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Archive for May, 2020

When rheumatoid arthritis is mentioned, should only dryness come to mind? – Physician’s Weekly

Tuesday, May 19th, 2020

To evaluate corneal parameters of rheumatoid arthritis (RA) patients by corneal topography.One hundred two RA patients and 60 control subjects were enrolled. Corneal topography measurements and ophthalmologic findings were examined from all participants files.Corneal thickness measurements were significantly lower in the RA group (p=0.025). All values of corneal curvatures (K1, K2, Kmean) in 3mm, 5mm, and 7mm zones were found statistically significantly higher in the RA group compared with the control group. Forty-five RA patients had a dry eye. Disease duration was correlated with dry eye in the RA group. There was a significant correlation between the duration of disease in RA patients and mean corneal curvatures (p 0.012/0.010/0.007, 3/5/7mm respectively) and central corneal thickness (p 0.025). There is no statistical difference between other topographic measurements.The results suggest that RA patients have thinner and steeper corneas compared with control subjects. These parameters change in negative correlation as the duration of the disease increases.Key Points Rheumatoid arthritis is an autoimmune disease with systemic involvement. In rheumatoid arthritis, systemic involvement is affected in the eyes. When it comes to eye involvement, it comes to mind that it makes the eyes more dryness. In addition to dryness in the eyes, rheumatoid arthritis makes morphological changes in the cornea.

PubMed

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Arthritis and related conditions: The biggest causes of pain in the UK – Open Access Government

Tuesday, May 19th, 2020

Millions of people in the UK live in pain every day. Arthritis and related conditions are the biggest causes of that pain.

In fact, more than half of the 10 million people with arthritis say they experience pain every single day, and eight out of ten say they experience it most days. (1) Its not short-term or one-off bursts but persistent pain. It can fluctuate but for most but it never truly goes away.

During the COVID-19 pandemic, many people with arthritis will be unable to access essential services to manage their pain such as physiotherapy or hydrotherapy. The impact of joint replacement operations cancelled or postponed will mean more people with arthritis living in debilitating pain. Versus Arthritis is supporting people with arthritis during these challenging times by standing with them and working for them so they are not alone.

The persistent pain of arthritis makes the simplest of movements exhausting and excruciating. Imagine not being able to stand, walk, hug or hold without pain. Imagine not being able to work. To be independent. Imagine not being able to remember what its like to not be in pain.

The pain itself and the fear of making it worse can lead to isolation and depression. In fact, depression is four times more common among people in persistent pain compared to those without pain. (2)

Put simply, pain erodes life.

Ken Brown is 61 and has been living with the pain of osteoarthritis for most of his adult life. He says: My experience of the pain from arthritis is the feeling you get the day after a very intense workout at the gym. The fatigue is so hard to describe, but the worst feeling of all is the grinding bone pain as if someone has drained the energy out of you. The realisation that you cant do what you used to is hard to come to terms with its difficult to even go out to the shops sometimes.

Pain is not something that people can see and is therefore often difficult for others to comprehend. It is a hidden disability.

But it has more than just a personal impact. The impact of musculoskeletal pain on our health service is huge. It is estimated that arthritis-related pain alone costs the health service 5 billion every year in England (3) and accounts for one in eight of all GP appointments. (4)

Our society today creates an environment where people in pain are too often dismissed or not taken seriously. Everyday phrases like no pain, no gain, the glorification of your pain threshold or ability to grin and bear it, create a culture that exacerbates silently suffering with pain. It prevents people from speaking openly and honestly about how they are feeling, something which is an integral part of effective pain management for millions of people.

Theres also been insufficient progress on treatment. The options patients are offered today havent moved on significantly in a few decades. For many, they are limited to drugs rather than a care plan that includes effective treatments like physiotherapy, exercise and talking therapies.

At Versus Arthritis, we believe its time for change. The pain associated with arthritis should not be tolerated in society, and people with the condition should not have to live silently with its impact.

Research into pain is underfunded in the UK and over the past five years, we have begun to invest significantly to redress this and help us understand the complex causes and treatments for the pain of arthritis.

Along with the direct funding we provide ourselves, we have been working in partnership with other funders to influence their research spend and to convince them to invest in pain research. We are leading a co-ordinated national approach to pain research that aims to accelerate our understanding of persistent pain, while developing and testing new ideas, solutions and treatments that can be developed and scaled for the greatest possible impact on people living with persistent pain.

For the first time, we brought together international health and research experts and people with arthritis, to identify and set out the challenges that must be tackled across research and public health to improve the quality of life for people living with persistent pain.

In response to this initiative, we have launched a joint partnership with the UK Government through UK Research and Innovation (UKRI) to establish the Advanced Pain Discovery Platform (APDP). The APDP is an ambitious 24 million five-year partnership that aims to unravel the complexities of persistent pain by bringing together multidisciplinary experts in the UK along with people living with persistent pain to tackle the problem. Through cutting edge science and technology, the platform will focus on human data, bridging biological, psychological and social sciences to better understand pain mechanisms and develop new treatment solutions. Through our industry partners, we will ensure a rapid take up and development of new treatments.

With the new knowledge developed by the partnership, we will also better understand the transition from acute to persistent chronic pain and also how persistent chronic pain may itself worsen and become debilitating. Understanding biological mechanisms will help inform future approaches to both primary and secondary prevention of persistent pain.

The IASP 2020 Global Year for the Prevention of Pain is an important initiative that shines a light not only on the impact of persistent pain, but also highlights what is known about primary and secondary prevention of persistent pain. There is much that can be done to reduce the chance of developing persistent pain and through the global year initiative, IASP aims to disseminate important information to lead to better outcomes for patients.

References

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Rheumatoid Arthritis Increases Risk for Early Cardiac Events in End-Stage Renal Disease – Rheumatology Advisor

Tuesday, May 19th, 2020

Clinicians should be aware that patients with rheumatoid arthritis (RA) who develop end-stage renal disease (ESRD) are at risk of experiencing cardiac events sooner than patients in the general population, although RA is not an independent risk factor for all-cause or cardiovascular mortality in ESRD. This is according to findings published in the Journal of Clinical Rheumatology.

Using Cox proportional hazards modeling, this cohort study was designed to characterize cardiovascular disease (CVD) events, cardiovascular mortality, and all-cause mortality in patients with RA and ESRD compared with those with ESRD without RA. Data from 48,005 patients were obtained from the United States Renal Database System (USRDS). The study sample included 407 patients with ESRD and RA and a random sample of 5% (n=2417) of patients with ESRD without RA. The study duration spanned up to 5 years, depending on initiation of dialysis and mortality.

Heart failure was the most common CVD event among participants both with and without RA (47.4% and 27.8%, respectively). Compared with those without RA, patients with RA showed a significantly shorter mean time from start of dialysis to an incident CVD event (20.112.2 months vs 21.214.1 months; P <.01). No significant differences in total incident CVD events were seen by RA status (P =.09) or individual CVD events (P .11) besides atherosclerosis and heart failure, which were significantly more prevalent in participants without RA (P <.01 for both). Multivariable adjusted models showed that RA was not associated with increased 5-year risk for all-cause mortality (adjusted hazard ratio [aHR], 1.09; 95% CI, 0.94-1.27) or cardiovascular mortality (aHR, 0.95; 95% CI, 0.74-1.22). In patients with RA, risk factors for all-cause and cardiovascular mortality included older age and a higher Charlson comorbidity index.

Study investigators concluded that time to first cardiac event is shorter in patients with RA and ESRD compared with the general population of patients with ESRD. However, in patients with ESRD, RA is not an independent risk factor for either all-cause or cardiovascular mortality.

Reference

Paudyal S, Waller JL, Oliver A, et al. Rheumatoid arthritis and mortality in end stage renal disease. J Clin Rheumatol. 2020;26(2):48-53.

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COVID 19 PANDEMIC: Rheumatoid Arthritis Diagnosis Tests Market Report (2019-2025) | The demand for the Market will drastically increase in the Future…

Tuesday, May 19th, 2020

The Rheumatoid Arthritis Diagnosis Tests report provides independent information about the Rheumatoid Arthritis Diagnosis Tests industry supported by extensive research on factors such as industry segments size & trends, inhibitors, dynamics, drivers, opportunities & challenges, environment & policy, cost overview, porters five force analysis, and key companies profiles including business overview and recent development.

Rheumatoid Arthritis Diagnosis Tests MarketLatest Research Report 2020:

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In this report, our team offers a thorough investigation of Rheumatoid Arthritis Diagnosis Tests Market, SWOT examination of the most prominent players right now. Alongside an industrial chain, market measurements regarding revenue, sales, value, capacity, regional market examination, section insightful information, and market forecast are offered in the full investigation, and so forth.

Scope of Rheumatoid Arthritis Diagnosis Tests Market: Products in the Rheumatoid Arthritis Diagnosis Tests classification furnish clients with assets to get ready for tests, tests, and evaluations.

Major Company Profiles Covered in This Report

Antibodies Inc.,Euro Diagnostica AB,Qiagen NV,Siemens Healthcare GmbH,Bio Rad Laboratories Inc.,Genway Biotech, Inc., Abbott Diagnostics,Beckman Coulter, Inc.,F. Hoffmann-La Roche Ltd.,Thermo Fisher Scientific Inc,others.

Rheumatoid Arthritis Diagnosis Tests Market Report Covers the Following Segments:

Application: By Type:,Serology Tests ,o Erythrocyte Sedimentation rate ,o Anti-Cyclic Citrullinated Peptide ,o Rheumatoid Factor ,o Antinuclear Antibody,o Uric Acid,o Others,Monitoring Rheumatoid Arthritis Treatment Efficiency Tests ,o Muscle Enzyme Tests ,o Salicylate Level Count,o Creatinine Test,By End-User:,Hospitals,Diagnostics Laboratories,Ambulatory Surgical Centers

North America

Europe

Asia-Pacific

South America

Center East and Africa

United States, Canada and Mexico

Germany, France, UK, Russia and Italy

China, Japan, Korea, India and Southeast Asia

Brazil, Argentina, Colombia

Saudi Arabia, UAE, Egypt, Nigeria and South Africa

Market Overview:The report begins with this section where product overview and highlights of product and application segments of the global Rheumatoid Arthritis Diagnosis Tests Market are provided. Highlights of the segmentation study include price, revenue, sales, sales growth rate, and market share by product.

Competition by Company:Here, the competition in the Worldwide Rheumatoid Arthritis Diagnosis Tests Market is analyzed, By price, revenue, sales, and market share by company, market rate, competitive situations Landscape, and latest trends, merger, expansion, acquisition, and market shares of top companies.

Company Profiles and Sales Data:As the name suggests, this section gives the sales data of key players of the global Rheumatoid Arthritis Diagnosis Tests Market as well as some useful information on their business. It talks about the gross margin, price, revenue, products, and their specifications, type, applications, competitors, manufacturing base, and the main business of key players operating in the global Rheumatoid Arthritis Diagnosis Tests Market.

Market Status and Outlook by Region:In this section, the report discusses about gross margin, sales, revenue, production, market share, CAGR, and market size by region. Here, the global Rheumatoid Arthritis Diagnosis Tests Market is deeply analyzed on the basis of regions and countries such as North America, Europe, China, India, Japan, and the MEA.

Application or End User:This section of the research study shows how different end-user/application segments contribute to the global Rheumatoid Arthritis Diagnosis Tests Market.

Market Forecast:Here, the report offers a complete forecast of the global Rheumatoid Arthritis Diagnosis Tests Market by product, application, and region. It also offers global sales and revenue forecast for all years of the forecast period.

Research Findings and Conclusion:This is one of the last sections of the report where the findings of the analysts and the conclusion of the research study are provided.

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Spontaneous Rupture of Extensor Pollicis Longus Tendon: Clinical and Occupational Implications, Treatment Approaches and Prognostic Outcome in…

Tuesday, May 19th, 2020

Background:Spontaneous rupture of extensor pollicis longus (EPL) tendon is a rare condition often found in patients actively having regular extensive use of hands and fingers especially the thumb. In this article, we report 7 cases of spontaneous rupture of EPL tendon and investigate the associated factors and treatment outcome.

Methods:Retrospectively, the databases for the 7 cases were retrieved and studied. These cases represent all cases of spontaneous rupture of EPL in our institution. Demographic data, clinical presentation, any history of trauma or steroid injection, laboratory and clinical findings suggestive for rheumatoid arthritis, co-morbidities and imaging findings were obtained. In addition, the operative technique and findings were retrieved. Moreover, histopathological studies and follow-up assessment were included.

Results:Six males and one female were included. The mean age was 45.2 years. No prior history of trauma, rheumatological disease or steroid use was detected in any patient. All patients experienced prodromal pain in the radial side. Clinical examination was the most effective diagnostic measure. Magnetic resonance imaging (MRI) was used to confirm the diagnosis and to look for other abnormalities that may predispose to rupture. Five patients underwent extensor indicis proprius to EPL tendon transfer employing Pulvertaft weave technique and one patient underwent primary repair as there was a little gap in the tendon ends. In this study, one patient refused any treatment. All patients achieved a favorable outcome at the last follow-up.

Conclusion:Diagnosis of spontaneous ruptures of EPL tendon can be confirmed through clinical examination and MRI for patients with restricted thumb movement even with the absence of any identifiable predisposing risk factor. During surgery, detailed attention must be drawn towards the tendon ends which can have unusual gaps and bone abnormalities.

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Innovating in inflammation and immunology – – pharmaphorum

Tuesday, May 19th, 2020

For World Inflammatory Bowel Disease day we spoke to Pfizers Matt Shaulis, president of international developed markets for inflammation and immunology, to hear how the company hopes to harness innovation to address the many unmet needs in these disease areas.

What would you say are the biggest challenges in the area at the moment?

One of the biggest challenges in the area of immune-mediated and inflammatory diseases is the lack of understanding of the true burden of these diseases, which has meant that these patients have historically been underserved.

While significant advances have been made in the treatment of rheumatic diseases, such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), many patients still experience the daily burdens of living with these diseases.

Whether a patient is unable to reach remission with his or her current treatment or is settling for good enough, uncontrolled disease can lead to irreversible joint damage and may also impact overall wellbeing and daily functioning.

For this reason, different treatment options in addition to timely diagnosis and access to advanced therapies are needed.

As for gastroenterology, chronic inflammatory diseases of the digestive tract can be painful, inconvenient and embarrassing, dramatically affecting how patients live their lives. Many patients have not been able to achieve optimal symptom control with current therapies and lead a life profoundly impacted by ongoing symptoms.

Wearable technologies commonly seen in the fitness field can be employed to measure itching and sleep disturbance in atopic dermatitis

There is also a critical unmet need for diseases such as nonalcoholic steatohepatitis (NASH), a leading cause of liver transplant, for which there are no approved drug therapies.

In dermatology, despite significant recent advances in inflammatory skin diseases, there are still many such as atopic dermatitis (AD), alopecia areata (AA) and vitiligo where new treatments are needed to make a meaningful impact in patients lives.

Are there any particular issues in diagnosis and detection youre hoping to address?

The treatment landscape for immune-mediated diseases has evolved significantly, from broad immunosuppression with steroids to targeted immune modulation through selective agents. However, improved treatment options will only really make a difference to patients lives if they go hand in hand with an increase in awareness among physicians and other healthcare providers.

We need to work with the medical community to enable a deeper understanding of immunological disease management, triggers, and the importance of treatment adherence. The resulting improvement in patient wellbeing can soften the impact on healthcare systems.

What does innovation mean to you when it comes to inflammation and immunology?

Innovation comes in many forms for the inflammation and immunology (I&I) team. Innovation in research and development is crucial and we are relentlessly pursuing new breakthroughs such as next generation kinase inhibitors, novel biologics, biosimilars and topicals.

But we also strive to innovate in how we run clinical trials both in terms of the technology we use for example employing wearable technologies commonly seen in the fitness field to measure itching and sleep disturbance through to the means to undertake testing in patients homes to obtain true real world evidence.

Finally, we partner with a variety of organisations who are driving innovation in helping patients make informed lifestyle choices, manage treatment adherence and facilitate doctor/patient relationships.

What kind of beyond-the-pill measures are important for patients in these disease areas?

There are improvements that could be proposed at all levels of the healthcare ecosystem to help address immunological and inflammatory diseases, but a critical step is for stakeholders to collaborate and drive meaningful change at the policy level.

This begins with establishing guidelines to ensure standardised treatment paradigms. Further assistance can be provided to patients through holistic patient and family support programmes that integrate disease management with good overall health and wellness practices.

One organisation we are partnering with in this regard is Sidekick Health, which offers technology-based solutions for patients suffering from the two main IBD conditions ulcerative colitis (UC) and Crohns disease (CD), and also for patients with rheumatoid arthritis (RA), atopic dermatitis (AD) and psoriatic arthritis (PsA).

The platform provides these patients with a rich user experience, where they earn rewards for managing their nutrition, exercise, sleep, stress and medication adherence. They also receive condition-specific education, and a connection to a community of health professionals and patients on a similar health journey.

Finally, expanded general awareness of AD can break the stigma associated with its flare-ups. When patients concerns are met with understanding and support, it can lessen their embarrassment and anxiety. This in turn may make them more likely to seek the help they need to manage their condition successfully.

Whats your overall view on how digital technology fits into I&I research, treatment and care?

There is a lot of interesting work being done in I&I research utilising technologies from the broader health arena. For example, our own Pfizer Innovation Research (PfIRe) lab is looking at solutions such as using wearable devices to help scientists monitor treatment for atopic dermatitis.

The lab equips patients with a device that can monitor sleep disruption caused by scratching. The team assesses that sleep disruption both with treatment and without treatment to determine how effective a particular therapy is for that particular endpoint. This is particularly critical in assessing scratching and sleep disruption in younger patients who would have trouble recalling or indeed articulating these symptoms themselves.

Do you think eczema and other inflammatory skin diseases are overlooked compared to other conditions?

Chronic inflammatory skin diseases can have a devastating impact on a persons mental and emotional wellbeing, although they are often overlooked as being simply cosmetic. This leads to a vast discrepancy in how patients are managed around the globe. Furthermore, the physical and social pressure that this disease creates goes hand in hand with a financial burden as patients pay for various products and treatments in search of symptom relief.

One recent study found that the average AD patient spends an additional 927 per year on health care expenses. Add to this the potential cost of doctors visits and treatments for co-morbidities, and the economic impact of absenteeism and time off work, and we start to get a true picture of the cost this condition imposes on health care systems at large.

We are now seeing an increased focus on developing treatments for chronic inflammatory skin diseases, but there is still a long way to go.

How do you see I&I evolving in the future?

The JAK pathways are believed to play an important role in inflammatory processes as they are involved in signalling for over 50 cytokines and growth factors, many of which drive immune-mediated diseases. JAK inhibition may offer patients with these conditions a potential new advanced treatment option.

Were taking a different R&D approach to that of other companies involved in JAK research instead of studying a single molecule for all its potential uses, where it may not be optimal for some, we purposefully match Pfizers candidates with unique selectivity profiles to the conditions where, if approved, we believe they have the greatest potential to address unmet need.

Ultimately, we are working toward supporting fast, accurate diagnoses, providing effective treatment options and enabling appropriate patient choices which lead to freedom from the burden of immune-mediated and inflammatory diseases.

About the interviewee

Matt Shaulis currently serves as the president of Pfizer inflammation and immunology for international developed markets. He has approximately 20 years of experience in the pharmaceutical industry across several functions including: in-line and global strategic marketing, sales management, strategic customers group, licensing and acquisitions, finance, and compound and indication launches across multiple disease states. He joined Pfizer from Teva Pharmaceuticals, where he was vice president, global CNS, multiple sclerosis.

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Back Pain and Types of Arthritis – Newswire

Tuesday, May 19th, 2020

Dr.Brian McKay of Core Health Darien discusses arthritis pain and how it relates to low back pain. Core Health Darien is located at 551 Post Road.

(Newswire.net -- May 14, 2020) Darien, CT --Osteoarthritis is a common condition involving articular surfaces that can develop gradually over time into a debilitating condition, which causes pain and restriction of motion. Specifically, spine osteoarthritis is the presence of disc degeneration and osteophyte formation as well as pain. Facet joint arthritis is present in 19% of individuals between the ages of 45 and 65 years of age and 57% of patients over the age of 65 in the United States. The facet joint is where the bones meet to form a biomechanical arch, this is where weight is supported. With undue stress, the surface of the bone starts to wear out causing pain. Arthritis can affect any articular surface; it is more likely to affect weight-bearing joints, which includes the spinal column.

Osteoarthritis is a chronic, degenerative disease. Low back pain and spine arthritis are among the leading health-related causes of disability and reduction in patients' quality of life. Pathologically osteoarthritis can cause spinal stenosis, herniated nucleus pulposus, myelopathy, radiculopathy, spondyloarthritis, and spondylolisthesis. Also complicating the diagnosis is how radiographic imaging of spine osteoarthritis does not necessarily correlate with patients' pain and thus leads to treatment options that may not improve symptoms.

Osteoarthritis is responsible for the breakdown of the cartilage (the tissue that cushions the ends of the bones between joints), bony changes of the joints, deterioration of tendons and ligaments, and various degrees of inflammation of the joint lining (called the synovium). Spinal arthritis is a degenerative process that develops over time in response to the stresses placed on the spinal joints.

Arthritis is a general term that describes conditions that affect your joints. There are many types of arthritis besides osteoarthritis, here are a few of the more common ones. Ankylosing spondylitis (AS) is a type of inflammatory arthritis that targets the joints of the spine. Reactive arthritis is a form of arthritis that occurs as a result of some bacterial infections. Rheumatoid arthritis is a long-term condition that causes pain, swelling, and stiffness in the joints. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease. Psoriatic arthritis is a chronic, inflammatory disease of the joints and the places where tendons and ligaments connect to bone. Psoriatic arthritis can also cause inflammation of the eyes, such as Conjunctivitis and Iritis.

Osteoarthritis is the most common type of arthritis. The treatment for these common types of arthritis is usually rest, ice, and NSAIDs. Lumbar osteoarthritis is a form of degenerative arthritis in the lower back that causes pain, stiffness, and inflammation in the joints between vertebrae. Arthritis is the most common cause of lower back pain, especially in people over age 50, and affecting approximately 27 million Americans. While osteoarthritis can damage any joint, the disease most often affects joints in your spine, hands, knees, and hips.

Chiropractic care can help take the stress off the arthritic joints by restoring biomechanical efficiency. When the joints are properly aligned the muscles, ligaments, tendons, and discs all work together to support the body's weight effortlessly. You should consider chiropractic care if you have arthritis. Chiropractic treatment is natural and unlike NSAIDS has no dangerous side effects.

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Treat-to-target With Urate Lowering Therapy Recommended for All Gout Patients – Rheumatology Network

Tuesday, May 19th, 2020

New treatment guidelines for gout strongly support a treat-to-target strategy for urate lowing therapy with a serum urate target of less than 6 mg/dl.

The 2020 iteration of the guidelines by the American College of Rheumatology (ACR) are based on a review of data from recently published research clinical trials. There are 42 recommendations of which 16 are considered strong due to the high quality of the evidence. The strong recommendations address indications, initiation of treatment, titration and treat-to-target, treatment approaches post urate lowering therapy (ULT) failure, and treatment protocols for managing flares.

With this update, we sought to look at new and emerging clinical evidence that would be beneficial for treating patients with gout , said John FitzGerald, M.D., Ph.D., a rheumatologist and one of the guidelines co-principal investigators. The guideline now includes expanded indications for starting ULT, a greater emphasis to use allopurinol as the first line agent for all patients with gout that require urate lowering therapy including those patients with chronic kidney disease, and broadened recommendations about who needs HLA-B*5801 testing prior to starting allopurinol.

The 2020 and 2012 versions both support the use of treat-to-target strategies for urate-lowering therapy (ULT). In 2012, the recommendation was made conditionally due to poor quality evidence, but in 2020, it was bumped up to a strong recommendation due to higher quality evidence.

"Data from more recent research clinical trials comparing treat-to-target protocols versus usual care provide the basis for the strong recommendation to use a treat-to-target strategy with urate lowering therapy that includes a plan to achieve and maintain an serum urate target of less than 6 mg/dl to optimize patient outcomes," wrote the authors of the guidelines published this month in the journal Arthritis Care and Research. "These guidelines reinforce the strategy of starting with low-dose ULT and titrating up to achieve the serum urate (SU) target."

RELATED: "The 2020 Treatment Guidelines for Gout"

Adherence to urate lowering therapies is poor in the U.S. and over the last 20 years, there has been no increase in the use of urate lowering therapies among gout patients. The authors speculated this may be due to conditional recommendations made in 2012, but adherence to ULT in gout is lowest among seven common chronic medical conditions so there may be factors at play.

Among the most noteworthy recommendation, allopurinol is recommended as the first-line treatment for all patients, including patients with chronic kidney disease. This recommendation was made, in part, due to the cost of medications and concerns over cardiovascular-related issues with febuxostat.

For patients with severe disease, the guideline does not support achieving serum urate levels of below 6 mg/dl. "There is ample evidence that lower serum urate levels hasten the resolution of tophi and are associated with less frequent gout flares, suggesting that lower serum urate thresholds may be preferable for patients with more burdensome gout."

The authors note that while there have been extensive clinical trials on treatment strategies for achieving a serum urate target of less than 6 mg/dl, to date, there are no data to support targeting lower serum urate levels for patients with severe disease.

While it wasn't included in the 2012 guidelines, the indications for receiving urate lowering therapies have been expanded to include individuals with evidence of radiographic damage due to gout. This is important because gout presents in a number ways, including joint damage.

REFERFENCE: "2020 American College of Rheumatology Guideline for the Management of Gout," Arthritis Care and Research, May 6, 2020. DOI:10.1002/art.41247

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Global Rheumatoid Arthritis Therapeutics Market SHARE, SIZE 2020| EMERGING RAPIDLY WITH LATEST TRENDS, GROWTH, REVENUE, DEMAND AND FORECAST TO 2026 -…

Tuesday, May 19th, 2020

Global Rheumatoid Arthritis Therapeutics Market Size, Status and Forecast 2020-2026 initially represents the historical overview of the current market situation and forecast 2026. The report gives a comprehensive study of various factors of the global Rheumatoid Arthritis Therapeutics market. The report analyzes the market by carrying out the valuation in the constrained period. After an in-depth market study and analysis of the market, the analysts have testified the constant growth in the market, considering the current unsteady market scenario in terms of revenue. The major players dominating the market are focused upon throughout the by analyzing their revenue, their business summary, product segmentation along with the latest developments.

Then the report gives analysis on market size, trends, share, growth, and cost structure and drivers. The global Rheumatoid Arthritis Therapeutics market report has studied key opportunities in the market and influencing factor which is useful and helpful to the business. The report assists users to analyze the future demand and predict exact implementation. The report explains current business and industrial developments, future policy changes, and opportunities available in the market. It gives a detailed summary of the market trends, shares, and patterns of revenue growth and the market value.

DOWNLOAD FREE SAMPLE REPORT: https://www.magnifierresearch.com/report-detail/30461/request-sample

Competitive Analysis:

The report gives you a detailed list of competitive analysis and it would give you a detailed report on the various market strategies, models and growth patterns in terms of revenue of the competitors. The players examination will help the reader identify the footprints of the manufacturers by knowing about the global revenue of manufacturers, the global price of manufacturers, and production by manufacturers during the forecast period of 2015 to 2026. Major market players of the global Rheumatoid Arthritis Therapeutics market are analyzed on various aspects such as company profile, product portfolio, sales analysis, revenue generation through the forecast period from 2020 to 2026.

Leading companies reviewed in the report are: AbbVie, Boehringer Ingelheim, Novartis, Regeneron Pharmaceuticals, Pfizer, Bristol-Myers Squibb, F. Hoffmann-La Roche, UCB S.A., Johnson & Johnson Services, Amgen,

Market product type segmentation as provided below:

Market applications can be fragmented as: Prescription, Over-the-Counter (OTC),

The global Rheumatoid Arthritis Therapeutics market is analyzed across key geographies namely: North America (United States, Canada, Mexico), Asia-Pacific (China, Japan, South Korea, India, Australia, Indonesia, Thailand, Malaysia, Philippines, Vietnam), Europe (Germany, France, UK, Italy, Russia, Rest of Europe), Central & South America (Brazil, Rest of South America), Middle East & Africa (GCC Countries, Turkey, Egypt, South Africa, Rest of Middle East & Africa)

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The newly arrived players in the global Rheumatoid Arthritis Therapeutics market can up their growth potential by a great amount and also the current dominators of the market can keep up their dominance for a longer time by the use of our report. The report will cover the main region and share information about the market size and value in a particular region. It also offers similar information for other regional segmentation. With the help of this research knowledge about the market and its key players can be gained for those wanting to enter the market.

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Global Rheumatoid Arthritis Therapeutics Market SHARE, SIZE 2020| EMERGING RAPIDLY WITH LATEST TRENDS, GROWTH, REVENUE, DEMAND AND FORECAST TO 2026 -...

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Can hydroxychloroquine prevent a COVID-19 infection? Thats Trumps hope, it appears and it is being looked into by researchers – MarketWatch

Tuesday, May 19th, 2020

President Donald Trumps unprompted admission that hes been taking hydroxychloroquine for a week and a half is aligned to some degree with medical research that aims to understand if the controversial drug can prevent infections with the coronavirus in high-risk frontline workers.

Hydroxychloroquine, which is approved by the Food and Drug Administration to treat malaria, lupus and rheumatoid arthritis, is not a proven treatment or prophylaxis for COVID-19. It received emergency-use authorization from the FDA in mid-March to be used in certain clinical settings as a treatment for COVID-19 patients. But, in the two months since then, medical experts have raised questions about the heart risks associated with the drug and its efficacy against the virus and how those concerns play out against a backdrop of political maneuvering.

Youd be surprised at how many people are taking it, especially the frontline workers before you catch it, Trump told reporters on Monday. I happen to be taking it.

Several White House staffers have recently tested positive for the coronavirus, including Katie Miller, Vice President Mike Pences press secretary, as well as one of Trumps personal valets. It is unclear whether Trump was exposed to any of those individuals; however, a letter from Dr. Sean Conley, the White House physician, that was shared on social media mentions that a member of Trumps support staff tested positive for COVID-19.

Read:The next stage of the COVID-19 recovery is here. This is how investors prepare, says UBS

Since the earliest days of the pandemic in the U.S., Trump has been promoting hydroxychloroquine and chloroquine, an older formulation of the same drug. His remarks in favor of the decades-old medicine likely helped spur a run on the drug that created a supply shortage for the patients who already take the treatment for lupus and rheumatoid arthritis.

But a series of medical studies, many of which haven't been peer reviewed, have concluded that the drug isnt efficacious against COVID-19 infections, including one conducted at Veterans Health Administration hospitals that found patients taking the drug had higher mortality rates. Then the FDA on April 24 issued a warning to health-care providers about the serious heart-rhythm problems that can occur in patients taking the drug. And Dr. Rick Bright, former director of Biomedical Advanced Research and Development Authority, has accused the administration in a whistleblower complaint of demoting him when he resisted promoting chloroquine without transparent information on the potential health risks.

Even the Federal Aviation Administration has warned pilots that they cant fly while taking the drugs or for 48 hours after the last dose, citing the known risks of these medications, such as cardiac rhythm disturbances and hypoglycemia against unproven benefits.

Among clinicians, however, it has been one of the few tools available to treat patients hospitalized with COVID-19, at least until Gilead Sciences Inc.s GILD, -3.23% remdesivir received an emergency-use authorization earlier this month. Many frontline clinicians are using a range of therapies, including zinc, azithromycin, hydroxychloroquine, and some HIV and anti-inflammatory arthritis drugs. Plus, hydroxychloroquine and chloroquine have proven safety profiles, are cheap to make and are readily available.

The choice to use these drugs has already been made, probably in hundreds of thousands of patients, but with scant evidence about the risks and benefits, researchers wrote in a New England Journal of Medicine editorial about hydroxychloroquine and chloroquine.

Raymond James analyst Steven Seedhouse, who said he still sees the potential in hydroxychloroquine, wrote in a May 7 note to investors that the study preprints, including the VA research, collectively paint a jumbled picture of hydroxychloroquine, and he believes the drug may reduce mortality by targeting antiviral activity that cant be picked up by a traditional diagnostic test.

See also:Darkest winter in modern history coming without stronger coronavirus response, Rick Bright to testify

This may be why clinical trials testing hydroxychloroquine as a possible COVID-19 treatment or prophylactic are moving forward.

The World Health Organization plans to study hydroxychloroquine and chloroquine in 20,000 frontline health-care workers, as will a trial funded by the COVID-19 Therapeutics Accelerator, which is backed by the Bill and Melinda Gates Foundation, among others.

The National Institute of Allergy and Infectious Diseases said last week it is testing hydroxychloroquine and the antibiotic azithromycin in 2,000 patients with mild and moderate cases of COVID-19 to see if the drug can reduce the need for hospitalizations and prevent death. The University of Minnesota began trialing hydroxychloroquine in health-care workers reporting pre- and post-exposure to the novel coronavirus in early April. A University of Chicago study aims to see if the drug can slow the progression of the disease and keep patients out of the hospital, and the Baylor Research Institute wants to see if hydroxychloroquine can prevent infections among health-care workers in high-risk settings.

From the existing data, which need validation in a trial, it looks like hydroxychloroquine could be a good agent for prophylaxis, Trevor Mundel, president of the Gates Foundations global health program, wrote on the accelerators website. It actually blocks the entry of the virus into the cell, so the hypothesis makes a lot of sense: if you have the drug in your system and you get exposed, you wont let the virus get into your cells and you wont get onset of disease.

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Can hydroxychloroquine prevent a COVID-19 infection? Thats Trumps hope, it appears and it is being looked into by researchers - MarketWatch

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Coronavirus Briefing: Umbilical cord treatments, counter-narratives and tailgating – PRWeek

Tuesday, May 19th, 2020

Theres a lot to discuss this week and most of it isnt so bad theres a pervasive sense that the human race is picking itself up and dusting itself off. Pain and sadness are still very much on tap, but the world has changed and were starting to accept it, figure out how to make it work, tap into our inner Delores (fromWestworld) and architect a new reality. If were lucky, when this is all over itll turn out to have been a savage plot twist, and we can go back to worrying about all the things we worried about before we had real things to worry about.

Todays Coronavirus Briefing is 1,330words and will take you seven minutes to read.Click here to sign up for the newsletter.

Ideally, every country would share best practices with every other country when it comes to lifting lockdowns and reopening businesses, making the slogan were all in this together ring true.This is not going to be the Summer of Love. Dont take hydroxychloroquine without a medical reason.

Some new technologies are coming down the pike that, even in these early stages, give one some hope.

We may be tired of hearing it, but testing matters.

How were talking to our friends, employees, coworkers and families about the pandemic and the havoc its wreaking on us, matters.

Dont support Big Tobacco, unless theyreusing their plants to create a vaccine.

Some interesting, concerning and helpful statistics.

How is flying on a plane, like packing into a restaurant or bar, not simply a form of Russian Roulette?

We miss our squads. We need our tribes. Our social lives, reformulated with restrictions, are better than eternal solitaire.

Tailgating is the new black.

We may not go tripping through the desert in our festival finest this summer, but if we close our eyes and listen, we can dream.

Peace out and see you tomorrow.

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Coronavirus Briefing: Umbilical cord treatments, counter-narratives and tailgating - PRWeek

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Daughter of former journalist who died of colon cancer battling cancer of the bones – Nairobi News

Tuesday, May 19th, 2020

This Thursday will mark exactly 10 years since journalist Elly Abongo succumbed to colon cancer in Nairobi. He died just days after being featured in Daily Nations Living magazine, narrating his struggles with the disease.

His widow, Joyce Wambui, and daughter, Lakita Abongo, will be marking the anniversary in India. Since January, they have been at the Medanta Hospital in New Delhi where the 13-year-old Lakita is being treated for cancer of the bones.

CELL TRANSPLANT

Her right leg was amputated at the hip in March and she is now awaiting a stem cell transplant to as medics seek to ensure that the cancer, called osteosarcoma in technical terms, is banished from her body.

Hers is a hereditary condition. Tests by medics on Lakitas blood showed that she had inherited a syndrome that increases chances of a person contracting cancer.

She tested positive for Li-Fraumeni syndrome. That one makes someone be more susceptible to different types of cancer. So, that can run in the family, Ms Wambui told the Sunday Nation on Friday.

She explained that the death of Mr Abongos mother and two siblings might have been due to the predisposition to cancer, though it had not been established as such.

In Lakitas case, the cancer began with pain in the leg, which they tried managing but it just couldnt go away. Several scans later, it was discovered that she has osteosarcoma, which was manifesting itself as a tumour. The cancer forms in the cells that form bones.

LOSS OF LEG

One of the interventions done was to remove the affected part. In its place, a metallic blade was introduced to ensure the leg still supported the body.

But during the examination in January, it was discovered that the tumour was not responding to chemotherapy.

They did a scan and found out that the chemo wasnt working. When they analysed the site of the tumour, there was no other option but an amputation, said Ms Wambui.

To place further stops on the cancer, which doctors have deemed aggressive, medics have recommended a stem cell transplant. This weekend, doctors have been harvesting cells from her body to be reconditioned and later returned to her body.

If all goes according to plan, the transplant is scheduled for May 18. But that depends on whether they will have raised the Sh4.9 million required for the procedure, an amount that the family is asking well-wishers to contribute.

LOSS OF DADDY

If there is no money, they will continue with chemotherapy until we get money for a stem cell transplant, said Ms Wambui.

Lakita, Standard Eight pupil at Juja Preparatory, said it has not been easy dealing with the loss of a leg.

Sometimes I just feel like my leg is there, but its not. I reach out to touch it, but its not there, she said.

She hopes all financial hurdles will be cleared soon so that she can return to Kenya by June.

(I wish to) go back to my family and friends to resume school and sit my KCPE, she said.

Her father died at 32, when she was three years old. He had worked for Family TV, Citizen TV, Radio Ramogi, BBC Radio among other media outlets by the time of his demise.

Well-wishers can donate through M-PesaPaybill Number 8011987, with the senders name as the account name.

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The Problem With the Way Officials Are Categorizing COVID-19 Deaths – Yahoo Lifestyle

Tuesday, May 19th, 2020

Group of doctors and nurses talking about coronavirus.

As Ive watched the daily press briefings given by my state officials, it strikes me how they discuss COVID-19 deaths. They will list the age, gender, and county of the person who passed away before adding that one all-important phrase, with underlying health conditions. On the surface, at a public health level, that may seem like important information to include. But that label divides the population into two groups: those with pre-existing health conditions and those without.

Its psychologically painful to feel an ongoing sense of risk. People are not used to this level of discussion and disruption around health. Its easier to choose to believe that we are not actually at risk, that everything will be fine for us. The medias emphasis on how the people who died had preexisting conditions subconsciously reassures people without preexisting conditions that they are not at risk. It separates people into two tiers (healthy vs. not), and deaths from one of those tiers are now becoming viewed as expected and even acceptable.

Related: Download The Mighty app to connect in real time with people who can relate to what you're going through.

One man recently told my husband that he would be OK with one to two million deaths in the US from this virus, as long as the economy could have stayed open. What is the unspoken message of that belief? He is OK with that number of deaths because they would most likely be from vulnerable populations: elderly people, chronically ill people, and people with disabilities.

This current pandemic has led to many discussions around the Spanish Flu outbreak of 100 years ago, in which many children and young adults died. Lately, people who are against stay-at-home orders, mask usage, and social distancing will bring up that fact to show that the 1918 outbreak was different from todays outbreak because so many young, healthy people died. That differentiation is showing their true beliefs about the value of vulnerable populations, not only including the elderly (15 percent risk of dying from COVID-19) but also people with disabilities (close to 10 percent risk of dying from COVID-19).

Story continues

Related: What Makes My Life Different From Healthy People's Lives During COVID-19

Are their deaths without meaning because of their preexisting conditions, whether age or disability? This is what people are implying, whether consciously or unconsciously, when they constantly reiterate, But almost everyone who died had underlying health conditions.

This is where advocacy comes into play: dont let people in your life get away with saying that.

Challenge them: is massive loss of life acceptable to you as long as the deaths come from vulnerable population groups? Why are their lives not valuable to you?

On a personal level, dont allow yourself to fall into the easy trap of feeling safe just because you may not be at risk of death from this virus. Every time you read a report of someone who died from COVID-19 with preexisting health conditions, please pay homage to them by recognizing them in your mind as someone who loved and was loved, who had hobbies and joys and things in their life they looked forward to, same as you. Honor them through your acknowledgment.

Related: How I'm Managing My Anxiety and Parenting During COVID-19

While not everyone may have an underlying condition in the form of a disability, if we are fortunate, we will all grow old someday. When that day comes, I can only hope that others will view my life and passing with respect as well. Every life is deserving of protection and respect.

For more on the coronavirus, check out the following stories from our community:

Helping a Child With Autism Tolerate Wearing a Face Mask

To Those Who Question the Value of My Life During COVID-19

The COVID-19 Reopening Questions I Need Answers for as a Person at High Risk

It's OK If You're Functioning in Survival Mode Right Now

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Particle research could save wheat and other crops from deadly virus – New Food

Monday, May 18th, 2020

In a bid to protect wheat and other crops from the Brome Mosaic virus, scientists from UC Riverside set out to better understand how the virus particles interact with each other when infecting crops.

Brome Mosaic virus

University of California, Riverside scientists have announced that they have solved a 20-year-old genetics puzzle that could result in ways to protect wheat, barley, and other crops from a devastating infection.

Ayala Rao, professor of plant pathology and microbiology, has been studying Brome Mosaic virus for decades. Unlike some viruses, the genetic material of this virus is divided into three particles that until now were reportedly impossible to tell apart.

Brome Mosaic virus primarily affects grasses such as wheat and barley, and occasionally affects soybeans as well. According to Rao, it is nearly identical to Cucumber Mosaic virus, which infects cucumbers as well as tomatoes and other crops that are important to California agriculture.

Without a more definitive picture of the differences between these particles, we couldnt fully understand how they work together to initiate an infection that destroys food crops, Rao said. Our approach to this problem has brought an important part of this picture into very clear focus.

Inside each of the particles is a strand of RNA, the genetic material that controls the production of proteins. The proteins perform different tasks, Rao explained, some of which cause stunted growth, lesions and ultimately death of infected host plants.

Two decades ago, scientists used the average of all three particles to create a basic description of their structure. In order to differentiate them, Rao first needed to separate them, and get them into their most pure form.

Using a genetic engineering technique, Raos team disabled the pathogenic aspects of the virus and infused the viral genes with a host plant.

This bacterium inserts its genome into the plants cells, similar to the way HIV inserts itself into human cells, Rao said. We were then able to isolate the viral particles in the plants and determine their structure using electron microscopes and computer-based technology.

Now that one of the particles is fully mapped, it was said to be clear that the first two particles are more stable than the third.

Once we alter the stability, we can manipulate how RNA gets released into the plants, Rao said. We can make the third particle more stable, so it doesnt release RNA and the infection gets delayed.

Moving forward, Rao hopes to bring the other two viral particles into sharper focus with the expertise of scientists at UCLA and UC San Diego.

Not only could this research lead to the protection of multiple kinds of crops, it could advance the understanding of any virus, Rao added.

It is much easier to work with plant viruses because theyre easier and less expensive to grow and isolate. But what we learn about the principles of replication are applicable to human and animal viruses too.

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Particle research could save wheat and other crops from deadly virus - New Food

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Infectious Vaccines Partnering 2014 to 2020: Deal Trends, Players and Financials – PRNewswire

Monday, May 18th, 2020

DUBLIN, May 18, 2020 /PRNewswire/ -- The "Global Infectious Vaccines Partnering Terms and Agreements 2014 to 2020: Deal trends, players and financials" report has been added to ResearchAndMarkets.com's offering.

This report provides a detailed understanding and analysis of how and why companies enter infectious vaccines partnering deals.

The majority of deals are development stage whereby the licensee obtains a right or an option right to license the licensors vaccine technology. These deals tend to be multicomponent, starting with collaborative R&D, and commercialization of outcomes. The report also includes adjuvant deals and alliances.

This report provides details of the latest infectious vaccines agreements announced in the healthcare sectors.

Understanding the flexibility of a prospective partner's negotiated deals terms provides critical insight into the negotiation process in terms of what you can expect to achieve during the negotiation of terms. Whilst many smaller companies will be seeking details of the payments clauses, the devil is in the detail in terms of how payments are triggered - contract documents provide this insight where press releases and databases do not.

This report contains a comprehensive listing of all infectious vaccines partnering deals announced since January 2014, including financial terms where available, including over 350 links to online deal records of actual infectious vaccines partnering deals as disclosed by the deal parties. In addition, where available, records include contract documents as submitted to the Securities Exchange Commission by companies and their partners.

The initial chapters of this report provide an orientation of Infectious Vaccines dealmaking and business activities.

In addition, a comprehensive appendix is provided organized by Infectious Vaccines partnering company A-Z, deal type definitions and Infectious Vaccines partnering agreements example. Each deal title links via Weblink to an online version of the deal record and where available, the contract document, providing easy access to each contract document on demand. The report also includes numerous tables and figures that illustrate the trends and activities in Infectious Vaccines partnering and dealmaking since Jan 2014.

In conclusion, this report provides everything a prospective dealmaker needs to know about partnering in the research, development and commercialization of Infectious Vaccines technologies and products.

Analyzing actual contract agreements allows assessment of the following:

Companies Mentioned

For more information about this report visit https://www.researchandmarkets.com/r/8txhqv

Research and Markets also offers Custom Research services providing focused, comprehensive and tailored research.

Media Contact:

Research and Markets Laura Wood, Senior Manager [emailprotected]

For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900

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After Covid-19, what is the future of conflict? Part 1 – TheArticle

Monday, May 18th, 2020

We fought two world wars in the 20th Century in defence of liberal values in this country. Then, after 9/11, we fought a series of engagements that attempted to impose those same values in other peoples countries. Now, the handle is turning again and even that recent aberration appears a long time ago. A new strategic epoch seems to indicate that we no longer need to go looking for a fight. Conflict will come to us.

The front line is no longer a nameless hillside in Afghanistan but the firewalls inside the computer systems of the power grid or what masquerades as news on social media. The digital revolution and globalisation have, in combination, dramatically increased the vulnerability of Western societies to severe disruption. We no longer have to speculate what a rupture of the distribution systems of the major supermarkets would look like. The creation of a black market in loo rolls at the start of the pandemic was a darkly comic moment but showed just how quickly the normal conventions of an apparently ordered society can unravel. And that wasnt even the result of a break in supply, but simply human frailty; what if the same systems were subject to a sophisticated and concerted cyber-attack?

Ever mindful that it might have to pick up the pieces, Lloyds Insurance conducted a recent study into the implications of a successful cyber-attack on 50 suppliers of the power grid covering the north east of America. It concluded that 93 million people would be without power immediately and for up to two weeks. During that time, and in the biting cold of a New York winter or the suffocating heat of a Washington summer, the immediate consequences of a blackout would be compounded by the secondary effects of opportunist crime and civil unrest, both of which would test the competence of government.

This is not an abstract, hypothetical threat the massive attack against Estonia in 2007 and the 2017 NotPetya malware attack against a variety of Western companies reveal cyber operations as a weapon of choice in contemporary conflict. And its not just the bad guys who are at it. The Stuxnet attack on the Iranian nuclear programme set the standard for cyber intervention and seemed to leave a trail back to America and Israel.

At the same time, Russian attempts to influence the outcome of the 2016 US presidential election by disinformation and fake news and even the faintly risible Iranian attempt to encourage Scottish separatism using the same methods during the 2014 referendum are a matter of public record. Cyber and information operations are being directed against this country on a daily basis in a form of conflict that is pervasive, insidious, ambivalent and rarely attributable. The attack on the Skripal family in Salisbury breathtaking in both its audacity and incompetence showed that chemical attack could also be part of contemporary conflict. What if, on the back of Covid-19, biological weapons became part of this sinister equation too?

Hittite texts written beyond 1000 BC speak of infiltrating people infected with deadly, communicable disease into rival communities in what is probably the first historical reference to biological warfare. The grotesque idea of using disease as an instrument in conflict has come and gone over the subsequent millennia and it was only in 1990 that Gruinard Island, off the west coast of Scotland, was declared safe after it had been used for experiments with weaponised anthrax in 1942. Today, an objective observer might see a Covid-19 death toll that will eventually run into millions, global economic dislocation and debt levels of individual nations that equate to multiples of GDP. These are conditions only normally associated with large scale conflict and is it entirely irrational for nation states, terrorist groups or even criminal organisations to ponder cause and effect?

In 2011, Dutch virologists working at the Erasmus Centre in Rotterdam caused a mutation of the H5N1 (bird flu) virus. Around the same time, research at the University of Wisconsin-Madison was working on grafting the H5N1 spike gene on to H1N1 swine flu virus. The mortality rate of bird flu is higher than 50 per cent and an animated academic debate ensued about whether both pieces of research should be published or whether the risk of rogue scientists replicating the work was too great. In the event, the research was published in Science and Nature respectively and is now available in the public domain.

So, bad stuff is out there, but the problem has always been in weaponising it in a way that creates mass dissemination, as the failed attempts of the Aum Shinriyko millenialist cult to use anthrax in Tokyo in the 1990s illustrated. Unfortunately, advances in genetic engineering and delivery techniques mean this challenge becomes ever more soluble and a determined programme could probably overcome the technical hurdles. If it did, a biological weapon would have a number of advantages over other forms of anonymised attack: even miniscule quantities can be lethal; symptoms can have delayed onset; and, subsequent waves of infection can manifest beyond the original attack site. The effect would be pervasive, insidious, ambivalent and perhaps unattributable exactly the fingerprints of contemporary conflict.

Lets go one step further and explore the very boundaries of rational action. Is it inconceivable that a state actor lets call it China for the sake of argument might contemplate a form of biological self-immolation? If it was confident in the ability of its large and compliant population to absorb an epidemic, its ubiquitous security and surveillance apparatus to impose control and with the advantage of foreknowledge, might it seek strategic advantage in creating a pandemic in the certain knowledge that strategic competitors would suffer far more?

It probably is inconceivable but not in the conspiracy-obsessed social media echo chambers that pass for news reportage among the more fevered parts of the American alt-right community. And so this article turns full circle: a piece of thin analysis and opinion feeds a conspiracy debate and adds to the dead weight of fake news that bends our sense of reality. Or, alternatively stated, this is what future conflict might look like.

The implications are profound and beg questions such as: what is now the point of nuclear weapons; how do we deter these forms of attack; and is a defence doctrine built around expeditionary operations and platforms like the Queen Elizabeth class of aircraft carriers remotely relevant to the future?

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After Covid-19, what is the future of conflict? Part 1 - TheArticle

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Isaac Asimov: ‘How We’ll Live on the Moon’ – Popular Mechanics

Monday, May 18th, 2020

In March 1988, Popular Mechanics ran an article, written by sci-fi legend Isaac Asimov, exploring humanity's future on the moon. With NASA's plans to return to the moon in the coming years and President Trump's recent executive order clearing the way for companies to start mining the moon, Asimov's vision is more relevant than ever.

Reprinted here is the original article in its entirety.

Absolute silence.

The Lunarian stood in the eternal dark within the crater at the Moons south pole, and thought that silence was so characteristicand soothingand, yes, frighteningabout the Moon. He was not a true Lunarian, of course. He had come from Earth and when his 90-day stint was over, he would return to Earth and try to readjust to its strong pull of gravity.

There was no motion anywhere, no sound of living things. There was light along the crater top, as perpetual as the dark at this portion of the crater floor. Farther along the gently rolling floor, in the direction of the opposite side of the crater, was sunlight, too.

The Lunarian looked in that direction, and the photosensitive glass of his faceplate darkened at once.

The Lunarian thought: It is the year 2028 and the Moon has become our second world.

The line between dark and light swung slowly toward him and away in a 4-week cycle. It would never quite reach the point where he was standing, nor ever quite recede out of sight. If he were to move a few miles into the light, he would see the Sun skimming the crater edge along the horizon, but, of course, the faceplate grew virtually opaque if he accidentally looked in the Suns direction. At intervals, he could see the Earth, or a portion of it, edging above the crater wall. His heart would always melt at that sight. He tried not to think of Earth.

Pat Rawlins

For now, he was on the Moon. He could make out the line of photovoltaic cells in the sunlight and he knew that solar energy, never ending, was powering the world beneath his feetwhich was, as yet, very small. Already, dozens of human beings were housed there and in his lifetime it might well rise to hundreds. An experimental farm existed there, plus a chemical laboratory for the study of lunar soil, a furnace for baking out the small but precious amounts of volatile elements from appropriate ores.

This was not the only Moon base. A much larger one existed near the lunar equator, where the soil was mined and hurled into space to be used as a construction material. A much more specialized one existed on the Moon's far side where a huge radio telescope, insulated from Earth's radio interference by 2000 miles of solid Moon, was being completed.

The Lunarian thought: It is the year 2028 and the Moon has become our second world.

But it is now 1988. We have visited the Moon six times between 1969 and 1972, and 12 men have trod its surface. But those were visits only. We came, lingered and leftso that the total time human beings have spent on the Moon is less than two weeks.

But we have been sharpening our space abilities, and when we return to the Moon, it will be to stay. A day will come in the future after which there will never be a time when human beings will not be living on the Moon.

NASA is already planning Moon bases. In recent years, scientists, engineers, industrialists and scholars have met to discuss scientific, industrial and sociological issues in connection with living on the Moon. Former astronaut Dr. Sally K. Ride, America's first woman in space, recently produced a report outlining this nation's space goals. Satellite studies of the Earth will remain an important priority, along with the lofting of unmanned spacecraft to explore our solar system.

But the "Ride Report also stresses a manned permanent presence on the Moon before we embark on a manned mission to Mars, hoping to fully exploit the Moon's resources and scientific opportunities while boosting our own interplanetary learning curvebefore engaging in a Mars space spectacular.

Whether or not we choose to follow the Ride recommendations, the Moon will probably play an important role in man's future space explorations. But why bother? The Moon is a dead, desolate world, without air or water. It is a large super-Sahara. So what is there to make us want to go there, let alone live there?

Super-Sahara or not, the Moon would be useful, even vital, to us in many ways. Some of those ways are not material in nature. For instance, there is the question of knowledge. The Moon has not been seriously disturbed after the first half-billion years of the existence of the solar system (something that is not true of the Earth). We have been studying 800 pounds of Moon rocks astronauts retrieved, but merely bringing them to Earth has contaminated them, and the astronauts were only able to investigate isolated landing areas. If we can investigate the Moon's substance on the Moon, over extended periods and over every portion of its surface, we might learn a great detail about the early history of the Moon-and, therefore, of the Earth as well.

Unlike man's initial forays to the lunar surface, future trips to the Moon will be greatly aided by a space station positioned in low Earth orbit, by orbital transfer vehicles and by expendable lunar landers. It's envisioned that early lunar pioneers will reside in pressurized modules and airlocksnot unlike the modules currently being designed for the space station but with a significant difference. Because the Moon has no protective atmosphere, early settlers will cover their modules with up to 2 meters of lunar soil, or regolith, to protect them from solar radiation. These modules may give way to larger structures positioned beneath regolith archways or buildings made of lunar concrete as requirements change. Indeed, lunar building materials may one day be a principal lunar export.

Pat Rawlins

Solar collectors, photovoltaic systems and small nuclear powerplants positioned well away from lunar habitats would supply the power needs of an early Moon base. The resulting energy would support not only human explorers but a broad array of science and industrial activities, principally lunar mining and astronomical observation. Wheeled lunar rovers powered by the Sun would provide close-in transportation and cargo handling. Vertically launched rocket vehicles would aid in mapping and distant exploration. Some tasks may be performed by intelligent robots already on the drawing board.

After humans become established on the Moon, some visionaries foresee a complex of habitable dwellings and research labs for geochemical, physical and biological research. A life-giving atmosphere "manufactured on the Moon would promote ecological and agricultural pursuits, helping to make a Moon base self-supporting. Turning to the heavens, special detectors would analyze rays from astrophysical sources, and Moon-based particle accelerators would give new insight into the nature of matter. Spe cial units would process oxygen and refine new ceramic and metallurgical materials. "Moonmovers," adapted from Earthmovers, would excavate building and mining sites.

Think of the nuclear power stations we could build...where safety considerations did not bulk so large. Think of the efficiency of the solar power stations we could build on a world without an interfering atmosphere...

To what purpose? First, but not necessarily foremost, the Moon is a marvelous platform for astronomical observations. The absence of an atmosphere makes telescopic visibility far more acute. The far side of the Moon would allow radio telescopes to work without interference from human sources of light and radio waves. The Moon's slow rotation would allow objects in the sky to be followed, without interference from clouds or haze, for two weeks at a time. Neutrinos and gravity waves, together with other exotic cosmic manifestations, might be detected more easily and studied from the Moon than from the Earth. And, in fact, radio telescopes on the Moon and on the Earth could make observations in combination, allowing us to study in the finest detail the active centers of the galaxies, including our own Milky Way.

The Moon can also be used for experiments we would not wish to perform in the midst of the Earth's teeming life. Think of the genetic engineering we could perform, of the experimental life forms we could devise. We could obtain energy in copious quantities for use not only on the Moon, but for transfer to space structures and even to the Earth. Think of the nuclear power stations we could build (both fission and, eventually, fusion) where safety considerations did not bulk so large. Think of the efficiency of the solar power stations we could build on a world without an interfering atmosphere to scatter, absorb and obscure light.

Pat Rawlings

From the Moon's soil, we would obtain various elements. The Moon's crust is 40-percent oxygen (in combination with other elements, of course). This can be isolated. A common mineral on the Moon is ilmenite, or titanium iron oxide. Treatment with hydrogen can cause the oxygen of ilmenite to combine with the hydrogen, forming water, which can be broken up into hydrogen and oxygen.

But where would the hydrogen come from? Those portions of the Moon we have studied are lacking in the vital light elements: hydrogen, carbon and nitrogen. That makes it seem that these "volatiles will have to be imported from Earth (which has plenty), but there may be places where they can be found in small amounts on the Moon, especially in the polar regions where there are places where the Sun rarely shines. Lunar hydrogen can then be used to obtain oxygen, and lunar nitrogen can be used to dilute it. There you have an atmosphere.

Other elements, particularly iron, aluminum and titanium, all very useful structurally, are common in the lunar crust and can be smelted out of the soil. In addition, silicon can be obtained for making computer chips. The Moon will be an active mining base to begin with. Quantities of lunar soil can be hurled off the Moon by a "mass-driver, powered by an electromagnetic field based on solar energy. This would not be difficult because the Moon is relatively small and has a gravitational pull much weaker than that of Earth. It takes less than 5 percent as much energy to lift a quantity of matter off the Moon than it would to lift the same quantity off the Earth.

Pat Rawlings

To build observatories, laboratories, factories and settlements in space, it would make sense to use lunar materials, especially since Earthly resources are badly needed by our planet's population.

Because of the Moon's feebler gravity, it would be a particularly useful site for the building and launching of space vessels. Since far less power would be required to lift a vessel off the Moon's surface than off the Earth's, less fuel and oxygen would be needed and more weight could be devoted to payload.

Eventually, when space settlements are constructed, they may be even more efficient as places where space vessels can be built and launched, but the Moon will retain certain advantages. First, it will be a world of huge spaces and will not have the claustrophobic aura of the space settlements. Second, a lunar gravity, though weak, will be constant. On space settlements, a pseudo-gravitational field based on centrifugal effects may be as intense as Earth's gravitation in places, but will complicate matters by varying considerably with change of position inside the settlement.

The Moon, as an independent world, will represent a complete new turning in human history. Humanity will have a second world.

Then, too, since the Moon exists and is already constructed, so to speak, it can surely be developed first and be used to experiment with artificial ecologies.

Once the lunar colonists discover how to create a balanced ecology based on a limited number of plant and animal species (which may take awhile) that knowledge can be used to make space settlements viable.

Finally, of course, our Moon, with its enormous supply of materials, may eventually become a self-supporting, inhabited body in the solar system, completely independent of Earth. Surely this will become possible sooner than much smaller settlements elsewhere in space can achieve true independence.

The Moon, as an independent world, will represent a complete new turning in human history. Humanity will have a second world. If Earth should be struck by an unexpected catastrophe from without, say by a cometary strike such as the one that may have possibly wiped out the dinosaurs 65 million years agoor if humanity's own follies ruin Earth through nuclear war or otherwise then a second world will exist on which humanity will survive and on which human history, knowledge and culture will be remembered and preserved.

Asimov's Dream Coming True?

But when will this colonization take place? Naturally, we can't tell because so much of it depends not on technological ability but on unpredictable economic and political factors.

If all goes well, there is no reason why work on the project cannot be initiated in the 1990s. By 2005, the first outpost could be established, and by 2015, a permanently occupied Moon base may be in existence. After that, it may be that the Moon settlers will have developed their world to the point of being independent of Earth by the end of the 21st century.

On the other hand, if affairs on Earth are so mismanaged that there seems no money or effort to spare for space, or if humanity concentrates its efforts on turning space into a military arena and is not concerned with peaceful development or expansion, or if humanity ruins itself forever by means of a nuclear war in the course of the next few decades, then clearly there will be no Moon base, and perhaps no reasonable future of any kind.

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Isaac Asimov: 'How We'll Live on the Moon' - Popular Mechanics

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Specialised Covid-19 detection lab inaugurated at SUST – The Daily Star

Monday, May 18th, 2020

A specialised laboratory for detecting Covid-19 was inaugurated today at Shahjalal University of Science and Technology (SUST) around 3:00pm.

Foreign Minister Dr AK Abdul Momen inaugurated the lab through a video conference. Textiles and Jute Secretary Lokman Hossain Miah, who is also coordinator of Sylhet district during the pandemic, and SUST Vice Chancellor Professor Farid Uddin Ahmed were present during the video conference, reports our Sylhet correspondent.

"We spent around Tk 1.09 crore from our own fund to buy new equipment including one new RT-PCR machine," Professor Farid Uddin said.

The lab has been installed at the Department of Genetic Engineering and Biotechnology of the university.

A group of teachers and students of the department will be dedicated in operating the laboratory with guidance from head of their department Professor Dr Md Shamsul Haque Prodhan.

"A new RT-PCR machine has been installed in the laboratory and the biosafety level (BSL) has also been upgraded to level 2. We also installed waste management system to manage hazardous waste," said Ziaul Faruque Joy, assistant professor of the department.

"A team of 20 will be running one cycle daily, testing up to 94 samples each day. This cycle will be doubled soon," he said.

The lab at Sylhet MAG Osmani Medical College was overwhelmed with samples waiting to be tested on the lone RT-PCR machine, prompting SUST to join the cause.

After the university showed interest, the Ministry of Health and Family Welfare on April 12 ordered its concerned division to take steps to initiate testing at the lab. The Directorate General of Health Services (DGHS) cleared the way on May 3.

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Specialised Covid-19 detection lab inaugurated at SUST - The Daily Star

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Gene Editing Technologies in Diagnostic Platforms Market is expected to grow at a CAGR of 14.4% during the forecast period due to the rise in research…

Monday, May 18th, 2020

There has been a rise in government funding and research programs which is paving the way for the growth of the gene editing technologies in diagnostic platforms market. For example, the National Institutes of Health (NIH) has allocated funding on the study of clustered regularly interspaced short palindromic repeats (CRISPR) from 2011 to 2018. The NIH spent about US$ 3,083.4 million between the fiscal year 2011 and 2018 on a total of 6,685 projects. The funding has been increased by 213.1% between the fiscal year 2014 and 2015.

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Moreover, with the help of NIH Common Funds support, National Institutes of Health (NIH) launched Somatic Cell Genome Editing (SCGE) program on January 2018 which is working to improve the effectiveness and specificity of gene editing techniques to assist in the diminishing of the burden of common and erratic diseases caused by genetic variations. The program aims at developing quality tools to execute and determine effective and harmless genome editing in somatic cells of the body. These tools will be made extensively available to the research community to lessen the time and expense which is required to develop new therapies. Furthermore, Somatic Cell Genome Editing program will award approximately US$ 190 million to biomedical researchers over the six years starting from 2018 till 2023. Hence, these types of research programs and funding given to the researchers will help the diagnostic platforms to get the tools which will aid them in carrying out gene editing and will drive the future market of the gene editing technologies in diagnostic platforms.

The number of CRISPR related publications, as listed in the SCOPUS database of peer-reviewed research, shows the surge in funding. Between 2015 and 2016, the number of such publications raised 117.5% which is 1,457. In 2019, the number surpassed 3,900 and increased at a rate of 4.8%. Overall, 12,900 papers associated with the technique have been published since 2011, Thus, this increasing research is expected to assist in the gene editing technologies in diagnostic platforms market growth over the forecast period.

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The detailed research study provides qualitative and quantitative analysis of gene editing technologies in diagnostic platforms market. The market has been analyzed from demand as well as supply side. The demand side analysis covers market revenue across regions and further across all the major countries. The supply side analysis covers the major market players and their regional and global presence and strategies. The geographical analysis done emphasizes on each of the major countries across North America, Europe, Asia Pacific, Middle East & Africa, and Latin America.

Key Findings of the Report:

In terms of revenue, the gene editing technologies in diagnostic platforms market is expected to reach US$ 7,004.8 Mn by 2027, expanding at 14.4% CAGR during the forecast period due to the rising government funding for genome editing and engineering

Beam Therapeutics, Bio-Connect Group, CRISPR Therapeutics, Editas Medicine, GeneCopoeia, Inc., GenScript, Horizon Discovery Ltd., Inscripta, Inc., Integrated DNA Technologies, Inc., Intellia Therapeutics, Inc., Lonza Group Ltd., Merck KGaA, New England Biolabs, OriGene Technologies, Inc., Pairwise, Precision Biosciences, Sangamo Therapeutics, STEMCELL Technologies Inc., Thermo Fisher Scientific Inc., Transposagen Biopharmaceuticals, Inc. are the key market participants operating in the gene editing technologies in diagnostic platforms market.

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Gene Editing Technologies in Diagnostic Platforms Market:

By Technology

CRISPR

TALEN

ZFN

Others

By Application

Cell Line Engineering

Genetic Engineering

Animal Genetic Engineering

Plant Genetic Engineering

Others

By End-User

Biotechnology & Pharmaceutical Companies

Academic and Research Institutions

Contract Research Organization (CROs)

By Geography

North America

U.S.

Canada

Mexico

Rest of North America

Europe

France

The UK

Spain

Germany

Italy

Nordic Countries

Denmark

Finland

Iceland

Sweden

Norway

Benelux Union

Belgium

The Netherlands

Luxembourg

Rest of Europe

Asia Pacific

China

Japan

India

New Zealand

Australia

South Korea

Southeast Asia

Indonesia

Thailand

Malaysia

Singapore

Rest of Southeast Asia

Rest of Asia Pacific

Middle East and Africa

Saudi Arabia

UAE

Egypt

Kuwait

South Africa

Rest of Middle East & Africa

Latin America

Brazil

Argentina

Rest of Latin America

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Gene Editing Technologies in Diagnostic Platforms Market is expected to grow at a CAGR of 14.4% during the forecast period due to the rise in research...

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Gene Therapy Market will Generate Massive Revenue to $4,402 million by 2023 | Novartis, Kite Pharma, GlaxoSmithKline, Spark Therapeutics – News…

Monday, May 18th, 2020

The global gene therapy market was valued at $584 million in 2016, and is estimated to reach $4,402 million by 2023, registering a CAGR of 33.3% from 2017 to 2023. Gene therapy is a technique that involves the delivery of nucleic acid polymers into a patients cells as a drug to treat diseases. It fixes a genetic problem at its source. The process involves modifying the protein either to change the genetic expression or to correct a mutation. The emergence of this technology meets the rise in needs for better diagnostics and targeted therapy tools. For instance, genetic engineering can be used to modify physical appearance, metabolism, physical capabilities, and mental abilities such as memory and intelligence. In addition, it is also used for infertility treatment. Gene therapy offers a ray of hope for patients, who either have no treatment options or show no benefits with drugs currently available. The ongoing success has strongly supported upcoming researches and has carved ways for enhancement of gene therapy.

Top Companies Covered in this Report: Novartis, Kite Pharma, Inc., GlaxoSmithKline PLC, Spark Therapeutics Inc., Bluebird bio Inc., Genethon, Transgene SA, Applied Genetic Technologies Corporation, Oxford BioMedica, NewLink Genetics Corp.

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The gene therapy market is a widely expanding field in the pharmaceutical industry with new opportunities. This has piqued the interests of venture capitalists to explore this market and its commercial potential. Major factors that drive the growth of this market include high demands for DNA vaccines to treat genetic diseases, targeted drug delivery, and high incidence of genetic disorders. However, the stringent regulatory approval process for gene therapy and the high costs of gene therapy drugs are expected to hinder the growth of the market.

The global gene therapy market is segmented based on vector type, gene type, application, and geography. Based on vector type, it is categorized into viral vector and non-viral vector. Viral vector is further segmented into retroviruses, lentiviruses, adenoviruses, adeno associated virus, herpes simplex virus, poxvirus, vaccinia virus, and others. Non-viral vector is further categorized into naked/plasmid vectors, gene gun, electroporation, lipofection, and others. Based on gene type, the market is classified into antigen, cytokine, tumor suppressor, suicide, deficiency, growth factors, receptors, and others. Based on application, the market is divided into oncological disorders, rare diseases, cardiovascular diseases, neurological disorders, infectious disease, and other diseases. Based on region, it is analyzed across North America, Europe, Asia-Pacific, and LAMEA.

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Table Of Content

CHAPTER 1: INTRODUCTION

CHAPTER 2: EXECUTIVE SUMMARY

CHAPTER 3: MARKET OVERVIEW

CHAPTER 4: GENE THERAPY MARKET, BY VECTOR TYPE

CHAPTER 5: GENE THERAPY MARKET, BY GENE TYPE

CHAPTER 6: GENE THERAPY MARKET, BY APPLICATION

CHAPTER 7: GENE THERAPY MARKET, BY REGION

CHAPTER 8: COMPANY PROFILE

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Gene Therapy Market will Generate Massive Revenue to $4,402 million by 2023 | Novartis, Kite Pharma, GlaxoSmithKline, Spark Therapeutics - News...

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