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Archive for the ‘Preventative Medicine’ Category

electroCore, Inc. Announces Scottish Health Technology Group Recommendation For Use of gammaCore in NHS Scotland Cluster Headache Patients -…

Wednesday, January 27th, 2021

ROCKAWAY, N.J., Jan. 21, 2021 (GLOBE NEWSWIRE) -- electroCore, Inc.(Nasdaq: ECOR), a commercial-stage bioelectronic medicine company, today announced that Health Improvement Scotland (HIS) has published a Scottish Health Technology Group (SHTG) adaptation for NHS Scotland on the use of gammaCore for cluster headache. The SHTG publication is based on guidance produced in 2019 by the U.K. National Institute for Health and Care Excellence (NICE), which states that gammaCore, when used alongside standard of care, can reduce the frequency and intensity of cluster headache attacks, leading to significant quality of life benefits for people living with this condition and can save an average of 450 per patient in the first year of treatment through a reduction in acute rescue medication use, and with electroCore offering no-cost evaluations for all patients. The SHTG publication recommends that gammaCore should be available for a 3-month trial period for use in treating NHS Scotland patients suffering from cluster headache and the SHTG adaptation will now be disseminated across NHS Scotland health boards by HIS, to inform the use of gammaCore for cluster headache.

We are delighted by the recommendation from the Scottish Health Technology Group to consider the application of the medical technology guidance produced by NICE in 2019 to NHS Scotland, saidIain Strickland, electroCores VP of European Operations. We welcome the opportunity to provide our proven and established therapy to more patients in Scotland suffering from the debilitating condition of cluster headache. I would like to thank the Scottish experts who worked on this assessment and arrived at the conclusion that an equivalent recommendation to the one in effect in England and Wales was also needed in Scotland. The publication notes the devastating impact that cluster headaches can have on the lives of sufferers and the desperation that can result from ineffective treatment, so the further ratification of gammaCore as an effective treatment option is great to see.

The SHTG adaptation can be viewed at:

http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/topics_assessed/adaptation_01-21.aspx

About Scottish Health Technology Group

The Scottish Health Technologies Group (SHTG) is a national health technology assessment (HTA) agency. They provide evidence support and advice to NHS Scotland on the use of new and existing health technologies which are not medicines and which are likely to have significant implications for peoples care.

About electroCore, Inc.electroCore, Inc. is a commercial-stage bioelectronic medicine company dedicated to improving patient outcomes through its platform non-invasive vagus nerve stimulation therapy initially focused on the treatment of multiple conditions in neurology. The companys current indications are the preventative treatment of cluster headache and migraine and acute treatment of migraine and episodic cluster headache.

For more information, visit http://www.electrocore.com.

About gammaCoregammaCore(nVNS) is the first non-invasive, hand-held medical therapy applied at the neck as an adjunctive therapy to treat migraine and cluster headache through the utilization of a mild electrical stimulation to the vagus nerve that passes through the skin. Designed as a portable, easy-to-use technology, gammaCore can be self-administered by patients, as needed, without the potential side effects associated with commonly prescribed drugs. When placed on a patients neck over the vagus nerve, gammaCore stimulates the nerves afferent fibers, which may lead to a reduction of pain in patients.

gammaCore is FDA cleared in the United States for adjunctive use for the preventive treatment of cluster headache in adult patients, the acute treatment of pain associated with episodic cluster headache in adult patients, the acute treatment of pain associated with migraine headache in adult patients, and the prevention of migraine in adult patients. gammaCore is CE-marked in the European Union for the acute and/or prophylactic treatment of primary headache (Migraine, Cluster Headache, Trigeminal Autonomic Cephalalgias and Hemicrania Continua) and Medication Overuse Headache in adults.

In the US, the FDA has not cleared gammaCore for the treatment of pneumonia and/or respiratory disorders such as acute respiratory stress disorder associated with COVID-19.

Please refer to the gammaCore Instructions for Use for all of the important warnings and precautions before using or prescribing this product.

Forward-Looking Statements

This press release and other written and oral statements made by representatives of electroCore may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements include, but are not limited to, statements about anticipated government support provided by the HIS, SHTG, NHS and NICE; statements about electroCore's business prospects and clinical and product development plans; its pipeline or potential markets for its technologies; the timing, outcome and impact of regulatory, clinical and commercial developments; the Companys business prospects in Eastern Europe and other new markets and other statements that are not historical in nature, particularly those that utilize terminology such as "anticipates," "will," "expects," "believes," "intends," other words of similar meaning, derivations of such words and the use of future dates. Actual results could differ from those projected in any forward-looking statements due to numerous factors. Such factors include, among others, the ability to raise the additional funding needed to continue to pursue electroCores business and product development plans, the inherent uncertainties associated with developing new products or technologies, the ability to commercialize gammaCore, the potential impact and effects of COVID-19 on the business of electroCore, electroCores results of operations and financial performance, and any measures electroCore has and may take in response to COVID-19 and any expectations electroCore may have with respect thereto, competition in the industry in which electroCore operates and overall market conditions. Any forward-looking statements are made as of the date of this press release, and electroCore assumes no obligation to update the forward-looking statements or to update the reasons why actual results could differ from those projected in the forward-looking statements, except as required by law. Investors should consult all of the information set forth herein and should also refer to the risk factor disclosure set forth in the reports and other documents electroCore files with the SEC available at http://www.sec.gov.

Investors:Hans VitzthumLifeSci Advisors617-430-7578hans@lifesciadvisors.com

or

Media Contact:Jackie DorskyelectroCore973-290-0097jackie.dorsky@electrocore.com

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Poland’s defense minister: COVID-19 is forcing the military to reexamine its role – DefenseNews.com

Tuesday, January 12th, 2021

Without a doubt, 2020 will be recorded in history with the theme of COVID-19. The pandemic heavily affected our lives, creating new global challenges in almost all spheres, including security and defense. While the new normal is reshaping our reality, the existing security threats have not disappeared. It gives a reason to enhance our cooperation and develop a flexible approach more than any time before.

The outbreak has consequently led to a thorough examination of the armed forces role in countering this unprecedented crisis resulting from the spread of the virus.

Since the beginning, the Polish Armed Forces have been actively engaged in supporting civilian authorities and the health care system. Every day, an average of about 10,000 soldiers were actively fighting the pandemic, and another 10,000 were on standby. Fourteen military hospitals, five medical preventative medicine centers, and the Military Institute of Hygiene and Epidemiology are constantly providing support to the national health care system. Soldiers were collecting around 55 thousand swabs each week and were supported almost 700 hospitals, 173 sanitary-epidemiological stations, and about 11,000 combatants, veterans, seniors and medical staff families. Soldiers are also supporting construction of 17 temporary hospitals, have built over 50 isolation centers and have operated over 20 field-admission points.

In this demanding period, the Polish Territorial Defence Forces the relatively young fifth service of the Polish Armed Forces have impeccably proved their importance and effectiveness.

At the same time, Poland has been a part of numerous activities on the international level. NATO is using its existing mechanisms and bodies, such as the Euro-Atlantic Disaster Response Coordination Center and strategic airlift programs, to support allies. It has also developed new tools such as new operations plans and a trust fund to strengthen response capabilities. NATO members provide mutual assistance to each other by donating vital medical equipment and relief material. These actions are a visible proof of international solidarity in response to this extraordinary multidimensional challenge we face nowadays. They also constitute valuable lessons learned to be implemented to be better prepared and resilient for similar challenges in the future.

We realized that without exchanging experience, our efforts would not be so efficient. Therefore, in spring 2020, our Military Institute of Medicine led several medical missions to Italy, the United States and Slovenia. Our experts had a unique opportunity to share best practices and obtain knowledge that could be applied to design national response measures.

Regardless of our fight against COVID-19, effective deterrence and defense remain the core task of our armed forces. Therefore, throughout 2020 we made every effort to fulfill previously planned activities and goals. Several top exercises such as Defender Europe 2020, conducted in a highly sanitary regime, proved allied determination to sustain high readiness of its forces.

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The COVID-19 pandemic will most likely have an impact on national security policies, including defense budgets, but we remain committed to keeping out defense spending above the required 2 percent of gross domestic product.

On the national level, Poland continues to strengthen its defense potential through further development of the Polish Armed Forces and their modernization.

We intend to keep up international cooperation aimed at increasing defense capabilities, specifically contributing to the needs of the alliance and the European Union. In this respect, we will implement state-of-the-art equipment, such as the F-35 fighter jet, the Patriot missile defense system and the High Mobility Artillery Rocket System.

Where applicable, we will engage our national defense industry in modernization projects to include procurement of self-propelled howitzers and mortars.

As before, close international collaboration aimed at meeting key commitments and pledges will be of the utmost importance. Despite the negative effects that COVID-19 may bring to our economies, Poland will maintain its involvement in allied missions, operations and initiatives in line with the 360-degree approach applying to NATOs eastern flank and other strategic directions. It translates to our constant engagement in the Enhanced Forward Presence in Latvia, the Tailored Forward Presence in Romania and the Baltic Air Policing mission, as well as in peacekeeping activities in the Western Balkans. We will continue to declare significant forces to the Very High Readiness Joint Task Force, NATO Response Force and NATO Readiness Initiative, not to mention our support to the international community in the fight against terrorism.

The COVID-19 pandemic proves that stronger cooperation in security is needed, though some may raise the argument that with the public health challenges we confront every day, defense expenditures are secondary. Nevertheless, as we are responsible for building a security landscape for the coming decades, we must concentrate on common defense projects and put emphasis on solidarity.

Mariusz Blaszczak is Polands minister of defense.

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Poland's defense minister: COVID-19 is forcing the military to reexamine its role - DefenseNews.com

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Dr. Russell Surasky Helping Others Understand Opioid Addiction and the La – The Jerusalem Post

Tuesday, January 12th, 2021

Understanding how opiates work is something that most people are not that well-educated about. This poses a major problem, given that the United States has some of the highest opiate abuse rates in the world. Every hour, over five people die due to drug overdoses within the US. The first step in reducing opiate addiction rates is to educate people on how opioids work and how they lead to a high level of addiction seldom seen.Dr. Russell Surasky is someone who has become an expert on opiate addiction. He is triple board-certified in neurology, addiction medicine, and preventative medicine. Dr. Surasky is the medical director of Bridge Back to Life, which is a multi-center outpatient addiction treatment program that helps those addicted to dangerous opiates like fentanyl. He has also founded the Surasky Neurological Center for Addiction in Great Neck, NY.Dr. Surasky believes that once someone understands how opioids work, they will also realize why it is incredibly difficult for someone addicted to them to stop cold turkey. Rather than being a moral failing, as politicians have been telling us for decades, addiction is a complex chronic disease that includes a lifetime risk of relapse. Thankfully, there have been advances in our understanding of the brain and how opiates affect it. There are now treatments, which Dr. Surasky uses, that have the power to reverse the neurological damage caused by opiates, leading to a permanent recovery.The first step in understanding opioid addiction is to understand what opioids are themselves. Generally, the word opioid refers to drugs that originate from the opium poppy. These include morphine, codeine, heroin, fentanyl, and others. Synthetic drugs like Oxycodone and Hydrocodone, known as Percocet and Vicodin, are also classified as opioids. The way they work is by lighting up the opiate receptors in the brain and spinal cord. These opioids have the power to significantly reduce the amount of pain someone feels. However, opiate receptors will also play into how we feel, both mentally and emotionally. That leads to opioids temporarily improving someones well-being. In fact, they will drastically lower feelings of depression and anxiety in the user, but only temporarily.Opioids that get prescribed to mitigate pain can indeed provide pain relief. However, they do so at a cost. It is very easy to misuse them and get hooked on them. That is due to these drugs overstimulating the brain's reward system. There is a euphoria experienced when using opioids that, once gone, turns to depression.As soon as the drug wears off, it will detach from the opiate receptors it was locked into, which tells the brain that it needs more. Thankfully, there are safe and non-addictive methods today that can effectively wean people off of opiates, including Vivitrol and spinal adjustments, among others.

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Dr. Russell Surasky Helping Others Understand Opioid Addiction and the La - The Jerusalem Post

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New study reveals extent of psychological distress resulting from Covid-19 pandemic – News24

Tuesday, January 12th, 2021

The Covid-19 pandemic has disrupted daily life on a global scale faster and more severely than any previous economic recession or natural disaster, resulting in significant psychological distress.

A new longitudinal study, published in Preventative Medicine, has revealed that the first month of the pandemic caused as much distress in American individuals as experienced during the entire previous year.

The researchers used longitudinal data from a nationally representative sample of US adults over the age of 20 to compare psychological distress during the first two months of the pandemic with the highest level of distress experienced during the year before the pandemic.

The baseline survey, according to the researchers, was conducted in February 2019 and the survey focusing on the pandemic was conducted in May 2020, eight weeks after the declaration of the national emergency in the US.

Measuring distress

Researchers assessed psychological distress by using the Kessler-6 (K6), which is an instrument commonly used to determine clinically significant psychiatric conditions, the study explains.

According to the study, the researchers found that the prevalence of psychological distress during the pandemic exceeded levels that would be expected in the absence of the pandemic.

Moreover, the study states that people experienced the same amount of psychological distress in 30 days of the pandemic as experienced over an entire year before the pandemic.

The researchers also found an increased prevalence of psychological distress across all demographic groups in the sample, which makes the pandemic the most persistent and complex stressor that has affected the US population, the study explains.

Younger people report more psychological distress

Findings from the research reveal that the risk of psychological distress was higher among participants younger than 60.

Distress may be driven more by economic stressors than fears specific to the disease, since older individuals are widely reported to be at higher risk of morbidity and mortality related to the virus, the researchers state.

Although previous research suggests that those who experience psychological distress following a disaster will return to pre-disaster levels over time, the researchers state that the pandemics effects may continue for an extended period.

Tracing patterns of persistence of serious psychological distress will provide important information to guide the national public health response to the Covid-19 pandemic, the researchers concluded.

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Image credit: Getty Images

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These 2 Companies Are Leading The Clean Wellness Movement – Forbes

Tuesday, January 12th, 2021

The emerging clean wellness industry is about minimizing human exposure to harmful chemicals.

The clean beauty market has been growing immensely in recent years, with people demanding products that are free of toxic chemicals. According to experts, the Covid-19 pandemic has only increased the desire of conscious consumers to spend their money on companies who are committed to sustainability and social change. Here are two companies taking the lead in the emerging clean wellness movement. WTHN offers traditional healing methods including acupuncture and herbs. Genexa makes the only OTC medications that are free from allergens and other potentially harmful ingredients.

Michelle Larivee is the CEO and Cofounder of WTHN.

1)WTHN

WTHN is a modern wellness brand that shares the ancient healing techniques of acupuncture, cupping, and traditional Chinese herbal medicine through its retail studios and a clean wellness boutique that carries their own products as well as others. After opening at the end of 2018, in their first year they earned revenue of over $2 million and gave over 5,000 people their first ever acupuncture treatment. They helped women trying to get pregnant, clients struggling with chronic pain and mental health issues, and more.

WTHN also sells organic herbal supplements for stress, sleep, and immunity-boosting on their website as well as through partners like Goop, Erewhon, and Standard Dose. As the Covid-19 pandemic has forced the closure of the WTHN studio in Manhattan, the company has pivoted to expanding their online healing platform.

We fundamentally believe that there is a broad shift happening in US healthcare right now toward preventative care, says Michelle Larivee, the CEO and Cofounder of WTHN. Health and wellness is defined by being proactive and not just seeing the doctor when youre sick. Its about more than just eating healthy and working out. Its about knowing your body and mind and being empowered to make decisions that are right for you. The Covid-19 crisis has only increased the urgency around the need for more awareness of tools for preventative health.

Laviree has worked in the healthcare industry for the last 15 years. But her journey to WTHN began with a personal health transformation. Six years ago, she had a ski accident that left her with chronic neck pain. After countless rounds of physical therapy and other treatments, she tried acupuncture and herbal medicine. Not only did they give her pain relief, but also she found herself sleeping better, less stressed, and with a stronger immune system that resulted in fewer sick days. She also credits the treatments with helping her get pregnant.

The entrepreneurship journey is all about highs and lows and navigating those extremes, which can be exhausting, says Laviree. There is no boss or mentor or built-in comforts like in any other job I have had in the past, so a lot of self-reliance is required. One of the most helpful things I have done is to build out my own very strong support network that includes mentors, colleagues, other founders, and friends.

David Johnson is the CEO and cofounder of Genexa.

2) Genexa

Genexa makes clean, safe, over-the-counter (OTC) medicines using the same active ingredients as big brands but without the toxic, harmful ingredients. These medications include antacids, laxatives, pain relievers, and more. The products are available in more than 30,000 stores nationwide.

Along with business partner Max Spielberg, CEO David Johnson founded Genexa because as new fathers, they discovered that there were no clean medicines for their children to take. We were shocked to find out that many oral medications contain a potential allergen and almost half contain ingredients like lactose, hard-to-digest sugars and more. We believed medicine could and should be made cleaner, so we decided to do something about it.

Johnson grew up in a healthy household with parents who were naturopathic physicians and used only clean, organic ingredients in everything from food to cleaning products. When he had his son, he therefore found it extremely frustrating to not be able to find medicines without ingredients like red dye no. 40 and sucrose. Everyone deserves clean, safe medicine that works. Being able to provide that to consumers worldwide is my lifes purpose, he says.

To aspiring changemakers and entrepreneurs, Johnson offers this advice. Do the thing you cant stop thinking about, even if you dont know where to start. My partner and I werent scientists, pharmacists or doctors. We were two dads who believed there was a better way. A lot of doors were slammed in our faces, but we didnt stop trying. We couldnt stop thinking about what the world would look like if we could make another industry cleaner.

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These 2 Companies Are Leading The Clean Wellness Movement - Forbes

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Rapid antigen COVID-19 test not greenlight to return to pre-pandemic behavior – Dailyuw

Tuesday, January 12th, 2021

The University of Washington Medical Center is very quiet on April 1, 2020.

Think twice about the COVID-19 test you just took, because the rapid Abbott BinaxNOW COVID-19 antigen test has been found to be about 100 times less sensitive than standard lab tests, according to a new study by UW Medicine. That means those cleared by the test may still be infected with low levels of the virus and can transmit it to others.

The research, conducted by laboratory medicine and pathology assistant professor Dr. Alex Greninger, compared the sensitivity of Abbott tests to tests typically used in clinical labs, also known as real-time reverse transcription polymerase chain reaction tests, or rRT-PCR tests.

It found that the Abbott test is only able to detect the virus 95% of the time when samples contain at least 40,000 viruses. The rRT-PCR test only requires a few hundred viruses in a sample to detect it, making it around 100 times more sensitive.

As such, the Abbott test works well when administered within seven days of symptom onset, which is when infected individuals tend to shed large amounts of the virus. However, the test becomes less effective in detecting the virus past that period, even if those tested are still infected, according to UW Medicine.

The virus behaves so differently from person to person, so it really depends on the context, Greninger said. We dont recommend [the Abbott test] for hospital use, but it might be alright for a public health approach.

The Abbott test was approved by the U.S. Food and Drug Administration back in August, and was subsequently distributed across the country to be used in clinics, offices, and schools. The test works by rubbing a nasal sample on a rapid-result card, which can detect the presence of a coronavirus protein within 15 minutes.

Its convenience and affordability have made it a popular option as quarantine protocols increasingly hinge on negative COVID-19 tests. Greninger even speculates that the Abbott test might be available for over-the-counter use within the next year.

However, that does not mean that the Abbott test should serve as a greenlight for people to resume traveling or other infectious behaviors.

We hope [the Abbott test] will be used as an added test, [a] preventative measure, not a reason to change behavior, Greninger said. We are still very much in the midst of a pandemic.

As these tests are often administered to screen those without obvious symptoms, that means they are being used to clear people for whom they are least effective, which means that some of those infected can still slip through and continue to transmit the virus.

Especially with the recent emergence of the even more contagious COVID-19 strain first found in the United Kingdom, which he speculates will probably spread across the United States as well, Greninger recommends that people remain cautious in their behavior and remember that although the vaccine may be out, there is still a long road ahead of us.

Reach reporter Katherine Lin at news@dailyuw.com. Twitter: @linkat18

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VIVITROL Is Quickly Becoming the Go-To Treatment Option for Getting Rid of Opioid Addiction – The Ritz Herald

Tuesday, January 12th, 2021

Dr. Russell Surasky has been turning heads with his effective use of VIVITROL for successfully treating opioid addiction. This monthly injection has been found to reduce addictive cravings for opiate drugs. Unlike other alternatives like Suboxone and Methadone, it is not an opiate itself.

The fact that VIVITROL is not an opiate also means that it is not addictive. There is absolutely no physical dependency risk associated with taking it. Additionally, there are no negative side effects that similar alternatives feature, such as feeling high or sick. In fact, not much of anything is felt after receiving a Vivitrol injection.

The intense cravings to get the next fix of an opiate are gone after using VIVITROL. One of the best features of VIVITROL is the fact that a patient does not need to continue receiving injections for the rest of their lives. After one year of taking Vivitrol once a month, there is no further need to keep taking it.

Dr. Russell Surasky is triple board-certified in neurology, addiction medicine, and preventative medicine. This makes him an expert on addictions and how to treat them. At his multi-center outpatient addiction treatment programmed called Bridge Back to Life, Dr. Surasky has been administering VIVITROL to his patients. The results have been so remarkable that he has called VIVITROL one of the most effective treatments for opiate addictions.

However, VIVITROL isnt a miracle-maker. There has to be a bit of personal responsibility on the side of the patient that is undertaken. As long as a patient is firmly committed to getting rid of their opiate addiction, they will find VIVITROL treatment successful. They should also adhere to substance abuse therapy and have a healthy support system. You are the five or six people you spend the most time around, making it important to have an environment that reinforces healthy habits.

To date, Dr. Surasky has nothing but good things to say about VIVITROL. From his experience working with it, patients have seen dramatic improvements. VIVITROL has led to patients no longer feeling the intense cravings for opiate drugs they once had. Even further, they no longer even think about them. The patients Dr. Surasky has treated have expressed their relief about having finally freed themselves from the destructive additions that come with taking opiate drugs.

Dr. Surasky believes there is nothing more important than keeping families together and healthy. If someone in a family has fallen prey to opiate addiction, their family ends up suffering as well. Opiate addiction has found its way into every area of society. Nobody is immune to its dangers. That is why something like VIVITROL is a welcome solution that can help families everywhere avoid the terribly destructive consequences of opiate addiction.

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VIVITROL Is Quickly Becoming the Go-To Treatment Option for Getting Rid of Opioid Addiction - The Ritz Herald

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How Are Llamas Helping Cure the Coronavirus? Here’s What We Know – Green Matters

Tuesday, January 12th, 2021

It seems as though a llama may hold the answer we've been waiting for, in terms of combatting the ongoing coronavirus pandemic. A study conducted at Uniformed Services University's (USU) Center for Neuroscience and Regenerative Medicine showed that nanobodies produced by an absolutely gorgeous llama named Cormac may potentially be able to protect human lungs from infections such as COVID-19.

As previously mentioned, USU's researchers have been working with specific antibodies known as nanobodies derived from camels and llamas, which may be able to take down the coronavirus pandemic. According to the U.S. Department of Defense, when manipulated in the form of an aerosol or liquid form, nanobodies can act as a virus preventative and combatant. They weigh about 10 percent of a human antibody, and can apparently recognize virus proteins, latch themselves on, and fight them off.

Nanobodies are cheap and easy to work with in the realm of medical engineering, which is why USU's researchers had been testing them for months. Eventually, they discovered that Cormac the llama was producing a certain type of nanobody, NIH-CoVnb-112, which is thought to prevent, detect, and disembody SARS-CoV-2 spike proteins. Scientists tested this by immunizing Cormac five times over the course of a few weeks, using low levels of the SARS-CoV-2 spike protein, and seeing how he reacted.

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From doing this, researchers found that Cormac was producing low levels of the NIH-CoVnb-112 nanobodies, which latch onto the COVID-19 protein and prevent it from entering the body's cells. The nanobodies were then further tested in terms of infection prevention in petri dishes, and were eventually tested through an inhaler that used on asthma patients, which showed could work to treat patients in the form of a spray, according to National Institutes of Health.

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"One of the exciting things about nanobodies is that, unlike most regular antibodies, they can be aerosolized and inhaled to coat the lungs and airways," said Dr. David Brody, director of USU's Center for Neuroscience and Regenerative Medicine, and leader of the study. "This is promising in that it could potentially be used to protect the lungs from infections."

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How Miami-Dade opened all its public schools – and kept them open – KVIA El Paso

Tuesday, January 12th, 2021

Alberto Carvalho has been able to do what hundreds of his fellow superintendents have not: fully open his districts schools in the pandemic.

The head of Miami-Dade County Public Schools said hes been able to rely on the advice of scientific experts and follow through on a plan that has worked and gained trust.

Weve been well-informed by public health and medical experts. We convened a task force of experts, in pediatric medicine, in immunology, he told CNN, adding that one of the experts is Dr. Vivek Murthy, whom President-elect Joe Biden has nominated for US Surgeon General.

Weve been in good hands and that has translated into a set of protocols that has left very little room for doubting ourselves.

Those protocols listed in the county website include: daily health checks before students leave home, the wearing of masks and more space around children on school buses and in classrooms and cafeteria.

Carvalhos lack of doubt has helped win over many parents of the more than 350,000 students enrolled in his schools.

When you communicate that to the parents, then theres a sense of calm and trust that parents need prior to sending their students to school, he said.

Miami-Dade is the fourth largest school district in the country and the largest to reopen fully in the fall.

Carvalhos determination stems from his belief that there is no good replacement for in-person instruction.

There is no substitute, regardless of how great the technology may be, he said bluntly. You cannot Zoom effectively into a full understanding, a full level of engagement for students.

Carvalho also sees schools as an indispensable safe harbor for children academically, physically and emotionally even or perhaps especially in the middle of a pandemic.

I am a staunch believer that if we want to keep schools open if we want that normalcy and regularity to continue, if we want that protective umbrella for students, pedagogically speaking, academically speaking, in terms of their cognitive and emotional development if we will want that to happen, then the schools can do all they can in terms of preventative measures in terms of mitigating strategies in terms of protocols.

He said the cases of coronavirus in his schools are lower than in the community at large. Miami-Dade alone has reported more than a fifth of all Covid-19 cases in Florida, according to Johns Hopkins University data. But Carvalho said schools had an advantage.

Here in Miami-Dade, we see a greater adherence to protocols in schools because it is a controlled, safe environment than we see those same protocols being followed in their community in general, whether were talking about the bars and restaurants at the beach or social gatherings, he said.

New York City is seeing a similar outcome after it reopened its public elementary schools last month, despite an increasing coronavirus test positivity rate in the city as a whole.

The city has conducted about 100,000 Covid tests in schools, and found a positivity rate of 0.68%, far below the citywide rate of just under 9%, according to New York City data.

The evidence that schools are not hotbeds of virus spread led New York Gov. Andrew Cuomo to reverse a policy requiring schools to close if the community positivity rate hit 9% or higher.

If their schools are below the level of positivity in the community then they can keep the schools open, he said last week, returning more control to local school districts.

While there is no official national database tracking the spread of Covid within schools, independent analysis suggests that schools can safely reopen if proper mitigation strategies are followed.

Its an issue on which even governors from political opposites can share similar views.

Last week Cuomo, a Democrat and frequent critic of President Donald Trump, said: The safest place in New York City is, of course, our public schools.

And last October, Florida Gov. Ron DeSantis, a Republican ally of the President, said: Closing schools due to coronavirus is probably the biggest public health blunder in modern American history.

But many school districts are not ready to reopen. Los Angeles, the second largest district behind New York City, remains fully online, as do San Francisco and Washington, DC.

On Monday, some Chicago students in pre-K and special education got to return to school for the first time since March. But the push to reopen schools was met with heavy resistance from the citys teachers union, which argued that the city had not invested enough in measures to make in-person learning safe for staff and children.

That also appears to be the feeling among many Chicago parents. Students in kindergarten through 8th grade may go back to in-person learning next month, but so far less than one-third have signed up.

Biden said reopening public schools is one of his priorities for his first 100 days in office.

With Miami-Dade already having met that bar, Carvalho has his own next priority in mind: make sure teachers are among the first to be vaccinated.

If our teachers are essential professionals, indispensable to our society, to our economy, then we ought to prioritize their status in terms of access to the vaccine, the superintendent said.

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VOTIS Subdermal Imaging Technologies And ii Ventures Announce Plans To Develop Preventative Medicine Devices To Screen For Peripheral Artery Disease…

Monday, December 28th, 2020

JERUSALEM and MUMBAI, India, Dec. 21, 2020 /PRNewswire/ -- VOTIS Subdermal Imaging Technologies, Ltd., an Israeli corporation, and ii Ventures Private Limited (iiV), an Indian company, announced today that they have entered into a memorandum of understanding to develop a system to screen the largely rural Indian population for peripheral artery disease (PAD). The devices, which allow for the early detection of the disease before tangible symptoms appear, will utilize the same technology that VOTIS is building into other devices intended for use in the US and Europe.

"PAD afflicts between 41 and 54 million Indians. Many of these people are impoverished, illiterate, and lack access to good healthcare," said Alfred Arambhan, Co-Founder and Mentor of iiV. "There is a great need for a system that is convenient, accurate, and affordable. We have found it in the VOTIS technology."

"In India, access to healthcare among the rural population is extremely limited," Mr. Arambhan explained. "Preventative healthcare is especially difficult to implement. In poor rural communities, preserving feet is crucial. Since rural life is agricultural, when someone loses a foot to amputation he is in a particularly desperate economic state, even as compared to the urban poor."

Mr. Arambhan continued, "India has been declared the Diabetic Capital of the world. Our initial plan is to establish VOTIS solutions in villages throughout India, and to create a robust and reliable platform for introducing and launching similar devices and solutions in the future. We are gratified that our plan has received encouragement and support from Governmental, private, and NGO sources in India."

"Our technology is especially suited for the Indian market," said Merrill Weber, Chief Executive Officer and President of VOTIS. "Our devices are entirely non-invasive and do not use X-rays (Roentgen) or other ionizing radiation. They are inexpensive and dependable. In India, the screening devices will enable easy, intuitive use. That will permit testing to be performed by technicians and nurses in the villages rather than medical doctors at hospitals or clinics. People found to have PAD will immediately be directed to specific locations where they can receive suitable medical treatment. With early disease identification and quick access to medical care, we expect incidence of PAD-related amputation to be reduced substantially."

Mr. Arambhan added, "We look to this plan to be a game changer in the Preventive Health Care Space in India."

The VOTIS devices use vascular optical tomographic imaging, or VOTI, an imaging technology developed under the leadership of Prof. Andreas Hielscher, professor and chair of the newly-formed Department of Biomedical Engineering at the New York University Tandon School of Engineering. The technology was developed in Prof. Hielscher's biophotonics and optical radiology laboratory, which he ran as professor of biomedical engineering, radiology and electrical engineering at the Fu Foundation School of Engineering and Applied Sciences at Columbia University.

VOTIS plans to release its devices commercially in 2022.

About VOTIS Subdermal Imaging Technologies, Ltd.

VOTIS Subdermal Imaging Technologies, Ltd. is an Israeli corporation that is developing a suite of devices that will be used to help diabetic patients keep their feet. The first device, the PedCheck, will be used to screen the feet of asymptomatic patients for PAD. If PAD is found, then the second device, the PedScan, will be used to stage and monitor disease progression and the impact of therapies applied by the patient's physician. The third device, the PedFlo, will be used during a revascularization procedure, in order to inform the practicing doctor regarding the level of blood flow in the foot. All three VOTIS devices use the same technology, software, and system architecture. They are safe, non-invasive, and free of ionizing radiation. More information is available at http://www.votis.net.

About ii Ventures Private Limited

ii Ventures Private Limited was Co-Founded and Mentored by Alfred Arambhan an early well-wisher of Israel India Business & Cultural relationship for the last 18 years. He is a Mumbai-based Serial Entrepreneur. Mr. Arambhan founded iiV to bring Israeli knowhow, technology, and experience to India in the Health, Agri, and Deep Tech space. iiV has been invited by a Singapore based US$50 Million fund to partner in their Business Plan. Mr. Arambhan's daughter, Pooja Armbhan, is CEO of iiV. She is an Israel-Asia Fellow who received her MBA from Tel Aviv University on a full scholarship from the Parasol Foundation.

For further information, contact: Merrill WeberTel.: (312) 340-0895Tel.: +972-(0)58-406-2386Email: merrillweber@votis.net

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SOURCE VOTIS Subdermal Imaging Technologies, Ltd.

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Monday Medical: Tips for a healthy New Year – Steamboat Pilot and Today

Monday, December 28th, 2020

STEAMBOAT SPRINGS Fostering good health is about more than just avoiding COVID-19: from dealing with chronic pain to practicing self-care, here are tips from local providers for having a healthy new year.

An ounce of prevention: From cancer screenings to staying up to date on vaccinations, preventative medicine is a key part of fostering good health.

Were trying to reinforce healthy lifestyle habits to keep people healthy for decades to come, said Dr. Kevin Borgerding, an internal medicine physician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. Its about disease prevention and health maintenance, or trying to maintain the best health we can for the long term so were not struggling as we mature.

Having a regular physical will help you ensure your health is on track. Recommendations on screenings, blood tests and vaccines vary by age and health conditions, so work with your provider to know whats best for you.

Address chronic pain: When overactive nerves are messaging theres pain even after an injury has healed, it can be helpful to address them with a multi-pronged approach to calming them down. That includes interventional steps such as neural stimulation, needling procedures and pain medication, as well as physical therapy, acupuncture, massage and behavioral health treatments.

Keep in mind that the increased stress and isolation at this time can be especially challenging for people dealing with chronic pain.

Anxiety can escalate pain. Social isolation can escalate pain. Lack of opportunities to exercise and recreate can escalate pain, said Amy Goodwin, a licensed professional counselor and behavioral health specialist with UCHealth Yampa Valley Medical Center. Its more important than ever for people to seek help when they need it.

Support your anxious child: In a year that seems filled with anxiety, you may find your child struggling.

Keep in mind that its normal for children to experience anxiety, as long as it is transient and can be calmed with reassurance from a parent.

But if a childs fear or worry is intense, doesnt resolve with reassurance, or interferes with how the child functions at home or school, they may have an anxiety disorder.

Anxiety is the most common emotional problem in children, affecting 8% of children ages 3 to 17, said Dr. Sheila Fountain, a pediatrician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. That number increases to 25% if we look at just 13- to 18-year-olds.

Through a combination of cognitive behavioral therapy, a healthy lifestyle and sometimes medication, children struggling with an anxiety disorder often see signs of improvement in two to four weeks.

Practice self-care: Theres no doubt its been a stressful year, which makes finding ways to take care of yourself more important than ever. Self-care involves a range of efforts, from regular movement and healthy eating, to mental and social health.

Self-care will allow you to incorporate more fun into your life, to create more room for joy, said Molly Lotz, a behavioral health social worker with UCHealth Yampa Valley Medical Center. Youll feel better and your anxiety will decrease.

When incorporating self-care into your routine, start small and dont forget the fun parts, such as incorporating play and laughter.

And remember that taking care of yourself allows you to better care for those you love.

If our tank is empty, something is going to suffer our health, our relationships, Lotz said. But if were prioritizing what we need and what makes us feel healthy and good, then were automatically more available for the other people in our lives.

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.

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Deep Longevity Adds Three Medical Organizations To Its Growing Longevity Network: Healthy Hire Healthy Retire, International Medical Clinics and Peak…

Monday, December 28th, 2020

TipRanks

Semiconductors are one of the modern worlds essential industries, making possible so much of what we rely on or take for granted: internet access, high-speed computers with high-speed memory, even the thermostats that control our air conditioning there isnt much, tech-wise, that doesnt use semiconductor chips.With the end of 2020 in sight, its time for the annual ritual of evaluating the equities for the New Year. Wells Fargo analyst Aaron Rakers has cast his eye on the chip industry, tagging several companies as likely gainers next year.The analyst sees several factors combining to boost demand for chips in 2021, including cloud demand, new gaming consoles, and a market resolution to the future of the PC segment. Overall, however, Rakers expects that memory chips and 5G enabled chips will emerge as the drivers of the industry next year. The analyst expects that semiconductor companies, as a group, will see between 10% and 12% growth over the next 12 months.Thats an industry-wide average, however. According to Raker, some chip companies will show significantly higher growth, on the order of 30% to 40% in year ahead. We can look at those companies, along with the latest TipRanks data, to find out what makes these particular chip makers so compelling.Micron Technology (MU)Among the leading chip makers, Micron has staked out a position in the memory segment. The company has seen its market cap expand to $78 billion this year, as shares have appreciated 32% year-to-date. The surge comes on a product line heaving on computer data storage, DRAM, and flash storage.Look back at 2020, Micron has seen revenues increase each quarter, from $4.8 billion in Q1 to $5.4 billion in Q2 to $6.1 billion in Q3. Earnings came in at 87 cents per share, up from 71 cents in Q2 and 36 cents in Q1.The calendar third quarter was Microns 4QFY20, and the full fiscal year showed a decline due attributed to the COVID pandemic. Revenue came in at $21.44 billion, down 8.4% year-over-year, and operating cash flow fell to $8.31 billion from $13.19 billion in FY19. During this past quarter, Microns 1QFY21, the company announced the release of the worlds first 176-layer 3D NAND chip. The new chip promises higher density and faster performance in flash memory, and the architecture is described as a radical breakthrough. The layer count is 40% higher than competing chips.Looking ahead, Micron has updated its F1Q21 guidance, predicting total revenue of $5.7 billion to $5.75 billion. This is a 10% increase from the previous guidance.Wells Fargo's Aaron Rakers calls Micron his top semiconductor idea for 2021. He points out a deepening positive view on the memory, and in particular the DRAM industry. DRAM accounts for approximately two-thirds of Microns revenue and over 80% of the companys bottom-line profits. In addition, Rakers notes Microns technology execution 1Znm DRAM leadership; recently outlined 1nm ramp into 2021, as well as Microns move to 176-Layer 2nd -gen Replacement Gate 3D NAND to drive improved cost curve. We would also highlight Microns execution on graphics memory (e.g., GDDR6X), Multi-Chip Packages (MCPs), and High-Bandwidth Memory (e.g., HBME2) as positives.In line with these comments, Rakers rates Micron shares a Buy, along with a $100 price target. This figure suggests room for 41% growth in 2021. (To watch Rakers track record, click here)Micron has 24 recent reviews on record, breaking down to 19 Buys, 4 Holds, and 1 Sell, and giving the stock a Strong Buy from the analyst consensus. Shares are priced at $70.96, and recent appreciation has pushed them almost to the $74.30 average price target. But as Rakers outlook suggests, there may be more than just 4.5% upside available here. (See MU stock analysis on TipRanks)Advanced Micro Devices (AMD)With $6.5 billion in total sales last year, and a market cap of $110.7 billion, AMD is a giant company but it doesnt even crack the top five of the worlds largest chip makers. Still, AMD has a solid position in the industry, and its x86 processors provide stiff competition for market-leading Intel (INTC). AMD shares have shown solid growth this year, and are up 101% as 2020 comes to a close.The share growth rides on the back of steady revenue gains since the corona crisis peaked in Q1. AMDs Q3 top line came in at $2.8 billion, up 55% from the $1.8 billion recorded in the year-ago quarter and beating the forecast by 10%. Earnings, at 37 cents per share, were up 220% year-over-year. The company credited the growth to solid results in the PC, gaming, and data center product lines, and boasted that it was the fourth consecutive quarter with >25% yoy revenue growth.AMD announced last month a new product for the scientific research market, the Instinct MI100 accelerator. The new chip is billed as the worlds fasted HPC GPU, and the first such x86 server to exceed 10 teraflops performance.Covering AMD for Wells Fargo, Rakers wrote: We remain positive on AMDs competitive positioning for continued sustained gradual share gains in PCs We also believe AMDs deepening data center GPU strategy with new Instinct MI100 GPUs and the release of RoCM 4.0 software platform could become increasingly visible as we move through 2021. AMDs roadmap execution would remain an important focus 7nm+ Ryzen 4000-series, new RDNA Radeon Instinct data center GPUs (MI100 / MI120), and the 3 rd -gen 7nm+ EPYC Milan CPUsRakers stance supports his Buy rating, and his $120 price target implies a 30% one-year upside to the stock.The Moderate Buy analyst consensus view on AMD reflects some residual Wall Street caution. The stocks 20 recent reviews include 13 Buys, 6 Holds, and 1 Sell. AMD shares are selling for $91.64, and like Micron, their recent appreciation has closed the gap with the $94.71 average price target. (See AMD stock analysis on TipRanks)Western Digital Corporation (WDC)Closing out the Wells Fargo picks on this list is Western Digital, a designer and manufacturer of memory systems. The companys products include hard disk drives, solid state drives, data center platforms, embedded flash drives, and portable storage including memory cards and USB thumb drives. WDC has had a tough year in 2020, with shares down 19% year-to-date. Still, the stock has seen gains in November and December, on the heels of what was seen as a strong fiscal 1Q21 report.That earnings report showed $3.9 billion in revenue, which was down 3% year-over-year, but the EPS net loss, at 19 cents, was a tremendous yoy improvement from the 93-cent net loss in the year-ago quarter. The earnings improvement, which beat the forecast by 20%, was key for investors, and the stock is up 30% since the quarterly report. The company also generated a solid cash flow in the quarter, with cash from operations growing 111% sequentially.Wells Fargos Rakers acknowledges WDCs difficulties in 2020, but even so, he believes that this is a stock which is worth the risk.Western Digital has been our toughest constructive call of 2020 and while we believe calling a bottom in NAND Flash (mid/2H2021?) remains difficult and WDs execution in enterprise SSDs will remain choppy, our SOTP analysis leaves us to continue to believe that shares present a compelling risk / reward. We continue to believe that Western Digital can drive to a ~$7/sh.+ mid-cycle EPS story; however, we continue to think a key driver of this fundamental upside will not only be a recovery in the NAND Flash business, coupled with WDs ability to see improved execution in enterprise SSDs, but also a continued view that WDs HDD gross margin can return to a sustainable 30%+ level, Rakers opined.To this end, Rakers rates WDC a Buy along with a $65 price target. Should the target be met, investors could pocket gains of 29% over the next months Where does the rest of the Street side on this computer-storage maker? It appears mostly bullish, as TipRanks analytics demonstrate WDC as a Buy. Out of 11 analysts tracked in the last 3 months, 7 are bullish, while 4 remain sidelined. With a return potential of 9%, the stocks consensus target price stands at $54.44. (See WDC stock analysis on TipRanks)To find good ideas for tech stocks trading at attractive valuations, visit TipRanks Best Stocks to Buy, a newly launched tool that unites all of TipRanks equity insights.Disclaimer: The opinions expressed in this article are solely those of the featured analysts. The content is intended to be used for informational purposes only. It is very important to do your own analysis before making any investment.

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Emerging Options for Treatment and Prevention of HIV Infection – Contagionlive.com

Monday, December 28th, 2020

Moderator

Joseph Eron, MDProfessor of Medicine, Division of Infectious DiseasesUniversity of North Carolina School of MedicineChapel Hill, NC

Panelists

Allison L. Agwu, MD, ScMAssociate Professor of Pediatric and Adult Infectious DiseasesJohns Hopkins University School of MedicineBaltimore, MD

Ian Frank, MDProfessor of MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphia, PA

Colleen F. Kelley, MD, MPHAssociate Professor of Medicine, Division of Infectious DiseasesEmory University School of MedicineAtlanta, GA

Julia Marcus, PhD, MPHInfectious Disease EpidemiologistAssociate Professor, Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care InstituteBoston, MA

New antiretroviral drugs with unique mechanisms of action and delivery provide promising options for treatment and pre-exposure prophylaxis (PrEP) of HIV infection and may improve adherence in certain subgroups of individuals. However, the development of an effective vaccine remains elusive, according to experts who participated in a recent Contagion Peer Exchange panel.

Emerging Treatment Options for HIV

Fostemsavir (formerly BMS-663068/GSK3684934), a prodrug whose active metabolite (temsavir) is a first-in-class attachment inhibitor that binds directly to the viral envelope glycoprotein 120 near the CD4+ binding site,1 was approved by the FDA on July 2, 2020, for adults living with HIV who have tried multiple HIV medications and whose infection cannot be treated with other therapies because of resistance, intolerance, or safety reasons.2 This approval was based largely on results from a phase 3 trial, which showed a virologic response (HIV-1 RNA <40 copies/mL) at week 48 in 54% of patients with heavily pretreated, multidrug-resistant HIV infection who received fostemsavir plus optimized background therapy.3 Session moderator Joseph Eron, MD, said that its oral dosing is advantageous over ibalizumab, which is dosed intravenously, although he said that fostemsavir will probably be limited for patients with few or no treatment options.

Allison Agwu, MD, added that long-acting injectable and oral agents, capsid inhibitors, and monoclonal antibodies are also being studied in the HIV space, as are alternative delivery approaches, such as subcutaneous injections, pumps, implants, and patches. However, she pointed out that access to and the cost of these novel options will be key issues moving forward, particularly when currently available oral agents are highly effective for suppressing HIV viral load in the majority of cases.

The discussions well have to have on how and who and where are going to be very important, said Agwu. It doesnt mean we shouldnt have those discussions because for the people who are living with HIV, these are maybe life-saving, game-changing remedies for them.

Long-Acting Injectable Therapies to Treat HIV

The panelists discussed potential uses and challenges with the long-acting injectable therapy containing cabotegravir (an HIV-1 integrase strand-transfer inhibitor) and rilpivirine (a non-nucleoside reverse-transcriptase inhibitor), which is injected in 2-mL doses in the gluteus medius every 4 weeks for the maintenance of virologic suppression in patients who are initiating or transitioning therapy. Although the FDA declined to approve the combination in December 2019 due to concerns related to chemistry manufacturing and controls, the drug manufacturer (ViiV Healthcare) stated that no related safety issues have been reported and the safety profile of the products has not changed. ViiV Healthcare submitted another new drug application that was accepted in April 2020.

Colleen Kelley, MD, said that a benefit of long-acting injectable dosing is that it may help reduce the internalized stigma for many individuals living with HIV who take a daily oral medication. Its a constant reminder when you have that pill bottle on your bathroom stand that says, I am HIV positive, she noted.

However, the panelists pointed out potential drawbacks with long-acting injectables, such as the risk for drug resistance in patients who miss injections and the possible need to modify the clinic set-up to ensure availability of nursing staff when patients are receiving injections.

Although there may be some adherence problems that get solved by the injections, I think that there are other adherence risks that get created, said Ian Frank, MD. Itll be more incumbent upon us as providers to ensure that our patients are coming in at the appropriate frequency, and we may need to modify our practices.

Long-Acting Injectables as Pre-Exposure Prophylaxis

Long-acting injectable therapy with cabotegravir may provide a discreet option for PrEP that does not require daily dosing, according to a recent interim analysis of the phase 2b/3 HPTN 083 trial (NCT02720094).4 The interim results from the trial showed that cabotegravir injection every 8 weeks was superior to daily oral emtricitabine/tenofovir (Truvada) for preventing HIV acquisition in cisgender men who have sex with men and transgender women who have sex with men.4

To have population-level effectiveness, long-acting injectable PrEP needs to cater to a population of individuals who are eligible for and interested in receiving it but are not interested in daily oral PrEP, according to Julia Marcus, PhD. If the only people who are interested in long-acting PrEP are people who are already taking daily PrEPits not going to have any population-level effectiveness, she said.

Marcus added that identifying individual barriers to receiving oral PrEP is important to assess whether long-acting injectable PrEP is appropriate for them, noting that it would be more likely to benefit an individual who forgets to take daily medications than one who has difficulty with coming into the clinic.

If their [issue is] that they dont want to be coming into the clinic every 3 months, long-acting injectables may not help them, she said. They may have to come in even more.

Other individuals who may be good candidates for long-acting injectable PrEP include those for whom having oral medication may put them at risk for bodily or emotional harm, such as people in unequal power relationships, commercial sex work, or homeless living situations, said Eron and Marcus. Individuals who use injectable drugs or are on methadone maintenance may also be good candidates for PrEP if they come in frequently for syringe changes, said Marcus.

Agwu added that long-acting injectable PrEP could also expand the options in the armamentarium for a given patient at different times of their life.

If a patient has to go abroad for 2 months, maybe thats the time to get your shot, she said. You dont have to worry about taking your pills to Morocco.

She said that further work is needed to optimize system and administration issues and improve practices for delivering long-acting injectable therapy in the clinic. Eron concluded that further research to ensure the efficacy and demedicalization of PrEP is important to improve uptake, as the perception that PrEP care is more intensive than HIV care continues to persist among individuals who are eligible for PrEP.

Preventative and Therapeutic HIV Vaccines

Although the phase 2b/3 HVTN702 trial (NCT02968849), which studied the RV144 Thai vaccine regimen for the prevention of HIV infection in South Africa, was recently discontinued because of a lack of efficacy, Kelley said that this outcome does not mark the end of the journey for finding an effective vaccine, which will be the key to ending the HIV epidemic.

Theres still more work to be done and no reason to lose hope, she said. Were thinking about monoclonal antibodies and long-acting antiretrovirals in place of a traditional vaccine.

Kelley said that researchers are getting closer to identifying what the immune system needs to do to protect itself from HIV infection. If these neutralizing antibodies are the key, how do we make our human immune system create those neutralizing antibodies? .Thats been extremely difficult to do, she said. We can make the antibodies outside the person, but we cant make the person produce the antibodies. This is the biggest barrier right now.

Frank added that therapeutic vaccines are also being investigated as a strategy for curing HIV, with cure defined in the context of doing something other than requiring people to take regular antiretroviral therapy to control the virus replication. Specifically, the goal of a therapeutic vaccine is to improve the individuals immune response against the infection to enable the withdrawal of antiretroviral therapy and promote an improved immune response to control virus replication, said Frank. He concluded that although therapy and prevention continue to improve, the absence of an effective vaccine and a cure are the real vacuum in HIV prevention and treatment, respectively.

Advice for Physicians Treating Patients with HIV

At the conclusion of the exchange, the panelists discussed tips for physicians in the screening, diagnosis, and treatment of patients living with HIV. Agwu stressed the importance of asking patients about risk factors for HIV, including sexual activity, and testing and offering PrEP for patients at high risk. Kelley added that in addition to routine discussions about sexual health, maintaining consistency in the treatment of each patient and identifying other issues that are common to those living with HIV, such as other sexually transmitted infections, is important.

Marcus added that discussing sexual health in an open-ended, nonjudgmental, patient-centered way is important for optimal communication with patients and that communicating the U = U (undetectable = untransmissible) message can be transformative for them.

Frank concluded that although undetectable viral load is often the primary focus of antiretroviral therapy, providers should also consider additional factors, such as comorbid conditions, when optimizing HIV therapy and managing overall care for patients.

Its important that we remind our patients that they may have other medical conditions, or they may develop other medical conditions, and those medical conditions may pose as great a risk, if not a bigger risk, than their HIV disease, said Frank. I have many patients with uncontrolled hypertension and uncontrolled diabetes and lipids that are high. I tell them that theyre going to die of a heart attack or a stroke or be on dialysis long before they ever get a complication of their HIV. Dying of a heart attack with an undetectable viral load isnt my goal of their treatment. Its not just about their HIV.

References

1. Langley DR, Kimura SR, Sivaprakasam P, et al. Homology models of the HIV-1 attachment inhibitor BMS-626529 bound to gp120 suggest a unique mechanism of action. Proteins. 2015; 83(2):331-350. doi:10.1002/prot.24726

2. FDA approves new HIV treatment for patients with limited treatment options. Press release. FDA. July 2, 2020. Accessed October 13, 2020. https://www.fda.gov/news-events/press-announcements/fda-approves-new-hiv-treatment-patients-limited-treatment-options.

3. Kozal M, Aberg J, Pialoux G, et al; BRIGHTE Trial Team. Fostemsavir in adults with multidrug-resistant HIV-1 infection. N Engl J Med. 2020;382(13):1232-1243. doi:10.1056/NEJMoa1902493

4. Long-acting injectable form of HIV prevention outperforms daily pill in NIH study. News release. National Institutes of Health. July 7, 2020. Accessed October 13, 2020. https://www.nih.gov/news-events/news-releases/long-acting-injectable-form-hiv-prevention-outperforms-daily-pill-nih-study

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Antibody study aims to protect those exposed to coronavirus from illness – The Jerusalem Post

Monday, December 28th, 2020

Two new clinical trials in the UK are examining whether administering an antibody combination after someone has already been exposed to the novel coronavirus could protect them from developing COVID-19, the disease caused by the virus.

The University College London Hospitals (UCLH) NHS Trust announced on Friday that it is running the trials at a new vaccine research center.

Both trials are examining AZD7442, a long-acting antibody (LAAB) combination developed by AstraZeneca.

The first study, called STORM CHASER, is examining whether the antibody can provide immediate and long-term protection to people recently exposed to the SARS-CoV-2 virus.

We know that this antibody combination can neutralize the virus, so we hope to find that giving this treatment via injection can lead to immediate protection against the development of COVID-19 in people who have been exposed when it would be too late to offer a vaccine, said study leader UCLH virologist Dr. Catherine Houlihan in a press release from the hospital.

STORM CHASER had recruited 10 people as of Friday. Key participants will include healthcare workers, students in group housing, patients exposed to anyone with the virus, residents of long-term care facilities and those in industrial or military settings.

THE SECOND study, called PROVENT, is examining whether people who may not respond to the vaccine, including immuno-compromised people, or at-risk groups, such as the elderly or those with preexisting conditions, may be helped by AZD7442, even prior to exposure.

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We will be recruiting people who are older or in long-term care, and who have conditions such as cancer and HIV, which may affect the ability of their immune system to respond to a vaccine," said UCLH infectious diseases consultant Dr. Nicky Longley, the head of the study. "We want to reassure anyone for whom a vaccine may not work that we can offer an alternative, which is just as protective.

Both UCLH studies will examine whether AZD7442 reduces the risk of developing COVID-19 and/or reduces the severity of the infection compared to a placebo.

Trial participants will be able to safely leave the study in order to get licensed vaccines if it is deemed medically beneficial, according to UCLH.

Antibodies are produced by the body to help fight infections. Monoclonal antibodies are artificially produced in laboratories for possible medical treatments in patients already infected with the virus and could provide protection before exposure as well.

While vaccines train the body over a matter of weeks to produce its own antibodies, antibody injections skip that step, aiming to provide immediate protection against viruses.

AZD7442 is a combination of two LAABs derived from recovering patients that were discovered by Vanderbilt University Medical Center and then licensed to AstraZeneca, according to the company, which then optimized the LAABs with half-life extension in order to increase the durability of the therapy for six to 12 months. The combination is also designed to reduce the risk of resistance developed by the virus.

In pre-clinical experiments published in Nature, the LAABs in AZD7442 were shown to block the novel coronavirus from binding with host cells, protecting against infection.

UCLH'S NEW Vaccine Research Center, which opened in December, is operating under the patronage of the National Institute of Health Research (NIHR) UCLH Biomedical Research Center and the UCLH Research Directorate, and represents an extension of the NIHR UCLH Clinical Research Facility led by Prof. Vincenzo Libri.

Libri is also a principal investigator on the Oxford/AstraZeneca vaccine trial and provides oversight of all COVID-19 vaccine/preventative treatment trials.

Mene Pangalos, AstraZeneca's executive vice president of BioPharmaceuticals Research & Development, stated in the UCLH release that AZD7442 has the potential to be an important preventative and therapeutic medicine against COVID-19, focusing on the most vulnerable patients."

"The STORM CHASER trial in particular is a unique approach, with enrollment initiated on site following the identification of a confirmed case to halt the spread of COVID-19 in the facility or community," Pangalos said. "We offer our appreciation and gratitude to everyone involved in these trials from the scientists, researchers and clinicians, to the trial participants and study sites as we all work together to help end this pandemic.

Antibody treatments have been evaluated since nearly the beginning of the pandemic.

In May, the Israel Institute for Biological Research (IIBR) completed a groundbreaking scientific development, identifying an antibody that neutralizes the coronavirus.

Maayan Jaffe-Hoffman, Anna Ahronheim and Idan Zonshine contributed to this report.

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Antibody study aims to protect those exposed to coronavirus from illness - The Jerusalem Post

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Prairie People: New hires and promotions – Grand Forks Herald

Monday, December 28th, 2020

Dale Carnegie of North Dakota and Northwest Minnesota has new ownership

FARGO, N.D. Bethany Berkeley is now the CEO and co-owner of Dale Carnegie of North Dakota and Northwest Minnesota. She partners with Katie Munion, who is the chief transformation officer and co-owner.

Both women begin this journey with strategic focus, a wealth of experience and grateful hearts. Theyve been in the business and know the industry. Prior to ownership, Berkeley was the managing partner and president, and Munion was the vice president of training and quality.

They are excited to continue offering the core Dale Carnegie courses and in-house customized training solutions with a specialized focus on communication and interpersonal skills, presence and storytelling, sales and customer service excellence, leadership training for new and aspiring managers and experienced managers. All solutions are offered in versatile formats: in-person (socially distanced at minimum capacity), live-online, or blended.

They represent clients primarily in the manufacturing, distribution, engineering, construction, government, agriculture, technology, finance, and professional service industries. They also have a new space to collaborate and facilitate training solutions -- the Railyard at 1630 1st Ave. N. in Fargo.

Enclave welcomes two new team members

FARGO, N.D. Ashley Kossan has joined Enclave as accounts payable & receivable specialist.

A graduate of North Dakota State University, Kossan brings experience as an accountant, mortgage loan officer and royalties analyst. Originally from Minot, N.D., she previously served as an accountant at Legendary Capital.

Enclave also has hired Travis Golobich as assistant project manager.

A native of Coon Rapids, Minn., and a graduate of North Dakota State University, Golobich joins Enclave with more than seven years of experience in project management. Previously, he served as project manager at Moorhead Electric.

In his role at Enclave, Golobich will assist in collaborating with the construction and design teams, sub- contractors, and clients to ensure timely project delivery within budget.

Essentia Health hires new health provider

FARGO, N.D. Essentia Health welcomes Dr. Olayinka David Ajayi

Dr. Olayinka David Ajayi has joined the Essentia Health team in Fargo, where he specializes in hyperbaric medicine. Hyperbaric oxygen therapy is a noninvasive, painless procedure that uses 100% oxygen in a pressurized chamber to improve the bodys natural healing process, treat carbon monoxide poisoning and other FDA/UHMS approved medical conditions.

Dr. Ajayi received his medical education at the University of Ibadan College of Medicine, Nigeria. He earned his masters degree in public health and completed a residency in public medicine at Emory University Public Health, Atlanta, Ga.

His fellowship in undersea and hyperbaric medicine was completed at Hennepin Healthcare in Minneapolis, Minn. Dr. Ajayi is board certified by the American Board of Medical Specialties in public health and general preventative medicine.

Alerus hires new senior business advisor and senior financial guide

FARGO, N.D. Alerus has welcomed Brad Loween as senior business advisor. In this role, Loween serves as the trusted point of contact for business clients, delivering comprehensive financial advice to help them achieve their financial wellness goals.

Loween works closely with experts across Alerus to serve business clients holistic financial needs and ensure access to the companys full suite of diversified services.

Loween has nearly a decade of experience in the financial industry, with expertise in wealth management and business banking. He holds a bachelors degree in biology from Montana State University and served 21 years in the North Dakota National Guard, including deployments to Afghanistan and Kosovo.

He is a volunteer for the Fargo Moorhead West Fargo Chamber of Commerces Military Affairs committee and the Department of Defenses Employer Support of the Guard and Reserve program. He also serves as a board member for Rebuilding Together of Fargo-Moorhead.

Alerus also has welcomed Isaac Bumgardner as senior financial guide. In this role, Bumgardner is responsible for assisting clients in identifying their specific financial needs and providing comprehensive advice to help them achieve their financial wellness goals.

He works closely with experts across Alerus to ensure each client has access to the companys full suite of diversified services.

Both of the new hires are based at Alerus office at 51 Broadway in Fargo.

Send your promotions and new hire information to aweeks@prairiebusinessmagazine.com.

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2-year degrees that go on to the most meaningful jobs – Gwinnettdailypost.com

Monday, December 28th, 2020

A third of a lifetime is spent working, making a meaningful career a critical life decision. Having a consequential career is not about monetary gain for many hard-working Americans. On the contrary, it is about making a marked difference in the world. Take, for example, teachers, who shape the minds of future generations. While the entry-level annual salary for teaching is slim compared to other careers, it doesn't stop the thousands who pursue a career in education because they find great purpose in their profession.

Studies also show that those who love their work live longer, which is a priceless consideration when choosing a profession. Balancing out working a meaningful job and making the median full-time wage (around $50,000) can be challenging, but it's possible to live the dream and make a decent living at the same time. Stacker compiled a list of two-year degrees using 2020 data from Payscale on the most meaningful employment. Jobs are ranked by degrees whose graduates report having a high meaning job, with ties broken by highest mid-career pay.

Many of the degree programs and jobs listed are in the health care field, ranging from medical secretarial science to alcohol and drug studies. While some find meaning in providing administrative support, others find daily joy in performing diagnostic tests. All of the jobs listed assist the general public in one way or another, requiring an altruistic attitude.

Money certainly plays a small role in job satisfaction, with seven of the top 10 most meaningful jobs earning mid-career pay above $60,000 per year. Helping others won out over money however, as the top job on the list saw its professionals earn less than $50,000 by the mid-point of their careers.

Continue reading to find out the two-year degrees that go on to the most meaningful jobs.

You may also like: Highest-paying state for 50 different jobs

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Why Data is the Real Value Behind VR – MarketScale

Monday, December 28th, 2020

On Spatial Perspectives, host Dan Cui will have a one-on-one dialog with innovators and thought leaders in the growing Spatial Reality, or Spatial Computing, market. Cui will invite guests who can discuss the real world use cases of the technology and how it could benefit mankind while exploring any drawbacks and how they might be mitigated.

It is an undeniable fact that data affects our everyday lives. While data gets a bad rap in the news when associated with data breaches or privacy concerns, the collecting and analyzing of data can change lives. Stan Karpenko, Co-Founder & CTO at GiveVision knows this first hand. Dan Cui, Host, Spatial Perspectives, sat down with Karpenko to learn more about the true value of data.

GiveVisions goal is to make the lives of visually impaired people better with the help of their products and services. One such asset they provide to those who are visually impaired is a services product thats attached to their glasses that will allow the clinicians to have the ability to actually monitor their patient and provide new treatment regimes for that patient based on what they see happening on a daily basis.

When it comes to data, Karpenko feels it is a vital element of developing products that can help people. I think the data becomes the key part. I think the hardware becomes irrelevant over time, it will become a commodity. The real insights and the real values in the data, Karpenko said. He posed important questions like, can we effectively collect the healthcare data about the patient over a long period of time to make clinical decisions? Can we arrive at a point in time where we dont need the patient to call the doctor when they can feel the symptoms? Can we pick up the symptoms before they can feel them? So the entire sort of changing the career pathway is really what we see as the biggest opportunity facing the AR and VR world. I think, in reality, theres an enormous opportunity for AR and VR companies to develop products that will, just the same as smartwatch, become just a vehicle to collect healthcare data for the benefit of the patient, Karpenko explained.

He believes that those devices will be used for entertainment, or in our case as an enabler for them to do things. But as a byproduct of that, they will be able to watch for patients and inform the doctor when they need to see the patient before its too late. So thinking about preventative medicine if you like, Karpenko said.

For more insight into how data is a key element of progress, listen in to this weeks episode of Spatial Perspectives.

Follow us on social media for the latest updates in B2B!Twitter @TechMKSLFacebook facebook.com/marketscaleLinkedIn linkedin.com/company/marketscale

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MK warns of spiritual side effects as vaccination drive continues on Shabbat – The Times of Israel

Monday, December 28th, 2020

Ignoring rabbis objections, and prompting fury from religious politicians, Israel vaccinated thousands of citizens on Shabbat.

The Health Ministry views all-week-long vaccination as key to achieving quick coronavirus protection part of a plan, which also involves 24-hour clinics, to vaccinate more than 150,000 a day.

This past Saturday, the first of the vaccination drive, all four healthcare providers carried on giving shots to the 60-plus public, albeit at significantly reduced capacity, they told The Times of Israel.

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MK Uri Maklev of United Torah Judaism slammed the Health Ministry for encouraging it. How will there be a blessing for the work of their hands, when they harm Shabbat and the [religious] public in such a serious manner? he asked rhetorically in a Haredi newspaper on Sunday.

A woman receives a coronavirus vaccine at a clinic run by the Meuchedet healthcare provider. (courtesy of Meuchedet)

The politician claimed that Health Minister Yuli Edelstein had promised him that there would not be Shabbat vaccinations, and attacked the justification given to administer them.

Edelstein said it was done so that the country can quickly deliver COVID-19 protection, and invoked the Jewish legal principle of saving a life, or pikuah nefesh, which trumps nearly all other religious requirements, including Shabbat. The coronavirus endangers all of us, the vaccines will save all of us, he said.

Hospital workers in protective gear are seen in the coronavirus ward at Ziv Medical Center in the northern city of Safed on October 7, 2020. (David Cohen/Flash90)

But many Orthodox Jews say that pikuah nefeshdoes not normally extend to preventative medicine. They put everything in the category of pikuah nefesh, Maklev said of Health Ministry leaders. We have seen in the past that many of their instructions did not stand up to scrutiny.

There is no prohibition on administering or receiving a vaccine on Shabbat, according to most rabbis, but they say clinics should stay shut because their operation involves other actions considered to desecrate the holy day of rest, like logging patient information on computers and operating other electrical items that are needed. They also express concern that people are made to break the religious rule against driving on Shabbat to make their appointments.

The chief rabbis have refused to back operation of vaccine centers on Shabbat for now. Currently, there is no permission to violate Shabbat for the sake of vaccination, Ashkenazi Chief Rabbi David Lau said on Thursday, according to Orthodox media.

Israels Ashkenazi Chief Rabbi David Lau at the Western Wall, in the Old City of Jerusalem, July 21, 2019. (Noam Revkin Fenton/Flash90)

He stressed that he supports vaccination, but argued that so long as clinics are not operating during every hour of every other day, working on Shabbat is not justified. For now, they should ramp up capacity without working Saturdays, he argued.

If and when clinics are vaccinating 24/6, it will be possible to consider also vaccinations on Shabbat, Lau said.

Even if the chief rabbinate eventually gives its blessing to Shabbat shots, there are indications that some influential ultra-Orthodox rabbis will remain steadfast in their objection to them.

The massively influential ultra-Orthodox halachic authority Rabbi Asher Weiss wrote that the situation is not urgent enough to consider vaccination an act of pikuah nefesh.

Rabbi Asher Weiss. (Gershon Ellinson/Flash90)

He was responding to questions from the UK and the US, so it is possible that he will issue another ruling regarding Israel. If he does not, Shabbat vaccination, even if part of a 24/7 campaign, is likely to remain taboo for a large part of the Israeli Haredi community, including politicians from Maklevs party, who revere the rabbi.

The one proviso in Weisss position was for people in high-risk categories, or who risk infecting people who are high-risk. If they have Shabbat appointments that cannot be moved without incurring delays, in some circumstances, he would allow them to be treated and even driven to the vaccination station in certain cases, though by a non-Jewish person, and not by a Jewish person who, in his estimation, is supposed to be observing Shabbat.

Religious objections are not stopping healthcare providers. A spokeswoman for Maccabi Healthcare Services told The Times of Israel that her nurses vaccinated 7,000 people on Shabbat, some of whom had appointments for next month and were offered to vaccinate earlier if they took Saturday appointments. Opposition from rabbis would not stop them during future weekends, she said.

Meuhedet gave 1,500 injections, mostly in Netanya and Tel Aviv. Leumit gave 2,000, mostly in central Israel. Clalit only operated in the Arab Jerusalem neighborhood of Sheikh Jarrah.

Weiss and Lau both hail from the ultra-Orthodox community. But while religious Zionist rabbis are often thought to take more lenient approaches than their Haredi counterparts, when it comes to this issue, they have not done so.

Rabbi Shlomo Aviner (Yossi Zamir/Flash90)

If they arent working at night, its serious but not urgent, leading religious Zionist Rabbi Shlomo Aviner told The Times of Israel on Sunday, saying no to Shabbat vaccinations. Like Lau, he said that if Israel were providing vaccinations 24/6, the answer might be different.

Aviner, one of the stricter rabbis of religious Zionism, said: The vaccine itself does not involve Shabbat desecration, but the actions around it are, giving examples of logging patient data on computers.

His observation that the injection itself does not transgress Shabbat reflects the laws as they are found in the book, Shemirat Shabbat Kehilchatah, widely viewed as the authoritative Orthodox laymans guide for Sabbath observance.

The Hebrew text from the religious guide, Shemirat Shabbat Kehilchatah, which says that there is no Torah prohibition on taking a regular vaccine on Shabbat. (Zak Jeffay)

Rabbi David Stav, chairman of the moderate Orthodox rabbinic alliance Tzohar, also said he cannot justify Shabbat vaccinations for now, apart from very high risk populations, but added that he hopes this will change.

I urge the government to decide how important it is to keep centers open, and if they are open 24/6, Im almost positive that rabbis would allow vaccination on the seventh day as well.

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Love Island’s Dr Alex George opens up about the hardest year of his life – Devon Live

Monday, December 28th, 2020

Former Exeter University student and Love Island contestant Dr Alex George has opened up about dealing with grief and working though the coronavirus pandemic after the sudden death of his younger brother.

The A&E doctor, from Carmarthenshire, bravely spoke out about coming to terms with his loss in a year which has also seen him work 18-hour days for weeks on end balancing his role as a frontline medic with his role as a public health figure.

On July 24, Alex - who studied medicine at the University of Exeter - shared news of his 19-year-old brother's death in a heartbreaking post on social media.

Llyr, a talented student who was about to start medical school, took his own life.

Now Alex has spoken about his determination to help others with their mental and physical health to try and prevent other families from going through the pain that his family have endured over the last six months.

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Speaking to WalesOnline the 30-year-old said: "Its an up and down journey. I think what is interesting is that my life feels a bit like before and after there is this big line of separation.

"My memories feel very distant but I think thats part of a trauma like this. Grief is an ongoing thing.

"Especially with the pandemic, work, and obviously Im living alone, its not helping unfortunately. Saying youre allowed to bubble with other people is one thing but the reality is you dont see people very much.

"But Ive been able to see my family and I have a really good set of friends so we are getting through it. Its just about taking each day as it comes and trying to do something positive. I bury myself in my work quite a lot which is both a good and bad thing but it does help me in scenarios with things like this.

"[Christmas] will be tough, all of the firsts will be hard and Christmas will be really tough but well get through it. We dont have any other options. I would never wish this on anyone else you just have to accept its happened to you and do what you can with your life."

In the weeks and months after his brother's death Alex has not shied away from talking about a situation that to many people is simply unimaginable.

Speaking to Lorraine Kelly in September the former reality star described how he had been in a restaurant with friends in London when his dad phoned him with the news. In the emotional interview he went on to talk about how he and his brother Elliott had to drive together back to Wales sitting in silence, crying, and shouting in anguish during the unthinkable five-hour journey.

He has also spoken about the trolling he had endured and shared one message that read: "Your brother is dead, get off social media" to which Alex responded: "Imagine being this person. Im holding by a thread and you get people like this."

Despite everything, what Alex is determined to do is pay tribute to a younger brother who he describes as a "mini me" a conscientious, empathetic, and confident teenager and talented footballer who would have doubtlessmade a "very good doctor".

Alex said: " It is hard. At the moment [Llyr's] name is associated with a certain thing and suicide and its very very hard to separate that but we do do our best. Ive got pictures and stuff of him and we do try and laugh about certain things. I saw a meme and I just thought: 'Hed laugh at that' you have got to think about those things.

"I think its important to be open. I would never want to shy away from whats happened. With suicide theres no shame in it. Its the same as if someone has a heart attack its a very sad, preventable cause of death of course but its not something I would ever be ashamed of. Its happened we have to try and do something positive.

"Its hard enough to deal with it anyway but quite frankly in the public eye it's tough but also the amount of support Ive had is unbelievable. There is no doubt, really, people have been so kind I think social media gets a bad rep sometimes, even the media in general, but people have been very kind and supportive and thats helped me a lot."

It's not just online that Alex has received support however. When his mother Jane started knitting to help keep herself busy dozens of people from the Carmarthen community put in orders to buy her products, which will raise money for mental health charities. Then there are those who also volunteered to help, creating an "army of knitters" for the Welsh bank worker.

Alex added: "She started knitting to try and distract herself. She had that feeling of guilt you inevitably get in that scenario, especially as a mother or father. So she sat there and said: 'Ill knit to distract myself' and thought: 'Well, Ill try and sell some of this stuff'.

"Someone actually bought a pair of her gloves and then she thought 'People might buy this' and all of a sudden the orders started coming in.

"My dad is retired, my mum is still working in a bank but obviously is off on long-term leave and its really, really tough. If you sit still too long its not good for you. You need to keep busy its not good for you to not to be active mentally."

When it comes to keeping busy it would be difficult to overemphasise how hard Dr Alex has worked this year. Working in the A&E department of University Hospital Lewisham in south London he and his team have seen first-hand how hard the area has been hit by Covid-19. That's at the same time as the content Alex has been sharing with his combined two million followers on Instagram and YouTube talking about everything from vaccines to health and wellbeing advice.

In his podcast series, the Waiting Room, he and emergency medical consultant Dr Anna Colclough describe facing huge amounts of patients coming in and needing to be intubated both young and old. You can find more about that here.

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Alex, speaking in mid-December, said: "Lewisham was hit so hard and so early that we kind of realised that it was coming. The speed in which it happened and how unwell patients were coming in, it was obvious we had a big problem so there was a real realisation that something terrible was happening.

"Lewisham and south London has been very, very hard-hit. In fact we are going through a very difficult wave at the moment, we are really busy at the moment the hospital is full with a lot of Covid patients.

"Its been tough, its been really tough, but the sense of teamwork we have, weve pulled together, the camaraderie, we really are a team. Weve looked out for each other and supported each other so in many ways its been a reminder that there are other things in the world.

"Its something you look back on now and you think: 'At least I felt I was a part of it, at least I could do something positive'. I do feel that throughout the pandemic in hospital and through using my platform that I have helped people. And I do think I get some comfort from that.

"I love my job, its my passion, and I would feel very lost without it."

Talking about managing the second wave of the pandemic this winter, Alex added: " I gave so much in round one, Ive got to try and preserve a bit of energy the second time. It nearly killed me that first round.

"There were 18-hour days almost I did 22 weeks and I didnt take a single day off. I wasn't necessarily in A&E every day, I was going into A&E four or five days but Id be doing YouTube videos. PHE [Public Health England] were expecting us to do a huge amount of advisory stuff, most people would listen to doctors and not presenters, so the amount of responsibility to create this content was huge. Im a little bit burnt out. "

Despite everything this year has brought Alex is determined to remain positive for the new year ahead. Next year he hopes to transition into GP work as well as his A&E role a move into the preventative medicine he has become passionate about, especially giving advice around mental and physical health.

In May 2021 he will also celebrate the release of his first book Live Well Every Day a book addressing the modern health challenges we face and how little changes to our routines can make a big difference. According to Alex using the principles and advice in his book has helped him deal with his hardest days, from his time as a medical student to the monumental challenges he is now facing.

Explaining the thinking behind his book, he said: "The idea of the book came many years ago when I was at medical school.

"I ended up being on placement somewhere that I was a bit isolated and started feeling not myself. I stopped exercising, I started eating badly, I was sleeping quite badly, I wasnt really seeing friends. I wasnt doing the things that I knew were right for me and my mental health and my own happiness as well.

"I made changes, little changes I started going outside for a walk every day, I started exercising every day, I planned my own meals, healthy meals, I planned bedtimes, I had time off my phone, doing all those good things. I became quite isolated so I made a plan to call someone every night someone different, a friend, a family member, every night and chat with them.

"I found those changes, an accumulation of those changes, meant that I just felt so much happier and healthier and I think thats the premise of this book giving people those tools they can use to make small changes to their own lives that ultimately that will make changes to not just their mental health but physical health too.

"Most of the book I wrote through the pandemic actually. I felt quite inspired and quite driven to write it with everything that happened with my brother.

"The book isnt written for him in that sense but I do feel it was a huge motivating factor. I couldnt help him but maybe this book will help other people and hopefully can protect people from ending up in that scenario.

"He was very proud of it he was really excited about the book. I had written a bit of it and we had actually had the publishing contract and agreement and he was so excited the book was coming to life."

You can pre-order Live Well Every Day from retailers including Amazon, Waterstones, and WHSmith.

Samaritans (116 123) operates a 24-hour service available every day of the year. If you prefer to write down how youre feeling, or if youre worried about being overheard on the phone, you can email Samaritans at jo@samaritans.org.

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Israel Paying Economic Price for 4th Election in 2 Years – The Media Line

Monday, December 28th, 2020

Economic uncertainty and instability are real cost of Israels elections

Elections cost money. And Israels upcoming election, the fourth in two years, will cost much more than previous ones.

The financial burden of the election on state coffers is compounded by the fact that the government has not passed national budgets for 2020 and 2021.

The cost of holding Israels upcoming election, scheduled for March 23, 2021, is estimated at close to 500 million NIS ($155.4 million). This is at least 20% higher than the last elections in March 2020 and higher by as much as 40% than the first election in the last two years that took place in April 2019.

There is a price for everything, and a democracy requires spending money, Giora Pordes, spokesman for Israels Central Election Commission, told The Media Line.

One reason for this cost increase is arrangements needed to hold elections during the coronavirus pandemic. Adding extra voting sites and poll workers, taking precautionary measures and dealing with the unknown are major factors driving up those costs.

The Knesset, Israels parliament, disbanded itself in late-night votes on Monday that stretched into early Tuesday morning, once again sending the country to the polls

But economic uncertainty and instability are the real cost to Israels economy of holding new elections.

Israel is suffering from a lack of governing decisions, with not passing national budgets for 2020 and 2021 among the most major. The economic situation has been made even more difficult during the past year for the country, and the entire world, due to the coronavirus pandemic.

Clearly, under normal conditions, Israel as an advanced economy with 14% unemployment and in a recession due to the pandemic should have a well-functioning government with a well-defined budget and a set of reforms. Unfortunately, we are not there, Leo Leiderman, professor of comparative economics at Tel Aviv University, told The Media Line.

I think clearly that going to the fourth elections in two years is not something to be applauded by anyone. On the other hand, we have to realize that the existing government has not been performing. It is in paralysis in its decision-making processes, said Leiderman, who is the chief economic advisor to Bank Hapoalim, Israels largest commercial bank, and formerly served at the Bank of Israel as head of the research department and a senior director.

There is a price for everything, and a democracy requires spending money

Not having an annual national budget is a major factor in the uncertainty that Israel currently is facing.

On the cusp of the new year, the government is still running itself based on the 2019 budget, alongside certain emergency pandemic- and defense-related allocations. Because of this, government ministries cannot prepare for 2021.

We dont know what to do. We dont know whether to prepare cuts in our budget or not. We are in a period of uncertainty, said a source in one ministry who asked not to be named.

The finance ministry told The Media Line on Wednesday that it will provide instructions to the ministries in the coming days.

Only after the election and the formation of a new government can a budget be planned, passed and implemented.

In perspective, 2021 seems like it will be a very challenging year for the political system and we need to have a budget as early as possible, by mid-year or later, Gil Bufman, chief economist for Bank Leumi, Israels oldest banking corporation, told The Media Line.

Government policies have longer-term impact, especially regarding structural changes in the economy, for instance with tax breaks or with policies directly connected to the countrys social fabric, Bufman said.

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Health care, mental health, social services and education are some of what Bufman termed, soft infrastructure. These are areas that are suffering greatly from a lack of investment by the state, he said.

A budget framework with multi-year elements of planning gives more time for longer projects like hard infrastructure projects, for instance, energy, water and transportation. We already see a lot of these in much deeper progress, such as the Tel Aviv subway system, Bufman explained.

For Bufman, the lack of a budget, and even more so during another election period, is a big challenge. We need structural change. Putting things off from year to year is not healthy, he said.

There is a large degree of inequality of what is in the pipeline. I have a feeling that the soft infrastructure projects will suffer, he said.

If and when we get the coronavirus pandemic under control and the economy starts to recover next year, our economic pace will be much lower than our potential. We could be doing much better with a stable government, infrastructure projects and reform. It is not a catastrophe, but it is a pity, it is too bad

The Alyn Hospital Pediatric & Adolescent Rehabilitation Center says its projects will suffer, too.

There is no preventative medicine. We [the healthcare sector] are dealing with emergencies because of the lack of strategic planning and policies. The government is not looking at long-term health processes, said Dr. Maurit Beeri, Alyn Hospitals director-general.

There is a lack of policy building. The HMOs are looking at things quarterly, short-term instead of long-term. Frankly, they should be investing in these young people, rather than paying far more for services when these children grow older, Beeri told The Media Line.

Yet, even with the pandemic hanging over a new governments policies, Israel is in a comparatively good position relative to other developed economies.

This is a result of the country starting the pandemic in a better position due to the growing high-technology sector and steady population growth, which much of the developed world lacks, Bufman said.

Israel has a good economy, Bufman said. We are in better shape than Spain, France and the UK. We are doing much better, he said.

Leiderman said that Israels good economy could be better if the country was in a good political situation.

If and when we get the coronavirus pandemic under control and the economy starts to recover next year, our economic pace will be much lower than our potential. We could be doing much better with a stable government, infrastructure projects and reform. It is not a catastrophe, but it is a pity, it is too bad, he said.

Still, Leiderman noted, the sooner elections occur, the sooner the political situation can become clarified which can lead to better times.

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