of techniques. First, we are incorporating isothermal amplification technologies, which, unlike current PCR-based tests, do not require intricate heating and cooling to operate. We are combining this with our CRISPR-based diagnostics, allowing for sensitive detection and readout in a simple visual format, akin to a pregnancy test. We hope that this test will significantly lower the barrier for accurate diagnosis and provide another approach for Covid-19 surveillance.

Excerpt from:
3 Questions: How Covid-19 tests work and why they're in short supply - MIT News

Recommendation and review posted by Bethany Smith

Takeda has a number of early-stage gene therapies in its pipeline, including several for rare diseases. However, the pharma giant is looking to bolster its early-stage assets further with an agreement with Evotec GT.

Evotec GT is housed in Orth an der Donau, Austria, and specializes in the development of gene therapy for hemophilia, hematology, metabolic and muscle diseases.

After its acquisition of Shire, hematology now constitutes a core part of Takedas portfolio, meaning that this collaboration could offer the potential to strengthen its treatment base in the years to come.

Few further details were offered, and no financials were disclosed. Evotec only acknowledged that there would be an upfront payment and additional various payments over time.

What is known is that the long-term partnership will support multiple targets within Takedas four core therapeutic areas, oncology, rare diseases, neuroscience and gastroenterology. With Steven Hitchcock, global head of research for Takeda, suggesting that the rare disease area would likely be the principal focus.

With the Shire takeover complete, Takeda has turned its attention to signing small deals to fill out its early-stage pipeline in complementary areas to the formers portfolio, which saw it sign a deal for a microbiome-based therapeutic for Crohns disease and saw it acquire PvP Biologics to take on the companys therapeutic enzyme for celiac disease.

Read more:
Takeda and Evotec partner on gene therapy - BioPharma-Reporter.com

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The COVID-19, pandemic has brought the world to its knees in a way that has not been seen in most peoples lifetimes.

In addition to an enormous impact on human health in many countries, restrictions imposed in an attempt to control the virus and protect vulnerable populations are having far reaching impacts across the global economy.

Biotech and pharma companies in Europe and elsewhere have rushed to support work on developing new diagnostic tests, treatments and vaccines for the virus. But with most non-COVID-19 clinical research at a standstill, laboratories shut and staff working from home, many companies are losing out.

Recruiting patients into new or ongoing clinical trials seems to be an issue not for a few companies, but at least half of the companies I follow, said Marcus Wieprecht, healthcare specialist and managing director of equity research at Mainfirst bank in Frankfurt.

Frontrunners in the race to develop a vaccine include Moderna in the US and BioNTech and CureVac in Germany. Moderna has begun phase I tests in human volunteers, BioNTech plans to start testing this month and CureVac hopes to begin tests in June.

The move into infectious disease vaccines marks a change in direction for Moderna and BioNTech, which initially were applying their messenger RNA technologies in the development of cancer vaccines. CureVac too, has taken an mRNA-based cancer vaccine into clinical development, but it also has positive safety and tolerability data for a rabies vaccine, and an approved manufacturing facility in Tbingen.

If the data from our COVID-19 project is as positive as our rabies data, then certainly there will be an accelerated kind of approval process, said Franz-Werner Haas, acting CEO of CureVac. This is what we have to discuss with the regulatory authorities, but there is a potential that this could be the first one.

You have to follow the same manufacturing steps whether its a rabies vaccine, a COVID vaccine, or an oncologic vaccine, Haas said. The mechanism is always the same.

Who stands to lose?

In the rush to test drugs against COVID-19, clinical trials in other indications are being interrupted by the strains on healthcare systems and the fact that many potential patients are those most likely to suffer severe effects from coronavirus infection.

This will have an impact on the financial health of small biotechs with limited cash runways, which are now facing longer waits for clinical trials to read out.

For example, in March, Swiss biotech Addex Therapeutics announced it is postponing the registration study of its lead programme dipraglurant in the treatment of Parkinsons disease. Similarly, fellow Swiss company Geneuro said the start of a phase II trial of its lead programme, temelimab in multiple sclerosis, due to be held at the Karolinska Instituet, was being deferred.

Delays in starting trials will lead to delays in getting results and this will hit the finances of small companies that rely on delivering data to raise the next tranche of private capital or trigger a milestone payment from a commercialisation partner. Companies have a base level of cash burn, even if they arent running an active clinical trial.

Addex and Geneuro are fortunate not to have started their trials. Many companies with ongoing clinical studies that have already sucked up a large amount of time and money, are now unclear when they will end. Regulators are taking a flexible approach and allowing deviations from trial protocols, for example, allowing patients to have assessments by telephone and for supplies of trial drugs to be delivered to patients homes. They also promise flexibility when the time comes that trials can restart.

One company that is benefitting from this flexibility is French biotech Sensorion, which is currently running a phase II study testing a gene therapy in hearing loss. While it has had to delay the recruitment of new patients, it continues to monitor those already enrolled.

Since some patients enrolled in the study may be unable to complete the follow-up visits as planned in the protocol, follow-up visits are being planned via teleconference or videoconference with the clinical sites, said Nawal Ouzren, CEO of Sensorion.

It is important the regulators work with companies to ensure trials that have been put on hold are not invalidated, said Eric Le Berrigaud, managing partner of equity at the French investment bank Bryan Garnier & Co, which has a focus on healthcare. We really have to make sure that everything can remain statistically meaningful, he said. When theres a few weeks delay, protocols are [drawn up] in such a way that you can adjust for that, but if it's a matter of months, then it could put a lot of trials in jeopardy.

Investor sentiment

Biotech and pharma shares have suffered far less than other sectors from the havoc COVID-19 has wreaked in stock markets around the world, but there have been falls nonetheless. On January 23 as the COVID-19 crisis began to unfold, the share price of the Nasdaq-quoted Austrian biotech Hookipa Pharma was US$13.80. It hit a low of $5.90 on March 16, recovering to $7.98 at the close last Thursday, 9 April.

Theyre doing well, but in the aftermath of COVID-19, in-sync with the overall market, suddenly their share price goes down, with no good reason, said Markus Hosang, General Partner at BioMed Partners venture capital firm in Basel, an early backer of Hookipa.

Hosang said BioMed Partners is continuing to invest in startups, but is taking a more cautious approach. Already at the outset we will have to make sure that enough capital is made available, particularly to young earlier-stage companies.

Andreas Schmidt, CEO of Proteona, a specialist in single cell proteomic analysis, believes this is a time for dynamic rethinking. The Singapore-based company was due to run tests of its technology in Germany, but with many big research centres in the country closed, it needs to do these elsewhere.

We are very international. We have operations in California and Germany and Singapore ... right now, we are hardly affected in terms of operations in Singapore. So we just say, okay, anything we would have done in Germany, we will now do in Singapore.

Government assistance

The sheer scale of the problem has resulted in governments across Europe introducing grants, loans and other assistance for companies in difficulty due to COVID-19. The French government for example, introduced measures that have been taken up by local biotechs including Pixium Vision, which is developing a retinal implant for correcting sight loss.

The European Commission is also providing support for smaller companies and will make 1 billion available from the EU budget over the next few weeks, to activate 8 billion of financing for 100,000 European small and medium enterprises.

The commission has also announced dedicated research and development funding. Over 1,000 start-ups and small and medium-sized companies with ideas for tackling the COVID-19 pandemic have applied for funding in the European Innovation Councils special 164 million call.

Some small life sciences companies have benefitted from 47.5 million in dedicated funding from Horizon 2020, to support development of diagnostic tests, treatments, vaccines and monitoring and other medical systems.

One beneficiary is the Irish company HiberGene, which was awarded 1 million to fast track development of a COVID-19 diagnostic.

Another source of finance is crowdfunding, with equity crowdfunder Aescuvest for example collaborating with other crowdfunding platforms to raise money for biotechs working on combating COVID-19.

Schmidt is on the board of Aescuvest. All the crowd investment platforms are aligning forces to look at raising money very quickly beyond the normal business model, he said. It's a bit of an experiment. I think nobody has tried that before.

Vaccines, and antiviral and antibiotic drugs are not seen as an attractive area for investment, due to long and expensive development timelines and low returns on investment. The current pandemic is so devastating and widespread it could leave more of a long-term legacy than other recent outbreaks, such as Ebola and Zika, which have had less impact in terms of their geographical spread.

Its not clear as yet what this legacy will be, but when the dust settles and the reports are written, one likely outcome will be a greater prioritisation of pandemic preparedness in western countries.

Its like the immune system. If you want to prime with active immunisation, you want to prime your body to be protected if the situation occurs, said Haas. If it doesnt occur, fine, but if it occurs, the body is already alerted and knows what to fight for.

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Balancing the scales in healthcare: winners and losers from COVID-19 - Science Business

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