Every week there are numerous scientific studies published. Heres a look at some of the more interesting ones.

Mutation Found in Dark Matter of the Genome New Target for Cancer

The so-called dark matter of the genome is the non-coding regions that make up about 98% of the genome. Researchers at the Ontario Institute for Cancer Research (OICR) recently identified a novel cancer-driven mutation in this region that is linked to brain, liver and blood cancer. They published the two studies in the journal Nature.

Non-coding DNA, which makes up 98% of the genome, is notoriously difficult to study and is often overlooked since it does not code for proteins, said Lincoln Stein, co-lead of the two research studies and Head of Adaptive Oncology at OICR. By carefully analyzing these regions, we have discovered a change in one letter of the DNA code that can drive multiple types of cancer. In turn, weve found a new cancer mechanism that we can target to tackle the disease.

The mutation is dubbed U1-snRNA, and it appears to disrupt normal RNA splicing, which changes the transcription of genes that drive cancer. The mutation was identified in tumors of patients with specific subtypes of brain cancer and was found in almost all of the samples. The cancer was sonic hedgehog medulloblastoma. It was also found in samples of chronic lymphocytic leukemia (CLL) and hepatocellular carcinoma.

Our unexpected discovery uncovered an entirely new way to target these cancers that are tremendously difficult to treat and have high mortality rates, said Michael Taylor, pediatric neurosurgeon and senior scientist in Development and Stem Cell Biology and Garron Family Chair in in Childhood Cancer Research at The Hospital for Sick Children and co-lead of the studies. Weve found that with one typo in the DNA code, the resultant cancers have hundreds of mutant proteins that we might be able to target using currently available immunotherapies.

Diagnosing Lyme Disease in 15 Minutes

About 300,000 people are diagnosed with Lyme disease each year. Borrelia burgdorferi is transmitted by the bite of infected Ixodes ticks, and if untreated, can cause neurologic, cardiac, and rheumatologic complications. Current testing involves two complex tests, ELISA and western blot. Researchers have developed a rapid microfluidic test that can provide comparable results in as little as 15 minutes. It will require more refinement and testing before widespread use.

Gene Therapy for Wet Age-Related Macular Degeneration Shows Promise

Research was recently presented on six patients who received a gene therapy for wet age-related macular degeneration (AMD). The patients have gone at least six months without continued injections for the disease that were previously required every four to six weeks. The therapy, which is injected into the eye, generates a molecule much like aflibercept, a broadly used anti-VEGF drug.

How Dementia Spreads Throughout Brain Networks

Frontotemporal dementia (FDT) is similar to Alzheimers disease, but tends to hit patients earlier and affects different parts of the brain. Researchers studied how well neural network maps made from brain scans in healthy people could predict the spread of brain atrophy in FTD patients over several years. They recruited 42 patients at the UCSF Memory and Aging Center with a form of FTD and 30 with another form. They received MRI scans and then follow-up scans a year later to determine how the disease had progressed. They found that the standardized connectivity maps were able to predict the spread of the disease.

Mucus and Microbes: A Therapeutic Gold Mine.

A specific type of molecule called glycans that are found in mucus prevent bacteria from communicating with each other. Mucus also prevents the bacteria from forming infectious biofilms. It is also pointed out that more than 200 square meters of our bodies are lined with mucus. There are hundreds of different types of glycans found in mucus, and most of them are responsible for suppressing bacteria. Katharina Ribbeck, a professor at the Massachusetts Institute of Technology, says, What we have in mucus is a therapeutic gold mine.

Mechanisms that Regulate Brain Inflammation

The role of brain inflammation in diseases like Alzheimers and Parkinsons is becoming better understood. Researchers recently identified mechanisms that regulate brain inflammation, which has the potential to open new avenues for treating and preventing these diseases. The scientists found that a protein called TET2 modulates the immune response in microglia, immune cells in the brain, during inflammation. In mice engineered not to have TET2 in the microglia, neuroinflammation is reduced. Normally, TET2 with other proteins regulates the activity of genes by removing specific chemical markers from DNA, but TET2 appears to behave differently in microglia.

Pilot Study: Even Short-Term Vaping Causes Lung Inflammation

Research out of The Ohio State University Comprehensive Cancer Center found cellular inflammation was caused by e-cigarette, i.e., vaping, use in both long-term smokers and people who did not smoke. They used bronchoscopy to evaluate for inflammation and smoking-related effects and found a measurable increase in inflammation after only four weeks of vaping without nicotine or flavors. The amount of inflammation was small compared to the control group, but the data suggests that even short-term use can result in inflammatory changes at a cellular level. Inflammation in smoking is a driver of lung cancer and other respiratory diseases.

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Research Roundup: Genomic Dark Matter Mutation and More - BioSpace

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Sudden Infant Death Syndrome (SIDS), sometimes known as crib death, occurs when an infant under the age of one dies inexplicably.The typically healthy child will often die while sleeping and is the leading cause of death of children between the ages of one month and one year, claiming approximately 3000 lives a year. There has been little known about the cause of SIDS but new research is now showing that some form of SIDS could be linked to a genetic inability to digest milk.

A study out of theUniversity of Washington School of Medicine focused on the "mitochondrial tri-functional protein deficiency, a potentially fatal cardiac metabolic disorder caused by a genetic mutation in the gene HADHA."

It found that newborns with had the genetic mutation are unable toproperly digest some of the fats found in breastmilk, resulting in cardiac arrest. It found that "the heart cells of affected infants do not convert fats into nutrients properly," and once these fats build up they can cause serious heart and heart health issues.

There are multiple causes for sudden infant death syndrome, said Hannele Ruohola-Baker, who is also associate director of the UW Medicine Institute for Stem Cell and Regenerative Medicine. There are some causes which are environmental. But what were studying here is really a genetic cause of SIDS. In this particular case, it involves a defect in the enzyme that breaks down fat.

Lead author on the study Dr. Jason Miklassaid that it was his experience researching heart disease that prompted him to look at the possible link with SIDS. There was one particular study that had noted a link between children who had problems processing fats and who also had cardiac disease that caused him to delve a little deeper.

Miklas andRuohola-Baker teamed up to begin their own research study.If a child has a mutation, depending on the mutation the first few months of life can be very scary as the child may die suddenly,Miklas noted. An autopsy wouldnt necessarily pick up why the child passed but we think it might be due to the infants heart-stopping to beat.

Were no longer just trying to treat the symptoms of the disease, Miklas added. Were trying to find ways to treat the root problem. Its very gratifying to see that we can make real progress in the lab toward interventions that could one day make their way to the clinic.

Ruohola-Baker says their findings are a big breakthrough in understanding SIDS. There is no cure for this, she said. But there is now hope because weve found a new aspect of this disease that will innovate generations of novel small molecules and designed proteins, which might help these patients in the future.

Read Next:Babies May Not Be 'Designed' For Sleeping, According To SIDS Expert

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4-Year-Old Boy Interrupts Mom's Live News Broadcast

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SIDS May Be Linked To A Genetic Inability To Digest Milk, Study Finds - Moms

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KENILWORTH, N.J.--(BUSINESS WIRE)--Merck (NYSE: MRK), known as MSD outside the United States and Canada, today announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has adopted a positive opinion recommending approval of two regimens of KEYTRUDA, Mercks anti-PD-1 therapy, for the first-line treatment of metastatic or unresectable recurrent head and neck squamous cell carcinoma (HNSCC). KEYTRUDA, as monotherapy or in combination with platinum and 5-fluorouracil (5-FU) chemotherapy, is recommended in patients whose tumors express PD-L1 (combined positive score [CPS] 1). This recommendation is based on data from the pivotal Phase 3 KEYNOTE-048 trial, in which KEYTRUDA, as monotherapy and in combination with chemotherapy, demonstrated a significant improvement in overall survival, compared with standard treatment (cetuximab with carboplatin or cisplatin plus 5-FU), in these patient populations.

Head and neck cancer remains a devastating disease with poor long-term outcomes and advances in survival have been difficult to achieve for more than 10 years said Dr. Jonathan Cheng, vice president, clinical research, Merck Research Laboratories. The positive EU CHMP opinion further validates the potential of KEYTRUDA, as monotherapy and in combination with chemotherapy, to help patients and address the high unmet need in this aggressive form of head and neck cancer.

Merck currently has the largest immuno-oncology clinical development program in HNSCC and is continuing to advance multiple registration-enabling studies investigating KEYTRUDA as monotherapy and in combination with other cancer treatmentsincluding, KEYNOTE-412 and KEYNOTE-689. The CHMPs recommendation will now be reviewed by the European Commission for marketing authorization in the EU, and a final decision is expected in the fourth quarter of 2019.

About Head and Neck CancerHead and neck cancer describes a number of different tumors that develop in or around the throat, larynx, nose, sinuses and mouth. Most head and neck cancers are squamous cell carcinomas that begin in the flat, squamous cells that make up the thin surface layer of the structures in the head and neck. Two substances that greatly increase the risk of developing head and neck cancer are tobacco and alcohol. It is estimated that there were more than 705,000 new cases of head and neck cancer diagnosed and over 358,000 deaths from the disease worldwide in 2018. In Europe, it is estimated that there were more than 146,000 newly diagnosed cases of head and neck cancer and around 66,000 deaths from the disease in 2018.

About KEYTRUDA (pembrolizumab) InjectionKEYTRUDA is an anti-PD-1 therapy that works by increasing the ability of the bodys immune system to help detect and fight tumor cells. KEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.

Merck has the industrys largest immuno-oncology clinical research program. There are currently more than 1,000 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patients likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.

About KEYTRUDA (pembrolizumab) InjectionKEYTRUDA is an anti-PD-1 therapy that works by increasing the ability of the bodys immune system to help detect and fight tumor cells. KEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.

Merck has the industrys largest immuno-oncology clinical research program. There are currently more than 1,000 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patients likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.

Selected KEYTRUDA (pembrolizumab) IndicationsMelanomaKEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.

KEYTRUDA is indicated for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.

Non-Small Cell Lung CancerKEYTRUDA, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of patients with metastatic nonsquamous non-small cell lung cancer (NSCLC), with no EGFR or ALK genomic tumor aberrations.

KEYTRUDA, in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, is indicated for the first-line treatment of patients with metastatic squamous NSCLC.

KEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with NSCLC expressing PD-L1 [tumor proportion score (TPS) 1%] as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, and is stage III where patients are not candidates for surgical resection or definitive chemoradiation, or metastatic.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 (TPS 1%) as determined by an FDA-approved test, with disease progression on or after platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving KEYTRUDA.

Small Cell Lung CancerKEYTRUDA is indicated for the treatment of patients with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy and at least one other prior line of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

Head and Neck CancerKEYTRUDA, in combination with platinum and fluorouracil (FU), is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent head and neck squamous cell carcinoma (HNSCC).

KEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC whose tumors express PD-L1 [combined positive score (CPS) 1] as determined by an FDA-approved test.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic HNSCC with disease progression on or after platinum-containing chemotherapy.

Classical Hodgkin LymphomaKEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma (cHL), or who have relapsed after 3 or more prior lines of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Primary Mediastinal Large B-Cell LymphomaKEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or who have relapsed after 2 or more prior lines of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. KEYTRUDA is not recommended for the treatment of patients with PMBCL who require urgent cytoreductive therapy.

Urothelial CarcinomaKEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who are not eligible for cisplatin-containing chemotherapy and whose tumors express PD-L1 [CPS 10] as determined by an FDA-approved test, or in patients who are not eligible for any platinum-containing chemotherapy regardless of PD-L1 status. This indication is approved under accelerated approval based on tumor response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

Microsatellite Instability-High (MSI-H) CancerKEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR)

This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with MSI-H central nervous system cancers have not been established.

Gastric CancerKEYTRUDA is indicated for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma whose tumors express PD-L1 (CPS 1) as determined by an FDA-approved test, with disease progression on or after two or more prior lines of therapy including fluoropyrimidine- and platinum-containing chemotherapy and if appropriate, HER2/neu-targeted therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Esophageal CancerKEYTRUDA is indicated for the treatment of patients with recurrent locally advanced or metastatic squamous cell carcinoma of the esophagus whose tumors express PD-L1 (CPS 10) as determined by an FDA-approved test, with disease progression after one or more prior lines of systemic therapy.

Cervical CancerKEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS 1) as determined by an FDA-approved test. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Hepatocellular CarcinomaKEYTRUDA is indicated for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Merkel Cell CarcinomaKEYTRUDA is indicated for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Renal Cell CarcinomaKEYTRUDA, in combination with axitinib, is indicated for the first-line treatment of patients with advanced renal cell carcinoma (RCC).

Selected Important Safety Information for KEYTRUDA

Immune-Mediated PneumonitisKEYTRUDA can cause immune-mediated pneumonitis, including fatal cases. Pneumonitis occurred in 3.4% (94/2799) of patients with various cancers receiving KEYTRUDA, including Grade 1 (0.8%), 2 (1.3%), 3 (0.9%), 4 (0.3%), and 5 (0.1%). Pneumonitis occurred in 8.2% (65/790) of NSCLC patients receiving KEYTRUDA as a single agent, including Grades 3-4 in 3.2% of patients, and occurred more frequently in patients with a history of prior thoracic radiation (17%) compared to those without (7.7%). Pneumonitis occurred in 6% (18/300) of HNSCC patients receiving KEYTRUDA as a single agent, including Grades 3-5 in 1.6% of patients, and occurred in 5.4% (15/276) of patients receiving KEYTRUDA in combination with platinum and FU as first-line therapy for advanced disease, including Grade 3-5 in 1.5% of patients.

Monitor patients for signs and symptoms of pneumonitis. Evaluate suspected pneumonitis with radiographic imaging. Administer corticosteroids for Grade 2 or greater pneumonitis. Withhold KEYTRUDA for Grade 2; permanently discontinue KEYTRUDA for Grade 3 or 4 or recurrent Grade 2 pneumonitis.

Immune-Mediated ColitisKEYTRUDA can cause immune-mediated colitis. Colitis occurred in 1.7% (48/2799) of patients receiving KEYTRUDA, including Grade 2 (0.4%), 3 (1.1%), and 4 (<0.1%). Monitor patients for signs and symptoms of colitis. Administer corticosteroids for Grade 2 or greater colitis. Withhold KEYTRUDA for Grade 2 or 3; permanently discontinue KEYTRUDA for Grade 4 colitis.

Immune-Mediated Hepatitis (KEYTRUDA) and Hepatotoxicity (KEYTRUDA in Combination with Axitinib)Immune-Mediated HepatitisKEYTRUDA can cause immune-mediated hepatitis. Hepatitis occurred in 0.7% (19/2799) of patients receiving KEYTRUDA, including Grade 2 (0.1%), 3 (0.4%), and 4 (<0.1%). Monitor patients for changes in liver function. Administer corticosteroids for Grade 2 or greater hepatitis and, based on severity of liver enzyme elevations, withhold or discontinue KEYTRUDA.

Hepatotoxicity in Combination with AxitinibKEYTRUDA in combination with axitinib can cause hepatic toxicity with higher than expected frequencies of Grades 3 and 4 ALT and AST elevations compared to KEYTRUDA alone. With the combination of KEYTRUDA and axitinib, Grades 3 and 4 increased ALT (20%) and increased AST (13%) were seen. Monitor liver enzymes before initiation of and periodically throughout treatment. Consider more frequent monitoring of liver enzymes as compared to when the drugs are administered as single agents. For elevated liver enzymes, interrupt KEYTRUDA and axitinib, and consider administering corticosteroids as needed.

Immune-Mediated EndocrinopathiesKEYTRUDA can cause hypophysitis, thyroid disorders, and type 1 diabetes mellitus. Hypophysitis occurred in 0.6% (17/2799) of patients, including Grade 2 (0.2%), 3 (0.3%), and 4 (<0.1%). Hypothyroidism occurred in 8.5% (237/2799) of patients, including Grade 2 (6.2%) and 3 (0.1%). The incidence of new or worsening hypothyroidism was higher in 1185 patients with HNSCC (16%), receiving KEYTRUDA, as a single agent or in combination with platinum and FU, including Grade 3 (0.3%) hypothyroidism. Hyperthyroidism occurred in 3.4% (96/2799) of patients, including Grade 2 (0.8%) and 3 (0.1%), and thyroiditis occurred in 0.6% (16/2799) of patients, including Grade 2 (0.3%). Type 1 diabetes mellitus, including diabetic ketoacidosis, occurred in 0.2% (6/2799) of patients.

Monitor patients for signs and symptoms of hypophysitis (including hypopituitarism and adrenal insufficiency), thyroid function (prior to and periodically during treatment), and hyperglycemia. For hypophysitis, administer corticosteroids and hormone replacement as clinically indicated. Withhold KEYTRUDA for Grade 2 and withhold or discontinue for Grade 3 or 4 hypophysitis. Administer hormone replacement for hypothyroidism and manage hyperthyroidism with thionamides and beta-blockers as appropriate. Withhold or discontinue KEYTRUDA for Grade 3 or 4 hyperthyroidism. Administer insulin for type 1 diabetes and withhold KEYTRUDA and administer antihyperglycemics in patients with severe hyperglycemia.

Immune-Mediated Nephritis and Renal DysfunctionKEYTRUDA can cause immune-mediated nephritis. Nephritis occurred in 0.3% (9/2799) of patients receiving KEYTRUDA, including Grade 2 (0.1%), 3 (0.1%), and 4 (<0.1%) nephritis. Nephritis occurred in 1.7% (7/405) of patients receiving KEYTRUDA in combination with pemetrexed and platinum chemotherapy. Monitor patients for changes in renal function. Administer corticosteroids for Grade 2 or greater nephritis. Withhold KEYTRUDA for Grade 2; permanently discontinue for Grade 3 or 4 nephritis.

Immune-Mediated Skin ReactionsImmune-mediated rashes, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) (some cases with fatal outcome), exfoliative dermatitis, and bullous pemphigoid, can occur. Monitor patients for suspected severe skin reactions and based on the severity of the adverse reaction, withhold or permanently discontinue KEYTRUDA and administer corticosteroids. For signs or symptoms of SJS or TEN, withhold KEYTRUDA and refer the patient for specialized care for assessment and treatment. If SJS or TEN is confirmed, permanently discontinue KEYTRUDA.

Other Immune-Mediated Adverse ReactionsImmune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue in patients receiving KEYTRUDA and may also occur after discontinuation of treatment. For suspected immune-mediated adverse reactions, ensure adequate evaluation to confirm etiology or exclude other causes. Based on the severity of the adverse reaction, withhold KEYTRUDA and administer corticosteroids. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Based on limited data from clinical studies in patients whose immune-related adverse reactions could not be controlled with corticosteroid use, administration of other systemic immunosuppressants can be considered. Resume KEYTRUDA when the adverse reaction remains at Grade 1 or less following corticosteroid taper. Permanently discontinue KEYTRUDA for any Grade 3 immune-mediated adverse reaction that recurs and for any life-threatening immune-mediated adverse reaction.

The following clinically significant immune-mediated adverse reactions occurred in less than 1% (unless otherwise indicated) of 2799 patients: arthritis (1.5%), uveitis, myositis, Guillain-Barr syndrome, myasthenia gravis, vasculitis, pancreatitis, hemolytic anemia, sarcoidosis, and encephalitis. In addition, myelitis and myocarditis were reported in other clinical trials, including cHL, and postmarketing use.

Treatment with KEYTRUDA may increase the risk of rejection in solid organ transplant recipients. Consider the benefit of treatment vs the risk of possible organ rejection in these patients.

Infusion-Related ReactionsKEYTRUDA can cause severe or life-threatening infusion-related reactions, including hypersensitivity and anaphylaxis, which have been reported in 0.2% (6/2799) of patients. Monitor patients for signs and symptoms of infusion-related reactions. For Grade 3 or 4 reactions, stop infusion and permanently discontinue KEYTRUDA.

Complications of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)Immune-mediated complications, including fatal events, occurred in patients who underwent allogeneic HSCT after treatment with KEYTRUDA. Of 23 patients with cHL who proceeded to allogeneic HSCT after KEYTRUDA, 6 (26%) developed graft-versus-host disease (GVHD) (1 fatal case) and 2 (9%) developed severe hepatic veno-occlusive disease (VOD) after reduced-intensity conditioning (1 fatal case). Cases of fatal hyperacute GVHD after allogeneic HSCT have also been reported in patients with lymphoma who received a PD-1 receptorblocking antibody before transplantation. Follow patients closely for early evidence of transplant-related complications such as hyperacute graft-versus-host disease (GVHD), Grade 3 to 4 acute GVHD, steroid-requiring febrile syndrome, hepatic veno-occlusive disease (VOD), and other immune-mediated adverse reactions.

In patients with a history of allogeneic HSCT, acute GVHD (including fatal GVHD) has been reported after treatment with KEYTRUDA. Patients who experienced GVHD after their transplant procedure may be at increased risk for GVHD after KEYTRUDA. Consider the benefit of KEYTRUDA vs the risk of GVHD in these patients.

Increased Mortality in Patients With Multiple MyelomaIn trials in patients with multiple myeloma, the addition of KEYTRUDA to a thalidomide analogue plus dexamethasone resulted in increased mortality. Treatment of these patients with a PD-1 or PD-L1 blocking antibody in this combination is not recommended outside of controlled trials.

Embryofetal ToxicityBased on its mechanism of action, KEYTRUDA can cause fetal harm when administered to a pregnant woman. Advise women of this potential risk. In females of reproductive potential, verify pregnancy status prior to initiating KEYTRUDA and advise them to use effective contraception during treatment and for 4 months after the last dose.

Adverse ReactionsIn KEYNOTE-006, KEYTRUDA was discontinued due to adverse reactions in 9% of 555 patients with advanced melanoma; adverse reactions leading to permanent discontinuation in more than one patient were colitis (1.4%), autoimmune hepatitis (0.7%), allergic reaction (0.4%), polyneuropathy (0.4%), and cardiac failure (0.4%). The most common adverse reactions (20%) with KEYTRUDA were fatigue (28%), diarrhea (26%), rash (24%), and nausea (21%).

In KEYNOTE-054, KEYTRUDA was permanently discontinued due to adverse reactions in 14% of 509 patients; the most common (1%) were pneumonitis (1.4%), colitis (1.2%), and diarrhea (1%). Serious adverse reactions occurred in 25% of patients receiving KEYTRUDA. The most common adverse reaction (20%) with KEYTRUDA was diarrhea (28%).

In KEYNOTE-189, when KEYTRUDA was administered with pemetrexed and platinum chemotherapy in metastatic nonsquamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 20% of 405 patients. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonitis (3%) and acute kidney injury (2%). The most common adverse reactions (20%) with KEYTRUDA were nausea (56%), fatigue (56%), constipation (35%), diarrhea (31%), decreased appetite (28%), rash (25%), vomiting (24%), cough (21%), dyspnea (21%), and pyrexia (20%).

In KEYNOTE-407, when KEYTRUDA was administered with carboplatin and either paclitaxel or paclitaxel protein-bound in metastatic squamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 15% of 101 patients. The most frequent serious adverse reactions reported in at least 2% of patients were febrile neutropenia, pneumonia, and urinary tract infection. Adverse reactions observed in KEYNOTE-407 were similar to those observed in KEYNOTE-189 with the exception that increased incidences of alopecia (47% vs 36%) and peripheral neuropathy (31% vs 25%) were observed in the KEYTRUDA and chemotherapy arm compared to the placebo and chemotherapy arm in KEYNOTE-407.

In KEYNOTE-042, KEYTRUDA was discontinued due to adverse reactions in 19% of 636 patients; the most common were pneumonitis (3%), death due to unknown cause (1.6%), and pneumonia (1.4%). The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia (7%), pneumonitis (3.9%), pulmonary embolism (2.4%), and pleural effusion (2.2%). The most common adverse reaction (20%) was fatigue (25%).

In KEYNOTE-010, KEYTRUDA monotherapy was discontinued due to adverse reactions in 8% of 682 patients with metastatic NSCLC; the most common was pneumonitis (1.8%). The most common adverse reactions (20%) were decreased appetite (25%), fatigue (25%), dyspnea (23%), and nausea (20%).

Adverse reactions occurring in patients with SCLC were similar to those occurring in patients with other solid tumors who received KEYTRUDA as a single agent.

In KEYNOTE-048, KEYTRUDA monotherapy was discontinued due to adverse events in 12% of 300 patients with HNSCC; the most common adverse reactions leading to permanent discontinuation were sepsis (1.7%) and pneumonia (1.3%). The most common adverse reactions (20%) were fatigue (33%), constipation (20%), and rash (20%).

In KEYNOTE-048, when KEYTRUDA was administered in combination with platinum (cisplatin or carboplatin) and FU chemotherapy, KEYTRUDA was discontinued due to adverse reactions in 16% of 276 patients with HNSCC. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonia (2.5%), pneumonitis (1.8%), and septic shock (1.4%). The most common adverse reactions (20%) were nausea (51%), fatigue (49%), constipation (37%), vomiting (32%), mucosal inflammation (31%), diarrhea (29%), decreased appetite (29%), stomatitis (26%), and cough (22%).

In KEYNOTE-012, KEYTRUDA was discontinued due to adverse reactions in 17% of 192 patients with HNSCC. Serious adverse reactions occurred in 45% of patients. The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia, dyspnea, confusional state, vomiting, pleural effusion, and respiratory failure. The most common adverse reactions (20%) were fatigue, decreased appetite, and dyspnea. Adverse reactions occurring in patients with HNSCC were generally similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy, with the exception of increased incidences of facial edema and new or worsening hypothyroidism.

In KEYNOTE-087, KEYTRUDA was discontinued due to adverse reactions in 5% of 210 patients with cHL. Serious adverse reactions occurred in 16% of patients; those 1% included pneumonia, pneumonitis, pyrexia, dyspnea, GVHD, and herpes zoster. Two patients died from causes other than disease progression; 1 from GVHD after subsequent allogeneic HSCT and 1 from septic shock. The most common adverse reactions (20%) were fatigue (26%), pyrexia (24%), cough (24%), musculoskeletal pain (21%), diarrhea (20%), and rash (20%).

In KEYNOTE-170, KEYTRUDA was discontinued due to adverse reactions in 8% of 53 patients with PMBCL. Serious adverse reactions occurred in 26% of patients and included arrhythmia (4%), cardiac tamponade (2%), myocardial infarction (2%), pericardial effusion (2%), and pericarditis (2%). Six (11%) patients died within 30 days of start of treatment. The most common adverse reactions (20%) were musculoskeletal pain (30%), upper respiratory tract infection and pyrexia (28% each), cough (26%), fatigue (23%), and dyspnea (21%).

In KEYNOTE-052, KEYTRUDA was discontinued due to adverse reactions in 11% of 370 patients with locally advanced or metastatic urothelial carcinoma. Serious adverse reactions occurred in 42% of patients; those 2% were urinary tract infection, hematuria, acute kidney injury, pneumonia, and urosepsis. The most common adverse reactions (20%) were fatigue (38%), musculoskeletal pain (24%), decreased appetite (22%), constipation (21%), rash (21%), and diarrhea (20%).

In KEYNOTE-045, KEYTRUDA was discontinued due to adverse reactions in 8% of 266 patients with locally advanced or metastatic urothelial carcinoma. The most common adverse reaction resulting in permanent discontinuation of KEYTRUDA was pneumonitis (1.9%). Serious adverse reactions occurred in 39% of KEYTRUDA-treated patients; those 2% were urinary tract infection, pneumonia, anemia, and pneumonitis. The most common adverse reactions (20%) in patients who received KEYTRUDA were fatigue (38%), musculoskeletal pain (32%), pruritus (23%), decreased appetite (21%), nausea (21%), and rash (20%).

Adverse reactions occurring in patients with gastric cancer were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.

Adverse reactions occurring in patients with esophageal cancer were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.

In KEYNOTE-158, KEYTRUDA was discontinued due to adverse reactions in 8% of 98 patients with recurrent or metastatic cervical cancer. Serious adverse reactions occurred in 39% of patients receiving KEYTRUDA; the most frequent included anemia (7%), fistula, hemorrhage, and infections [except urinary tract infections] (4.1% each). The most common adverse reactions (20%) were fatigue (43%), musculoskeletal pain (27%), diarrhea (23%), pain and abdominal pain (22% each), and decreased appetite (21%).

Adverse reactions occurring in patients with HCC were generally similar to those in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy, with the exception of increased incidences of ascites (8% Grades 3-4) and immune-mediated hepatitis (2.9%). Laboratory abnormalities (Grades 3-4) that occurred at a higher incidence were elevated AST (20%), ALT (9%), and hyperbilirubinemia (10%).

Among the 50 patients with MCC enrolled in study KEYNOTE-017, adverse reactions occurring in patients with MCC were generally similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy. Laboratory abnormalities (Grades 3-4) that occurred at a higher incidence were elevated AST (11%) and hyperglycemia (19%).

In KEYNOTE-426, when KEYTRUDA was administered in combination with axitinib, fatal adverse reactions occurred in 3.3% of 429 patients. Serious adverse reactions occurred in 40% of patients, the most frequent of which (1%) included hepatotoxicity (7%), diarrhea (4.2%), acute kidney injury (2.3%), dehydration (1%), and pneumonitis (1%). Permanent discontinuation due to an adverse reaction occurred in 31% of patients; KEYTRUDA only (13%), axitinib only (13%), and the combination (8%). The most common adverse reactions (>1%) resulting in permanent discontinuation of KEYTRUDA, axitinib or the combination were hepatotoxicity (13%), diarrhea/colitis (1.9%), acute kidney injury (1.6%), and cerebrovascular accident (1.2%). When KEYTRUDA was used in combination with axitinib, the most common adverse reactions (20%) were diarrhea (56%), fatigue/asthenia (52%), hypertension (48%), hepatotoxicity (39%), hypothyroidism (35%), decreased appetite (30%), palmar-plantar erythrodysesthesia (28%), nausea (28%), stomatitis/mucosal inflammation (27%), dysphonia (25%), rash (25%), cough (21%), and constipation (21%).

LactationBecause of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment and for 4 months after the final dose.

Pediatric UseThere is limited experience in pediatric patients. In a trial, 40 pediatric patients (16 children aged 2 years to younger than 12 years and 24 adolescents aged 12 years to 18 years) with various cancers, including unapproved usages, were administered KEYTRUDA 2 mg/kg every 3 weeks. Patients received KEYTRUDA for a median of 3 doses (range 117 doses), with 34 patients (85%) receiving 2 doses or more. The safety profile in these pediatric patients was similar to that seen in adults; adverse reactions that occurred at a higher rate (15% difference) in these patients when compared to adults under 65 years of age were fatigue (45%), vomiting (38%), abdominal pain (28%), increased transaminases (28%), and hyponatremia (18%).

Mercks Focus on CancerOur goal is to translate breakthrough science into innovative oncology medicines to help people with cancer worldwide. At Merck, the potential to bring new hope to people with cancer drives our purpose and supporting accessibility to our cancer medicines is our commitment. As part of our focus on cancer, Merck is committed to exploring the potential of immuno-oncology with one of the largest development programs in the industry across more than 30 tumor types. We also continue to strengthen our portfolio through strategic acquisitions and are prioritizing the development of several promising oncology candidates with the potential to improve the treatment of advanced cancers. For more information about our oncology clinical trials, visit http://www.merck.com/clinicaltrials.

About MerckFor more than a century, Merck, a leading global biopharmaceutical company known as MSD outside of the United States and Canada, has been inventing for life, bringing forward medicines and vaccines for many of the worlds most challenging diseases. Through our prescription medicines, vaccines, biologic therapies and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through far-reaching policies, programs and partnerships. Today, Merck continues to be at the forefront of research to advance the prevention and treatment of diseases that threaten people and communities around the world - including cancer, cardio-metabolic diseases, emerging animal diseases, Alzheimers disease and infectious diseases including HIV and Ebola. For more information, visit http://www.merck.com and connect with us on Twitter, Facebook, Instagram, YouTube and LinkedIn.

Forward-Looking Statement of Merck & Co., Inc., Kenilworth, N.J., USAThis news release of Merck & Co., Inc., Kenilworth, N.J., USA (the company) includes forward-looking statements within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of the companys management and are subject to significant risks and uncertainties. There can be no guarantees with respect to pipeline products that the products will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements.

Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the companys ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the companys patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions.

The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the companys 2018 Annual Report on Form 10-K and the companys other filings with the Securities and Exchange Commission (SEC) available at the SECs Internet site (www.sec.gov).

Please see Prescribing Information for KEYTRUDA at http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf andMedication Guide for KEYTRUDA at http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_mg.pdf.

See the rest here:
Merck Receives Positive EU CHMP Opinion for Two New Regimens of KEYTRUDA (pembrolizumab) as First-Line Treatment for Metastatic or Unresectable...

Recommendation and review posted by Bethany Smith

Spontaneous recovery from disease is often painted as superstition but our body can heal itself

It may come as a surprise to some, especially those with conventional medical training, but the default state of the body is one of ceaselessregeneration. Without the flame-like process of continual cell turnover within the bodylife and death ceaselessly intertwinedthe miracle of the human body would not exist

In times of illness, however, regenerative processes are overcome by degenerative ones. This is where medicine may perform its most noble feat, nudging the body back into balance with foods, herbs, nutrients, and healing energies and intentions.

Today, however, drug-based medicine invariably uses chemicals that lackregenerative potential; to the contrary, they commonly interfere with bodily self-renewal in order to suppress the symptoms against which they are applied.

In other words, most medicines attack disease symptoms rather than support the bodys own ability to combat disease.

Over the course of the past few years of trolling MEDLINE (the National Institutes of Healths website produced by the National Library of Medicine), we have collected a series of remarkable studies on a topic considered all but heretical by the conventional medical systemspontaneous remission.

There is actually a broad range of natural compounds with proven nerve-regenerative effects. A 2010 study published in the journalRejuvenation Research, for instance, found a combination of blueberry, green tea and carnosine have neuritogenic (i.e. promoting neuronal regeneration) and stem-cell regenerative effects in an animal model ofneurodegenerative disease.Other researched neuritogenic substances include:

There is another class of nerve-healing substances, known asremyelinatingcompounds, which stimulate the repair of the protective sheath around the axon of the neurons known as myelin. Myelin is often damaged in neurological injury and/or dysfunction, especially autoimmune and vaccine-induceddemyelination disorders.

It should also be noted that evenmusicandfalling in lovehave been studied for possibly stimulating neurogenesis, regeneration and/or repair of neurons, indicating that regenerative medicine does not necessarily require the ingestion of anything; rather, a wide range oftherapeutic actionsmay be employed to improve health and well-being, as well.

[To view the first-hand biomedical citations on these neuritogenic substances, visit GreenMedinfosneuritogenicresearch page online.]

Glycyrrhizin, a compound found within licorice that is also a powerfulanti-SARS virus agent, has also been found to stimulate the regeneration of liver mass and function in the animal model of hepatectomy. Other liver regenerative substances include:

[To view the first-hand biomedical citations, visit GreenMedinfosliver regenerationresearch page on the topic online.]

The medical community has yet to harness the diabetes-reversing potential of natural compounds. Whereas expensive stem cell therapies, islet cell transplants, and an array of synthetic drugs in the developmental pipeline are the focus of billions of dollars of research, annually, our kitchen cupboards and backyards may already contain the long sought-after cure for type 1 diabetes. Nature has a way of providing the things our bodies need.

The following compounds have been demonstrated experimentally to regenerate the insulin-producing beta cells, which are destroyed in insulin-dependent diabetes, and once restored, may (at least in theory) restore the health of the patient to the point where they no longer require insulin replacement.

[To view the first-hand biomedical citations onbeta cell regeneration, visit GreenMedinfos research page on the topic online.]

Secretagogues are substances in the body that cause other substances to be secreted, like sulfonylureas, which triggers insulinrelease. Secretagogues, includingsynthetic secretagogues, can increase the endocrine glands ability to secrete more of a hormone. But even better are substances thattruly regeneratehormones which have degraded. They do this by emitting electrons into potentially carcinogenic transient hormone metabolites. One of these substances isvitamin C.

A powerful electron donor, this vitamin has the ability to contribute electrons to resurrect the form and function of estradiol (estrogen; E2), progesterone, and testosterone, for instance. In tandem withfoods that are able to support the function of glandslikethe ovaries, vitamin C may represent an excellent complement or alternative to hormone replacement therapy.

Not too long ago, it was believed that cardiac tissue was uniquely incapable of being regenerated. A new and rapidly growing body of experimental research now indicates that this is simply untrue. A class of heart-tissue regenerating compounds, known asneocardiogenicsubstances, are able to stimulate the formation of cardiac progenitor cells which can differentiate into healthy heart tissue. Neocardiogenicsubstances include the following:

Another remarkable example of cardiac cell regeneration is through what is known as the fetomaternal trafficking of stem cells through the placenta. The amazing process known as fetal microchimerism allows a fetus to contribute stem cells to the mother which are capable of regenerating her damaged heart cells, and possibly a wide range of other cell types.

Curcuminandresveratrolhave been shown to improve recovery from spinal cord injury. Over a dozen other natural compounds hold promise in this area, which can be viewed on GreenMedinfosspinal cord injurypage online. As far as degenerative joint disease, i.e. osteoarthritis, there are a broad range of potentially regenerative substances, with 50 listed on the sitesosteoarthritisresearch page.

Regenerative medicine poses a unique challenge to the current medical paradigm, which is based on costly drug trials, patents, and an economic infrastructure supported by drug-based interventions. It is a simple truth that symptom suppression is profitable. It guarantees both the perpetuation of the original underlying disease and the generation of an ever-expanding array of additional, treatment-induced symptoms known as side effects.

But cures, especially those that come from natural sources, dont have this built-in income potential. Worse perhaps, from a Big Pharma perspective, they can not be easily patented. In the current regulatory environment, that means that companies have no incentive to conduct the costly trials required to have these cures approved by the FDA and then used in clinical settings. Without patents, they cant be controlled and sold.

But suppressing symptoms with drugs that cause side effects requiring other drugs is a non-sustainable, infinite growth model. It is doomed to fail and eventually collapse.

The current approach also interferes with the bodys natural regenerative and immune capabilities. Cultivating diets, lifestyles and attitudes conducive to bodily regeneration can interrupt this pathological circuit. With true health, we can attain the bodily freedom that is a precondition for the liberation of the human spirit.

SayerJiis the founder ofGreenmedinfo.com, a reviewer at theInternational Journal of Human Nutrition and Functional Medicine, co-founder and CEO ofSystome Biomed, vice chairman of the board of theNational Health Federation, and steering committee member of theGlobal GMO Free Coalition.This article was originally published on GreenMedinfo.com

Read more:
6 Bodily Tissues That Can Be Regenerated Through Nutrition - The Epoch Times

Recommendation and review posted by Bethany Smith

One of the more recent trends among parents-to-be is the so-called gender reveal, a party complete with pink or blue cake to answer the burning question, Is it a boy or girl? After all, its presumed that theres a 50-50 chance youd have one or the other. In a new article published in Current Biology, Michigan Medicine researchers studying the sex chromosomes have discovered genes that, at least in mice, skew that assumed ratio to favor one sex and that could have major implications for male infertility.

There are a handful of genes known to underlie male infertility but theres still a lot unknown, says Alyssa Kruger, a Ph.D. student within the Department of Human Genetics. Kruger, who works in the lab of principal investigator Jacob Mueller, Ph.D., and their colleagues have been studying the X and Y chromosomes which are delivered by sperm to an egg to determine an offsprings sexacross species and across millions of years of evolution.

Sex chromosomes are unique, Kruger explains, because while they were once an identical pair of chromosomes, they independently evolved distinct sets of genes. Upon examining mice sex chromosomes, they found two recently evolved X-linked gene families that are found only in mice. Interestingly, these genes are also present multiple copies. To figure out what the genes are responsible for, Krugers team removed them from the genomes of some mice using CRISPR and other technologies.

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Removing all copies of one X-linked gene family produced mice whose offspring were biased towards being male by a ratio of 60-40. This discrepancy wasnt a result of more Y-bearing spermthe number of X and Y sperm remained the same in the mice. This suggests to us that this gene is impacting the relative fitness of X versus Y sperm, but we dont know how. Maybe the Y-bearing sperm are swimming faster or in a straighter line, we dont yet know, says Kruger.

Next, the team decided to increase the copy number of both X-linked gene families to get a better sense of why there are multiple copies. They duplicated these regions of the genome and surprisingly, this also skewed the sex ratio 60-40, only this time in favor of female offspring.

Kruger says that these X-linked gene families appear to be a dial for the fitness of X-bearing sperm. Interestingly, a related gene family on the Y-chromosome is also present in multiple copies and may serve an analogous role in Y-bearing sperm. The same sex-skewing has been observed in other experiments using fruit flies and, she says, something similar could be present in humans, though harder to observe. We think of the back and forth copying of these genes as kind of an evolutionary arms race between the X and Y chromosomes that has played out over 20 million years to maintain the 50-50 male to female sex ratio.

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Beyond their sex-ratio effects, an important feature of the two genes is that their complete removal leads to male mouse infertility.

Specifically, removing all copies of both X-linked gene families prevented male mice from producing sperm; they were unable to transform round cells to the elongated cells with a head and tail we recognize as sperm. Says Kruger, There are a lot of cellular processes that have to happen that arent. We hope this model will give us a better understanding of the developmental process of sperm production.

Other than Kruger and Mueller, this work involved U-M researchers Michele A. Brogley, Jamie L. Huizinga, and Jeffrey M. Kidd, Ph.D.

Paper Cited: A neofunctionalized X-linked ampliconic gene family is essential for male fertility and equal sex ratio in mice Current Biology, 2019. DOI: 10.1016/j.cub.2019.08.057

Link:
Genes Linked to Sex Ratio and Male Fertility in Mice - Michigan Medicine

Recommendation and review posted by Bethany Smith

AS producers continue to reshape their drought strategies, the term core breeder group is a common one. Many producers refer to their core breeders, however the definition of these animals is much harder to establish.

Often, when pressed, the description is that the core breeders are the good ones or the reliable ones. Many producers also refer to the genetics that have been invested in the animals or the selection that has been used to create the herd.

While these points are all equally valid, there is also a high level of emotional value attached to these cattle. This often clouds the decision-making process around the animals, and in drought situations this can restrict timely and well-considered decisions.

Defining a core breeder should be an objective process, based solidly in the breeding objectives of a program. The key attributes must come down to those that will directly contribute to the productivity and profitability of the business, particular in the drought recovery phase.

Fertility underpins this attribute. While many producers have already removed from the herd those cows that failed to conceive or rear a calf, this doesnt automatically mean that any female left is a core breeder. Within the group of pregnant females, or those that have now calved, there will be a group which consistently join and calve later.

These females are often forgiven for their later conception because they still produce a calf.

Perhaps in normal seasons this tolerance is understandable, however in drought conditions where decisions on numbers have to be made, this is a group that can become a focus for removal.

This not only reduces some pressure, but also in the longer term will add to the herds fertility and productivity levels.

Genetics are often cited as a key attribute for retention of breeders. While there are often valid reasons for this, there are equally as many herds where this reason is overstated.

As descried in last weeks Beef Central genetics review, there is generally a lag between a seedstock operation and the commercial producer. Bull selection contributes to this lag, particularly if the bulls entering a program are of average or just above average genetic merit.

Not every producer purchases bulls that are in the top EBV percentiles. The practical implication is that the herd these bulls are used in will, genetically, be some time behind leading operations.

The practical outcome is that many herds are perhaps not as genetically superior as many of their owners believe.

As discussed last week, selection pressure and generational interval are two of the options producers have to increase their rates of genetic gain. The drought places a high degree of selection pressure on females. This should be combined with selection from producers to focus on the other attributes that are important in achieving breeding outcomes.

The opportunity to remove females for later or earlier maturity patterns is an obvious one. Often the later-maturity, larger-framed animals are the first to go in a drought, in order to reduce feed demand. Still, this is an opportunity not to overlook.

Selection decisions on structure and temperament are also important.

The other key to moving a breeder into the core breeder group is to assess her past history and to evaluate her calves at weaning. Which females are those that consistently calve early, and then wean heavier calves?

Calving early is not enough to make a core breeder. Its important to capitalise on early calving by having high growth to weaning.

These assessments are often the ones that separate a group of breeding cows into average cows and then a group of core animals.

Not ever animal will display the traits and performance that makes them a productive and profitable female. However in a drought where decisions are often being made about animals, having an objective assessment and considering these areas can add some clarity to the decision-making process.

While selection pressure particularly nutritional pressure from the season will help sort breeders out, its essential to add the objective scrutiny on each animal in order to find those leading animals.

Its equally important to consider past bull purchases, and objectively consider if that bull was a genetically superior animal or if he was in the good-to-average category.

This can help take some of the emotional investment out of the selection on genetics, and open up the opportunity to focus on finding genetically better bulls ahead of the next joining season.

Remaining focussed on the key traits and using objective assessments and performance data from past years is an essential requirement to find the most valuable breeding animals.

Without these considerations it will be very hard to separate a core animal from an average breeder.

Alastair Rayner

Alastair Rayner is the Principal of RaynerAg, an agricultural advisory service based in NSW. He regularly attends bull sales to support client purchases and undertakes pre sale selections and classifications. He can be contacted here or through his website http://www.raynerag.com.au

More:
Weekly genetics review: Defining the 'core breeder' in times of drought - Beef Central

Recommendation and review posted by Bethany Smith

An early October blizzard hit western South Dakota six years ago. It was named Storm Atlas. Three-plus feet of sudden snow devastated cattle and calves still out on summer pastures.

It was a disastrous blow to ranchers both in loss of livestock, genetics and cattle they had been raising for generations, as well as a huge financial loss.

I was in the Black Hills speaking at an agricultural event with South Dakota ranching women attendees. My plan was to drive to my next speaking event in western North Dakota. But instead, I was stranded at a lodge, without electricity, with 30 or so female ranchers and women in agriculture (and a few husbands) plus a national tour group waiting to see Mount Rushmore.

Every early fall I think of the storm, a couple of days of no electricity, no heat other than the fireplace in the main lobby of the lodge and lodge staff preparing food for guests on the one gas stove in the lodge, using ingredients and meat from what was supposed to be prepared into a feast for a weekend outdoor wedding. Instead, it fed those of us stranded.

There were no generators or snow blowers and all roads and our vehicles were covered in 38 inches of snow. We had two shovels and worked together when the snow stopped. We flagged down a road crew to help.

The messy memories arent what I recall annually though.

Its the people who made the difference in Storm Atlas. The ranchers who sat around, unable to leave, but trying to get ahold of their families at home to check on their livestock.

The losses would be deep for these families I knew. You could expect them to be bitter at the circumstances they had no control over, and instead, they chose to be better.

As we sat in front of the fire at the lodge, the group of ranch and farm women planned outreach and fundraising to help those in agriculture who would need a hand up in the months to recover from Storm Atlas.

They didnt grab headlines but raised awareness and aid that positively impacted others in need. Ranching women chose to better together.

At the same time, I remember a tour group attendee demanding she get a ride to the airport and saying she was leaving South Dakota. The staff tried to explain there were no flights and absolutely no way to get her out of the closed highways of the Black Hills. The woman couldnt change her circumstances and bitterly expressed her frustration.

Here we are, in another set of devastating circumstances for many in agriculture in our region. Its not from one storm event but most likely the wettest early fall on record.

Water fills our farm fields and the anticipation for harvest fades for some as worry or anxiety sets in. Its been a limited growing season with numerous setbacks.

We cannot control the weather. We can care for one another. We can choose to support one another through communication and awareness, and create a path that gives others an outlet to show support. You do not have to be in a specific industry or be an expert in anything to support and encourage those struggling in a season of difficulty.

Communicate about the setbacks your region is faced with, not just grumbling over coffee with your family or the neighbors, but with your elected officials, online and offline.

Reach out to the media (thats us) with a unique experience or story your farm or community has never experienced before this season.

Check-in on your farming friends and neighbors. Help plan or volunteer at a community event. Youre not alone in difficult times. Choose to be better from a time that could make us bitter. There will be more storms, blizzards, droughts and then too much rain in our lives. We cannot control the rain, the sunshine or frost date.

We can be better through outreach to one another and communication to make sure agricultures story is shared with those nearby and far from our fields.

Katie Pinke is the publisher of Agweek, a weekly agriculture newspaper published by Forum Communications Co.

Read this article:
When we could be bitter, choose to be better - PostBulletin.com

Recommendation and review posted by Bethany Smith

The topics of women and mental health typically intersect at an uncomfortable point that, like so many other core elements of our society, is rooted in the patriarchy. The practice and dissemination of the mental health arts was a prototypical male profession as it emerged in the late 1800s and early 1900s, its central modern figures mostly men (Freud, Pavlov, Kanner, Lacan). The code of ethics and modus operandi of psychoanalysis was forged around the implicit idea that the examiner is male and the patient could be of any gender.

But the first people in analysis were overwhelmingly female, like Freuds oft-written about patient, Dora, and the hundreds of Victorian women diagnosed with everything from hysteria to sociopathy; now, with depression and anxiety. Decades of over-diagnosing and experimentally treating women is mirrored in literature by a parade of insane women locked up attics, from the narrator of Charlotte Perkins Gilmans 1892 short story, The Yellow Wallpaper, through the Gothic masterpieces, to the cornucopia of unwell women in the 1999 film, Girl, Interrupted.

Society has had no problem gaslighting women for the better part of modernity, pinning on us an array of nervous ailments presented as specifically female disorders. This perceived propensity toward hormonally-induced and nervous conditions has been used against us to impugn our abilities and capability to perform high-functioning and managerial tasks. The trope of the crazy girlfriend informs contemporary relationships in real life as much as in sitcoms; our female CEOs and politicians still struggle to demonstrate a steely immunity to sentiment beyond what is required of their male counterparts, lest they be accused of acting unstable.

This is not to say that mental illness in men is portrayed in a better, more empathetic way. Male characters with psychiatric conditions are also grossly exaggerated, written as roles that give actors the opportunity to deliver over-the-top performances like Anthony Hopkins Hannibal Lechter, Christian Bales American Psycho, and the menagerie of psychopaths and perverts that populate the Law and Order franchises. By now its become clear that none of these stereotypes and hyperboles benefit the still-stigmatized view of mental illness in our culture. And while no one is a winner, men are the ones being left behind in our attempt to conquer this stigma.

The kernel of truth buried deep within these unhelpful representations is that in real life men and women both experience and exhibit mental health challenges differently, due to possible biological and clear social reasons. For example, a 2003 British study shows that while women statistically report symptoms of depression and anxiety two and a half times more frequently than men, many more men than women seek help for substance abuse issues. The evidence on PTSD (post-traumatic stress disorder) shows a far greater incidence in women (20.4%) than men (8.1%), clearly explained by the far greater incidence of sexual assaults on women worldwide.

But mental health providers dont know for sure whether women biologically are primed to experienced mood disorders, eating disorders, and OCD symptoms or if its the centuries of stress we feel as caretakers, organizers, and householders has been resulted in the development of these conditions. Studies seem to show men and women experience mental health issues equally, despite our physiological differences, but that the social trauma we are subjected to in our culture makes us more prone to some symptoms more than others, like dementia, but also feelings like sadness, and apathy.

We cannot decide whether women are more likely to experience depression because we are biologically primed to perform feats of hormonal dexterity (like menstruating and birthing children), or if its because of the patriarchy keeps us mentally in a homebound space. We dont know if its just that men rage, self-medicate, and develop more chemical dependence issues because of their genetics and hormones, or if our culture prohibits them sadness and gives them too much time to hang out at the bar. Like in most nature/nurture debates, each of these are likely factors, as is the conditioning with which mental health providers recognize and treat those who need it. The sword of stigma is sharp and it cuts both ways.

Women have long been victimized, making us prone to certain conditions. Weve then been oppressed by the over-diagnosis and treatments for some of these conditions. Men have been all but abandoned. We are for this reason the best equipped to help men get the visibility they need in this sphere, one of the few in which they didnt take up the spotlight. This fact alone: the rate of male suicide in the United States exceeds womens four to one. Though women are twice as likely to experience mental health concerns and seek treatment, mens reluctance to admit to the struggle and to commit to medication when it is indicated, drives four times as many of them to a final and irrevocable resort.

A ten-year study conducted by the National Institutes of Health probes the likelihood that men will seek support in one another the way women often do. The results did not surprise me, as it seems quite clear in our culture that men are not encouraged to speak about their feelings. The vast majority of the test subjects, who ranged in age, marital status, and socioeconomic advantage, would consider speaking to a woman about their feelings and fears but would not even consider talking to another man. Many admitted to feeling primed to shame any man who would try.

Men compartmentalize relationships, meaning guys have no problem paling around town with their buddies for hours on end, but they may never have a single deep conversation in all that time. Those talks, they save for their wives, girlfriends, and mothers. Feelings are considered to be our territory and men grossly lack social supports to help them through tough times. They may have a social network but it provides them too small a net.

Meanwhile, women have found ways to rely on one another to fill in the gaps between or replace ineffective medical treatments. This safety net might even stand in for treatment, even insufficiently, in that it wont necessarily best manage the issue, but our social connections seems to be keeping more of us in the fight. Even bearing the brunt of motherhood and raising children makes women more likely to stick around for the benefit of our kids.

Men rely on women for connection, but many men dont have women in their circles. Some dont even know to seek these connections out. As the mother of boys, I definitely see that the trope that women talk about their problems while men muscle through begins early. We still need much work on that as a society, but in order to effectively reach anyone who needs treatment, we have to dig deeper than even each other. More surprising to me than the gendering of the stigma is that mental illness itself is still taboo in 2019. Most people who suffer from mental illness need professional help to get better even talking to good friends wont be enough. And while women are doing better than men in seeking assistance and following through with treatment, both genders are still underreporting our own symptoms.

According to the World Health Organization, physicians tend to under diagnose psychological conditions, with a rate of accuracy of less than 50%. We can imagine that this is because an average doctors visit is short and highly specialized, so that we might be dragging ourselves through a cloud of depression to get to the ENT, but shell spend three and a half minutes diagnosing a sinus infection and miss the signs of our sadness while shes writing out the script.

Mental health screenings are not routine parts of medical examinations, except for the first few postpartum checkups for women who have the opportunity to become mothers (and even this has been proven insufficient to fully address maternal depression). This inadequate check-in excludes all other female patients and men. As patients, we are lacking in the confidence or perhaps the information to reach out, unprompted, to our providers. Only 2 out of every 5 people who experience anxiety, mood, or substance dependence disorders report them to a doctor within the first year of struggle.

This all amounts to a public health crisis, in which mental health conditions are both known to be debilitating to the sufferer and fairly common, but seemingly out of helps reach if we dont find a way to break the taboo. Depression and its offshoots is projected to reach the number two spot in causes of global disability by 2020. While the figures indicate that all genders could use a little more help than they are currently receiving, dispelling the myth around mens mental health specifically might be the last taboo we need to kill to finally give everyone the psychological support they need.

As much as it has been a grueling millennium under the male psychiatric gaze, our high visibility as patients has afforded us women a much greater emotional literacy than our male counterparts. Men have difficulty finding someone to talk to and accepting their own vulnerability, but they likely dont even know what symptoms mean or realize they manifest differently.

If men are conditioned to think that depression is only manifest as sadness and sadness is weakness and weakness is for women, how are they supposed to realize that depression to them might feel like anger, instead? Since men, especially in some cultures, are not socially expected to multitask between work inside and outside of the home, how would they know that they would actually be capable of far more if they took care of their mental health?

An essential step in dispelling the myths that prevent men from getting the help they need is a reminder that disease does not discriminate and they are vulnerable to the same conditions we are. Next, we all need to be better educated on how these conditions manifest. While a depressed woman might recognize listlessness as a symptom, a man who engages in high-risk behavior might not be able to confront that this is a result of an underlying condition and not a socially-encouraged show of virility. Symptoms vary from one individual to another, and we are particularly ignorant about behaviors that appear to be more prevalent amongst men.

The time to get acquainted with the hallmarks of mental conditions is now. According to reports recently published in Mens Health, depression and anxiety are affecting men at increasing rates. The incidence of suicide among men is also alarmingly on the rise.

Horrifying headlines over the last decade are also strong indicators that men do not realize that aggression and violent behavior are such indicators until its too late for their victims. The people around them dont recognize that unusual thinking and behaviors often announce serious underlying conditions, like personality disorders. Suicidal thoughts are the most extreme symptoms and yet these, too, often go unrecognized.

Very rarely, but perhaps this is one of those times when the thing that helped instigate the problem might contain part of the solution. As women, we suffered overrepresentation as mental health patients in popular culture for too many decades. This unjustly molded the image of the female patient into a grotesque cartoon, yes, but weve stayed on the radar of the profession. What if men dont see their own issues because they have such dearth of representation that cant even imagine what mental illness looks or feels like?

In the last decade, beloved and prominent men in the arts have left us by suicide, and the general feeling among circles both close and distant has been great surprise to know their suffering. And what about decades prior and the men we lost to reckless behavior and overdoses? We lacked the information and experience to understand that Belushi, Farley, and Jackson were struggling as Hoffman, Williams, Foster Wallace would. We arent yet good enough at recognizing the behaviors that announce what men have been trying hard to hide from view. Our best vaccination in the face of this epidemic is to turn to Hollywood and the media again, now for some help and visibility.

By now we know and must disseminate that men, too, suffer from body dysmorphia, eating disorders, panic attacks/anxiety, and depression, even the postpartum kind. We are indebted as a society to actors like Dwayne The Rock Johnsons, who has revealed he has suffered from depression; to athletes like Kevin Love (from the Cleveland Cavaliers), who shared he has experienced panic attacks; to performers like Zayn Malik, who has identified himself as someone struggling with anxiety and an eating disorder. When even the alpha men amongst us can seek help, their street cred untarnished, whats stopping the rest of us from seeking help?

As those who have the megaphone continue to increase public knowledge of mens mental health issues, the wellness industry, which is also female-dominated, can also do its part to remind everyone that physical and mental health are connected. We all need to internalize how biological and environmental factors can contribute to our mental well-being and that there is a wide range of symptoms that can announce underlying problems. Hopefully by becoming better informed and discussing mental health equitable and in the open, we can help our brothers out.

More:
How Women Can Help Kill the Taboo Around Mental Health and Men - BELatina

Recommendation and review posted by Bethany Smith

Founded in 2012, Copenhagen-based Goodiebox provides a monthly subscription for a box of beauty products for women. The startup has also developed its own range of cosmetics and skin care products under the name Comme Deux, based on hundreds of thousands of insights from Goodiebox members.

At the moment, Goodiebox has approximately 100,000 subscribers (or as they call them, members) in Denmark, the Netherlands, Sweden, Norway, Belgium, Austria, Switzerland, Finland and soon in Germany.

Interestingly, this beauty tech startup was founded by two men,Rasmus Schmiegelow (CEO) and Nikolaj Leonhard-Hjorth (CMO).

Below, Rasmus shares his experiences founding the startup (and as a man working in a womans world), and what beauty tech holds in store for us in the future.

Please tell us about yourself, your story, and where you got the idea for Goodiebox.

Im 45, married to an amazing woman (Therese) with three energetic boys (Sebastian, Nor and Kristoffer) and living in the center of Copenhagen. Im also a qualified lawyer, having worked with venture capital and especially M&A with big law firms in Copenhagen and London (DLA Piper and Moalem Weitemeyer Bendtsen) as well as big corporates (Maersk).

My co-founder Nikolaj (who also happens to be my best friend going 25 years back) and I got the idea for Goodiebox in December 2011 and launched the first box in February 2012 to our initial 500 members in Denmark.

The main goal of Goodiebox is to create as much happiness as possible; for our members, employees and partners. This has been the core of Goodiebox since day one, and with over 125 employees and over 100k members this is still the guiding principle in all we do. Nikolaj and I wanted to create a company that we ourselves would have done everything to get to work for.

Further, we saw that a gigantic sector beauty and cosmetics (worth $560 billion globally) was still controlled by a few legacy players and only approximately 7% of global sales were digital. The way to reach consumers was changing with social media and we could have European (and global) access to consumers (for us members) much faster than before, when you also needed brick and mortar retail.

Tell us about Goodiebox what problems do you solve, and what are your offerings?

At Goodiebox one of our fundamental ambitions is to help our members discover new products and brands they will love. Normally in e-commerce, you can try before you buy (if you buy a new pair of jeans from Zalando, Asos or Net-a-porter, you can return them if they dont fit), but that is not possible with beauty and cosmetics (if you buy a new lipstick online you cannot try it and return if the color is not right).

But with Goodiebox, the members get to try new beauty products and brands (based on their beauty profile and feedback in general) so they know their new favourites before they order online.

We can offer this because our internal team of beauty experts is at the forefront of beauty trends, and works closely together with our internal team of data and consumer experts to track and analyse behaviours of our members. We can then use this information to predict what our members will like thereby creating more happiness for them.

Of course happiness is difficult to define, but there are various proxies that we at Goodiebox use to quantify it. Some are explicit, for example, we track how much customers like certain products via star ratings where the members earn Goodiepoints. We also track and analyse implicit signals, including which members end up buying the products they receive in their boxes; changes in subscription status (suspensions, pauses); and member referrals to name a few.

To best source and assign beauty products to our members, we are developing a predictive model that can predict how each member will like each beauty product and their Goodiebox as a whole.

We now help Goodiebox members in Denmark, Sweden, Norway, Finland, Netherlands, Belgium, Austria, Switzerland and Germany (from November) find their new favourite beauty products and brands.

Your startup was founded in 2012. What was it like starting out, and what were some of the challenges you faced?

When we started, Nikolaj and I took on all roles in Goodiebox. From sourcing beauty products over customer service to marketing and tech. Luckily Nikolaj came from a marketing and branding background, as my learning curve as a lawyer was pretty steep!

Furthermore, we were bootstrapped our initial five years in Denmark, with lots of ups and downs. And it was only when we had perfected the model and had control of the key metrics that we got investors in. Since our first investment in May 2017 we have been able to increase our growth significantly still with sustainable key metrics even when growing membership three-fold year on year.

Our insane focus on putting members first in all we did helped us a lot when we needed to prioritise and make difficult decisions. And the members would forgive us more easily when we made mistakes (and we made a lot) because they never doubted our intentions. They knew we wanted to build a new beauty company that would put the members first. Always.

Also, having a real product (the Goodiebox) we needed to source products for, pick and pack, and then ship to our members was a real operational challenge, and we spent many late evenings and nights packing boxes and doing personal deliveries.

Whats it like to be a male founder of a beauty tech company?

Being a male founder in beauty tech has given me and Goodiebox an edge, as it has forced me to be humble from the start and not take anything for granted. And I have used data and business intelligence more; as I have not been raised knowing which beauty products are better than others. Also, as a male founder, Ive had to earn the trust from our female members.

But I have learned a lot in the last seven years (and still learning) from great members and our amazing team. And I would call myself a beauty-expert now. I have definitely tested, used and read more about beauty products and trends than any of my friends

How is beauty tech changing?

Personalisation enabled by tech will change the beauty industry using AI and gene technology. We are already seeing the first smart serums and 3D printed makeup. Innovators from the worlds of tech and beauty are visualising and developing hyperpersonalised beauty products right now, and theyll be in our hands as early as next year. For example, Atolla is making smart serums that treat your skins unique needs and predicts how your complexion will change over time to help prevent breakouts, redness and sensitivities based on an app using a similar algorithm as Netflix, so it learns more about your skin the more you use it (their founder previously worked in 3D printing).

Tech will also enable us to create skin care products based on genetics. Making it possible to predict how our skin will age and how to reverse course based on an evaluation of our genetic makeup. For example, as we get older certain genes flip on triggering enzymes that break down collagen and causing wrinkles. But if we realise thats happening on a molecular level, we can use prescription ingredients to quiet the overactive genes and normalise the skin. So the key to truly smooth skin could be written in your DNA.

Youve been growing rapidly entering seven new markets in just 16 months, and you now reach 100k customers. What has this experience been like, and what have been some of the challenges youve faced expanding into new markets?

The last 18 months have been insane in every aspect.

This year alone, 76 new people have joined Goodiebox and we now have a team of 126 super talented people from 17 different nationalities creating happiness for our members and partners every day working with marketing, tech, operations, design, content, member experience, people development partnerships, business intelligence, talent acquisition, finance and business development. We have gone from one office in Copenhagen to opening new offices in Amsterdam, Berlin and London as well.

Growing the organisation this fast has been a challenge as Nikolaj and I have the ambition that Goodiebox should be the best place to work at. Making sure that we have the structures and processes in place have been very demanding and we are not 100% yet. Also, making sure that we have the same Goodiebox culture in the different offices and within the different teams have been challenging. One of my main responsibilities is now to make sure we have Goodiebox culture across the teams and offices.

It has also been a very real challenge to learn the cultural differences among members in Scandinavia, Benelux and DACH. The Goodiebox version of happiness working in Denmark is not working 1:1 in Austria. Making sure that we on group level oversee what is working in the different markets so we can support local growth and content teams in the best possible way has been difficult and we have experimented a lot before we found the right scalable formula.

What do your customers enjoy the most about your service? Whats your most popular product / product line?

We are member-centric in everything we do. The members are really the starting point for all our activities and we have a very bold ambition of having the happiest members in the world. We really want to be best friends with our members. This is the reason why we dont have customer service but Team Happiness, not agents but Happiness Heroes, not tickets, but conversations and KPIs for keeping the conversations as long as possible (the record for a phone call is 4 hours and 48 minutes).

So our members really like our products but they love our insanely great service. Which is also reflected in our TrustScore on Trustpilot and NPS of over 70. We know that we got to earn this trust and dedication from our members and just because we did great with our Danish members yesterday we still need to prove ourselves for all our new members across Europe tomorrow and the day after tomorrow.

Where do you see Goodiebox in another five years?

In five years Goodiebox will have over two million members across Europe, US and Asia with personalised boxes based on AI and member preferences.

But Goodiebox is more than a great box with awesome beauty products. We really want to create an emotional connection with our members and give them happy moments not just when they receive their Goodiebox, but everyday. So in five years Goodiebox are creating great content (podcasts, videos, long-reads etc.) with members and other external partners. Not just on beauty but on all aspects of life making you happy.

Finally, over the last five years Goodiebox have created several beauty brands based on all the insights and learnings from members in Europe, US and Asia. Our own Comme Deux is the first brand co-created with the members and the initial feedback is amazing. Utilizing tech and feedback from millions of members, we can create relevant products brands to every beauty consumer taking DtC beauty to the next level. We call it DwC (direct-with-consumer) brands.

Read more:
Shaping the future of beauty tech: Interview with Goodiebox CEO and co-founder Rasmus Schmiegelow - EU-Startups

Recommendation and review posted by Bethany Smith

The Alcor Life Extension Foundation is the world leader incryonics,cryonicsresearch, andcryonics technology.Cryonicsis the practice of using ultra-cold temperature to preserve a human body with the intent of restoring good health when thetechnologybecomes available to do.

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Huge Demand of Cryonics Technology Market 2019 Predictable to Witness Sustainable Evolution Over 2024 Including Leading Vendors- Praxair, Cellulis,...

Recommendation and review posted by Bethany Smith

Montreal community members crowded into the Redpath Museum Auditorium on Sept. 27 for a Freaky Friday lecture. In the talk, Professor Joe Schwarcz, Director of the McGill Office for Science and Society, discussed humanitys historical attempts to delay aging.

Nobody looks forward to getting old, Schwarcz said. Historically, there has been this search for the Fountain of Youth, and, over the years, many anti-aging regimens have been developed.

One such regimen consisted of bathing in sour donkey milk and was practiced by Queen Cleopatra in the first century BC. Modern science suggests that, since sour milk contains lactic acid, the remedy could have had a slight rejuvenating effect. Lactic acid belongs to a class of compounds called alpha hydroxy acids (AHAs) that speed up the turnover of skin cells and are now marketed in cosmetic face creams.

In the 19th century, physiologist Charles Brown-Squard observed that eunuchs suffered from medical problems and hypothesized that a substance present in the testes was the key to health and longevity. He injected himself with extracts from dog testes, inspiring other researchers to further investigate gland transplants.

This tradition continued into the early 20th century when John Brinkley, a charlatan without medical credentials, made a fortune by transplanting the testicles of goats into the scrota of aging men.

He had very few complications because he never connected the goat testicles to anything, but he had plenty of men saying how happy they were, [] undoubtedly due to the placebo effect, Schwarcz said. Although we look back on these ventures as being virtually comical, [] this really was the beginning of hormonal therapy.

Attempts to exploit the gullibility of the public persisted, even as legitimate science advanced. Human growth hormone (HGH), the production of which declines as a person ages, became a widely promoted remedy after a 1990 study observed that HGH treatments increased lean mass and bone density in elderly men.

HGH, at the time, was very difficult to come by, Schwarcz said. But there were clinics that popped up [] that were offering HGH injections for much less than [the expected price], so no one knows what they were actually injecting.

When public awareness caught up, companies instead began marketing an HGH secretagogue, a substance that supposedly stimulates the secretion of raw materials to form HGH proteins inside the body. However, HGH levels decline because of the reduced activity of enzymes that assemble raw materials into proteins, not because of a shortage of raw materials.

Supplying these secretagogues is like supplying bricks and windows and doors and hoping that they will assemble themselves into a building, which will not happen because the builder is missing, Schwarcz said.

Schwarcz also noted that the manipulative tactics of advertisers are present in many modern anti-aging products.

Marketing very often uses clever words such as It may help [] and, as soon as you do that, you are protected legally, Schwarcz said.

Some companies push this principle above and beyond. Based in Arizona, the Alcor Life Extension Foundation specializes in cryonics, a pseudoscience that insists on freezing human corpses in the hope of resurrecting them in the future.

It [costs] at least $100,000, Schwarcz said. This is of course nonsense. When you are cold and dead, you are dead.

While some make expensive bets on futuristic technologies, Schwarczs recommendations for prolonging life are a lot less flashy. Okinawa Island in Japan is home to more centenarians than any other place in the world. The lifestyle of this population is characterized by a high consumption of fish, vegetables, and fruit, a low consumption of red meat and processed food, and high levels of activity.

Eating a proper balanced diet, [] exercise, and [genetics] are a few keys, but these are not highly marketable, Schwarcz said. There constantly are these miracle solutions, but there are no miracles.

Continued here:
Searching for the Fountain of Youth - McGill Tribune

Recommendation and review posted by Bethany Smith

As the co-inventors of CRISPR/Cas9 gene-editing technology, Jennifer Doudna, Emmanuelle Charpentier and Feng Zhang are typically the first names that spring to mind when CRISPR is being discussed. What you may not know, however, is that the CRISPR mechanism was originally discovered back in the 90s by a particularly humble microbiologist, Francisco Mojica, Professor at the University of Alicante.

Kicking offTechnology Networks Explores the CRISPR Revolution, Professor Mojica, or "Francis", takes us on a journey back to the original research that, despite being deemed "crazy" by members of the scientific community at the time, led to the CRISPR revolution that is anticipated to edit evolution forever.Impossible to anticipate

The greatest finds in scientific discovery are typically unanticipated when a researcher embarks on a study. The discovery of CRISPR is no exception: "It was absolutely impossible to anticipate the huge revolution that we are enjoying nowadays," Mojica tells me as he laughs, still seemingly astounded by it.

In 1992, Mojica was working on his thesis at the University of Alicante. A keen microbiologist, he was studying microorganisms belonging to the Archaea family, a group of prokaryotes that he brands "quite peculiar". These microorganisms are halophiles, meaning they require high-salt conditions to survive. Mojica and colleagues were interested in understanding how Archaea are able to grow in high salinity and, when required, adapt to changes in such salinity.

They opted to sequence their DNA to look for clues in the genome. In a pre-Human Genome Project era, this was quite the task. The scientists didn't have the luxury of sequencing data being at their disposal.

Nevertheless, Mojica and the team's efforts were successful. They discovered that the halophiles' DNA possessed a series of regularly spaced repeats, which they labelled tandem repeats (or TREPS). "We saw that these repeated regions in the halophiles were transcribed, meaning they were active. The cell was reading this information in each of the growing conditions that we tested, and so we knew that they had to be important for the cell," Mojica tells me.

The researchers scoured the literature for evidence of previous work outlining the existence of TREPS. They struck gold in the form of a paper published in 1987 by Ishino and colleagues (a huge feat considering that PubMed was yet to be invented). The Japanese researchers had too stumbled across these TREPS in E. coli.1 A "crazy" hypothesis, and a backlash from the scientific community

Mojica's curiosity was sparked. What function did these repeats serve? They existed in bacteria and archaea thus, surely their origin was ancestral?

"In 1995 we published a paper where we suggested a hypothesis which, nowadays, may sound crazy. We hypothesized that the repeats were involved in the segregation of the chromosomes in cell division," Mojica tells me.2 "It was completely wrong," he laughs, "but it fit with our data at the time."

Mojica's efforts to explore the functional role played by the repeats were greeted with an initial backlash from the scientific community.

"When we didn't have any idea about the role these systems played, we applied for financial support from the Spanish government for our research," he explains. "The government received complaints about the application and, subsequently, I was unable to get any financial support for many years." It immediately occurs to me that the culprits behind the complaints are probably kicking themselves now.

I pause for a second, slightly bewildered, before asking him why. "Initially they said, "You want to explore the role played by some repeats in very peculiar and strange organisms. Maybe you discover the role, maybe you don't. But, in any case, your findings will only apply to these strange organisms."" They doubted the relevance of the research. "That was the first criticism. Next I was implored by the reviewers of the grant to move to a model organism such as E. coli, which I did." Mojica continues, "It was a huge mistake."

Whilst the repeats are transcribed in halophilic archaea, in E. coli, they are repressed unless you create mutations. "I spent many years trying to understand the function of these repeats in a model organism in which the system was not working. I could not get any results," he tells me, surprisingly maintaining an upbeat, positive tone to his voice at all times during this recollection. Unphased by his lack of results, Mojica persisted. In 2000, TREPS received a rebranding after he discovered that the repeats existed in many other organisms that were hardly close on the evolutionary tree. Going forward, the repeats were to be known as short regularly spaced repeats, or SRSRs.3 CRISPR enters scientific literature

By 2001, both Mojica and Ruud Jansen, of Utrecht University, were searching for the repeats in various prokaryotic organisms. Jansen reached out to Mojica to inform him that his research team had discovered genes next to the repeats and wanted to agree on common terminology for the repeats.

Several names were proposed before an agreement was made. "I thought about a few alternatives, of which I just remember RISR and CRISPR," Mojica says. "I introduced them to Ruud, explaining their meaning and the pros and cons of each. CRISPR was the one that considered all the features of the repeats. We agreed to use it in our future publications." In 2002, the first mention of clustered regularly interspaced short palindromic repeats, or CRISPR, appeared in the scientific literature.4A dramatic revelation courtesy of the genomic era

In the early 00s, science entered a "genomics era" in which genome sequencing technologies rapidly advanced, paralleled by increased sequencing data being made available to scientists in public databases.

Such data permitted a revelation for Mojica in his work.

When sequencing one particular strain of E. coli, Mojica discovered that there were sequences between the repeats known as "the spacer regions" of CRISPRs that matched the sequence of a particular virus. Further exploration of sequencing data revealed that this was the case in many other, extremely different organisms. These DNA sequences protected the prokaryotes from being infected by viruses carrying the same sequence in its genome; the virus simply couldn't infect the cell. And so, he realized: "This is an immune system. This is an adaptive immune system!"

As he sits with a wide grin on his face recalling the fine details, it is very clear to me that the sheer thrill of making this discovery remains with Mojica to this day. "It was a very nice surprise," he says.

Unfortunately, the scientist was once again greeted by criticism when he endeavoured to publish his research findings. "The paper was rejected by four different journals for many different reasons. One journal said to us that it wasn't interesting enough and another said we needed more experimental proof. We almost considered not publishing the paper." One of those papers was the journal Nature. He adds: "I guess it was a very new idea. We presented our findings at a conference in Spain and some of my colleagues came to me and suggested that what we were doing was very pretentious and 'overgrown'." Mojica laughs.

The study was eventually published in the Journal of Molecular Evolution in 2005.5

Genome-editing came as a "wonderful surprise"

Following the publication of their discovery in 2005, Mojica and colleagues anticipated that their research findings would have a large impact on the biotechnology, biopharmaceutical and clinical science sectors.

And so, in 2012, when Doudna and Charpentier demonstrated that they had reprogrammed the CRISPR mechanism to function as a gene-editing tool in vitro, Mojica was "wonderfully surprised, and very, very impressed."

Since the 2012 publication, a wide variety of research groups have further developed and manipulated the CRISPR mechanism for an array of purposes, ranging from agriculture, diagnostics, drug development, cancer research the list goes on, and will be explored throughout the series.

I am intrigued to know what Mojica deems his favourite application of CRISPR thus far. "My goodness, every single one of them has been astonishing," he continues, "I cannot choose one. I must choose two! And they are the two papers published back to back in Science in 2013." Mojica is referring to a paper published by Feng Zhang that was followed by a second paper in the same journal by George Church.6,7Both research groups outlined their novel use of the CRISPR tool to edit the genome of mice and human cells, igniting the CRISPR genome-editing "revolution".

Filing a patent? I never thought about it An ongoing patent dispute lurks behind the excitement and flurry surrounding CRISPR technology, which will be explored in a later instalment of the series. Interestingly, Mojica is one of few scientists involved in the discovery of the CRISPR mechanism and its applications that has not filed a patent.

"Some people ask me why I didn't file a patent 10 years ago," he pauses. "I have to confess, I never thought about doing that. In my lab, we aim to understand biology. Filing patents probably should be one of the goals," he laughs before adding, "But it is not."

He then goes on to express his anxieties regarding the impact the patent dispute may have on the progress of CRISPR research and applications. "I'm pretty sure the patent dispute could be slowing down the transfer of experiments and research from the lab to the clinic. I'm not absolutely sure, but I fear that could be a problem, and that isn't fair." He adds "It's quite difficult for me to understand why there is such a long-lasting dispute on getting money from research."

Mojica strikes me as a passionate scientist who truly thrives on the quest for novel discovery and is modest in doing so. When asked in a previous interview how he would react to being awarded a Nobel Prize for his work in the CRISPR field, he admitted, "I will disappear from the planet. I need to rest and relax, and I need time to get back to what motivates me and return to the lab." Looking to the future of CRISPR

Mojica's work in this the field of CRISPR is certainly far from finished. He tells me, "We are still interested in understanding how the CRISPR mechanisms work in nature; particularly how these systems develop the memory of past infections. There is a huge diversity of CRISPR Cas mechanisms, and different systems work differently in a variety of organisms." "We are using metagenomics high-throughput sequencing to identify more CRISPR Cas systems and variants that are different to those we know of currently. We hope that either our group, or other groups across the globe can look to identify further applications for these systems or improve the current CRISPR tools we have now."

I ask Mojica what he envisions the CRISPR research field to look like in 10 years' time.

"I am a microbiologist, I'm not a specialist in genome editing but I do read a lot!" he laughs. " It's risky to predict any situation, but I wish that in 10 years' time CRISPR will already be in the clinic, and some patients will have been cured from diseases that currently have limited treatment options. Who knows exactly how many diseases could be tackled by CRISPR."

"A reality right now is CRISPR's application in agriculture. I do anticipate that in some countries, we will soon be eating food that is derived from CRISPR-edited crops. But it's risky to predict any situation."

As our interview comes to a close, I express my sheer gratitude to Mojica for lending his time to me and for sharing his CRISPR story. He replies, humble as ever, "The pleasure is all mine."

ProfessorFrancisco Mojica was speaking with Molly Campbell, Science Writer, Technology Networks.

References:

1. Ishino, Shinagawa, Makino, Amemura, and Nakata. 1987. Nucleotide Sequence of the iap Gene, Responsible for Alkaline Phosphatase Isozyme Conversion in Escherichia coli, and Identification of the Gene Product. Journal of Bacteriology. DOI: 10.1128/jb.169.12.5429-5433.1987.

2. Mojica, Ferrer, Juez and Rodrguez-Valera. 1995. Long stretches of short tandem repeats are present in the largest replicons of the Archaea Haloferax mediterranei and Haloferax volcanii and could be involved in replicon partitioning. Molecular Microbiology. DOI: 10.1111/j.1365-2958.1995.mmi_17010085.x

3. Mojica, Dez-Villaseor, Soria and Juez. 2000. Biological significance of a family of regularly spaced repeats in the genomes of Archaea, Bacteria and mitochondria. Molecular Microbiology. DOI: 10.1046/j.1365-2958.2000.01838.x

4. Jansen, Embden, Gaastra and Schouls. 2002. Identification of genes that are associated with DNA repeats in prokaryotes. Molecular Microbiology. DOI: 10.1046/j.1365-2958.2002.02839.x

5. Mojica, Dez-Villaseor, Garca-Martnez and Soria. 2005. Intervening Sequences of Regularly Spaced Prokaryotic Repeats Derive from Foreign Genetic Elements. Journal of Molecular Evolution. https://doi.org/10.1007/s00239-004-0046-3.

6. Cong et al. 2012. Multiplex genome engineering using CRISPR/Cas systems. Science. DOI: doi: 10.1126/science.1231143.

7. Mali et al. 2012. RNA-Guided Human Genome Engineering via Cas9. Science. DOI: 10.1126/science.1232033.

The rest is here:
Francis Mojica: The Modest Microbiologist Who Discovered and Named CRISPR - Technology Networks

Recommendation and review posted by Bethany Smith

CRISPR And CRISPR-Associated (Cas) Genes Market Report provides a relevant source of perceptive data for investors. CRISPR And CRISPR-Associated (Cas) Genes Market Report also examines global CRISPR And CRISPR-Associated (Cas) Genes Industry growth analysis, the past and innovative cost, demand and supply information, and revenue.

CRISPR And CRISPR-Associated (Cas) Genes MarketReport 2019 provides the newest industry data and industry future trends, allowing you to identify the products and end users driving Revenue growth and profitability. The industry report lists the leading competitors and provides the insights strategic industry Analysis of the key factors influencing the market.

This report studies the global CRISPR And CRISPR-Associated (Cas) Genes Market analyses and researches the CRISPR And CRISPR-Associated (Cas) Genes development status and forecast in the United States, EU, Japan, China, India, and Southeast Asia. This report focuses on the top players in the global market.

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Clustered regularly interspaced short palindromic repeats (CRISPR) are segments of prokaryotic DNA containing short repetitions of base sequences. Each repetition is followed by short segments of spacer DNA from previous exposures to a bacteriophage virus or plasmid.

The CRISPR/Cas system is a prokaryotic immune system that confers resistance to foreign genetic elements such as those present within plasmids and phages, and provides a form of acquired immunity. CRISPR associated proteins (Cas) use the CRISPR spacers to recognize and cut these exogenous genetic elements in a manner analogous to RNA interference in eukaryotic organisms. CRISPRs are found in approximately 40% of sequenced bacterial genomes and 90% of sequenced archaea.

, CRISPR And CRISPR-Associated (Cas) Genes industry is relatively concentrated, manufacturers are mostly in the Europe and North America. Among them, North America region accounted for more than 45.70% of the total market of global CRISPR And CRISPR-Associated (Cas) Genes.

Although this market has great potential for future development, we do not recommend entering the market for investors who do not have strong capital or do not have key technology.

TheGlobal CRISPR And CRISPR-Associated (Cas) Genes market is valued at 350 million US$ in 2018 and will reach 5220 million US$ by the end of 2025, growing at a CAGR of 40.0% during 2019-2025. The objectives of this study are to define, segment, and project the size ofThe CRISPR And CRISPR-Associated (Cas) Genes market based on company, product type, end user and key regions.

With tables and figures helping analyze worldwide Global CRISPR And CRISPR-Associated (Cas) Genes market, this research provides key statistics on the state of the industry and is a valuable source of guidance and direction for companies and individuals interested in the market.

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List of Major CRISPR And CRISPR-Associated (Cas) Genes marketcompetition by top manufacturers, with production, price, and revenue (value) and market share for each manufactures:

The report also focuses on global major leading industry players of Global CRISPR And CRISPR-Associated (Cas) Genes market providing information such as company profiles, product picture, and specification, capacity, production, price, cost, revenue and contact information. Upstream raw materials and equipment and downstream demand analysis are also carried out. The Global CRISPR And CRISPR-Associated (Cas) Genes market development trends and marketing channels are analyzed. Finally, the feasibility of new investment projects is assessed and overall research conclusions offered.

By theproduct type, the market is primarily split into:

Look into Table of Content of CRISPR And CRISPR-Associated (Cas) Genes Market Report at @https://www.360marketupdates.com/TOC/13714540#TOC

By theend users/application,this report covers the following segments:

The study objectives of this report are:

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Recommendation and review posted by Bethany Smith

Two years ago, federal corrections officer Emmitt Landry was taken to a Houston hospital after having a stroke at age 41. About a month earlier, Landry had been feeling fatigued when coworkers told him about Optimum Wellness, a clinic in Nederland, Texas, that could treat him with hormones.

"I was just looking for something to help me get through the day," Landry told CBS News chief medical correspondent Dr. Jonathan LaPook. At the hospital, doctors tried to figure out why someone so young would have a stroke. The only thing doctors could deduce, according to Landry, was that the testosterone caused a clot.A nurse practitioner at the clinic Landry visited in Nederland had prescribed him testosterone even though his testosterone blood levels were normal. Optimum Wellness is one of a number of medical clinics across the country selling hormone therapy that some believe could provide patients a fountain of youth. A CBS News investigation found there are clinics across the country prescribing hormones like testosterone to people with normal blood levels.

Landry says his nurse practitioner only highlighted the benefits and never discussed a possible risk of heart disease, stroke or any other problems whatsoever.

In Texas, nurse practitioners are not allowed to prescribe hormones without a doctor's approval. Landry's treatment was overseen by Dr. James Kern, an OB/GYN in Houston about 100 miles away. In October 2017, the Optimum clinic was raided by the DEA and shortly after that, Kern withdrew his supervision. The DEA declined to comment.

Amy Townsend, a doctor in southeast Texas, told CBS News, "I'm seeing multiple people that are my friends and my family that are being treated completely inappropriately."

So, she decided to report the clinic to the state nursing board. But according to Townsend, they didn't take action.

Oversight comes from state medical and nursing boards. CBS News reached out to both sets of boards in all 50 states and of the 95% that responded, only seven states have both medical and nursing boards who keep track of incidents related to hormone therapy. "Right now this practice of giving testosterone to people who, in your mind, shouldn't be getting it, it's still going on?" LaPook asked.

"It's widespread throughout the country," Townsend said.

Landry said these clinics prey on people's fears of growing old and that when he walked out of the hospital after suffering a stroke, he felt embarrassed.

"I went to these physicians looking for help and I had a stroke," Landry said. "And I'm supposed to be taking care of my family."In February 2018, the nurse practitioner who treated Landry lost his license for inappropriately prescribing hormones to Landry and others and in August, the clinic closed its doors for good.Landry is now suing Dr. Kern and the nurse practitioner who treated him at the clinic. They've denied Landry's allegations.

CBS News reached out to Dr. Kern and the nurse practitioner, but they declined our request for comment.

If you or someone you know have information you'd like to share regarding a hormone therapy clinic, email:investigates@cbsnews.comor contact the CBS News Investigative Unit via one of the methods on ourtips page.

2019 CBS Interactive Inc. All Rights Reserved.

The rest is here:
A clinic treated a fatigued 41-year-old with testosterone. A month later he had a stroke. - CBS News

Recommendation and review posted by Bethany Smith

Medical clinics across the country are advertising a treatment some believe is a fountain of youth. They're selling hormone therapy as a way to make people look and feel younger. But a CBS News investigation finds this may be putting patients at risk.

Last year, at the age of 60, Cindy Kinder-Benge was rushed to a hospital in New Albany, Indiana, with a heart rate four times normal. Two months earlier, she had gone to the emergency room with palpitations.

"A cardiologist walks in and he said, 'Who put you on thyroid medicine?'" Kinder-Binge said.

She had been prescribed a thyroid hormone for menopausal symptoms like hot flashes, even though her thyroid blood levels were normal. She says her cardiologist had her stop taking the hormone because he believed it contributed to her irregular heartbeat.

She was treated by a nurse practitioner at a clinic called 25 Again. Hormone therapy is promoted as a way to help patients lose weight and feel younger. But a CBS News investigation found there are clinics across the country prescribing hormones like thyroid and testosterone to people with normal levels and it's not just 25 Again.

Ultrasound technician Leighann Decker is a former employee of an OB-GYN in Owensboro, Kentucky. The doctor Decker worked for prescribed testosterone to patients with normal testosterone levels looking to turn back the clock.

"More and more practitioners have tried to jump on board and when they've seen the profit that's being made from it. Of course, it's cash pay. It's easy money," Decker said.

The doctor in Kentucky and the practitioner in Indiana both attended seminars given by Dr. Neal Rouzier. He has been promoting hormone replacement therapy for decades and said he's trained thousands of clinicians around the world. During a 2016 deposition, he said he gives testosterone to patients even if their levels are normal.

"I don't care about the number. I treat patients. I treat symptoms," Rouzier said.

Some research suggests testosterone therapy may increase the risk of heart attack or stroke. In 2015, Rouzier dismissed that concern.

"There's thousands of articles to show protection against heart attacks," he said.

But under oath, in that deposition, he was unable to point to any evidence that would back up his claim that his approach to testosterone therapy is safe.

"The problem is that there is no fountain of youth," said Dr. Steven Nissen, a cardiologist at the Cleveland Clinic. Nissen is leading an FDA-mandated study to see if giving testosterone affects the risk of heart attack or stroke in men with low levels."There's no scientific basis for giving hormone therapy to people whose levels are already normal and there's lots of suggestions that it may actually be harmful," Nissen said.

Kinder-Binge is suing 25 Again. The company told CBS News the overall health of their patients is their priority and they make patients aware of any risks. Rouzier declined our request for an interview and did not respond to a list of written questions.

The company 25 Again sent the following statement to CBS News:

We thank CBS News for reaching out to us regarding our company. While we are unable to speak to a particular patient's health because of federal health guidelines (HIPAA), we are eager to discuss the many benefits we provide to our patients and clear up any confusion or false information regarding hormone replacement therapy.

At 25 Again, the overall health of our patients is our priority and our mission. Hormone therapy is only a part of what we do in consideration of a person's health. Many of the patients we see have been turned away by their primary care physician or have not otherwise been able to find help to alleviate symptoms they may be experiencing.

From the start, when a potential patient visits us, we make them fully aware of any possible risks associated with hormone replacement therapy. Patients must sign a consent form before they can participate. Every patient at 25 Again is also required to undergo a physical and blood test, so that our team can first look at each person's health history to decide the best course of action, whether hormone replacement is the best fit for the patient, and the level of hormones needed for the individual patient. Individuals can also opt out at any time, and all patients are directed to, and agree to, remain under the care of another physician for all other medical conditions.

Hormone replacement therapy can be used to alleviate many signs and symptoms known to be associated with certain declining hormones, including inflammation in the body, which is the root cause of many diseases like cardiovascular disease, arthritis, depression, stress and more. Studies show lower hormone levels can cause these symptoms, and hormone replacement therapy can help people reach their optimal hormone levels.

According to the Food and Drug Administration (FDA), normal lab test values are a set of upper and lower limits generally given as a range because normal values vary from person to person. At 25 Again, we treat the patient individually and consider many other factors while addressing hormone levels. We have more than 7,000 customers, many of whom have found relief with this method. If a patient is still experiencing symptoms, additional hormones may be given safely.

Like other forms of medication in the health care industry, before a potential patient signs a consent form, they are informed that this treatment may not be effective for every individual. An individual's lab results are always available upon request, and are often used to show them how wide the range of normal can be for hormone levels.

If you or someone you know have information you'd like to share regarding a hormone therapy clinic, email:investigates@cbsnews.comor contact the CBS News Investigative Unit via one of the methods on ourtips page.

Read more:
Hormone therapy clinics could be putting patients in danger - CBS News

Recommendation and review posted by Bethany Smith

Erin Reed was just 13 years old when she first began researching gender transition. It took her another 18years to transition publiclyand access to treatment, or lack thereof, played a big role in the wait.

As a teen, Reed found that in order tobe prescribed hormone therapy, she would need letters from gender specialists and she would have to present as a girl for months (or even longer) prior to her first dose. It just didnt seem like something I could access, she told Rewire.News. Transitioning without hormones terrified Reedalthough many trans people do transition non-medically, she didnt want toso she didnt try at all.

There was no way I could present as female for a year before receiving treatment. The whole process just seemed really daunting to me, Reed said.

It wasnt until adulthood that Reed, now the digital director of the progressive news site Shareblue, discovered informed consent (IC) clinics, where trans people can access hormones without jumping through the various hoops. Reed booked an appointment at one a few hours from her home in Washington, D.C., and began hormone replacement therapy a few months ago. But after herchallenging road to finding the resources she needed, Reed felt inspired to help others. So she created what has become one of the largest repositories of information on IC clinics in the country: a map of clinics all over the United States.

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Conventional medical wisdom holds that hormone therapy treatment should involve a long series of complex steps. Rather than having to consult with a mental health professional and present as their gender for a year, patients at informed consent clinics are educated about the impact of the drugs they are interested in starting therapy with. If they are determined to be of sound mind and fully able to consent, they can sign a form and begin treatment. Patients, who are often still in the early stages of hormone therapy at IC clinics, are then monitored carefully; their hormone levels are checked every few months.

For Reed, this was key: You can just start. That just blew my mind. I wished I could have done it 10 or 15 years ago. Knowing that was an option gave me the confidence to transition.

Informed consent doesnt mean that trans people are receiving medication with any less oversight thanpatients being prescribed any other non-addictive drug. IC clinics just operate the way standard treatment processes should,allowing doctors to treat their patients as they see fit and giving patientsthe right to advocate for themselves. The clinics vary in structure; some are independent facilities, and others, likethe transgender health program at Bostons Fenway Health and the trans health clinic at the University of California, San Francisco (UCSF), are operated by larger medical systems. Some Planned Parenthood clinics offer IC hormone treatment, but not all of them.

A study of 12 informed consent clinics conducted bya UCSF medical professor found minimal risk of regret and no known cases of malpractice suits. UCSF also noted that most providers are already familiar with the hormones used for gender-affirming hormone therapy because the medications areused for conditions ranging from male pattern baldness to menopause.

Some people have criticized IC clinics forpotentiallytreating patients who arent actually trans or who later change their minds. Statistically, however, thatseems to be incredibly rare. A 2018 study of surgeons that had treated more than 22,000 transgender patients in total found that, between them, the providers could only recall62 patientsthat had ever expressed regret about transitioning.

I always hear that the big concern is that: What if you are letting people through that are just going to de-transition, or what if you are letting people through who arent transgender? I can tell you from my personal life and from everyone I have spoken to . If youre looking into transitioning, chances are youre transgender, Reed said.

Generally speaking, patients have to be 18 to accesshormone therapy and related treatment through informed consent, although advocates are pushing for that limitation to be dropped in certain cases. For adult trans folks, though, IC can streamline the process significantly.

Considering all of this, Reed decided to share the word about informed consent. I spent probably 20 to 25 straight hours in front of my laptop, just looking up clinics, she explained. Reed scoured the internet and also crowdsourced info on clinics from other trans folks, asking people to send in the names and locations of clinics they had used. Once she found them, Reed compiled the clinics into a map she shared on social media, which has now been viewed more than 88,000 times.

Reeds map shows a serious dearth of informed consent clinics in certain areas of the country, like Montana, North and South Dakota, and Wyoming. Overall, the Rocky Mountain, Southeast, and Midwest regions have far fewer clinics than the Northeast and the West Coast. Clinics are also concentrated near major metropolitan areas.

Informed consent clinicscannot necessarily guarantee that a patients medication will be covered by their insurance; Reed is still paying out pocket for hers because of the slow process of approval through Kaiser.

Informed consent isnt a complete or perfect solution, but the IC map has still been a powerful tool for transpeople.

I have gotten private messages from people saying stuff like that: that they wouldnt have been able to do it without the map,Reed said. And I wouldnt have been able to transition without [knowing about informed consent], so I understand.

Reed hopes that her map will not only be a resource for other transpeople, but potentially serve as an example for policymakers, health-care practitioners, and other decision-makersboth trans and cisabout the importance of informed consent. Ideally, Reed said, projects like hers will eventually be replicated by others, taking some of the pressure off of trans people to constantly produce their own resources in the absence of information.

If we didnt have to take all the burden on ourselves, that would be great, she said.

For many transpeople, access to hormone therapy is an important aspect of being able to live on their own terms and feel comfortable in their bodies. Being able to begin treatment without the trauma and expense of being forced to see gender specialists can be radically liberating.

Moving from transition being a theoretical thing, to an actual concrete thing, being able to make a plan, knowing that there is a physical place you can go, and seeing it on the mappotentially not far from youI think it gives people a little bit of courage to be themselves, Reed said.

Original post:
Meet the Woman Making It Easier for Trans People Around the Country to Get Hormones - Rewire.News

Recommendation and review posted by Bethany Smith

Do you sometimes run through all your childrens names first when trying to call the dog? (Amy! Dave! Brian oh, for the love of Beanie!) Recalling whats-her-name who did that thing with that guy in that movie? (You know who, that guy who also did the thing?) If you are a postmenopausal woman, you might be able to blame your fogginess on the length of time your body produced estrogen naturally and how long you took hormone replacement therapy (HRT), also known ashormone therapy (HT).

Related: Perimenopause and Menopause: Whats the Difference?

Men and women have different sex hormones that have different effects on the brain as we age. A study published online October 16, 2019,in thejournal Menopausehas found that the longer a woman has been exposed to estrogen (from onset of menstruation to menopause or through early use of HT after menopause), the better her brain health and mental flexibility as she enters her sixties.

Related: Hormones and Your Health: An Essential Guide

The study looked at more than 2,000 postmenopausal women over 12 years to discover what, if any, association there is between estrogen and brain health. They focused on how long the woman had been exposed to estrogen, adjusting for pregnancies (when they would be exposed to more hormones), breastfeeding (when they would have produced less estrogen), and if they took HT for any length of time.(Use of hormonal birth control was not considered because thiscontraception methodregulates, rather than significantly add, estrogen.)

The women were tested at various points on five factors of brain health, including psychomotor skills, memory, identification and association, orientation, and concentration and calculation. It would make sense to define this as broad thinking skills, such as memory, concentration, and being able to make decisions quickly, explainsJoshua M. Matyi,lead study author and doctoral candidate in the department of psychology at Utah State University in Logan.

Related: Stress Can Shrink Your Brain, Study Says

This study found that the longer the estrogen window (when women were naturally producing estrogen), the better the womens brain function was. The brain function of participants who took HT remained the same, but was higher than those who did not take HT. Cumulatively, length of estrogen exposure was associated with how the participants would do on the cognitive measure test, says Matyi.

Related: Treatments for Menopausal and Perimenopausal Symptoms

Many studies on estrogens effect have been conflicting and complex. In 2003, the large Womens Health Initiative Memory Study(WHIMS) showed anincreasein dementia risk for women taking HT. (These are the studies that influenced the application of the black box warning on many HT products.) However," Matyisays, "our results are in contrast to those results. Also, our study shows support for the critical window hypothesis, which suggests that HT should be initiated closer to menopause, rather than later, to reduce any reduce any risks related to thinking and learning abilities.He adds, We also did not see any change in women who started and stopped HT. Thats an indication that the majority of effect occurred years before our study. This means that benefits may potentially continue even after discontinuing.

Some women go into menopause earlier than normal because of cancer treatments or removal of the ovaries.This study shows that for these women (under age 45), early treatment with HT at least until the natural age of menopause (around age 51 in the United States) the benefits will outweigh the risk, unless there is a clear reason to avoid HT, such as breast cancer history.

Related: How to Keep Your Brain Sharp and Healthy as You Age

The decision gets more complicated as you get older. Weve suggested that any woman going through menopause before the age of 45 should use HT, for the protective effect. unless there is a medical reason not to do so. It helps not just the brain but the heart and bones as well. Its never going to be cut and dried; it has to be weighed out in terms of risk and benefits, saysStephanie S. Faubion MD, medical director ofNAMS, and Penny and Bill George Director of the Mayo Clinic Center for Womens Health in Rochester, MInnesota.

The actions described can provide additional benefit even if you are taking hormone therapy. According to Harvard Health Publishing, you can up your chances of finding your glasses, phone, or keys by following these suggestions:

Related: 7 Ways to Move More at Midlife

Further research is needed on the connection between the brain health and estrogen. These are complicated questions but researchers are looking into it. This study brings us one step close to solving the riddle, says Faubion.

More:
Estrogen May Protect Brain From Cognitive Decline - Everyday Health

Recommendation and review posted by Bethany Smith

Melatonin is a hormone produced by your brains pineal gland, which controls your internal sleep and body clock.

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

The supplements you buy in the store contain a synthetic version of melatonin. They will not increase your sleep drive or put you to sleep, and most research does not show significant benefit in using them as sleeping pills.

But if melatonin is taken at a time and dosage that is appropriate for someones sleep problem, it can help shift the biological sleep clock earlier. This can be helpful for shift workers and people with circadian rhythm disorders.

My general recommendation is less is more, or 0.3 milligrams to 1 milligram taken several hours before bedtime. Unfortunately, most melatonin sold over-the-counter is available in doses ranging from 3 milligrams to 10 milligrams, which is much more than your body needs.

To allow your bodys own melatonin to work best, you should create optimal conditions. Keep lights dim in the evening and avoiding using a computer, smartphone or tablet before bed, as bright light exposure can inhibit the release of melatonin. In addition, getting light exposure in the morning can help keep your sleep-wake cycle on track, so get outside for a morning walk when you wake up, if possible.

Sleep specialist Michelle Drerup, PsyD

See original here:
What's the Right Way to Take Melatonin? - Health Essentials from Cleveland Clinic

Recommendation and review posted by Bethany Smith

October 12 2019, 12:01am,The Times

A child gender clinic in London is being threatened with legal action. The question of whether children can agree to life-altering treatment must be carefully weighed

The moment a pregnancy is announced, expectant mothers are asked whether they are awaiting a boy or a girl. As children get older, most have a straightforward relationship with their gender. Yet for a growing minority, the question becomes vexed and can cause immense distress.

In recent years the number of children reporting gender dysphoria the conviction that the sex on their birth certificate is the wrong one has rocketed. Five years ago, 468 children were referred to the Tavistock and Portman NHS trusts gender identity development service in north London, while last year alone, 2,519 children were referred.

Today we report that the clinic is being threatened with legal action by a parent who wants to stop it from prescribing hormone blockers

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Subscribe now and get unlimited digital access on web and our smartphone and tablet apps, free for your first month.

More here:
The Times view on the Tavistock clinic and hormone-blocking drugs for the young: Informed Consent - The Times

Recommendation and review posted by Bethany Smith

PEORIA UnityPoint Health is offering a new form of birth control.

Long Acting Reversible Contraception (LARC) is a one-time long-term method of birth control that can be easily removed by a doctor. Users have three to ten years of birth control depending on which method they use.

My goal is to improve reproductive health for women. Im always looking for opportunities to increase our communitys access to birth control, especially the under served public insurance population, said Dr. Rahmat NaAllah, UnityPoint Clinic Family Medical Center provider and Family Residency Program faculty member.

In addition to providing the option to women at the UnityPoint Clinic Family Medical Center, the organization is also working to get more physicians trained to dispense LARC.

As a faculty member in our residency program, I want to train the residents to be more competent and confident in contraceptive procedures. Currently less than 20 percent of family physicians nationwide are trained in LARC placement. As a doctor, I want to increase accessibility for our patients, said NaAllah.

UnityPoint Health is offering women two LARC options. Nexplanon is an arm implant. A plastic rod the size of a matchstick is inserted in the arm under the skin. The intrauterine device is a T-shaped plastic device placed inside the uterus. A non-hormone copper IUD alternative is available. Nexplanon and the IUDs release the hormone progestin, which make it difficult for sperm to reach an egg in the uterus.

Women who use LARC dont require any other form of birth control. LARC also reduces menstrual pain, and doesnt interfere with sexual activity. Many women like LARC because it can make periods lighter. And because they dont have to take a pill every day or renew a prescription, its more convenient, said Na'Allah.

LARC is the most effective birth control with a failure rate of less than one percent, said NaAllah. All the major healthcare organizations like the CDC, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and American Academy of Pediatrics support these findings.

NaAllah notes that contrary to popular belief, the risk of an IUD puncturing the uterus is less than 2 percent. Her team takes extra precaution in measuring the depth of a womans uterus before placing the IUD to ensure it is safely secure.

Every woman has a right to plan their pregnancy, so they can be empowered and productive members of society. To help women reach their best, they need to have access to birth control. I want to help our community and beyond. I want to be able to train more future family physicians so wherever they go to practice they are part of the solution and not part of the problem, said NaAllah.

The Family Medical Center is a UnityPoint Health family medicine and residency clinic with the University of Illinois College of Medicine Peoria partnership. Doctors at the clinic are currently dispensing the LARC devices during a once-a-month clinic, but the program may be expanded to once a week to meet demand.

UnityPoint Clinic Family Medical Center is at 815 Main St. in Downtown Peoria. To schedule a LARC appointment to speak to a provider about different LARC options, call 672-4977.

Link:
UnityPoint Health is offering Long Acting Reversible Contraception - Pekin Daily Times

Recommendation and review posted by Bethany Smith

CRANBURY, N.J.--(BUSINESS WIRE)--OncLive, the nations leading multimedia resource focused on providing oncology professionals with the most current and insightful information they need to offer the best patient care, will host its latest State of the Science Summit on Genitourinary Cancer on Tuesday, Oct. 22, from 5-9 p.m. at the Renaissance Phoenix Downtown Hotel, in Arizona. The chair for the summit will be Alan H. Bryce, M.D., medical director of the genomic oncology clinic, chair of the division of hematology/oncology and associate professor of medicine at Mayo Clinic.

This interactive and educational meeting will analyze and discuss novel treatments for patients with genitourinary cancers. The expert presenters will explore a wide variety of related topics, such as novel imaging in nonmetastatic hormone-sensitive prostate cancer, the role of radiation therapy in prostate cancer, treatment of nonmetastatic castration-resistant prostate cancer, advances in metastatic prostate cancer, advanced urothelial cancer and the role of cytoreductive nephrectomy in renal cell cancer. The presenters will also engage in a peer exchange and address audience questions.

The presenters for the summit include the following:

State of the Science Summit is a premier conference series hosted by OncLive that features medical experts from across the nation discussing treatment options. Each summit integrates academic and community-based physicians and health care professionals across key disciplines, from medical and surgical oncology to hematology.

Registration is free and open to all health care professionals, and food and beverages will be served. For more information and to register, visit https://www.onclive.com/meetings/soss or contact Kayla Collins at kcollins@onclive.com.

About OncLive

A digital platform of resources for practicing oncologists, OncLive offers oncology professionals information they can use to help provide the best patient care. OncLive is a brand of MJH Life Sciences, the largest privately held, independent, full-service medical media company in the U.S. dedicated to delivering trusted health care news across multiple channels.

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OncLive Presents State of the Science Summit on Genitourinary Cancers - Business Wire

Recommendation and review posted by Bethany Smith

You know how some people could eat ice cream every day, and others are satisfied with one cone a month? Your sex drive is like your appetite, according to Sheryl Kingsberg, PhD, the chief of behavioral medicine at University Hospitals Cleveland Medical Center. Some people are in the mood for sex daily, while others are happiest getting action less often. But what might it mean if your sex drive suddenly goes AWOL?

An ebb in sexual appetite is often due to a combination of biological, psychological, and social factors. Here are a few of the reasons you may be less interested in getting it on:

If deadlines, family woes, or spats with friends are weighing on your mind, chances are theyll also put the kibosh on any interest in sex. If there are too many things causing inhibition, those will outweigh your ability to process and respond to a sexual cue, explains Kingsberg.

Obvious alert: Discomfort during sex makes it very difficult to focus on any pleasure that may also be happening. But many women who experience this kind of pain think that what they feel is normal, says Irwin Goldstein, MD, the director of sexual medicine at Alvarado Hospital in San Diego, California.

Pain is never normal, but it is common: Three in four women have pain during sex at some time in their lives, according to the American College of Obstetricians and Gynecologists.

Pharmaceuticals can be a huge help for certain medical conditions, but a side effect of some can be low sexual desire. One biggie: SSRIs (selective serotonin reuptake inhibitors), which can help those living with depression but also increase serotonin, a known inhibitor of desire. About 40 percent of sexual dysfunction in people with depression can be attributed to antidepressants, according to a 2016 paper in the Mayo Clinic Proceedings.

Additionally, some birth control pills can decrease desire because they lower the production of testosterone, Dr. Goldstein explains. Although women have less of this sex hormone than men do, a drop in T can impair womens libido.

Bringing a child into the world impacts, well, everything, and that can definitely include how often youre in the mood. The changes in your hormones during pregnancy, after giving birth, and while breastfeeding may interfere with the hormones that cause sexual drive, Kingsberg explains.

Additionally, if youre breastfeeding, you may think of your bodyand your breasts in particularas maternal and not sexual. Or, you may be touched out by having constant contact with baby. Add to all of that a potential shift in body image and a lack of time, energy, and privacy, and your sex drive can go totally MIA.

Both current and past relationships can take a toll on your sex life. Previous traumas, a partners sexual dysfunction, infidelity, not feeling connected to your partner, trust issues, and more can all make it hard to want to be intimate.

HSDD is the persistent loss of sexual thoughts, feelings, fantasies, and interest in sex that causes distress, Kingsberg explains. You may have HSDD if you know what its like to want to have sex and masturbate, yet you no longer feel that way. If this feeling lasts for at least six months and it bothers you, HSDD might be to blame.

Many women just deal with the disappearance of their sex drive. In one recent survey* of 1,686 women ages 25 to 49, almost half of respondents who said they experienced symptoms of low sexual desire havent discussed them with anyone.

Plus, research shows that the majority of women with desire issues and distressing sexual problems dont mention them to a healthcare provider, often because theyre too embarrassed or uncomfortable. But, your sexual health is important to your overall health and quality of life, and treatments are available, Kingsberg says. You dont need to suffer in silence. So speak up!

Therapy, either alone or in combination with medication, can help you get your mojo back. Psychotherapy can change the dynamic between a couple living with low desire or help a woman change her perception of how and what sex means to her, Kingsberg says. It can also validate your experience, in turn helping you regain your confidence and sexuality.

A physical exam can be the first step to diagnosing conditions that may be causing the issue, such as ovarian cysts or endometriosis. Chatting with your doctor could help you figure out how to relieve pain caused by something more temporary, such as a lack of lubrication or a UTI.

Its def worth talking to to your doctor to see if an alternative treatment option might be available.

Make sure you set aside time for yourself to exercise, eat well, and relaxall things that can help with a shift in body image and low energy levels. And def make time for the occasional date night. This will help you get out of mommy-mode so you can get your sexy back.

If youre still not into the idea of having sex after a few months of taking more time for self care, see your doctor to rule out any other underlying issues.

Your doctor can diagnose you by asking a set of questions about your sex drive. If it turns out thats the cause, they may prescribe medication that raises dopamine and lowers serotonin (desire starts in the brain, not the genitals, Kingsberg explains), or a medication that activates melanocortin receptors, which increase sexual desire.

* Survey was conducted by Women's Health & Cosmopolitan, in partnership with a pharmaceutical company that sells a drug to treat hypoactive sexual desire disorder (HSDD).

See the original post here:
What It Might Mean If You're Craving Sex Less Often Than You Used To - Women's Health

Recommendation and review posted by Bethany Smith

Patients with life-threatening conditions have been left waiting on the phone to see a doctor at a medical practice in Wokingham.

A woman receiving post-cancer treatment and an 84-year-old man who was subsequently rushed to hospital after waiting outside Wokingham Medical Centre are among those affected by large waiting times and frustrating appointment booking systems.

Hordes of patients registered at the Wokingham Medical Centre (WMC) have contacted The Wokingham Paper this week, most of whom have found it increasingly difficult to book an appointment with a GP.

With over 164,000 people currently registered across the boroughs 13 GP practices, resources are in heavy demand.

Local resident, Jane Thomas (whose name has been changed for privacy), believes that the service provided by WMC isnt set up for patients with ongoing medical needs.

The 35-year-old had breast cancer five years ago, and has since had multiple surgeries alongside a thyroid condition.

She said: I have to have an injection every 12 weeks as part of post-cancer hormone suppression treatment. This is time critical and so has to happen as close as possible to 12 weeks.

However Wokingham Medical Practice doesnt put more than four weeks of appointments on the system at one time, so there is no way of booking my next injection at the time I am having an appointment.

Because the booking system isnt working for thse who need ongoing medical treatment. Ms Thomas sometimes has to use A&E if she cannot get a time-appropriate appointment for her post-cancer hormone suppression treatment.

Dr Helen Rutherford, GP at Wokingham Medical Centre and Medical Director for the Wokingham Division of Modality Partnership said: At Wokingham Medical Centre, patient care is our number one priority.

We appreciate that in certain instances being able to book an appointment three months in advance would be beneficial. For example, where patients need a regular appointment for a time-critical medication to be administered.

However, the reason that we reduced this to four weeks ahead was due to the significant numbers of patients not coming to their advance booked appointments.

The numbers of Did Not Attend were on average 450 appointments a month, and by having a four weekly booking process this number has been reduced to an average of 216 missed appointments a month.

Telephone wait times

Local resident Karen Knight is currently undergoing physiotherapy from a private healthcare provider, and is in need of an MRI scan, for which she requires a GP referral.

She said: I have tried unsuccessfully to get a doctors appointment for over a week, and was looking to book an appointment for up to a months time, all to no avail.

I was religiously calling each morning at 8am on the dot, and my place in the queue varied from 41st to 35th each time.

Sometimes I was holding on the line for over an hour and then before getting through, I was getting cut off on the majority of occasions.

When Mrs Knight eventually got through to reception, she was told that there were no pre-bookable appointments, even for one month in advance.

The reception staffs response to my concern and disappointment with not getting an appointment was to say that I need to call tomorrow, said Mrs Knight. Tomorrow will be no different, as I know from past experience.

The current system in place requires patients to either ring first thing, when the centre opens at 8am, or to queue outside from 7.30am to see a doctor the same day.

Ms Thomas said: No matter how minor the issue, you have to go and stand in person for half an hour before the surgery opens to have any hope of getting seen that day.

Dr Rutherford said: We have reviewed and we are changing our telephone system, so it is more responsive, and will be able to recognise a callers details. This will help speed up the call process, so patients should have less of a wait to speak to someone.

Effect on the elderly

The most common concern that patients of WMC have is the difficulty in obtaining appointments and how this is affecting the elderly.

Expressing concern for her stepfather, Sue Woodason said: My 84-year-old stepfather was very poorly last Tuesday. He phoned the Wokingham Medical Centre at 8am and was 40th in the queue.

He made the decision to get to the practice and was able to get an appointment that day so he waited in the surgery. When he finally saw a GP they immediately phoned for an ambulance to take him to A&E. He then was left sitting in the A&E waiting room for over six hours after initially being accessed, then waiting for results of a blood test.

A spokesperson from Modality Partnership said: We have introduced new ways to ensure any patient who needs a same-day appointment for an urgent need can be seen either in our acute care clinic or can receive an online consultation with a GP via our Push Doctor service, this has helped to alleviate some of the pressure.

However, WMC isnt the only surgery coming under fire for their appointment wait times.

Resident Catherine Smith who attends Brookside Practice, Earley said that she often experienced a four-week wait time to see a named GP, after having a double transplant.

Yet, she attributes the difficulties in getting a GP appointment to failings by the national Government in their provisions for the NHS.

Ms Smith said: Currently, too few GPs are trying to take on ever-increasing numbers of patients to the detriment of their own well being.

I believe the problem is caused by successive governments not training sufficient numbers of doctors nor providing suitable conditions for them to work in when qualified. This includes all hospital doctors, nurses and other health care professionals.

For Ms Smith, not being able to see a named GP had almost life-threatening consequences.

There have been occasions, within the NHS system, where a doctor has tried to give me medications that are banned for me, she said. This is why a named GP is so important.

Not every sick person is able or well enough to inform a strange doctor of all their relevant conditions. And not every doctor has the time to read every patients relevant details due to the increased pressure they are under.

Access to a named GP was also addressed by the Modality Partnership. Dr Rutherford said: The national shortage of GPs also means we have to change the way patients access appointments. This means that seeing your named GP at a time that you request is not always possible.

As a practice we actually offer 4 more appointments per 1,000 patients a week, than the nationally recommended figure of 72 appointments per 1,000 patients, and we recognise we need to respond further to the increasing demand for appointments.

We have started to introduce new alternative healthcare practitioners, who have their own particular areas of expertise. Often these practitioners are better placed to see and treat patients for certain conditions than GPs.

We want to ensure that our patients see the right clinician, the first time. Our new roles at Wokingham Medical Centre include two GP Pharmacists and two Urgent Care Practitioners who work alongside our well-established nursing team that includes two Nurse Practitioners. Two new Physicians Associates are due to start with us in November.

In addition to this, we are continuing to advertise to recruit new GPs, but sadly so far, we have been unable to fill the vacancies.

Stretched NHS

A spokesperson from The Royal Berkshire NHS Foundation Trust said: We are aware of the concerns raised by patients regarding telephone access and waits for appointments and are looking into these issues with the practice concerned.

In Wokingham as elsewhere in the country, demand for GP appointments is rising and there are challenges in recruiting and retaining doctors and practice nurses.

In response to this, practices across Wokingham Borough have been introducing changes to improve access, such as longer opening hours and new on-the-day clinics.

Practices are also working together through new Primary Care Networks (clusters of neighbouring GP surgeries which have grouped together to form a new-style healthcare network in their local neighbourhoods) to bring in new staff such as paramedics and clinical pharmacists.

The CCG is working with the new Primary Care Networks and with Wokingham Borough Council to consider what else can be done to improve access for local residents.

The lucky ones

However, not all residents of the Wokingham Borough are being hit equally by demands on their local GP.

Wargrave resident Marjie Thorn has a positive experience at her surgery.

I can call at 8am, Monday to Friday and almost always get an appointment for the same day, she said. For appointments that arent urgent, theres usually a waiting time of a week or two, depending on what its for.

Mary Perkins Crowthorne resident, said: We are lucky in Crowthorne. If youre at Ringmead Medical Practice you can use the extended hours service run by Berkshire Primary Care which operates 365 days a year.

Currently, Wargrave surgery has 7,113 registered patients. This is compared to WMC which has 22,872, Brookside, with 27,373 and Ringmead, which has 22,584 registered patients.

Dr Rutherford said: We are listening carefully to the feedback about access and availability of appointments. However, like many other GP practices up and down the country, we are struggling with an ongoing national shortage of doctors. This is unfortunately not a unique issue for Wokingham; nor a new problem in primary care, and sadly cannot be instantly resolved. Our teams are working very hard, under extreme pressure to respond to the demand for appointments.

As the population of Wokingham Borough grows year on year, a question arises as to whether the 13 GP practices are able to match the patient demand, and how this issue can be addressed on a national level.

View post:
Wokingham patients frustrated by wait times at GPs - The Wokingham Paper

Recommendation and review posted by Bethany Smith

A FORMER soldier transitioned to female after having gender reassignment surgery admits it was a mistake which was "making me ill".

Peter Benjamin, 60, is back living as a man, but has been unable to reverse the surgery.

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He began taking hormones from unlicensed vendors and read transgender websites, after starting cross-dressing when he was in his teens.

But after changing gender he started having panic attacks and drinking heavily and realised he wanted to be a man again.

Peter told The Sunday Times: "My anxiety levels were sky high.

"I was seeing the doctors for all sorts of problems. My drinking was going up because I couldn't cope any more with being transgender. I just had to get out of it."

Peter served in the British Army from the age of 16 to 20, but his career ended when he wore a skirt to his barracks after a heavy drinking session.

The ex-squaddie married three times, but was diagnosed with gender dysphoria after his third wife died in 2011.

A female lodger began calling him Victoria, saying: "You're a posh bird. You need a posh name."

In 2015, Peter had surgery to remove his male genitalia.

He said the NHS paid a private London hospital 10,000 to operate on him, but his doctor would not recommend him for breast augmentation surgery.

My drinking was going up because I couldn't cope any more with being transgender. I just had to get out of it

But after surgery he realised he had made a mistake after his son and daughter drove him home and he was left alone.

Peter said: "They took my suitcase upstairs and then my daughter gave me a hug and then they left. That was the only support I had. There was no follow-up psychiatry nothing."

He also said he didn't look much a like a woman and struggled to be accepted by female friends.

"I hoped to have more female friends but the opposite happened. I thought, 'Ladies who lunch, go on holiday, have friends around for coffee,' but it just didn't happen."

The ex-squaddie was also scared bigots would attack him after he transitioned.

Peter said: "It's easy, isn't it, being a man? I can just put on a pair of trousers and a top and go out. Being a woman, people ridicule it.

"People were staring. I had to watch my back."

He added: "Travelling on the train, I'd be absolutely dripping when I came up to London because I was scared I would be attacked or assaulted.

"I'm not scared where I am living, but for a simple thing like leaving for the shops, I'd be having panic attacks."

Peter said he binned seven bags of women's clothing, wigs and make up after deciding to switch back to being a man

But he hasn't updated a birth certificate issued on August 31, 2016, which said he was born a girl and is now warning that children are encouraged to transition too quickly.

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It comes after it was revealed a former psychotherapist at England's first NHS child gender clinic called for judges to stop children from having hormone-blocking treatment unless it is in their interests.

Peter added: "We're going to have mental health hospitals full, dealing with these children who have decided that they are not transgender as they grow older.

"The NHS is going to have such a big burden on it over what's happening. I am so worried."

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Read the rest here:
Ex-soldier, 60, who transitioned to female then switched back admits gender reassignment surgery was mistake - The Sun

Recommendation and review posted by Bethany Smith

In just a few years we've gone from having a limited number of Korean beauty brands available in the U.S. to pioneering curators here and getting K-beauty launches at the very same time as South Korea. And as more and more K-beauty products become widely available, it's apparent that there's no single type of K-beauty brand. We're regularly seeing everything, including cute-as-can-be, cartoonishly packaged products, elegantly presented items with incredibly effective ingredients, and, of course, sheet masks in every variety imaginable. This month, we're seeing super-affordable serums, stay-put liquid shadow, and soothing sunscreen.

Here are the latest and greatest K-beauty products from brands such as The Crme Shop, Tonymoly, and more, hitting real and virtual shelves in October.

All products featured on Allure are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

Here is the original post:
The Best New K-Beauty Skin Care and Makeup of October 2019 - Allure Magazine

Recommendation and review posted by Bethany Smith